1. other boyne Da 5 B 2. other knowles this House 3. Library DAG 26 BOROUGH OF DAGENHAM ANNUAL REPORT of the Medical Officer of Health for the year 1952 CECIL HERINGTON, M.D. (Lond.), D.P.H. BOROUGH OF DAGENHAM ANNUAL REPORT of the Medical Officer of Health for the year 1952 CECIL HERINGTON, M.D. (Lond.), D.P.H. 3 To the Mayor, Aldermen and Councillors of the Borough of Dagenham. Madam Mayor, Ladies and Gentlemen, My report on the health of Dagenham for the year 1952 is on similar lines to that for 1951 in as much as there is no line of demarcation drawn between the services administered through the local sanitary and local health authorities. There has been a slight decrease in the number of births— 1,708 compared with 1,729. The crude birth rate of 15.09 when corrected becomes 14.33, that for England and Wales for the same period is 15.3. The infant mortality rate, that is the number of infants who died before attaining the age of one year per 1,000 live births was 26.35, comparing favourably with the national figure which was 27.6. Deaths of residents amounted to 826, giving a crude death rate of 7.3, which being corrected by the application of the comparability factor becomes 11.97, the rate for England and Wales being 11.3, that for the 160 Great Towns with which are included Dagenham 12.1, and London 12.6. I am pleased to record that there were no maternal deaths, and none occurred attributable to Measles, Whooping Cough, Scarlet Fever or Diphtheria. It is also gratifying to note that there has been a slight decline in deaths from Cancer, 168 against 175. ante-natal relaxation classes. The value of systematized relaxation in preparation for labour has been clearly demonstrated recently, and with a view to making these benefits available to expectant mothers in this district, four of our Health Visitors attended a special course of instruction. Classes have been set up in four of the ante-natal clinics, each one being conducted by a specially trained Health Visitor. They ate held weekly and are so arranged that each course of instruction consists of 10 to 12 sessions of approximately two hours duration. The first half hour or so is devoted to a lecture, this is followed by exercises of the abdominal, respiratory and pelvic muscles which also last for about half an hour, then relaxation for a further hour takes place. Although only commenced quite recently, these classes have become very popular and are well attended. We are frequently told by expectant mothers who are attending these courses how the terrors of child birth have been removed. If they succeed only in dispelling some of the old wives' tales and superstitions which have been current from time immemorial, their inauguration will be fully justified. 4 IMMUNISATION. The number of children protected against Diphtheria has again shown an increase, but there is a slight falling-off in those who have been submitted to reinforcing doses. Although we are now happily almost free from this dangerous disease it is safe to prophesy that a relaxation in our efforts would almost certainly result in its reappearance as a public health hazard. Whooping Cough immunization was made available to Dagenham children in 1946, and to those of the County as a whole in April, 1953. There is still much room for improvement in the efficacy of the vaccines at present at our disposal, but there is evidence that both the severity and duration of the illness are lessened. The incidence however appears to be little affected. Our experience in 1953 adds weight to this argument although the numbers treated up to date are too small to prove this thesis. TUBERCULOSIS. The Chest Clinic at King George Hospital Out-Patient Department, Five Elms, is now well established and fully equipped. It serves a very useful purpose and is easily accessible from most parts of the Borough. The treatment of tuberculosis is a function of the Regional Hospital Board but the prevention remains with the Local Health and Local Sanitary Authorities. This splitting of responsibility may appear to be somewhat untidy administration and doubtless in some areas it has led to confusion and misdirection of effort. We are fortunate here, however, in having good liaison and cordial relationship between the members of the respective authorities and the officers concerned. As an illustration it may be mentioned that the Chairman of the Health Area Sub-Committee and of the Public Health Committee is also a member of the Hospital Management Committee and is Chairman of the Tuberculosis Care Association. A register of all contacts of tuberculosis is kept in the Health Area Office and these persons are urged at appropriate intervals to present themselves to the Chest Physician for examination. Great advances have been made in diagnostic and treatment methods of recent years. Looking back I find that for the years 1939 to 1945 there was an average of 59 deaths from respiratory tuberculosis per annum, the average from 1946 to 1950 was 46, in 1951 there were 24 and 26 in the year under review. The work of the domiciliary occupational therapist is most valuable and much appreciated. This lady devotes three days a week to Dagenham and two to Barking. Apart from relieving or dispelling the inevitable boredom of being housebound or bedridden, most of the patients readily acquire under tuition a high degree of skill in the handicraft which they pursue. At the time of writing there are approximately 25 Dagenham patients on the live register of the occupational therapist. 