I LON 98 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1972 To be presented, 18th October, 1973. PORT AND CITY OF LONDON HEALTH COMMITTEE (as at 31st December, 1972) Chairman Henry Duckworth, J.P., Deputy Deputy Chairman Herbert Twyneham Pike, Deputy Aldermen Sir Denys Colquhoun Flowerdew Lowson, St., M.A. Lindsay Roberts Ring Robin Danvers Penrose Gillett, R.D. Neville Bernard Burston, M.A. Commoners Edwin Stephen Wilson Richard Christopher Larkins Charvet, R.D. Arthur Malcolm Bell, LL.B. Samuel Sheppard, O.B.E. Philip Frederick Allday Thomas Cuthbert Harrowing, Deputy Arthur Edward Chase Green, M.B.E., T.D., D.L. Dudley Recknell Clack Capt. Frederick Arthur Kemmis Betty, O.B.E., V.R.D., R.N.R. Thomas Ernest Chester Barratt, C.B.E., M.A., LL.B., Deputy Kenneth Alfred Ballard, M.C. Eric Frederick Wilkins, C.B.E., Deputy Sir Stanley Graham Rowlandson, M.B.E., J.P., G.L.C. Francis Seymour Smith, T.D. Dennis Gordon Fisher William Ian Baverstock Brooks Leslie Joseph Walshaw Smith Andrew Hugh Fitzgerald Olsen, B.Sc. Henry Wimburn Sudell Horlock, M.A., Sheriff William Harold Wylie-Harris, Deputy Stanley Edward Cohen, C.B.E. Dr. James Cope William George Alfred Harries Iris Samuels William Allan Davis Cyril Edward BayIis CyriI Henry Murkin Ronald Arthur Ralph Hedderwick Col. Frederick Arthur Sudbury, O.B.E., E.R.D., J.P. Sir Thomas Kingsley Collett, Kt., C.B.E., Deputy Lady Donaldson, J.P. INDEX Page Ambulance Service 56 Animal Boarding Establishments Act, 1963 50 Area of City 62 Atmospheric Pollution 24 At Risk Register 53 Automatic Vending Machines 43 Bacteriological, Analytical & Chemical Work 10, 12, 35, 37 Births 52, 63 Care of Mothers and Young Children 53 Catering and Other Food Premises:- Adulterations and Irregularity 38 Bacteriological Examination 37 Complaints 31, 36 Health Education 33 Hygiene 32, 49 Infectious Disease 31, 33 Legislation 30 Prosecutions 42 Registration of Food Premises 43 Sampling 33, 35 Surrendered or Seized Food 46, 47, 48, 67 Unsatisfactory Premises 32 Vending Machines 43 Causes of Death 64 Cervical Cytology 60 Child Health Clinics 53 Chiropody 57 Clean Air 24 Clearance Area 9 Closing Orders 9 Common Lodging House 14 Deaths:- Infant 53 Vital Statistics 63 Maternal 53 Causes 64 Dental Officer's Report 61 Diseases of Animals Act, 1950 50 Disinfection 30 Domicilliary Physiotherapy 60 Factories Act, 1961 22 Family Planning 59 Fertilizers & Feeding Stuffs Act, 1926 45 Fish Inspection 45 Food Hygiene (Dock Carriers, etc.) Regulations, 1960 49 Food Hygiene (General) Regulations, 1970 49 Food Hygiene (Market Stalls & Delivery Vehicles) Regulations, 1966 43, 49 Food Hygiene — Smithfield Market 49 Food Premises — Registration 43 Food Sampling 33, 35 Foot and Mouth Disease 51 Hairdressers & Barbers Shops 22 Health Centres 53 Health Committee 2 Health Education 33, 58 Health Visiting 54 Home Nursing 56 Housing 8 Illegitimate Births 63 Immunisation 53 Imported Food Regulations, 1968 46 Incontinent Persons 58 Infectious Diseases 66 Introduction Legislation 30, 66 Live Poultry (Restrictions) Order, 1971 51 Meat & Food Inspections 45 Meat Surrendered or Seized 46, 47, 48 Medical Examination of Staff 65 Page Midwifery Services 54 Mortuary 29 National Health Service, Act, 1946 53 Noise 13 Notification of Infectious Diseases 66 Officers of the Health Department 4 Offices, Shops & Railway Premises Act, 1963 15 Ophthalmic Optician Service 65 Outwork 23 Penny Rate 62 Performing Animals (Regulations) Act, 1925 51 Personal Health Services 52 Pet Animals Act, 1951 50 Pharmacy & Medicines Act, 1941 45 Pharmacy & Poisons Act, 1933 44 Pigeon Control 29 Population 62 Post Mortems 51 Poultry 46 Preface 7 Prevention of Illness, Care and Aftercare 56 Psittacosis or Ornithosis Order, 1953 50 Publications 66 Rateable Value 62 Rats and Mice 29 Regulation of Movement of Swine Order, 1959 51 Registration of Food Premises 43 Riding Establishments Acts, 1964 & 1970 50 Rodent Control 29 Sanitary Circumstances 23 School Dental Service 62 School Health 60 Sewerage 13 Shops Act, 1950 22 Smallpox Vaccination 58 Smithfield Market 45 Smoke Control 24 Staff of Health Department 4 Statistics:- Atmospheric Pollution 24, 26, 27, 28 Deaths 53, 63, 64 Disinfection 30 Factories Act 22, 23 Food 34 - 43 Housing 8 Infectious Diseases 66 Medicals 65 Offices, Shops & Railway Premises 16, 17, 20, 21 Outworkers 23 Rodent Control 29 Vital 63 Water Samples 11 Surrender of Unfit Food 43 Swimming Baths 10 Swine Vesicular Disease 51 Temples Order, 1971 53 Tuberculosis 55, 56 Unfit Houses 8, 9 Unsound Food 46, 47, 48, 67 Vaccination and Immunisation 53, 56, 58 Venereal Disease 58 Verminous Persons 30 Veterinary Officer's Report 50 Vital Statistics 63 Water Supply 10 Welfare Foods 53 Well Women's Clinic 59 STAFF (as at 31st December 1972) Commenced Service MEDICAL OFFICER OF HEALTH (for the Port and City of London) PRINCIPAL SCHOOL MEDICAL OFFICER AND DIRECTOR OF SOCIAL SERVICES (City of London) W.G. SWANN, M.D., B.Ch., B.A.O., D.(Obst.), R.C.O.G., D.P.H., B.Sc., D.P.A., F.R.I.P.H.H. January 1964 DEPUTY MEDICAL OFFICER OF HEALTH (for the Port and City of London) D.T. JONES, B.Sc., M.B., B.Ch., M.F.C.M., D.C.H., D.P.H., D.C.T., F.R.I.P.H.H. March 1958 MEDICAL OFFICER (for the Port and City of London) A.E.L. DE THIERRY, M.A., M.B., B.Chir., D.(Obst.), R.C.O.G., D.P.H. March 1967 ASSISTANT MEDICAL OFFICERS W. STOTT, M.B., B.S.,(Hons.), D.P.H., (Gold Medal), F.R.I.P.H.H., F.R.S.H., (Part-time) August 1958 A. WHITE FRANKLIN, M.A., M.B., B.Ch., F.R.C.P. (Child Health Clinic) (Part-time) April 1965 DENTAL OFFICER L.J. WALLACE, T.D., L.D.S., R.C.S. June 1965 PUBLIC ANALYST W.B. CHAPMAN, B.Sc., M.Chem.A., M.Ph.A., F.R.I.C., F.I.F.S.T. April 1971 DEPUTY PUBLIC ANALYST E.H.W.J. BURDEN, B.Sc., M.Chem.A., F.R.I.C., F.I.F.S.T. (Public Analyst services are provided for the Corporation by the Scientific Branch of the G.L.C.) April 1971 AGRICULTURAL ANALYST J.H. HAMENCE, O.B.E., Ph.D., M.Sc., M.Chem.A., F.R.I.C. July 1969 DEPUTY AGRICULTURAL ANALYST P.S. HALL, B.Sc., M.Chem.A., F.R.I.C. July 1969 ADMINISTRATIVE STAFF (Port and City of London) R.C.RATLIFF Chief Clerk March 1930 E.V.SMITH Deputy Chief Clerk October 1938 R.H.COLLINS, M.R.I.P.H.H., L.M.R.S.H. First Assistant Clerk January 1963 Mrs. D.M.SHEPHERD Principal Assistant April 1965 R.G.RUTTER Principal Assistant July 1968 B.E.DAVIES Senior Assistant November 1972 P.J.JARVIS Senior Assistant July 1972 S.C.DARLISON Senior Assistant April 1964 R.G.FARREL Senior Assistant July 1965 Miss M.L.GURNEY First Class Assistant May 1939 R.G.HEMMING First Class Assistant May 1965 J.G.COX First Class Assistant August 1970 Mrs. I.H.HAMBLIN First Class Assistant October 1957 1 Vacancy - - - Mrs. E.J.A. MORROW General Grade Assistant March 1968 D.H.TICKNER General Grade Assistant August 1972 Mrs. J.L.CREGEEN General Grade Assistant April 1972 Miss P.M. O'REGAN General Grade Assistant November 1972 R.L.VALDINI General Grade Assistant August 1972 2 Vacancies - - - 4 Commenced Service ADMINISTRATIVE STAFF (Port and City of London) (Contd.) Mrs. J.E.GRAHAM Clerical Assistant (Temporary) August 1971 Miss B.LOVATT Senior Shorthand Typist November 1969 Miss L.SHARMA Shorthand Typist July 1970 Mrs. P.L.LAWSON Copy Typist August 1970 1 Vacancy Shorthand Typist A.W.THREADGOLD Senior Assistant (Meat Inspector's Office) November 1923 E.J.PETERS Clerical Assistant (Meat Inspector's Office) November 1935 J.E.CASH Clerical Assistant (Meat Inspector's Office) March 1954 R.J.F.PARISSIEN Clerical Assistant (Meat Inspector's Office) March 1971 J.T.HADLEY, A,M.R.S.H. Senior Assistant (Diseases of Animals Act) December 1964 Mrs. W.A.A.SCOFIELD Clerical Assistant (Diseases of Animals Act) August 1967 Mrs. J.LYONS Clinic Clerk (Part-time) April 1965 H.T.LLOYD Senior Messenger/Driver November 1968 J.A.LAMBERT Messenger/Driver November 1968 G.HAMMOND Messenger/Driver March 1969 PUBLIC HEALTH INSPECTION STAFF E.THOMPSON, M.A.P.H.I. Chief Public Health Inspector September 1948 M.J.FLYNN, M.A.P.H.I. Deputy Chief Public Health Inspector July 1951 J.H.RILEY, M.A.P.H.I. Senior Public Health Inspector August 1962 J.B.WELLDON, M.A.P.H.I., M.R.S.H. Senior Public Health Inspector August 1962 H.L.SHEPLEY, M.A.P.H.I. Senior Public Health Inspector May 1964 J.A.HOARE, M.A.P.H.I. Senior Public Health Inspector May 1964 T.B.MEANEY, M.A.P.H.I., M.R.San.A., F.R.S.H. Senior Public Health Inspector March 1968 W.J.BAXENDALE Public Health Inspector January 1964 D.F.CORFIELD Public Health Inspector June 1964 D.HITCHCOCK, M.A.P.H.I., M.R.S.H. Public Health Inspector November 1967 B.L.NUNN Public Health Inspector April 1968 G.L.PAGE, D.M.A., M.A.P.H.I., M.R.S.H. Public Health Inspector July 1968 B.J.DAWSON Public Health Inspector February 1969 M.C.J.ELKINGTON, M.A.P.H.I. Public Health Inspector February 1969 A. BATES, D.M.S., A.I.Sc.B., A.M.B.I.M., M.A.P.H.I. Public Health Inspector April 1971 W.G.SMITH, M.A.P.H.I. Public Health Inspector May 1972 D.T.W. FREEMAN Technical Assistant March 1968 P.J.FOX Technical Assistant June 1972 P.W.KERRIDGE, L.M.R.S.H. Technical Assistant July 1972 C.E.W.EASTMAN, L.M.R.S.H. Technical Assistant September 1972 MEAT INSPECTION STAFF W.R.LEE, M.lnst.M., M.A.P.H.I. Chief Meat Inspector July 1930 W.L.MORRIS, M.lnst.M., M.A.P.H.I. Deputy Chief Meat Inspector September 1946 K.S.SEYMOUR, M.lnst.M., M.A.P.H.I., M.A.M.I. Senior Meat Inspector July 1935 J.C.WILSON, M.lnst.M., M.A.M.I. Senior Meat Inspector January 1936 H.C.FIELD, M.A.P.H.I. Senior Meat Inspector August 1954 J.T.COX, M.A.P.H.I. Meat Inspector August 1954 G.GINGELL, A.R.S.H., M.lnst.M., M.A.P.H.I. Meat Inspector August 1954 B.G.F.PAYNE, D.F.C., M.A.P.H.I Meat Inspector December 1960 F.E.ELSEY, M.A.P.H.I. Meat Inspector January 1964 P.E.P.POVEY, M.A.P.H.I. Meat Inspector May 1971 1 Vacancy Meat Inspector 1 Vacancy Technical Assistant (Authorised) R.HUDSON Senior Porter May 1963 5 Commenced Service HEALTH AND WELFARE SECTION Miss G.L.BENFIELD, S.R.N., S.C.M., H.V., Nursing Admin., P.H. Cert., M.R.S.H. Principal Health and Welfare Officer April 1965 Miss M.T.DOWD, R.F.N., S.R.N., H.V. Health and Welfare Officer March 1967 Mrs. E.A.DIEPPE, S.R.N., H.V. Health and Welfare Officer July 1972 Mrs. L.ASHKEN, S.R.N., H.V. Health and Welfare Officer September 1972 Mrs. P.A.MIMMS, R.D.S.A. Clerk/Dental Surgery Assistant September 1965 R.JONES, M.Ch.S., M.C.S.P. Chiropodist (Part-time) April 1969 Mrs. M.GRAHAM, S.R.Ch., Ch.S. Chiropodist (Part-time) March 1971 10 Home Helps 1 Cook DISEASES OF ANIMALS ACT G.S.WIGGINS, M.R.C.V.S., F.R.S.H. Veterinary Officer October 1964 J.A.MORRIS, M.R.C.V.S. Veterinary Officer (Part-time) April 1967 R.J.HAYHURST, D.F.C. Senior Inspector October 1964 K.W.KING, A.M.R.S.H. Inspector April 1966 V.O.GUBBINS Inspector (Part-time) April 1965 RODENT STAFF G.A.MASON Foreman Rodent Operative December 1946 P.M.BERRY Rodent Operative June 1967 J.PEGRAM Rodent Operative September 1967 R.C.HARRIS Rodent Operative December 1967 F.H.PRIEST Rodent Operative March 1969 G.A.CROMPTON Rodent Operative May 1971 MORTUARY AND DISINFECTING STATION F.H.LAWRENCE Superintendent of the City Mortuary and Disinfecting Station May 1936 J.W.T.SUNNICK Senior Disinfector and Mortuary Attendant May 1950 MANUAL WORKERS W.T.STEELE (General Duties at Mortuary) August 1958 T.H.POLLEY (General Duties at Mortuary) February 1970 E.A.HIGLEY (General Duties at Smithfield Market) September 1967 Mrs. M.M.SHEEHAN (Bath Attendant and Cleaner) October 1962 G.W.JACOBS (General Duties at Mortuary) December 1966 W.H.DALTON (General Duties at Smithfield Market) May 1970 A.J.FREW (General Duties at Smithfield Market) November 1970 G.BARBER (General Duties at Smithfield Market) March 1971 E.G.HIGLEY (General Duties at Smithfield Market) October 1972 6 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1972 To the Right Honourable The Lord Mayor, Aldermen and Commons of the City of London in Common Council assembled. GUILDHALL, E.C.2. Telephone: 01-606 3030 My Lord Mayor, Ladies and Gentlemen, I have the honour to submit the following report on the work of the Department for the year ending 31st December, 1972. During the year every endeavour has been made to increase the number of inspections of premises under the Offices, Shops and Railway Premises Act, 1963. Continued efforts have also been made to further reduce the atmospheric pollution of the City. Noise, mostly due to development work, has continued to cause annoyance and distress to both resident and day time workers. This is a problem which has been vigorously tackled by your Officers both during normal working hours, at weekends and at night. The medical and nursing staff of St. Bartholomew's Hospital have continued to be most cooperative and helpful. I am most grateful to all those who have contributed to the work of the Department during the year, especially the Chairman and members of the Port and City of London Health and Social Services Committees and the staff of the Department. I have the honour to be, My Lord Mayor, Ladies and Gentlemen, Your obedient Servant, W.G. SWANN, M.D., B.Sc., Medical Officer of Health, Port and City of London. 7 HOUSING Housing Acts 1. Number of houses which on inspection were considered to be unfit for human habitation:- 2 2. Number of houses in which defects were remedied in consequence of informal action by the Local Authority or their Officers:- 2 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:- NIL NIL 4. Number of notices served during the execution of works:- NIL 5. Number of houses which were rendered fit after service of formal notices:- 1 6. Number of demolition or closing orders made:- NIL 7. Number of houses in respect of which an undertaking was accepted under subsection (4) of section 16 of the Housing Act, 1957:- NIL 8. Number of houses demolished:- 1 9. Number of inspections and reinspections of housing accommodation:- 54 The Corporation has the duty to carry out from time to time inspections of the housing accommodation in their area to establish a programme regarding unfit houses. The Housing Acts, 1957-1969, make provision for the clearance of unfit houses, either individually or as clearance areas, and in appropriate casesmakeprovision to secure the improvement to present-day standards, again either individually or collectively, of housing which although structurally sound, lacks modern amenities. Grants are available as of right or at the local authority's discretion to enable owners to carry out such improvements. During the year under review the Inspectorate have again been active as regards privately occupied housing accommodation in the City. Most of this accommodation is provided as part of or in association with employment; for example, Managers' flats, Directors' suites and Caretakers' accommodation. By and large this accommodation is in good order, as are the small number of private blocks of flats which exist, mainly in the area abutting the Law Courts and Temple. However, as in previous years a few dwellings have been found which were considered to be unfit for human habitation. These were mainly occupied by persons who require some form of geriatric care. This seems to be a well-established pattern and it may well be that the Corporation will have to consider whether they have sufficient accommodation of a type suitable for rehousing such displaced persons. During the year, 27 inspections were made, necessitating 27 re-inspections. In two instances defects were remedied informally, and an undertaking as regards works to be carried out was received in respect of another of these premises. In a fourth case, formal notice was served requiring the execution of works. At the end of the year there were four houses which were unfit but it is proposed to take action in respect of these early in the new year and reports have been submitted to the Housing Committee in respect of three of them. 8 Housing Act, 1957, Part II - Individual Houses On routine inspections two houses were found to be unfit and because of the amount of work required both were considered incapable of being rendered fit at reasonable cost. One of these is owned by the Bridge House Estates and steps are being taken to re-house the tenant concerned. As regards the other, the appropriate notices have been served and a decision is due to be taken early in the New Year, after an opportunity has been given to the owners of the premises to make representations to the Housing Committee. The Housing Department during the latter part of 1972 re-housed the tenant from the property declared unfit in 1970, which is owned by the City Corporation and the Planning and Communications Committee has arranged for the house to be closed pending its demolition when the area is subsequently redeveloped. Housing Act, 1957, Part III — Clearance Area, Fleet Lane After protracted but abortive negotiations between the Comptroller and City Solicitor's Department and the owners of the property contained in the clearance area, the Secretary of State for the Environment arranged for a local Public Inquiry, which was held on 20th April, 1972. At the Inquiry the fact that the houses were unfit was not disputed, but it was vigorously contended that the method chosen by the Corporation, of making a clearance and a compulsory purchase order to deal with the properties, was not the best and it was inferred that the decision of the Corporation had been in part motivated in order to obtain land for road-widening at cheaperthan-market price. This imputation was far from the truth. In any event, fears of this Department regarding nuisances occurring afterthe premises were closed and the dangers of illegal occupancy were not sufficient to influence the Secretary of State, and in a letter dated 31st July, 1972, he quashed the orders but expressed the hope that the "owners would take effective steps to prevent illegal occupancy of the premises and to give serious consideration to improving the decorative state of the front elevation". The Minister's Inspector felt that the dwellings could be dealt with by a Closing Order and towards the end of 1972 this matter was again reported to the Housing Committee and a deoision is due to be taken early in 1973 after representations have been received from the owners of the property. The following report has been received from the Housing Manager:- "During the year 224 families were rehoused leaving 646 families on the housing register at the end of December 1972 which included 238 tenants who required more suitable accommodation. The second stage of the Middlesex Street Estate redevelopment was completed in the early part of the year and provided 80 units of accommodation in Petticoat Tower. The final stage of the redevelopment is under construction and good progress is being made. The estate, when completed will provide a shopping and residential precinct of 181 flats and 38 shops with parking and garage facilities at lower levels. The construction of the Old People's Unit comprising 60 units of accommodation, and 30 family residential units on the site of Otto House, Sydenham Hill progressed satisfactorily and the accommodation is programmed for occupation during the summer of 1973. The fourth and final stage of the redevelopment of the Holloway Estate having been approved will provide, when built, 64 flats on the site between Camden Road and Parkhurst Road of which 52 flats will be for Corporation use and 12 ground floor flats will be let to John Groom's Association for the Disabled on terms agreed. These are designed to meet the special needs of disabled people. It is anticipated that building works will commence towards the end of 1973. The appropriation of those properties in the Kennington Road which were formerly part of the Bridge House Estate was finalised and the properties transferred to the management of the Housing Committee to facilitate the development of the site bounded by Kennington Road, Hercules Road and Cosser Street. The redevelopment, as approved, will provide 98 units of accommodation and 9 shops with Blake House being retained on the Hercules Road frontage. Of the 2,100 flats and houses in the Barbican residential development approximately 1,000 have been completed, 300 of these during the year, including the four hundred feet high Cromwell Tower which is now being let. There are now about 1,500 residents in Barbican. The Barbican Hostel is now fully occupied, providing accommodation for 200 students and young people. Work on the excavation and foundations of the Arts Centre is well under way." 9 EXAMINATION OF WATER SUPPLIES The Corporation of London exercise their functions with regard to water supply under the Public Health Acts, 1936 and 1961, and the Water Acts of 1945, 1948 and 1955. There is also a provision in the Offices, Shops and Railway Premises Act, 1963, which requires all employers of shop and office workers to ensure that there is available to their staff an adequate supply of wholesome drinking water. In the City there are two sources of water supply:- (1) From the statutory water undertaker, which in the case of the City is the Metropolitan Water Board. (2) From deep wells which supply water to private premises within the City. There are 108 such wells in use, a reduction of six as compared with the previous year, and they serve 52 premises. The Metropolitan Water Board supply is usually safe, potable and wholesome at the point of delivery to premises, but owing to storage conditions within the premises and other matters over which the Board has no control the water can become contaminated. Observations, investigations and sampling have been carried out by the Public Health Inspector responsible for this aspect of environmental health in order to ensure that the water supply within all City premises is wholesome and potable. The water samples which have been taken for bacteriological examination fall into the following categories:- Metroplitan Water Board Supply (1) Water from drinking-water points 72 (2) Water used in food-preparation premises 42 (3) Water from storage tanks 5 Deep Well Supply (1) Water from drinking-water points 14 (2) Water from well risers 17 (3) Water used in food-preparation premises 8 (4) Water from storage tanks 3 The water from the bore holes of the private wells comes from the London Basin, where it collects in a hard grey chalk stratum which is protected from contamination by an impervious stratum. The former stratum lies between 200 to 600 feet below ground-level. The water that it yields is satisfactory in quality and quantity, contains some natural fluorine, and is non-plumbosolvent with a total hardness of about 325 ppm. It is very unusual to find an adverse bacteriological report on water abstracted from the well risers. The sterilisation of this water is carried out by means of liquid chlorine, which is introduced in the system so as to produce not less than 0.1 ppm. If this form of sterilisation is increased there may be taste complaints. These usually occur at about 0.4ppm. Some supplies are, however, sterilised by the ultra-violet light method. The chalk stratum is rich in iron hydroxides which can sometimes be seen in the water as a rusty discolouration. This can easily be eliminated by the use of diatomacious filters, which have been fitted in some premises. Swimming Baths It is also the duty of the City Corporation to ascertain the purity of swimming bath water within its area. There are three such pools in the City. These are visited weekly while the baths are in use. Bacteriological samples are taken from the inlet and outlet. Combined residual and free-chlorine are ascertained and the pH value is also taken. The total number of such samples taken during the year was 475. The following table shows details of bacteriological examinations of drinking water supplies and swimming bath water. 