1MR CMANA DW 5B ICE 411(1)DAGEMAM DAG 27 BOROUGH OF DAGENHAM ANNUAL REPORT of the Medical Officer of Health for the year 1953 CECIL HERINGTON, M.D. [Lond.], D.P.H BOROUGH OF DAGENHAM ANNUAL REPORT of the Medical Officer of Health for the year 1953 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 twentieth Annual Report I think it opportune to invite your attention to a retrospect of the conditions obtaining when I took up my duties in Dagenham. I would however, make it very clear that the vastly improved state of the health of the people cannot fairly be attributed to any one cause, still less to any one individual. Population 98,710, number of inhabited houses 21,918, rateable value £484,108, product of a penny rate £1,875, deaths attributable to childbirth seven, deaths from measles 21, whooping cough seven. 124 infants in their first year died, giving an infant mortality rate of 63.98 per 1,000 live births, the infant mortality rate for illegitimate infants was 136.36 per 1,000 illegitimate live births. There were 337 cases of diphtheria, of these 34 were fatal, 755 cases of scarlet fever were notified with one death. Deaths from tuberculosis 48. That was what happened in 1934. Turning to 1953 we find the following: Population 114,000, number of inhabited houses 29,591, rateable value £694,806, product of a penny rate £2,819, deaths attributable to childbirth nil, deaths from measles nil, whooping cough nil. 49 infants died in their first year giving an infant mortality rate of 27.28 per 1,000 live births, the infant mortality rate for illegitimate infants was 30.77 per 1,000 illegitimate live births. There was one case of diphtheria (unimmunised) who recovered. 236 cases of scarlet fever were notified, all recovered. Deaths from tuberculosis 22. INTEGRATING OF HEALTH SERVICES. With regard to the integration of the local health services with the general medical and hospital and specialist services, the Chairman of the Health Area Sub-Committee is a member of. the Local Executive Council and also of a Hospital Management Committee the catchment area of which covers a large part of the Borough of Dagenham; additionally the Area Medical Officer, who is also the Medical Officer of Health, is a member of a Hospital Management Committee which covers the remainder of the Borough. CONTACTS OF TUBERCULOSIS. A contacts register is kept in the department and all contacts of known cases are encouraged to submit themselves to the Chest Physician. These contacts are followed up and visited from time to time by the Health Visitors. They are kept under serveillance as long as is deemed necessary by the Chest Physician. 4 MASS MINIATURE RADIOGRAPHY. The Mass Miniature Radiography Unit visited the Area in the Autumn of 1953 and some 5,300 persons were X-rayed; this was apart from visits paid by the Unit to large factories in the Borough. During the past year occasion has not arisen for instituting any special tuberculosis case-finding surveys. LAUNDRY SERVICE FOR THE INCONTINENT AGED. The Public Health Act 1936, Section 84, dealing with the cleansing of filthy articles gives power to Local Sanitary Authorities to cleanse at the Authority's expense any article which, upon a certificate of the Medical Officer of Health or Sanitary Inspector, requires to be cleansed in order to prevent injury or danger to the health of any persons in the premises. Aged people who may be neither sick nor well are often incontinent and the provision of a municipal laundry service (within the terms of Section 84) for such persons is of great benefit. It will, of course, be appreciated that private laundries offer no facilities for these cases. With the co-operation of the Ilford and Barking Hospital Management Committee the Council were able to inaugurate a service in December, 1953. Only bedding and personal clothing which have been soiled with excreta or urine are accepted for laundering. A small covered metal bin is provided for use at each home and after soiled articles have been rinsed and hand wrung they are placed in the bin to await collection. Soiled articles are collected and laundered articles returned each Monday. Wednesday and Friday morning. At the time