THIS COPY MUST NOT BE CUT E4411(1)dagenham dag 25 BOROUGH OF DAGENHAM ANNUAL REPORT of the Medical Officer of Health for the year 195 CECIL HERINGTON, M.D. (Lond.), D.P.H BOROUGH OF DAGENHAM ANNUAL REPORT of the Medical Officer of Health for the year 1951 CECIL HERINGTON, M.D. (Lond.), D.P.H. 3 To the Mayor, Aldermen and Councillors of the Borough of Dagenham. Mr. Mayor, Ladies and Gentlemen, In presenting my report on the health of Dagenham for the year 1951, I would again invite your attention to the fact that much of the report deals with the services which are administered by the Local Health Authority through the Health Area SubCommittee. With a view to making the report informative the services affecting the health of the Borough are discussed without discriminating between the Authorities ultimately responsible for them. The birth and death rates approximate very closely to those of the previous year, there being 44 fewer births in the current year and an increase of 41 deaths of residents. This is to be expected as the population becomes stabilised and the average age thereby increases. The death rate however is still below that of the country as a whole. The crude death rate for Dagenham was 7.42 but in order to compare this with the rate for England and Wales, the comparability factor of 1.64 must be applied which gives the figure of 12.16. The comparable rate for the 126 County Boroughs and Great Towns (including London) is 13.4. The uncorrected birth rate was 15.25, the corrected rate 14.48, this is less than that for the Great Towns which was 17.3. The infant mortality rate was 30.08, that for the Great Towns was 33.9 and for England and Wales 29.6. MATERNAL DEATHS. I regret to have to report that one maternal death occurred. The patient was apparently a healthy woman and had been regularly examined at the ante-natal clinic and the usual laboratory tests were applied and revealed no abnormality. Furthermore, the patient co-operated intelligently throughout the pregnancy and during the labour. The services of the obstetric emergency unit were invoked and were in operation within a matter of minutes of being called. As there was no clear indication of the cause of death the Coroner was informed and an autopsy performed by a Pathologist. The findings showed that there was early rheumatic involvement of the mitral valve of the heart and gross oedema and congestion of both lungs with scanty sub-pleural haemorrhages. One of my colleagues and I searched the literature and as a result were of the opinion that death was probably due to pulmonary 4 embolism by amniotic fluid. This is a rare condition which is stated to have occurred in one in 8,000 obstetric cases over a period of nine years at the Chicago Lying-in Hospital. As far as is known this obstetric emergency is unpredictable and therefore when it does supervene death will be inevitable. INFANT WELFARE CENTRES. The Regional Hospital Board have decided to adapt the Out-Patient Department of King George Hospital for use as a Chest Clinic to serve Dagenham. This has necessitated the removal of the clinic formerly held at this hospital to other premises and for the time being will occasion some inconvenience to mothers living in that vicinity. Provision, however, is made by holding additional sessions at other clinics and negotiations have been taking place to establish an Infant Welfare Centre in close proximity to Five Elms. The clinic held at the London City Mission Hall, Dagenham Road, has been fully attended and an additional session has been arranged in order to meet the needs. CARAVANS. Further applications for land in the Northern part of the Borough to be used as sites fo caravans were received. All were refused in view of the inability to provide satisfactory sanitary facilities. One appeal against the Council's decision was dismissed by the Magistrates' Court. In co-operation with the Town Planning Authority, a general policy has been adopted whereby applications in respect of individual vans will only be granted in the unsewered Northern are. where the applicant submits plans for a permanent dwelling to be erected (when a building licence is obtained) on the site. It was mentioned in my report for last year that an adjoining Borough was extending and modernising its mortuary. This work has now been completed and when the notice to the Borough, with whom Dagenham has now entered into arrangements, expires, the facilities offered by the first-mentioned local authority will be accepted. MORTUARY. RAG FLOCK AND OTHER FILLING MATERIALS ACT. This Act came into operation on the 1st November, 1951, and two premises where filling materials are used have been registered. One licence was issued to a manufacturer of rag flock and one for the storage of this material. A sample of rag flock, manufactured from new materials only, consisting of coloured and bleached offcuts from