10 Number of Samples Number of Samples giving results above 0 per giving plate counts above Source of Supply Number of Samples 1 00 mis. 0 Cols/ml after 24 hours Coliform Bact. Coli. at 37°c. Count (Type 1) 1. Deep wells within the City area 42 1 — 15 2. Metropolitan Water Board 119 1 1 88 3. Swimming Pools within the City 95 — — 19 TOTAL 256 2 1 122 Three samples were unsatisfactory. In each case an investigation was carried out immediately and appropriate measures taken to eliminate the source of contamination. Subsequent samples taken from the same premises proved to be satisfactory. The Director of Water Examination of the Metropolitan Water Board has supplied the following Report:- "1.(a) The supply was satisfactory both as to (i) quality, and (ii) quantity throughout 1972. (b) All new and repaired mains are disinfected with chlorine; after a predetermined period of contact the pipes are flushed out and refilled; samples of water are then collected from these treated mains; and the mains are returned to service only after the analytical results are found to be satisfactory. The quality control from these laboratories is carried out by means of daily sampling from sources of supply, from the treatment works or well stations, from the distribution system, and through to the consumer. Any sign of contamination or any other abnormality is immediately investigated. (c) (i) The Board has no record of the number of structurally separate dwellings supplied in your area, but the population supplied direct according to the Registrar-General's estimates at 30th June, 1972, was 4,449. (ii) No houses were permanently supplied by stand-pipe. (d) No artificial fluoride is being added, and where the fluoride content is indicated in the analyses it represents the naturally occurring fluoride in the water. 2.(a) The supply was derived from the following works and pumping stations:- River Thames-derived water from Thames Valley grouped stations. New River-derived water from Stoke Newington works. No new sources of supply were instituted and there were no changes to the general scheme of supply in your area. The number of samples collected and the bacteriological and chemical analyses of the supply from the above sources after treatment are shown on the attached sheets. (b) On account of their hardness content and alkaline reaction the Board's river and well water supplies are shown to be not plumbo-solvent. It should, however, be appreciated that all types of water pick up varying amounts of metal from the material of water piping particularly when it is newly installed; this applies to copper, zinc, iron and also to lead." 11 METROPOLITAN WATER BOARD - WATER EXAMINATION DEPARTMENT AVERAGE RESULTS OF THE CHEMICAL EXAMINATION OF WATER SUPPLIED TO THE CORPORATION OF LONDON FOR 1972 Milligrammes per litre (unless otherwise stated) Description of the Samples Number of Samples Ammoniacal Nitrogen Albuminoid Nitrogen Nitrate Nitrogen Oxygen abs. from KMn04 4 hrs. at 27ºC. B.O.D. 5 days at 20°C. Hardness (total) CaC03 Hardness (noncarbonate) CaC03 Magnesium as Mg Sodiurr as Na Potassium as K Chloride as CI Phosphate as P04 Silicate as Si02 Sulphate as S04 Natural Fluoride as F Surfaceactive material as ManoxoI OT Turbidity units Colour (Burgess units) PH value Electrical Conductivity (micromhos) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) Stoke Newington 52 0.020 0.055 7.8 0.70 - 308 78 5.5 28.8 5.1 41 2.2 10 52 0.15 0.002 0.1 9 7.9 650 River Thames derived 364 0.031 0.069 6.9 1.06 - 274 82 5 24.5 5.5 35 2.8 10 58 0.15 0.02 0.1 13 7.9 570 BACTERIOLOGICAL RESULTS - YEARLY AVERAGES, 1972 WATER SUPPLIED TO THE CORPORATION OF LONDON Sources of Supply BEFORE TREATMENT AFTER TREATMENT Agar plate count per ml. Coliform count Escherichia coli count Agar plate count per ml. Coliform E.coli count Number of Samples 20-24 hours at 37°C. 3 days at 22°C. Per cent samples negative in 100 ml. Count per 100 ml. Per cent samples negative In 100 ml. Count per 100 ml. Number of Samples 20-24 hours at 37°C. 3 days at 22°C. Per cent samples negative in 100 ml. Per cent samples negative in 100 ml. Stoke Newington 753 47.5 67.07 2.6 81.81 0.5 255 28.1 100.0 100.0 River Thames— derived 8,087 42.3 41.94 10.2 56.76 4.0 3,891 10.0 99.85 99.97 12 SEWERAGE AND SEWAGE DISPOSAL Sewerage and sewage disposal in the City of London are the responsibility of the City Engineer who has supplied the following information:- "The sewerage system in the City is comprised mainly of ovoid shaped brick sewers, the average internal dimensions being 1219mm x 813mm wide, this size being adopted only to provide access for sewerman, as the normal dry weather flow depth of effluent is only about 228 mm at an average velocity of 609 to 914 mm per second. The Corporation sewers discharge into the Greater London Council intercepting sewers which flow eastwards across the City at a much lower depth to their Beckton Sewage Treatment Works. In my opinion, the system of sewerage in the City is adequate, with ample margin for diverting flows from sewers during reconstruction and maintenance works." NOISE No Medical Officer of Health with responsibilities in the Inner London area can view with equanimity the bitterness and persistence associated with complaints about noise. The complaints arise from noise being created throughout the twenty-four hours of a day, and this implies that staff must be available to investigate trouble during normal working hours and, due to the noise predominately occurring during people's leisure hours, at night time and on Saturdays and Sundays. Day-time noise interferes with commerce, and in many instances the building industry have co-operated in carrying out their noisy work before 10.00 a.m. and not starting again until after 4.00 p.m. As a compensating factor they wish to work on Saturdays and Sundays or later than normal in the evening, but this again intrudes on residents' leisure and sleeping time and naturally there is great resentment on their part. It follows, therefore, that developers and their architects must give much more thought in the planning stage to meeting these problems before they arise. It is rather futile to dismiss such considerations as of no consequence because their noise will last only two or three months. Some other noise will inevitably follow in an area like the City, where the processes of demolition and reconstruction seem to be continuous. Inthese days,when more and more mechanical equipment is installed in buildings-ventilating fans and motors, standby generators and the like - great care must be exercised when these are installed in the upper floors that such equipment will not create such noise as will intrude above the ambient night-time noise levels. Often there has been criticism from the complainants of the apparent ineffectiveness of the nuisance procedure under the Noise Abatement Act for dealing with their complaint rapidly. The built-in defence for the offender of having adopted the best practical means of eliminating the noise does not necessarily mean that the noise will cease or be effectively reduced, should the offender convince the courts in this direction. In cases such as this the complainants may be worse off than they would have been if the staff of the Department had been left to negotiate with the noise-maker. There may be good grounds for rethinking the law of Noise Abatement. The most difficult complaints to handle effectively are those from unduly sensitive people, and these usually arise from low-level noise, in terms of decibels, but which apparently causes distress to such people by its quality, particularly when they are trying to sleep. Often the complainant is very unahppy with the inspector investigating the matter and feels that the latter is prejudiced, even when there is full discussion of the instrument readings. The sources of such "noises" are often difficult to isolate, and, even when isolated and corrective measures taken, the complainant is not always convinced. This may be the time when an independent consultant should be used, subject to some prior arrangement over the fees involved. During the year proposals were received to establish a heliport on the river off the north shore between Blackfriars Bridge and London Bridge. Such proposals should be viewed with some misgivings, since the noise from aircraft can be very intrusive. Furthermore, this area will be subject to some extensive redevelopment to improve the amenities, including the re-siting of the City of London School on the banks of the Thames. During the year great annoyance and distress was caused to some of the occupiers of the Sarbican Estate by the construction techniques adopted on the Arts Centre. Without arguing the technical merits of diaphragm walling, it is a system which, it was alleged, must be continuous and, once started, could not be stopped at the end of a normal working day. Working throughout the night with noisy machinery made life unbearable for a number of people. It does seem that we must view with scepticism the rash claims often advanced that equipment or work procedures cannot be modified. It may be the will is lacking. 13 In the report on "Neighbourhood Noise" from the working group of the Noise Advisory Council a number of useful recommendations are made to enable local authorities to come to grips more effectively with what is a frustrating problem as far as the public are concerned and the group trust their proposals will receive the support of the public. There seems to be very little doubt on this score. There is also little doubt that, if their proposals are implemented, as they surely must be, health departments will shoulder further responsibilities to preserve the quality of our public and private life. During the year under review 177 complaints were received, involving 928 re-visits. COMMON LODGING HOUSE It was revealed in the national press during the year under review that a reporter had stayed for one night at the registered Common Lodging House in Middlesex Street, E.1., which is run by the Salvation Army. Although the conditions described related to a visit during the previous year and because of the writings of this particular journalist the problems of the down-and-outs were once again highlighted. The levels of infestation found during early-morning inspections still show that lice present a major source of concern, notwithstanding the fact that during the year there was a considerable improvement in the numbers of men reporting to the cleansing station - an increase which reflects both the response to the Public Health Inspector's pressures and persuasions and the greater willingness of men to attend at the cleansing station of their own volition. Beds Average Infest- Total No. of Inspected Verminous aiion Rate Persons Cleansed 1971 6,216 561 9.0% 1,094 1972 4,364 404 9.2% 1,233 One film show and lecture was given by the Public Health Inspector during the year, which gave information about the life cycle of lice and the preventive measures that need to be taken in order to keep the problem under control. It is hoped that this kind of service can be repeated during the forthcoming year to a wider audience. There is still a surprising amount of ignorance about the nature and origins of lice. Some people still believe that they actually grow from human beings. In normal circumstances the life cycle of the louse can be broken, making its propagation impossible, by various domestic habits and processes, such as changing into night clothes, regular bathing and washing of hair, laundering of clothes and ironing. These measures contribute towards the prevention of the spread of this parasite, which requires warmth and human blood in order that the species may breed. In closely-knit communities where all the occupants do not carry out these domestic chores, lice can breed at an alarming rate and can spread to nearly all the occupants of the building. Towards the end of the year the Salvation Army submitted proposals for improving the Common Lodging House. These proposals included the reduction of overcrowding by removing a total of thirteen beds from three of the more crowded dormitories, the repair of certain structural defects, the maintenance of a constant supply of hot water to wash-hand basins, the construction of additional sanitary accommodation to serve the fourth and fifth floors, and the provision of showers in the basement. During the year, as a result of consultation with the District Surveyor, considerable improvement has been effected in safety standards and in the means of escape in case of fire. 14 OFFICES, SHOPS AND RAILWAY PREMISES ACT, 1963 During the year 10,654 visits were made to offices within the City. This total number is made up of general inspections and subsequent inspections. The number of general inspections alone which were carried out during the year was 2,936. In the course of routine general inspections throughout the City it is surprising tofind that, almost ten years after the passing of the Act, there are still some employers, opening offices in the City, who appear to be unaware of their obligation to register their premises. In every case where these premises are discovered registration is effected immediately. During the year 630 new offices were registered and 543 were removed from the register. These new registrations, together with deletions due to removals and demolition of buildings, change-over of occupants, and large-scale office developments, mean that a considerable amount of time and effort is expended merely on statistical inspections and debit and credit bookkeeping. It is in fact questionable whether existing staff is sufficient to guarantee effective coverage of the whole of the City at reasonably frequest intervals. The number of new offices alone is posing an increasing problem for the manpower resources available. For instance, during the year to 31st December, 1971, there were 389 new registrations and 363 removals from the register, with a net gain in new offices of 26. That is, of all registrations in 1971, 7% were entirely new additions to the total. During the current year there were 630 new registrations and 543 removals from the register, with a net gain in new offices of 87. That is, of all registrations in 1972, 14% were entirely new additions to the total. The trend is therefore to escalating office turnover, with activity during the current year increased by 36% and entirely new additions increased by 100%. In terms of manpower, the inspection of offices in relation to deletions, renewals and entirely new registrations effectively represents the full-time annual workload of one Inspector. So far as existing offices in the City are concerned, the scale of the problem is large and in volume it is the biggest single responsibility of the Department. One office alone involved 2,500 employees and approximately a quarter of a million square feet of office space, and since this particular office was in single occupation it was recorded as only one general inspection. The problem of ensuring an effective deployment of staff resources to the inspection of offices has meant that in the past few years the City Public Health Inspectors have been obliged to shoulder an excessive workload. During the current year, therefore, the Offices Section was reorganised. An additional Senior Public Health Inspector was appointed, who assumed complete control of the organisation and co-ordination of the work necessary to implement effectively the provisions of the Act. This has resulted in greatly increased productivity in relation to office inspections and the consequent release of some Public Health Inspectors to tackle more in-depth problems in other partially neglected spheres in the City. For instance, with the use of more effective management techniques and the employment of one additional Inspector, general inspections for the current year have increased since last year by nearly 50% - that is, from approximately two thousand in 1971 to approximately three thousand in 1972. It is interesting to review the annual number of general inspections of offices carried out in the City since the Act came into force in 1963 and to note the trend of ever-increasing annual inspections. The following time series says much for the efforts of the Inspectors concerned. The trend upswing is considerably in excess of the proportional increase in available staff who were engaged in this work. 15 TIME SERIES SHOWING ANNUAL NUMBER OF GENERAL OFFICE INSPECTIONS Since the Act relates to the working conditions of employees, the approximate number of persons who benefited from office inspections during the year is in excess of 148,000. Of these, some 107,000 benefited indirectly from general inspections and as a result of verbal intimations and comments relating to deficiencies, most of which were remedied either immediately or within a few days. Of the remainder, 28,000 benefited directly owing to more formal action by the Department and the subsequent improvement of conditions following written representation. The table below shows the number of written intimations which have been sent during the course of the year. 16 SUMMARY OF DEFECTS FOUND AND NOTICES SENT 1. Cleanliness — Dirty conditions 275 Accumulations of Refuse 2 2. Overcrowding 11 3. Temperature — Unreasonable 3 — Absence of Thermometer 105 — Absence of Warming Facilities — 4. Ventilation — Inadequate 70 5. Lighting — Inadequate 54 6. Sanitary Conveniences — Insufficient 5 — Unsatisfactory/Defective 10 — Not separate for sexes 18 7. Washing Facilities — Insufficient 1 — Unsatisfactory/Defective 26 — No Hot water 13 — Soap/Drying Facilities 4 8. Drinking Water — Inadequate supply 3 — Disposable vessels/Rinsing facilities - 9. Clothing - Inadequate accommodation 4 — Inadequate drying facilities - 10. Hoists & Lifts 162 11. Floors, - Unsound construction 62 