LON 99 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1973 To be presented Thursday, 27th June, 1974. PORT AND CITY OF LONDON HEALTH COMMITTEE (as at 31st December, 1973) Chairman Henry Duckworth, J.P., Deputy Deputy Chairman Herbert Twyneham Pike, Deputy Aldermen 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 All day 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. Sir Stanley Graham Rowlandson, M.B.E., J.P., G.L.C. Francis Seymour Smith, T.D. Dennis Gordon Fisher William Ian Baverstock Brooks Andrew Hugh Fitzgerald Olsen, B.Sc. Henry Wimburn Sudell Horlock, M.A. 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 Bay I is Cyril 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. Brig. Joseph John Packard INDEX Page Ambulance Service 54 Animal Boarding Establishments Act, 1963 46 Atmospheric Pollution 24 At Risk Register 52 Automatic Vending Machines 39 Bacteriological, Analytical & Chemical Work 9> 10, 12, 32 Births 51 Care of Mothers and Young Children 51 Catering and Other Food Premises:- Adulterations and Irregularity 33 Bacteriological Examination 32 Complaints 31 Prosecutions 38 Registration of Food Premises 38 Sampling 30, 32 Surrendered or Seized Food 40, 42, 43, 44 Vending Machines 39 Causes of Death 61 Cervical Cytology 57, 58 Child Health Clinics 51 Chiropody 55, 59 Clean Air 24 Clearance Area 8 Closing Orders 8 Common Lodging House 13 Deaths:- Infant 51 Maternal 51 Causes 61 Dental Officer's Report 59 Diseases of Animals Act, 1950 46 Disinfection 29 Domicilliary Physiotherapy 58 Factories Act, 1961 22 Family Planning 56 Fertilizers & Feeding Stuffs Act, 1926 40 Fish Inspection 40 Food Hygiene (Dock Carriers, etc.) Regulations, 1960 45 Food Hygiene (General) Regulations, 1970 45 Food Hygiene (Market Stalls & Delivery Vehicles) Regulations, 1966 39, 45 Food Hygiene - Smithfield Market 45 Food Premises — Registration 38 Food Sampling 30, 32, 33 Hairdressers & Barbers Shops 22 Health Centres 51 Health Committee 1 Health Education 56 Health Visiting 52 Home Nursing 54 Housing 8 Immunisation 52, 54, 59 Imported Food Regulations, 1968 41 Incontinent Persons 55 Infectious Diseases 50, 59 Introduction 7 Legislation 48, 50 Live Poultry (Restrictions) Order, 1971 47 Meat & Food Inspections 40 Meat Surrendered or Seized 40, 42, 43, 44 Medical Examination of Staff 49 Midwifery Services 52 Mortuary 29 National Health Service, Act, 1946 51 Noise 13 Notification of Infectious Diseases 50 Officers of the Health Department 4 Offices, Shops & Railway Premises Act, 1963 14 Ophthalmic Optician Service 49 Outwork 23 Page Performing Animals (Regulations) Act, 1925 47 Personal Health Services 51 Pet Animals Act, 1951 46 Pharmacy & Medicines Act, 1941 39 Pharmacy & Poisons Act, 1933 39 Pigeon Control 29 Post Mortems 29, 47 Preface 7 Prevention of Illness, Care and Aftercare 54 Psittacosis or Ornithosis Order, 1953 46 Publications 50 Rats and Mice 28 Regulation of Movement of Swine Order, 1959 47 Registration of Food Premises 38 Riding Establishments Acts, 1964 & 1970 46 Rodent Control 28 Sanitary Circumstances 23 School Dental Service 58 School Health 58 Sewerage 13 Shops Act, 1950 22 Smallpox Vaccination 56 Smithfield Market 40 Smoke Control 24 Staff of Health Department 4 Statistics:- Atmospheric Pollution 25, 26, 27, 28 Deaths 61 Disinfection 29 Factories Act 22, 23 Food 30-38 Housing 8 Infectious Diseases 50 Medicals 49 Offices, Shops & Railway Premises 15, 16, 17, 20, 21 Outworkers 23 Rodent Control 28 Water Samples 9, 10, 12 Surrender of Unfit Food 40 Swimming Baths 9 Swine Vesicular Disease 47 Temples Order, 1971 51 Tuberculosis 53 Unfit Houses 8 Unsound Food 31, 33 Vaccination and Immunisation 52, 54, 56, 59 Venereal Disease 56 Verminous Persons 29 Veterinary Officer's Report 46 Water Supply 8 Welfare Foods 52 Well Women's Clinic 57 STAFF (as at 31st December 1973) 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 VETERINARY OFFICERS G.S. WIGGINS, M.R.C.V.S., F.R.S.H. October 1964 T.W. FRASER, B.V.S.M., M.R.C.V.S. (Part-time) July 1973 J.R. SMITH, M.R.C.V.S., B.Vet.Med. (Part-time) July 1973 V. JESSEN, B.V.Sc., M.R.C.V.S. (Part-time) July 1973 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 Mrs. I.H. HAMBLIN First Class Assistant October 1957 4 ADMINISTRATIVE STAFF (Port and City of London) (Contd.) Commenced Service Mrs. E.J.A. MORROW First Class Assistant March 1968 N.G. KEMP First Class Assistant January 1973 D.H. TICKNER First Class Assistant August 1972 R.L. VALDINI General Grade Assistant August 1972 Miss P.M. O'REGAN General Grade Assistant November 1972 Miss A. HINTON General Grade Assistant August 1973 Mrs. C.P. BRAY General Grade Assistant December 1973 Mrs. J.E. GRAHAM Clerical Assistant (Temporary) August 1971 4 Vacancies General Grade Assistants - Miss B. LOVATT Senior Shorthand Typist November 1969 Mrs. D.M. HARMAN Shorthand Typist (Temporary) (Part-time) September 1972 1 Vacancy Shorthand Typist - 1 Vacancy Copy Typist - E.J. PETERS Senior Assistant (Meat Inspector's Office) November 1935 J.E. CASH First Class Assistant (Meat Inspector's Office) March 1954 R.J.F. PARISSIEN Clerical Assistant (Meat Inspector's Office) March 1971 1 Vacancy Clerical Assistant (Meat Inspector's Office) - 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. I.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. J.B. WELLDON, M.A.P.H.I., Senior Public Health Inspector August 1962 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 J.F. MARSHALL, M.A.P.H.I. Public Health Inspector August 1973 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 K.S. SEYMOUR, M.lnst.M., M.A.P.H.I., M.A.M.I. Deputy Chief 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 G. GINGELL, A.R.S.H., M.lnst.M., M.A.P.H.I. Senior Meat Inspector August 1954 J.T. COX, 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 S.G. COLLINS Meat Inspector January 1973 1 Vacancy Technical Assistant (Authorised) - R. HUDSON Senior Porter May 1963 5 HEALTH AND WELFARE SECTION Commenced Service 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 1 Vacancy Social Worker - 1 Vacancy Health Visitor - 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 INSPECTORS 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 P.M. BERRY Foreman Rodent Operative June 1967 J. PEGRAM Rodent Operative September 1967 R.C. HARRIS Rodent Operative December 1967 F.H. PRIEST Rodent Operative March 1969 J.E. KIDDY Rodent Operative February 1973 W.R. STRACHAN Rodent Operative May 1973 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 H.GROUT (General Duties at Smithfield Market) April 1973 E.G. HIGLEY (General Duties at Smithfield Market) October 1972 7 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1973 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, 1973. During the year the staff have been involved in additional work in connection with the Joint Liaison Committee and its Working Parties preparing for the transfer of Personal Health services to the City and East London Area Health Authority brought about by the National Health Service Reorganisation Act, 1973. Due to continued redevelopment work in the City noise problems occupy much time and energy of your Officers. Continued efforts resulted in an increase, over the previous years, in the number of general inspections of Offices made under the Offices, Shops and Railway Premises Act, 1963. The medical and nursing staff of St. Bartholomew's Hospital have, as always, co-operated with and have been most helpful to the Department. As I am to retire from the office of Medical Officer from the end of August, 1974, this is the last Annual Report for the City of London that I shall have the honourto submit. I should especially like, therefore, to say how grateful I am to all those who have contributed to the work of the Department during the year, particularly the Chairman and members of the Port and City of London Health and Social Services Committees, and also to the staff of the Department whose assistance and loyalty I greatly value. 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. HOUSING As indicated in my Annual Report for 1972, after a Public Inquiry, the Secretary of State for the Environment refused to confirm the decision of the City Corporation that the unfit housing accommodation in Fleet Lane should be dealt with by means of a Clearance and Compulsory Purchase Order. Accordingly, therefore, early in 1973 this problem was finally resolved by the City Corporation making a Closing Order in respect of the three premises 29, 30 and 31, Fleet Lane. The following report has been received from the Corporation's Housing Manager:- "During the year 114 families were rehoused, leaving 885 families on the Housing Register at the end of December 1973 which include 309 tenants who require more suitable accommodation. The final stage of the Middlesex Street Redevelopment is under construction and good progress is being made. The estate, when complete, will provide a shopping and residential precinct of 181 flats and 38 shops with parking and garage facilities at lower levels. The redevelopment is programmed for completion in the latter part of 1974. 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, is progressing satisfactorily. The unit will be named Mais House, and the family accommodation — Otto Close. It is expected that occupation will take place in the early part of 1974. The fourth and final stage of the redevelopment of the Holloway Estate, having been approved, will provide when built, 62 flats between Camden Road and Parkhurst Road of which 50 flats will be for Corporation use and 12 ground floor flats will be let to John Grooms Association for the Disabled on terms agreed. These are designed to meet the special needs of disabled people. Building works are programmed to commence in the Spring of 1974. The appropriation of those properties in the Kennington Road which were formerly part of the Bridge House Estates was finalised and the properties transferred to the management of the Housing Committee to facilitate the redevelopment of the site bounded by Kennington Road, Hercules Road and Cosser Street. The redevelopment, as proposed, will provide 98 units of accommodation and 9 shops with Blake House being retained on the Hercules Road frontage. Management of the residential properties of the Bridge House Estates comprising some 650 units of accommodation and previously managed by the City Surveyor was transferred to the Housing Manager with effect from February 1974. As a result of the review of the new developments proposed, the Housing Committee submitted a report on Corporation Housing policy to the Court of Common Council on 13th December which sets out the objects and achievements in housing by the Corporation following a previous policy statement made in 1958." EXAMINATION OF WATER SUPPLIES The Corporation of London exercise their functions with regard to water supply under the Public Health Acts, 1939 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 is the Metropolitan Water Board. (2) From deep wells which abstract water from the London Basin level of grey chalk stratum below the City. The Metropolitan Water Board provides water that is safe, potable and wholesome at the point of delivery to the premises served, but, due to storage conditions within the premises and other matters over which the Metropolitan Water Board have no control, the water may become contaminated. For this reason the Public Health Inspector responsible carried out periodic observations, investigations and sampling to ensure a satisfactory and safe water supply. Samples are taken for both bacteriological examination and chemical analysis. 8 The bacteriological sampling is carried out in order to determine the presence of any pathological organisms so that effective measures can be taken to prevent the spread of water-borne infection. Chemical analysis is undertaken to find any indication of metallic contamination or sewage pollution. The general qualities of the water are also determined. The supply from private wells is satisfactory in quality and quantity, contains some natural fluorine and is non-plumbo solvent with a total hardness of about 325 parts per million - a relatively hard water. It is very unusual to find an adverse bacteriological report on water taken from the well risers. This water is sterilised as a further safeguard usually by means of liquid chlorine which is introduced by means of a dosing syphon to produce a condition of not less than 0.1 parts per million chlorine. Some abstractors use an ultra violet light method which has no residual properties as a sterilisation agent. The chalk stratum is rich in iron hydroxides which can sometimes be seen as a rusty discolouration. These are usually removed by the introduction of a diatomacious filter. Swimming Baths There are three swimming pools within the City used by school children and members of swimming clubs. These are visited weekly while the schools are in session and bacteriological samples are taken from the inlets and outlets. At the same time combined residual and free chlorine are measured and the pH or hydrogen ion measurement is made. The following tables show details of bacteriological examinations made of drinking water and swimming bath water during 1973. Metropolitan Water Board Supply (1) Water from drinking water points 70 samples (2) Water from food preparation premises 33 " (3) Water from storage tanks 1 " (4) Water from swimming pools 170 " Deep Well Supply (1) Water from drinking water points 16 samples (2) Water from well risers 35 " (3) Water used in food preparation premises 2 " (4) Water from storage tanks 3 " Total 330 samples Source of Supply Number of Samples Number of Samples giving results above 0 per 100 mis. Number of Samples giving plate counts above 0 Cols/ml after 24 hours at 37°c. Coli form Count B. Coli. (Type 1) 1. Deep wells 56 16 - 10 2. Metropolitan Water Board 104 9 2 - 3. Swimming Pools 170 5 1 13 TOTAL 330 30 3 23 Three samples were unsatisfactory. These were immediately investigated and the appropriate measures taken to eliminate the source of contamination. Subsequent samplings of these supplies proved to be satisfactory. The three unsatisfactory samples showed colonies of B. Coli. (type 1), an indication of faecal contamination. 9 Chemical Sampling Eight samples were taken upon complaint during the year and subjected to chemical examination. A table of results is shown below. Where indicated, samples were also submitted for bacteriological examination. No. Source Supply Use Condition of water Remarks 1 Tap M.W.B. Drinking Colourless, clear, taste — usual. Suspected of causing intestinal disorders. Found to be chemically and bacteriologically satisfactory. 2 Tap M.W.B. Bath Supply Colourless, clear, partially softened. Alleged to be causing allergy. No evidence found to support allegation. 3 Tap M.W.B. Drinking Colourless, clear. Contained no insoluble material but small amounts of iron and zinc in solution and nitrite present. Sampled following complaints of brown & white deposits in water. Found to be chemically and bacterially satisfactory. Complainant advised to have supply pipes cleaned and descaled. 4 Storage Tank Well Drinking Colourless, contained copious white solids composed largely of calcium carbonate and was comparatively free of oil. Sampled to determine if water contaminated with mineral oil from defective oil seals and if excess lime method of softening was working correctly. Premises Manager advised to discontinue excess lime treatment. 5 Storage Tank M.W.B. Drinking Clear. Slight musty smell and flat taste. Contained small quantity of phenols. Found to be chemically satisfactory. Smell & taste possibly derived from phenols present, which probably resulted from bituminous paint coating of tank. 6 Tap M.W.B. Drinking Colourless, clear, very slightly musty. Suspected of causing intestinal disorders. Found to be bacteriologically and chemically satisfactory. 