434 LON84 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1958 Printed by the Authority of Common Council 17th December 1953. B STAFF. Date of MEDICAL OFFICER OF HEALTH (For the Port and City of London) Appointment Wilson, John Greenwood, M.D., F.R.C.P., D.P.H., F. A.P.H.A. (Hon.) April 1956 ADMINISTRATIVE STAFF (Port and City of London) Blunt, H.F. Food Administrative Officer May 1924 McLorg, w.l. General Administrative Officer Feb. 1927 Ratliff, R.c Finance & Establishment Officer March 1930 Stout, J.E. Senior Assistant July 1930 Betts, c.w.r. Senior Assistant April 1926 Smith, E.V. Senior Assistant Oct. 1938 Lott, R.h. First Class Assistant May 1947 Osborn, F.B. First Class Assistant May 1952 Gurney, Miss M.L. General Grade Clerk May 1939 West, Mrs. I.r. General Grade Clerk Sept. 1956 Hamblin, Miss, I.H. General Grade Clerk Oct. 1957 PUBLIC HEALTH INSPECTORS McGrath, W.R. Senior Health Inspector March 1922 Sillett, D.E. Senior Health Inspector April 1926 Neale, W.G.C., Senior Health Inspector July 1928 Thompson, E. Senior Health Inspector Sept. 1948 Harrington, G.E. Dec. 1925(Retired Thorpe, R.C March 1930 °ct- 958) Hudson, L.A. April 1934 Campbell, J.W Sept. 1946 Flynn, J July 1951 ADMINISTRATIVE STAFF - MEAT INSPECTION threadgold, A.W. First Class Assistant Nov. 1923 Peters, E.J. General Grade Clerk Nov. 1935 Cash, J.E. General Grade Clerk March 1954 MEAT INSPECTION STAFF Thompson, F.E. Chief Meat Inspector July 1924 Lee, W.R. Deputy Chief Meat Inspector July 1930 Garrard, S.S. Meat Inspector Sept. 1946 Morris, W.L. Meat Inspector Sept. 1946 Seymour, K.S. Meat Inspector July 1935 Wilson, J.C. Meat Inspector Jan. 1936 Leach, R.A. Meat Inspector Sept. 1952 Cox, J.T. Meat Inspector Aug. 1954 Field, H. Meat Inspector Aug. 1954 Gingell, G. Meat Inspector Aug. 1954 Giles, H.W. Meat Inspector Aug. 1956 Bernhardt, D.R. 'Authorised Officer' under Food Hygiene Regulations, 1955 May 1931 RODENT OFFICER Carter, J Sept. 1931 RODENT OPERATIVES Mason, G.A. (Foreman Rodent Operative) Dec. 1946 Tremayne, L.RNov. 1943 Cardy, E.G. June 1950 Brown, G.J. Aug. 1950 Clayton, J.G. Nov. 1951 KEEPER OF THE MORTUARY Lawrence, F.H May 1936 DISINFECTING APPARATUS ATTENDANT Burton, J.H. March 1936 MESSENGERS Bourne, A.W. March 1956 Woods, T.A. Nov. 1955 SENIOR PORTER AT SMITHFIELD MARKET Prevost, A.E. Feb. 1926 MANUAL WORKERS CarmODY, J. (General Duties at Mortuary) Feb. 1950 (Retired july 1958) Sunnick, J.W.T. (General Duties at Mortuary) May 1950 Mann, E.V. (General Duties at Smithfield Market) Jan. 1928 Lawrence, C.J. (General Duties at Smithfield Market) Feb. 1928 Portbury, T. (General Duties at Smithfield Market) July 1953 Wright, J. (General Duties at Smithfield Market) Oct. 1953 Bright, T.W. (General Duties at Smithfield Market) Oct. 1956 Lawrence, E.E. (General Duties at Mortuary) Aug. 1954 Steele, W.T. (General Duties at Mortuary) 1958 Jollie, Mrs. F.G. (Bath Attendant and Cleaner) Sept. 1955 OCCASIONAL DEPUTY MEDICAL OFFICER OF HEALTH Stott, William, M.B., B.S., D.P.H., F.R.I.P.H Aug. 1958 PUBLIC ANALYST Williams, H.A., Ph.D.(Lond.) A.C.G.F.C., F.R.I.C. Jan. 1958 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1958. To the Right Honourable The Lord Mayor, Aldermen and Commoners of the Corporation of London. Guildhall, E.C.2. Telephone: MONarch 3030 July. 1959 My Lord Mayor and Gentlemen, I have the honour to submit the following report on the work of ray Department during the year 1958. Vital Statistics The resident population of the City according to the Registrar General's estimate at midyear 1958 was 5,000. The birth rate dropped to 5.22 per 1,000 resident population and the death rate rose to 11.42 per 1,000 resident population, as compared with 5.93 and 10.50 per 1,000 respectively in 1957. 29 babies were born, two of which died within four weeks of birth. One of these, a female, was born in a maternity hospital outside the City and died within 24 hours being congenitally deformed as to the skull and face. The other was a newly born male found floating in the River Thames and there is no reason to believe that its parents were City residents. This latter death, however, increased the City neo-natal death rate by 50%, which fact endorses the contention of the Medical Officer of Health that the vital statistics of the City cannot be usefully compared with those of other areas or even with those of previous years because the numbers on which the rates are calculated are so small. All births were legitimate and there were no still-births. The total number of deaths of all ages was 56; 34 male and 22 female. Eleven deaths were due to cancer, only one of which was cancer of the lung. Four deaths were from pneumonia and five from bronchitis. Five deaths were accidental, and two men over 45 years of age committed suicide. Infectious Disease The incidence of infectious disease fell cosiderably, only 27 notifications being received. There were three cases of dysentery (6) and nine of measles (19), five of food poisoning (14), four of scarlet fever (2) and six of pulmonary tuberculosis (5). (The figures in brackets denote the comparable number of cases in 1957). Food Poisoning Appended is a copy of the Annual Return made to the Minister of Health on food poisoning in the City of London during 1958. None of the three outbreaks was serious. The two instances in which the agent was identified as Clostridium welchii were due to the consumption of re-heated meat in a restaurant and at the mid-day meal in a school respectively. ANNUAL RETURN OF FOOD POISONING IN THE CITY OF LONDON 1. YEAR ENDED 31st DECEMBER, 1958 2. (a) FOOD POISONING NOTIFICATIONS (Corrected) as returned to Registrar General:— 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total Nil 1 Nil 4 5 (b) Cases otherwise ascertained:— 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total 61 61 (c) Symptomless Excreters 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total (d) Fatal Cases 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total 2 3. PARTICULARS OF OUTBREAKS Agent No. of outbreaks No. of Cases Total N o. of C ases F amily Outbreaks Other Outbreaks Notified Otherwise ascertained Agent identified: (a) Chemical Poisons Nil Nil Nil Nil Nil (b) Salmonella Nil Nil Nil Nil Nil (c) Staphylococci (including toxin) Nil Nil Nil Nil Nil (d) Cl.botulinum Nil Nil Nil Nil Nil (e) Cl. welchii Nil 2 Nil 26 26 (f) Other bacteria Nil Nil Nil Nil Nil T otaIs Nil 2 Nil 26 26 Agent not identified Nil 1 Nil 35 35 4. SINGLE CASES Agent No. of Cases Notified Otherwise ascertained Total No. of Cases Identified: (a) Chemical Poisons Nil Nil Nil (b) Salmonella Nil Nil Nil (c) Staphylococci (including toxin) Nil Nil Nil (d) CI. botulinum Nil Nil Nil (e) CI. welchii Nil Nil Nil (f) Other bacteria Nil Nil Nil Totals Nil Nil Nil Agent not identified 5 Nil 5 5. SALMONELLA INFECTIONS, NOT FOOD-BORNE Salmonella Outbreaks No. of Cases (outbreaks) Single Cases Total No. of Cases (outbreaks and single cases) Family Other Nil Nil Nil Nil Nil FOOD POISONING - PREVENTIVE MEASURES "The strength of a chain is no stronger than its weakest link" can be very aptly applied to the efforts of local authorities and management to ensure an habitual high degree of hygienic practice in the kitchens of catering establishments on the part of the kitchen staff, but in spite of all the efforts made in this direction, investigations into instances of food poisoning still disclose evidence of carelessness, thoughtlessness, or plain ignorance of a member or members of the kitchen staff — the weak link. In an endeavour to reach directly those who actually handle food with a constantly visible reminder of their responsibilities and particular reference to one of the principal causes of food poisoning — faulty refrigeration — 951 letters and coloured plastic notices, as under, designed for attachment to refrigerators, were delivered to the owners or occupiers of catering establishments in the City — Dear Sir (or Madam), FOOD POISONING - PREVENTIVE MEASURES The Health Committee of the Corporation has given consideration to what further measures could be taken in the City of London to minimize outbreaks of food poisoning. One of the principal causes of food poisoning is the practice of preparing and cooking such dishes as meat, gravies, made-up meat dishes, trifles and custard, on the day before they are to be eaten. If this practice is followed and the storage arrangements for these foodstuffs are unsatisfactory, e.g. there is a lack of efficient refrigerated space, the food remains for many hours at a temperature favourable for the growth and multiplication of organisms. The result is that a poisonous dose of organisms and their products may be served with the meal the following day. 3 Enclosed is a notice which sets out measures designed to assist in the preventing of possible outbreaks of food poisoning in your establishment. It will be observed that among the measures recommended is the use of an approved sterilizing agent after the normal daily cleansing of all surfaces upon which food is prepared or stored. For your guidance a list of such agents is appended, together with the name and address of the firm supplying the product. The Health Committee will welcome your co-operation in this matter by exhibiting thenotice in a prominent position in the kitchen and by taking every opportunity to impress upon staffs the importance of the advice contained in the notice. It is also the wish of the Corporation that the Officers of my department shall take every opportunity to assist the staff and management of the catering industry to improve their knowledge of food hygiene by any means that may be available. Should your firm wish to arrange for a short lecture or film show on this subject for your staff perhaps you will kindly let me know. Yours faithfully, (Sgd.) J. Greenwood Wilson, M.D., F.R.C.P., Medical Officer of Health, Port and City of London. The Proprietor or Manager. Enc. CORPORATION OF LONDON FOOD POISONING (1) Illness through food poisoning is increasing year by year. (2) Many cases of food poisoning result from a failure properly to wash and sterilize kitchen utensils and equipment, and from the practice of preparing and cooking meat, gravies, made-up dishes, trifles and custards on the day before they are to be eaten. (3) If it is practicable all food should be cooked and served the same day. (4) The following measures for preventing the possible outbreak of food poisoning should be strictly observed: (a) All surfaces in the kitchen and the refrigerator on which food is prepared or stored should be properly washed at least once daily and sterilized by an approved chemical agent. (b) Meat or made-up dishes must be well cooked. (c) To prevent harmful germs from multiplying, all food after cooking; unless it is for immediate consumption, must be rapidly cooled in a well ventilated room or larder outside the kitchen. (d) The food should then be stored in a refrigerator maintained at a temperature between 32 deg. F. and 40 deg. F. at all times. (Every refrigerator should be fitted with a thermometer). (e) The food must be served as quickly as possible after re-heating. (5) Further information on this or any other aspect of hygiene in catering establishments is obtainable from the Medical Officer of Health, Guildhall, City of London, E.C.2. February, 1958 MASS RADIOGRAPHY The Mass Radiography Unit of the North East Metropolitan Regional Hospital Board continued to operate during the year from your premises at 20, Golden Lane. The total number of examinees was 54,798, in addition to 5,367 City workers when the Unit was mobile, i.e. when operating at the premises of three large City firms, where employees were X-rayed at their place of work. The Unit is also available to the boroughs of Finsbury and Shoreditch,although the majority of examinees are employed in the City. The following is a Report received from the Medical Director of the Unit, Dr. W.D.R. Thompson. 