Stairs, — Obstruct ion/slipping 60 Passages - Handrail (lack of) 29 — Protection of Openings 16 12. Machinery - Inadequate guarding 95 13. First Aid — Inadequate Provision 102 14. Information — No Handbook available 150 15. Dangerous Practices — 75 16. Miscellaneous (including letters requesting registration) 400 1,755 17 The unsatisfactory conditions which were found are segmented into varying categories. It is still unfortunately true that a high proportion of notices refer to dirty, grimy and dingy conditions relating to both daily and maintenance cleaning deficiencies. We find general indiscipline and a a lazy attitude adopted towards the maintenance of clean conditions in offices, particularly in some of the older, smaller buildings, although some of the more modern blocks are not without fault. It might therefore be of advantage to re-state the objectives and relevance of cleanliness in the office environment. For instance, what is meant by 'clean'? It could mean different things in different circumstances. A definition of cleaning would be 'the removal of soil, man-made or natural, from any surface, leaving it in a dust-free or grease-free condition'. Amongst the reasons for cleaning are: to protect health; to make safe; to make surfaces last longer; and to make them attractive. Maintenance is of tremendous importance, and with a proper repetitive schedule of cleaning many problems may be eliminated. The cleaning of the outside of office buildings in the City is a well-known feature of daily life and a valuable programme of beautification, but from a health, safety and welfare point of view it is less important than internal cleaning. One of the most valuable assets of adequate internal cleaning is its capability of reducing accidents and accident hazards. During the current year, of the 386 office accidents reported in the City, 177 involved falls of persons; and of those 177, 87 involved falls of persons on level ground. Most of those falls — either on the same level or from different levels — could be traced in many respects to lack of proper cleanliness, to litter, deposited items on the floor and to lack of floor maintenance. Regrettably, those who work as cleaners are often lowly paid and ill-trained in sophisticated cleaning techniques. If a cleaner is poorly paid, has little or no supervision, and his equipment is not properly checked or replaced when necessary, is there any wonder that poor conditions sometimes still persist? With the continuing trends to fewer and fewer 'Mrs. Mops', heavy reliance is placed on contract cleaning and the use of machinery. Particular attention should be given to the edges and corners of rooms and to the areas under and around the bases of equipment in using these machines. Increasing use is being made of all-over carpeting in office situations. Many of these floor-coverings are synthetic and demand special 'in situ' cleaning techniques. In relation to windows, a particular problem arises with some double-glazing fitments, where it is difficult or impossible to clean the internal surfaces of the installation. Effective artificial lighting, when provided, is sometimes impaired by heavy accumulations of dust and grime on the diffusers - an often-forgotten item. Good lighting plays an important part in creating a satisfactory environment in the office. A bright environment creates optimism; a gloomy environment produces a stressed frame of mind and leads to accidents. If gloomy lighting, caused by dirty conditions, is allied to dirty ceilings and walls the position is even more unsatisfactory. The percentages of light reflected from some differently coloured and textured surfaces are as follows:- Surface Percentage Reflection Matt white ceiling 70 Glossy white tiles 80 Matt white stone 58 Matt primrose wall finish 76 Matt eau-de-nil 47 Matt middle-brown 12 Matt crimson 6 Cleanliness plays an important part in maintaining a high reflection factor. A development of special interest in the City is that although accepted belief follows the line that office development in general is reducing, and that location of offices in more decentralised areas is causing a reduction in the number of office employees in the London area, precisely the opposite trend is occurring in the City. As an example: the number of new offices registered in the City last year showed a net gain of 86 and the number of persons employed in office work increased by nearly 8,000. Complementary to this trend is the fact that deletions from the register refer in general to small offices and buildings with a few employees, whilst additions are related increasingly to multi-development projects employing vastly increased numbers of workers. The tendency to high glass-slab office buildings is posing an increasing problem of overheating and glare in sunny weather conditions, together with problems of privacy from external observation. This has resulted in the technological development of glass processes designed to combat these three factors. One process is in the manufacture of the glass itself and a further process relates to the application of a film to the glass in existing window areas. Both of these systems reduce glare, reflect external heat and offer privacy. Both types have been used in the City, following complaint, and have been found satisfactory. Whilst the level of comfortable conditions has been laid down by law in relating to minimum temperatures in offices, it might now be appropriate to investigate the need for legislation setting maximum limits of temperature. 18 In general, standards in the observance by employers of their responsibilities under the Act are very high in the City. During the year the instances of exceptionally good standards have been the rule rather than the exception. Very good standards are found both in multi-storey singleoccupation blocks and in some smaller and older premises which have been internally rebuilt to quite high specifications. Instances of bad or unsatisfactory conditions are usually associated with office buildings having some external constraint or inhibitor to modernisation. These may be office buildings situated within proposed demolition or redevelopment zones. In these circumstances, where a definite undertaking is received that the premises will be vacated by a specific date in the near future it is the practice to require only cleanliness and safety measures and not to press for any structural works. The use of Section 22 of the Offices, Shops and Railway Premises Act, 1963, has been found to be of considerable value in the City, more in its implications than in its application. During the year the provisions of Section 22 of the Act were drawn to the attention of both landlords and occupiers, mainly in relation to hoists and lifts; drive shafting of ventilation plant; the ill design and abuse of stationery chutes. In all these circumstances the dangerous practices were stopped immediately. A particular problem area relates to the report by a competent person on a hoist or lift where defects are found which require immediate attention in order that the lift may be used in safety. Since a period of twenty-eight days is allowed before a copy of the report is required to be filed with the Local Authority, it is inconsistent to suggest that in these circumstances the provisions of Section 22 might be used nearly one month after the danger was discovered. This is particularly so, since, if the danger were noted during a routine visit by the Public Health Inspector it could be stopped on the day of discovery. In this connection some strengthening of legislation would be desirable. A further area where strengthening of existing powers would have been helpful is associated with the high rate of turnover of office situations within the City. Office development is predominantly on a speculative basis, although a small proportion of development is designed for specific use. In many cases the prior approval of this Department is sought. Since the Offices, Shops and Railway Premises Act is geared to both occupation and structure, approval is usually given only when facilities are at a high level in relation to the proposed or expected density of occupation. This places firms seeking approval at a financial disadvantage to those not seeking approval and allowing poor design to be shown up later during a routine inspection. In conclusion, the implementation of the Act and Regulations has proceeded at a satisfactory pace, with the introduction of more efficient methods. The City office-workers' environment has been found to be reasonably satisfactory, with predominantly more good premises than bad, although standards should progressively rise. Some strengthening of legislation is thought necessary in the correlation between Section 22 provisions of the Act and the reporting by competent persons of defects which require immediate attention. Additionally, in view of the high degree of speculative office development in the City it is felt that adequate standards regarding structure and facilities could be controlled more effectively if firms were required to obtain prior approval under the Act. 19 TABLE A REGISTRATION AND GENERAL INSPECTIONS Class of premises Number of premises newly registered during the year Total number of registered premises at end of year Number of registered premises receiving one or more general inspections during the year Offices 630 6836 2936 Retail shops 74 869 200 Wholesale shops, warehouses 23 724 50 Caiering establishments open to the public, canteens 10 535 243 Fuel storage depots NIL NIL NIL TOTALS 737 8964 3429 TABLE B NUMBER OF VISITS OF ALL KINDS (INCLUDING GENERAL INSPECTIONS) TO REGISTERED PREMISES 10968 TABLE C ANALYSIS BY WORKPLACE OF PERSONS EMPLOYED BY REGISTERED PREMISES AT END OF YEAR Class of workplace Number of persons employed Offices 277570 Retail shops 4602 Wholesale departments, warehouses 5509 Catering establishments open to the public 6447 Canteens 4581 Fuel storage depots 1 Total 298710 Total Males 179490 Total Females 119220 20 21 TABLE D-EXEMPTIONS TABLE E - PROSECUTIONS [####]M/C. Line No. Class of premises No. of exemptions current at end of year During the year M/c. Line No. Prosecutions instituted of which the hearing was completed in the year No. of exemptions No. of applications Appeals to Court against refusal to grant or extend an exemption or against the withdrawal of an exemption newly granted extended expired or withdrawn refused opposed by employees Section of Act or title of Regulations or Order No. of informations laid No. of informations leading to a conviction No. made No. allowed (1) (2) (3) (4) (5) (6) (7) (8) (9) (1) (2) (3)[/####] 1 Offices 1 Part 1 - Space (sec. 5(2) 1 1 7 (1) 1 1 2 Retail shops 2 3 Wholesale shops, warehouses 3 4 Catering establishments open to public, canteens 4 5 Fuel storage depots 5 Part II — Temperature (sec. 6) 11 Offices 11 12 Retail shops 12 13 Wholesale shops, warehouses 13 14 Catering establishments open to the public, canteens 14 No. of persons or companies prosecuted 1 15 Fuel storage depots 15 No of complaints (or summary NIL Part III — Sanitary Conveniences (sec. 9) No. of interim orders granted NIL 21 Offices 21 TABLE F- STAFF 22 Retail shops 22 23 Wholesale shops, warehouses NIL 23 24 Catering establishments open to public, canteens 24 No. of inspectors appointed under section 52(1) or (5) of the Act... 5 full time 25 Fuel storage depots 25 Part IV — Washing Facilities (sec. 10(1) ) 13 part time 31 Offices 31 No. of other staff employed for most of their time on work in connection with the Act 2 32 Retail shops 32 33 Wholesale shops, warehouses NIL 33 34 Catering establishments open to the public, canteens 34 35 Fuel storage depots 35 SHOPS ACT, 1950 Arrangements for the health and comfort of those shop workers not included in the Offices, Shops and Railway Premises Act, 1963, are covered by the Shops Act, 1950. These arrangements make provision for: Seating for female workers Ventilation Heating Lighting Sanitary accommodation Washing facilities Facilities for taking meals During the current year 224 inspections of such shops were carried out by Public Health Inspectors, when infringements were noted concerning the following matters:- Ventilation Heating Lighting Sanitary and washing facilities These infringements were of a major nature and official representation and remedial action have been instituted. HYGIENE IN HAIRDRESSING AND BARBERS SHOPS Section 77 of the Public Health Act, 1961, empowers local authorities to make Byelaws dealing with hygienic conditions in Hairdressers' and Barbers' shops. During the year 11 inspections were made. The Greater London Council (General Powers) Act, 1967 requires all persons who wish to carry on the business of a hairdresser or barber to be registered in respect of their premises. During the year 7 hairdressers and barbers were so registered and 2discontinued their business bringing the total on the Register to 74. FACTORIES ACT 1961 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 Occupiers prosecuted (i) Factories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities 68 157 28 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 501 27 8 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 179 62 6 - TOTAL 748 246 42 - 22 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 Found Remedied Referred To H.M. Inspector by H.M. Inspector Want of cleanliness (S.I.) 8 8 Overcrowding (S.2.) Unreasonable temperature (S.3.) 5 5 Inadequate ventilation (S.4.) 8 8 Ineffective drainage of floors (S.6.) 6 6 Sanitary Conveniences (S.7.) (a) insufficient 1 1 (b) unsuitable or defective 20 18 4 4 (c) not separate for sexes 4 4 Other offences against the Act (not including offences relating to Outwork) 1 1 1 1 TOTAL 53 51 5 5 Part VIII of the Act Outwork (Sections 133 and 134) Section 133 Section 134 Nature of work No. of outworkers in August list required by Section 133 (1) (c) No. of cases of default in sending lists to the Council No. of prosections for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions 1 2 3 4 5 6 7 Wearing apparel (Making, etc.) 152 - - - - - TOTAL 152 - - - - - Outwork and the inspection of outworkers' premises etc. Lists received from City Firms employing outworkers 19 Names and addresses of City outworkers received from other Authorities 11 Names and addresses of outworkers resident outside the City, employed by City firms transmitted to other Authorities. 152 No case of infectious diseases was reported in connection with outworkers' premises in the City. SANITARY CIRCUMSTANCES The general sanitary supervision has been maintained and in this connection 19,110 inspections have been made. As a consequence of these inspections, it was necessary to serve 1,563 Intimation Notices. Tenement Houses were inspected and the only common lodging house in the City was kept under regular supervision. 23 ATMOSPHERIC POLLUTION CITY OF LONDON (VARIOUS POWERS) ACT, 1954 CITY OF LONDON (VARIOUS POWERS) ACT, 1971 CLEAN AIR ACT, 1956 CLEAN AIR ACT, 1968 CHIMNEY HEIGHT REGULATIONS, 1969 CLEAN AIR (EMISSION OF GRIT AND DUST FURNACES) REGULATIONS, 1970 Atmospheric pollution legislation is contained in the above-mentioned Acts and subsequent Regulations and Orders. Work connected with this legislation has resulted in a total of 2,560 visits being made during the year and included the following: Clean Air Acts — Initial Inspections 555 Clean Air Acts — Re-Inspections 81 Clean Air Acts — Smoke observations 527 Smoke contraventions 50 Verbal intimations 43 Notices served 36 Notices complied with 31 Number of complaints dealt with 67 Clean Air Acts — Visits to obtain essential information 121 City of London (Various Powers) Act, 1971 Visits to obtain essential information 430 Clean Air Acts Chimney Height — Number of applications received 19 Number of visits in connection with volumetric survey 625 Sulphur Oxides On the first of January, 1972, the City of London (Various Powers) Act, 1971, came into operation, placing the City in the unique position, in Britain, of having statutory powers to deal with the emission of sulphurous gases from chimneys. It is commonly known that sulphur dioxide concentration in this area has caused some concern and when this form of pollution seemed to be lessening in the British Isles generally by as much as 20% and in Greater London by as much as 10% during the last five years, the level of concentration in the City has increased. Sulphur gases are serious pollutants of the atmosphere and in some forms attack building materials and stonework, damage vegetation, and can adversely affect the health of many people. Over the years much time and energy has been devoted to the removal or neutralizing of sulphur compounds from flue gases resulting from the burning of various types of fuel, but formany reasons no one method has proved to be the final answer. The City Corporation felt that the answer was to avoid burning fuels which had a high sulphur content. The legislation proposed by the City of London received sympathetic consideration as Parliament felt the Corporation had a special case for the following reasons:- (a) Rapid redevelopment of the area. (b) Larger quantities of fuel used for heating because of the increase in the capacity of new office buildings. (c) Rise in the comfort level provided for occupiers of offices. (d) Topographical configuration of city buildings does not allow for rapid dispersal of flue gases. (e) Chimney heights are comparatively low. Therefore, a reduction of pollution at source was desirable, as that would lead to a reduction of SO2 concentration in the vicinity of the City. The legislation therefore required that furnaces burning fuel oil of more than 1% sulphur content by weight must, within the next fifteen years, change to a fuel oil of less than 1% sulphur content. All new oil burning appliances installed within that period will be required to burn such a fuel forthwith. In practice, it is often more economical to change over at an early stage for the following reasons:- (a) There is a reduction in maintenance costs. (b) Electricity for pre-heating the heavier oils is not required. (c) Plant corrosion is reduced. 24 Some firms who have already made the alterations to their plant claim that they have lowered the overall cost of their heating requirements, although mild winter conditions could account for some of this. In order to effectively bring the Act into operation it was found necessary to commence field work in the following manner:- (1) To carry out a survey of all premises to ascertain fuel usage and type, the capacity of the furnace and other relevant matters. (2) To increase the monitoring facilities of particulate matter and SO2. This is at present being carried out in two ways:- (a) By the installation of additional standard volumetric samplers; and (b) By careful observation of weather conditions, particularly periods of temperature inversion. The facts so obtained are now correlated and an enlightening picture is beginning to form. It is necessary to know the amount and nature of the emissions in question, the initial and local aerodynamic influences on the movement and dispersion of the effluent plume, and the subsequent dispersion in the atmosphere as a whole. Meteorological considerations enter into some of these factors. It has been found that the work concerned with this survey is time-consuming and that the full facts of the case will not be known for some time to come, but the results so far are encouraging and would suggest that there has already been some reduction of S02 pollution. Because of the additional responsibilities placed on the Department to implement the provisions of this Act and other Clean Air legislation, some of which commenced on January 1st, a specialist section was set up, dealing, among other things, with the monitoring of sulphur dioxide levels, the survey of boiler plants, the observation of weather conditions, the consideration of proposed chimney heights, detection of smoke nuisance from premises and demolition and reconstruction sites, the ascertainment of boiler efficiencies for the purpose of eliminating soot and acid smuts, and the giving of technical advice about fuels and the operation of plant. Two of the staff were placed on this work in a full-time capacity and other Inspectors devote part of their time to these duties. Much of the work carried out by this section is of a routine nature and, as such, can be planned to give the maximum effect for the furtherance of environmental pollution control. It will be appreciated that although this work is organised on a routine basis specialised technical skill is required. One factor is that the City was the first local authority in Britain to obtain legislation for controlling sulphur in fuel oil, so that practical work carried out in this field is entirely new and there is little experience to draw upon. Chimney Height, Section 6, Clean Air Act, 1968 During the year, 19 applications for the approval of chimney height were received and considered. These applications dealt exclusively with furnaces and chimneys that were renewed or altered in existing premises. Prior consultation was encouraged between the Applicant, the Planning Officer and this Department. This avoided duplication of applications and ensured a common policy between departments. The Chimney Height Memorandum provides a workable minimum limit to the height of chimneys and ensures that, together with the provisions of the Clean Air Act, 1968, the chimney height is taken to such a height as to disperse the flue gases with a minimum nuisance to the surrounding locality. Correctly placed chimneys can help to minimise ground-level concentration of sulphur dioxide and other unpleasant and noxious flue gases. When investigating these applications considerations must be given to:- (a) the purpose of the chimney; (b) the position and description of buildings near it; (c) the levels of the neighbouring ground; (d) any other matter requiring consideration in the circumstances. An interesting facet of this problem is that of gas-fired installations which have a fandiluted flue. The reason for this method of discharge of the products of combustion is that the flue gases are discharged in a diluted condition at low level and allegedly obviate the necessity of a costly chimney. Although there is little sulphur-dioxide pollution from this source, there are other offensive gases that may be emitted. Owing to the congested conditions prevailing in the City, it is felt that this kind of discharge is undesirable, and the outlets are now required to be taken to a more realistic height. 