7 Tap M.W.B. Drinking Colourless, clear. Suspected of causing intestinal disorders. Found to be chemically and bacteriologically satisfactory. 8 Tap Well Drinking Colourless, clear. Taste - slightly brackish, metallic. Sampled following complaint of brackish taste. Found to be chemically & bacteriologically satisfactory. Brackish taste due to salt residues from partial softening process. 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 1973. (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, 1973, was 4,449. (ii) No houses were permanently supplied by stand-pipe. 10 (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 1973 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 27°C. B.O.D. 5 days at 20°C. Hardness (total) CaC03 Hardness (noncarbonate) CaC03 Magnesium as Mg Sodium as Na Potassium as K Chloride as CI Phosphate as P04 Silicate as Si 02 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 51 0.040 0.060 8.3 0.64 — 298 64 5.5 33.8 5.6 45 2.3 10 52 0.16 0.02 0.1 5 7.8 630 River Thames derived 357 0.039 0.080 7.4 1.00 - 276 74 5.7 27.5 6.1 41 3.0 9 62 0.15 0.02 0.1 8 7.8 580 BACTERIOLOGICAL RESULTS - YEARLY AVERAGES, 1973 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 741 46.3 58.97 2.8 77.33 0.8 254 33.5 99.21 100.0 River Thames - derived 8,064 43.4 30.78 15.7 53.58 4.1 3,858 9.9 99.92 100.0 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 914mm 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 In my Annual Report of 1972 I commented that no Medical Officer of Health could feel easy about the problems associated with noise. This is still true to-day. The same problems are with us. The introduction during 1973 of the Protection of the Environment Bill contained some useful proposals to ensure a more rational approach to the problem of noise, and I am sure most local authorities would welcome these proposals. On the other hand, this is not to say that officials concerned with noise abatement require more power just for the sake of power. To some extent the proposals would enable local authorities to anticipate the problems that develop and would avoid some of the animosity and recriminations that often arise at present. It is to be hoped that this Bill will pass through Parliament and become an Act. During the year, again, demolition work and foundation work have compelled the staff of the department to carry out investigations at all hours of the day and night. Often the cause is the unrealistic timetables that contractors have accepted to carry out such works. This again may be due to an inadequate appraisal of the environment of the City. Most people working in the City require a degree of quietness for their type of work; on the other hand, people do live in the City and they also must receive consideration. All those engaged in the building industry should accept the fact that where noisy operations are concerned they must agree to the compromises on the timing of this work suggested by the Corporation's officers. It cannot be accepted - as is being advocated in some quarters, as far as "general" pollution is concerned — that "what is or is not acceptable is a question of economics". This philosophy can lead only to a general deterioration of our surroundings and is a facile argument that could find ready acceptance in the present difficult economic climate. Perhaps because the work is rough, hard and dirty, those men engaged in demolition appear to have little regard at times for their own safety and welfare and it is little wonder that they may have scant consideration for neighbouring occupiers. It is inevitable, therefore, that local authorities must bring pressure to bear on their employers. To achieve adequate control of any noise problem there must be frank and effective cooperation from all concerned: the architects, contractors and enforcement officials. This cooperation is often absent and consequently the results are often below what might otherwise have been achieved. COMMON LODGING HOUSE There is only one registered Common Lodging House within the City of London and this is controlled by the Salvation Army. Originally, when this Shelter opened at the beginning of the century it catered in the main for men who were out of work, and acted as a place of temporary refuge whilst they found employment. To-day, because of the problems which face a variety of men, the scope of this lodging house is far wider. For instance, even the occasional tourist finds his way here and, no doubt, is relieved when the time comes to leave the following morning. The accommodation provided is somewhat basic, and as far as sleeping arrangements are concerned,most of the beds are in large open dormitories. It is in these rooms that most of the lice infestation is spread from person to person. Because of the proximity of beds one to another, of men sleeping in the wrong beds, of men who slip in to unused beds which may be vacant for a night, and of frequent breakdowns in the laundry service, the lice infestations are stilI a problem in this hostel, notwithstanding the continuous surveillance and action of the Public Health Inspector concerned. 13 During the year under review, a shorter period of registration was applied to cover the time when work required by the Corporation was put in hand. Towards the end of the year, work was commenced to improve the facilities on the upper floors by providing sanitary accommodation adjacent to the dormitories on the fourth and fifth floors. It has been observed that many men living at this hostel do so because they cannot cope with the strain of modern living or the responsibilities of family life, and are often indicative of the sad results of divorce or broken families. There are others who live here by choice and appear to enjoy the work they do for the modest sums received for such tasks as bed-making, cleaning, or assisting in the kitchen. Throughout the year regular inspections have been made, mainly in the early morning but also during the day. One film show and talk was given to the residents on the subject of lice infestation. OFFICES, SHOPS AND RAILWAY PREMISES ACT, 1963 It is now ten years since the Offices, Shops and Railway Premises Act became law. With the new Health and Safety at Work etc. Bill it is likely that large parts of the Act may be repealed and replaced by new legislation. It is perhaps appropriate, therefore, to review the achievements and changes of the past ten years and deal with some of the basic problems which arise in connection with new premises, many of which have been built since 1963 and which will provide a high proportion of the workload under future legislation. THE CURRENT YEAR General During the year, 16,194 visits were made to offices within the City. This total number is made up of general inspections and subsequent inspections. The number of new premises registered was 690 and 1133 were removed from the register. Continuing special effort by Inspectors in the Offices Section of the Department, together with the achievement of agreed quotas of office inspections by some Public Health Inspectors engaged primarily on District work, has meant a further increase in the number of general inspections recorded at the end of the year. It is important at this stage to re-state the scale of some office inspections in the City, and the following will serve as examples:- (a) The inspection of one building in single occupation involved four Inspectors for eight days and related to office space covering 15 acres or three-quarters of a million square feet. (b) A second building had 255,000 square feet of office space exclusive of common parts; had four caretakers' flats; 16 passenger lifts; four banks of lift motor rooms; and 1,730 employees. Inspections of this size are not uncommon. The following chart represents the number of general inspections carried out each year since the Act came into force:- 14 TABLE I TIME SERIES SHOWING ANNUAL NUMBER OF GENERAL OFFICE INSPECTIONS The number of persons who benefited from office inspections during the year was approximately 182,750. Of these, some 112,500 benefited indirectly from general inspections and as a result of informal action which produced improvements within a few days. Of the remainder, 70,250 benefited directly owing to more formal action by the Department and the subsequent improvement of conditions following written communication. The following table shows the number of these representations carried out during the year:- 15 TABLE II SUMMARY OF DEFECTS FOUND AND NOTICES SENT 1. Cleanliness - Dirty conditions Accumulations of Refuse 437 5 2. Overcrowding 26 3. Temperature - Unreasonable Absence of Thermometer Absence of Warming Facilities 1 91 1 4. Ventilation - Inadequate 84 5. Lighting - Inadequate 92 6. Sanitary Conveniences - Insufficient Unsatisfactory/Defective Not separate for sexes 13 136 21 7. Washing Facilities - Insufficient Unsatisfactory/Defective No Hot water Soap/Drying Facilities 11 28 15 7 8. Drinking Water - Inadequate supply Disposable vessels/Rinsing facilities 4 1 9. Clothing - Inadequate accommodation Inadequate drying facilities 4 10. Hoists & Lifts 148 11. Floors, Stairs, Passages - Unsound construction Obstruct ion/slipping Handrail (lack of) Protection of Openings 143 110 46 14 12. Machinery - Inadequate guarding 152 13. First Aid - Inadequate Provision 173 14. Information - No Handbook available 215 15. Dangerous Practices — 52 16. Miscellaneous (including letters requesting registration) 104 17. Registration 586 2,720 16 Accident Investigations During the year, of the total number of accidents reported to the Department, 46.7% required a full investigation. Perhaps the most tragic accidents of the year concerned injury to two employees by letter and parcel bombs. These accidents were investigated by the Senior Public Health Inspector in co-operation with the City of London Police. One person during the year fell from an upper landing floor when he tripped, fell forward beneath the protective handrail, and crashed head-first through a full-size landing window. This accident is of considerable importance as it raises a doubt regarding the modern glass-slab style of office building design, the adequacy of staircase protection on landings, and the structural strength of the glass panels. Some office machinery also leaves a great deal to be desired, particularly in the increased use of mobile filing and storage racks, which has resulted in foot injuries. None of the installations inspected had an effective safety stop to prevent these minor hazards or to allay the fears of employees of being crushed between the banks of movable storage racks. Shredding machines used in some offices also caused problems during the year. Apart from minor finger injuries with these machines, one operator had his tie caught in the shredding knives and was pulled in towards the machine. Only the quick action of a colleague in immediately switching off the machine averted what might have been a serious accident. Advice regarding some of these machines was sought by a number of employers during the year and resulted in two feedhole covers being designed for their particular machines: one by a Technical Assistant in the Offices, Shops and Railway Premises Section of the Department; and another by the Senior Public Health Inspector in charge of that Section. TABLE III ACCIDENT STATISTICS - 1973 Cause Code Number No. of Accidents Machinery Non-power driven machinery or relevant part in motion 11 0 Power-driven machinery or relevant part in motion 13 2 Machinery or relevant part at rest (power and non-power driven) 14 6 Lifting and conveying machinery and plant 1 0 Cutting and mixing machinery Food mixers and mincers 2 0 Food slicers 3 0 Other food cutters 4 0 Cutters of materials other than food 5 0 Transport Vehicle in motion not moved power 31 1 Vehicle stationery 34 0 Fire and explosion 41 7 Electrical 43 2 Hand Tools 45 9 Falls of persons On or from fixed stairs 51 62 On or from ladders or stepladders 52 11 Other falls from one level to another 53 19 Falls on the same level 34 74 Stepping on or striking against object or person 61 23 Handling goods 62 65 Struck by falling object 63 17 Not otherwise specified 64 79 TOTAL 377 17 Hoists and Lifts During the year several document-handling systems were inspected, one of them being a SOVEX preselective handling system. The particular system links five office blocks and serves all floors in each block. It incorporates 49 sending/receiving stations and it is claimed to be the largest document-handling system in the United Kingdom and the first of its type in Europe. The system incorporates half-a-mile of conveyors and 600 feet of vertical elevators. Some doubt was expressed as to whether the system could be defined as a lift within the meaning of the Offices, Shops and Railway Premises (Hoists and Lifts) Regulations, 1968. From the practical point of view, however, the following are some of the precautions which are considered necessary on these installations:- 1. The elevator should not be started without the knowledge of persons who may be in the vicinity at various levels. A warning system which can be heard on all floors is recommended. 2. A means of communication between floors, for example a telephone or speaking tube, is recommended. 3. Considerable guarding is necessary at the bottom section of the elevators, particularly if material can fall to the ground and cause dangerous conditions. 4. Access to plant rooms or unfenced machinery for maintenance purposes could be controlled by a Castell or similar key system. The firm in question took Counsels advice and placed the system on its list of hoists and lifts requiring inspection by a competent person at the statutory intervals. Legal Proceedings During the year legal proceedings were initiated in three cases. These cases concerned failure to report an accident and structural defects. Total fines of £150 with £35 costs were imposed. Achievements since 1963 The passing of the Act in 1963 placed a very heavy burden on the resources of the Health Department. Public Health Inspectors, already understaffed and heavily committed, had to tackle the problem of ensuring the health, safety and welfare of the largest concentration of office employees in the United Kingdom. Inevitably the beginnings were slow, but over the years, with increasing staff and reorganisation of work within the Department, the problem gradually became manageable. During 1973 a record of 3,655 general inspections of offices was achieved, but underlying the cold statement of numbers is the fact that the Department has achieved almost total coverage of all office premises in the City. Of the total day-time population of the City, over 75% are employees entitled to protection under the Act. With ten years of vigorous implementation of the provisions of the Act, together with the willing co-operation of most employers, it can be said that the City office workers' environment is reasonably satisfactory. There are predominantly more good premises than bad, with standards in many cases considerably higher than mere compliance with the statute. The Act: Strengths and Weaknesses Although there was previously some legislation, such as the Public Health Acts and Shops Acts, covering "places of employment", the main strength of the Offices, Shops and Railway Premises Act lies in its attempt to bring greater statutory protection to a wider section of the working population. To the City, this meant the inclusion of approximately 290,000 office and shop employees. The Act has made both employers and employees aware of their statutory and moral obligations. Safety and health at work is a vast and diverse subject and the Act makes a valuable contribution to the evolutionary process of health legislation. The fundamental weakness of the Act is that it forms only a small part of the statutory system relating to working conditions and a large number of employees are still left out. Since the working conditions in modern offices are largely predetermined at the design and planning stage, particularly in such areas as structural condition, ventilation, solar gain, hoists and lifts, density of occupation, services and facilities, an obvious weekness in the Act is that prior approval is not required. Trends in modern office development in the City are towards multi-storey-complex development. Economic and aesthetic features have first priority, often to the detriment of the working environment on completion and occupation. The Act in these circumstances merely attempts to close the door after the horse has bolted. 