4 NORTH EAST METROPOLITAN REGIONAL HOSPITAL BOARD MASS RADIOGRAPHY UNIT 6D 1st JANUARY TO 31st DECEMBER 1958 Introduction During 1958 the Unit examined 39,943 males and 28,016 females, making a total of 67,959 which is an increase of nearly 4% on the previous year's figures. Up to the end of 1958 the Unit has examined 288,413 males and 205,585 females making a grant total of 493,998 since it commenced operations in May 1950. Sixty-five active cases of tuberculosis have been discovered which gives a rate of .96 per 1,000 examinees. There were also discovered sixteen cases of carcinoma of the lung, which is an increase of approximately 23% on the previous year's findings. The zone of the Unit has remained the same, viz. City of London and the Metropolitan Boroughs of Finsbury and Shoreditch. The modus operandi of the Unit has continued as in past years — about nine months at the Mass Radiography Centre, 20, Golden Lane, E.C.I, with the remaining period (excluding three weeks holiday leave) allocated to various firms and organisations. As space, electric current and other services have to be placed at the disposal of the Unit we gratefully acknowledge all the assistance rendered by the organisations concerned. With the exhaustion of its stock of "Female" cards early in January 1958 the Unit discontinued the practice of arranging separate sessions for men and women, so that both sexes are now X-rayed during the same sessions. This is a method which has proved acceptable to the majority of firms. After the announcement by the Adrian Committee in the Autumn of 1958 that the radiation dosage received by people attending a Mass Radiography Unit was negligible, the opportunity was taken in emphasising this fact in our contacts with firms, and others. Doctors Referrals As intimated in our last Annual Report a new procedure for Doctors referrals was introduced in January 1958 by means of which doctor's patients can attend the Unit while it operates at the Mass Radiography Centre without a prior appointment. A supply of the specially designed form was sent to all general practitioners within our zone. The response has been most encouraging although few abnormal cases have been found. Medical Procedure The practice adopted in previous years has continued throughout 1958. All clinics have recorded their sputum findings and 18 cases with a positive sputum have been reported, of which 14 were male and 4 were female. Where an investigation was outside the province of a Chest Clinic the co-operation of St. Bartholomews Hospital is secured, and I acknowledge my indebtedness to Dr. N.C. Oswald and his colleagues. Conditions of Interest other than Tuberculosis The following cases of interest, other than tuberculosis, have been found during 1958:— 1. Tumours of the Bony Thorax Osteoclastoma (1) 2. Cardio-vascular lesions (a) Congenital Dextro-cardia (8) Aortic Co-arctation (2) Ventricular Septal Defect (3). Congenital Defect Pulmonary Artery (2) Atrial Septal Defect (8) Anomaly Inferior Vena Cava (1) Right Aortic Arch (1) Anomaly Aorta (1) Congenital Pulmonary Stenosis (3) Enlarged Pulmonary Vein (1) (b) Acquired Bundle Branch Block (1) Calcified Pericardium (1) Pericardial Cyst (1) 3. Abnormalities of Diaphragm Diaphragmatic Hiatus Hernia (2) Achalasia of Cardia (2) 4. Pulmonary Conditions Dermoid (1) Parrafin Granuloma of Lung (1) Adenoma Bronchi (2) Aspiration Pneumonia (2) Substernal Thyroid (4) Bronchial Cyst (1) Neuro-fibroma (1) Hamman Rich Syndrome (1) Sarcoidosis (11) Silicosis (2) Hamartoma (1) Haematoma of Lung (1) Sequestrated Segment of Lung (1) 5 Propoganda The normal forms of propoganda have been employed where necessary although in most cases contact with firms has been made by personal contact or special letters. Staff During the year under review there has been several changes in the personnel on the Unit. I would like to express my appreciation of the good work done by the staff throughout the year. Conclusion Throughout the year helpful relationships have existed between Dr. J. Greenwood Wilson, Medical Officer of Health for the City of London, and with the Medical Officers of Health for the Boroughs of Finsbury and Shoreditch as well as the Divisional Medical Officers in Health Divisions 3, 4 and 5. Our appreciation of the services rendered by the Central Group Hospital Management Committee and the Regional Hospital Board must also be recorded. (Sgd.) W.D.R. THOMPSON, Medical Director. IMPORTED MEAT AND OFFAL NOT FOR HUMAN CONSUMPTION The desirability of requiring the sterilization and staining of meat and offal unfit for human consumption has been apparent for some time. The importation into this country of consignments of offals, especially livers, marked "Not for human consumption" or "For animal food only", a high percentage of which have been found to be affected with hydatid cyst has accentuated the need for control. The Public Health (Imported Food) Regulations, 1937 and 1948, give powers for inspection and movement control if necessary of meat or meat products intended for human consumption, but meat and offal if marked "Not for human consumption" are outside the scope of the Regulations and local authorities have no powers of control. The trade in this class of meat has grown from imports from New Zealand to an animal food processing plant — in respect of which no complaint is made as delivery of consignments is effected under proper control — to the importation on a growing scale for chance sale. It is this kind of importation to which there is objection, and evidence suggests that the uncontrolled entry and sale of this type of meat is leading to its appearance as meat for human consumption. The importation of pharmaceutical livers is free from criticism because these are usually dyed and no difficulties are experienced in exercising proper control. Control difficulties arise in the first instance from the fact that on the ships' manifest meat not for human consumption is not usually shown separately from meat for human consumption, and thus the Port Health Inspector is not warned of its entry. Agreement has been reached between Riparian Medical Officers of Health that movement from the area of one authority to another be notified but this is of course only possible upon knowledge of entry in the first instance. Apart from the matter of imported meat and offals, it is, I consider, a necessary precaution on public health grounds that all meat, offals, etc. condemned as unfit for human consumption as a result of slaughter or inspection should be sterilized and stained. It has always been the practice at Smithfield Marked and Islington Cattle Market that condemned meat and offals are stained before removal by the Corporation's contractors for processing. Bearing in mind the possibility of communication of disease from animal to man it would appear that sterilization and staining is preferable to sterilization or staining as an alternative. During the year importations of unstained livers marked "not for human consumption" or "for animal feeding only" reached alarming proportions, and to give some idea of the scale on which these livers were arriving into this country, 3,000 bags were imported in one week, all of which were handled by a small number of meat and offal distributors. Enquiries elicited the fact that large quantities were being disposed of to retail butchers throughout London without disclosing their diseased condition. On removal from the bags such livers are distinguishable from those fit for human consumption only by an expert and the inherent dangers of such a position are obvious. In order to ensure that the public are protected from the danger of any of this diseased meat finding its way into channels whence it may be used for human consumption, quite apart from the desirability or otherwise of its use as pet food, the seizure of all such meat found within the City of London was authorised in order that it may be dealt with by a Justice. On the 2nd July all such meat was accordingly seized by the City's Chief Meat Inspector under Sections 9 and 111 of the Food & Drugs Act, 1955 and was taken before the Guildhall Justice on Friday, the 4th July, for his decision as to disposal. The Alderman after inspecting the meat condemned the same as unfit for human consumption and ordered it to be so disposed of as to prevent it from being used for human consumption. 6 The Justice's Order has the effect of giving control over the disposal of such meat coming within the City of London and none of this material has since been released to retail butchers' shops so far as meat passing under the control of the Port and City of London's Medical Officer is concerned. Release to pet food shops has only been authorised in those instances where the local Medical Officer of Health is satisfied that the meat will not be disposed of except for animal feeding. As from 31st August the exportation of all reject livers from New Zealand was prohibited. Draft Regulations of the Ministry of Agriculture, Fisheries and Food for the staining and sterilization of all unfit meat have been approved and early confirmation is expected. LECTURES ON MEAT INSPECTION AT SMITHFIELD MARKET When the Meat Inspectors' offices at Smithfield Market were built it was considered desirable to incorporate a well-equipped lecture room with screen and epidiascope. This apparatus, which allows for the visual reproduction of printed diagrams and illustrations on to a screen, was transferred to the Civil Defence Department in 1939, and eventually to the Guildhall Library, as it was found not to be entirely suitable for its purpose at Smithfield. There has been a steadily increasing use of the lecture room by technical colleges in the London area for their students attending lectures and demonstrations at Smithfield as part of a regular course in meat inspection. Overseas teaching organisations introduce a number of medical and public health students for training in this country, many of whom undertake part of their course at Smithfield. During 1958, 38 lectures and demonstrations were given. FIRE AT POULTRY MARKET SMITHFIELD In the early hours of Thursday,23rd January, fire was discovered in the honeycombed underground part of the Poultry Market at Smithfield. That part of the Poultry Marked above ground was totally destroyed and the fire continued to burn in the underground passages and insulated stores for many days. At the time, it was estimated that some 400 — 500 tons of meat and poultry were in the affected part of the Market, of which it might be necessary to remove some 200 tons as and when demolition work proceeded and areas were declared safe. It was feared that increasing nuisance would arise from the decomposing flesh to which access was limited by the speed of demolition and safety work, and a chemical manufacturer was consulted as to the best means available to minimise offensive odour. The task of removing the fire and water damaged meat and poultry was under the direction of the Chief Meat Inspector, Mr. F.E. Thompson, and the staff meat porters under his control volunteered to carry out the extremely dirty and offensive work. The Corporation contractors for the removal of unsound meat offered their co-operation which was gratefully accepted, and appreciation is due to them for their willing assistance in the provision of vehicles and the removal and disposal of material often of no commercial value. The Worshipful the Port and City of London Health Committee authorised the purchase of protective clothing and other expenditure found to be necessary from time to time. The work of removing the damaged and rapidly decomposing meat was commenced on 28th January and was completed on 10th May. In all, 311 tons of this material was removed, 180 tons from ground level, and 131 tons from below ground