of writing this report 21 cases have been helped by the service; 11 of these have died, 5 have been removed to hospital and 5 are still participating; the number of articles laundered is 3,445. SLAUGHTERHOUSES. Prior to the Ministry of Food taking over control of slaughtering in 1940, there were four slaughterhouses operating in the Borough. At that time applications under Section 57, Food and Drugs Act 1938, in respect of each slaughterhouse, had already been considered. Two licences were granted but in the intervening years the licences have lapsed (one of the premises was destroyed by enemy action the other has been utilised for a different purpose). Of the remaining two premises one application was refused as the premises were considered altogether unsuitable, and consideration of the other was deferred pending repairs and alterations. 5 With the return to private slaughtering applications have recently been received to use the two latter premises; both have been refused as the premises are not suitable and it is not considered to be reasonably practicable to render them suitable. The needs of the local butchers appear to be amply met by the facilities available in London. VACCINATION AND IMMUNISATION. I regret to say that the vaccination rate in Dagenham is extremely low. In fact it is the lowest of the eleven areas in the county. The acceptance rate for children under one is 15.9 per cent of live births. In the Administrative County of London it is 48.1 per cent. We have fortunately, and I repeat fortunately, been free from Smallpox in Dagenham for a number of years, but our proximity to debarkation points coupled with a highly susceptible population puts us in jeopardy. A brighter picture is presented when the position of active immunisation against Diphtheria is examined. In all 1,337 children were immunised and 1,157 received boosting doses. These figures when aggregated exceed those for the previous year by 376. Immunisation was introduced in Dagenham as far back as 1930, peaceful persuasion (and penetration!) has been sustained ever since. The steep downward curve of the incidence of Diphtheria demonstrates very clearly the effectivity of this form of active prevention. Now that the compulsory element has been removed (by the National Health Service Act 1946) from vaccination against Smallpox it is our earnest hope that peaceful persuasion will prevail (No penetration is required, only a superficial scratch). To the Members of the Council, with whom I have had the honour to have been associated for twenty years, I offer my sincere thanks, for their interest in the work of the Department. Many changes have taken place and many things have happened since 1934. New functions, e.g., Midwives Acts and Food and Drugs, have been entrusted to the Corporation, some functions have been transferred to the County Council and legislation has extended the duties of Local Authorities in many directions. Dagenham has always exercised all the (health) powers permitted by law. It will be recalled that the Day Foster Mother Scheme introduced in Dagenham in 1937 with the blessing of the then Minister of Health has since, with some slight modifications been applied to the country as a whole in the guise of the Nurseries and Child Minders Regulation Act 1948. The present Members of the Council and their predecessors have always been health conscious; this attitude of mind has been much to the benefit of the health of our community and has been an important factor in facilitating the work of my department. 6 It has been my privilege to work with a competent, conscientious and loyal team for many years. I claim that we have always been a "happy ship" and it is my earnest hope that this viewis shared by all my colleagues. I extend to them individually and collectively, my grateful thanks. In the passage of time my conviction has strengthened that goodwill should be the watchword in administration. It is necessary, on occasions, to resort to enforcement and it is helpful to have the knowledge that if persuasion fails there are other methods. Much can, however, be achieved by goodwill alone, and further, and most important of all, neither party is left with a sense of grievance. I end on this note. I am, Mr. 