5 The Mass Miniature Radiography Unit is due to visit Dagenham in the autumn of 1953. It is earnestly hoped that full advantage will be taken of the opportunity for a check up. food poisoning. What appeared to be an outbreak of food poisoning occurred amongst guests at a wedding reception. Out of a total of approximately 70 persons partaking of the food I was informed that at least 34 were affected. The symptoms were abdominal pains, diarrhoea and vomiting. The reception commenced at 2.30 p.m. and the first guest to be unwell had abdominal pains at about 6.30 the same evening; others commenced during the night, some on the following day and night, and several 48 hours after the reception. Apparently no one was sufficiently ill to call in their doctor; not a single notification was received. The matter was first reported to me by a large local catering organisation responsible for the reception, but owing to the inevitable delay, all food, with the exception of the wedding cake, had been consumed or otherwise disposed of. A sample of the cake, which was made by a friend of the bridegroom, was sent for examination and the Pathologist reported as follows:– Cake: Diphtheroids only grown. Almond Icing: Non-haemolytic streptococci and B. subtilis grown. White Icing: A heavy growth of yellow pigmented haemolytic staphylococci. The tube coagulase however proved negative. In the circumstances the staphylococci cannot be regarded with certainty as pathogenic. The very heavy contamination of the icing with this organism is noteworthy. 6 Although to the best of our knowledge this episode ended happily for all concerned, it is given some prominence because it so clearly demonstrates the potential danger in the neglect of hygienic technique when preparing food. If the contaminating organism had been of a more virulent type, which it may well have been, the result can be left to the imagination. It is fair to assume that the bridegroom's friend was the guilty party, unwittingly of course. This might have been an example of killing (or injuring) by kindness (with carelessness). ATMOSPHERIC POLLUTION It will be remembered that dense fog enveloped the London area, including Dagenham, for the five days commencing December 5th. It is significant that during the week covering this period the number of deaths in this area from certain respiratory diseases increased fourfold. The contamination of the atmosphere was scientifically confirmed by observations made in the Borough in co-operation with the Department of Scientific and Industrial Research. Given similar meteorological conditions the disaster would no doubt recur; this emphasises the need for more active measures to be adopted with a view to reducing or, better still, eliminating the avoidable pollution of our skies. I have pleasure once again in recording my appreciation of the excellent services of my colleagues with whom of course I include all members of the staff. Finally I tender my sincere thanks to the members of the Committees concerned, particularly to the Chairman and Vice-Chairman of those with which the work of the Public Health of the district is most closely associated. I am, Madam Mayor, Ladies and Gentlemen, Your obedient Servant, CECIL HERINGTON, Medical Officer of Health. Public Health Department, Civic Centre, Dagenham. 7 MEMBERS OF THE COUNCIL (31st December, 1952) Mayor: Alderman (Mrs.) E. M. MILLARD, J.P. Deputy Mayor: Councillor J. P. HOLLIDGE, J.P., E.C.C. Aldermen: W. E. BELLAMY F. GRINDROD, J.P. F. BROWN A. E. PRENDERGAST (Mrs.) R. J. D. CLACK C. PRENDERGAST L. F. EVANS (Mrs.) M.B.E., J.P., E.C.C. Councillors: S. F. BANKS L. R. JONES, B.Sc. R. BLACKBURN A. KEMPSON J. BOWLES J. F. MOULTRIE, F.A.I. I. M. BROCKELBANK (Mrs.) D. O'DWYER G. A. BROOKER B. M. ROADKNIGHT (Mrs.) E. A. BROWNE J. SCOTT R. F. BURSILL L. S. SNELLING (Mrs.) F. COOMBS D. THOMAS G. H. A. CROUCH F. G. THOMAS E. W. DEEKS S. J. C. WARR M. EALES A. F. WARR (Mrs.) A. S. HADDOCK PUBLIC HEALTH COMMITTEE Alderman (Mrs.) A. E. PRENDERGAST, Chairman Councillor (Mrs.) B. M. ROADKNIGHT, Vice-Chairman Her Worship the Mayor (Alderman Councillor G. A. BROOKER (Mrs.) E. M. MILLARD, J.P.) The Deputy Mayor (Councillor J. P. Councillor D. O'DWYER HOLLIDGE, J.P., E.C.C.) Councillor R. BLACKBURN Councillor S. J. C. WARR 8 DAGENHAM HEALTH AREA SUB-COMMITTEE Alderman (Mrs.) A. E. PRENDERGAST, Chairman Alderman (Mrs.) L. F. EVANS, M.B.E., J.P., E.C.C., Vice-Chairman Members:— Borough Council The Mayor: Alderman (Mrs.) E. M. MILLARD, J.P. Councillor R. BLACKBURN Councillor G. A. BROOKER Councillor R. F. BURSILL Councillor J. BOWLES Councillor (Mrs.) I. M. BROCKELBANK Councillor F. COOMBS Councillor E. W. DEEKS Councillor M. EALES Councillor J. P. HOLLIDGE, J.P. Councillor A. KEMPSON Councillor D. O'DWYER Councillor (Mrs.) B. M. ROADKNIGHT Councillor S. J. C. WARR County Council Alderman (Mrs.) M. BALL Councillor (Mrs.) M. BREDO Councillor W. HERRIDGE Councillor E. R. D. De ROUGEMONT Councillor (Mrs.) E. SAYWOOD Councillor Dr. C. SKINNER 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 Organisations Mr. H. BAILEY, Miss J. M. LANE, Miss N. L. O'DELL and Miss I. WHEELER 9 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.) (C) 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) M. T. ROCHE (5, 7) I. A. BARROW (5, 6, 13) L. SALTER (5, 6, 7) A. K. GIBSON (5, 6, 7) D. B. STEWART (5, 6, 7) D. GORDON (5, 6, 7, 9, 10, 14) J. E. THOMAS (5, 6, 7, 10, 14) D. HICKEY (5, 6, 7) R. E. WALKER (5, 6, 7, 12, 13) J. M. J. MORGAN (5, 7) L. WARR (5, 13) E. RICHARDS (5, 6, 7) (One vacancy) 10 Senior Midwife: (C) E. M. BEDFORD (5, 6) Midwifes: (C) M. GOODBUN (5, 6) M. M. ROBSON (6, 10) M. HALL (6) M. ROCK (6) H. MITSON (5, 6) M. J. STOREY (6) M. M. RICHARDS (6) M. TEATHER (5, 6) Clerical Staff: Chief Clerk: (C) F. W. KNIGHT (1, 2) Clerk to Sanitary Inspectors: G. DOVEY E. ADAMS (C) Clerks: G. K. HARRIS I. M. BISHOP (C) S. B. LEADER (C) N. BRIAND (C) F. H. MARTIN (C) (16) M. A. BRIDESON (C) L. A. MOORE (C) N. E. CLOKE (C) E. NEALE (C) S. DOWDING (C) J. POWELL L. M. FREESTONE (C) D. TYLER (C) M. GOODCHILD (C) M. A. WATTS (C) H. GOODCHILD (C) Day Nurseries: (C) Goresbrook Nursery, MATRON: E. MADDISON (12) Dagenham Avenue, DEPUTY: K. GRAHAM (8) Dagenham. Chadwell Heath Nursery, MATRON: I. MUSGRAVE (8) Ashton Gardens, DEPUTY: P. HEINSON (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: (C) K. RICHARDS Dental Attendant: (C) M. E. SEALEY 11 Part-Time Staff Dentist: A. S. ROBERTS, L.D.S., R.C.S.(Edin.) Public Analyst: J. HUBERT HAMENCE, Ph.D., M.Sc., F.R.I.C. Occupational Therapist: ZELDA E. MERCER (New Zealand Diploma of Occupational Therapy) Chiropodist: C. K. BOWER (11) Certificate of Royal Sanitary Institute 1 Meat Inspector's Certificate 2 Sanitary Science as applied to Building and Public Works Certificate 3 Smoke Inspector's Certificate 4 General Trained Nurse 5 State Certified Midwife 6 New Health Visitor's Certificate 7 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 Diploma in Public Administration 16 12 STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 6,556 Registrar-General's estimate of resident population, 1952 113,200 Population Census, 1951 114,588 Number of inhabited houses (end of 1952) according to Rate Books 29,169 Rateable value (December 31st, 1952) £680,946 Sum represented by a penny rate (approximate 1952-53) £2,763 Extracts from Vital Statistics for the Year. Live Births:— Total Male Female Legitimate 1,668 845 823 Crude birth rate per 1,000 of the estimated resident population, 15.09. Illegitimate 40 17 23 Stillbirths:— Legitimate 42 22 20 Rate per 1,000 total (live and still) births, 25.67. Illegitimate 3 1 2 Deaths 826 475 351 Crude death rate per 1,000 of the estimated resident population, 7.30. Deaths from pregnancy, childbirth, abortion:— Deaths. Rate per 1,000 total (live and still) births. Nil Nil Death rate of infants under one year of age:— All infants per 1,000 live births 26.35 Legitimate infants per 1,000 legitimate live births 25.78 Illegitimate infants per 1,000 illegitimate live births 50.00 Deaths from Cancer (all ages) 168 „ „ Measles (all ages) Nil „ „ Whooping Cough (all ages) Nil „ „ Gastritis, Enteritis and Diarrhoea (all ages) 7 13 Births. 1,708 live births were registered during the year, there being 862 males and 846 females. There is a decrease of total births from 1,729 in 1951 to 1,708. The birth rate per thousand population was 15.09 compared with 15.3 for England and Wales and 16.9 for the 160 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, 15.36 and 15.25 for the years 1927 to 1951 inclusive. The illegitimate birth rate continues to be very low, being only 2.34 per cent. of total births. The rate of illegitimate stillbirths is 6.67 per cent. of total stillbirths. Death Rate. Total deaths in district 588 Outward transfers 147 Inward transfers 385 Deaths of residents 826 Of the 147 deaths of non-residents occurring in the district, 10 took place at the Dagenham Hospital, 123 at Rush Green Hospital and eight at Hainault Lodge. Of the 385 deaths of local residents taking place outside this area, most occurred in institutions. Of these 199 occurred at Oldchurch Hospital; 35 at 117, Suttons Lane, Hornchurch; 15 at King George Hospital; 11 at St. Joseph's Hospice; 10 at the London Hospital; nine at Severalls Hospital; nine at Harold Wood Hospital; six at Ilford Isolation Hospital; five at St. Andrew's Hospital, Billericay; and four at Barking Hospital. The death rate of 7.30 compares with 11.3 for England and Wales. For the years from 1927 to 1951 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, 6.92 and 7.42. A table giving the causes of death, and the age periods at which they occurred, is given at the end of the report. 14 Table showing Birth-rate, Death-rate and Analysis of Mortality during the year 1952. 