25 Bonfires — City of London (Various Powers) Act, 1954, amended by City of London (Various Powers) Act, 1971 The situation concerning fires burnt on demolition and reconstruction sites has improved as action can now be taken by virtue of the above-mentioned Acts. Two prosecutions were taken against demolition contractors burning debris that produced smoke. Both were successful. Measurement of Atmospheric Pollution These measurements have continued throughout the year at two stations; a third station was brought into use in March 1972, which monitors particulate matter and sulphur dioxide and is situated in one of the City's high flats. Its situation is of a temporary nature and results are now being compared with that of the permanent stations. Samples of rainwater and various pollutants are collected once a month in a standard deposit gauge situated on the roof of the Guildhall. These samples are submitted to the Corporation's Public Analyst and the resultant analysis returned to the Health Department. The following tables express the results of these analyses and daily concentration of smoke and sulphur dioxide for 1972:- TABLE 1 RAINFALL COLLECTED IN THE DEPOSIT GAUGE AT GUILDHALL FOR THE YEAR 1972. * MONTH M/M PER DAY RETAINED WATER LITRES P.H. January 1.62 3.7 5.2 February 1.78 3.8 5.2 March 1.48 3.7 5.2 April 1.80 3.3 5.4 May 0.72 1.7 6.8 June 0.77 1.8 6.8 July 0.89 1.9 7.2 August 0.27 0.6 6.6 September 0.43 1.0 4.6 October 0.13 0.3 4.8 November - 1.1 4.2 December 1.09 2.0 3.8 26 TABLE II ANALYSIS OF DEPOSITED MATTER IN RAINFALL COLLECTED AT GUILDHALL FOR THE YEAR 1972. TOTAL UNDISSOLVED MATTER ASH TOTAL DISSOLVED MATTER TOTAL SOLIDS CA2 + S042 CL MONTH G Deposit MG/M2D G Deposit MG/M2D G Deposit MG/M2D G Deposit MG/M2D G Deposit MG/M2D G Deposit MG/M2D G Deposit MG/M2D January 0.2731 120 0.1480 65 0.6094 267 0.8825 387 0.872 38 0.2260 99 0.0270 12 February 0.3010 141 0.1403 66 0.4954 232 0.7964 373 0.0793 37 .0.3290 154 0.0372 17 March 0.4836 193 0.2812 112 0.5516 221 1.0352 414 0.0946 38 3.2592 104 0.0384 15 April 0.2464 134 0.1606 87 0.3362 183 0.5826 317 0.1580 86 0.0562 31 0.0282 15 May 0.2387 101 0.1570 67 0.2975 126 0.5362 228 0.0619 26 0.0428 18 0.0182 8 June 0.799 34 0.0373 16 0.4033 171 0.4832 205 0.0890 38 0.0433 18 0.0114 5 July 0.1633 77 0.1086 51 0.2027 95 0.3660 172 0.0646 30 0.0437 20 0.0152 7 August 0.0534 24 0.0338 15 0.2256 102 0.2790 126 0.0648 29 0.0181 8 0.0110 5 September 0.0805 34 0.0413 18 0.1376 58 0.2181 93 0.0427 18 0.0145 6 0.0066 3 October 0.1714 75 0.0878 38 0.2815 123 0.4529 199 0.0594 26 November December 0.0953 52 0.0671 37 0.4170 227 0.5123 279 0.1615 88 0.0455 25 0.0182 10 Due to a fault in the equipment no results are available for the month of November. 27 TABLE III NATIONAL SURVEY - CITY AREA SMOKE AND SULPHUR DIOXIDE MICROGRAMMES PER CUBIC METRE MILTON COURT SMOKE SULPHUR DIOXIDE MONTH 1970/71 1971/7 2 Percentage 1970/71 1971/72 Percentage Decrease Increase Decrease Increase April 38 36 5 — 302 282 5 — May 39 17 56 — 198 200 — 1 June 30 — — — 173 — — — July 22 28 — 27 132 141 — 7 August 29 26 10 — 146 146 — — September 35 52 — 49 242 240 .7 — October 52 57 — 10 280 277 1 — November 45 55 — 22 342 308 10 — December 58 76 — 31 357 354 .8 — January 69 60 13 — 401 323 19 — February 52 60 — 15 353 329 7 — March 35 — — — 267 — — — SNOW HILL April 47 — — — 319 — — — May 41 — — — 191 — — — June 35 34 1 — 216 212 2 — July 33 27 18 — 138 132 4 — August 39 30 23 — 169 91 47 — September — 59 — — — 177 — — October — — — — — 194 — — November 65 51 22 — 325 311 4 — December 62 55 11 — 374 361 4 — January — 56 — — — 371 — — February — — — — — — — — March — — — — — — — — TABLE IV QUANTITIES OF FUEL USED (BY TYPES) AND QUANTITIES OF SULPHUR CONTENT (TONS) IN PREMISES SURVEYED TYPE OF FUEL TONS CUBIC FEET SULPHUR CONTENT (TONS) Oil 28 & 35 second Redwood 15,919 95.5 Oil 200 second Redwood and above 12,651 291.0 Coke 228 2.9 Northumberland Singles (Coal) 176 1.0 Anthracite Grains 57 0.5 Town Mains Gas (Figures for whole of City) 2,493,592,216 11.1 Electricity TOTALS 29,031 2,493,592,216 402.0 28 RODENT CONTROL Work involved in implementing the Prevention of Damage by Pests Act 1949 can be classified under three main headings. (a) The inspection of premises on complaint followed by treatment of infested premises and advice as to preventive measures. (b) Survey work, with consequent follow up work, undertaken on a systematic basis. (c) Control work in the sewers. (a) Complaints Numbers of complaints received 775 Infestations confirmed House mouse infestations 588 Rat infestations 49 (b) Survey work Premises surveyed 2,270 House mouse infestations 478 Rat infestations NIL (c) Destruction of rats in sewers Two direct poison treatments were carried out in September and October using zinc phosphide and arsenious oxide respectively. Two pre-baiting treatments were carried out in March and June followed by zinc phosphide treatment where necessary. Currently there is general interest in the Greater London Area because of the evidence that the infestation rate and resistance to treatment of mice is increasing. The London Pests Unit of the Ministry of Agriculture Fisheries and Food, South Eastern Region, undertook the organisation of a survey covering a four week period during the Autumn of 1972. Information as to City infestations was supplied and the findings on statistical analysis should offer a useful guide as to trends of infestation and efficacy of treatment. PIGEON CONTROL The Public Health Act 1961 gives local authorities permissive powers to take steps to abate or mitigate nuisances from pigeons believed to have no owner. Complaints during the yearstemmed from the fouling of buildings and pavements, the presence of mites in offices originating from pigeon nests on adjacent window sills and fouling of seats and clothing and damage to plants in the City open spaces and gardens. Despite the mild winter of 1971-2 giving a large carry over of pigeons from the previous season, reductions to acceptable levels were effected in the case of complaints relating to buildings. Control measures were not so effective in the case of the open spaces and gardens, particularly those towards the perimeter of the City, serving as they do as gathering points for flocks of pigeons for some distance around and often only for a short period - about mid-day. A reassessment of the methods used is being carried out in an effort to achieve an improvement in the present position. CITY MORTUARY Bodies received 207 Post Mortem Examinations made 207 Inquests on bodies 27 Inquests held at Holloway Prison NIL Inquests on fires NIL Inquests on Treasure Trove NIL 29 DISINFECTION AND CLEANSING OF VERMINOUS PERSONS, ETC. Export of Clothing, etc. Articles, by weight 7 tons 18 cwt No. of articles disinfected 342,520 No. of operations 1,203 Fees received £2,651.70 General Disinfection, Infectious Diseases, etc. Cells at Police Stations disinfected 5 Lockers at Post Offices disinfected 11 Verminous premises disinfected 10 Beds and bedding disinfected 2765 Cleansing of Persons No. of verminous persons bathed 1233 No. of persons with scabies bathed 2 No. of articles disinfected 12350 CATERING AND OTHER FOOD PREMISES THE SECTION S WORK AND RESPONSIBILITIES The section specialising in the control of catering and other food premises is staffed by four Public Health Inspectors, who devote the whole of their time to this work. Additionally, the Deputy Chief Public Health Inspector devotes part of his time to this work in addition to his supervisory duties. The responsibilities of the section include the administration of the following statutory enactments:- DIRECTLY ENFORCED Food Hygiene Food Hygiene (General) Regulations, 1970 Food Hygiene (Markets, Stalls and Delivery Vehicles) Regulations, 1966. Food Hygiene (Markets, Stalls and Delivery Vehicles) (Amendment) Regulations, 1966. The Licensing Act, 1964. Food and Drugs Food and Drugs Act, 1955 Imported Food Regulations, 1968 Offices, Shops and Railway Premises Offices, Shops and Railway Premises Act, 1963 Offices, Shops and Railway Premises (Hoists and Lifts) Regulations, 1968 DIRECTLY ENFORCED BY MEANS OF SAMPLING AND INDIRECTLY BY ADVICE Bread and Flour Regulations, 1963 Bread and Flour (Amendment) Regulations, 1972 Butter Regulations, 1966 Canned Meat Product Regulations, 1967 Cheese Regulations, 1965 Cheese (Amendment) Regulations, 1966 Condensed Milk Regulations, 1959 Ice Cream Regulations, 1967 Meat Pie and Sausage Roll Regulations, 1967 Sausage and Other Meat Product Regulations, 1967 Soft Drinks Regulations, 1964 Antioxidant in Food Regulations, 1966 Artificial Sweeteners in Food Regulations, 1966 Colouring Matter in Food Regulations, 1966 Fluorine in Food Regulations, 1959 Arsenic in Food Regulations, 1966 Emulsifiers and Stabilisers in Food Regulations, 1962 Salad Cream Regulations, 1966 Solvents in Food Regulations, 1967 Cream Regulations, 1970 30 Milk and Dairies (General) Regulations, 1959 Milk and Dairies (Channel Island and South Devon Milk) Regulations, 1956 Milk (Special Designations) Regulations, 1963 Milk (Special Designations) (Amendment) Regulations, 1972 Labelling of Food Regulations, 1970 Labelling of Food (Amendment) Regulations, 1972 Lead in Food Regulations 1961 Food (Control of Irradiation) Regulations, 1967 Food (Control of lrradiation)(Amendment) Regulations, 1972 Preservatives in Food Regulations, 1962. The activities of the section over the past year in administering the above statutes, and generally promoting good food hygiene, can be broadly classified as:- 1. Planned work instigated by the Public Health Inspectors. 2. Unplanned work instigated by external sources. Planned work instigated by the Inspectors has taken the form of routine visits to the various catering premises within the City to determine whether or not statutory standards are being complied with. The discovery of defects led either to written or verbal intimations to the party responsible for the execution of remedial action. Subsequently, planned re-visits were made to check upon the effectiveness of the action taken. Foodstuffs were sampled regularly, in order to determine whether statutory composition and and labelling standards are being complied with by manufacturers. Finally, hygiene education lectures were given to the staff of a number of large institutions within the City. The unplanned work of the section is instigated by external sources and has involved Inspectors in a number of different functions:- INVESTIGATIONS Complaints from the public are actively investigated and take one of three forms:- 1. Complaints relating to foodstuffs purchased within the City. Each complaint has involved much detailed investigation, in order to ascertain the relevant facts, obtain the opinion of retailers and manufacturers involved, and consider these in the light of the Public Analyst's Report. If appropriate, evidence was then collated for presentation to Mr. Comptroller and City Solicitor, for his opinion as to whether the facts are sufficient to justify a prosecution. 2. Similarly, complaints relating to the state of premises within the City, or to alleged foodhandling malpractices therein, were investigated in detail. 3. Complaints relating to illness alleged to result from eating meals within the City are treated as cases of potential food poisoning until the contrary is proven. Usually, after detailed investigation, often involving the bacteriological examination of suspected foodstuffs, it is not possible to prove the existence of food poisoning. However, in one instance a large outbreak occurred in a staff canteen, involving 133 people, who had suffered from various symptoms, including diarrhoea and vomiting, and which was attributable to the eating of a made-up meat food contaminated with Clostridium welchii bacteria. The investigation involved over three weeks of one Public Health Inspector's time. Other investigatory work included the investigation of accidents in catering premises, in accordance with the Offices, Shops and Railway Premises Act, 1963. Finally, the Inspectors investigated instances of notified infectious disease amongst food handlers - such as tuberculosis and paratyphoid fever. The objective was to prevent risk to the public from contacts or carriers, and there was close liaison between the various professional officers in the Department. ADVICE Manufacturers, Retailers and Caterers have increasingly contacted the section over the course of the year for advice relating to the interpretation of the law concerning food and food-handling premises. This developing role of the section is referred to in "Observations" below. The advisory role of the section in relation to new projects has continued over the course of the year. 31 ADDITIONAL DUTIES These have included the inspection of premises following applications for, and the renewal of, Club Registration Certificates, and the administration of the Offices, Shops and Railway Premises (Hoists and Lifts) Regulations, 1968, within catering premises. Inspectors were also involved in the inspection of food to assess fitness for human consumption and in the inspection of imported food at the one remaining wharf within the City. Finally, Inspectors visited premises upon receipt of applications 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 (in accordance with Section 16 of the Food and Drugs Act, 1955). OBSERVATIONS Clearly the advisory role of the section has developed and expanded over the course of the year. Increasingly the section is contacted by organisations, many whose activities extend outside the City, for advice relating to technical and legal problems. Numerous enquiries have been made with regard to labelling of foods and food compositional standards, in addition to requests for advice with regard to the interpretation of the Food Hygiene Regulations. A policy of informal consultation and advice is considered appropriate to the City environment. When informal consultation and advice fails, or when conditions of gross neglect are discovered, the Department recommends that legal action be taken. Twenty prosecutions have been conducted over the course of the year, 2 in respect of unsatisfactory catering premises, 12 in respect of food complaints, and 6 as a result of formal or informal samples. The prosecutions involved a great deal of investigation and administrative work by Inspectors and administrative staff in the Department, in order to obtain sufficient evidence to ensure the success of the prosecution. In this respect I am grateful for the helpful advice and assistance of Mr. Comptroller and City Solicitor. A number of practices have been noted with concern over the course of the year:- 1. Lack of hygiene behind the bar in some of the City's pubs, clubs and other licensed premises has resulted in discussions with the City of London Licensed Victuallers Association, which kindly co-operated in circularising its members with the following letter:- "Dear Member, 10th November, 1972 Hygiene in the Bar Following discussions with the Chairman of the City Licensed Victuallers Association, I have pleasure in drawing your attention to the following matters which have been a source of concern to Public Health Inspectors in the City 1. Cases have been noted where barstaff have been collecting the spillage from beer pumps and serving it to customers. There are grave dangers in this practice, particularly when used glasses are refilled, allowing any bacteria to be washed over the rim together with saliva and dust. 2. A further potential danger is present where the non-drip type of measuring tap is used for serving spirits and liqueurs. Each service involves the rim of a glass being pushed against the vending arm of the measure. Clearly, after a short period of dispensing second drinks to a number of glasses the bacterial contamination of the vending arms can be very high. The remedy is to use a new glass on each occasion a drink is served. 3. Many glass-washing techniques are inadequate and in some instances cold or merely tepid water is used. In other instances double sinks are not used for their correct purpose of washing and rinsing. The most effective method of glass-washing is to use hand-temperature water together with a sterilizing agent. I would add that sterilizing agents are obtainable which are specially formulated to retain the head on beer. 4. Screening of food on display is important to prevent it from becoming contaminated by customers. 5. Smoking behind the bar involves the fingers coming into contact with the mouth and bacteria can be transferred from the mouth to the fingers and finally to food and drink. 32 Quite apart from the legal consequences of the above practices, I am sure you will appreciate the importance of good hygiene behind the bar. Any of the Public Health Inspectors will be pleased to visit you upon request to give any further advice or assistance. Yours faithfully, (Sgd.) W.G. SWANN Medical Officer of Health, Port and City of London. " 2. Warm weather during the summer months contributed towards the high number of complaints about mouldy or decomposed foods. Surprisingly, in many instances premises were discovered without refrigerated display facilities, and in other cases stock rotation of perishable foods was inadequate. In one instance a cafe proprietor had retained a pork pie for five days prior to its sale, and the pie was subsequently sold in a highly decomposed condition. A prosecution on behalf of the Corporation resulted in the cafe proprietor being fined £5 and ordered to pay £28 towards the cost of the prosecution. 3. On a number of occasions major works involving new catering units or alterations to existing units were begun without the Department having been asked to comment upon the proposed works, and some of these projects were subsequently discovered to be badly planned to such an extent that it would be unlikely that the completed premises when in use would satisfy the Food Hygiene Regulations. Architects were contacted and informed of the observations of the Public Health Inspector. The subsequent alterations to plans and implementation of necessary structural work inevitably resulted in heavy expenditure and delay. 4. During the course of the year two food handlers were discovered to have active pulmonary tuberculosis, and arrangements were made by the Health and Welfare Officers to have all contacts X-rayed. The Public Health Inspectors were concerned with reducing risk to the public and improving the factors in the working environment, such as ventilation and overcrowding, which could influence the spread of the disease amongst workers. 