a clothing factory, 5 All charges for the use of public con' veniences in the Borough have now been abolished, with the exception of facilities for persons who desire to use the private wash-room which includes the use of brush, comb and towels for which a charge of 2d. is made. This is a matter of some importance and should contribute to the public health of the district. Formerly, all persons using the water-closet were exhorted to wash their hands immediately after doing so which might have been embarrassing financially for some people. I wish to record this advance made in public health practice by this Borough and express the hope that less enlightened sanitary authorities will emulate Dagenham. All conveniences are now open day and night and are provided with running hot and cold water. At the three attended conveniences electric hand-driers have been installed and gas incinerators have been installed in the women's section. I record once more my grateful thanks to the officers and members of the staff for their continued efficiency and loyalty. In conclusion, I express my deep appreciation to the Chairman, Vice-Chairmen and Members of the Committees chiefly concerned for their support and interest in the promotion of preventive medicine in Dagenham. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, CECIL HERINGTON, D Medical Officer of Health. Public Health Department, Civic Centre, Dagenham. PUBLIC CONVENIENCES. contained 34 parts per 100,000 of chlorine (the Act prescribes a maximum of 30 parts per 100,000). It was considered that the condition was due to the presence of certain dyes in the coloured material and arrangements were made for all new material to be washed. A subsequent sample of rag flock manufactured from washed new material was found to contain 51 parts per 100,000 of chlorine. Softened water (the apparatus was re-generated with salt) was used at a laundry where the rag flock was washed and this was considered the probable source of the trouble. 6 MEMBERS OF THE COUNCIL (31st December, 1951) Mayor : Councillor J. P. HOLLIDGE, J.P., E.C.C. Deputy Mayor : Alderman (Mrs.) A. E. PRENDERGAST. Aldermen : W. E. BELLAMY L. F. EVANS (Mrs.), M.B.E., F. BROWN, J.P. J.P., E.C.C. J. W. BURRIDGE F. GRINDROD, J.P. R. J. D. CLACK F. G. THOMAS Councillors : S. F. BANKS L. R. JONES, B.Sc. A. BASS A. KEMPSON R. BLACKBURN E. M. MILLARD (Mrs.) J. BOWLES J. F. MOULTRIE, F.A.I. I. M. BROCKELBANK (Mrs.) D. O'DWYER G. A. BROOKER C. PRENDERGAST E. A. BROWNE B. M. ROADKNIGHT (Mrs.) F. COOMBS L. A. SAYER G. H. A. CROUCH L. S. SNELLING (Mrs.) E. W. DEEKS D. THOMAS A. S. HADDOCK S. J. C. WARR Wm. C. IRELAND PUBLIC HEALTH COMMITTEE Alderman (Mrs.) A. E. PRENDERGAST, Chairman Councillor G. A. BROOKER, Vice-Chairman His Worship the Mayor (Councillor Councillor I. M. BROCKELBANK J. P. HOLLIDGE, J.P., E.C.C.) (Mrs.) Alderman J.W. BURRIDGE Councillor D. O'DWYER Alderman J. W. BURRIDGE Councillor B. M. ROADKNIGHT Councillor A. BASS (Mrs.) DAGENHAM HEALTH AREA SUB-COMMITTEE Alderman (Mrs.) A. E. PRENDERGAST, J.P., Chairman Alderman (Mrs.) L. F. EVANS, M.B.E., J.P., E.C.C., Vice-Chairman Members: — Borough Council The Mayor: Councillor J. P. HOLLIDGE, J.P., E.C.C. Alderman J. W. BURRIDGE Councillor A. BASS Councilor R. BLACKBURN Councillor (Mrs.) I. M. BROCKELBANK Councillor G. A. BROOKER Councillor F. COOMBS Councillor E. W. DEEKS Councillor A. KEMPSON Councillor D. O'DWYER Councillor C. PRENDERGAST Councillor (Mrs.) B. M. ROADKNIGHT Councillor L. A. SAYER Councillor S. J. C. WARR County Council Alderman K. GLENNY Councilor (Mrs.) M. BREDO Councillor W. HERRIDGE Councillor P. PORTER Councillor (Mrs.) E. SAYWOOD Councillor K. STONEBANK Councillor (Mrs.) A. F. WARR Hospital Management Committee Alderman (Mrs.) L. F. EVANS, M.B.E., J.P., E.C.C. Executive Council for Essex Mr. E. E. FARRANT Local Medical Committee for Essex Dr. P. GROARKE Voluntary Mr. H. BAILEY, Miss N. L. ODELL and Organisations Miss I. WHEELER 7 8 OFFICERS OF THE PUBLIC HEALTH SERVICES (at time of going to press) Officers employed by the Essex County Council are indicated thus "(C)" Full-Time Staff : Medical Officer of Health : CECIL HERINGTON, M.D., B.S.