18 Areas of Special Interest Heating, Ventilation and Air Conditioning It is unfortunate that there is such a close relationship between the heating and ventilation concepts. The desire to achieve greater and greater heat conservation produced large-scale ventilation proposals with very high degrees of recirculated vitiated air. In some cases the amount of this recirculated air has been proposed at 98%. The problem of the degree of recirculation is extremely vexing, particularly since there is no adequate guidance on this subject. However, there are alternatives to heat conservation by recirculation. These are found in systems employing heat transfer by thermal wheel, which allows almost total introduction of "fresh air" and almost total exhaust of vitiated air. "Air conditioning" in many modern office blocks has been found necessary during summer months. Many small "air conditioning" ancillary units have been installed in the City, mainly at upper executive level, which points to a need for a better appraisal by architects of the precise ambient environment desirable in office design. Solar Gain Solar gain in modern office buildings is a structural problem. It is closely related to the type of building, its ventilation and heating design and to its aspect. Unless the problem is tackled at the design stage there is little that can be done without tremendous expense. The provision of sun-blinds, whether vertical or horizontal, merely cuts out glare. The application of a plastic film to the glass is expensive but reasonably effective, provided abrasives are not used in window cleaning. Structural solar shield glass, specified at the design stage, provides the most acceptable answer, together with an adequate air-conditioning system. There is no doubt that a great deal in the way of structural insulation in modern office blocks is becoming increasingly necessary. Natural and Artificial Lighting Natural and artificial lighting has generally been found to be good. However, it is a pity that some codes of practice recommend standards of lighting which are much lower than those achieved in practice in the City. The Allocation of space in Working and Storage Areas Space is always at a premium and there is naturally a trend by employers to expect occupation of office space increasingly closer to the legal standard. During one inspection, cubic capacity per employee was being calculated by a Personnel Manager with a slide rule, in order to achieve maximum occupancy just within the legal requirement. The provision of mobile storage and filing bays has already been mentioned. These do provide more effective use of storage space as they require only about two-thirds of the area required under a conventional system. As yet, the use of micro-film and micro-fiche document storage is not common. Conclusion The current year has been a record in relation to the efforts of Inspectors and to the numbers of inspections carried out. However, once total coverage has been completed the number of general inspections will be reduced and more in-depth projects undertaken. From slow beginnings the City office-workers' environment has been improved to a standard in many cases well above the legal requirements. The pattern of close co-operation between architects, employers, workers and their representatives, and the Public Health Inspectors, which has been a feature over the past ten years, has resulted in a health, safety and welfare standard for office workers of which the City may be justly proud. A tremendous amount has still to be done, but with greater co-operation and more streamlined legislation the achievements of the next ten years will hopefully be as good, if not better, than the last. 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 598 6495 3655 Retail shops 77 784 231 Wholesale shops, warehouses 10 706 56 Catering establishments open to the public, canteens 5 522 377 Fuel storage depots NIL NIL NIL TOTALS 690 8507 4319 TABLE B NUMBER OF VISITS OF ALL KINDS (INCLUDING GENERAL INSPECTIONS) TO REGISTERED PREMISES 16194 TABLE C ANALYSIS BY WORKPLACE OF PERSONS EMPLOYED BY REGISTERED PREMISES AT END OF YEAR Class of workplace Number of persons employed Offices 273199 Retail shops 4299 Wholesale departments, warehouses 5222 Catering establishments open to the public 6371 Canteens 4573 Fuel storage depots 1 Total 293665 Total Males 175895 Total Females 117770 20 TABLE D-EXEMPTIONS TABLE E - PROSECUTIONS M/C. Line No. Class of premises (1) No. of exemptions current at end of year (2) 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 (3) extended (4) expired or withdrawn (5) refused (6) opposed by employees (7) Section of Act or title of Regulations or Order (1) No. of informations laid (2) No. of informations leading to a conviction (3) No. made (8) No allowed (9) 1 Offices / Part I — Space (sec.5(2) ) / 1 48 / / 2 Retail shops 2 3 Wholesale shops, warehouses 3 4 5 Catering establishments open to public, canteens Fuel storage depots 4 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 applications) made under Section 22 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 13 part time 25 Fuel storage depots 25 Part IV - Washing Facilities (sec. 10(1) ) No. of other staff employed for most of their time on work in connection with the Act. 2 31 Offices 31 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 During the current year Public Health Inspectors carried out 214 inspections of shop premises. These inspections relate to those specific sections of the Act which concern the safety and comfort of shop workers, who in some instances are not protected by the more comprehensive provisions of the Offices, Shops and Railway Premises Act, 1963. Infringements were noted concerning:- Ventilation Heating Lighting Sanitary and Washing Facilities Many of these unsatisfactory conditions were of a major nature and could only be resolved by extensive structural and environmental rearrangement. All these matters have been reported to the Port and City of London Health Committee and are the subject of official representations. Both short and long-term remedial action is now under way. 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? hairdressers and barbers were so registered and 1 discontinued their business bringing the total on the Register to 75. 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 85 9 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 487 3 2 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 165 13 5 - TOTAL 718 101 16 - 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.1.) 6 5 Overcrowding (S.2.) - - Unreasonable temperature (S.3.) 2 2 Inadequate ventilation (S.4.) 3 2 Ineffective drainage of floors (S.6.) 2 2 Sanitary Conveniences (S.7.) (a) insufficient 2 2 (b) unsuitable or defective 10 9 2 3 (c) not separate for sexes 2 2 Other offences against the Act (not including offences relating to Outwork) - - TOTAL 27 24 2 3 Part VIII of the Act Outwork (Sections 133 and 134) Section 133 Section 134 Nature of work 1 No. of outworkers in August list required by Section 133 (1) (c) 2 No. of cases of default in sending lists to the Council 3 No. of prosections for failure to supply lists 4 No. of instances of work in unwholesome premises 5 Notices served 6 Prosecutions 7 Wearing apparel (Making, etc.) 107 - - - - - TOTAL 107 - - - - - Outwork and the inspection of outworkers' premises etc. Lists received from City Firms employing outworkers 18 Names and addresses of City outworkers received from other Authorities 12 Names and addresses of outworkers resident outside the City, employed by City firms transmitted to other Authorities. 107 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 29,459 inspections have been made. As a consequence of these inspections, it was necessary to serve 1,873 Intimation Notices. Tenement Houses were inspected and the only common lodging house in the City was kept under regular supervision. 23 ATMOSPHERIC POLLUTION The work in connection with the prevention of atmospheric pollution is of great importance to the community and is pursued with vigour by the Department. I mentioned in my report for 1972 that a section specialising in this work had been set up in the Health Department to extend the field work and to secure effective liaison with the Department of the Environment, the Scientific Branch of the Greater London Council, and other interested bodies. The field work at present includes a survey to gain precise information of all furnaces in the City, the types of fuel used, the chimney heights involved, and the pollutants likely to be produced. Proceeding concurrently with this activity is the system for monitoring air pollution. This activity is organised in conjunction with the Department of the Environment at Warren Spring, Hertfordshire, in their National Survey of atmospheric pollution. The monitoring stations in the City have been increased to six, and they produce daily measurements of the concentrations of sulphur dioxide and particulate matter. One of the units is used as a mobile station and can be installed in premises where a particular problem may arise. At present it is being used to monitor atmospheric conditions associated with brewing in the City. The information obtained enables useful comparisons to be made for rates of flue gas emission and variations in the concentrations of sulphur dioxide at ground level. These can be directly related to proposals regarding the installation of new furnaces. The rain which has fallen during each month is collected in a standard deposit gauge situated on the roof of the Guildhall. These samples, together with other matter which has fallen out of the atmosphere into the bowl of the gauge, is submitted to the Public Analyst of the Corporation. The detailed analysis which is returned to the Department is also part of the information required by the National Survey. A table of the results is appended. Weather reports are obtained from the Meterological Office giving daily information on the weather experienced in the neighbourhood, and include specific information on wind speeds and directions, temperature variations and periods of temperature inversion. From this information a relationship can be established between the daily ground-level concentration of pollutants and the maximum quantities of fuel burnt in the neighbourhood. Sulphur Dioxide The concern felt by the Corporation over the fact that, while concentrations of particulate matter had fallen consistently since the original Clean Air legislation, and thus had followed the pattern elsewhere, the SO2 concentrations in the City were showing a tendency to rise, led to the action they took in 1971 in securing the first legislation of its kind in this Country to reduce the production of SO2 at source by imposing limits on the amount of sulphur in liquid fuels used in the City to not more than 1%. The results during the past year are encouraging and justify this action, in that the SO2 concentrations have shown a steady downward trend. Perhaps here I might be allowed to express my appreciation of the help and co-operation received from City firms, the Petroleum Industry and all concerned, in getting this "interesting experiment" off to a good start. Heights of Chimneys In addition to controlling the production of atmospheric pollutants at source, it is important to ensure that, when they are produced, they are effectively dispersed. Obviously the height of the chimney concerned is an important factor. Chimney heights for new buildings and buildings subject to substanital alterations must be submitted for consideration by local authorities. Early consultation is encouraged between the applicant, the City Engineer, the City Architect and Planning Officer, and this Department. This arrangement goes a long way towards avoiding confusion and duplication of effort and ensures a common policy between departments. It will be appreciated that there can be fundamental differences between the requirements of good town planning and good public health. My staff have to ensure that the products of combustion are not ensnared by the contours and profiles of the building, as this could cause problems in the building the chimney serves and elsewhere. A low profile chimney at the top of a high building does not necessarily imply a chimney of adequate height. The Chimney Height Memorandum provides useful guidance for the determination of the height chimneys and ensures that, together with the provision of the Clean Air Act, 1968, the chimney is built to such a height as to disperse the flue gases with minimum nuisance to the surrounding locality. Correctly placed chimneys can help to minimise ground-level concentration of air pollutants. When investigating applications for chimney height approval consideration must be given to:- 24 (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 matters requiring consideration in the circumstances. Gas-fired installations are included in the legislation and low-level discharge of diluted products of combustion is discouraged. Smoke and Particulate Matter The reduction of these pollutants is obtained by the strict control of smoke emissions from chimneys, bonfires and diesel-driven electricity generators. Smoke emissions in the City are largely associated with furnaces burning the heavier grades of fuel oil and where maintenance or supervision is faulty. In the past, considerable and unnecessary nuisances were caused by the burning of rubbish on demolition sites. This unsatisfactory state of affairs has been largely remedied by the amendment of the City of London (Various Powers) Act, 1954, by the 1971 Act of the same name which included demolition and other contractors in the definition of "occupiers" and a precise defining of "premises". Legal proceedings were taken against offenders in three instances, all of which were successful and resulted in fines and costs totalling £87.00 being imposed. The installation of electricity generators powered by diesel engines for emergency purposes has caused some concern. At present there is some doubt as to whether or not these plants have to comply with the Chimney Height Regulations with regard to the point of emission of the exhaust gases. This question has been taken up with the Department of the Environment and a decision is expected in the near future. Apart from the fume problems, noise problems can occur if insufficient consideration is given to the location and method of installation of a generator. In addition to the general work on atmospheric pollution, attention has been given to plant and equipment inside premises which can cause problems from chemicals used in the processes involved. Dry-cleaning premises use perchlorethylene, which, if discharged or allowed to escape in the gaseous state, is highly toxic, especially to people who indulge in smoking in its presence. Several complaints have been received about this type of pollution and investigations have been made to determine the concentrations of the gas. These have resulted in alterations to the reclaiming plant and other modifications to reduce or eliminate the emission of the perchlorethylene. Carbon