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 Whooping Cough Diphtheria Influenza Diarrhoea and Enteritis (under two years) Total Deaths (under one year) England and Wales 15.3 0.35 11.3 0.00 0.00 0.00 0.00 0.04 1.1 27.6 160 County Boroughs and Great Towns, including London 16.9 0.43 12.1 0.00 — 0.00 0.00 0.04 1.3 31.2 160 smaller towns (1951 Census) resident population 25,000-50,000 15.5 0.36 11.2 0.00 — 0.00 0.00 0.04 0.5 25.8 London 17.6 0.34 12.6 — — 0.00 0.00 0.05 0.7 23.8 Dagenham (Corrected) 14.33 0.40 11.97 — — — — 0.01 2.3 26.35 15 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, Chadwell Heath. Weekly Thursday, a.m. 38 1 Weekly Thursday, p.m. 46 2 Becontree Clinic, Becontree Avenue, Dagenham. Weekly Monday, p.m. 45 2 Weekly Tuesday, a.m. 27 1 Weekly Tuesday, p.m. 48 2 The Leys Clinic, Ballards Road, Dagenham. Weekly Thursday, a.m. 32 1 Weekly Thursday, p.m. 33 2 Out-Patient Department, King George Hospital, Five Elms, Dagenham. Weekly (Discontd. 10.9.52) Wednesday, a.m. 37 2 Weekly *Wednesday, p.m. 45 3 Weekly (Discontd. 5.9.52) Friday, a.m. 26 1 Rush Green Clinic, 179, Dagenham Road, Rush Green. (2nd, 4th & 5th in month) Friday, a.m. 12 1 Weekly Friday, p.m. 25 1 The Clinic, Ford Road, Dagenham. Weekly Tuesday, a.m. 63 3 Weekly Tuesday, p.m. 59 3 Weekly (Commenced 4.7.52) Friday, a.m. 23 1 The Clinic, Manford Way, Hainault. Weekly Monday, p.m. 30 2 London City Mission Hall, Dagenham Road, Dagenham. Weekly (commenced 15.5.52) Thursday, a.m. 31 1 Weekly Thursday, p.m. 55 3 * Transferred to The Clinic, Becontree Avenue. 16 Ante-Natal Clinics CENTRE Sessions Held Times Sessions Held Average Attendances Average New Cases The Clinic, Ashton Gardens, Chadwell Heath. Weekly Wednesday, p.m. 13 2 The Clinic, Becontree Avenue, Dagenham. Weekly Tuesday, p.m. 14 2 Weekly Wednesday, a.m. 12 2 Weekly (discontd. 27.6.52) Friday, a.m. 12 2 Weekly Friday, p.m. 10 1 The Leys Clinic, Ballards Road, Dagenham. Weekly Tuesday, a.m. 12 1 Weekly Wednesday, a.m. 11 1 Rush Green Clinic, 179, Dagenham Road, Rush Green. (1st & 3rd in month) Friday, a.m. 9 1 York House, Frizlands Lane, Dagenham. Weekly Tuesday, a.m. 24 3 Weekly Wednesday, p.m. 24 3 Weekly Thursday, a.m. 17 2 Weekly Thursday, p.m. 18 3 The Clinic, Ford Road, Dagenham. Weekly Monday, a.m. 20 3 Weekly Monday, p.m. 27 3 The Clinic, Manford Way, Hainault. Weekly Monday, a.m. 6 1 17 Sanitary Inspection of the District Report of the Sanitary Inspectors. (a) Nature and number of visits:— Overcrowding and Housing Conditions 1,041 Nuisances under Public Health Acts— Dwelling-houses 4,567 Other Premises 636 Bakehouses 82 Milkshops and dairies 100 Foodshops, stalls and itinerant vendors 2,720 Cafes and canteens 777 Infectious disease enquiries 1,042 Visits to foster-mothers' premises 156 Number of complaints investigated 942 Outworkers' premises 88 Workplaces and offices 38 Rag Flock, etc. 52 Tents, vans and sheds 585 Stables 12 Pet shops 45 Hairdressers' and barbers' premises 101 Shops Act 189 Ice Cream premises and vehicles 422 Houses disinfested 34 Other Visits 41 (b) Notices served:— Complied with:— Statutory 146 127 Informal 528 488 Legal proceedings were instituted in respect of three properties to enforce compliance with statutory notices. 18 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 24 29,169 7 1,423 30,623 *Number of properties inspected as a result (a) of notification, or (a) 5 143 — 66 214 (b) otherwise (b) 14 289 5 76 384 Number of properties found to be infested by rats Maj. — — — — — Min. 4 114 — 30 148 Number of properties found to be seriously infested by mice 4 74 — 57 135 Number of infested properties treated by the Local Authority 8 188 — 87 283 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 following issue of notice under Section 4 — — — — — Legal Proceedings — — — — — Number of "Block control" schemes carried out 24. * These figures do not include the regular routine inspection of food premises, factories, etc., by the Sanitary Inspectors. 19 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 fiction was called for in respect of any form of contamination. Approximately .058 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 Whalebone Lane North 4" 179 yards Marston Close 3" 53 „ Total 232 „ 524 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." 20 FACTORIES ACTS, 1937 & 1948 Inspections. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Factories without mechanical power 22 37 1 — Factories with mechanical power 135 222 5 — Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 20 31 2 – TOTAL 177 290 8 — Defects Found. No. of defects No. of prosecutions instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness — — — — — Overcrowding 1 — — — — Unreasonable temperature — — — — — Inadequate ventilation 1 1 — 1 — Ineffective drainage of floors — — — — — Sanitary Conveniences:— Insufficient 1 1 — 1 — Unsuitable or defective 5 5 — 1 — Not separate for sexes — — — — — Other offences 1 1 1 — — TOTAL 9 8 1 3 — Outwork No. of out-workers in August list 35 Nature of work Making, etc., wearing apparel. 