level, the latter consisting mostly of offensive matter containing a large amount of debris. During this operation, 6,000 gallons of disinfectant was constantly sprayed over the debris, and it is satisfying to report that few serious complaints were received as to offensive odour, against which a number of letters of appreciation of the action being taken was received from Market tenants. Mr. Thompson must be commended for the admirable manner in which this extremely offensive operation was conducted in keeping cause for complaint to a minimum, and the staff of meat porters for their willing acceptance of what at times was a revolting and onerous task. FOOD HYGIENE REGULATIONS, 1955 (CATERING ESTABLISHMENTS) Messrs.Thompson and Flynn,the two public health inspectors who specialise in the hygiene of catering establishments, report to the following effect:— During the year under review further steady but unspectacular progress has been made in securing improvements of all kinds in restaurants, cafes, public houses and staff restaurants throughout the City. Much time and effort has been spent on new catering premises which have been adapted or constructed during the year, particularly those forming an integral part of new office blocks. It has been felt that these new catering facilities were of paramount importance and a great effort has been made to ensure that the design of the kitchen and ancillary rooms and the arrangements generally will provide a satisfactory basis for the preparation and serving of food under hygienic conditions. The magnitude of the problems involved in dealing with these new catering establishments is not generally realised, not the least of the difficulties being the inadequacy of floor space in the kitchen and other functional rooms. There is no doubt that because of the high level of rents within the City, the caterer must be able to accommodate a given number of customers, and the provision of an economic seating capacity is often the first decision made in planning a new establishment. The space then left over must be put to the best possible use for the kitchen and stores, etc., irrespective of the fact as to whether the space is the wrong shape or right size. These are not criticisms of the catering industry but merely indicate the very complex problems which have to be solved, even when dealing with new premises. Technically the most insistent and difficult problem which has confronted us, both in our discussions in relation to new buildings and the improvement of existing establishments, is the provision of suitable and sufficient means of ventilation. As indicated in previous reports, the standards generally advised and accepted in the past have, in practice, proved to be too low. Furthermore, ventilating plants seldom reach their theoretical standard of efficiency, and the problem is aggravated by the fact that Ventilating Engineers frequently are not given a free hand in the design of plant nor in many instances is their advice asked for or taken. Often they do no more than quote to the specification of some unqualified person. Whilst ensuring that the ventilating arrangements of kitchens will be efficient and secure a reasonable degree of comfort for the staff working therein, it is essential to avoid any nuisance arising from noise or smells. Both these factors have proved to be very troublesome, and past experiences have enabled us to make recommendations regarding new installations, such as the terminal points of exhaust ducts, etc., and the positioning and housing of exhaust fans, which we hope will prevent, or at least minimise, complaints about the many plants which are at present being installed. On the credit side, perhaps the greatest improvement effected is the sustained reduction both in the number and extent of verminous infestations of all kinds. For instance, a few years ago it was not unusual to find evidence of cockroaches or steam flies, etc., in the kitchens and serveries of City restaurants. Now, due to structural improvements and to such measures as the use of insecticidal lacquers, any infestation is becoming the exception rather than the rule. Likewise, rat infestation of City restaurants, once very prevalent, is now under control to such a degree that the presence of a single rat causes more consternation than did a heavy infestation a few years ago. This encouraging position has been achieved by improvements in structural conditions, and the efficiency and vigilance of the Rodent Officer and his operatives. It is interesting to note that notwithstanding the many written notifications of the infringement of statutory requirements, and the extensive and numerous improvements effected during the course of the year, recourse to legal proceedings has not been necessary in a single instance. Legal proceedings were, however, instituted against an employee in a City snack bar who sold to a customer a portion of veal and ham pie containing a fingerstall which had come from his own finger. In this instance the defendant pleaded guilty. He was given an absolute discharge and ordered to pay five guineas costs. It is also encouraging to report that after many years of patient struggle and persistent endeavour, the provision of suitable washing facilities for the use of staff engaged in the preparation and service of food is now being accepted and recognised as an essential prerequisite of any satisfactory hygiene routine. It has always been easy to arrange for the installation of wash hand basins complete with running hot and cold water, but it was rather more difficult to ensure that clean towels, soap and a nail brush were available, that basins were kept in a clean condition, and that they were not used for culinary purpose. The insistence on the display of suitable notices drawing the attention of the staff to the importance of washing their hands after the use of the sanitary convenience, helped in emphasizing to all concerned the necessity of providing and maintaining these amenities. The availability of free washing facilities in the City Corporation's public conveniences undoubtedly assists in the focussing of public attention on this vital aspect of personal hygiene. Whilst the trade as a whole has been co-operative in arranging for the execution of essential works and the installation of new equipment, etc., it is still felt that too frequently the proprietors and managers consider their responsibility is over when capital expenditure has been undertaken. In many instances the improvement in the standard of cleanliness is not commensurate with the cost and extent of the work carried out. It is often found the management do not take a direct and active interest in the maintenance of cleanly conditions and the observance of hygienic practices. Frequently they are pre-occupied with unskilled routine duties which could be carried out easily by subordinate staff. In other words, because of staff shortages and difficulties, the management tend to do anybody's and everybody's job but their own. 8 It is also felt that the limiting factor in the extent and speed of further improvements in good hygienic practice is the low calibre of the staff employed, and the general disinterest displayed by many of the staff in everything relating to the job, and particularly in anything connected with hygiene and cleanliness which may require additional effort or attention on their part. Catering always appears to have been the Cinderella of industries, and until its status is raised, it is difficult to suggest means of attracting a better and more responsible type of employee. It is rather a distressing thought to realise that the welfare and comfort, if not the lives of hundreds of thousands of City workers is dependent to such an extent upon personnel who literally neither know nor care what possible dangers result from their lethargy and indifference. It has been said often that the catering employee needs educating in elementary hygiene, especially personal hygiene, but it has yet to be determined how to educate a person who does not wish to learn. For some years past visitors have come to the City of London from other parts of the country, the continent and the dominions to study and observe the principles and practice of food hygiene as carried out in the City. During this year the number of people visiting the catering establishments has shown a marked increase over previous years, and I have no doubt they have found the experience stimulating. The co-operation of other Departments of the City Corporation, particularly those of the City Engineer and the City Planning Officer, in advising all prospective caterers to consult us before formulating proposals for new restaurants has been of great assistance and has enabled us to make known our point of view and advise upon the best means of securing compliance with statutory requirements at an early stage. This procedure has been of mutual advantage, both to the caterers and to this Department, and as a result a much higher standard of construction and design has been achieved than would otherwise have been possible. THE FOOD AND DRUGS ACT, 1955 Three hundred and seven samples have been submitted to the Public Analyst, fifteen of which were formal and two hundred and ninety-two were informal samples. Adverse reports were received on twelve samples; no legal proceedings were instituted and in certain instances appropriate cautions were administered. Milk The average composition of genuine milk samples taken during the year was:— milk fat: 3.66 per cent; solids (not fat); 8.65 per cent: total solids 12.32 per cent. Twelve samples of pasteurised milk were submitted to the phosphatase and methylene blue tests and satisfactory reports were received thereon. The phosphatase test is a check on the efficiency of the heat treatment applied to the milk, and the methylene blue test on its keeping quality which bears relation to cleanliness and care in handling. One sample of sterilised milk was examined by the turbidity test which in the case of this particular milk is also a check on the efficiency of heat treatment. The report received was negative. Eighty-seven Supplementary Licences in respect of twenty-four firms and individuals, and thirty-eight Dealer's Licences in respect of sixteen firms and individuals, were issued under the Milk (Special Designation) (Raw Milk) Regulations 1949/54 and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949/53. Dairy Cream Nine samples of cream submitted to the Public Analyst complied with the standards laid down by the Food Standards (Cream Order) 1951. Ten samples of double, one of single and one of sterilised cream were submitted for examination by the Bacteriologist. Adverse reports were received on two double and one single creams. The vendor was communicated with and steps taken to eliminate the contamination which was due to the hand sealing of the bottles. Adverse reports were also received on samples of Jersey T.T. Cream. The County Milk Regulations Officer of the East Sussex Agricultural Executive Committee was communicated with. This resulted in an improvement of the system of carton filling which should prevent any further trouble. Ice Cream Two samples submitted to the Public Analyst complied with the requirements of the Food Standards (Ice Cream) Order, 1953. Food Labelling No formal administrative action has been required. Enquiries however, continue to be received from time to time and advice and assistance have been given wherever possible to help ensure compliance with the requirements of the Labelling of Food Order, 1953 and also with the Merchandise Marks Acts, 1887/1953. Administration Generally Details of the formal and informal samples taken and submitted for analysis and of action taken with regard to adulteration or other irregularities, appear later in this Report. 