(Lond.), D.P.H., M.R.C.S., L.R.C.P. Deputy Medical Officer of Health : H. D. H. ROBINSON, M.R.C.S., L.R.C.P., D.P.H. (C) Assistant Medical Officers : CATHERINE FITZPATRICK, M.B., B.Ch. (C) FANNIE HIRST, M B., Ch.B., D.P.H. (C) JEANNE LISTER, M.B., B.S. (Lond.) WILHELMINA C. MAGUIRE, L.R.C.P., L.R.C.S.I. (C) MADELINE WEIZMANN, M.R.C.S., L.R.C.P. (C) Chief Sanitary Inspector : L. E. PRIOR (1, 2) Sanitary Inspectors : J. W. ALLAM (1, 2) A. HUTCHINGS (1, 2) F. W. S. FOX (1, 2, 3, 4) A. J. JAMES (1) Superintendent Health Visitor : (C) V. A. EVERITT (5, 6, 7) Health Visitors: (C) M. E. ALLAM (5, 7) E. RICHARDS (5, 6, 7) I. A. BARROW (5, 6, 13) L. SALTER (5, 6, 7) G. M. CLUGSTON (5, 6, 7) D. B. STEWART (5, 6, 7) A. K. GIBSON (5, 6, 7) J. E. THOMAS (5, 6, 7, 10, 14) D. GORDON (5,6,7,9,10,14) R. E. WALKER (5, 6, 7, 12, 13) D. HICKEY (5, 6, 7) L. WARR (5, 13) (One vacancy) 9 Senior Midwife : (C) E. M. BEDFORD (5, 6) Midwives: (C) M. GOODBUN (5, 6) M. M. ROBSON (6, 10) M. HALL (6) M. ROCK (6) H. MITSON (5, 6) M. J. STOREY (6) K. MOYNIHAN (5, 6) M. TEATHER (5, 6) M. M. RICHARDS (6) Clerical Staff : Chief Clerk: (C) F. W. KNIGHT (1, 2) Cler\ to Sanitary Inspectors: G. DOVEY Clerks : E. ADAMS (C) S. B. LEADER (C) I. M. BISHOP (C) F. H. MARTIN (C) N. BRIAND (C) L. A. MOORE (C) N. E. CLOKE (C) E. NEALE (C) S. DOWDING (C) J. POWELL M. GOODCHILD (C) D. TYLER (C) H. GOODCHILD (C) M. A. WATTS (C) G. K. HARRIS J. WHATLING (C) Day Nurseries: (C) Soresbrook Nursery, MATRON : E. MADDISON (12) Dagenham Avenue, DEPUTY : K. GRAHAM (8) Dagenham. Chadwell Heath Nursery, MATRON : I. MUSGRAVE (8) Ashton Gardens, DEPUTY: P.BOND (15) Chadwell Heath. Kingsley Hall Nursery, WARDEN : D. HOWES Parsloes Avenue, Dagenham. Domestic Help Organiser : (C) G. HICKINBOTHAM Chiropodists : (C) N. FREEMAN M. KELLY (11) Foot Clinic Receptionist : K. RICHARDS (C) Dental Attendant : (C) M. E. SEALEY 10 Certificate of Royal Sanitary Institute 1 Meat Inspector's Certificate Sanitary Science as applied to Building and Public Works Certificate 5 Smoke Inspector's Certificate 4 General Trained Nurse 5 State Certified Midwife 6 New Health Visitor's Certificate State Enrolled Assistant Nurse 8 State Certified Mental Certificate 9 Registered Mental Nurse 10 Member of Society of Chiropodists 11 State Registered Fever Nurse 12 Tuberculosis Certificate 13 Certificate of Royal Medico-Psychological Association 14 Certificate of National Nursery Examination Board 15 Part-Time Staff : Dentist : F. C. RITCHIE, L.D.S., R.C.S. (Eng.) Public Analyst: J. HUBERT HAMENCE, Ph.D., M.Sc., F.R.I.C. 11 Extracts from Vital Statistics for the Year. Live Births :— Total Male Fem ale Legitimate 1,681 812 869 Birth rate per 1,000 of the estimated resident population, 15.25. Illegitimate 48 28 20 Stillbirths Legitimate 24 15 9 Rate per 1,000 total (live and still) births, 14.81. Illegitimate 2 2 - Deaths 841 497 344 Death rate per 1,000 of the estimated resident population, 7.42. Deaths from pregnancy, childbirth, abortion :— Deaths. Rate per 1,000 total (live and still) births. 1 0.57 Death rate of infants under one year of age :— All infants per 1,000 live births 30.08 Legitimate infants per 1,000 legitimate live births 28.55 Illegitimate infants per 1,000 illegitimate live births 83.33 STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 6,556 Registrar-General's estimate of resident population, 1951 113,400 Number of inhabited houses (end of 1951) according to Rate Books 28,496 Rateable value (December 31st, 1951) £666,278 Sum represented by a penny rate (approximate 1951-52) £2,715 12 Deaths from Cancer (all ages) 175 „ „ Measles (all ages) 1 „ „ Whooping Cough (all ages) Nil „ „Gastritis, Enteritis and Diarrhœa 4 Births. 1,729 live births were registered during the year, there being 840 males and 889 females. There is a decrease of total births from 1,773 in 1950 to 1,729. The birth rate per thousand population was 15.25 compared with 15.5 for England and Wales and 17.3 for the 126 large towns, including London. The rate compares with that of 24.2, 26.5, 30.6, 23.8, 23.6, 20.4, 18.6, 19.6, 18.59, 18.47, 18.7, 18.06, 17.61, 18.77, 19.08, 20.37, 19.83, 22.26, 19.54, 22.34, 23.71, 19.15, 17.14, and 15.36 for the years 1927 to 1950 inclusive. The illegitimate birth rate continues to be very low, being only 2.78 per cent. of total births. The rate of illegitimate stillbirths is 7.69 per cent. of total stillbirths. Death Rate. Total deaths in district 622 Outward transfers 156 Inward transfers 374 Deaths of residents 840 Of the 156 deaths of non-residents occurring in the district, two took place at the Dagenham Hospital and 144 at Rush Green Hospital. Of the 374 deaths of local residents taking place outside this area, most occurred in institutions. Of these, 173 occurred at Oldchurch Hospital; 31 at 117, Suttons Lane, Hornchurch; 20 at the London Hospital; 18 at King George Hospital; 14 at Severalls Hospital; 12 at Ilford Isolation Hospital; 10 at St. Josephs Hospice; eight at Harold Wood Hospital ; five at Warley Hospital; four at Whipps Cross Hospital, and four at Barking Hospital. The death rate of 7.42 compares with 12.5 for England and Wales. For the years from 1927 to 1950 inclusive, the local rates were 7.0, 7.3, 8.3, 6.6, 7.2, 6.5, 6.5, 6.6, 5.63, 6.43, 6.24, 6.19, 5.96, 8.90, 8.51, 6.85, 7.98, 7.81, 6.97, 6.63, 6.63, 6.15, 6.64 and 6.92. A table giving the causes of death, and the age periods at which they occurred, is given at the end of the report. 13 Table showing Birth-rate, Death-rate and Analysis of Mortality during the year 1951. Provisional Figures.