monoxide can be emitted from furnaces where incomplete combustion is taking place and in some circumstances it can leak from the furnace into the boiler houses or rooms near the discharge point. Several complaints of this nature have been investigated and remedied during the year. Samples of lead compounds have also been taken where specific emitters have been found, and alterations have been suggested to eliminate risk. Much of the work carried out in connection with atmospheric pollution is of a routine but essential nature and can be planned to give the maximum degree of control. This, together with the specialised skill possessed by the staff involved, enables the work to proceed with efficiency and smoothness TABLE I RAINFALL COLLECTED IN THE DEPOSIT GAUGE AT GUILDHALL FOR THE YEAR 1973. MONTH M/M PER DAY RETAINED WATER LITRES p.H. January 0.44 1.0 3.5 February 0.84 1.8 4.4 March 0.61 1.4 4.8 April 1.04 2.3 3.9 May 2.31 5.1 4.1 June 2.38 5.4 4.1 July 1.68 3.7 4.5 August 3.17 7.0 4.3 September 2.76 6.3 4.9 October 0.87 1.98 4.3 November 0.72 1.7 4.8 December 1.18 2.6 5.1 25 TABLE II analysis of deposited matter in rainfall collected at guildhall for the year 1973. Month Total undissolved matter G Ash G total dissolved matter G total solids G CA2+ G So42 G CL G Deposit mg/m2d Deposit mg/m2d Deposit mg/m2d Deposit mg/m2d Deposit mg/m2D Deposit mg/m2d Deposit mg/m2d January 0.2536 - 0.0882 39 0.5074 223 0.7610 334 0.1738 76 - - February 0.2227 104 0.1832 86 0.4589 215 0.6816 320 0.1942 91 0.0684 32 March 0.1838 8 0.1004 44 0.1983 87 0.3821 168 0.1298 57 0.0469 20 April 0.1294 59 0.0708 32 0.4556 207 0.5850 266 0.1518 69 0.0488 22 0.0257 12 May 0.1953 89 0.0618 28 0.5566 252 0.7519 341 0.2507 114 0.0516 23 0.0272 12 June 0.1714 75 0.1140 50 July 0.1766 80 0.0902 41 August 0.2582 117 0.1150 52 September 0.1617 71 0.0977 43 October 0.1682 74 0.0771 34 November 0.2445 104 0.1257 53 December 0.1713 78 0.0890 40 MG/M2D = M/Grammes per Meter2 CA2 + =Calcium Ion S042 = Sulphate Ion Sulphuric Acid CL = Chlorine 26 TABLE III MONTHLY AVERAGE OF SULPHUR DIOXIDE IN MICRO GRAMMES PER CUBIC METRE DEPOSITED IN THE CITY OF LONDON IN THE YEARS 1970/71 AND 1972/73 SHOWN AS PERCENTAGE INCREASE/DECREASE AND AS A COMPARISON GRAPH. MONTH 1970/71 1972/73 PERCENTAGE INCREASE DECREASE April 310 266 14 May 194 257 32.5 June 196 126 35.7 July 134 133 .74 August 157 171 9. September 242 185 23.5 October 280 211 24.4 November 333 276 17. December 365 347 5. January 401 347 13.5 February 353 321 9. March 267 271 1.5 27 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 24,911 - 199.0 Oil 200 second Redwood 10,744 - 248.0 Oil 960 second Redwood 339 - 24.0 Coal 131 - 1.8 Coke 43 - 0.39 Gas - 11,311,695 10.0 TOTALS 36,168 11,311,695 483.19 TABLE V DETAILS OF PREMISES SURVEYED DURING 1973 TYPES OF FUEL USED SOLID FUEL OIL GAS ELECTRICITY VACANT TOTAL Numbers of Premises visited 9 123 130 87 27 376 Number of Boilers in use for different types of fuel 13 338 151 2 524 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 600 Infestations confirmed House mouse infestations 388 Rat infestations 30 (b) Survey work Premises surveyed 2,786 House mouse infestations 239 Rat infestations NIL (c) Destruction of rats in sewers Three direct poison treatments were carried out in March, June and December using arsenious oxide and racumin. One pre-baiting treatment was carried out in September followed by zinc phosphide treatment where necessary. A notable feature of control work during the year was the receiving of three complaints concerning the ship rat, which indicate a reappearance of this species of rodent after a break of some years. Of the three complaints, one concerned a colony of rats and the other two concerned a single rat in each case. The colony was totally eliminated and the other two caught by trapping. Checks are being maintained to ensure that the premises and localities remain free from infestation. 28 PIGEON CONTROL The Public Health Act, 1961, gives local authorities permissive powers to take steps to abate or mitigate nuisance from pigeons believed to have no owner. Complaints received concerned nuisances due to pigeons on individual buildings and in open spaces and gardens within the City. The contractor employed by the City Corporation maintained a steady reduction in the number of pigeons to a generally acceptable level. During the latter part of the year two buildings were found to be harbouring a large number of pigeons in the roof space. Co-operation was promised by the owners and tenders were obtained for cleaning and proofing.lt is expected that the steps being taken will considerably reduce this localised nuisance. CITY MORTUARY Bodies received 245 Post Mortem Examinations made 244 Inquests on bodies 42 Inquests held at Hollway Prison NIL Inquests on fires NIL Inquests on Treasure Trove NIL DISINFECTION AND CLEANSING OF VERMINOUS PERSONS, ETC. Export of Clothing, etc. Articles, by weight 11 tons 4 cwt. No. of articles disinfected 312,145 No. of operations 1,031 Fees received £2666.91 General Disinfection, Infectious Diseases, etc. Cells at Police Stations disinfected 5 Lockers at Post Offices disinfected 9 Verminous premises disinfected 11 Beds and bedding disinfected 1,438 Cleansing of Persons No. of verminous persons bathed 1,283 No. of persons with scabies bathed 8 No. of articles disinfected 12,910 CATERING It is fashionable to criticise caterers for some transgression or other, real or imagined, but seldom is there an attempt to evaluate the service they provide to the public. In the City, at least, it can be said they offer a service as essential as that provided by public transport, often for very little reward. The small independent caterer invariably works at least a twelve-hour day, and even in this age of increasing leisure he is still to be found working on Saturday mornings. There is within the City a variety of catering establishments, from the smallest snack-bar and popular restaurant to the most exclusive of establishments. In addition there are numerous public houses, luncheon clubs and staff canteens. Regretfully, so far as the welfare of city workers is concerned, the number of popular restaurants again shows a decrease, and this reduction in facilities is likely to continue as this type of catering would no longer appear to be a profitable proposition. The general surveillance of catering units of all types has proceeded satisfactorily during the year under consideration, notwithstanding the difficulties experienced as a result of staff leaving and the delays in recruiting replacements. In spite of this staffing problem, 1128 routine inspections were made and 222 communications sent to the responsible persons and companies, drawing their attention to a wide range of contraventions of the provisions of the Food Hygiene Regulations. Unfortunately, the most common source of criticism continues to be a lack of regular and thorough cleaning. Usually the excuse for such an unsatisfactory state of affairs is either staff shortage, the poor calibre of staff available, or the inefficient service rendered by contract cleaners. 29 The policy of the Department has been to help and advise and to give caterers an opportunity of improving their premises and of rectifying any contraventions of statutory requirements. On the whole, this approach has proved to be successful, as is indicated by the fact that during the year it was necessary to institute legal proceedings in three instances only. Convictions were secured in each case andresulted in the imposition of fines totalling £420. Costs awarded amounted to £47. Priority has again been afforded to the consideration and supervision of new projects. Whilst this is very time-consuming, it is advantageous both to the Department and to any intending caterer and does avoid problems developing after new restaurant facilities have been put into commission. In some cases it has been possible to persuade prospective tenants not to lease premises which were basically unsuitable for the purpose for which they wished to use them. In spite of the prevailing difficulties of the industry it would be fair to state that the efforts of the Department, combined with the general goodwill and co-operation of the trade, have been successful in maintaining reasonable standards in catering premises throughout the City. SAMPLES PURCHASED AND SUBMITTED FOR ANALYSIS Article Informal Formal Article Informal Formal Artificial sweeteners 2 Marzipan 1 Beers, lager and cider 5 3 Meat, canned 11 Bacon 1 pies 12 Beans, baked 1 products 4 Biscuits 4 Milk, buttermilk 1 Bread 2 condensed 1 Bread, rolls & sandwich — dried 3 filled 4 fresh 8 28 Cakes 10 hot 1 2 Cereal beverage 1 Long Life 1 Cheese 53 shake 1 Cheesecake 1 sterilised 1 Cheese products 7 Top of the Milk 1 Chicken, pre-packed 1 Mustard 1 products 7 Pasty, Cornish 3 Chocolate, drinking 1 Pastry, Danish 3 health 1 Pate 2 and rum sauce 1 Peanut Butter 1 Coffee, ground 1 Pepper, white 1 Coleslaw 1 Pickle, mixed 1 Cream, fresh 3 1 Pickled Onions 1 Long Life 1 Pizza Pie 1 tinned, sterilised 1 Pudding, Cherry Plum Fool 1 Coffee Dessert 1 Chocolate Fool 1 Crispbread 1 Christmas 1 Drink, Bitter Lemon 1 Instant Whip 1 Lemon Tea 1 Peach Dessert with Orange Crush 1 cream 1 Faggots 2 Rice with cream 1 Fish, canned 2 Salad Dressing 1 Lumpfish Roe Caviar 3 Sausage 9 Pressed Cod Roe 1 Sausage Rolls 2 Smoked Marine Eel in Scotch Eggs 2 Peanut Oil 1 Soup 2 Smoked Sprats 1 Stuffed Vine Leaves 1 Fruit, canned 1 Strawberry Jam, diabetic 1 pies 4 Tea 2 Health cereal 1 Tomato Puree 1 Ice cream 1 Vegetables, canned 2 Lemon Cheese with butter 1 Vinegar, malt 2 Liqueur chocolates and Wines and Spirits 18 33 confectionery 9 Yoghurt 6 Low Fat Spread 2 TOTALS 256 69 30 FOOD COMPLAINTS During the year under review there was an increase in the number of complaints concerning food sold in an unsound condition or food containing extraneous material. Legal proceedings were instituted in 6 cases and fines and costs were imposed totalling £296.50. The complaints investigated related to the following:1. Mould growths, staleness and unsoundness which affected the following articles:- Cottage Cheese - Mouldy U.H.T. Milk - Contained insoluble milk protein Steak and Kidney Pie - Contained mould growth Doughnut — Tainted with a "catty" odour Meat Sandwich - Mouldy Meat Pie - Contained mould Fresh Apple — Bruised Fruit Pie — Mouldy Sausage Roil - Mouldy Patty Shells (Pastry) - Mouldy Yoghurt — Mouldy Apricot Pie — Mouldy Bread — Mouldy Apple Strudel - Contained green colouring matter Danish Pastry — Mouldy Walnut Gateau — Contained mould Cottage Cheese with Chives — Mouldy U.H.T. Milk — Alleged to be tainted but found to be satisfactory Cornish Pasty — Contained mould Mint Sweets — Had only a faint taste of mint Part-baked loaf — Mouldy Cheese — Mouldy 2. Extraneous objects discovered in food:- Chicken — Contained a piece of hardened fat Sandwich — Contained cat hairs Currant Pudding — Contained a metal clip Cheese Roll - Contained a piece of rubber or plastic Potato Crisps — Contained a mouldy agglomerate of potato Crusty Roll - Contained pitch Ice Cream - Contained a piece of glass Peach Flan - Contained a piece of glass Sausage Roll - Contained burnt dough Buttered Roll — Contained overheated dough Cheese & Tomato Roll — Contained a piece of glass Bread — Contained burnt wheatmeal Egg & Tomato Roll — Contained jute fibres Jarlsburg Cheese — Contaminated with paper fibres, dust and dirt Pancake — Contained a piece of steel wire Soft Drink — Contained food residues adherent to carton in which purchased Hamburger - Contained a piece of metal Portion of Bread Pudding - Contained a cigarette end Meat Pie — Contained a leaf 3. Rodent and insect contamination:- Sandwich — Contained insect larva Chocolate Wafer Bar — Attacked by rodents Bag of Chips — Contained a number of cockroaches in nymphal stage 31 OTHER SAMPLES SUBMITTED FOR ANALYSIS Article Apple, fresh 1 Apple Strudel 2 Bean Jelly 1 Boiled Oysters 1 Biscuits 2 Bread 3 Bread, Rolls 5 Sandwiches 3 Buckwheat Vermicelli 1 Cakes 1 Cheese 5 Cheese & Onion Crisps 1 Chicken Products 2 Chocolate Paste 1 Confectionery 1 Cough Medicine 1 Cream, fresh 1 trifle 1 Danish Pastry 1 Doughnuts 2 Drink, soft 1 Foreign objects found in food 6 Article Fruit Pies 1 Lard 11 Mayonnaisse 1 Mi Ik Chocolate Wafer Bar 1 Milk, Long Life 2 Mushrooms 3 Meat 2 Meat Pies 4 Meat Products 4 Osama Udon with Soup Base 1 Pancake 1 Pasty, Cornish 1 Patty Shells 1 Sausage 1 Sausage Rolls 2 Spanish Rose Table Wine 1 Tomato Puree 1 Yoghurt 1 Water 8 Abacus Seeds 1 TOTAL 91 Bacteriological Examination Frozen Cooked Prawns 1 Smoked Meat Spread 2 32 NATURE OF ADULTERATION OR IRREGULARITY OF SAMPLES PURCHASED UNDER THE FOOD AND DRUGS ACT, 1955. Article Type of Sample Nature of adulteration or irregularity Action Jam Tarts Informal Contained a non-permitted red colouring matter. A letter was sent to the retailer concerned. New formulation of colouring matter introduced by supplier. Steak and Kidney Pie Informal No list of ingredients included on label. A letter was sent to the supplier concerned. Labels in process of being reprinted. Yoghurt Informal List of ingredients on the label was not headed by word "ingredients". A letter was sent to the manufacturer concerned. Label to be amended. Dessert Whip Mix Informal List of ingredients incorrectly placed on label. A letter was sent to the supplier concerned advising amendment of label. Chicken and Mushrooms Informal List of ingredients incorrectly place on label and less than correct minimum length. A letter was sent to the supplier concerned advising amendment of label. Cheese Spread Informal No list of ingredients on label. A letter was sent to the supplier concerned advising amendment of label. Ham and Tongue Pate Informal Contained starch not shown in the list of ingredients on the label. A letter was sent to the supplier concerned. The labels were amended. Steak and Kidney Pie Informal List of ingredients on the label was obscured. A letter was sent to the supplier concerned advising amendment of label. Pork Pie Pork Pie Informal Lists of ingredients on the labels were obscured. A letter was sent to the supplier concerned. Labels were amended by manufacturer. Tomato Puree Informal List of ingredients was incorrectly placed on label. A letter was sent to the supplier concerned advising amendment of label. Raspberry Yoghurt Informal List of ingredients was not headed "ingredients". A letter was sent to the supplier concerned advising amendment of label. Lemon Tea Drink Informal List of ingredients was incorrectly placed on label. A letter was sent to the supplier concerned advising amendment of label. Ice Cream Informal No name and address on label. A letter was sent to the supplier concerned advising amendment of label. Milk Formal Contained milk fat 0.2%. Deficient of presumptive legal minimum of 3.0%. A letter was sent to the retailer concerned. Matter taken up and investigated by supplier. Christmas Pudding Informal List of ingredients incorrectly placed on label. A letter was sent to the supplier concerned advising amendment of label. Steak Pie Informal Total meat content 1.25oz. Deficient of legal minimum of 1.5oz. A letter was sent to the manufacturer concerned. Hamburgers Informal List of ingredients incorrectly placed on label. A letter was sent to the retailer concerned. Labels amended by supplier. Cultured Buttermilk Informal Misleading description. List of ingredients incorrectly placed on label and not headed "ingredients". A letter was sent to the supplier concerned advising amendment of label. 