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, 1953) Mayor: Councillor A. KEMPSON, J.P. Deputy Mayor: Alderman (Mrs.) E. M. MILLARD Aldermen: W. E. BELLAMY F. GR1NDROD. J.P. F. BROWN, E.C.C D. O'DWYER L. F. EVANS (Mrs.) A. E. PRENDERGAST (Mrs.) M.B.E., J.P., E.C.C. C. PRENDERGAST Councillors: S. F. BANKS R. BLACKBURN J. BOWLES G. A. BROOKER E. A. BROWNE R. F. BURSILL F. G. BYRNE G. H. A. CROUCH M. EALES A. S. HADDOCK J. P. HOLLIDGE, J.P., E.C.C. B. L. HOLLINGSWORTH, B.Sc., Ph.D., A.R.I.C. L. R. JONES, B.Sc. J. F. MOULTRIE, F.A.I. B. M. ROADKNIGHT (Mrs.) J. SCOTT L. S. SNELLING (Mrs.), E.C.C. A. R. THOMAS (Mrs.) D. THOMAS F. G. THOMAS L. W. TODD S. J. C. WARR M. WARREN (Mrs.) PUBLIC HEALTH COMMITTEE Alderman (Mrs.) A. E. PRENDERGAST, Chairman Councillor S. J. C. WARR, Vice-Chairman His Worship the Mayor (Councillor Councillor M. EALES A. KEMPSON, J.P.) The Deputy Mayor (Alderman Councillor (Mrs.) E. M. MILLARD) (Mrs) B. M. ROADKNIGHT Alderman D. O'DWYER Councillor (Mrs.) M. WARREN 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: Councillor A. KEMPSON, J.P. The Deputy Mayor: Alderman (Mrs.) E. M. MILLARD Alderman F. BROWN Alderman D. O'DWYER Councillor J. BOWLES Councillor R. F. BURSILL Councillor M. EALES Councillor A. S. HADDOCK Councillor (Mrs.) B. M. ROADKNIGHT Councillor J. SCOTT Councillor (Mrs.) A. R. THOMAS Councillor F. THOMAS Councillor S. J. C. WARR Councillor (Mrs.) M. WARREN County Council Alderman (Mrs.) M. BALL Councillor (Mrs.) M. EREDO Councillor E. R. D. De ROUGEMONT Councillor W. HERRIDGE Councillor L. F. SAUNDERS Councillor (Mrs.) E. SAYWOOD Councillor Dr. C. SKINNER 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 N. L. ODELL, Miss A TOLD 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) F. COLLINS (5, 6, 7) Health Visitors: (C) M. E. ALLAM (5, 7) I. A. BARROW (5, 6, 13) L. DUNBAR (5, 6, 7) A. K. GIBSON (5, 6, 7) D. GORDON (5, 6, 7, 9, 10, 14) D. HICKEY (5, 6, 7) J. M. J. MORGAN (5, 7) E. RICHARDS (5, 6, 7) L. SALTER (5, 6, 7) D. B. STEWART (5, 6, 7) J. E. THOMAS (5, 6, 7, 10, 14) E. VALENTINE (5, 6, 7, 12) R. E. WALKER (5, 6, 7, 12, 13) L. WARR (5,3) 10 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) M. M. RICHARDS (6) M. LEATHER (5, 6) Clerical Staff: Chief Clerk: (C) F. W. KNIGHT (1, 2) Clerk to Sanitary Inspectors: G. DOVEY Clerks: E. ADAMS (C) I. M. BISHOP (C) M. A. BRIDESON (C) N. E. CLOKE (C) S. DOWDING (C) L. M. FREESTONE (C) M. GOODCHILD (C) G. K. HARRIS B. ISBELL (C) S. B. LEADER (C) F. H. MARTIN (C) (16) L. A. MOORE (C) E. NEPORT (C) E. NEALE (C) I. PAGE (C) J. POWELL K. RICHARDS (C) G. SHANNON (C) D. TYLER (C) M. A. WATTS (C) Day Nurseries: (C) Goresbrook Nursery, Dagenham Avenue, Dagenham. Chadwell Heath Nursery, Ashton Gardens, Chadwell Heath. Kingsley Hall Nursery, Parsloes Avenue, Dagenham. MATRON: E. MADDISON (12) DEPUTY: K. GRAHAM (8) MATRON: I. MUSGRAVE (8) DEPUTY: P. HEINSON (15) WARDEN: D. HOWES Domestic Help Organiser: (C) G. HICKINBOTHAM Chiropodists: (C) N. FREEMAN M. KELLY (11) 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 The rapist: 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, 1953 114,000 Number of inhabited houses (end of 1953) according to Rate Books 29,591 Rateable value (December 31st, 1953) £694,806 Sum represented by a penny rate (approximate 1953-54) £2,819 Extracts from Vital Statistics for the Year. Live Births:— Legitimate Illegitimate Stillbirths Legitimate Illegitimate Deaths Total 1,731 65 Male 892 35 Female 839 30 Birth rate per 1,000 of the estimated resident population, 15.75. 37 1 17 20 1 Rate per 1,000 total (live and still) births, 120.72. 766 438 328 Death rate per 1,000 of the estimated resident population, 6.72. 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 27.28 Legitimate infants per 1,000 legitimate live births 27.15 Illegitimate infants per 1,000 illegitimate live births 30.77 Deaths from Cancer (all ages) 167 ,, ,, Measles (all ages) Nil Whooping Cough (all ages) Nil ,, ,, Gastritis, Enteritis and Diarrhoea (all ages) 10 13 Births. 