—The mortality rates for England and Wales refer to the whole population, but for London and the towns to civilians only. Rate per 1,000 total Population Annual Death-rate per 1,000 Population Rate per 1,000 Live Births Live Births Still Births All Causes Typhoid and Paratyphoid Fevers Smallpox Measles Scarlet Fever Whooping Cough Diphtheria Influenza Diarrhoea and Enteritis (under two years) Total Deaths (under one year) England and Wales 15.5 0.36 12.5 0.00 0.00 - - 0.01 0.00 0.38 1.4 29.6 126 County Boroughs and Great Towns, including London 17.3 0.45 13.4 0.00 0.00 - - 0.01 0.00 0.36 1.6 33.9 148 smaller towns (1931) resident population 25,000-50,000 16.7 0.38 12.5 0.00 0.00 - - 0.01 0.00 0.38 1.0 27.6 London 17.8 0.37 13.1 - - - - 0.01 0.00 0.23 0.7 26.4 Dagenham 15.25 0.23 7.42 - - 0.01 - 0.00 0.00 0.13 1.74 30.08 14 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA Infant Welfare Centres CENTRE Sessions Held Times Sessions Held Average Attendances Average New Cases The Clinic, Ashton Gardens, Weekly Thursday, a.m. 38 1 Chadwell Heath. Weekly Thursday, p.m. 48 2 Becontree Clinic, Becontree Avenue, Weekly Monday, p.m. 53 3 Dagenham. Weekly Tuesday, a.m. 29 1 Weekly Tuesday, p.m. 45 2 The Leys Clinic, Weekly Thursday, 30 1 Ballards Road, Dagenham. Weekly a.m. Thursday, p.m. 41 2 Out-Patient Department, King George Hospital, Weekly Wednesday, a.m. 35 1 Five Elms, Dagenham. Weekly Wednesday, p.m. 50 3 Weekly Friday, a.m. 32 1 Rush Green Clinic, 179, Dagenham Road, (2nd, 4th & 5th in month Friday, a.m. 13 1 Rush Green. Friday, p.m. 22 1 The Clinic, Ford Road, Weekly Tuesday, a.m. 53 3 Dagenham. Weekly Tuesday, p.m. 67 4 The Clinic, Manford Way, Hainault. Weekly Monday, p.m. 35 3 London City Mission Hall, Dagenham Road, Dagenham. Weekly (commenced 3.2.51) Thursday, p.m. 53 3 15 Ante-Natal Clinics CENTRE Sessions Held Times Sessions Held Average Attendances Average New Cases The Clinic, Ashton Gardens, Chadwell Heath. Weekly Wednesday, p.m. 18 2 The Clinic, Becontree Avenue, Weekly Tuesday, p.m. 17 3 Dagenham. Weekly Wednesday, a.m. 14 2 Weekly Friday, a.m. 14 2 Weekly Friday, p.m. 13 2 The Leys Clinic, Ballards Road, Weekly Tuesday, a.m. 14 2 Dagenham. Weekly Wednesday, a.m. 14 2 Rush Green Clinic, 179, Dagenham Road, Rush Green. (1st & 3rd in month) Friday, a.m. 8 2 York House, Frizlands Lane, Weekly Tuesday, a.m. 25 3 Dagenham. Weekly Wednesday, p.m. 20 3 Weekly Thursday, a.m. 16 2 Weekly Thursday, p.m. 17 3 The Clinic, Ford Road, Weekly Monday, a.m. 19 3 Dagenham. Weekly Monday, p.m. 24 3 The Clinic, Manford Way, Hainault. Weekly Monday, a.m. 7 1 16 Sanitary Inspection of the District Report of the Sanitary Inspectors. (a) Nature and number of visits: — Overcrowding and Housing Conditions 870 Nuisances under Public Health Acts— Dwelling-houses 5,414 Other Premises 702 Bakehouses 92 Milkshops and dairies 134 Foodshops, stalls and itinerant vendors 2,096 Cafes and canteens 770 Infectious disease enquiries 962 Visits to foster-mothers' premises 308 Number of complaints investigated 1,043 Outworkers' premises 206 Workplaces and offices 11 Tents, vans and sheds 230 Stables 19 Hairdressers' and barbers' premises 84 Shops Acts 78 Ice Cream premises and vehicles 275 Houses fumigated 30 Other Visits 239 (b) Notices served:— Complied with: — Statutory 166 154 Informal 643 632 Legal proceedings were instituted in respect of 12 properties to enforce compliance with statutory notices. 17 PREVENTION OF DAMAGE BY PESTS ACT, 1949 Type of Property Total Local Authority Dwelling Houses Agricultural All other (including Business and Industrial) Total number of properties 50 28,496 10 1,396 29,952 *Number of properties inspected as a result (a) of notification, or(a) 7 224 1 96 328 (b) otherwise (b) 2 29 - 25 56 Number of properties Maj. 1 - - - 1 by rats Min. 4 49 - 13 66 Number of properties found to be seriously infested by mice 1 20 - 34 55 Number of infested properties treated by the Local Authority 6 69 - 47 122 Number of notices served under Section 4 :— (1) Treatment - - - - - (2) Structural Works (i.e., Proofing). - - - - - Number of cases in which default action was taken by Local Authority folio wing issue of notice under Section 4 - - - - - Legal Proceedings - - - - - Number of "Block control" schemes carried out. 3 These figures do not include the regular routine inspection of food premises and factories, etc., by the Sanitary Inspectors. 