33 Article Type of Sample Nature of adulteration or irregularity Action Dijon Mustard Informal Contained preservative which was not declared on the label. List of ingredients not headed "ingredients". A letter was sent to the supplier concerned advising amendment of label. Meat Spread Informal Contained sodium nitrate not given in list of ingredients on label. A letter was sent to the supplier concerned advising amendment of label. Cherry Brandy Formal Contained alcohol 37.5% proof spirit. Deficient of recommended minimum of 40% proof spirit. A letter of caution was sent to the distilling company concerned by the Corporation's legal officer. Pork Sausage Informal No common or usual name or list of ingredients on the label. A letter was sent to the supplier concerned advising amendment of label. Apple Pie Informal No appropriate designation on label. A letter was sent to the supplier concerned advising amendment of label. Apricot Pie Informal No appropriate designation on label. A letter was sent to the supplier concerned advising amendment of label. Smoked Sprats Informal No list of ingredients on the label. A letter was sent to the supplier concerned advising amendment of label. Cornish Pasty Cornish Pasty Informal No address was shown on the . label. A letter was sent to the retailer. The label was amended. Breakfast Cereal Informal Incorrect and misleading claims on label concerning calorific and protein value. Calorie content not stated. List of ingredients in wrong position. Designation "nuts" in ingredients list generic and not specific. Letters to retailer and manufacturer. New box printed to comply with labelling regulations. Chocolate Paste Informal Contained prohibited colouring matter, Brilliant Blue FCF. Imported food — letter sent to importer stipulating that paste should not be used until impending new regulations on colouring matter in food came into force. Cream Cheese Informal No address of packer or labeller shown on label. A letter was sent to the supplier concerned. The label was amended. Canned Mushrooms Informal List of ingredients on label in incorrect position. Imported food — a letter was sent to the local Medical Officer of Health. Dried Mushrooms Informal Appropriate designation not conspicuous on label. Imported food — a letter was sent to the local Medical Officer of Health. Cottage Cheese and Cucumber Informal Incorrect appropriate designation on the label. A letter was sent to the restaurant proprietor concerned. Description of cheese was amended. Soft Cheese with Chives Informal Contained onion not declared in appropriate designation. A letter was sent to the supplier. Presence of onion due to improper cleaning of carton filling machine. Action taken by supplier to ensure no future repetition. Full Fat Cheese Informal Incorrect appropriate designation on the label. A letter was sent to the continental manufacturer. The label was amended. Alcoholic Beverage (Blend of whisky and wine) Formal The appropriate designation on the label was too small. A letter was sent to the manufacturer concerned. The label was amended. Cream Informal The appropriate designation on the label was not conspicuous. A letter was sent to the manufacturing dairy concerned. The label was amended. 34 Article Type of Sample Nature of adulteration or irregularity Action Buckwheat Vermicelli Informal Appropriate designation on the label was too small. Imported foods — a letter was sent to the importer. Osama Udon (Japanese foodstuff) Informal List of ingredients wrongly placed on the label. Bakers Cheese Informal No appropriate designation on the label. A letter was sent to the retailer concerned. Suitable notice placed at point of sale. Cream Cheese Informal Contained fat 28.5%. Deficient of legal minimum of 45% for cream cheese. A letter was sent to the retailer and supplier concerned. Label amended to show correct designation of cheese. Cream Cheese, Double Cream Cheese and Creamery Cheese (13 samples) Informal Deficient of legal minimum milk fat content for cream cheese. Designation creamery cheese considered misleading when applied to Cheese not meeting the standard for cream cheese. Counsel's opinion was obtained. Formal sample taken later with a view to the institution of legal proceedings against the manufacturer concerned. Sliced Salami Informal Contained colouring matter not declared on the label. Letters were sent to the cafe proprietor and manufacturer concerned. Cream Cheese Informal Contained fat 32%. Deficient of legal minimum of 45% of cream cheese. A letter was sent to the cafe proprietor concerned. Description of cheese was amended on menu. Processed Cheese Informal Appropriate designation on label not conspicuous and too small. List of ingredients not headed "ingredients". A letter was sent to the retailer and continental manufacturer concerned. The label was amended by the manufacturer. Cinzano the Bianco Formal Appropriate designation on the label was too small. A letter was sent to the manufacturer concerned. The label was amended. Cognac Formal Appropriate designation on the label was too small. A letter was sent to the manufacturer concerned. The label was amended. Vodka Formal Contained alcohol 65%. Deficient of stated minimum of 65.5%. A letter was sent to the manufacturer concerned. Advocaat Informal Alcohol declaration on label not enclosed in a surrounding line. A letter was sent to the U.K. agent of the manufacturer. The label was amended. Cherry Heering Informal Appropriate designation on the label was too small. A letter was sent to the U.K. agent of the manufacturer. The label was amended. Bean Jelly Informal Designation "vegetable gelatin" in list of ingredients on the label was not specific. Imported food — a letter was sent to the importer. English Cheese Informal No appropriate designation on the label. A letter was sent to the retailer concerned. Type of cheese to be specified in future. Jarlsborg Cheese Informal No appropriate designation on the label. A letter was sent to the retailer concerned. Suitable notice was displayed at point of sale. Milk Formal Consisted of skimmed milk with non milk fat. Legal proceedings were instituted against the retailing company concerned but withdrawn on technical grounds. Cheese ) Cheese ) Informal No appropriate designation on the label. A letter was sent to the retailing company concerned. Cheese suitably labelled to comply with the regulations. 35 Article Type of Sample Nature of adulteration or irregularity Action Vodka ) Vodka ) Informal Contained alcohol 64.5% and 65% proof spirit respectively. Deficient of stated minimum of 65.5%. A letter was sent to the distilling company. Stock was returned by retailer and investigation made by Company with assistance of Public Analyst. Vodka Informal Contained alcohol 64% proof spirit. Deficient of stated minimum of 65.5%. In view of result, formal sample taken later and legal proceedings instituted against distilling company concerned. Lumpfish Caviar Informal Contained prohibited preservative, benzoic acid. A letter was sent to the retailer concerned who withdrew the commodity from sale. Cod Roe Informal Generic designation "firming additives" in list of ingredients on the label. A letter was sent to the retailer concerned advising amendment of label. Smoked Marine Eel Informal No list of ingredients on the label. A letter was sent to the retailer concerned advising amendment of label. Home Made Red Sausage Informal Lettering of list of ingredients on the label was too small. Imported food — a letter was sent to the local Medical Officer of Health. Bierschinken (Meat Product) Informal Lettering of list of ingredients on the label was too small. No appropriate designation on the label. Creamery Cheese Informal Deficient of legal minimum milk fat content for cream cheese. Designation considered misleading for cheese not meeting the standards for cream cheese. A letter was sent to the retailer and supplier concerned. Label amended to show correct designation of cheese. Sliced Irish Cheddar Cheese Informal Contained 46% fat in the dry matter. Deficient of legal minimum of 48%. A letter was sent to the restaurant manager concerned and to the parent catering company. Artificial Sweetener Informal Appropriate designation on the label not sufficiently specific. A letter was sent to the retailing company concerned. Matter still being pursued. Cherry and Plum Fool Informal Contained prohibited preservative benzoic acid, 180 parts per million. A letter was sent to the manufacturer and retailer concerned. Matter still being pursued. Jarlsburg Cheese Informal Appropriate designation not shown on a label or in immediate proximity of cheese. A letter was sent to the retailer concerned. Matter still being pursued. Whisky, Brandy, Vodka and Cherry Brandy Chocolate Liqueurs Informal Indication of origin on the labels not easily discernible and easily read. A letter was sent to the manufacturer and retailer concerned. The labels were amended. Whisky Informal Appropriate designation on the label was too small. A letter was sent to the distilling company concerned, the labels were amended. Angostura Bitters Informal Appropriate designation on the label was too small. Address and country of origin not clear and legible. A letter was sent to the manufacturer and retailer concerned. Matter still being pursued. Lager Informal Country of origin not shown on label. A letter was sent to the brewer and retailer concerned. Matter still being pursued. Lager Informal Country of origin not shown on label. A letter was sent to the retailing company concerned. Matter still being pursued. Hot Milk Formal Consisted of skimmed milk powder reconstituted with water. No action taken after investigation of use of milk in restaurant concerned. 36 Article Type of Sample Nature of adulteration or irregularity Action English Cheese Informal No appropriate designation labelled on or in immediate proximity to cheese. A letter was sent to the retailer concerned. Matter still being pursued. Full Fat Soft Cheese with Garlic and Herbs Informal No list of ingredients on the label. Appropriate designation not conspicuous. A letter was sent to the retailer concerned. Matter still being pursued. Vodka Formal Contained proof spirit 62.5%. Deficient of stated minimum of 65.5% proof. Legal proceedings were instituted against the distilling company concerned, which was fined £50 and ordered to pay £12 costs. Martini Bianco Formal Lettering of appropriate designation on the label was too small. A letter was sent to the manufacturer and retailer concerned. The label was amended. Whisky Formal Declaration of alcohol content on the label was too small. A letter was sent to the distilling company and retailer concerned. The label was amended. Bacardi Rum Informal Lettering of appropriate designation on the label was too small. A letter was sent to the retailing company concerned. Matter not pursued as label has been in use for not less than 30 years. Southern Comfort Informal Lettering of alcohol content on label was too small. A letter was sent to the manufacturer and retailer concerned. Matter still being pursued. Maraschino, Creme de Menthe and Bolskummel Miniatures Informal Lettering of appropriate designations and alcohol content on the labels was too small. A letter was sent to the manufacturing company and retailer concerned. Matter still being pursued. Blue Cheese Salad Dressing Mix Informal List of ingredients on label not headed "ingredients". A letter was sent to the manufacturer and retailer concerned. The label was amended. Kirsch D'Alsace (Miniature) Informal Contained 66% proof spirit. Deficient of the stated minimum of 70% proof spirit. Lettering of alcohol content on label too small. Country of origin not clear and legible. To be re-sampled formally with a view to possible legal proceedings. Sterilised Cream (Tinned) Informal Described on label as absolutely pure. Stated to contain not more than 0.2% sodium bicarbonate. Description "absolutely pure" considered misleading. A letter was sent to the producer and retailer concerned. Matter still being pursued. Pickled Onions Mixed Pickles Informal Contained sulphur dioxide preservative not included in the list of ingredients on the labels. A letter was sent to the manufacturer and retai ler concerned. Pickles withdrawn from sale while matter pursued. 37 PROSECUTIONS FOOD AND DRUGS ACT, 1955 Article Section Fine Costs Meat Pie — Contained mould 8 £20.00 £20.00 Cheese and Tomato Roll — Contained a piece of glass 2 £50.00 £15.00 Portion of Bread Pudding — Contained a cigarette end 2 £20.00 £12.50 Part Baked Loaf - Mouldy 8 £20.00 £12.00 Bag of Chips — Contained insect larvae 8 £30.00 £23.00 Cottage Cheese with Chives — Mouldy 8 £50.00 £24.00 Vodka — Deficient in proof spirit content 2 £50.00 £12.00 Unsatisfactory condition of restaurant Food Hygiene (General) Regulations 1970 £90.00 £12.00 Unsatisfactory condition of club catering premises Food Hygiene (General) Regulations, 1970 £260.00 £15.00 Unsatisfactory condition of snack bar Food Hygiene (General) Regulations, 1970 £70.00 £20.00 Unsatisfactory condition of vehicle ice cream vendor Food Hygiene (Markets,of Stalls and Delivery Vehicles) Regulations,1966 £45.00 £15.00 Unsatisfactory condition of meat delivery vehicle Food Hygiene (Markets,Stalls and Delivery Vehicles) Regulations, 1966 £50.00 £24.00 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 9 Cooking of Meat and Poultry for resale 5 Manufacture of Dripping 9 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 61 Selecting and Testing Sausage Casings 4 Sale of Ice Cream — Prepacked 33 Cooking of Prepacked Frozen Pies 1 TOTAL 172 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 10 tons 15 cwt 1 qr 26 lbs., which was disposed of as follows:- Tons Cwts Qrs Lbs Destroyed 10 15 1 26 Disposed of to Contractors — - — — 38 FOOD HYGIENE (MARKETS, STALLS AND DELIVERY VEHICLES) REGULATIONS, 1966 AUTOMATIC VENDING MACHINES Hot and cold beverage-vending by machine continues to be a growth industry in the City. This may well be a direct result of changing patterns of catering in the City and of the decline in the provision of industrial and commercial catering units. The "office cuppa" is also changing in the way in which it is presented to employees. The old "tea-making" room which used to be a feature of many offices is rapidly disappearing. In some cases offices which have a staff canteen are, in the interests of efficiency, restricting the use of the canteen for morning and afternoon refreshments. This applies also to the Trolley services which were operated by the ever-cheerful "tea lady". Some firms are now relying on the "take-away" services offered by adjacent snack bars and restaurants, who are finding increasing sales in this type of service. A further feature of morning and afternoon refreshment is the contract service, where adjacent catering firms are supplying and delivering refreshments to office blocks. As yet this type of service is not very widely used, but if it increases to any marked degree there may be hygiene problems in transporting large orders of beverages and snacks through the streets. Vending by automatic machine, however, supplies the most convenient answer to the problem of providing light-refreshment for staff. Automatic vending companies, offering a complete beverage service, are now more in evidence and most of them are placing high importance on the installation, cleansing and servicing of machines. A great deal, however, has still to be done in the design of the machine itself, particularly in relation to the internal surfaces, disposal of waste, reduction of internal condensation, and positioning of delivery points. Whilst automatic vending often provided an acceptable alternative to more traditional methods, on a cost basis the present oil shortage may to some extent offset this advantage in the future, as one of the major cost factors in modern automatic vending is the cup and many of those used in the industry are made of a polystyrene derivative which is a by-product of the petro-chemical industry. Nevertheless, in spite of these additional costs, there seems little doubt that automatic vending will continue to increase in the City, and apart from design deficiencies, most vending caterers are providing an acceptable product under reasonable condition of hygiene. The main cause for concern regarding unhygienic vending continues to be the number of vending machines sold to small firms and installed with little or no supervision. I am hopeful that, with the continuous efforts of the Public Health Inspectors and an increased awareness of vending hygiene by members of the public, the situation should improve. 