21 Bacteriological Sampling of Milk During the year 86 samples of milk were submitted for examination and three were found to be unsatisfactory. Particulars of these three are as follows:— One sample of pasteurised milk failed to pass the phosphatase test and was, in fact, raw milk. This small retailer's milk, already pasteurised, is delivered (premises situate in an adjoining district) in churns by a wholesale firm. The time of delivery is early morning and there appears to be little doubt that in the darkness of a January morning a churn of raw milk was inadvertently unloaded by the driver and included with the other churns of pasteurised milk. The matter was referred to the local authority concerned and the wholesaler; subsequent samples taken from this retailer have been satisfactory. Two samples of pasteurised milk failed to pass the Methylene Blue Test. Ice Cream Bacteriological Sampling. During the year 54 samples of ice cream were submitted for examination. They were graded as follows:— Grade I Grade II Grade III Grade IV Total 36 15 3 — 54 With regard to ice lollies 19 samples were submitted for examination; one was unsatisfactory. The manufacturer of the unsatisfactory sample later closed down his premises in this Borough. During the year nine 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. The majority of itinerant vendors of ice cream (mostly operating box tricycles) are selling only wrapped products. The few selling loose cream are required to have enclosed vehicles and carry suitable washing facilities. The Council protested to the Ministry of Food at the lowering of the standard for ice cream in respect of fat and non-fat milk solids, although it was realised that to maintain the standards existing at the time would be to reduce supplies. It is satisfactory to note that the alteration was only for a limited period. 22 FOOD AND DRUGS ACT, 1938 Analyses Article Number Examined Number Adulterated, etc. Formal Informal Formal Informal Almonds, Ground 1 — — — Arrowroot — 1 — — Banana Curd — 1 — — Bread — 4 — 4 Bread, Sliced — 1 — 1 Cake, Flour 1 — — — Cake, Mixtures 2 6 — — Cheese Spread — 1 — — Cinnamon 1 — — — Coconut — 2 — — Coffee — 4 — — Confectionery 1 7 — 2 Cordial, Tonic — 1 — — Crab, Dressed — 1 — — Cream, Synthetic — 2 — — Curry Powder — 2 — — Dessert Powder 1 — — — Egg Vermicelli — 1 — — Farinoca — 1 — — Fish Cake 1 — — — Flavour, Raspberry 1 — — — Gelatine 1 — — — Ginger, Ground 1 1 — — Herbs 1 3 — — Horseradish Cream — 1 — — Ice Cream — 21 — 2 Jam — 1 — — Jellies 1 8 — 2 Lemon Juice — 1 — — Lemonade Powder — 1 — — Lobster — 1 — — Meat Extract — 1 — — Medicinal Samples 7 18 2 — Milk 39 1 — 1 Mint in Vinegar — 1 — — Paste — 2 — — Olive Oil 1 2 — — Peanut Butter — 1 — — Pepper 2 5 — — Pepper, Flavoured Compound — 3 — — Rice, Ground — 1 — — Roll, Portion of — 1 — 1 Sausages 49 1 1 — Sild in Edible Oil — 1 — — Soft Drink Powder — 1 — — Soup 1 — — — Spice — 4 — — Suet, Shredded 1 — — — Tea 1 — — — Vinegar — 1 — — 23 Adulterated Samples, etc. Serial No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 1082A Bread Informal Showed patches of a yellowish brown discolouration. Vendor warned. 1083A Date Slice Informal Contained a piece of metal sheet which had been cooked in the dough. Vendor warned. 1084A Bread Informal Consisted masses of dirty dough containing traces of quartz sand and coal dust. Vendor warned. 1085A Bread Informal Contained a fragment of partly discoloured dough. Vendor warned. 1086A Milk Informal A partly filled bottle of milk was found to contain empty insect larvae cases. Vendor warned. 1109 A Bread Informal Contained portions of discoloured dough. Vendor warned. 1092A Lollie Creme Informal Contained only 1% of fat, an insufficient amount to justify the description 'creme'. Production discontinued. 1108A Lollie Creme Informal Contained only 1.8% of fat, an insufficient amount to justify the description 'creme'. 1110A Portion of Roll Informal Contained a foreign body consisting of discoloured dough containing a quarter of its weight of fat. Vendor warned. 1111A Sliced Bread Informal Contained a mass of cotton fibres embedded in discoloured dough. Vendor warned. 1153A Table Jelly Informal Out of condition. Heavy surface incrustation of sugar. Vendors warned. Withdrawn from sale. 1154A Table Jelly Informal Out of condition. Slight surface incrustation of sugar. 24 Adulterated Samples, etc.— continued. Serial No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 1162A Toffee Informal Contained fragments of a plastic foreign material. Manufacturers warned. 1963 Camphorated Chalk Formal 96% deficient in camphor. Vendor warned. 1967 Beef Sausages Formal Consisted of preserved sausages containing 220 parts per million of Sulphur Dioxide. Vendor warned. 2015 Fever Mixture Formal Contained 43% more nitric acid than the quantity stated on the label. Referred to Manufacturers. Section 13 and Byelaws under Section 15 In addition to numerous verbal requests and suggestions during the routine visits of the inspectors, 28 informal notices were served upon owners and occupiers. The Council authorised the institution of legal proceedings against a firm of local bakers because of general dirty conditions. The firm had previously been convicted for similar conditions and fined £5. Before proceedings could be commenced, the control of the business had been put in the hands of a Receiver, because of financial difficulties, and later closed down. Unsound Food Complaints continue to be received in respect of articles of food containing a variety of foreign substances. Legal proceedings were instituted in the three following cases:— (i) Mouldy veal and ham pie; defendants found guilty but given an absolute discharge on payment of £3 3s. 0d. costs. (ii) Mouldy sausage rolls; defendants found guilty and fined £5 with £3 3s. 0d. costs. (iii) Glass in bottle of milk; case dismissed. Clean Food Campaign During the year lectures have been given to members of several local women's organisations. The sanitary inspectors in their regular visits to all food premises in the Borough use every opportunity of stressing the need for the maintenance of a good standard of cleanliness in respect of personal habits, equipment and premises. 