18 Water The water supply is satisfactory in quality and quantity. Since November, 1938, eight local authorities in the South Essex Waterworks Company's area of supply have carried out a co-ordinated system of sampling. During the year two chemical and two bacteriological samples were taken from the Company's mains in this Borough and all were satisfactory. The water is not liable to have plumbo-solvent properties, and no action was called for in respect of any form of contamination. Approximately .059 per cent. of the inhabited houses and .032 per cent. of the population of the Borough take their water from standpipes. During the year the mains laid in the Borough were as follows:— Location Diameter Length Woodlands Estate 4" 447 yards Cranmer Road 4" 119 „ Whalebone Lane South 4" 48 „ Total 614 „ 471 supplies were afforded to houses during the year. The Chief Engineer of the South Essex Waterworks Company has furnished me with the following report:— "Bacteriological and chemical examinations are made of the raw river water, of the water in its various stages of treatment and of the water going into supply and of both raw and chlorinated water from the Company's wells. Analyses are also made of samples obtained from consumers' taps in the various parts of the Company's district and all proved to be satisfactory. Over 3,500 chemical, bacteriological and biological examinations have been made during the year. All water going into supply was wholesome." 19 FACTORIES ACTS, 1937 & 1948 Inspections. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Factories without mechanical power 22 27 - - Factories with mechanical power 117 240 6 — Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 17 31 3 - TOTAL 156 298 9 — Defects Found. No. of defects No. of prosecutions instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness 1 1 - - - Overcrowding - - — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary Conveniences:— Insufficient 2 1 — — — Unsuitable or defective 14 12 — 1 — Not separate for sexes 1 1 — — — Other offences 2 2 — — — TOTAL 20 17 — 1 — Outwork No. of out-workers in August list 43 Nature of work Making, etc., wearing apparel. 20 Smoke Abatement Observations were taken throughout the year; no serious cases of pollution were recorded. Bacteriological Sampling of Milk During the year 84 samples of milk were submitted for examination and two were found to be unsatisfactory. When The Milk (Special Designations) (Specified Areas) Order, 1951 came into force on the 1st October, the use of special designations for retail sales of milk in the Borough became compulsory. This meant that all milk sold by retail must be Pasteurised, Accredited, Tuberculin-Tested or Sterilised. Three small retailers had certain adjustments to make to comply with the Order. Ice Cream Bacteriological Sampling. During the year 44 samples of ice cream were submitted for analysis and three were found to be unsatisfactory. Registration of Premises. During the year seven applications for the storage and sale of ice cream were granted. In all cases the provision on the premises of running hot water is required. Where conditions are not considered altogether satisfactory for the sale of loose ice cream registration has been restricted to the storage and sale of ice cream "contained in containers of such materials and so closed as to exclude all risk of contamination." An itinerant vendor was summoned and convicted for selling ice cream with a fat content of only 3.7% (the minimum was 5%). 21 FOOD AND DRUGS ACT, 1938 Analyses Article Number Examined Number Adulterated, etc. Formal Informal Formal Informal Almonds, Ground 1 - - - Blanc Mange Powder 1 1 — — Bread — 7 — 7 Bread Roll — 1 — 1 Cake 1 3 — 3 Cake Mixture 4 2 — — Cayenne, Powdered — 1 — — Cherries, Glace 1 — — — Cocktails 3 — — — Cocoa and Malt Preparation — 1 — — Coconut, Dessicated and Sweetened 1 1 — — Coffee 1 1 — — Coffee and Chicory Essence 1 1 — — Condiment, non-brewed 1 1 — 1 Cream, Synthetic — 1 — — Culinary Oil — 1 — — Custard Powder 3 1 — — Dessert Powder — 1 — — Egg Roll — 1 — 1 Flour Mixture — 1 — — Frying Oil 2 — — — Gelatine 1 3 — — Ginger — 2 — — Herbs, Dried — 3 — — Ice Cream 1 16 1 1 Jellies 4 9 — - Lemon Juice — 1 — — Lemonade Crystals and Powder — 3 — — Lime Juice Cordial 1 — — - Medicinal Samples 9 4 — - Milk 40 — 2 - Milk Whipping Compound — 1 — — Mint 1 — — - Nutmeg, Ground - 1 — - Olive Oil 1 4 — - Onion Powder, Dehydrated — 1 — — Orangeade Crystals - 1 - - 22 Analyses—continued. Article Number Examined Number Adulterated, etc. Formal Informal Formal Informal Parsley - 1 - - Paste — 2 — — Peanut Butter — 1 — — Pepper 3 — — — Pepper Compound 2 1 — — Pineapple Crush 1 — — — Pork and Beef Loaf — 1 — — Pork Pie — 1 — — Potato Crisps 1 — — — Pudding Mixture — 2 — — Rissole Mix 1 — — — Roll, Buttered with Cheese — 1 — 1 Sage 1 3 — — Sage and Onion Stuffing 1 — — — Salad Cream 2 1 — — Salad Oil — 1 — — Sauces 2 5 - — Sausages 33 — 2 — Sausage Meat 6 — — — Sausage Rolls 1 — — — Semolina — 1 — — Shortbread Mixture — 2 — — Sild — 1 - — Soda Water — 1 — 1 Soup 1 1 — — Spice, Mixed 1 1 — — Suet — 1 - — Spread 1 2 — — Tapioca Dessert 1 1 — — Tea 3 - - — Tea Seed Oil 1 - - — Thyme 1 2 1 1 Tonic Wine 1 — - — Tumeric, Powdered — 1 - — Vinegar 4 — - — Whisky 17 - - - 23 Adulterated Samples, etc. Serial No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 945A Christmas Cake Informal Had an objectionable smell due to albumen constituent of the icing. Vendor warned. 