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, caustic sodas, ammonia, etc. Sixty-three inspections were made in connection with the administration of the Act, as a result of which a number of irregularities concerning labelling requirements were detected. Appropriate representations were made to the firms in question, but in one instance it was necessary to institute legal proceedings as the initial informal approaches did not secure compliance with the provisions of the Act. Three summonses were eventually issued against the same company in respect of three separate premises in the City. In each case a fine of £30 was imposed and costs of £15 were awarded to the City Corporation. 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. Three contraventions came to the notice of the Inspector. 39 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. Thirteen inspections were made. Two contraventions were noted. One sample of fertiliser was purchased and sent to the Agricultural Analyst for examination, and was 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 (including shellfish) Weight of Fish condemned Condemnation Rate 60,767 tons 165 tons 0.27% MEAT AND FOOD INSPECTION - SMITHFIELD MARKET Meat, Poultry and Other Foods delivered at Smithfield Market: 1973 246,087 tons 1972 264,476 tons The downward trend in total tonnage delivered at Smithfield continued, but is probably in line with increasing quantities of packaged cuts of meat received. The numbers of wholesalers dealing in frozen lamb carcases from Australia and New Zealand have been declining for some years. More traders are supplied from depots outside Smithfield to avoid the problems of buying and having meat delivered from Smithfield. Increased tonnage from home sources in England and Wales was 12,844 tons above 1972 and almost balances the drop of 13,721 tons in supplies from the Republic of Ireland. Meat Inspection More than 90% of total meat surrendered is unfit because of spoilage, decomposition or similar conditions of unsoundness. The balance of meat found to be diseased is mainly comprised of pork carcases and pieces in which deep seated lesions are found and carcases of sheep and calves in which the condition often is not really apparent until after rigor, cooling and setting. The plastic film vacuum packed chilled boneless beef has convenience in its favour but is subjected to fluctuations of temperature in distribution and handling and sometimes delay which may be detrimental to its condition. There are obvious difficulties in inspecting these packs of meat but they provide the quantities of Argentine meat surrendered as unsound. Internal decomposition (bonetaint) was a frequent cause of loss in beef carcase meat from the British Isles. Any reason for this could only be guessed. Meat Inspection Regulations, 1963 These Regulations apply to meat slaughtered in England and Wales. Deliveries of meat from these sources during 1973 were as follows: (1972 figures in parenthesis) Beef & Veal Mutton & Lamb Pork Tons 19,146 (19,357) 16,345 (14,119) 38,582 (33,342) 10 tons 11 cwts 0 qrs 16 lbs amounting to 0.014% (0.019%) of deliveries was surrendered, being diseased. 40 Local Authority stamps on carcases still tend to be illegible frequently due to running or blurring of the ink on a moist surface. The matter of colour of ink stamps was raised with some Local Authorities, criticism of blurred blue ink appearing green in colour was passed to the appropriate authorities who promptly took action. Deep seated lesions of disease found in pigs in Smithfield might in some cases have been disclosed in the slaughterhouse if possibly minor external lesions were regarded with more suspicion and the carcase split for further examination in accordance with Part V (12) of schedule 1 of these Regulations. Poultry inspection There are no premises in the City of London which are used for the processing of live poultry. There is now less disease found in poultry in Smithfield. The aged hens with their chronic diseases are giving way to younger fowls from modern egg farms and, in these, disease is comparatively rare and mostly affecting the reproductive system. Only fresh uneviscerated carcases can be examined for disease and surveillance of these was maintained. Mass or flock disease has become the first enemy. The picture of this type of disease is often confused but coliform septicaemia and respiratory disease together is found in occasional consignments. The bulk of poultry surrendered is unsound due to development of spoilage by bacterial growth, no doubt promoted by the wet condition of present day production. Imported Food Regulations 2,723 containers of imported meat etc. 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 186 containers destined elsewhere were forwarded to appropriate Local Authorities. Meat Refused Entry by U.S.A. 34 consignments of meats of Commonwealth origin which had been refused entry into the United States, arrived from other Ports of Entry and were detained at City Cold Stores pending results of the inspection of samples by this authority. 1 carton from one consignment was surrendered; 30 cartons from one consignment were sent for processing for animal feed; and one consignment of 906 cartons was re-exported; the remainder were released to the wholesale trade. The 30 cartons sent for processing were the cartons sampled in the U.S.A. and reported to contain pesticide residues. Sampling 130 samples were collected on behalf of the Government Chemist for pesticide research. Facilities to sample the meat referred to previously for examination by the Government Chemist for pesticide residues was arranged. 41 Educational Specimens of unsound, pathological or anatomical specimens were provided for practical examinations in Meat Inspection held in London and for Public Health Students from various colleges in and outside London who attended for instruction. Visitors entertained at the Meat Inspectors Office during 1973 included 29 veterinary and other officers of the Ministry of Agriculture, Fisheries and Food, one officer of the F.A.O., Rome, and three Veterinary Officers from Japan. 85 copies of the Corporation of London publication 'Handbook of Poultry Inspection' were sold to Local Authorities and Public Health Students. Export Certificates Twelve export certificates were issued for the export of meat, etc. to Canary Isles, Gibralter, Greece, Hong Kong, Italy, Malta and Spain. TABLE 1 TABLE SHOWING THE AMOUNT OF MEAT, POULTRY AND OTHER FOODS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON, 1973. Smithfield Market Leadenhall Market and City Shops Cold Stores Total T C Q L T C Q L T C Q L T C Q L Meat (Diseased) 11 16 2 25 20 11 16 3 17 Meat (Unsound) 125 11 1 27 16 1 12 2 2 19 126 10 2 2 Offal 32 13 1 10 10 2 16 32 14 0 8 Poultry & Feathered Game 40 10 3 6 12 0 13 41 2 3 19 Rabbits & Hares 7 1 0 7 1 0 Tinned Meat 1 11 1 22 1 14 1 11 3 8 Other Tinned Goods 2 2 0 21 2 14 2 2 3 7 Frozen Foods 1 3 4 1 3 4 Cheese 1 3 11 1 3 11 1973 214 13 0 27 1 13 1 14 3 1 7 216 9 3 20 1972 210 8 1 15 2 15 3 4 1 5 3 9 214 10 0 0 42 43 TABLE 2 TABLE SHOWING THE AMOUNT OF MEAT SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR DISEASED CONDITION, 1973. 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 1973 lbs Total 1972 lbs Argentina 14 14 5 Australia 40 40 4 Denmark 17 30 47 11 England & Wales 2,500 1,591 1,740 1,985 3,275 1,356 2,428 1,798 1,890 2,068 1,572 1,445 23648 28,677 Finland 23 118 28 13 182 1,186 Ireland, Northern 40 138 44 10 232 610 Ireland, Republic 311 45 84 97 92 25 233 96 140 30 1,153 6,347 Netherlands 18 18 - New Zealand 7 7 47 Norway 42 39 81 403 Poland - 8 Scotland 171 139 161 67 28 40 45 182 43 161 1,037 1,169 Sweden 47 19 8 74 1,008 1973 3,128 1,775 2,025 2,287 3,476 1,539 2,734 1,959 1,890 2,445 1,625 1,650 26,533 - 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 44 TABLE 3 TABLE SHOWING THE AMOUNT OF MEAT SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR UNSOUND CONDITION, 1973. 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 1973 lbs Total 1972 lbs Argentina 4,450 3,509 3,568 4,704 7,356 9,833 4,609 7,916 2,607 995 691 1,420 51,658 53,129 Australia 9,588 4,874 504 405 340 12 579 470 621 3,696 9 21,098 3,060 Botswana - 5 Brazil 49 20 10 79 153 Denmark 28 15 17 298 1,564 78 302 47 815 242 3,406 357 England & Wales 6,209 2,729 5,040 3,742 8,928 12,464 9,910 27,190 11,306 10,621 2,699 2,079 102,917 60,753 Finland 10,114 1,648 737 1,363 13,862 25,182 France 163 163 808 Germany 27 27 - Hungary - 261 Ireland, Northern 59 197 137 108 768 420 1,249 1,256 2,633 514 595 497 8,433 3,913 Ireland, Republic 2,509 2,354 1,073 663 7,751 3,893 2,363 1,234 4,019 2,403 2,528 1,725 32,515 60,256 New Zealand 48 48 85 355 2,405 109 405 76 573 398 4,502 2,775 Netherlands 35 12 22 123 77 10 9 50 338 73 Norway - 7,027 Poland 16 43 14 16 312 1,700 644 504 40 248 21 180 3,738 8,014 Scotland 250 576 491 147 1,136 2,303 2,198 4,221 2,943 790 631 1,131 16,817 21,207 S. Africa 1,824 733 461 1,384 1,637 509 1,181 2,804 4,517 2,503 3,013 444 21,010 9,308 S.W. Africa - 562 Sweden 1,288 16 22 16 454 242 380 45 2,463 7,929 U.S.A. 12 50 62 136 Other Countries 330 330 — 1973 26,269 15,129 11,288 11,533 38,482 33,901 27,853 47,622 29,413 21,902 11,575 8,451 283,418 - 1972 14,038 11,780 13,139 11,542 15,752 44,434 41,475 27,027 14,920 26,236 24,163 20,402 - 264,908 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 1973 comprised 330 stalls, occupied by 90 tenants. Each business is equipped with facilities required by regulations 16 and 18 of the Regulations. There are 299 porters licensed by the Clerk & Superintendent either self employed or employed by meat carriers. During the year 83 warning letters were despatched in respect of infringements of these regulations. All classes of food handlers continue to be exhorted and encouraged to improve standards of hygiene in handling food in compliance with these Regulations. These efforts of the Inspectors are not helped by the environment of the old market buildings which in the requirements for proper cleaning are labour intensive and costly; few modern techniques can be used. The behavior and dress of members of the public who come as retail buyers set no good example to market employees who are subject to the requirements of these Regulations. Restrictions on smoking in the public avenues of the marketare limited and a ban on smoking in the covered market area as included in new byelaws proposed sometime ago, but not yet in force, would be an advantage. Despite the offer of reward from the City Corporation to the designer of an acceptable improved market truck, the old trucks of traditional design are still used. They do not lend themselves to certain loads now common and are difficult to clean. Laundry services and replacement protective clothing are difficult to obtain and a continual struggle against problems ofdelivery and shortages still leads to a far from satisfactory situation. The Food Hygiene 'General) Regulations, 1970. Around Smithfield, in Leadenhall Market and in the City, including Billinsgate area, are 32 businesses dealing in meat, game and poultry which are subject to routine visits by Meat Inspectors. Number of Premises 32 Number of Premises fitted to comply with Regulation 18 32 Number of Premises to which Regulation 21 applies 31 Number of Premises fitted to comply with Regulation 19 32 Businesses of catering suppliers where meat and poultry is prepared for clients, tend to outgrow their available space and the increased use of film and cartons for packaging provided problems, among others, of where to put waste awaiting collection. It is often objectionable to the public. The evisceration of poultry in these firms remains an operation requiring frequent supervision and education by management and Inspectors. The Food Hygiene (Docks, Carriers, etc.) Regulations, 1960. These regulations apply to 4 public cold stores where meat is handled. The older public cold stores by reason of their construction and situation continue to demand supervision and assistance in efforts required to control mice infestation. Necessary preliminaries are good repair, cleanliness and good stowage. Vermin Infestation Contamination and damage to foodstuffs indicated an increasing mouse population in the spaces beneath the poultry market and Inspectors' reports showed some laxity and bad management inthe use of refrigerated spaces therein. The following code of practice was prepared and delivered to each tenant of this market under an explanatory letter. 45 CODE OF PRACTICE Recommendations: 1. Accumulations of rubbish must not be allowed to occur in basement areas, stairwells or cold rooms. 2. Broken boxes of meat or poultry must be repacked and made secure from vermin, open meat and poultry must be stored in such a manner that it is not vulnerable to vermin damage and contamination and must not be placed on the floor or low boards. 3. Stacking of boxes of poultry and meat must allow for a more widespread siting of poisons by providing access areas against walls of cold rooms (by siting some stacks with a 6 inch gap from walls). Poison baits and traps must not be disturbed other than by Rodent Operators. 4. Cold rooms must be regularly cleared of scraps of meat which may have accumulated on the floor. This will be done as the cold rooms become clear or partially clear. 5. Poultry and meat left in the shop overnight must be adequately protected against vermin. 6. Vermin infestation must be promptly reported to either the Markets Superintendent or Meat Inspectors Department. 