25 In conformity with the recommendations of the Ministry of Food (Circular MF 20/51) in respect of Dogs in Food shops, Restaurants, etc., notices were distributed to all food premises requesting customers not to bring dogs inside. The notice consisted of a small paint transfer to be fixed to the shop window. There was a very good response from the traders and the notices were invariably sited in a good position at the entrance to the premises. This type of notice was chosen because it was considered to be durable and it is pleasing to observe that the majority, after over one year's display, still have a clean and tidy appearance. Food Poisoning Outbreaks During the year 25 cases of food poisoning were notified; in only six single cases were the causative organisms identified. Housing After the Housing and Town Planning Committee had agreed to rehouse the tenants the necessary statutory procedure was commenced with a view to the demolition of a very old house in Chadwell Heath. In view of the long waiting list for housing accommodation, it has been the policy of the department to keep up the old property in the Borough so long as it provides reasonable shelter. This is the first house to be dealt with by this Authority under the provisions of the Housing Acts since 1939, but with the increasing dilapidation of many of the very old premises it is inevitable that similar action in other cases will become necessary. Overcrowding. A licence was issued under Section 61 of the Housing Act 1936 allowing two persons more than the "permitted number" of three to live at the house. The landlord had served a notice to quit on the tenants on the grounds of overcrowding. Later the tenants found other accommodation and the licence was revoked. Tents, Vans and Sheds. Two further applications for land in the Northern part of the Borough to be used as sites for caravans were refused. Proceedings were instituted in one case where the owner continued to use the site after his appeal against the Council's refusal to grant a licence was dismissed. He was fined £2 and ordered to clear the site. Legal proceedings were instituted in two cases where two garden sheds were occupied each by a family with three young children. The sheds were grossly overcrowded and altogether unsatisfactory. Action was taken under the provisions of the Public Health Act, 1936, Section 268, and Court orders were obtained requiring the occupants to vacate the huts within 28 days. The orders were complied with. 26 National Assistance Act, 1948—Section 47 From time to time information is received of persons, invariably aged men and women, who are unable to look after themselves and are without proper care and attention. In four cases (one male and three females) there was for some time persistent personal objection to removal to an institution. In each case, however, the voluntary agreement of the person was eventually obtained and removal arranged through the County Welfare Department. Although these cases required many visits and much patience and tact, the effort is considered well worthwhile inasmuch as it was unnecessary to use the statutory power for compulsory removal. Rag Flock and Other Filling Materials Act, 1951 Two premises have been registered under Section 2 of the Act. Two licences for the manufacture and one licence for the storage of rag flock have been issued. One manufacturer has ceased the production of rag flock owing to persistent failure to comply with the test in respect of Chlorine content. It is anticipated that when facilities are available on the premises for the washing of the raw material (in the past washing was carried out at laundries: only new material being used) production will be resumed. The other manufacturer of rag flock occupying new premises and using modern equipment has experienced some difficulty in complying with the soluble impurities test (permitted maximum 1.8%). The whole system of processing is being investigated with a view to finding a solution to the problem. Samples taken during the year were as follows:— Material Satisfactory Not Satisfactory Rag Flock 3 4 Cotton Felt 2 — Coire Fibre 1 — Kapok 2 — Sisal 1 — Woollen Felt 1 — Pet Animals Act, 1951 Five licences authorising the keeping of pet shops have been issued. The conditions attached to the licences are those approved by the Association of Municipal Corporations. Premises are regularly inspected and no serious breach of the conditions has arisen. Slaughterhouse An application for a licence in respect of a slaughterhouse which has not been used since 1939 but which has been licenced annually during the intervening years, was not granted because of recent alterations which rendered the premises unsuitable for use as a slaughterhouse. The necessary notice was served upon the occupier but was not complied with and the licence lapsed. 