946A Portion of Cheese and buttered Roll Informal Contained fragment of wood. Vendor warned. 960A Soda Water Informal Had a strong smell of sulphuretted hydrogen. Unfit for human consumption. Manufacturers warned. 961A Bread Informal Contained a foreign body found to consist of charred bread. Referred to Authority i n which bakery is situate. 962A Swiss Roll Informal Contained mice excreta. Manufacturer warned. 963A Bread Roll Informal Contained dark markings in centre of roll due to presence of charred bread. Referred to Authority i n which bakery is situate. 964A Bread Informal Contained two blackish foreign bodies found to be discoloured dough. Referred to Authority in which bakery is situate. 965A Bread Informal Contained two beetles. No action. Insufficient evidence. 992A Ice Cream Informal 34% deficient in fat. Formal sample obtained. 99 3A Bread Informal Contained discoloured areas due to presence of coal dust. Vendor warned 995A Thyme Informal Contained 3.9% of sand. Formal sample obtained. 1002A Condiment, non-brewed Informal 10% deficient in acetic acid. Vendor warned. 24 Adulterated Samples, etc.-continued. Serial No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 1013A Egg Roll Informal Showed small areas of surface discolouration probably due to the knife used to cut the roll. Vendor warned. 1014A Fairy Cake Informal Contained a small foreign body found to consist of coal dust. Manufacturer warned. 1035A Bread Informal Contained a number of small greyish' black nodules. No action. Insufficient evidence. 1052A Bread Informal Contained discoloured areas due to the presence of partly charred bread mixed with dough. Manufacturer warned. 1053A Bread Informal Contained a mass of foreign matter embedded in the bottom of the loaf consisting of insect web, a dead beetle, parts of insect pupae and eggs. Manufacturer warned. 1739 Pork Sausages Formal 5% deficient in meat. Manufacturer warned. 1745 Sausages (containing Bacon) Formal 7½% deficient in meat. Manufacturer warned. 1756 1766 Milk Milk Formal Formal 9% deficient in fat 6% deficient in fat "Appeal to Cow samples taken. 1774 Thyme Formal Contained 3.8% of sand. Vendor warned. Remainder of stock withdrawn. 1830 Ice Cream Formal 26% deficient in fat. Vendor prosecuted. 25 Unsound Food The department continues to receive articles of food containing a variety of foreign substances. In two cases legal proceedings were instituted. Warning letters were sent in other cases. Clean Food Campaign The film "Another Case of Poisoning" was exhibited (two showings) at the Civic Centre and all food handlers working in the Borough invited to attend. This film was also shown at nine canteens in the Borough and the employees at adjacent factory canteens were invited. Lectures have been given to members of some local organisations. Legal proceedings were instituted under Food & Drugs Act, 1938, Section 13, against a firm of local bakers in respect of dirty apparatus and utensils. A fine of £5 was imposed, plus £2 2s. Od. costs. Food Poisoning Outbreaks During the year 26 cases of food poisoning were notified; these covered two small outbreaks and 21 single cases. In four cases the causative organisms were identified. 26 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES NOTIFIABLE DISEASES (Other than Tuberculosis) Under year 1-2 3-4 5-9 10-14 15-24 25 and over Total Scarlet Fever _ 14 26 80 20 8 3 151 Whooping Cough 60 117 155 150 5 2 3 492 Acute Poliomyelitis:- Paralytic - - - - - - - - Non-paralytic - 2 - 2 - 1 1 6 Measles 48 347 452 546 8 4 2 1407 Diphtheria - - - - - - - - Under 5 years 5-14 15-44 45-64 65 and over J Total Pneumonia:- Acute Primary 5 5 15 8 4 37 Acute Influenzal - - 2 - 6 8 Dysentery 9 13 5 1 - 28 Smallpox - - - - — - Encephalitis, Acute:- Infective - - - - - - Post Infectious - - - - - - Enteric Fever - - - - - - Paratyphoid Fever 1 1 - - - 2 Erysipelas - - 1 4 - 5 Meningococcal Infection 2 - 1 - - 3 Food Poisoning 7 1 15 3 - 26 Puerperal Pyrexia - - 14 - - 14 Ophthalmia Neonatorum 5 - - - - 5 Pemphigus - - - - - - Malaria (Foreign Origin) - - 1 - - 1 27  Notified Admitted to Isolation Hospital, Rush Green Admitted to other Isolation Hospitals Admitted to other Hospitals Deaths Registered Diphtheria - - - - — Dysentery 28 4 1 — — Encephalitis, Acute — — — — — Enteric Fever — — — — — Erysipelas 5 — 2 — — Food Poisoning 26 1 3 1 — Malaria 1 — - 1 — Measles 1,407 14 3 3 1 Meningococcal Infection 3 3 - — — Opththalmia Neonatorum 5 — — — — Paratyphoid Fever 2 2 — — — Pemphigus — — — — — Puerperal Pyrexia 14 1 — 6 — Pneumonia.