9 HOUSING The Housing Act, 1957 came into operation on the 1st September, 1957. It repeals and reenacts in consolidated form the provisions of the earlier Housing Acts with the exception of financial provisions, which will be consolidated in a future bill. Sec.191 of the Act constitutes a comprehensive saving provision which secures continuity of action by enacting, inter alia, that anything done under a repealed enactment shall have effect as if done under the corresponding provisions of the new Act and that documents referring to a repealed enactment shall be construed as referring to the corresponding provision of the new Act. Housing Consolidation Regulations, 1925, No.866, Part IV. Inspection of District:— 1. Number of houses which on inspection were considered to be unfit for human habitation:— Nine 2. Number of houses in which the defects were remedied in consequence of informal action by the Local Authority or their Officers:— Eight 3. Number of representations made to the Local Authority with a view to (a) the serving of notices requiring the execution of works or (b) the making of demolition or closing orders:— (a) One (b) None 4. Number of notices served during the execution of works:— None None 5. Number of houses which were rendered fit after service of formal notices:— One 6. Number of demolition or closing orders made:— None 7. Number of houses in respect of which an undertaking was accepted under subsection (4) of section 16 of the Housing Act, 1957:— None 8. Number of houses demolished:— None During the year 58 families were rehoused, leaving 419 families for whom accommodation was required at the end of December 1958. No new housing accommodation was provided during the year. The modernisation of Dron House, Stepney, has been completed and work commenced on the modernisation of Kings Flats, Artizans Dwellings, in the City. This will be followed by the modernisation of further flats at Artizans Dwellings and at other pre-war estates. Isleden House continues to stimulate interest amongst those who are concerned with the housing and welfare of the elderly. Many of the elderly residents would be unable to maintain a flat if they had to prepare their own meals and if they were required to do all the work of a normal householder, and it is evident that the provision of a mid-day meal and of the other services assists the old people to remain in their homes and retain their independence. The Sick Bay under the supervision of an understanding Matron and her sympathetic Assistant has continued to work smoothly. Nearly 500 patients from St.Bartholomew's Hospital have been admitted since 1954 and this has made a very useful contribution in reducing the waiting list for beds at the hospital. Patients from the Corporation's housing estates have also been admitted for short periods and results have been most satisfactory. The redevelopment of the Corporation's housing estates in Holloway and adjoining the Metropolitan Cattle Market in Islington has had to be suspended, but with the use of the vacant site of the sheep lairs to the west of the market for the purpose of erecting an initial block of flats, it is hoped that the scheme may proceed. The Almshouses in Ferndale Road, Brixton are being individually brought up to date as they fall vacant. The City of London Old People's Welfare Association continues to look after the 1,350 over-60's for whom the City as a Housing Authority has a responsibility. No effort is spared to ensure that these old people have the services they require. A Mid-day Meals Service has been established at the Three Score Club adjoining the Corporation's flats in Gravel Lane, Stepney. 10 RODENT CONTROL Mr. J. Carter, the Rodent Officer, reports as follows:— In compliance with the provisions of the Prevention of Damage by Pests Act, 1949, it is the duty of every Local Authority to take such steps as may be necessary to secure as far as practicable that their district is kept free from rats and mice and in particular:— (a) from time to time to carry out such inspections as may be necessary for the purpose aforesaid; (b) to destroy rats and mice on land of which they are the occupier and otherwise to keep such land so far as practicable free from rats and mice; (c) to enforce the duties of owners and occupiers of land under Part 1 of this Act, and to carry out such operations as are authorised by those provisions; (d) to keep such records and make such reports relating to their functions under this part of this Act as may be required by any directions given by the Minister of Agriculture, Fisheries and Food. For the purpose of implementing the aforementioned provis:ons, organisation and procedure of the Rodent Control Department was similar to that of previous years, and comprised inspection of properties to ascertain the presence of infestation by rats and/or mice, treatment of any such properties found to be infested, recommendation of structural and incidental proofing, and periodical maintenance control measures for the destruction of rats in the City sewers. No problem has arisen necessitating statutory action to resolve the difficulty and the response to the policy of seeking the co-operation of owners and occupiers has been satisfactory. A total of 5,199 occupancies and properties were inspected, such properties ranging from new buildings in the course of construction, riverside food warehouses, public and private catering establishments, offices, shops and factories, to domestic dwellings. Altogether 523 infestations were subject of control measures, and of this number 291 infestations were notified by occupiers or owners and 232 infestations were found on inspection. This total comprised 2 major and 54 minor infestations of rats, and 36 major and 431 minor infestations of mice. Treatment of these infestations entailed 4,497 visits for operational purposes. In the application of control measures for rat infestation, 3,034 pre-baits and 336 poison baits were laid. These measures resulted in an estimated kill of 343 rats, and of this number 207 bodies were removed from premises. The use of Warfarin anti-coagulant rodenticide for the control of mice resulted in 1,012 bodies being found. No records are available of the results obtained by Pest Control undertakings servicing premises periodically. The downward trend of rat infestation manifest in recent years continued and a further decline in the number of infestations found and treated, and the numerical quality of the same has been experienced. The number of major infestations (20 rats or over) was 5 less than the previous year (7) and in both instances these were border line infestations, just qualifying for this category. In the minor classification there was a reduction of 51% (54 as against 105 the previous year). The majority of these infestations were principally of Ship (Black) rat character, and were numerically well within the range of the minor classification. Such infestations have a high nuisance value and often entail greater assiduity in respect of inspection and control measures than major infestations distributed over a similar area. This is emphasized more especially in new buildings where the odd rat or two, in search of food and water, traverses the long tortuous ducts, leaving a trail of very slight and spasmodic evidence anywhere between the basement and roof, and it is only by meticulous and methodical inspection that the evidence is revealed and the best baiting sites selected. It is no trouble for this species of rat, with its climbing abilities, to traverse great distances along ducts and up lift shaft ropes and guides, often as many as ten floors or more, as unrestricted movement is necessary for its well being. In reviewing the present situation a general perspective is necessary, the City having boundaries with five Metropolitan Boroughs,and a considerable riverside frontage of warehouses. In respect of the riverside, the Port Health Authority, by exercise of its functions relative to control of rat infestation in ships and lighters, makes a contribution of primary importance by minimising the possibility of re-infestation by Ship (Black) rats of shore premises from vessels and lighters discharging cargo alongside riverside wharves. Likewise, by their efforts the Rodent Control organisations of contiguous Local Authorities have similarly contributed to the overall plan of rodent control, and to this must be added the contribution of the commercial servicing undertakings. Infestation of Common (Brown) rat character was again on a very minor scale and mainly confined to new buildings in the course of construction, which offer every facility and are in every way conducive to infestation. All sites in progress were inspected periodically and anyaction found necessary was taken, and the fullest co-operation has been received from the various contractors. 11 As in the past, the low level of Common rat infestation is no doubt due to the systematic control measures applied in the City sewers at quarterly intervals. It is the purpose of these treatments to check the buildup of the rat infestation in the sewers, thus preventing infestation of surface premises from this source via defective drainage. In this respect, four "direct" poison controls with Fluoracetamide "1081" and an overall test baiting were applied. These controls comprised the second phase of a series of controls with "1081" which are designed for completion in 1960 and which it is hoped will provide comparable information to that obtained as the result of the Mono Sodium Fluoroacetate "1080" controls completed in 1956. On completion of the first series of four "direct" "1081" poison controls, September, 1957, it was decided, as the result of discussions held with the Technical Officers, London Division, Ministry of Agriculture, Fisheries and Food, to carry out three overall test baitings with the object of obtaining similar information to that supplied by the tests conducted on completion of the "1080" series of "direct" poison controls, June, 1956, and preceding the institution of the first "1081" series. Three such tests were applied, starting on the 10th October, 1957 , 5th December, 1957, and 6th March, 1958, respectively. For the purpose of the first test, three weeks after completion of the first series of poison controls, 400 sewer entrances were each baited with 4ozs. baits of soaked wheat, and the baits were left down 5 days. On examination 27 "takes" (15 complete, 9 x ¾, 1 x ½, and 2 x ¼) were recorded. In the second test 8 weeks later, 406 sewer entrances were baited, each bait being 4 ozs. damp sausage rusk, and these were left down 5 days. The recorded result in this instance was 69 "takes" (58 complete, 3 x and 8 x ½). The weather conditions during both these tests were fairly good, and although some rain was experienced it did not have an adverse effect on the recordings. For the final test, 13 weeks later, and 6 months after completion of the first series of poison controls, 394 entrances were baited, and the baits, each 4ozs. of soaked wheat were left down 7 days. The recorded result was 194 complete "takes". In this instance, bad weather was experienced. There was heavy rain on the second day when baiting was completed, this being followed by a heavy snowfall on the third day. It was impossible under the circumstances to record how many of the "takes", observed as such, were possibly washed away. Accepting the recorded "takes" of the final test as all "taken" and not washed away, the progressive rate of the complete "takes" in the three tests is 15, 58 and 194 respectively. The comparable results of the tests conducted after the "1080" series, and prior to the institution of the first series of "1081" controls was 36, 84 and 165 complete "takes" respectively. It is reasonable to assume, from wide experience of sewer control under all weather conditions that