27 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES NOTIFIABLE DISEASES (Other than Tuberculosis) Under 1 year 1-2 3-4 5-9 10-14 15-24 25 and over Total Scarlet Fever 1 19 58 179 27 5 1 290 Whooping Cough 38 75 73 109 5 — 2 302 Acute Poliomyelitis:— Paralytic — — 1 1 1 1 2 6 Non-paralytic — — — 1 — 2 — 3 Measles 59 348 508 911 14 5 2 1,847 Diphtheria — — — — — — — — Under 5 years 5-14 15-44 45-64 65 and over Total Pneumonia:— Acute Primary 3 8 5 16 3 35 Acute Influenzal 1 — 1 1 1 4 Dysentery 3 — — — — 3 Smallpox — — — — — — Encephalitis, Acute:— Infective — — — — — — Post-Infectious — — — — — — Enteric Fever — — — — — — Paratyphoid Fever — — — — — — Erysipelas — 1 4 13 1 19 Meningococcal Infection 3 — — — — 3 Food Poisoning 5 4 15 1 — 25 Puerperal Pyrexia — — 18 — — 18 Ophthalmia Neonatorum 9 — — — — 9 Pemphigus — — — — — — Malaria (Foreign Origin) — — — — — — 28  Notified Admitted to Isolation Hospital, Rush Green Admitted to other Isolation Hospitals Admitted to other Hospitals Deaths Registered Diphtheria — — — — — Dysentery 3 — — — — Encephalitis, Acute — — — — — Enteric Fever — — — — — Erysipelas 19 5 — 1 — Food Poisoning 25 1 3 — — Malaria — — — — — Measles 1,847 25 3 — — Meningococcal Infection 3 3 — — 1 Ophthalmia Neonatorum 9 1 — — — Paratyphoid Fever — — — — — Pemphigus — — — — — Puerperal Pyrexia 18 3 — 7 — Pneumonia:— 32 Acute Influenzal 4 1 — — Acute Primary 35 3 2 2 Poliomyelitis, Acute:— 1 Paralytic 6 3 3 — Non-paralytic 3 3 — — Scarlet Fever 290 13 14 1 — Smallpox — — — — — Whooping Cough 302 2 6 — — DIPHTHERIA IMMUNISATION The following is a summary of the work carried out during the year:— Number of SCHOOL children immunised without preliminary testing 102 Number of PRE-SCHOOL children immunised without preliminary testing 1,000 Number of SCHOOL children who received a boosting dose 610 Immunisation by General Practitioners. Number of SCHOOL children immunised without preliminary testing 27 Number of PRE-SCHOOL children immunised without preliminary testing 247 Number of SCHOOL children who received a boosting dose 132 WHOOPING COUGH IMMUNISATION The number of children who received protective doses against Whooping Cough was 115, the majority of these being between the ages of one and four years. 29 VACCINATION CARRIED OUT BY GENERAL PRACTITIONERS Vaccinated. 1952 (Under 1) 243 1948-51 (1—4) 62 1938-47 (5—14) 27 Before 1938 (15 or over) 88 Total 420 Re-Vaccinated. 1952 (Under 1) — 1948-51 (1—4) 2 1938-47 (5—14) 7 Before 1938 (15 or over) 110 Total 119 TUBERCULOSIS New Cases Deaths Primary Notifications 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 1 1 — 1 — — — — — — — — — 1— 3 8 2 — 1 — — 1 — — — — 5— 2 3 1 4 — 1 — 2 — 1 — — 10— 3 3 — 1 1 — — — 1 — — — 15— 5 14 1 1 — — — — — 1 — 1 20— 14 14 — — — 3 — — 1 — — — 25— 23 24 1 3 9 7 — — 3 1 — — 35— 6 5 — 1 1 1 — — 1 — — — 45— 7 4 — — 3 — 1 1 5 1 l 1 55— 5 3 — — 1 1 — — 3 1 1 — 65—and upwards 5 — 1 — 3 1 — — 5 1 — — 74 78 7 10 19 14 1 4 19 10 2 2 30 Register. Pulmonary Non-Pulmonary Male Female Male Female No. on register 1st January, 1952 524 417 75 77 During the year:— New notifications 74 78 7 10 New cases brought to notice by Registrars' Deaths Returns 6 2 1 1 Deaths 19 10 2 2 Transfers into area 13 12 — 3 Transfers out of area 21 26 2 4 Removed from register as "Recovered" 56 29 8 9 No. on register 31st December, 1952 521 444 71 76 MATERNITY AND CHILD WELFARE Notification of Births 1,885 notifications of Live births were received during the year. This number includes 156 children who were born in Rush Green Hospital but whose normal residence is not within the Borough. Stillbirths 23 male and 20 female stillbirths were notified, the corresponding figures for registration being 23 and 22. The rate per 1,000 of total population registered was 0.40, the rate for England and Wales being 0.35. Infant Mortality 45 infants under one year of age died during the year, giving an infant mortality rate of 26.35 per 1,000 live births compared with that of 27.6 for England and Wales and 23.8 for London. The rate amongst legitimate children was 25.78 while for illegitimate children it was 50.0. Ophthalmia Neonatorum Nine cases of this disease were notified: all made complete recoveries. There were 60 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 There were no maternal deaths assigned to this district during the year under review. 31 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 330 Total visits 557 (b) To children under 1 year of age First visits 1,960 Total visits 4,606 (c) To children between the ages of 1 and 5 years Total visits 12,609 (d) Ineffective visits Total visits 4,019 (e) Other visits Total visits 5,229 Grand Total 27,020 Domiciliary Midwifery Service The following is a summary of the reasons for sending for medical aid by midwives:— Perineal Tear 98 Discharging Eyes 60 Prolonged Labour 23 Ante-Partum Haemorrhage 21 Miscarriage 20 Rise of Temperature 19 Malpresentation 14 Post-Partum Haemorrhage 11 Threatened Miscarriage 9 Unsatisfactory Condition of Infant 7 Albuminuria 7 Abortion 6 Rash on Baby 5 Premature Baby 5 Cyanosed Infant 4 Toxaemia 4 Difficult 2nd Stage 4 Adherent Placenta 4 Premature Labour 4 Bleeding per Vagina 4 Inflammation over Veins in Leg 4 Early Rupture of Membranes 4 Jaundice 