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 is the responsibility of the London Boroughs with the exception of imported animals which is the soleresponsibility of the Corporation of London for the whole of Greater London. The Corporation acts, on an agency basis, for seventeen London Boroughs under this Act and associated Acts. 1973 was the eighth year in which agency arrangements were in operation and approximately 1550 visits of inspection were made to 807 premises. These included animal boarding establishments, animal hospitals, cattle and poultry shows and exhibitions, 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:- Riding Establishments Acts 1964 and 1970 Thirty-seven riding establishments were inspected for re-licencing and a number of visits were made following complaints. This service is carried out on behalf of eleven of the London Boroughs and reports and recommendations are submitted to the Boroughs concerned. Animal Boarding Establishments Act 1963 Services under this Act are carried out on behalf of six London Boroughs, visits being made and reports and recommendations concerning re-licencing being submitted on twenty-nine establishments. The service was also used to investigate complaints and in a consultative capacity. Pet Animals Act 1951 Seven London Boroughs require inspections to be carried out at pet shops in their areas and regular visits were made to 117 such shops. Visits of inspection were also made concerning complaints from the public, local authority, welfare societies, etc. Club Row Market and Shepherds Bush Market were also visited under the terms of this Act. Psittacosis or Ornithoses Order 1953 Enquiries were carried out concerning cases of psittacosis in the London Boroughs of Tower Hamlets and Camden and the City of Westminster. The first case in October concerned an Amazon green parrot which had died following purchase from a pet shop in Tower Hamlets. Your Officers, together with Officers of the London Borough and the Ministry, inspected the shop, which subsequently closed down. The second case occurred in November and concerned two parrots which died. They had been purchased by a pet shop owner in Chepstow from another shop in Tower Hamlets. A full inspection of the shop was carried out and improvements are being made. 46 The third case concerned some love birds at a shop in Camden, owned by a man living in Westminster. The shop was inspected on several occasions and the birds examined. In each of the above cases reports were submitted to the local authority concerned. Live Poultry (Restrictions) Order 1971 A licence was issued to the London Borough of Barking to enable the holding of a poultry show at the Dagenham Town Show and Carnival in July. An inspection was carried out to ensure that the terms and conditions of the licence were conformed to. Animals at the show included horses, rabbits, guinea pigs, tortoises, pigeons, budgerigars, ferrets, parrots, canaries, geese, poultry, etc. all displayed in excellent conditions. The Royal Smithfield Show was visited in December. Livestock, consisting of cattle, sheep and pigs were inspected as were floats, transport, etc. Special care was being taken this year to prevent the possibility of an outbreak of swine vesicular disease. Visits were made to markets, kosher poulterers, etc., together with Veterinary Officers of the Ministry of Agriculture, Fisheries and Food, following reports that live poultry was being sold to members of the public. Several meetings were held with Architects, Officers of the London Borough of Tower Hamlets and the Ministry of Agriculture, Fisheries and Food concerning the opening of new poultry slaughterhouses in Tower Hamlets. Advice was given regarding design, construction, etc., especially with regard to the European Economic Community regulations. Performing Animals 'Regulation) Act 1925 Eleven certificates of registration were issued under the terms of this Act to enable persons to train and exhibit camels, llamas, norses, bears, dogs, giraffes, lions, tigers, panthers, monkeys, apes, dolphins, sealions, killer whale, elephants, crocodiles, zebras, chimpanzees, leopards, snakes, penguins, parrots, donkeys, hyenas, wolves, porcupines, goats, pigs, sheep, alligators, cheetahs, and mules. Circuses appeared in several London Boroughs and all animals, performing animals certificates, quarters, etc., were inspected and performances witnessed. Visits were also made to television studios, dolphinariums and theatres concerning the use of animals in productions. 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 or slaughterhouse must be kept there until slaughtered. 120 such licences were received and verified. Post-Mortems Requests were received for post-mortem examinations to be carried out on animals which arrived dead or died at slaughterhouses or on farms, public highways, etc. During the year such examinations were carried out on twelve pigs, one lamb and one goat. Swine Vesicular Disease There were 137 outbreaks of this desease during the year, necessitating the slaughter of 89,112 pigs. No outbreaks occurred in the Corporation's agency area, but all owners of farms, especially those with swill boiling plants, were visited and informed of the extreme precautions to be taken. For a period of time the whole of England, Wales, and Scotland was declared to be a 'controlled area' which meant that pigs could only be moved under controlled areas licences. 356 such licences were issued. On the 19th April the Movement of Pigs (Waste Foods Precautions) Order 1973 came into operation. Under this Order, the movement of pigs which have been swill fed or on premises where swill is kept is allowed only to slaughterhouses and only under licence. During the year 429 licences were issued. 47 Ringworm In August and September enquiries were carried out into a case of ringworm in a kitten purchased in the London Borough of Richmond upon Thames. ACTS AND ORDERS 1973 Brucellosis (Eradication Areas) Orders 1973 Four of these Orders came into operation and declared certain areas to be eradication areas. They 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. Swine Vesicular Disease (Amendment) Order 1973 This Order amends the Foot and Mouth Disease Order 1928, as applied to swine vesicular disease by the Swine Vesicular Disease Order 1972, so that the restrictions which are to operate immediately on the certification of a suspected case of that disease apply to pigs only. Movement of Pigs (Waste Food Precautions) Order 1973 Under this Order the movement of pigs from premises to which waste food has been brought for any purpose within three months of the movement is allowed only under licence to a slaughterhouse for slaughter. Regulations also apply to road vehicles used for such purposes. Diseases of Animals (Waste Food) Order 1973 This Order revokes and re-enacts the Order of 1957. It extends the definition of waste food, contains provisions as to feeding of waste foods to animals, prohibits the feeding of imported waste food to animals and also contains provisions regarding the movement of waste food. Tuberculosis (Amendment) Order 1973 Amends the Tuberculosis Order 1964 and contains provisions for the notification of and isolation of bovine animals and carcases of the same which are suspected of being affected with tuberculosis. Your Veterinary Officer would again like to take this opportunity of expressing his gratitude to the staff for the excellent way in which they have carried out their duties often at weekends or out of office hours and particularly coping with difficult situations arising out of the nature of this department. 48 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 42 Number of staff who had not previously had an eye test 12 Visual defects found and corrected 8 Re-examinations of persons already using spectacles 30 Further correction needed and carried out 28 Medical Examinations During the year, 644 medical examinations have been carried out, as shown in the following table:- Reason for Examination Result Male Female Total Admission to Superannuation Scheme Fit 259 171 430 Unfit 6 1 7 Deferred 10 6 16 Referred for excessive sick absenteeism Fit for duty 17 1 18 Still unfit Unfit for further 12 0 12 service 8 2 10 Staff over 65 years of age continuing in employment Fit to continue 66 34 100 Unfit to continue 0 0 0 Special examinations 36 15 51 Exemption from parking meter fees Monument employees Temporary appointments Fitness to drive heavy goods vehicles (Cleansing Staff) TOTALS 414 230 644 49 NOTIFICATION OF INFECTIOUS DISEASE During the year 15 notifications of infectious diseases affecting City residents were received as shown in the following table which also shows comparable figures for 1972:- Disease 1972 1973 Dysentery 3 0 Food Poisoning 2 5 Hepatitis 0 1 Measles 8 0 Meningitis 0 1 Scarlet Fever 1 0 Tuberculosis, Pulmonary 6 8 Whooping Cough 1 0 21 15 In addition to the above a further 38 notifications (36 during 1972) 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 reside. 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:- The Milk (Special Designation) (Amendment) Regulations 1972 The Lead in Food (Amendment) Regulations 1972 Greater London Council (General Powers) Act 1972 Local Government Act 1972 National Health Service (Family Planning) Amendment Act 1972 The Poisons Rules 1972 The Skimmed Milk with Non-Fats (Amendment) Regulations 1973 The Equine Animals (Importation) Order 1973 The Fertilizers & Feeding Stuffs Regulations 1973 The Milk & Dairies (Milk Bottle Caps) (Colour) Regulations, 1973 The Arsenic in Food (Amendment) Regulations 1973 The Lead in Food (Amendment) Regulations 1973 The Colouring Matter in Food Regulations 1973 The Separated Milk Regulations 1973 The Milk & Dairies (Semi-Skimmed and Skimmed Milk) (Heat Treatment and Labelling) Regulations 1973 The Common Agricultural Policy (Wine) Regulations 1973 National Health Service Reorganisation Act 1973 PUBLICATIONS (1) Handbook of Poultry Inspection (2) Clean Food Handling 50 PERSONAL HEALTH SERVICES IN THE CITY (Comparable figures for 1972 are given in brackets where appropriate) The total number of births occuring in the City (St. Bartholomew's Hospital) was 1018 (742). Births (to City Residents) 1972 1973 Hospital Live Births 34 25 Domiciliary Live Births NIL NIL Number of these born with congenital malformations 1 1 Stillbirths NIL 1 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, personal health services have continued to be 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 in an infact born to City parents was recorded. Infant Deaths 1972 1973 Stillbirths NIL NIL Neo Natal 1 1 Perinatal NIL NIL Others under 5 years NIL NIL 1972 1973 Maternal Deaths NIL NIL Child Health Clinic Clinic Attendance of Children under 5 years. 1972 1973 Number of children attending 74 52 Total Attendances 606 344 Dr. A. White Franklin, the Paediatrician, has reported as follows:- "The Child Health Clinic continues to serve the needs of the local families, both in giving informed advice and in conducting a successful immunisation programme. Unfortunately, the character of the premises makes the organisation of parentcraft discussion and teaching rather difficult." 51 Vaccinations and Immunisations at Child Health Clinic 1972 1973 Diphtheria/Tetanus/Whooping Cough 10 13 Diphtheria/Whooping Cough 3 NIL Diphtheria/Tetanus 5 2 Poliomyelitis 16 14 Smallpox 4 NIL Measles 5 6 At Risk Register 1972 1973 Children aged under five years on the Register at the end of the year 10 10 Welfare Foods The sale of Welfare Foods continues at the Child Health Clinic, St. Bartholomew's Hospital. 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. 1972 1973 Home confinements attended NIL NIL Planned early discharge from hospital 1 1 Emergency cases attended NIL NIL Close liaison between hospital and domiciliary midwifery services has continued although the domiciliary midwives no longer visit the hospital to attend deliveries of City mothers. Midwives Act, 1951 The Corporation, as the supervising Authority for the City of London, received from midwives 42 (50) notifications of intention to practise during the year. SECTION 24 - HEALTH VISITING RECORD OF HOME VISITS 1972 1973 Children born in current year 29 26 Other children aged under 5 53 47 Persons aged 5-16, seen as health visiting, excluding those seen as part of School Health Service 11 16 Persons aged 17-64, seen as health visiting 103 132 Persons aged 65 and over seen as health visiting 85 99 Households visited on account of Tuberculosis 18 12 Households visited on account of other infectious disease 3 — Households visited for any other reason 1 — TOTAL 303 332 Number of persons in Mentally Handicapped — 2 1-5 above who were: Mentally III 6 24 52 CASE CONFERENCES ATTENDED WITH: (must last 1 hour minimum) 1972 1973 Hospital Staff - 2 General Practitioners 14 2 Any Combination of above - 1 Others (i.e. none of above present) 1 9 TOTAL 15 14 RE-VISITS Children born in current year 117 84 Other children aged under 5 61 182 Persons aged 5-16, seen as health visiting, not School Health Service 24 28 Persons aged 17-64, seen as health visiting 111 91 Persons aged 65 and over, seen as health visiting 421 293 Households visited on account of Tuberculosis 10 29 Households visited on account of other infectious disease 2 1 Households visited for any other reason - 1 TOTAL 746 709 MISCELLANEOUS VISITS Visits to General Practitioners' Surgeries 63 71 Visits to other General Practitioners' Clinics 10 24 Visits to Hospitals 87 106 Ante-natal visits 21 5 TOTAL 181 206 This report of the health visiting duties carried out by the Health and Welfare Officers in 1973, is the final report before the re-organisation of the National Health Service and the division of the Health and Social Services functions as performed by the Health and Welfare Officers in the City of London since 1965. The statistics show a change in emphasis in the conduct of health visiting; many more visits were made to City residents in hospital, to extend and develop the collaboration with hospital staff and to ensure that patients on discharge received the necessary community care services. This has proved most helpful to the patients and their general practioners; hospital staff have also appreciated the exchange of information and thehealth visitors have found the visits deepened their relationship with their patients and aided in a better understanding of thesupportive services provided and gave added emphasis to health teaching. Prevention of illness or recurrence of illness has acquired a greater meaning and is seen to be a more desired way of life. An increase of visits to General Practitioners Surgeries and clinics has also occurred, although domiciliary visits appear to have decreased. In view of the increase in the residential population of the City, this could well be explained by an increase of home visits recorded under Social Services; constant publicity of the provision of Social Services has helped to increase the number of enquiries and in most instances services were found to be necessary. Senior Nursing Officers and student nurses from St. Bartholomew's Hospital have again been welcomed to the Health Department and observation visits of the community care service were made. Eight Degree Course student nurses from St. Bartholomew's Hospital were also welcomed and each student spent one week on a specially planned community care programme. Each student prepared a short paper on one aspect of the services they were shown; these were read and discussed at a symposium held after all visits were completed. TUBERCULOSIS HEALTH VISITING 1972 1973 Cases notified (Residents) 13 8 Total home visits, old and new cases 26 37 Shops and office contact tracing number of investigations 18 14 (involving 88 persons + 165Mass X-Rayed) (involving 98 persons + 468 X-Rayed) 53 Again I have to report a slight rise in the volume of work in Tuberculosis health visiting, mainly in the follow up of work contacts in shops and offices within the City and the continual vigilance needed to prevent any further spread of infection within the common lodging house accommodation. SECTION 25 - HOME NURSING The Metropolitan District Nursing Association continued to provide home nursing services in the City. The family doctor group practice attachment scheme became well established. There has been a further increase in the number of patients attended. 1972 1973 Patients attended in their homes 67 53 Patients attended in General Practitioners Surgery 75 177 Patients attended elsewhere 8 30 Total Patients attended 150 260 Number of nursing treatments given 4011 4215 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 1973, 12570 (7200) doses were issued to City medical practitioners and doctors at St. Bartholomew's Hospital, the medical department of Unilever and various City business houses. 298 (77) adults (including Corporation staff and employees of City business houses) were vaccinated by Corporation medical staff. This increase was due to the numerous requests for vaccination (and the even greater number of requests for advice in general) in connection with the risk of contact during the period early in the year when cases were reported within the London area. Poliomyelitis vaccine is also issued at the request of St.Bartholomew's Hospital, Unilever Limited and City medical practitioners. In all 3910 (4170) doses were issued. (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:- "Nine City Residents with Pulmonary Tuberculosis are under regular observation and treatment, five of whom attended for the first time in 1973. Seven of the nine gave the Salvation Army as their address. The Mass X-Ray Unit attended the Salvation Army Hostel twice during.the year and, in all, 112 Residents had miniature films. Of these, eight were referred to the Chest Clinic, but only two attended. During 1973, 14 City Workers were notified as having Tuberculosis. This resulted in 98 contacts attending the Chest Clinic and a further 468 were X-Rayed by the Mass X-Ray Unit. None of these was found to have Tuberculosis. Twenty one City Residents attend the Chest Clinic for non-tuberculous chest disease. In addition, approximately 450 visits were made to the Clinic by City Workers." 