- Acute Influenzal 8 — — 2 - Acute Primary 37 3 2 1 5 47 Poliomyelitis, Acute - - - - - Paralytic — — — — — Non-paralytic 6 6 — — — Scarlet Fever 151 26 14 - — Smallpox — — — Whooping Cough 492 12 4 4 - DIPHTHERIA IMMUNISATION The following is a summary of the work carried out during the year:- Number of SCHOOL children immunised without preliminary testing 96 Number of PRE-SCHOOL children immunised without preliminary testing 974 Number of SCHOOL children who received a boosting dose 850 Immunisation by General Practitioners. Number of SCHOOL children immunised without preliminary testing 18 Number of PRE-SCHOOL children immunised with out preliminary testing 258 Number of SCHOOL children who received a boosting dose 119 WHOOPING COUGH IMMUNISATION The number of children who received protective doses against Whooping Cough was 96, the majority of these being between the ages of one and four years. 28 VACCINATION CARRIED OUT BY GENERAL PRACTITIONERS Vaccinated. 1951 (Under 1) 222 1947-50 (1—4) 73 1937-46 (5—14) 73 Before 1937 (15 or over) 91 Total 459 Re-Vaccinated. 1951 (Under 1) 2 1947-50 (1—4) 3 1937-46 (5—14) 18 Before 1937 (15 or over) 169 Total 192 TUBERCULOSIS New Cases Deaths Primary Notification Brought to notice other than by Form A Pulmonary NonPul monary Pulmonary NonPul monary Pulmonary NonPul monary M F M F M F M F M F M F Under I - - - - - - - - - - - - 1- 2 3 - - 1 1 1 - - - - - 5- 1 3 - - 1 2 - - - - - — 10- - - 4 2 - - - 1 - - - - 15- 3 10 - 3 - 2 - - - - 1 1 20- 11 16 - - 1 5 - - - 3 - - 25- 14 16 - 1 5 5 2 1 2 2 1 - 35- 11 10 1 1 2 1 - - 2 1 - - 45- 7 3 — 2 1 I - - 7 - — - 55- 6 — 2 — 3 — — — 4 — — - 65 and upwards 1 - - - - - - - 1 - - 56 61 7 9 14 17 3 2 16 6 2 1 29 Register. Pulmonary Non-Pulmonary Male Female Male Female No. on register 1st January, 1951. 538 406 79 90 During the year:— New notifications 56 61 7 9 Deaths 16 6 2 1 Transfers into area 14 17 3 2 Transfers out of area 22 26 1 5 Removed from register as "Recovered" 46 35 11 18 No. on register 31st December, 1951 524 417 75 77 MATERNITY AND CHILD WELFARE Notification of Births 1,888 notifications of live births were received during the year. This number includes 139 children who were born in Rush Green Hospital but whose normal residence is not within the Borough. Stillbirths 15 male and nine female stillbirths were notified, the corresponding figures for registration being 17 and nine. The rate per 1,000 of total population registered was 0.23, the rate for England and Wales being 0.36. Infant Mortality 52 infants under one year of age died during the year, giving an infant mortality rate of 30.08 per 1,000 live births, compared with that of 29.6 for England and Wales and 26.4 for London. The rate amongst legitimate children was 28.55, while for illegitimate children it was 83.33. Ophthalmia Neonatorum Five cases of this disease were notified; all made complete recoveries. There were 46 cases in which a medical aid notice was sent by a midwife to a medical practitioner on account of some eye condition occurring in a newly-born infant. All these cases were investigated by the Medical Officer of Health and all were visited by a Health Visitor. Maternal Mortality One maternal death was assigned to this district, which gives a maternal mortality rate of 0.57 per thousand births. That for England and Wales for the corresponding period was 0.79. 30 Work of Health Visitors The following table shows the number of visits paid by the Health Visitors during the year:- (a) To expectant mothers First visits 274 Total visits 492 (b) To children under 1 year of age First visits 2,049 Total visits 4,783 (c) To children between the ages of 1 and 5 years Total visits 13,603 (d) Ineffective visits Total visits 3,539 (e) Other visits Total visits 4,380 Grand Total 26,797 Domiciliary Midwifery Service The following is a summary of the reasons for sending for medical aid by midwives:— Perineal Tear 66 Discharging Eyes 46 Prolonged Labour 28 Rise of Temperature 21 Ante-Partum Haemorrhage 17 Threatened Miscarriage 15 Bleeding per Vagina 14 Miscarriage 12 Inflammation over Veins in Leg 12 Malpresentation 11 Post-Partum Haemorrhage 10 Threatened Abortion 9 Premature Labour 8 Adherent Placenta 6 Abortion 6 Early Rupture of Membranes 6 Hypertension and Albuminuria 5 Jaundice 5 High Blood Pressure 4 Unsatisfactory Condition of Infant 4 Sub-Involution 4 Persistent Vomiting 4 Septic Spots on Baby 3 Premature Baby 3 Albuminuria 3 Cyanosed Infant 3 Other Causes 40 371 31 Notices summoning medical aid. 371 For (a) Mothers 296 For (b) Infants 75 Notifications that they had been associated with the undermentioned conditions were received from domiciliary midwives:- Substitution of artificial feeding 13 Liable to be sources of infection 10 Stillbirths 3 Deaths of Mother or Child 2 Laying out dead bodies 1 Below is a table setting forth in statistical form the work of the County Midwives, Midwives residing at York House Training Home and Salvation Army Midwives for the year 1951:- County Midwives Midwives Residing at York House Training Home Salvation Army Midwives Births Attended: As Midwife 311 229 62 As Maternity Nurse 33 4 6 Miscarriages Attended (included in above) 5 11 7 Visits Paid: As Midwife 