4 Persistent Vomiting 3 Spina Bifida 3 Phlebitis 3 Other Causes 54 404 32 Notices summoning medical aid 404 For (a) Mothers 307 For (b) Infants 97 Notifications that they had been associated with the undermentioned conditions were received from domiciliary midwives:— Substitution of artificial feeding 28 Liable to be sources of infection 7 Stillbirths 3 Deaths of Mother or Child 3 Laying out dead bodies 4 Below is a table setting forth in statistical form the work of the County Midwives, Midwivaes residing at York House Training Home and Salvation Army Midwives for the year 1952:— County Midwives Midwives Residing at York House Training Home Salvation Army Midwives Births Attended: As Midwife 347 269 58 As Maternity Nurse 57 14 3 Miscarriages Attended (included in above) 7 31 5 Visits Paid: As Midwife 7,332 7,230 1,277 As Maternity Nurse 852 284 533 Ante-Natal 3,365 3,256 323 Ante-Natal Clinics Attended 750 311 78 Gas and Air Administered: As Midwife 175 211 49 As Maternity Nurse 31 10 2 33 Dental Treatment The following particulars relate to dental treatment provided for mothers and young children:— Expectant or Nursing Mothers Children Under Five Years of Age Number of patients examined 126 177 Number of patients needing treatment 123 174 Attendances for treatment 203 292 Number of patients who have completed treatment 114 162 Number of Extractions 1,020 485 Number of Fillings 60 15 Number of Anaesthetics administered: (a) local 2 — (b) general 204 297 Number of Scalings or scaling and gum treatment 38 – Number of Silver Nitrate treatment 1 15 Number of Dressings 5 — Number of X-ray examinations 3 2 Number of Dentures provided: (a) full 48 — (b) partial 19 — 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 16 Total 43 34 Total Attendances at Nurseries for 1952:— Goresbrook Nursery Under 2 years of age 3,410 Over 2 „ „ „ 9,335 Chadwell Heath Nursery Under 2 „ „ „ 2,196 Over 2 „ „ „ 8,186 Kingsley Hall Nursery Over 2 „ „ „ 8,205 Total 31,332 Premature Infants Live premature births occurring in the Area:— 21bs. 3ozs. or less 21bs. 4ozs.31bs. 4ozs. 31bs. 5ozs.41bs. 6ozs. 41bs. 7ozs.41bs. 15ozs. 51bs.51bs. 8ozs. Born alive at home and nursed entirely at home — — 2 6 29 Born alive at home and transferred to hospital 2 2 2 1 3 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 — — — — — — 1 — — — 4 1 1 3 5 1 4 1 3 1 1 — 19 7 2. Tuberculosis, other — — — — — — — 1 — 2 — — — — — 1 — — — — — — — 4 3. Syphilitic disease — — — — — — — — — — — — — — — — — — 2 — — 1 2 1 4. Diphtheria — — — — — — — — — — — — — — — — — — — — — — — — 5. Whooping Cough — — — — — — — — — — — — — — — — — — — — — — — — 6. Meningococcal infections 1 — — — — — — — — — — — — — — — — — — — — — 1 — 7. Acute Poliomyelitis — — — — 1 — — — — — — — — — — — — — — — — — 1 — 8. Measles — — — — — — — — — — — — — — — — — — — — — — — — 9. Other infective and parasitic diseases — — — — — — — — — — — — — — — — — — — — — 1 — 1 10. Malignant neoplasm, stomach — — — — — — — — — — — — 1 3 7 2 5 1 3 1 — 1 16 8 11. Malignant neoplasm, lung, bronchus — — — — — — — — — — — — — — 9 1 11 — 5 — 1 1 26 2 12. Malignant neoplasm, breast — — — — — — — — — — — — — 2 — 5 — 4 — 8 — — — 19 13. Malignant neoplasm, uterus — — — — — — — — — — — — — — — 3 — 4 — 1 — — — 8 14. Other malignant and lymphatic neoplasms — — — — — — 1 1 — 1 1 1 — 3 5 4 14 13 17 11 9 5 47 39 15. Leukaemia, aleukaemia — — — — 1 1 — — — — 1 — — 1 — — 2 — — — — — 4 2 16. Diabetes — — — — — — — — — — — — — — — — — 1 1 1 — 1 1 4 17. Vascular lesions of nervous system — — — — — — — — — — — 1 1 1 — 7 17 8 14 9 16 22 48 48 18. Coronary disease, angina — — — — — — — — — — 1 — — — 9 1 15 2 17 6 4 3 46 12 19. Hypertension with heart disease — — — — — — — — — — — — — — 2 1 — 3 3 6 8 5 13 15 20. Other heart disease — — — — — — — — 1 — 2 — 3 1 3 3 8 7 15 4 13 21 45 36 21. Other circulatory disease — — — — — — — — — — — 1 1 — 3 1 8 3 3 5 12 12 27 22 22. Influenza — — 1 — — — — — — — — — — — — — — — 1 — — — 2 — 23. Pneumonia 4 1 — 1 1 — 2 1 — — — — — — 1 1 5 2 3 1 3 4 19 11 24. Bronchitis 2 — — — — — — — — — — — 1 — 3 — 13 5 22 6 11 13 52 24 25. Other diseases of respiratory system — — — — — — — — — 1 1 — — — — — 2 — 1 — — — 4 1 26. Ulcer of stomach and duodenum — — — — — — — — — — — — 1 — 1 1 2 — 3 — — — 7 1 27. Gastritis, enteritis and diarrhoea 1 3 — — — — — — — — 1 — 1 — — — — — — — 1 — 4 3 28. Nephritis and nephrosis 1 — — 1 1 — — — — — — — — — 2 2 2 2 1 3 1 2 8 10 29. Hyperplasia of prostate — — — — — — — — — — — — — — — — 2 — 2 — 1 — 5 — 30. Pregnancy, childbirth and abortion — — — — — — — — — — — — — — — — — — — — — — — — 31. Congenital malformations 7 5 — — — — — — — 1 — — — — 1 — — 1 — — — — 8 7 32. Other defined and ill-defined diseases 11 8 1 — — — 1 1 1 1 2 2 2 5 4 6 10 6 5 4 8 15 45 48 33. Motor vehicle accidents — — — — — — — — 1 — 3 — — — 1 1 — — — — — 1 5 2 34. All other accidents 1 — — — — — — — 1 — 1 — — 2 — — 2 — 3 1 — 5 8 8 35. Suicide — — — — — — — — 1 — 1 — — 1 — 1 1 — 1 — — 1 4 3 36. Homicide and operations of war — — — — — — — — — — — — — — — — —. — — — — — — — 28 17 2 2 4 1 5 5 5 6 18 6 12 22 56 42 123 63 125 68 89 114 467 346 This total is 13 less than the figure returned by the Registrar General due to the loss in transit of a number of Inward Transfers.