54 Special Hostels for Tuberculous Men 1972 1973 Men resident during the year 5 4 Loan of Nursing Aids and Aids for handicapped 1972 1973 Supplied by the Department to Residents 145 55 The demand for nursing aids and aids for the handicapped continues, some equipment being loaned out for long periods of time. 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.1. From January to December, 1973, 494 domiciliary treatments were given in the Petticoat Tower and Petticoat Square block, and within that area. All of the patients were infirm or physically handicapped, and in the 70 to 90 year age group. None of them would have been able to attend a clinic, even a local one. Treatment was greatly appreciated by the patients and missed appointments were negligible. The service was a badly needed one and undoubtedly helped to keep these old people reasonably mobile." "Milton Court Clinic 163 treatments were given during the year, patients being seen at monthly intervals. The number of patients at the end of the year was 21 an increase of 12 over the year. Only three of the patients were men. Salvation Army As in the previous year the Salvation Army Hostel was visited once a month, 32 treatments were carried out. Due to the decline in patients attending for treatment only half a session is now being worked at each visit. Domiciliary Visits This service is for people who are housebound. Patients were seen once a month and a total of 356 treatments were carried out. Sir John Cass's Foundation School There were 22 visits during the year; this would have been 24 but for the gas strike at the beginning of the year when the school was closed, 188 children were inspected and many were found to be wearing shoes that were too small and not suitable for school. 112 treatments were carried out these being mostly verrucae, corns and nail conditions. I would like to thank the staff of the Medical Officer of Health, the Brigadier and his staff in the Salvation Army Hostel, the School's Head Master and his secretary for their help throughout the year." SERVICES FOR INCONTINENT PERSONS 1972 1973 Persons receiving service at end of year 12 14 Items washed 3730 4557 55 Under Section 13 of the Health Services and Public Health Act 1968 arrangements have been made for the linen of incontinent and other 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 fevervaccine to the designated centre atUnilever 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 2100 (2370) doses of vaccine were distributed. International Certificates of Vaccination against Smallpox 1972 1973 Number authenticated 3500 4150 Number returned as doctor did not practise in the City 40 26 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 follow up:- 1972 1973 City Cases NIL NIL Non City Cases 4 7 The work of the health visitor in the Special Treatment Clinic at St. Bartholomew's Hospital continues to develop in counselling and health education as well as in its prime function of contact tracing, so much so, that the Consultant Physician has requested an increase in the attendances of the Health Visitor. Due to shortages of staff this has not been fulfilled. HEALTH EDUCATION Subject Audience No. of Lectures Average number in the audience at each Lecture Child Development Expectant mothers attending St. Bartholomew's Hospital 5 19 Drug Abuse Engineering cadets 1 230 Family and Sexual Relationships City of London School pupils 12 25 Health & Social Services Home Helps (Training Course) 1 12 Community Services Student Nurses and degree student Nurses 2 10 Health Services & Community Care City of London Girls School senior pupils 1 40 The group teaching on matters concerning health maintenance has continued steadily and the distribution of leaflets and posters has proceeded as before and in addition the School of Nursing St. Bartholomew's Hospital and the hospital Social Workers also receive their own supply. FAMILY PLANNING Rent free premises are provided for the Family Planning Association at Milton Court where three lunch-time and one evening session 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:- "The provision of a family planning serviceto both residents of and people working in theCity of London was continued during 1973, which once again was a busy and satisfactory year in which 203 sessions were held. The number of people attending in the year was 1621 (86 City residents) of whom 478 were new patients (50 City residents) and 73 transferred from other clinics. Oral contraception is still by far the most popular method although all methods are discussed with patients by the medical staff to enable them to make an acceptable choice. Liaison with the Islington Family Planning Clinic continued and women wanting an intrauterine device (IUD) fitted have been referred there for this. Similarly patients requiring counselling for psycho-sexual difficulties can be referred, although only one patient needed help this year as we were fortunate in the fact that the doctor at the City clinic is specially trained for this work and was able to see patients before her birth control session. Cervical cytology was carried out for 1022 women and we are very happy to report that none of these were positive. Routine examination of patients and cytology often throws up evidence of infections and minor disorders which can be beneficially treated at an early stage and patients are referred for this to their general practitioners. The continued attendance of patients at the clinic and the referral of new people by their friends encourages us to feel that the provision of this service is very worthwhile and we have been happy to co-operate with the Corporation throughout 1973 in this way." 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 1973 has been received from Mr. D.K. Williams, F.R.C.S., M.R.C.O.G. "Total number of attendances:- 481 Abnormal Smears Inflammatory with Atrophic changes 10 Inflammatory changes alone 39 Atrophic changes alone 28 Trichomonas infection 4 Monilia infection 3 Pap. class III 2 Clinical Findings Cervical Polyps 13 Cervical Erosions 10 Fibroids 14 Benign breast lumps 3 Ovarian cysts 5 Prolapses 0 Pruritis vulvae 0 Cervical cervicitis 9 Cervical ectropian 0 Anaemia 1 Goitre 1 " 57 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.:- "During 1973, 147 women have been examined at the Cervical Smear Clinic at the Bank. I am glad to say none was positive. The reduction in numbers compared with the previous year is due mainly to a three yearly series having been completed. A new series was started in the Autumn and the Clinic continues to provide a useful service." ROUTINE CERVICAL CYTOLOGY RE-CALL SCHEME The Corporation continues to participate 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 Officer 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. 1972 1973 Number of patients treated during the year 32 26 Visits made to treat patients, visit doctors and clinics 277 411 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:- 1972 1973 Routine children inspected 39 41 Special children inspected 33 10 Re-inspection children inspected 63 129 Comprehensive Health Survey children inspected NIL 184 Selective Survey children inspected 32 NIL Medical inspections and Health Surveys were conducted by the school doctor and school nurse and the general standard of child health and hygiene continues to be maintained at a high level. School Dental Service. (The statistics given here complement the Dental Officer's Report). 1972 1973 Treatment sessions 51 52 Inspection sessions 4 4 Dental Health Education sessions 4 6 First Appointments 155 153 Subsequent appointments 199 217 Emergencies 1 - Total attendances 355 370 1st inspections carried out at school and clinic 249 194 Percentage requiring treatment 45% 60% Dental Officer - whole time equivalent 0.1% 0.1% 58 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 1973 6 (3) such clinics were held and 12 (10) children examined. Audiometry 102 (23) children were tested during the year at the school. Vaccination and Immunisation 1972 1973 Poliomyelitis 17 13 B.C.G. (including students) 240 189 Number Vaccinated 188 152 Diphtheria/Tetanus 17 2 Measles 1 5 Tetanus (students) 120 131 Infectious Diseases Reported from Schools 1972 1973 Chickenpox 5 2 Mumps 2 NIL Gastro-enteritis 1 NIL Tonsillitis 1 NIL Impetigo 1 1 German measles 1 NIL Chiropody Service in School. (See Report under Section 28 National Health Service). REPORT OF THE DENTAL OFFICER, 1973 "This is the last dental report before the re-organisation of the National Health Service on 1st April, when the City's statutory dental services will become administratively part of the City and Hackney district, of the City and East London Area Health Authority. Although the management of dental services will be the responsibility of other persons, those in receipt of them will not, in fact, notice a great deal of difference for some time in the delivery of dental care, although, of course, one always has a certain inborn faith that new methods will bring better results in due course. Coming to the year under review there is not any significant change to report in the pattern of dental treatment. The number of pre-school children requiring treatment remains the same; for school entrants (5-6 year olds) the treatment requirement was increased, whilst the number of those requiring treatment among the infant and junior children has risen slightly. Adult treatment demand is as great as ever. Pre-School Children Those requiring treatment remained constant at last years level of 50%. This is very unsatisfactory, really, in view of the fact that these children are all under five. Arrangements have been made to try and counter this to some extent by sending a birthday card on their third birthday, to child residents of the City, reminding their parents that a dental examination by their own dental practitioner or the school dental officer is desirable at this age. School Dental Service — Inner London Education Authority School entrants (5 year olds). The requirement for treatment in this age group has regrettably increased from 36% to 49%. 59 Infants and Juniors Treatment required for this group rose slightly from 41% last year to 48.5% this year. Both figures are well below the national average but with the small number involved and regular examinations, one would expect this to be so and indeed, one would hope for considerably less. Prevention Fluoridation of the water supply, which would do so much for children's dental health, seems as far off as ever and so the programme of applying fluoride jelly to children's teeth has been maintained at the time of the 6 monthly dental examination at Sir John Cass's Foundation School. Instruction in oral hygiene is given at the same time by the dental health educators of the Inner London Education Authority and one hopes that in due course the two together will forge some sort of shield against the ravages of the vast amount of sugar which we as a nation consume in ever increasing quantity. Apart from individual chairside instruction in dental hygiene, class room instruction is given to children by the Inner London Education Authority dental health educators with puppet shows and audio-visual systems. Teaching projects are also initiated. Orthodontics Rather more cases requiring specialist treatment have been referred to hospital than in previous years. National Health Service This is mainly concerned with adult dental treatment but includes a small number of pupils at the City Corporation Schools. The number of attendances was slightly up on last year and as was reported last year represents the appropriate level of demand that can be coped with at the present time. The aim must be to return to the recall system which has previously operated, because there are undoubted advantages to patients in having a reminder to attend for examination at 6 monthly intervals. St. Bartholomew's Hospital It is the good fortune of those who live, work and go to school in the City, to have the skills of this great hospital so readily at hand and as always patients who have been referred for general anaesthesia, oral surgery and orthodontia as well as other specialities have received highly skilled attention, always with the greatest courtesy. 60 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 1 _ _ - - - - - 1 - - - F - - - - - - - - - - - - B19(3) Malignant Neoplasm, Stomach M 1 - - - - - - - - - 1 - F - - - - - - - - - - - - B19(4) Malignant Neoplasm, Intestine M 2 - - - - - - - - 1 1 - F - - - - - - - - - - - - B19(6) Malignant Neoplasm, Lung, Bronchus M 2 - - - - - - - - 2 - - F - - - - - - - - - - - - B19(7) Malignant Neoplasm, Breast M _ _ - - - - - - - - - - F 1 - - - - - - - - - 1 B19( 11) Other Malignant Neoplasms, etc. M 1 - - - - - - - - 1 - - F 1 - - - - - - - 1 - - - B46(4) Multiple Sclerosis M 1 - - - - - - - - 1 - - F - - - - - - - - - - - - B25 Active Rheumatic Fever M 1 - - . - - - - 1 - - - F - - - - - - - - - - - - B28 Ischaemic Heart Disease M 11 _ - - - - - 1 - 6 3 1 F 1 - - - - - - - - - 1 - B29 Other Forms of Heart Disease M 1 - - - - - - - - - - 1 F - - - - - - - - - - - - B30 Cerebrovascular Disease M 3 - - - - - - 1 - - - 2 F 2 - - - - - - - - - - 2 B46(6) Other Diseases of Circulatory System M 1 - - - - - - - - - 1 - F - - - - - - - - - - - B32 Pneumonia M 2 _ _ _ _ _ _ _ 2 - - - F 1 - - - - - - - - - - 1 B33(1) Bronchitis and Emphysema M 2 - - - - - - - - 1 _ 1 F - - - - - - - - - - - - B34 Peptic Ulcer M 3 - - - - - - - 1 2 - - F - - - - - - - - - - - - B37 Cirrhosis of Liver M 1 - - - _ _ _ _ _ 1 _ - F - - - - - - - - - - - - B46(8) Other Diseases of Digestive System M 1 _ _ _ _ _ - 1 - - - - F - - - - - - - - • - - - B38 Nephritis and Nephrosis M - - - - - - - - - - - - F 1 - - - - - - - - 1 - B46(11) Diseases of Musculoskeletal System M 1 - - - - - - - - - - 1 F - - - - - - - - - - - - B43 Difficult Delivery and/ or Anoxic Condition M 1 1 - - - - - - - - - - F - - - - - - - - - - - - B45 Symptoms and Ill- Defined Conditions M 1 - - - - - - - - - - 1 F - - - - - - - - - - - - BE48 All Other Accidents M 1 - - - - - - - - 1 • - F - - - - - - - - - - - - TOTAL ALL CAUSES M 38 1 . - - - - 3 5 16 6 7 F 7 - - - - - - - 1 1 1 4 61 VITAL STATISTICS COMPILED FROM REGISTRAR GENERAL'S RETURN 1972 1973 Live Births Number 34 25 Rate per 1,000 population 7.4 4.8 Illegitimate Live Births Number 2 5 Illegitimate live births per cent of total live births 6 20 Still Births Number NIL NIL Rate per 1,000 total live and still births NIL NIL Total Live and Still Births 34 25 Infant Deaths (deaths under 1 year) 1 1 Infant Mortality Rates Total infant deaths per 1,000 total live births 29 40 Legitimate infant deaths per 1,000 legitimate live births 31 50 Illegitimate infant deaths per 1,000 illegitimate live births NIL N/A Neo-Natal Mortality Rate (deaths under 4 weeks per 1,000 live births) 29 40 Early Neo-Natal Mortality Rate (deaths under 1 week per 1,000 total live births) 29 40 Perinatal Mortality Rate (still births and deaths under 1 week combined per 1,000 total live and still births) 29 40 Deaths (all ages) Number 35 45 Rate per 1,000 resident population 7.6 8.7 STATISTICAL INFORMATION Area - 678 acres (including the Temple and foreshore) Population — Census 1961, 4,711; Estimated mid-year 1973, 5,190 Annual Rateable Value — as at 1st April, 1973, £242,804,926 Annual sum received from Penny General Rate — £2,285,000 62