approximately 15% of the 194 complete "takes" recorded in the final test were washed away. This is, in some measure substantiated by the similarity of the poison "takes" in the first control of the second series, and that of the initial control of the first series, December, 1956. On this basis, the pattern of the test results after "1081" controls is similar to that of the test results following the "1080" direct controls. The first poison control of the second "1081" series was applied immediately on completion of the final test. A total of 394 sewer entrances were treated each bait being 4ozs., comprising sausage rusk and water solution of "1081" at a concentration of 1% by weight. The baits were left down 4 — 6 days before clearance and on examination 91 "takes" (14 complete, 17 x ¾ 26 x ½ and 34 x ¼) were recorded. A total of 28 bodies were found and these were in the flows, in several instances a considerable distance from the sites of the baits. The weather in this instance was ideal and the majority of the bait residue was in good condition when cleared. The comparable result of the initial "1081" control 1956, was 87 "takes" (8 complete, 7 x 39 x ½ and 33 x ¼) ex 394 entrances baited, and 52 bodies were recovered. The estimated amount of poison bait accepted in the first instance above is 193 ozs. and in the latter 164 ozs. The second control of the series was applied on the 5th June, when 401 entrances were baited. The baits after being down 4 — 5 days were examined and the recorded result was 45 "takes" (25 complete, 8 x ¾ 11 x ½ and 1 x ¼) 14 bodies being found. In the latter part of this control continuous heavy rain was experienced, and 27 baits were recorded as washed away. This could possibly apply in some instances of the 25 "takes" recorded as complete. In the comparable control of the first series, the result was 60 "takes" (11 complete, 7 x ¾ 18 x ½ and 24 x ¼) ex 401 entrances baited, and 34 bodies were found. In this instance the weather was fine. 12 For the purpose of the third control, started on the 11th September, 406 entrances were baited and the recorded result was 31 "takes" (7 complete, 5 x ¾, 3 x ½ and 16 x ¼). In this instance 6 bodies were found. The equivalent control of the first series resulted in 18 "takes" (4 complete, 4 x ¾, 8 x ½ and 2 x ¼) ex 396 entrances treated. The fourth and final control of the series was applied on the 5th December and of a total of 399 entrances baited 29 "takes" were obtained (8 complete, 3 x ¾, 9 x ½ and 9 x ¼) as against 17 "takes" (4 x ¾ and 13 x ½) and 4 and 10 bodies respectively were found. The annual overall test was applied as from the 1st January, 1959, 22 days after completion of the final control of the second series and a total of 400 manholes were baited, and on examination 21 complete "takes" were recorded as opposed to 27 "takes" (15 complete, 9 x ¾, 1 x ½ and 2 x ¼) in the comparable test on completion of the first series of Controls. The third series of 4 "direct" controls at quarterly intervals is due to start in June, 1959 and will follow an overall test baiting after a lapse of six months, which will again provide data on the build-up during this period. In conclusion it is understood that the results of this series of controls on a full scale and under practical conditions, coincide with results of experiments conducted by the Scientific Officers of the Infestation Division, Ministry of Agriculture, Fisheries and F'ood. From observations of the Fluoracetamide, "1.081" controls and comparison of the detailed records collected, it does appear to be comparable to Mono Sodium Fluoracetate, "1080". Bearing in mind the complete "takes" of poison bait obtained in both series, it might well be more palatable than the latter, and this, when combined with slower onset of warning symptoms results in a larger bait acceptance. By reason of its coarser division it is safer to dispense and owing to lower toxicity to rats and presumably to man, is less hazardous in distribution. ATMOSPHERIC POLLUTION 1958 was the third complete year of the coming into operation of the smoke abatement provisions of the City of London (Various Powers) Act, 1954, and the second of the Clean Air Act, 1956. No application was received under Section 4 (2)(b) of the Various Powers Act for approval to use, in existing premises, a fuel other than one of those on the list of "authorised" fuels. Mr. City Engineer had three such applications in respect of new buildings which were subsequently approved by the Public Health Committee. Three notices of intention to install or replace furnaces in existing premises were received. In each case the fuel to be used was an "authorised" fuel under the Various Powers Act. Complaints of smoke emission relating to six premises were made by the general public. All were of a temporary nature and were remedied by suitable administrative action. During the year steam railway locomotives became subject to Regulations which specify the periods when emissions of smoke of prescribed densities will be allowed. The problem of smoke and grit emissions from steam traction diminished as a result of the replacement of a number of steam locomotives by modern diesel units. By June, 1959 this improvement will be more apparent by the greater use of diesel cars on some services and the electrification of others at Liverpool Street and Moorgate, but not until 1960/61 (the electrification of the London, Tilbury and Southend Section of the Eastern Region will be completed by then) will the full impact begin to be felt of the modernisation programme of the British Transport Commission. Meanwhile every effort is being made to secure supplies of low volatile fuel, and by frequent visits of the railway supervisory staff to ensure that smoke emissions are reduced to a minimum. In a contribution by members of the Department of Scientific and Industrial Research to the Conference in October of the National Society for Clean Air, the results of a survey of air pollution in London and its smokeless zones, indicated the probability of a 40 per cent reduction in average smoke pollution over much of the City of London, which more nearly agrees with the calculated figure of a maximum, at the centre, of 58 per cent. It has often been said that air pollution does not stop at local boundaries and that the air of a smokeless zone surrounded by smoky neighbours would be swamped by their emissions so that there would be no appreciable local benefit. The result of the survey should provide some encouragement to authorities who may be considering embarking on smoke control areas under the Clean Air Act. Of dust and grit deposition and sulphur dioxide emission it was concluded, as the result of the survey, that the measurements showed no reduction. In fact, in 1958, the water-insoluble matters i.e., dust and grit deposited in the gauges at Golden Lane and Guildhall were much in excess of that found in 1957 and for the average of the preceding 5 years. This is quite understandable having regard to the large scale re-development of war damaged sites, and much of the deposited matter is due to the demolition of old, and the erection of new , buildings. On the other hand the weight of tarry matter — a water-insoluble constituent closely associated with the emission of chimney smoke — is considerably less than the average for the preceding five years. 13 A recent survey undertaken by the Public Health and Scientific Departments of the London County Council concludes there is little doubt that living in London for a long period increases the risk of dying from respiratory disease, including bronchitis; furthermore since these diseases are often suffered over a number of years, morbidity too is associated with the length of residence. A significant relationship between mortality and the two types of atmospheric pollution chosen for the survey — sulphur dioxide and smoke — has not been demonstrated, though smoke looks more dangerous than sulphur dioxide. This does not preclude there being a critical level of one or both in combination that would be directly associated with increased mortality or morbidity, but equally there may be other types of pollutants more dangerous than either. It is suggested that the threshold level above which a smog incident is likely to occur in London is when the mean level for London attains a daily value of 200 milligrams of black suspended matter per 100 cubic metres of air and 40 parts of sulphur dioxide per 100 million parts of air, i.e. four times the customary winter level. In the City of London, in 1958, the average concentration in the six winter months for smoke was 15 mgs of black suspended matter per 100 cm of air and for sulphur dioxide 14 parts per 100 million parts of air. If, as is to be anticipated, measures to diminish the amount of atmospheric pollution reduce the amount of smoke it may be possible to assess with greater clarity the respective parts played by sulphur dioxide and smoke which have both so far been present concurrently in the atmosphere in roughly the same proportions during different episodes of fog. Table I records the results of the measurement of rainfall and deposited matter; Table II the volumetric determination of smoke concentrations; and Table III the concentrations of sulphur dioxide by the volumetric and lead peroxide methods. Table I.—Results obtained in 1958 of the monthly observations of rainfall and deposited matter by means of the deposit gauges. MONTH Rainfall collected in deposit gauge DEPOSITS Equivalent to Insoluble Soluble Total Millimetres inches of rain Millimetres inches of rain Tons per square mile STATIONS (see note below) A B A B A B A B January 47 1.86 — — 17.26 — 7.80 — 25.06 — February 59 2.31 — — 19.75 — 9.59 — 29.34 — March 26 1.01 — — 15.47 — 7.14 — 22.60 — April 44 1.72 — — 18.92 — 6.37 — 25.29 — May 57 2.26 — — 34.78 — 7.43 — 42.22 — June 120 4.73 115 4.55 12.21 15.71 6.87 9.29 19.08 25.00 July 42 1.65 36 1.40 15.60 21.19 6.11 7.77 21.71 28.96 August 78 3.08 71 2.80 22.14 12.54 7.73 10.14 29.87 22.67 September 89 3.51 79 3.11 19.48 15.10 7.83 8.85 27.31 23.96 October 79 3.12 54 2.12 13.74 13.82 6.87 8.79 20.61 22.61 November 29 1.13 39 1.56 4.48 11.18 5.97 18.85 10.45 30.04 December 72 2.83 65 2.55 32.76 25.17 8.93 20.75 41.69 45.92 Averages: 1958 62 2.44 66(a) 2.58(a) 18.88 16.39(a) 7.39 12.06(a) 26.27 28.45(a) 1957 42 1.66 — — 14.56 _ 7.17 _ 21.73 — 1956 44 1.74 — — 13.31 — 7.80 — 21.08 — 1955 43 1.71 — — 13.73 — 7.99 — 21.71 — 1954 47 1.80 — — 12.40 — 9.04 — 21.35 — 1953 36 1.40 — — 11.99 — 8.22 — 20.21 — 1953-57 42 1.66 — — 13.20 — 8.04 — 21.22 — Note: A — Golden Lane. B — Guildhall from 1st June, 1958. (a) average for 7 months. 14 TABLE II-Results obtained in 1958 of the daily observations of the concentration of SMOKE by the volumetric method. Month Rainfall collected in deposit gauge at Golden Lane Golden Lane POLICE STATIONS Bishopsgate Cloak Lane Snow Hill Monthly Average Monthly Average Monthly Average Monthly Average Equivalent to Millimetres inches of rain Milligrams per 100 cubic metres Milligrams per 100 cubic metres Milligrams per 100 cubic metres Milligrams per 100 cubic metres January 47 1.86 14 27 21 8 February 59 2.31 10 23 16 5 March 26 1.01 11 23 16 6 April 44 1.72 8 17 13 4 May 57 2.26 3 16 7 2 June 120 4.73 3 10 7 2 July 42 1.65 3 14 7 3 August 78 3.08 2 13 10 3 September 89 3.51 3 9 11 4 October 79 3.12 7 17 15 9 November 29 1.13 21 37 29 17 December 72 2.83 25 38 37 20 Averages: 1958 62 2.44 9 20 16 7 1957 42 1.66 9 25 15 7 1956 44 1.74 14 15(a) 12 13 1955 43 1.71 14 13(a) 10(a) 12(a) 1954 47 1.80 14 — — — 1953 36 1.40 13 — — — 1953-1957 42 1.66 13 _ — — (a) Measurement for 9 months of the year. TABLE III.