5. Particular attention was given to health education, and accordingly a number of lectures were given to food handlers and representatives of various organisations within the City. Many food hygiene malpractices,such as serving beer spillage, inadequate stock rotation, and lack of personal hygiene, are attributable to lack of knowledge of the dangers inherent in such practices. The long-term remedy lies in education of food handlers, in order to change attitudes which may have taken many years to develop. Even at senior management level, particularly with regard to new projects.it is frequently necessary to educate management and convince them that good kitchen design is important. Generally, hygiene education at senior management level is necessary to ensure a lasting change in policies and practices. CONCLUSIONS Although it has not proved possible either to conduct an inspection over the year of all of the City's 1,300 food-handling premises, or to conduct a comprehensive programme of hygiene education lectures, I am pleased to note the success of the unplanned work of the section and the fact that the investigating and advising work of the Public Health Inspectors has resulted in a steady improvement in conditions. Furthermore 273 written notices and 138 verbal instructions were given to the occupiers of food-handling premises over the course of the year. SAMPLING UNDER THE FOOD AND DRUGS ACT, 1955 As in previous years samples of various foodstuffs, purchased by the Sampling Officer, constituted a representative cross-section of articles of food in regular use. Of the 314 samples purchased, only 22, or approximately 7 per cent, were the subject of an adverse report by the Public Analyst. Most of the irregularities referred to infringements of the following regulations:- 33 Labelling of Food Order, 1953 9 Preservatives in Food Regulations 2 Colouring Matter in Food Regulations 2 Meat Pie and Sausage Roll Regulations 2 Food and Drugs Act, 1955, (False representation - a cream cake named as such but consisting of artificial-cream filling) 1 The remaining six were the subject of prosecution. In all, five cases were proceeded with after one case was withdrawn in court. The five cases proceeded with were as follows:- Two summonses in respect of adulterated milk (2 glasses of milk purchased in a cafe as formal samples) found on examination by the Public Analyst to be adulterated with water. The cafe proprietor was fined £50 and ordered to pay £11 towards the cost of the prosecution. One summons in respect of a prepacked portion of fresh chicken, purchased as an informal sample, which was found on examination by the Public Analyst to be unfit for human consumption. The provision merchant was fined £25 and ordered to pay £27 towards the cost of the prosecution. Two summonses in respect of 2 chicken and ham pies, purchased as informal samples, which were found on examination by the Public Analyst to contain foreign matter, i.e. feather in both pies. Both summonses were dismissed on a technical issue. Attention was again paid to the purchase of food of a perishable nature, such as pies of all descriptions, minced meat, sausage-meat and sausages, fish cakes, etc. As in previous years, these purchases were made early on Monday morning so that the freshness or otherwise of the food in question could be gauged, as most food premises are closed from Friday evening to Monday morning. It has been found on some occasions that mould has formed in food improperly refrigerated or kept for too long a period, and this has been a source of complaint from time to time from members of the public. In general it has been found that both wholesalers and retailers in the provision trade do endeavour to comply with the requirements of the various regulations in force and when their attention is drawn to any infringement they endeavour to remedy the faults without undue delay. 34 SAMPLES PURCHASED AND SUBMITTED FOR ANALYSIS Article Informal Formal Article Informal Formal Almonds 1 Margarine 4 Bacon 1 Meat, balls 1 Beefburgers 3 canned 12 Beers & Shandy 1 2 fresh 2 Biscuits 4 minced 4 Blancmange Powder 1 prepacked 4 Bread, loaves 5 pies (beef) 2 mix 1 (pork) 5 pudding 2 (Steak & Kidney) 6 Bread & Butter 1 (Veal & Egg) 1 Butter 2 Meat Products 4 Cakes & Pastries 33 Milk, canned 3 Cake Mix 4 fresh — 20 Cereal 2 hot — 2 Cheese 1 instant 2 Cheese Spread 3 long life 2 Chicken, casserole 1 Milk Puddings 2 croquettes 3 Milk Shakes, prepared 1 fillets in jelly 1 powder 1 pies 5 Mixed Grill 1 portions 5 Pancake Syrup 1 Christmas Pudding 1 Pasta 1 Chutney 2 Pâté 4 Cooking Fat 1 Pease Pudding 2 Cornish Pasties 2 Pharmaceutical Products 1 Cream, Dairy 4 Pineapple Desserts 1 Curry Paste 1 Pizza 1 Desiccated Coconut 1 Prawn Coleslaw 1 Drink, chocolate 1 Prunes 1 fruit 9 Sandwiches 7 Egg Noodles 1 Sauce Mix 1 Fish, cakes 1 Sauces & Toppings 6 canned 3 Sausages 7 frozen 1 Sausage Meat 3 shell 3 Sausage Rolls 5 Frankfurters 2 Scotch Eggs 6 Fruit, canned 8 Seasoning 1 dried 3 Spirits — 19 fresh 1 Spreads (Various) 3 pies 9 Tea 5 Honey 3 Tomato-Juice 1 Irish Stew 1 Tomato-Puree 1 Jam 1 Vegetables, canned 5 Jelly 1 dried 4 Vinegar 3 Yeast 1 Yoghurt 2 TOTALS 270 44 35 FOOD COMPLAINTS During the year under review there was a decrease in the number of complaints concerning food sold in an unsound condition or food containing extraneous material. However, legal proceedings were instituted in 12 cases and fines and costs were imposed totalling £631, both figures showing a substantial increase on those for the previous year. The complaints investigated related to the following:- 1. Severe mould growths, staleness and unsoundness which affected the following articIes Bread — Mouldy Danish Pastry — Mouldy Sausage Roll — Mouldy Coca Cola — Contained mould growth Tomato Juice — Fermenting Apple Slices — Mouldy Apple Slices — Mouldy Pork Pie — Contained bacterial growth Pork Pie — Contained mould growth Partly-baked Loaf — Mouldy Chocolate Eclair — Mouldy Chocolate Peanuts — Mouldy and rancid Apple Pie — Contained burnt fruit pulp Veal and Ham Pie — Contained animal skin and bristle French Bread with Sausage — Contained skin and hair Evaporated Milk — Decomposing Tarragon Vinegar — Contained bacterial growth Sausage Roll — Mouldy 2. Extraneous objects discovered in food:- Fruit Pie - Contaminated with aluminium fragments Fried Potato Chips — Contained fragment of root vegetable Cheese and Tomato Roll — Contained a screw Russian Bar Cake — Contained string and a piece of fruit skin Doughnut — Contained dust Biscuits — Contained natural and synthetic fibres Cottage Loaf — Contained human hair Doughnut — Contained a piece of paper Nut Toffee Block — Contained a matchstick Coca Cola - Contained dust and dirt Chelsea Bun — Contained a brass rivet Doughnut — Contained a staple Salmon and Cucumber Sandwich — Contained a spiral of tinned steel Beef Pie — Contained vegetable fibre Chicken Noodle Soup — Contained a piece of wire Potato Chip — Contained a plant stem 3. Adulteration:- Honey ) Honey ) ¯ Contained powdered nut 4. Rodent and Insect Contamination:- Pate Sandwich — Contained insect fragments Quiche Lorraine — Contained rodent droppings Potato Crisps — Contained rodent droppings Bread Roll - Contained a fly It will be noted that a number of these complaints concerned foods which were mouldy or stale, the unfitness in some cases being due to the fact that the food in question had been sold beyond the "expiry date" inserted in code on the wrapper or package. Recent Government pronouncements have indicated that legislation is to be introduced, requiring clear and precise information to be shown on the wrapper or package in certain types of food, giving a date on or before which that particular food is to be sold. Hitherto, such codings have often been understood only by the manufacturers of these various foods, and in some cases have not even been intelligible to the retailer, making it difficult to secure efficient stock rotation. 36 It will also be noted from the following table that action was taken in several instances under the Labelling of Food Regulations, 1970, relating to such matters as incorrect designations on labels, and incorrect or incomplete lists of ingredients. In all of these cases appropriate representations were made to the firms responsible and amendments to the labels in question secured. From 1st January, 1973, all parts of the Labelling of Food Regulations, 1970, will be in force, and there has been an increasing number of enquiries requesting information on these matters. OTHER SAMPLES SUBMITTED FOR ANALYSIS Article Informal Formal Article Informal Formal Biscuits 3 Milk, evaporated 2 Bread 3 Milk, Vending Machine 1 Butter 1 Mushrooms 1 Butter Oil 1 Pizza 2 Cakes & Pastries 12 Rolls 4 Calpis Concentrate 1 Sandwiches 2 Chicken 1 Sausage Rolls 2 Coffee 1 Seaweed, rolled dried 1 Coffee, Vending Machine 1 Soup 2 Confectionery 2 Soya Beans 1 Drink, soft 2 Soya Paste 1 Fruit Juice 1 Tomato Juice 1 Fish, canned 4 Vegetables, canned 2 dried 1 potato, chips 2 frozen 1 crisps 1 pre-packed 1 instant 1 Fruit, canned 3 Vinegar 1 fresh 1 Vitamin Powder 1 pies 2 Water 3 Honey 2 African Beads 4 Maize Flour 1 Drain Coagulant 1 Meat, pies 4 Hair Preparations 4 products 4 TOTALS 93 0 A further 19 samples of various foodstuffs were purchased in the City of London and submitted to the Public Analyst, to determine the extent of contamination by toxic chemicals. This sampling was carried out by the Corporation at the request of the Association of Municipal Corporations (in association with the County Councils Association and the Urban District Councils Association) as part of a national survey to discover the extent of the contamination of foodstuffs by toxic chemicals. Bacteriological Examinations Ice Cream Powder — 1 37 NATURE OF ADULTERATION OR IRREGULARITY Article Type of Sample Nature of adulteration or irregularity Action Fruit Pie Complaint Contaminated with aluminium fragments. A letter of caution was sent to the retailer concerned. Apricot Yoghurt Informal Contained benzoic acid contrary to Preservatives in Food Regulations. A letter of caution was sent to the retai ler concerned. Bread Complaint Mouldy Legal proceedings were instituted against the retailer concerned who was fined £10 and ordered to pay £40 costs. Cake Fruit Mixture Informal Contained mineral hydrocarbons not shown in the list of ingredients on the label. A letter was sent to the retailer concerned. Label to be amended. Honey Complaint ) Contained 20% powdered nut. A letter of caution was sent to the manufacturer. Honey Complaint ) Vegetable Broth Informal Generic designation "dried vegetables" in the list of ingredients contrary to the Labelling of Food Order. Imported food — Merchant and local Medical Officer of Health informed. Pate Sandwich Complaint Contained insect fragments. A letter of caution was sent to the cafe' proprietor concerned. Cream Splits Informal Filling consisted of imitation cream. A letter of caution was sent to the cafe' proprietor concerned. Jam Tarts Informal ) Blackcurrant jam in the tarts contained an unidentifiable red colouring matter with characteristics not consistent with those of a permitted colouring matter. Representations were made to the retai ler and manufacturer. The tarts were withdrawn from sale. Jam Tarts Informal ) Steak Pie Informal Contained 1.15 oz. meat, deficient of legal minumum of 1.5 oz. A letter of caution was sent to the retailer concerned. Apricot Tart Informal ) Generic designations "sugars, fruit, pulp, starch flour and leavening" in list of ingredients. Imported food - Merchant and local Medical Officer of Health informed. Orange Tart Informal ) Stuffed Pork Roll Informal Generic designation "cereal" in list of ingredients. Representations were made to the wholesaler. Label to be amended. Grapefruit Informal Contained tin, 320p.p.m., in excess of recommended maximum of 250 p.p.m. The consignment was withdrawn from sale. Quiche Lorraine Complaint Contained rodent droppings. A letter of warning was sent to the caterer concerned by the Corporation's Legal Officer. Fried Potato Chips Complaint Contained fragment of root vegetable. Investigation established that no action was required. Danish Pastry Complaint Mouldy A letter of caution was sent to the manufacturer. Milk Formal ) Deficient of 17.6% of the presumptive minimum standard of non-fatty milk solids i.e. Contained at least 19% of extraneous water. Legal proceedings were instituted against the caterers concerned, who were fined £50 and ordered to pay £11 costs. Milk Formal ) Apple Pie Complaint Contained burnt fruit pulp. A letter of caution was sent to the manufacturer. Canned Medium Red Salmon Informal Decomposing Representations were made and the consignment was withdrawn from sale. 38 Article Type of Sample Nature of adulteration or irregularity Action Creamed Macaroni Milk Pudding Informal Contained milk not shown in the list of ingredients on the label. A letter was sent to the manufacturer concerned, who subsequently amended the labels. Cheese and Tomato Roll Complaint Contained a screw. A letter of caution was sent to the retailer. Russian Bar Cake Complaint Contained string and a piece of fruit skin. A letter of caution was sent to the manufacturer. Sausage Roll Complaint Mouldy Legal proceedings were instituted against the caterer concerned, who was fined £50, and ordered to pay £19 costs. Doughnut Complaint Contained dust. A letter of caution was sent to the retailer concerned. Biscuits Complaint Contained natural and synthetic fibres. Matter taken up with the company concerned. Chicken and Ham Pie Informal ) Contained part of a feather. Legal proceedings were Chicken and Ham Pie Informal ) stituted against the manufacturer. The cases were dismissed. Cottage Loaf Complaint Contained human hair. A letter of caution was sent to the manufacturer. Doughnut Complaint Contained a piece of paper. Legal proceedings were instituted against the manufacturer who was fined £10 and ordered to pay £12 costs. Nut Toffee Block Complaint Contained a matchstick. Legal proceedings were instituted against the manufacturer who was fined £25 and ordered to pay £22 costs. Coca Cola Complaint Contained mould growth. Legal proceedings were instituted against the bottlers concerned who were fined £20 and ordered to pay £22 costs. Tomato Juice Complaint Fermenting A letter of caution was sent to the supplier concerned. Apple Juice Informal No common or usual name was given on the label. Representations were made to the retailer and supplier. The labels are to be amended. Farmhouse Pate Informal Incorrect appropriate designation on the label. Contained cereal binder not shown in the list of ingredients. Representations were made to the retailer and supplier. The labels are to be amended. Tinned Milk Informal No appropriate designation on the label. Representations were made to the retai ler and supplier. The labels are to be amended. Apple Slices (Confectionery) Complaint Mouldy Legal proceedings were instituted against the supplier concerned who was fined £50 and ordered to pay £15 costs. Apple Slices (Confectionery) Complaint Mouldy Legal proceedings were instituted against the supplier concerned who was fined £50 and ordered to pay £15 costs. Coca Cola Complaint Contained dust and dirt. Legal proceedings were instituted against the bottlers concerned who were fined £20 and ordered to pay £22 costs. 39 Article Type of Sample Nature of adulteration of irregularity Action Potato Crisps Complaint Contained rodent droppings. Legal proceedings were instituted against the retailer concerned who was fined £50 and ordered to pay £72 costs. Pork Pie Complaint Contained bacterial growth. Legal proceedings were instituted against the retailer concerned who was fined £5 and ordered to pay £28 costs. Pork Pie Complaint Contained mould growth. A letter of caution was sent to the manufacturer concerned. Chelsea Bun Complaint Contained a brass rivet. A letter of caution was sent to the manufacturer concerned. Frying Medium (Cooking Fat) Informal No common or usual name on the label. Letters were sent to the retailer and manufacturer. The labels were amended. Patum Peperium (Anchovy paste) Informal No appropriate designation on the label. Retailer and manufacturer advised that labels should be amended. Curry Sauce Mix Informal Contained starch not shown in list of ingredients. Retailer and manufacturer advised that labels should be amended. Partly Baked Loaf Complaint Mouldy Legal proceedings were instituted against the manufacturer who was fined £25 and ordered to pay £12 costs. Doughnut Complaint Contained a staple. A letter of caution was sent to the manufacturer concerned. Veal and Ham Pie Complaint Contained animal skin and bristle. Representations were made to the manufacturer concerned. Chocolate Eclair Complaint Mouldy Representations were made to the retailer concered. Salmon and Cucumber Sandwich Complaint Contained a spiral of tinned steel. Legal proceedings were instituted against the catering company concerned who were fined £25 and ordered to pay £12 costs. Cream Slices Informal Filled with imitation cream. A letter of caution was sent to the retailer concerned. Currants Informal Contained mineral hydrocarbon, not shown in list of ingredients. Retailer and supplier advised that the labels should be amended. Soft Drink Informal No common or usual name on the label. Manufacturer advised that the labels should be amended. Bread Roll Complaint Contained a fly. A letter of caution was sent to the baker concerned. Chocolate Peanuts Complaint Mouldy and rancid. A letter of caution was sent to the retailer concerned. French Bread with Sausage Complaint Contained skin and hair. A letter of caution was sent to the manufacturer concerned. Lambs Liver Informal Tainted with an aromatic odour. Legal proceedings were instituted against the retailer concerned but subsequently withdrawn. Chicken Informal Sour odour. Legal proceedings were instituted against the retailer concerned who was fined £25 and ordered to pay £27 costs. 40 Article Type of Sample Nature of adulteration of irregularity Action Beef Pie Complaint Contained vegetable fibre. Representations were made to the retailer and manufacturer concerned. Evaporated Milk Complaint Decomposing Investigation of the circumstances revealed that no action was necessary Chicken Noodle Soup Complaint Contained piece of wire. Representations were made to the caterer concerned. Potato Chip Complaint Contained plant stem. Representations were made to the caterer concerned. Tarragon Vinegar Complaint Contained bacterial growth. Investigation carried out on request of a Canteen Manager. No further action necessary. Vodka Formal Alcohol content 63.8% deficient of minimum limit of 65%. A letter of caution was sent to the licensee concerned. Further samples to be drawn. Pancake Syrup Informal Contained sorbic acid contrary to the Preservatives in Food Regulations. A letter of caution was sent to the supplier concerned. Rose Hip Syrup Informal Contained vitamin C 72mg./fl.oz. Deficient of minimum 80mg./fl. oz. claimed on label. A letter of caution was sent to the supplier concerned. Pork Pâté Informal Contained cereal binder not shown in list of ingredients. A letter of caution was sent to the retailer concerned, who contacted the suppliers. Beurre D' Isigny Informal No common or usual name on the label. A letter of caution was sent to the supplier concerned. Derby Sage Cheese Informal Contained fat in dry matter, 45%. Deficient of minimum limit of 48% fat in dry matter. A letter of caution was sent to the supplier concerned. Soy Bean Paste Informal Contained sorbic acid contrary to Preservative in Food Regulations. Imported food — Information forwarded to local Medical Officer of Health. Fish Informal No name and address of the packer, labeller or importer was shown on the label, contrary to the Labelling of Food Regulations. Imported food - A letter was sent to the importer concerned, with a copy to the local Medical Officer of Health. Labels to be amended. Dried Seaweed Informal A non-specific designation was shown in the list of ingredients, contrary to the Labelling of Food Regulations. Imported food — A letter was sent to the importer concerned, with a copy to the local Medical Officer of Health. Labels to be amended. Sausage Roll Complaint Mouldy Representations were made to the retailer concerned, regarding storage. Slimming Tablets Informal Consisted of diethylpropion tablets, should only be prescribed by a doctor. Investigation carried out on behalf of Medical Adviser of a City company. No further action. 