7,129 5,913 1,941 As Maternity Nurse 517 78 135 Ante-Natal 3,527 2,342 508 Ante-Natal Clinics Attended 877 15 95 Gas and Air Administered: As Midwife 152 173 52 As Maternity Nurse 16 1 4 32 Dental Treatment The following particulars relate to dental treatment provided for mothers and young children:- Expectant or Children Nursing Under Five Mothers Years of Age Number of patients examined 152 239 Number of patients needing treatment 136 223 Number of patients treated 136 223 Number of patients made dentally fit 98 161 Number of Extractions 774 654 Number of fillings 6 Number of Anaesthetics administered: (a) local (b) general 200 391 Number of Scalings or scaling and gum treatment 26 Number of Silver Nitrate treatment 6 16 Number of Dressings 10 Number of X-ray examinations 1 Number of Dentures provided: (a) full 60 (b) partial 32 Day Nurseries There are three Nurseries in the Borough, accommodating 164 children in all. Staff: Matrons 2 Deputy Matrons 2 Wardens 3 Nursery Trained Nurses 7 Nursery Assistants 12 Nursery Assistant (Part-Time) 1 Nursery Students 15 Nursery Helper 1 Total 43 33 Total Attendances at Nurseries for 1951:- Goresbrook Nursery Under 2 years of age 3,151 Over 2 „ „ „ 10,160 Chadwell Heath Nursery Under 2 years of age 2,217 Over 2 „ „ „ 8,241 Kingsley Hall Nursery Over 2 „ ,, „ 8,001 Total 31,770 Premature Infants Live premature births occurring in the Area:- 2lbs. 3ozs. or less 2lbs. 4ozs.3lbs. 4oz. 3lbs. 5ozs4lbs.6oz. 4lbs. 7ozs.4lbs. 15oz. 5 lbs. 51bs.8ozs. Born alive at home and nursed entirely at home - - — 5 19 Born alive at home and transferred to hospital 4 - 1 1 1 Born alive in a private nursing home and nursed entirely there - - - — — Born alive in a private nursing home and transferred to hospital - - - - - CAUSES OF DEATH (As classified in Public Health Dept.) Under 1 year 1 and under 2 years 2 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 35 years 35 and under 45 years 45 and under 55 years 55 and under 65 years 65 and under 75 years 75 and over TOTAL M F M F M F M F M F M F M F M F M F M F M F M F 1. Tuberculosis, respiratory - - - - - - - - - 3 2 3 2 1 5 1 5 - 2 - - - 16 8 2. Tuberculosis, other — — — — — - — — 1 1 — — — - - - - - - - - - 1 1 3. Syphilitic disease — — — — — — — — — — — - - - - - - - 1 - 1 - 2 - 4. Diphtheria — — — — — — — — — — -_ - - - - - - - - - - - - -_ 5. Whooping Cough — — — — — — — — — — — — — — — — — — — - - - - - 6. Meningococcal infections - - - - - - - - - - - - - - - - - - - - - - - - 7. Acute Poliomyelitis — — — — — - - - - - - - - - - - - - - - - - - - 8. Measles 1 - - - - - - - - - - - - - - - - - - - - - 1 - 9. Other infective and parasitic diseases — — — — — — — — — — — — — — - 1 — — — — — — — 1 10. Malignant neoplasm, stomach — — - — — — — — — — — — 1 2 7 5 11 3 2 3 3 1 24 14 11. Malignant neoplasm, lung, bronchus — - - — — — — — — — — — 2 — 14 — 13 - 9 - — 1 38 1 12. Malignant neoplasm, breast — - — — — — — — — — — — — 1 — 2 — 1 — - — 2 — 9 13. Malignant neoplasm, uterus — - — — — — — — — — — — — 2 - — - 5 — 2 — — — 9 14. Other malignant and lymphatic neoplasms - - - 1 - - - - - 1 - - 2 2 11 6 11 10 11 7 5 8 40 35 15. Leukaemia, aleukaemia — — — — — — — — — — 1 — 2 — — - — - 1 - - 1 4 1 16. Diabetes — - — — — — — — — — — — — — 1 1 2 2 1 2 — 2 4 7 17. Vascular lesions of nervous system — - — — — — — — — 1 — — — — 5 6 9 8 6 15 7 11 27 41 18. Coronary disease, angina — - — — — — — — — — — — 2 — 7 4 7 3 9 2 5 3 30 12 19. Hypertension with heart disease - - - - - - - - - - - - - - — 1 7 4 7 5 2 5 16 15 20. Other heart disease — - — — — — — — — 2 — 2 3 4 7 6 6 5 15 8 16 23 47 50 21. Other circulatory disease — - — — — — — — — — — — 2 — 1 2 8 6 5 6 15 6 31 20 22. Influenza — - — — — - — — — 1 — — — — 1 1 2 - 2 1 4 2 9 5 23. Pneumonia 9 2 1 — — — — — 1 — — 1 — - 3 1 5 - 6 7 4 11 29 22 24. Bronchitis 1 1 1 - — - - 1 — — 2 1 1 - 10 1 21 6 18 3 20 11 74 24 25. Other diseases of respiratory system — — — — — — — — — — — — 1 — 1 — 1 - 2 - - — 5 - 26. Ulcer of stomach and duodenum — — — — — — — — — — — 1 — — 3 - 2 — 1 - 2 1 8 2 27. Gastritis enteritis and diarrhoea - 2 1 — — -— — — — — — — — 1 — - — - — - — - 1 3 28. Nephritis and nephrosis 1 1 — — — -— — — — — — — — 1 — — 2 3 1 — 2 2 6 7 29. Hyperplasia of prostate — - — — — - - - - - - - — — — — — — 3 — 1 — 4 — 30. Pregnancy, childbirth, abortion — - — — — - — — — — — 1 — — — - — - — — - - - 1 31. Congenital malformations 9 1 — - - - - - - - - - - - - - - - - - - — 3 1 32. Other defined and ill-defined diseases 19 10 — 1 1 — — — — 3 4 2 5 2 5 3 4 9 7 2 15 17 60 49 33. Motor vehicle accidents — — — — 1 — — — 1 — 1 — — — — — — — 3 — 1 — 7 - 34. All other accidents — — — — 1 — — 1 1 — 1 — 1 — 2 1 — — — — 6 2 35. Suicide — — — — — — — — — — 2 — 1 — — 2 1 — — 1 — — 4 3 36. Homicide and operations of war — — — — - - - - - - - - - - - - - - - - - - — - 33 17 3 2 3 - - 2 4 12 13 11 25 16 83 44 118 65 112 67 103 107 497 343