—Results obtained in 1958 of the measurement of SULPHUR DIOXIDE by the volumetric and lead peroxide methods. Month Rainfall collected in deposit gauge at Golden Lane Police Stations LEAD PEROXIDE METHOD Golden Lane Bishopsgate Cloak Lane Snow Hill Golden Lane Finsbury Circus Equivalent to Millimetres inches of rain Monthly Average Monthly Average Monthly Average Monthly Average Mgs. (S.0.3) per day per 100 sq. cm. J anuary 47 1.86 16 21 16 13 5.00 4.05 F ebruary 59 2.31 11 18 14 12 3.70 3.87 March 26 1.01 11 16 15 12 3.88 3.40 April 44 1.72 7 12 11 9 2.54 2:52 May 57 2.26 5 10 8 4 1.99 1.78 June 120 4.73 5 9 7 5 1.89 1.42 July 42 1.65 5 8 6 5 1.39 1.61 August 78 3.08 5 9 6 4 1.82 1.40 September 89 3.51 6 9 9 7 2.60 1.78 October 79 3.12 10 15 12 12 3.37 2.75 November 29 1.13 16 21 21 17 4.11 3.38 December 72 2.83 18 24 21 18 4.86 3.99 Averages: 1958 62 2.44 10 14 12 10 3.10 2.66 1957 42 1.66 9 12 11 11 2.71 2.47 1956 44 1.74 10 15(a) 12 13 2.69 2.42 1955 43 1.71 10 13(a) 10(a) 12(a) 2.85 2.57 1954 47 1.80 11 — — — 2.54 2.60 1953 36 1.40 11 — —- —- 2.30 2.47 1953-1957 42 1.66 10 — — — 2.62 2.51 (a) Measurements for 9 months of the year. 15 PIGEON NUISANCE The firm of pigeon catchers employed under contract by the City Corporation have continued to give satisfaction. The Corporation's policy is not entirely to exterminate all pigeons but to control their numbers to such proportions as will ensure that the pleasure they give to residents and visitors is not outweighed by the nuisance they cause. The very small number of complaints received during the year of damage caused by these birds justifies the Medical Officer in his belief that the activities of the contractor are being well directed in achieving a nice balance between the aesthetically pleasing and the hygienically satisfactory. During the year 1,203 pigeons were humanely trapped and killed. Early in the year an article appeared in a daily paper stating that psittacosis could be caught from pigeons. The article could be read to infer that this discovery was new. It has, however, been known for many years that pigeons are prone to this disease and can communicate it to man. The virus comes down the bird's nostrils whence it is transferred to its feathers by constant pecking. Anybody handling such pigeons could easily become infected. Psittacosis is not fatal in humans but can be a "pretty acute" illness. On two occasions six pigeons were caught in the City and submitted to bacteriological examination. In the first instance psittacosis-like virus was isolated from one of the birds, and in the second instance one bird had a high titre of complement fixing antibody to psittacosis in its serum, indicating that it had been infected and was probably a carrier of the virus. EXCAVATION OF HUMAN REMAINS Human remains which are unearthed in the course of excavation are, with the sanction of the Home Office, the Ecclesiastical Authorities, the City Coroner and the City Police, reverently reinterred in an approved burial ground or cremated at an established crematorium. During the year all human remains were removed from the crypt of the St. Swithun London Stone Church in Cannon Street and taken to a cemetery in Surrey where they were re-interred. The crypt has been closed for burial since 1853. The majority of the remains were in lead coffins most of which were identifiable, the names on the coffins still being legible. During excavation work on a building site bounded by Farringdon Street, Stonecutter Street and Shoe Lane some human remains were discovered. The bones were of great age and Mr. N.C. Cook, B.A., F.S.A., The Keeper of the Guildhall Museum considered that the bodies were probably buried prior to the Great Fire of London. The absence of coffins suggested that the site had been a Plague Pit in 1665. The British Museum became interested in these relics and as a result of their request the Home Office gave permission for some of the bones to be retained in the British Museum (Natural History). The rest of the remains were cremated at the City of London Crematorium at Little IIford. CANCER DIAGNOSIS The City Corporation have for some years been considering the advisability and practicability of inaugurating a Scheme in the City to provide, for members of the public, free examination (including X-ray photography) for the purpose of diagnosing whether such person is suffering from cancer or not, and by publicity to encourage people to take advantage of this scheme so as to ensure that, if the disease is present, it is diagnosed and treated in its early stages. During 1958 it was decided to approach the Governors of St. Bartholomew's Hospital with a view to enlisting their co-operation in establishing a clinic for the diagnosing of cancer, in that hospital. About the beginning of the present century, medical and public opinion began to grow in favour of an all-out attack on what was then, still, in the words of John Bunyan "Captain ofthe men of death". In fact the first move in that direction came many years before in the City of London, where at 6 Liverpool Street on June 13th 1848, a large house was opened "... to maintain a Public Dispensary at which persons suffering from Affections of the Chest might receive gratuitous advice and medicine". This was because in the words of the first Annual Report of the Dispensary for the year 1848, "several gentlemen had prominently brought under their notice the great frequency and fatality of Diseases of the Chest among the indigent portion of the population and the unavoidably imperfect provision for their treatment in the Northern and Eastern districts of the Metropolis". The idea first started in the City, spread rapidly, so that there was soon a network of Tuberculosis Dispensaries throughout the United Kingdom. (We still have a "City of London Tuberculosis Dispensary" housed in the Out-patient Department of St. Bartholomew's Hospital). The pattern of growth of tuberculosis control has been dwelt upon at some length, because its apparent success has led to the idea that similar success might attend a plan of campaign directed against cancer, another great killer of mankind. 16 The diagnosis of almost any serious disease nowadays demands the aid of so many and so complex a variety of ancillary equipment, apparatus, technicians and medical specialists that it is irrational to provide these at any but a big general hospital which can at least aim at an economy in the use of such facilities by employing them in application to as many diseases as possible. To supply modern facilities of this kind in clinics and hospitals established for dealing with cancer alone would prove astronomically expensive and entirely uneconomic. The facilities for the diagnosis and treatment of cancer are generally available in our National Health Scheme, but the Governors of St. Bartholomew's Hospital are prepared to develop a system of early laboratory diagnosis of cancer which could be applied to certain organs of women in the first instance. It might be developed to extend to other organs and to both sexes at a later stage. As a result of discussions which have already taken place it is confidently hoped that during 1959 definite arrangements will be made for the establishment of a clinic for the diagnosis of cancer which will be available, through their medical advisers, to City residents and to the many thousands of persons employed in the City. The Corporation have no statutory powers to spend money on work of this nature out of rates, they would however, be prepared to do so out of City's Cash. RADIOACTIVITY AND PUBLIC HEALTH "Too often the subject of atomics is treated with the reverence accorded to a mystical cult, with the furtiveness appropriate to industrial restrictive practices, or with the secrecy which national security may or may not require. Yet what we are witnessing is perhaps the greatest ecological change since the recession of the polar icecap at the end of the last Ice Age. Even the small amount of research already done has demonstrated the selective uptake of radioactive isotopes by certain aquatic and terrestrial plants, the varying sensitivity of different forms of life to increasing radiations, the biological concentration of some isotopes in the tissues of the animal body, and their effect on genetic mutations. We are standing on yet another fringe of the unknown, not as Man alone, but with the whole range of living things grouped around us in a symbolic question-mark. It is against this enormous background that we have to examine our more local problems of radioactivity." ("The Lancet", 24th May 1958). In terms of practical action in an area like the City, it is clear that there is little that can be done at this stage. We are a long way from the day when every City Public Health Inspector need be equipped with a geiger counter, although it is true that these are now obtainable in a fairly rough form but convenient for use at as low a price as £10 each. In this connectidn it should be remembered that the Civil Defence Department which is always ready to co-operate in case of need, already possesses a set of valuable instruments for measuring radioactivity, including some that are far more accurate than the instruments on sale at £10 each. There are also some instruments for measuring radioactivity available at the Sir John Cass Institute, these with certain types of emanations, might be more suitable for measurements than the Civil Defence instruments. Meanwhile, as a first step, arrangements were made towards the end of the year for the Public Health Inspectors to attend a Course of lectures at the Sir John Cass College on "Radioactivity and its hazards in biology and medicine" — a course which was conducted very successfully in the early part of 1959. It may well be that another course of instruction will be arranged to extend the knowledge already gained and so keep the Inspectors in touch with further developments in this important field. In addition to the help and advice in measuring and dealing with sources of radioactivity which could be obtained from the Sir John Cass Institute and the Civil Defence Department there is a Government Radiological Protection Service. Apart from institutions like Windscale and Harwell which can clearly be relied upon to take all necessary measures for the protection of the public as well as their own workers from excess radioactivity, the chief sources of danger in this respect are radiological and radiobiological apparatus and substances in hospitals, and the factories where they make such things. A minor contributor is the X-Ray apparatus in the shoe shop for assessing accurate shoe fitting. Apparently some jewellers also have small quantities of radioactive materials for use in their work. There are six shoe shops and four jewellers shops in the City, and the Medical Officer is satisfied that the radioactivity from these sources is well under control at the moment, although at any time it would be possible to borrow an instrument from the Civil Defence department for him to satisfy himself in that respect. In St. Bartholomew's Hospital, the only hospital in the City, all precautions are taken by the Staff to ensure that no unwarranted radiations are used, that no radioactive contamination is permitted and that the disposal of radioactive waste is carried out without any hazards to personnel within or without the hospital. 