41 PROSECUTIONS FOOD AND DRUGS ACT 1955 Article Section Fine Costs * Chocolate Bar containing maggot 2 £10 £8 Fresh Chickens — diseased 8 £330 £11.60 *Cheese Roll containing metal disc 2 £25 £11 * Chocolate and Nut Bar containing maggots 2 £100 £12 * Pizza Pie containing cigarette end 8 £20 £10 * Chocolate and Nut Bar containing larvae 2 £100 £12 Bread — mouldy 8 £10 £40 Milk - adulterated 2 £50 £11 Sausage Roll - mouldy 8 £50 £19 Doughnut - containing paper 2 £10 £12 Bottle of Soft Drink - dirty 2 £20 £22 Nut Rock Bar containing match stick 2 £25 £22 Bag of Potato Crisps containing rodent droppings 2 £50 £72 Bottle of Soft Drink — mouldy 2 £20 £22 Apple Slice — mouldy 8 £50 £15 Apple Slice — mouldy 8 £50 £15 Pork Pie — mouldy 8 £5 £28 Chicken — sour 8 £25 £27 Salmon & Cucumber Sandwich containing piece of Metal 2 £25 £12 Bread — mouldy 8 £25 £12 Unsatisfactory condition of cafe Food Hygiene (General) Regulations 1970 £210 £20 Unsatisfactory condition of Restaurant Food Hygiene (General) Regulations 1970 £75 £15 No head covering, smoking whilst handling meat (Meat Handler) — London Central Markets Food Hygiene (Markets, stalls & Delivery Vehicles) Regulations 1966 £20 £11 Smoking whilst handling meat (Meat Handler) — London Central Markets Food Hygiene (Markets, stalls & Delivery Vehicles) Regulations 1966 £20 £10 Dirty condition of stall Food Hygiene (Markets, stalls & Delivery Vehicles) Regulations 1966 £150 £15 Prosecutions relating to articles listed above marked * were the results of complaints received in 1971. 42 FOOD AND DRUGS ACT, 1955 (Section 16) The 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. The following table shows the types of business carried on Nature of business for which registered. Brining of Meat 16 Boiling of Shellfish 5 Cooking of Meats and Poultry 8 Cooking of Meat and Poultry for resale 5 Manufacture of Dripping 7 Manufacture of Ice Cream 2 Manufacture of Pies 2 Manufacture of Sausages 11 Pickling and Bottling of Shellfish 3 Preparation and Bleaching of Tripe 1 Preparation of Jellied Eels and Shellfish 8 Preparation of Poultry 2 Sale and Storage of Prepacked Ice Cream 60 Selecting and Testing Sausage Casings 4 Sale of Ice Cream — Prepacked 31 Cooking of Prepacked Frozen Pies 1 TOTAL 167 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 9 tons 12 cwt 2 qrs 8 lbs., which was disposed of as follows:- Tons Cwts Qrs Lbs Destroyed 9 9 2 26 Disposed of to Contractors 2 3 10 FOOD HYGIENE (MARKETS, STALLS AND DELIVERY VEHICLES) REGULATIONS, 1966 AUTOMATIC VENDING MACHINES The increase in the number of vending machines still continues. With hot and cold beverage machines used in many office buildings where other catering facilities are not provided, it cannot be too strongly emphasised that regular servicing and cleansing of vending machines is absolutely essential. Following last year's unsatisfactory findings in relation to these machines in the City, a survey was carried out during the current year and the results were somewhat disturbing. It would appear that there is scope for improvement in the design of these machines by the manufacturers and in the servicing arrangements on the part of those persons responsible for the installation. 43 Of the total number of machines inspected on a random sample, 66 per cent were found to be unsatisfactory in respect of the following matters:- Internal cleanliness External cleanliness Siting of the machines Maintenance of the machines Services to the machines Storage of make-up powders to the machines Machine design Protection of food from contamination Some of the main conditions found included the following:Cleaning, Sterilisation and Maintenance Nozzles were dirty. Internal surfaces were dirty, with accumulated filth, dust, and exudates of sugar, dried milk and dried coffee. Accumulations of litter, dirt and spillage were found on adjacent floor and wall surfaces. Delivery tubes were dirty and scaled. Leaking water service pipes were evident in some cases. There were damaged doors and rusted and dirty metal bases and shelves. No visible records of previous cleaning programmes or bactericidal treatment were evident. Machines were set on filthy metal bases and on floor surfaces which were incapable of being cleaned. There were inaccessible areas which allowed litter to build up around and behind machines. Some machines were sited in such a way as to inhibit internal heat dissipation. Some were sited in positions remote from water supplies, sinks and drainage facilities. Some were installed without mains water supplies. No close spur points were provided in some cases, with the result that there were long trailing electrical connections. Food Protection There were food containers with the covers left off. In some cases strong detergents were slopped over surfaces and into food delivery channels. Caustic cleaning materials were dumped in some machines. Make-up food powder packets were stored beside machines and slopping in spillage. Design There was poor internal design, militating against easy cleaning procedures. Delivery points were generally positioned at a level which made it difficult to extract the beverage and encouraged spillage. The overwhelming conclusion is that vending machines, as such, should not be purchased by firms which do not have full catering facilities and control of catering staff. Where this is not the case, firms must ensure that they are provided with a hygienic, reliable service, geared to food catering rather than machine sales. A further factor which firms should consider in their decisions regarding automatic vending machines for their employees, is the workload of service operators used by vending service companies. Since adequate cleaning, sterilising and servicing of a machine takes approximately twenty-five mintues, workloads of more than twelve to fifteen machines per operator may eventually lead to skimped procedures. No prior approval is necessary for the installation of these machines, and since there are some 7,000 registered offices in the City, employing more than a quarter of a million people, the true magnitude of the problem is unknown. However, as these unsatisfactory conditions come to light as a result of the routine inspection of offices, appropriate action is taken. 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. Thirty-seven inspections were made in connection with the administration of the Act. Two contraventions of a minor nature were effectively dealt with. 44 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 advertisements or by labels on medicine bottles. Nine inspections were made. No contraventions came to the notice of the Inspector. FERTILISERS AND FEEDING STUFFS ACT, 1926 This Act requires sellers of certain specific 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. Eleven inspections were made. No contravention was noted. Eight samples of various fertilisers were purchased and sent to the Agricultural Analyst for examination. All were found to be satisfactory. FISH INSPECTION Inspection of fish in the City of London is carried out by officers of the Worshipful the Fishmongers' Company. The Fishmeters returns indicated as follows:- Deliveries at or near Billingsgate Market Weight of Condemnation (including shellfish) Fish condemned Rate 69,052 tons 162 tons 0.23% MEAT AND FOOD INSPECTION - SMITHFIELD MARKET Smithfield Markets were designed originally to handlefresh meat for London. Meat is delivered after midnight and wholesalers aim to have a clear market at the end of the days trading. Smithfield is the centre of the meat trade and the market is described as the largest dead meat market in the world. Its function can be appreciated by reflecting that Greater London has one and a half times the population of Sweden and that regular deliveries extend from Smithfield to the coastal towns of Southern England. Meat Poultry and Other Foods delivered at Smithfield Market 1972 264,476 tons 1971 275,470 tons Variations largely consisted of reduced tonnage.from the sources as shown below:- England & Wales N. ireland Republic of Ireland New Zealand Tons Tons Tons Tons 1971 125,529 20,690 45,505 40,637 1972 122,453 14,156 33,732 35,335 Meat Inspection Decomposition especially during adverse weather conditions, and spoilage on refrigerated meat whether chilled or cooled was the cause of most unsoundness. The present day packing of boneless meat in vacuumed plastic bags makes examination difficult. The figures shown in table 3 for Argentine represent this type of meat. The Meat Inspection Regulations, 1963 These Regulations apply to meat slaughtered in England and Wales. Deliveries of meat from these sources during 1972 were as follows:- (1971 figures in parenthesis) Beef & Veal Mutton & Lamb Pork Tons 19,357 (22,733) 14,119 (13,193) 33,244 (33,342) 12 tons 16 cwts 0 qrs 5 lbs amounting to 0.019% (0.021%) of deliveries was surrendered being diseased. 45 Legibility of inspection stamps is often poor and no doubt could be improved given time for careful application on drier surfaces. If stamps were legible on carcases rejected for diseased condition the Local Authority was notified as a routine. Some communication was made with local authorities concerning goat carcases. Traditionally these were sent to market unskinned, a practice which in the interest of hygiene has been discouraged for some years. Goats are subject to the requirements of these regulations. Poultry Inspection There are no premises in the City of London which are used for the processing of live poultry. Poultry packers in the United Kingdom were the main suppliers. Legal proceedings were taken against one of the larger Poultry Packers for 22 offences under section 8(1)(b) of the Food and Drugs Act, 1955 in respect of a consignment of young chickens which were eviscerated (an experimental anticipation of E.E.C. requirements) but which showed evidence of disease. The result of the proceedings were fines totalling £330 with costs of £11.60 being awarded. Uneviscerated carcases were scrutinised. and where suspect, examined for disease. Imported Food Regulations, 1968 6,066 containers of Imported Meat, mostly from the Republic of Ireland, notified as unexamined at the Port of Entry for the purpose of these Regulations were examined at smithfield. Notifications concerning 273 containers destined elsewhere were forwarded to appropriate Local Authorities. 68 consignments of meat which had been refused entry into the U.S.A. were notified to this Authority and examined in accordance with these regulations. Sampling 126 samples were collected on behalf of the Government Chemist for pesticide research. Educational The variety of unsound, pathological or anatomical specimens available are valuable to students, colleges and others connected with Public Health Education. Practical examinations in Meat Inspection held in London were supplied with specimens. Mounted specimens were loaned to Local Authorities for Public Health Exhibitions. 77 copies of the Corporation of London publication "Handbook of Poultry Inspection" containing colour pictures taken by a member of the Inspectorate showing diseases in poultry were sold to Local Authorities and Public Health Students. Exports Number of exportation certificates issued 3 TABLE 1 TABLE SHOWING THE AMOUNT OF MEAT, POULTRY AND OTHER FOODS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON, 1972. Leadenhall Smithfield Market Market and City Cold Stores Total Shops T C Q L T C Q L T C Q L T C Q L Meat (Diseased) 17 12 0 21 1 2 17 12 1 23 Meat (Unsound) 117 8 2 3 5 3 7 10 3 18 118 5 1 0 Offal 27 11 2 20 1 3 14 3 19 28 6 3 14 Poultry & Feathered Game 41 13 1 2 1 13 0 15 43 6 1 17 Rabbits & Hares 1 0 3 10 1 0 18 1 2 0 0 Tinned Meat 2 17 3 3 1 2 8 2 19 1 11 Other Tinned Goods 2 3 3 15 13 2 7 2 17 1 22 Fish 25 25 1972 210 8 1 15 2 15 3 4 1 5 3 9 214 10 0 0 1971 266 6 0 10 2 3 1 10 4 15 0 6 273 4 1 26 46 TABLE 2 TABLE SHOWING THE AMOUNT OF MEAT SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR DISEASED CONDITION, 1972, Country of Origin January lbs February lbs March lbs April lbs May lbs June lbs July lbs August lbs September lbs October lbs November lbs December lbs Total 1972 lbs Total 1971 lbs Argentina 5 5 11 Australia 4 4 5 Belgium 10 Denmark 11 11 - England & Wales 2,483 2,793 3,679 1,989 2,793 1,340 1,480 2,724 2,261 2,499 3,220 1,416 28,677 33,211 Finland 84 46 175 148 41 453 239 1,186 2,746 Hungary - 29 Ireland, Northern 193 90 26 25 11 28 48 189 610 1,316 Ireland, Republic 939 630 933 886 655 528 513 619 132 258 216 38 6,347 10,220 New Zealand 12 9 14 12 47 30 Norway 297 40 66 403 - Poland 8 8 - Scotland 124 142 284 83 30 169 130 172 35 1,169 2,107 Sweden 101 212 336 75 6 178 100 1,008 312 1972 3,823 3,701 5,108 3,106 3,912 2,593 2,579 3,490 2,568 3,117 3,788 1,690 39,475 - 1971 5,309 3,615 5,226 3,707 3,665 5,868 2,957 3,152 5,155 2,479 3,958 4,906 - 49,997 47 TABLE 3 TABLE SHOWING THE AMOUNT OF MEAT SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR UNSOUND CONDITION, 1972. Country of Origin January February March April May June July August September October November December Total Total 1972 1971 lbs lbs lbs lbs lbs lbs lbs lbs lbs lbs lbs lbs lbs lbs Argentina 4,840 2,147 3,272 1,840 5,675 3,509 4,244 1,368 3,245 8,029 6,068 8,892 53,129 32,854 Australia 120 60 228 60 495 241 82 1,690 84 3,060 2,209 Botswana 5 5 — Brazil 22 26 46 59 153 326 Canada — 200 Denmark 8 55 35 14 20 31 12 182 357 588 England & Wales 3,538 4,321 3,707 3,345 4,443 6,246 7,964 7,447 5,708 5,935 4,678 3,421 60,753 133,805 Finland 441 115 11 20 102 15,037 9,446 10 25,182 7,309 France 134 146 328 200 808 931 Germany — 4,088 Hungary 28 75 93 15 30 8 12 261 69 Ireland, Northern 384 17 415 35 61 570 798 337 234 680 382 3,913 31,864 Ireland, Republic 4,176 3,721 5,097 5,173 3,465 15,654 2,558 8,402 2,172 2,422 3,134 4,282 60,256 78,967 New Zealand 127 677 246 216 116 572 167 44 58 209 330 13 2,775 6,739 Netherlands 8 45 20 73 — Norway 21 7,000 6 7,027 — Poland 10 98 44 74 163 315 15 7,280 15 8,014 1,422 Scotland 294 538 493 245 1,513 1,358 4,359 2,640 2,538 971 5,820 438 21,207 18,013 S. Africa 40 10 300 4,740 156 156 1,493 2,413 9,308 225 S.W. Africa 55 507 562 — Sweden 17 32 1,529 4,416 381 389 865 217 83 7,929 269 U.S.A. 20 30 86 136 424 Yugoslavia — 6,312 1972 14,038 11,780 13,139 11,542 15,752 44,434 41,475 27,027 14,920 26,236 24,1*3 20,402 264,908 — 1971 14,155 15,748 15,336 8,399 17,708 33,877 46,083 40,024 42,008 46,967 25,644 21,665 — 326,614 48 FOOD HYGIENE - SMITHFIELD MARKET The Food Hygiene (Markets, Stalls & Delivery Vehicles) Regulations, 1966. These Regulations are enforced in Smithfield Market which at the 31st December 1972 comprised of 330 stalls, occupied by 100 tenants. Each business is equipped with facilities required by regulations 16 and 18 of the Regulations. There are 336 porters licensed by the Clerk and Superintendent either self employed or employed by meat carriers. During the year 210 warning letters were despatched in respect of infringements of these regulations and three successful prosecutions were heard at the Guildhall Justice Rooms (details below). The Poultry Market at Smithfield is modern and comparatively easy to clean, the old fashioned design of the main markets with undrained wood floors, nooks and crannies and somewhat Dickensian stairs, offices and passages above are more of a problem. The cleanliness of persons handling meat and other foods both in their person and their habits, constantly engage the attention of the Market Inspectors and prosecutions show only the tip of the iceberg. Day by day salesmen, shopmen, porters, buyers and carriers are exhorted to remember that the handling of open food calls for special care. 3uyers who shop in the market to stock their own freezers, immigrants who arrive to treat the market as they would in their own land do not buy for resale, therefore are outside the scope of the regulations. The recently imposed restrictions on non market vehicles until the afternoons has kept away the large number of unsuitable vehicles, often ordinary motor cars, used by these people. Increasing supplies of meat which is cut, trimmed, frozen or chilled and boxed before being sent to Smithfield is much easier to handle and less liable to risk of contamination. Prosecutions Infringement Regulation Fine Costs Smoking whilst handling meat. 8(e) £10 £11 Failing to wear clean washable head covering whilst carrying meat. 9 £10 Smoking whilst handling meat. 8(e) £20 £10 Failing to keep clean a Market Stall. 5 £50 £15 Failing to keep clean articles of equipment 6 £100 (3 offences). The Food Hygiene (General) Regulations, 1970. Around Smithfield, in Leadenhall Market and in the City including Billingsgate area are 33 businesses dealing in meat, game and poultry which are subject to routine visits by Meat Inspectors. Number of premises 33 Number of premises fitted to comply with Regulation 18 33 Number of premises to which Regulation 21 applies 32 Number of premises fitted to comply with Regulation 19 33 During the year 11 warning letters were despatched in respect of infringements of these regulations. Meat, poultry and game is prepared for the hotel and other catering outlets in premises in the Smithfield area. Much attention has been given to achieving the most hygienic methods of evisceration and trussing in order to minimise the spread of contamination by organisms intrinsic to the carcases. The Food Hygiene (Docks, Carriers etc.) Regulations, 1960. These regulations apply to 4 public cold stores where meat is handled. Of these four public cold stores, only one is modern and easily managed. The others are old, clumsily lagged, irregular in shape, labyrninthine in layout, and therefore difficult to keep clean and free from vermin. 49 Surrounded by unused and neglected buildings, vacant ground, and cuttings for the underground railway system it is becoming more and more difficult to keep them clear of vermin (mice). However, by constant attention to order and discipline of stowage and cleanliness, satisfactory standards are being maintained. Pest control firms have contracts with the cold stores and many of the food businesses and friendly co-operation with these firms has been achieved and maintained, especially in connection with the cold stores. Vermin Infestation The responsibility for control of vermin in the Market is assumed by the Corporation and is under the supervision of the Clerk & Superintendent who has been informed of any repair or maintenance work necessary for control or where baiting is required. Reference elsewhere has been made to the difficulty of controlling vermin in ancient and delapidated buildings. In addition the immunity gradually developed by mice to some poisons makes the task of control more difficult. Constant attention to repair and cleanliness of all food premises is essential to success. DISEASES OF ANIMALS ACT 1950 & ASSOCIATED ACTS Mr. G.S. Wiggins, M.R.C.V.S., Veterinary Officer for the City of London, has submitted the following report:- "The administration of the Diseases of Animals Act 1950, with the exception of imported animals, is the responsibility of the individual London Boroughs. The Corporation of London acts, on an agency basis, for seventeen London Boroughs under this Act and Associated Acts. In 1972, which was the seventh year in which agency arrangements were in operation, a total of 1740 visits of inspection were made to 780 premises which the Corporation undertook to visit. These included animal boarding establishments, animal hospitals, cattle and poultry shows, circuses, dolphinariums, farms, kosher and other butchers and poulterers, market stalls, parks, pet shops, piggeries, research laboratories, riding establishments, slaughterhouses, theatres, zoos, etc. The work carried out under these Acts and Orders included the following:Psittacosis or Ornithosis Order 1953 Enquiries were carried out concerning cases of suspected psittacosis in the London 3oroughs of Hammersmith, Richmond upon Thames and Islington. The first case, in January, concerned a budgerigar which was purchased from a pet stall and died very soon after purchase. In the second case two parrtos purchased from a pet stall died. This case occurred in September. In February, a paraquet which had been sold to a pet shop died. The carcase was taken to a laboratory where psittacosis was confirmed. A further case occurred in May when a person in hospital was found to be suffering from psittacosis. She had been employed in a pet shop in the London 3orough of Tower Hamlets. Restrictions were placed on the shop for several weeks. Riding Establishments Acts 1964 and 1970 Services under these Acts are carried out on behalf of eleven London Boroughs. Forty riding establishments were inspected for re-licensing purposes and investigations were made following complaints. It was also necessary for evidence to be given in Court concerning one establishment. Pet Animals Act 1951 Seven London Boroughs require the Corporation to carry out visits to pet shops in their areas. There is one pet shop in the City of London. 117 such shops received regular visits of inspection and recommendations concerning re-licensinn were submitted to the 3oroughs. Club Row and Shepherds Bush Markets were also visited and pet stalls at these markets were inspected. Apart from the regular visits of inspection, a number of visits were made to investigate complaints from members of the public. Animal Boarding Establishments Act 1963 The Corporation carries out services under this Act for five London Boroughs and visits of inspection were made to thirty one animal boarding establishments. Reports were submitted concerning re-licensing. The service was also used in a consultative capacity and to investigate complaints. 