17 The important thing in the Medical Officer's opinion is to avoid becoming unduly anxious about radiation hazards as they exist today when there is little cause for anxiety, but to maintain an alert and flexible attitude of mind ready to meet new problems as they arise. ANTI-POLIOMYELITIS CLINIC In October the London County Council Divisional Medical Officer Area 5, in which is includeed the City of London, approached the Corporation's Medical Officer of Health for assistance in connection with the Councils proposed anti-poliomyelitis campaign to offer inoculation to all young persons born in the years 1933-1942, such assistance to include suggestions for the establishment of a lunch hour clinic centrally situated in the City. It was decided to circularise the larger firms in the City and to publicise the offer of inoculation to the extended age group in the press and by poster and leaflet during the week November 10th - 16th, and the Divisional Medical Officer was supplied with a list of the names of the medical practitioners working for City firms so that he could write to them direct to invite their co-operation in the campaign. The most convenient and suitable site for a clinic appeared to be the Civil Defence Control accommodation in the Sub-basement of the Office Block, and by courtesy of the Chairman of the Civil Defence Committee and with the co-operation of the Civil Defence Department this was made available for the purpose. The City Medical Officer of Health undertook the arrangements for the display of posters and dissemination of record cards and information. The Clinic was planned to operate on Monday,Tuesday and Wednesday of each week between the hours of 12 noon and 2 p.m. and commenced operations on Tuesday, 11th November, when the response was immediate and encouraging, there were sometimes as many as 500 attending one clinic. The total number of persons inoculated at the City Clinic by the 19th November was, 1,925. The many activities of Area 5 apparently centred in this clinic at the Guildhall where some 5,040 injections had been given by the end of the year. In addition a team comprising a London County Council Doctor, a Nurse and a Clerk with equipment had been sent to 32 Hanks, Insurance Houses and commercial undertakings in the City in order to inoculate staffs at their places of employment. I should like to thank the Chairman and members of the Port and City of London Health Committee for their help and encouragement in the work of the City Health Services as well as all those, for example traders, business firms and members of the public, who have co-operated in the promotion of health. I have the honour to be, Your obedient Servant, J. GREENWOOD WILSON, Medical Officer of Health, Port and City of London. STATISTICAL INFORMATION Area.— 678 acres (including the Temple and foreshore). Population. — Census 1951, 5,268. Estimated mid-year 1958, 5,000. Annual Rateable Value. — As at 1st April, 1958, £11,812,950. Annual Sum received from Penny General Rate. — £50,100. Legitimate Illegitimate Births:- M. F. M. F. Live Births 15 14 — — 29 Live Birth rate per 1,000 population 5.22 Still-births — — — — 0 Still-births rate per 1,000 live and still-births - Total live and still-births 15 14 — — 29 Illegitimate live births per cent of total live births — Deaths:— Deaths of infants (under one year of age) 11 — — 2 Neo-natal deaths (under four weeks) 1 1 — — 2 Infant mortality rate per 1,000 live births—total 68.97 Infant mortality rate per 1,000 live births — legitimate* 68.97 Infant mortality rate per 1,000 live births— illigitimatet — Neo-natal mortality rate per 1,000 live births — (first four weeks) 68.97 * Legitimate I.M.R. = leg. deaths under 1 year leg. live births † Legitimate I.M.R. =leg. deaths under 1 year illeg. live births Maternal deaths (including abortion) — — — — 0 Maternal mortality rate per 1,000 live and still-births M F — Deaths, all ages 34 22 56 Death rate per 1,000 resident population 11.42 INFECTIOUS DISEASE Notifications received:— Total cases notified Dysentery 3 Measles 9 Food Poisoning 5 Scarlet Fever 4 Tuberculosis (Pulmonary) 6 ANALYTICAL EXAMINATIONS (Other than Food and Drugs Act) Apricots, Dried 3 Oranges, tinned 3 Apricots, tinned 2 Pastry 1 Butter, Creamery 1 Pepper, Red 1 Cheese 1 Sandwich Filling 1 Chinese Food, tinned 1 Sauces 2 Currants 2 Sherry 1 Fertilizers- Soup, tinned 2 Sulphate of Ammonia 1 Sultanas 7 Vegerite Compound 1 Water 1 Melon, peeled, tinned 1 Wines, Red 1 BACTERIOLOGICAL EXAMINATIONS The following specimens were examined during the year:— Cheese 3 Salmon, tinned 1 Egg products 140 Sandwich, pork 1 Faeces 17 Sandwich, Truffle 1 Ham, tinned 3 Sputa 1 Meat, tinned 7 Swab, throat 1 Prawns, tinned 6 Water 2 Saithe, tinned 1 19 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1958 CAUSES OF DEATH NETT DEATHS AT THE SUBJOINED AGES OF RESIDENTS WHETHER OCCURRING WITHIN OR WITHOUT THE DISTRICT All Ages Under 1 yeai 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and under 75 years 75 and upwards 1 2 3 4 5 6 7 8 9 10 All Causes 56 2 1 4 22 16 11 1. Tuberculosis, respiratory M — — — — — — — — F — — — — — — — — — 2. Tuberculosis, other forms M — — — — — — — — — F _ — — — _ — — — 3. Syphilitic disease M — — — _ — — — F — — — — — — — 4. Diphtheria M — — __ — — _ _ _ F — — — — — — — — — 5. Whooping Cough M — — — — — — — — — F — — — — — — — — — 6. Meningococcal infections M __ — — — _ — — — — F — — — — — — — — — 7. Acute poliomyelitis M — — — _ — — _ — — F — — _ — _ — — — — 8. Measles M — _ — _ — _ — F — — — — — 9. Other infective and parasitic disease M — — — — — — — — — F — — — — — — — — — 10. Malignant neoplasm-stomach M — — — — _ — _ __ F 1 — — — — — 1 — — 11. Malignant neoplasm-lung, Bronchus. . M 1 — — — — — 1 — — F — — — — — — — — — 12. Malignant neoplasm-breast M — — _ — — — — — — F 2 — — — _ 1 — 1 — 13. Malignant neoplasm-uterus . F — — — — — — — — — 14. Other malignant and lymphatic neoplasms M 3 — — — — — — 2 1 F 4 — — _ — — 1 2 1 15. Leukaemia, aleukaemia M — — — _ — — — — — F — — _ — — — — — — 16. Diabetes . . M — — — — — — — — — F 17. Vascular lesions of nervous system M 3 — — — — — 2 1 — F — — — — — — — 18. Coronary disease, angina M 6 — — — — — 3 2 1 F 1 — — _ _ — — 1 — 19. Hypertension with heart disease M 3 2 1 F .1 — 1 20. Other heart disease M — _ _ _ _ _ — — — F 5 — _ — — _ 1 — 4 21. Other circulatory disease . M 2 — — — — — — 2 - F 2 — — — — — — - 2 22. Influenza . . M __ __ _ __ C1 23. Pneumonia r M 3 2 _ 1 r 1 i 24. Bronchitis r M 1 4 i 3 1 F 1 1 25. Other diseases of respiratory system M F — — — — — — — — — 26. Ulcer of Stomach and duodenum M 1 — 1 — _ _ F __ _ 27. Gastritis, enteritis and diarrhoea M _ F 1 1 28. Nephritis and nephrosis M __ — — _ F — 29. Hyperplasia of prostate M — F - - - - - - - - - Carried forward M 26 __ 1 13 9 3 F 19 — - - 1 1 5 5 7 20 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1958-continued CAUSES OF DEATH 1 NETT DEATHS AT THE SUBJOINED AGES OF RESIDENTS WHETHER OCCURRING WITHIN OR WITHOUT THE DISTRICT All Ages ? Under 1 year 3 1 and under 5 years 4 5 and under 15 years 5 15 and under 25 years 6 25 and under 45 years 7 45 and under 65 years 8 65 and under 75 years 9 75 and upwards 10 Brought forward M 26 _ _ __ 1 13 9 3 F 19 _ i 1 5 5 7 30. Pregnancy, childbirth, abortion F _ 31. Congenital malformations M _ __ F 2 1 - - - 1 - - 32. Uther defined and ill-defined diseases M 1 1 F 1 — — — — _ 1 33. Motor vehicle accidents . . M _ _ F __ _ __ 34. All other accidents M 5 2 2 1 - F — — — — — — — - — 35. Suicide . . M 2 — — — — — 1 1 — F — — — — — — — — — 36. Homicide and operations of war M F - - - - - - - - - Totals M 34 1 _ — 3 16 11 3 F 22 1 - - 1 1 6 5 8 MATERNITY AND CHILD WELFARE The following details have been received from the Divisional Medical Officer of the Londoi County Council with regard to work carried out in connection with Maternity and Child Welfare ii the City. Infant Welfare Centre Total No. of children who first attended during the year and who on the date of their firs attendance were :— Under 1 year of age 23 Total No. of children who attended during the year, and who were born in 1958 25 1957 24 1956-1953 33 Total attendances by children:— Under 1 year of age 626 1—5 years of age 517 Health Visitors Total No. of children visited 47 No. of infants under 1 year of age visited for first time 25 Total visits to infants under 1 year of age 101 Total visits to children aged 1 year but under 2 years 81 Total visits to children aged 2 years but under 5 years 112 No. of expectant mothers visited 6 Total visits to expectant mothers 17 Care of Premature Infants No. of premature births during the year 3 No. of deaths under 1 month — Diphtheria Immunisation No. of children who completed a full course of primary immunisation:— Under 5 years of age 28 5—15 years of age — No. of children who were given a secondary or reinforcing injection 48 Vaccination No. of children successfully vaccinated or re-vaccinated 35 Home Help Service No. of maternity cases provided with home help 1 21 FACTORIES ACTS, 1937 and 1948 Factory premises have been under such supervision as is necessary, and the following gives details of the work carried out:— PART I OF THE ACT 1.—INSPECTIONS for the purposes of provisions as to health. Premises Number on Register Number of Inspections Written notices Occup iers prosecuted (i) Factories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities U87 (including 1,055 kitchens) 2 J 71 (including 2,146 kitchens) 165 (including 163 kitchens) - (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority . . 93 107 15 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises). . . . . . . TOTAL 1,280 2,278 180 - 2.-CASES IN WHICH DEFECTS WERE FOUND (If defects are discovered at the premises on two, three or more separate occasions they are reckoned as two, three or more "cases"). Particulars No. of cases in which defects were found Number of cases in which prosecutions were instituted F ound Remedied Referred To H.M. Inspector Bv H.M. Inspector Want of cleanliness (S.l.) . . 712 629 _ _ Overcrowding (S.2) . . — — — — — Unreasonable temperature (S.3) 4 1 — — — ■Inadequate ventilation (S.4). . _ _ 55 34 — — — Ineffective drainage of floors (S.6) . . 7 1 — — — Sanitary Conveniences (S.7) (a) insufficient . . 6 2 — — — (b) unsuitable or defective 183 123 — 21 — (c) not separate for sexes 6 6 — — — Other offences against the Act (not including offences relating to Outwork) 430 325 - - - TOTAL 1,403 1,121 21 — OUTWORK AND THE INSPECTION OF OUTWORKERS' PREMISES, ETC. Lists received from City Firms . . . . . . . • . . . • 89 Names and Addresses, etc.,received from other Authorities . . . . 125 Names and Addresses transmitted to other \uthorities . . . . . . 600 No case of infectious disease was reported in connection with outworkers premises in the City. SHOPS ACT, 1950 27 inspections of shops and warehouses have been carried out. Defects found have been remedied after the service of 6 Intimation Notices and without recourse to legal proceedings. Certificates granting exemption from the provision of sanitary accommodation and washing facilities in accordance with Section 38 (2) (4) and (6) of the Act were issued in respect of one shop. HYGIENE IN HAIRDRESSERS' AND BARBERS' SHOPS In accordance with Section 18 of the London County Council (General Powers) Act, 19E)4, the Corporation made Bye-laws for securing the cleanliness of premises registered under this Section, also of instruments used and persons employed therein. 80 hairdressers' establishments are now registered in the City. Inspections thourghout the year have shown that the standards required by the Bye-laws are being maintained. 22 MEAT INSPECTION Tons. Cwts. Ore. Lbs. Meat, etc., delivered at Smithfield Market 327,134 0 0 0 Meat, etc., surrendered to Inspectors at Smithfield Market 3(58 11 0 11 Meat, etc., surrendered to Inspectors at Leadenhall Market and City shops 5 7 2 20 Meat, etc., surrendered to Inspectors at Cold Stores 3 16 3 10 Various commodities surrendered to Inspectors and sent to Lett's Wharf (in addition to 2,690 eggs) 115 2 1 Number of Exportation Certificates Issues 117 Number of demonstrations and lectures given 38 Number of Students attending 149 ITINERANT FOOD VENDORS Constant inspections of barrows and of itinerant food vendors have been maintained and no difficulty has been experienced in connection with this class of trade. FOOD INSPECTION Foodstuffs, in addition to meat, condemned as unfit for human consumption as a result of the inspection of food landed at Riverside Wharves and in grocers shops, cafes, restaurants etc. amounted to 171 tons 10 cwt. 0 qrs. 15 lbs., which was disposed of as follows:— Released for stock feeding 56 tons 7 cwts. 2 qrs. 4 lbs. Disposed of to contractors 57 tons 14 cwts. 1 qrs. 19 lbs. Destroyed 57 tons 8 cwts. 0 qrs. 20 lbs. 85 tons 2 cwts. 0 qrs. 8 lbs. of food were placed under stop and subsequently released to be dealt with under the supervision of other local authorities. FOOD HYGIENE REGULATIONS 1955 Supervision in accordance with these Regulations has been carried out at Smithfield Market. During the year 540 infringements were noted. 