50 Live Poultry (Restrictions) Order 1971 Three Licences were issued under the terms of this Order, to enable the holding of poultry exhibitions and shows by the West Essex Bantam Society at the Bethnal Green Institute, the International Poultry Show at Olympia and the Dagenham Town Show at Central Park, Dagenham. Inspections were carried out at these exhibitions to ensure that the terms and conditions of the Order were conformed to. In June, a contravention of this Order was discovered during a visit to Sclater Street Market, concerning the sale of hens, chickens and ducks. The sale was prohibited and a report sent to the local authority concerned. The Royal Smithfield Show was visited in December and all livestock, floats, transport etc., was inspected. A full report was sent to the local authority. Performing Animals (Regulation) Act 1925 Three certificates of registration were issued under the terms of this Act to enable persons to train and exhibit horses, lions, leopards, elephants, tigers, dogs, monkeys, donkeys, kangaroos and bears. Television studios, theatres, dolphinariums etc., were visited concerning the use of performing animals in productions. Three circuses were visited during the year. Cottle and Austen's Circus appeared in several London Boroughs; the Circus Togni was situated in Richmond; Denning and Wild's Circus appeared at a theatre at Charing Cross, London. All animals, performing animals certificates, quarters etc. were inspected and performances witnessed. The circus at Charing Cross was visited on several occasions as it was considered that the premises were not suitable for the keeping of animals and some advice was given concerning positioning of cages, fire precautions etc. Regulation of Movement of Swine Order 1959 Under the terms of this Order, animals moved under the authority of a licence to premises other than a bacon factory or slaughterhouse, must be kept on the premises, separate from other animals, for a period of 28 days. Animals moved to a bacon factory of slaughterhouse must be detained there until slaughtered. 360 such licences were received and verified. On two occasions the attention of transporters had to be drawn to the overcrowding of pigs being transported to an abattoir, in contravention of the Transit of Animals (Amendment) Order 1931. Post Mortems Frequest requests were received for post mortem examinations to be carried out on animals which arrived dead or died at slaughterhouses or were found dead on farms, public highways etc. During the year such examinations were carried out on thirty pigs, three sheep, three calves and one goat. Swine Vesicular Disease The first outbreak of this disease occurred on the 11th December in Staffordshire and up to the 31st December there had been thirty-four outbreaks. All of England south of Lancashire and Yorkshire was declared to be a 'controlled area' which meant that pigs could only be moved under controlled areas licences. The cause of the outbreaks are still being investigated, but is thought to be infected swill. All owners of swill boiling plants have been contacted and informed of the extreme precautions which must be taken. Foot and Mouth Disease Following confirmation of the above disease in two pigs at the Royal Veterinary College, arrangements were made for the contact animals on the premises to be slaughtered and for the carcases to be destroyed by burning. For this purpose, use was made of the flame guns owned by by the Corporation. The animals destroyed consisted of a cow, calves, sheep and pigs. Miscellaneous Enquiries were carried out at a pet shop in the London Borough of Camden following a report that five people were suffering from ringworm, said to have been caught from a cat purchased from the shop. A full report was sent to the Borough. In February, investigations were made concerning a case of yersinia in a child who may have caught the disease from a hamster. A full report was submitted to the local authority. Enquiries were carried out in March concerning the possibility of warfarin poisoning in a dog which had died. Once again, a report was sent to the local authority. 51 Acts and Orders 1972 The following legislation, affecting the work of the department came into operation during the year: Brucellosis (Eradication Areas) Orders Brucellosis (Area Eradication) Orders A number of these Orders came into operation. They declare certain areas to be eradication areas and prohibit vaccination of cattle in those areas unless authorised by the Minister. They also prevent movement of cattle into such areas and on or off premises to prevent the spread of brucellosis. Tuberculosis (Compensation) Amendment Order 1972 This Order amends the Tuberculosis (Compensation) Order 1964. Live Poultry (Restrictions) Amendment Order 1972 Amends the Live Poultry (Restrictions) Order 1971, by prohibiting the granting of licences by local authorities for auctions of store poultry between 1st October and 31st December in any year. Diseases of Animals (Approved Disinfectants) Order 1972 Sets out lists of approved disinfectants for dealing with foot and mouth disease, fowl pest and tuberculosis and other diseases requiring the use of approved disinfectant. Foot and Mouth Disease (Infected Areas) (Vaccination) Order 1972 This Order requires the owners of animals in an area infected with foot and mouth disease to submit them for and assist in vaccination against the disease, as the Minister proposes. Swine Vesicular Disease Order 1972 Swine Vesicular Disease (Compensation) Order 1972 Under the first of these Orders, swine vesicular disease becomes a notifiable disease. It enables affected animals and those exposed to infection to be slaughtered. It also applies to swine vesicular disease certain provisions relating to foot and mouth disease. The latter Order prescribes the scale of compensation for slaughtered animals. Diseases of Animals (Seizure of Carcases) (Amendment) Order 1972 This Order extends the list of things which may be seized to prevent the spread of foot and mouth disease and swine vesicular disease and allows for compensation. I would again like to pay tribute to the staff of this department for their continued support in carrying out services during the year in a most enthusiastic manner often under very difficult circumstances and out of office hours." PERSONAL HEALTH SERVICES IN THE CITY (Comparable figures for 1971 are given in brackets where appropriate) The total number of births occurring in the City (St. Bartholomew's Hospital) was 742 (580). Births (to City Residents) 1971 1972 Hospital Live Births 32 34 Domiciliary Live Births 1 NIL Number of these born with congenital malformations NIL 1 Stillbirths NIL NIL 52 NATIONAL HEALTH SERVICE ACT, 1946 (as amended by the Health Services and Public Health Act, 1968) The Corporation of London is responsible for services as set out in Sections 21 to 28 (excluding Section 27) of the National Health Service Act, 1946. The Greater London Council is responsible for the administration of all ambulance services within the Greater London area under Section 27 of the Act. TEMPLES ORDER, 1971 Following the Temples Order which came into effect in 1971, a greater volume of personal health services have been provided to residents of the Temples. SECTION 21 - HEALTH CENTRES There are no such Centres in the City of London. SECTION 22 - CARE OF MOTHERS AND YOUNG CHILDREN During the year only one congenital defect of an infant born to City parents was recorded. Infant Deaths 1971 1972 Stillbirths NIL NIL Neo Natal NIL 1 Perinatal 1 NIL Others under 5 years NIL NIL Maternal Deaths 1971 1972 NIL NIL Child Health Clinic Clinic Attendance of Children under 5 years. Number of children attending 74 Total attendances 606 Dr. A. White Franklin, the Paediatrician, has reported as follows: "The general standard of health and hygiene and the use of immunisation facilities during the past year have all remained high." Vaccinations and Immunisations at Child Health Clinic 1971 1972 Diphtheria/Tetanus/Whooping Cough 9 10 Diphtheria/Whooping Cough - 3 Diphtheria/Tetanus 3 5 Poliomyelitis 11 16 Smallpox - 4 Measles 3 5 At Risk Register 1971 1972 Children aged under five years on the Register at the end of the year 3 10 Welfare Foods The sale of Welfare Foods continues at the Child Health Clinic St. Bartholomew's Hospital and at the Health Department Office. 53 SECTION 23 - MIDWIFERY SERVICE The Metropolitan District Nursing Association continued to provide domiciliary midwifery services in the City. No request for midwifery services within the Temples was made. 1971 1972 Home confinements attended NIL NIL Planned early discharge from hospital 7 1 Emergency cases attended 1 NIL The midwives continued to visit St. Bartholomew's Hospital maternity department in order to promote closer liaison between hospital and domiciliary midwifery services and to attend deliveries of City mothers who have been accepted for discharge home after 48 hours. Midwives Act, 1951 The Corporation, as the supervising Authority for the City of London, received from midwives 50 (44) notifications of intention to practise during the year. SECTION 24 - HEALTH VISITING First visit nECORD OF HOME VISITS 1972 this year Children born in current year 29 Other children aged under 5 53 Persons aged 5-16, seen as health visiting, exluding those seen as part of 11 School Health Service Persons aged 17-64, seen as health visiting 103 Persons aged 65 and over seen as health visiting 85 Households visited on account of Tuberculosis 18 Households visited on account of other infectious disease 3 Households visited for any other reason 1 TOTAL 303 Number of persons in Mentally Handicapped - 1-5 above who were: Mentally III 6 CASE CONFERENCES ATTENDED WITH: (must last 1 hour minimum) Social Workers — Hospital Staff - General Practitioners 14 Any Combination of above — Others (i.e. none of above present) 1 TOTAL 15 RE-VISITS Total Children born in current year 117 Other Children aged under 5 61 Persons aged 5-16, seen as health visiting, not School Health Service 24 Persons aged 17-64, seen as health visiting 111 Persons aged 65 and over, seen as health visiting 421 Households visited on account of Tuberculosis 10 Households visited on account of other infectious disease 2 Households visited for any other reason - TOTAL 746 MISCELLANEOUS VISITS Visits to General Practitioners' Surgeries 63 Visits to other General Practitioners' Clinics 10 Visits to Hospitals 87 Ante-natal visits 21 TOTAL 181 54 The Health and Welfare Officers visited 29 out of the 34 infants registered as born to city residents during the year. The remaining five infants were traced to addresses outside the city as the parents had subsequently removed to accommodation elsewhere. Statistics for 1972 have been recorded in a more detailed format and present a fuller picture of the health visiting content of the work undertaken by the staff: it also shows an increase of home visits due to the larger residential population and includes visits to all age groups from infancy to extreme old age. One Health and Welfare Officer transferred her employment to another London Borough during the early part of the year and two Health and Welfare Officers were appointed at a later date, thus increasing the staffing establishment to one Principal Health & Welfare Officer and three field staff. This made it possible to rearrange case loads and develop the health visitor attachment to a General Practioners' Group Practice. It enabled staff to devote more time in seeking out elderly people in need of health maintenance services and to provide the necessary supportive social services. One Health and Welfare Officer was allocated to St. Bartholomews Hospital Special Treatment Clinic for two sessions a week to assist in the contact tracing programme. Another Health and Welfare Officer extended her role in assessment and provision of Health and Welfare Services to men living in the Salvation Army Hostel. The development supports a plan of the General Practitioner who now holds surgery sessions on three mornings a week in the hostel in an attempt to meet the very real need of medical and community care found to be present among many men lodging there. As the child population grew, more mothers with infants attended the Child Health Clinic in St. Bartholomews Hospital; this created a need for improved play facilities for the toddlers within the clinic setting giving mothers the opportunity to talk to one another whilst the children play. Senior Nursing Officers from St. Bartholomews Hospital have been welcomed once more to the Department, each spending one or two days observation visits in community care. Before the year ended, two groups of eleven student nurses from the hospital also participated in observation visits. The Health and Welfare Officers not only carry out Health visiting duties but incorporate all Social Works functions apart from the Mental Health and Child Care duties provided by Tower Hamlets Social Services Department. Over the years since 1965, the two roles have gradually merged into a whole and it is increasingly difficult for field staff to define the duties as separate work functions. Many residents "in need" are found to require both services in fairly equal measure and each service enhances the other to the benefit of the recipient. The year 1972 has been one of consolidation and change to keep abreast of the steady increase in the population and the need to adapt services and techniques to provide community care in specific areas of the City where redevelopment has created new problems. To this must be added the growing awareness of residents in the Temples to the Health and Social Service resources available to them, since the Temples Order came into effect in November 1971. Tuberculosis Health Visiting 1971 1972 Cases notified (residents) 9 13 Total home visits, old and new cases 32 26 Shops and office contact tracing No. of investigations 16 18 (involving (involving 88 240 persons) persons + 165 Mass X-Rayed) The volume of work in Tuberculosis health visiting has shown a slight increase and there is continued need to support, educate and advise patients and their families. This continued need is reflected in the work of contact tracing in shops and offices to enable City workers to receive radiological examinations and to combat the spread of infection. In the Salvation Army Men's Hostel, the casual occupants are frequently at high risk of infection and some indeed have contracted the illness. In an attempt to reduce the spread of infection the men are actively encouraged to use the facilities of the Mass X-Ray mobile van which is now organised to make twice yearly visits outside the Hostel. The General Practioner and the Health and Welfare Officer at the Surgery Sessions in the Hostel are constantly alerted to the need to check and follow-up men who lapse in their Chest Clinic attendances. 55 SECTION 25 - HOME NURSING The Metropolitan District Nursing Association continued to provide home nursing services in the City. With the development of the family doctor group practice attachment scheme there has been an appreciable increase in the number of patients attended. 1971 1972 Patients attended in their homes 77 67 Patients attended in General Practioners Surgery NIL 75 Patients attended elsewhere 4 8 Total patients attended 81 150 Number of nursing treatments given 2443 4011 Number of patients being attended at the end of the year 24 71 SECTION 26 - VACCINATION AND IMMUNISATION In accordance with the then Ministry of Health instructions that smallpox vaccine should be distributed to medical practitioners by the Local Authority in whose area they practise, arrangements continue for the vaccine to be distributed to City doctors. During 1972, 7200 (6063) doses have been issued to City medical practitioners and doctors at St. Bartholomew's Hospital, the medical department of Unilever and various City business houses. Poliomyelitis vaccine is also issued at the request of St. Bartholomew's Hospital, Unilever Limited and City medical practitioners. In all 4170 (3200) doses were issued. 77 (76) adults (including Corporation Staff) were vaccinated by Corporation medical staff. (See other sections for vaccinations and immunisations of school children and children under five years of age). SECTION 27 - AMBULANCE SERVICE The Greater London Council are responsible for the ambulance service in the Greater London area. SECTION 28 - PREVENTION OF ILLNESS, CARE AND AFTERCARE City of London Chest Clinic Dr. Neville C. Oswald, the Chest Physician, has reported as follows:- "Thirteen City Residents with Pulmonary Tuberculosis are under regular observation and treatment, eight of whom attended for the first time in 1972. Ten of the thirteen gave the Salvation Army Hostel as their address. Of the forty eight Residents of the Salvation Army Hostel who attended the Mass X-Ray Unit, three were referred to the Chest Clinic, but none reported to the Clinic, nor could they be traced. During 1972, eighteen City Workers were notified as having infectious Tuberculosis. This resulted in eighty-eight contacts being examined at the Chest Clinic, and a further one hundred and sixty-five were X-Rayed by the Mass X-Ray Unit. One of these contacts was found to have active Pulmonary Tuberculosis. Sixteen City Residents attend theChest Clinicfor non-tuberculous chest disease. In addition, approximately three hundred visits were made to the Clinic by City Workers." Special Hostels for Tuberculous Men 1971 1972 Men resident during the year 4 5 Loan of Nursing Aids and Aids for handicapped 1971 1972 Supplied by Health Department 67 145 Supplied by British Red Cross Society - 2 NIL City Branch 56 The number of items of nursing Aids and Aids for the Handicapped on loan have increased steadily year by year. It is not easy to differentiate in all cases which are nursing aids and which are aids for handicapped persons. One person may receive both types of aids particularly in chronic ill health. But it is very apparent that the aids do considerably assjst many people to be nursed more comfortably in their own homes and greatly enable them to function more independently. Chiropody Service The following reports have been received from Mr. R. Jones, M.Ch.S., S.R.Ch., and Mrs. M. Graham, S.R.Ch., respectively:- "Chiropody Treatments at Petticoat Square and Petticoat Tower, E.I. Since the closing of the Gravel Lane Clinic 43 patients had Domiciliary visits during the year. All of the patients were now in the 70 plus age group and a number of these are physically handicapped and quite unable to attend a Clinic. Two of the patients out of 43 had died during the year. Out of the 43 patients 33 were females and had the usual corns, callosities and bunion troubles. As before, the palliative treatment helped to keep them mobile and the service was greatly appreciated. Each patient was seen at approximately monthly intervals and had a regular appointment which worked very well. I would like to place on record that the co-operation of the Medical Officer of Health's Staff helped tremendously in keeping the service extremely successful. As in the previous year the elderly, physically handicapped and school children were treated under the chiropody service. Since September an extra session a week was worked thus enabling patients to be seen more frequently. Milton Court Patients were generally seen once a month at Milton Court Clinic. A total of 114 treatments were given during the year. The number of patients at the end of the year was 9. Salvation Army The frequency of visits to the Salvation Army was increased to once a month instead of once every six weeks as in the previous year. 11 sessions were held during the year and 37 treatments were given. The men still do not make as much use of the service as the condition of their feet demands. Domiciliary Visits This service is for the housebound or people who have difficulty in getting to Milton Court Clinic. The treatment of these patients is mostly palliative, helping to keep them mobile around the house. Due to the extra session a week, patients are usually seen once a month. 317 treatments were given during the year. Sir John Cass's Foundation School 16 visits were made to the school. 