114 were in connection with clothing, 82 in connection with containers, 73 in respect of meat contamination, 30 in regard to premises and equipment, and 72 were instances of smoking whilst handling food. 18 trucks and 148 vans and cars were observed to be infringing the Regulations. 3 meat handlers with cut fingers were not wearing washable dressings on the wounds. Suitable warnings were given in connection with these cases. There are estimated to be some 7,000 persons using Smithfield Market Daily, which figure includes approximately 600 porters licensed by the Superintendent of the Market, including some 120 freelance porters popularly known as "bummarees". some 200 pitchers who arrive at the Market with the various meat vans, unload the vehicles and leave the Market again on the vans. tenants' staffs, buyers and their staffs, there are 349 stalls on the Market occupied by approximately 110 tenants. FISH INSPECTION Inspection of fish in the City of London is carried out by officers of the Worshipful the Fishmonger's Company. The Fishmeter's returns indicated as follows Deliveries at or near Billingsgate Market V/eight of Condemnation (including shell fish) Fish Condemned Rate 119,335 tons 424 tons 0.36% SANITARY CIRCUMSTANCES The general sanitary supervision has been maintained and in this connection 4,175 inspections have been made. \s a consequence of these inspections, it was necessary to serve 11 Intimation Notices. No Statutory Orders were served. No Legal proceedings were necessary. Tenement Houses were inspected and the only common lodging house in the City was kept under regular supervision. 23 CATERING ESTABLISHMENTS Before establishing a new catering business planning approval must be obtained before premises, new or existing, are adapted for this purpose. In order that the applicants for such approval can be satisfied that the premises are suitable from a public health point of view and that the various statutory requirements can be met, they are referred by the City Planning Officer to your Medical Officer of Health. 41 such applications were received during the year as a consequence of which 141 inspections were made. PHARMACY AND POISONS ACT, 1933 This Act provides for registration by the Local Authority of persons not already registered! in respect of poisons in Part I of the Poisons List who desire to sell poisons included in Part II. Part I of the Poisons List includes the more dangerous poisons such as strychnine — which may be sold only by Pharmacists registered by the Pharmaceutical Society of Great Britain, whereas Part II includes the less dangerous poisons such as phenols, hair dyes, etc. 68 firms were registered under this . Act, all of which were re-registrations. One infringement was noted. 91 inspections were made in connection with the administration of the Act. PHARMACY AND MEDICINES ACT, 1941 This Act has continued to have the attention of the Inspector. It aims to protect the public from misleading claims by advertisement or by labels on medicine bottles. 30 inspections were made and no contravention came under the notice of the Inspector. FERTILISERS AND FEEDING STUFFS ACT, 1926 This Act requires sellers of certain specified fertilisers and feeding stuffs for cattle or poultry to furnish purchasers with a statutory statement indicating the name under which the article is sold and the amount, if any, of certain scheduled ingredients. 42 inspections were made ; no contraventions were noted. FOOD AND DRUGS ACT, 1955, AND FOOD REGULATIONS Informal and Formal Samples submitted for Analysis Article Informal Formal Article Informal Formal Almond Oil 1 Brought forward 68 — Almonds, ground _ Cough Mixture 1 - Alum. . . 1 Cream 9 — Apple Juice . . 1 — Curry Powder 2 — Arnica, Tincture of . . 1 Dessert Powder 4 — Arrowroot 1 Drinks, soft 4 — Aspirin Tablets — Drinks, soft, powders 4 — Baking Powder 1 — Dripping 3 — Basilicon Ointment 1 — Dusting Powder 1 — Biscuits 1 Epsom Salts 1 - Bismuth Lozenges,Compound 1 — Eucalyptus, Oil of 4 — Blackcurrant puree, canned. 1 — Figs, Syrup of 1 - Blancmange Powder — Fish, bottled 1 - Borax 1 — Fish, cakes 1 — Boric Acid Ointment 1 Fish, paste 6 — Butter 4 Flavouring essence 4 — Cake Decorations Flour, self-raising 3 — Calamine Lotion Friars Balsam 3 — Camphorated Oil 1 Fruit, canned 1 - Cascara evacuant 1 Fruit, dried 4 — Castor Oil 1 Fruit Curd 4 — Cheese (various) 11 Fullers Earth 1 — Chocolate, drinking 1 — Gelatine 4 - Coconut, desiccated — Ginger, ground 1 - Cod Liver Oil 1 Gravy Browning 1 - Coffee — Gravy Preparation 1 - Coffee & Chicory Essence 1 Gregory's Powder 1 - Colouring Matter Groundnut Oil 1 - Confectionery, Sugar 7 — Halibut Liver Oil 1 - Cooking Fat 1 — Herbs, dried 2 — Cornflour 1 - Honey 4 — Carried forward 68 — Carried forward 146 — 24 Informal and Formal Samples submitted for Analysis - continued Article Informal Formal Article Informal Formal brought forward 146 Brought forward 217 13 Hydrogen Peroxide 1 — Quinine, Ammoniated Tincture of 1 _ Hypophosphites, Compound Syrup of 1 Quinine, Ammoniated Tincture of, with Cinnamon 1 Ice Cream 2 Ice Cream Mixture 1 — Quinine Bisulphate Tablets 1 — Iodine, Tincture of 1 Rennet, Essence of 1 — Jelly Powder 1 — Rose Hip Syrup 1 — Jelly Tablets Compounds 2 — Rum Rutter 1 — Jam 2 Saccharin Tablets 1 — Juniper, Oil of 3 — Salmon Salad in Mayonnaise, canned 1 _ Lanoline 1 Lard 2 _ Sal Volatile, Spirit of 1 — Lemonade Crystals 1 Sauces (various) 7 1 Linctus 2 Sausages and Sausage Meat 15 - Liquorice Powder, Compound 1 — Seidlitz Powder 1 - Macaroni 1 Soda, Bicarbonate of 1 — Margarine 1 — Soup, Canned 1 - Marzipan 2 — Soya Flour 1 — Mayonnaise 3 — Spaghetti 1 — Meat Products 12 — Spices, various 10 1 Meat Products, bottled 2 1 Stuffing Mixture 1 - Meat Products, canned 2 Suet 1 — Meat Extract 1 Sugar 1 - Medicated Tablets 1 Sulphur, Flowers of 1 — Medicines 5 Sulphur Ointment 1 - Milk 1 12 Sulphur Tablets 1 - Milk, condensed 1 Tea — Milk Pudding, canned 1 — Thymol, Glycerin of 1 — Mincemeat 1 Tomato Juice — Mustard 1 Vegetables, canned 4 — Myrrh Vinegar, Malt 1 - Oil, cooking 1 _ Vitamin Tablets 1 — Olive Oil Welsh Rarebit Preparation 1 — Olives, stuffed 1 Wheat Germ Oil Capsules 1 - Pancake Mixture 1 — Wintergree, Oil of 3 — Paraffin, medicinal 1 — Witch Hazel 2 — Peel, mixed — Zinc & Castor Oil Cream 2 — Pepper 1 — Zinc Ointment 2 — Petroleum Jelly 1 - Pickles 1 — TOTAL 292 15 Pudding, cbristmas 2 - Carried forward 217 13 ADMINISTRATIVE ACTION REGARDING ADULTERATION OR OTHER IRREGULARITY Article Informal or Formal Sample Nature of adulteration or irre gularity Action Minced Turkey- Informal Excess of water and misleading label. Formal sample taken Glycerine, Lemon, Honey & Ipecac Informal Labelled to contain 0.25% chloroform but was found to contain 0.23% chloroform. After correspondence with manufacturers the deficiency is to be rectified. Minced Turkey Formal Excessive proportion of water and inaccurate and misleading label. Agreed standards of meat content under discussion. Labels to be modified to conform with standards to be agreed. Pate de Foie Truffle Informal Genuine but stated to contain dead bacteria Sample submitted to bacteriologist who reported the product was fit for consumption. Ammoniated Tincture of quinine with cinnamon Informal 65% excess of ammonia. Letter to suppliers. Stocks withdrawn and replaced with article which conforms with statutory requirements. Ground nutmeg Informal Contamination by insect fragments, larvae and pupae. Formal sample taken. 25 Administrative action regarding adulteration or other irregularity — continued Article Informal or Formal Sample Nature of adulteration or irregularity Action Ground nutmeg Formal Insect fragments. Without prejudice no formal action taken in view of explanations received, and that utmost care will be exercised to avoid repetition. Chili sauce Informal Excess benzoic acid preservative to the extent of 500 p.p.m. Formal sample taken. Apple juice. Informal Presenoe of added carbon dioxide not disclosed on label No formal action in view of undertaking that labels will be revised when reprinted. Chili sauce Formal Excess benzoic acid to the extent of 700 p.p.m. Importers not to import until independent analyses are satisfactory. Pork sausages Informal Presence of preservative not disclosed. Vendor warned that notice must be exhibited in shop. Eucalyptus Oil Informal Cineole 57% instead of not less than 70%. Vendor warned, and existing stocks withheld from sale pending discussions with manufacturers. Lanolin Informal Not more than 60% Lanolin. Consisted of a skin cream made from lanolin, mineral oil and other ingredients. Description misleading. Vendor warned, and existing stocks withheld from sale pending discussions with manufacturers. PROSECUTION Food and Drugs Act, 1955 NIL. FOOD AND DRUGS ACT, 1955 (Section 16) This Section provides for registration of premises for the sale, manufacture for sale or storage of ice cream, or the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale. 148 such premises were registered at the end of the year. The following table shows the type of business carried on Nature of Business No. of premises registered Sale and storage of pre-packed ice cream 78 Sale and storage of ice cream 4 Selecting and sorting of sausage casings 10 Preparation and cooking of jellied eels and shellfish 13 Cooking of hams 1 Cooking of Beetroot 1 Manufacture of sausages, dripping and cooked meats, and brining of meat. 38 Cooking, smoking and canning of meat products 1 Manufacture of pies 1 Smoking of bacon 1 148 AGRICULTURAL PRODUCE (GRADING & MARKING) 4CTS, 1928-1931 Regulations made under these Acts prescribe designations referred to as 'Grade designations" indicating the quality of certain articles of agricultural or fishery produce. Such regulations contain definitions of the quality indicated by every "grade designation" thereby prescribed and specify a "grade designation mark" to represent each grade designation". The Acts also stipulate that all "preserved" eggs shall be so marked before being offered for sale and that all premises used for the cold storage or chemical storage of eggs shall be registered with the local authority. The premises of one firm are so registered in the City of London. No difficulty was experienced in the administration of these Acts. 26 Merchandise Marks Act, 1926 This Act prohibits the importation of certain foodstuffs unless they bear marks indicating the "country of origin" or whether they are of "foreign" or "empire" origin. No difficulty has been experienced in the administration of this Act. CITY MORTUARY Bodies received 167 Post Mortem Examinations made 166 Inquests on bodies 33 Inquest held at Holloway Prison 1 Inquest on fires . . — DISINFECTION AND CLEANSING OF VERMINOUS PERSONS, ETC. Export of Clothing, etc.:— No. of articles disinfected 1,000.046 Cases of horsehair 182 Clothing by weight 3 tons 11 cwt. Fees received £3,443 General Disinfection. Infectious Diseases, etc.:— Articles of bedding disinfected 311 Premises disinfected after cases of infectious disease 2 Lockers at Post Offices disinfected 26 Verminous premises disinfected 22 Cleansing of Persons :— No. of verminous persons bathed . . 651 No. of Scabious Persons bathed 2 No. of articles disinfected . . 6,530