195 children were inspected, 25 required further treatment. These conditions were mostly verrucae, corns and nail conditions. A total of 80 treatments were given throughout the year. Many children were still wearing shoes which were too small, often because parents failed to have their feet measured. Girls again tended to wear fashionable shoes, but fortunately current fashion coincided with sensible styles such as wide lace-up shoes. I would like to thank the staff of the Medical Officer of Health, the Brigadier and his staff in Salvation Army Hostel, the School's Head Master and his secretary, for their help and co-operation throughout the year." 57 Services for Incontinent Persons 1971 1972 Persons receiving service at end of year 10 12 Items washed 3370 3730 Under Section 13 of the Health Services and Public Health Act 1968 arrangements have been made for the linen of incontinent persons to be laundered free of charge. A twice weekly collection and delivery service is operated by Corporation transport and payment is made to the London Borough of Tower Hamlets for carrying out the laundering on behalf of the Corporation. The service is of great value not only to the incontinent patient, but also to the caring members of the family. Yellow Fever Vaccination The Corporation continued to supply yellow fever vaccine to the designated centre at Unilever House. As the Corporation is also the Port Health Authority for the Port of London arrangements have also been made for distribution to two Shipping Federation Medical Centres. During the year 2370 (3255) doses of vaccine were distributed. International Certificates of Vaccination against Smallpox 1971 1972 Number authenticated 3730 3500 Number returned as doctor did not practise in the City 42 40 V.D. Contact Tracing The Principal Health and Welfare Officer is responsible for the follow up of possible contacts of known cases within the City. Requests received for assistance in 1971 1972 follow up: City Cases 1 NIL Non City Cases 2 4 At the end of the year arrangements were made for a Health and Welfare Officer to participate in the work of contact tracing in the Special Clinic at St. Bartholomews' Hospital, and to spend two sessions at the clinic each week. The Health and Welfare Officer attended a short training course prior to commencing her duties and a one week induction course arranged by the Consultant Physician. It is perhaps too early to assess the value of this new field of work but it has already shown some measure of effect in the procedures of contact tracing and also in the greater problem of follow-up of clinic defaulters. An average of ten patients are seen at each session and the role is developing into what best can be described as that of a counsellor and health educator. Health Education Subject Audience No. of Lectures Average number in the audience at each Lecture Health Hygiene and Functions of the Human 3ody Primary School Children 6 20 Baby Care Expectant mothers attending St. Bartholomew's Hospital 6 20 Medical aspects of Drug Dependence Merchant Navy Officers & Petty Officers 1 70 Family and Sexual Relationships City of London School Pupils 12 25 Home Safety Home Helps (Training Course) 1 14 Community Health Care State Registered Nurses St. Bartholomew's Hospital Stoma Care Course 1 6 58 It is with regret that the changing work pattern of the Health and Welfare Officers duties did not allow for the continued development of group education in health education during the year. Established group teaching was maintained throughout the year where possible. The distribution of literature and posters to General Practioners' Surgeries, St. Bartholomews Hospital, various 3anks and Business Houses, the Citizens Advice Bureau has continued to meet the constant demand. Family Planning Rent free premises are provided for the Family Planning Association at Milton Court where three lunch-time and one evening sessions are held each week for City Workers and residents. The Corporation continues to underwrite the cost of consultation and supplies to married women residents referred on medical grounds. Following the National Health Service (Family Planning) Act 1967, the Corporation also underwrites the cost of consultation to married women residents or other residents who seek advice on social grounds. The Corporation also gives a grant to the Family Planning Association. The Association has submitted the following report on their work in the City "As in previous years the Family Planning Clinic has been busy and all sessions well attended. 550 women, of whom 35 were City residents had never been to Family Planning Association Clinics before and 110 were transferred from other clinics. The total attendances were 4,377, and this number is slightly lower than last year because many of those who have attended the clinic for several years are seen at longer intervals than the newer patients. The majority of people came referred by their friends which we hope points to a good service and the majority choose oral contraception as their method. However there are still those who with to use other methods and the Clinic Medical Staff is happy to discuss these with each person enabling them to make a reasoned decision as to which method is most suitable for them. Those wishing to befitted with an I.U.D.(intra uterine device)have been referred to Islington Family Planning Centre. 837 cervical smears were taken during the year all of which were negative. In the meantime we know that those people who do take advantage of the facilities provided are extremely appreciative and we are very glad for the opportunity of co-operating with the Corporation in the provision of the service." Well Women's Clinic The clinic, set up in 1958 with Corporation funds, is established at St. Bartholomew's Hospital. The following report of the work of the clinic during 1972 has been received from Mr. D.K. Williams, F.R.C.S., M.R.C.O.G. "Total number of attendances:- 528 Abnormal Smears Inflammatory changes 53 Atrophic changes 44 Trichomonas infection 2 Monilia infection 4 Pap. class III 1 Clinical Findings Cervical Polyps 15 Cervical Erosions 23 Fibroids 27 3enign breast lumps 4 Ovarian cysts 6 Prolapses 4 Pruritis vulvae 1 Cervical cervicitis 17 Cervical ectropian 1 " 59 Bank of England Cervical Smear Scheme The following report on the work of the clinic during the year has been received from Dr. I.D. MacDonald, M.D.:- "With reference to the work of the Cervical Smear Clinic at the Bank during 1972, I have to report 239 women were examined. There were no positive results, but, as usual, a number of women were advised to visit their own doctor for treatment for minor disorders. Interest in the Clinic continues to be well maintained." ROUTINE CERVICAL CYTOLOGY RE-CALL SCHEME From January 1972 a national scheme of periodic recall for routine cervical cytology was introduced by the Department of Health and Social Security. Records of women whose last test took place five years earlier are passed by the National Health Service Central Register to the local authority of her area of residence. These patients are then invited by the local authority to attend for a further examination. All general practitioners, hospitals and clinics involved in these tests are advised to use a revised request/report/recall form and after completion of the test copies of the form giving the result are distributed by the laboratory to the patients general practitioner and to the local Medical Officer of Health. The latter, in turn, passes the result form on to the patient's area of residence and thus it can be verified whether or not a patient invited to attend for reexamination has, in fact, done so. The Corporation is participating in this scheme and those City residents notified by the National Health Service Central Register as being due for recall are advised that they should contact their general practitioner or attend a clinic for re-examination. If they fail to do so, a follow up visit is made by a Health and Welfare Officer. A form showing the test result is received for every test which is dealt with by the cytology laboratory at St. Bartholomew's Hospital. Those relating to City residents are retained for follow-up purposes and those for non-City residents are forwarded, in each case, to the Medical Officer of Health of the patient's area of residence. In a similar way forms in respect of City residents who have attended a clinic out of the City are received in from the Medical Officers of Health of many other areas. Domiciliary Physiotherapy The Metropolitan District Nursing Association continued to employ a sessional domiciliary physiotherapist to treat, under general practitioner or hospital supervision, those persons who would usefully benefit from this type of service which may not be provided by a local authority under the Act. 1971 1972 Number of patients treated during the year 18 32 Visits made to treat patients, visit doctors and clinics 320 277 EDUCATION ACT, 1944 SCHOOL HEALTH SERVICE The general standard of health at the Sir John Cass's Foundation School remains good and the high level of hygiene continues satisfactorily. During the year the following school medical inspections were carried out:- 1971 1972 Routine children inspected 51 39 Special children inspected 33 33 Re-inspection children inspected 86 63 Comprehensive Health Survey children inspected 171 NIL Selective Survey children inspected 97 32 The Selective Inspections are conducted by the School Nurse. The general standard of hygiene amongst the school children was good, and no head or body infestation occurred during the year. 6 home visits were made to City parents to follow up matters arising from the medical inspections. 60 School Dental Service. (The statistics given here complement the Dental Officer's Report). 1971 1972 Treatment sessions 51 51 Inspection sessions 2 4 Dental Health Education sessions 4 4 First appointments 161 155 Subsequent appointments 155 199 Emergencies 1 1 Total attendances 317 355 1st inspections carried out at school and clinic 230 249 Percentage requiring treatment 60.0 45.0 Dental Officer - whole time equivalent 0.1 0.1 Special Clinics A clinic is held at the Sir John Cass's Foundation School from time to time for those pupils who have been examined at school medical inspections and for whom further investigation is felt to be necessary. During 1972 3 (5) such clinics were held and 10 (15) children examined. Audiometry 23 (29) children were tested during the year at the school. One child was referred to a Specialist. Vaccination and Immunisation 1971 1972 Poliomyelitis 23 17 B.C.G. (including students) 246 240 No. vaccinated 161 188 Diphtheria/Tetanus 50 17 Measles - 1 Tetanus (students) 96 120 Infectious Diseases Reported from Schools 1971 1972 Chickenpox 2 5 Measles 1 NIL Mumps 1 2 Gastro-enteritis 2 1 Scarlet fever 1 NIL Tonsillitis NIL 1 Impetigo NIL 1 German measles NIL 1 Chiropody Service in School (See Report under Section 28 National Health Service). Owing to the change of health visitor personnel, Health Education as a class subject was discontinued after June, to enable the new school nurse to organise her work and to get to know the staff and their pupils. This does not mean that Health Education was neglected, but merely presented in a different way to smaller groups as the occasion arose during the nurse's visits and health topics were related to situations and conditions presented by the pupils themselves. REPORT OF THE DENTAL OFFICER, 1972 "There has been no great change in the dental picture as reported last year. It may be regarded as rather brighter in that the number of pre-school children needing treatment was lower and that of primary and junior school children was reduced considerably. The high demand for treatment by adults continues. Pre-school Children The number requiring treatment fell from 62% last year to 50% this year. This is quite an improvement but, of course, far from satisfactory when one considers that these children are all under the age of 5. 61 SCHOOL DENTAL SERVICE - INNER LONDON EDUCATION AUTHORITY School Entrants (5 yr. olds) The situation is not as good as last year in that 36% needed treatment as against 20% last year. Infants and Juniors There is quite an improvement in this age group only 41% requiring treatment as against 60% last year. Prevention It will be appreciated that the dental picture presented above does not necessarily reflect the pattern of dental disease among children in Inner London as a whole, because the numbers are small, for obvious reasons. On the other hand, one would certainly hope that the state of the mouths of some of the school children resident in the City (as distinct from school children living outside it) would not be reflected in the overall pattern, because, as had been said repeatedly in these reports, some of the worst mouths seen are those of City children. The only real hope that one can have for any improvement in this situation would seem to be by means of water fluoridation. As reported last year, in an attempt to obtain at least some measure of benefit from fluorides, the teeth of those school children at Sir John Cass's Foundation School whose parents accepted it, were painted with fluoride gel. At the same time instruction in oral hygiene was given by Dental Health Educators of the Inner London Education Authority. A very satisfactory total of 89% of the children received this preventive treatment and one hopes that as time goes on, the percentage will go even higher. It is, however, rather too early yet to measure the effect of this exercise in topical fluoridation. Group instruction in oral hygiene to groups of children in the classroom to reach those not covered in other ways is also desirable. This aims by talks, puppet shows, teaching projects, audio-visual methods, etc. to show the basis of oral hygiene instruction, namely, how to remove the film, now known as plaque, which attaches itself to teeth, and which, it is believed, causes decay and gum disease. Orthodontics An increase in this form of treatment, which aims to correct irregularities of teeth, was noticed this year. National Health Service This covers the field of adult dental treatment. The number of staff treated was about the same as the previous year and could be said to indicate that the introduction of increased patient contributions has not really reduced the demand for treatment. In fact, it would not be easy to deal with any great increase in numbers; the limit of capacity having been reached, and indeed it is a matter for great regret that it is not possible to offer a recall service, i.e. 6 monthly check-up. St. Bartholomew's Hospital The numbers referred to hospital for purposes of general anaesthesia, oral surgery and orthodontia have increased slightly,and as always, both patients referred, and the dental staff here, have the greatest admiration and gratitude for the skilful treatment, general co-operation and unfailing courtesy, invariably received from the hospital staff." STATISTICAL INFORMATION Area- 678 acres (including the Temple and foreshore) Population - Census 1961, 4,711; Estimated mid-year 1972, 4,080 Annual Rateable Value - as at 1st April, 1971, £49,652,608 Annual sum Received from Penny General Rate - £499,000 62 VITAL STATISTICS COMPILED FROM REGISTRAR GENERAL'S RETURN 1971 1972 Live Births Number 36 34 Rate per 1,000 population 8.3 7.4 Illegitimate Live Births Number 3 2 Illegitimate live births per cent of total live births 8 6 Still Births Number NIL NIL Rate per 1,000 total live and still births NIL NIL Total Live and Still Births 36 34 Infant Deaths (deaths under 1 year) 2 1 Infant Mortality Rates Total infant deaths per 1,000 total live births 28 29 Legitimate infant deaths per 1,000 legitimate live births 30 31 Illegitimate infant deaths per 1,000 illegitimate live births NIL NIL Neo-Natal Mortality Rate (deaths under 4 weeks per 1,000 live births) 28 29 Early Neo-Natal Mortality Rate (deaths under 1 week per 1,000 total live births) NIL 29 Perinatal Mortality Rate (still births and deaths under 1 week combined per 1,000 total live and still births) NIL 29 Maternal Mortality (including abortion) Number NIL NIL Rate per 1,000 total live and still births NIL NIL Deaths (all ages) Number 56 35 Rate per 1,000 resident population 12.7 7.6 63 NUMBERS OF DEATHS BY CAUSE, SEX AND AGE GROUPS (Statistics supplied by the General Register Office on Form S.D.25) CAUSE OF DEATH Sex All Ages Under 4 weeks 4 weeks & under 1 year AGE IN YEARS 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75 and over B5 Tuberculosis of Respiratory System M 2 _ _ _ _ _ _ _ 1 _ 1 _ F - - " - - - - - - - - - B19(4) Malignant Neoplasm, Intestine M 1 - - - - - - - - - 1 . F - - - - - - - - - - - - B19(6) Malignant Neoplasm,Lung, Bronchus M 1 - - . - - . - - . 1 . F - - - - - - - - - - - B19(9) Malignant Neoplasm, Prostate M 1 - * - - - - - - - - 1 B19(10) Leukaemia M _ - . _ _ _ _ _ - _ _ _ F 1 - - - - - - - - 1 - - B46(5) Other Diseases of Nervous System M 1 - - - - - - - - 1 - - F - " - - - - - - - - - - B28 Ischaemic Heart Disease M 3 - - _ _ _ _ _ . 1 2 . F 3 - - - - - - - - - - 3 B29 Other Forms of Heart Disease M 1 _ _ _ _ _ _ _ _ _ 1 _ F - - - - - - - - - - - - B30 Cerebrovascular Disease M 5 - . - - - - - - 3 1 1 F 2 - - - - - - - - - 1 1 B46(6) Other Diseases of Circulatory System M 2 - - . - - . - _ 2 _ _ F - - - - - - - - - - - - B31 Influenza M 1 _ _ _ _ _ _ _ _ _ 1 _ F - - - - - - - - - - - - B32 Pneumonia M 1 - - - - - - - - 1 - - F 1 - - - - - - - - - - 1 B33(1) Bronchitis and Emphysema M 2 - - . - - - - - - 1 1 F • - - - - - - - - - - - B37 Cirrhosis of Liver M 1 - . - . - - - 1 - . . F - - - - - - - - - - - - B46(8) Other Diseases of Digestive System M - . - - - - - - - - - - F 1 - - - - - - - - - - 1 B38 Nephritis and Nephrosis M - - - - - - - - - - . - F 1 - * - - - - - - - 1 - B44 Other Causes of Perinatal Mortality M _ - - - - - . - . - - - F 1 1 - - - - - - - - - - BE47 Motor Vehicle Accidents M 1 _ _ _ . _ _ _ 1 . _ _ F - " - - - - - - - - - - BE48 All Other Accidents M 1 _ _ _ _ _ _ _ - 1 - - F - - - - - - - - - - - - BE50 All Other External Causes M - - - - - - - - - - - - F 1 - - - - - - - 1 - - - TOTAL ALL CAUSES M 24 - _ _ _ _ _ _ 3 9 9 3 F 11 1 - - - - - - 1 . 1 2 6 64 CORPORATION STAFF Ophthalmic Optician Service Since March, 1959, a firm of Ophthalmic Opticians have been operating an eye testing service for members of the staff. This service is operated under the National Health Service, and examinations are therefore free, although charges are made, in the usual way, for the dispensing of prescriptions. The sessions are held at fortnightly intervals. Examinationscarried out during the year are shown in the following table: — Total examinations carried out 46 Number of staff who had not previously had an eye test 10 Visual defects found and corrected 9 Re-examinations of persons already using spectacles 36 Further correction needed and carried out 30 Medical Examinations During the year, 653 medical examinations have been carried out, as shown in the following table:— Reason for Examination Result Male Female Total Admission to Superannuation Scheme Fit 289 117 406 Unfit 0 0 0 Deferred 13 6 19 Referred for excessive sick absenteeism Fit for duty 17 0 17 Still unfit 8 1 9 Unfit for further service 20 1 21 Staff over 65 years of age continuing in employment Fit to continue 69 26 95 Unfit to continue 0 0 0 Special examinations Exemption from parking meter fees Monument employees 81 5 86 Temporary appointments Fitness to drive heavy goods vehicles (Cleansing Staff) TOTALS 497 156 653 65 NOTIFICATION OF INFECTIOUS DISEASE During the year 21 notifications of infectious diseases affecting City residents were received as shown in the following table which also shows comparable figures for 1971:- Disease 1971 1972 Dysentery 1 3 Food Poisoning 3 2 Measles 5 8 Scarlet Fever 0 1 Tuberculosis, Pulmonary 9 6 Tuberculosis — other 2 0 Whooping Cough 0 1 20 21 In addition to the above a further 36 notifications (26 during 1971) were received relating to persons who normally reside outside the City. These notifications were brought to the attention of the Medical Officers of Health of the areas where these persons normally resided. NEW LEGISLATION DURING THE YEAR The following enactments, which effect the work of the Department and which have not been mentioned previously in this Report, were made during the year- Agriculture (Miscellaneous Provisions) Act, 1972 Deposit of Poisonous Waste Act, 1972 Deposit of Poisonous Waste (Notification of Removal of Deposit) Regulations, 1972 Housing (Prescribed Forms) Regulations, 1972 Immigration Act, 1971 (Commencement) Order, 1972 Medicines Act 1968 (Commencement No. 1) Order, 1972 Medicines Act 1968 (Commencement No. 2) Order, 1972 Poisons List Order, 1972 Smoke Control Areas (Exempted Fireplaces) Order, 1972 Smoke Control Areas (Exempted Fireplaces) (No. 2) Order, 1972 National Health (Family Planning) Amendment Act, 1972 PUBLICATIONS (1) Handbook of Poultry Inspection (2) Clean Food Handling 66