1,796 live births were registered during the year, there being 927 males and 869 females. There is an increase of total births from 1,708 in 1952 to 1,796. The corrected birth rate per thousand population was 14.33 compared with 15.5 for England and Wales and 17.0 for the 160 large towns, including London, and is the same as that for 1952. The illegitimate birth rate continues to be very low, being only 3.62 per cent. of total births. The rate of illegitimate stillbirths is 2.63 per cent. of total stillbirths Death Rate. Total deaths in district 574 Outward transfers 141 Inward transfers 334 Deaths of residents 767 Of the 141 deaths of non-residents occuring in the district 10 took place at the Dagenham Hospital and 121 at Rush Green Hospital. Of the 334 deaths of local residents taking place outside this area, most occurred in institutions. Of these 193 occurred at Oldchurch Hospital; 16 at King George Hospital; 16 at the London Hospital; nine at the Ilford Isolation Hospital; seven at Harold Wood Hospital; five at the Barking Hospital; four at St. Joseph's Hospice; four at Victoria Hospital, Romford; four at Whipps Cross Hospital and four infants at the East End Maternity Hospital. The crude death rate of 6.72, when corrected becomes 11.02 and compares with 11.4 for England and Wales. 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 1953. 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 15.5 0.35 11.4 0.00 0.00 0.01 0.00 0.16 1.1 26.8 160 County Boroughs and Great Towns, including London 17.0 0.43 12.2 0.00 0.00 0.01 0.00 0.15 1.3 30.8 160 smaller towns (1951 Census) resident population 25,000-50,000 15.7 0.34 11.3 — 0.00 0.00 0.00 0.17 0.9 24.3 London 17.5 0.38 12.5 — — 0.00 — 0.15 1.1 24.8 Dagenham (Corrected) 14.33 0.34 11.02 — — — - 0.07 3.34 27.28 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. 34 1 Weekly Thursday, p.m. 39 2 Becontree Clinic, Becontree Avenue, Dagenham. Weekly Monday, p.m. 42 3 Weekly Tuesday, a.m. 23 2 Weekly Tuesday, p.m. 53 4 Weekly Wednesday, p.m. 29 1 The Leys Clinic, Ballards Road, Dagenham. Weekly Thursday, a.m. 29 1 Weekly Thursday, p.m. 34 2 Rush Green Clinic, 179 Dagenham Road, Rush Green. (2nd, 4th & 5th in month) Friday, a.m. 13 1 Weekly Friday, p.m. 28 1 The Clinic, Ford Road, Dagenham. Weekly Tuesday, a.m. 56 3 Weekly Tuesday, p.m. 55 3 Weekly Friday, a.m. 23 2 The Clinic, Manford Way, Hainault. Weekly Monday, p.m. 29 2 London City Mission Hall Dagenham Road, Dagenham. Weekly (Commenced Wednesday, p.m. 30 2 1 . 4 . 53) Weekly Thursday, a.m. 27 1 Weekly Thursday, p.m. 50 3 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. 10 2 The Clinic, Becontree Avenue, Dagenham. Weekly Tuesday, p.m. 12 2 Weekly Wednesday, a.m. 9 1 Weekly Friday, p.m. 12 2 The Leys Clinic, Ballards Road, Dagenham. Weekly Tuesday, a.m. 7 1 Weekly Wednesday, a.m. 10 1 Rush Green Clinic, 179 Dagenham Road, Rush Green. (1st & 3rd in month) Friday, a.m. 10 2 York House, Frizlands Lane, Dagenham. Weekly Tuesday, a.m. 21 3 Weekly Wednesday, p.m. 24 3 Weekly Thursday, a.m. 16 2 Weekly Thursday, p.m. 12 2 The Clinic, Ford Road, Dagenham. Weekly Monday, a.m. 20 3 Weekly Monday, p.m. 23 2 The Clinic, Manford Way, Hainault. Weekly Monday, a.m. 8 1 17 Sanitary Inspection of the District Report of the Sanitary Inspectors. (a) Nature and number of visits:— Overcrowding and Housing Conditions 1,346 Nuisances under Public Health Acts— Dwelling-houses 4,671 Other Premises 713 Bakehouses 69 Milkshops and dairies 87 Foodshops, stalls and itinerant vendors 2,412 Cafes and canteens 689 Infectious disease enquiries 917 Visits to foster-mothers' premises 176 Number of complaints investigated 1,095 Outworkers' premises 118 Workplaces and offices 43 Rag Flock, etc 42 Tents, vans and sheds 372 Stables 17 Pet shops 49 Hairdressers' and barbers' premises 91 Shops Act 156 Ice Cream premises and vehicles 389 Houses disinfested 43 Other Visits 68 (b) Notices served:— Statutory 198 Informal 607 Complied with 170 496 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 29,569 7 1,520 31,120 Number of properties inspected as a result (a) of notification 4 127 75 206 (b) survey 14 284 — 179 477 (c) otherwise 3 33 4 601 641 Number of properties found to be infested by rats: Major — — — — — Minor 2 75 — 24 101 Number of properties found to be seriously infested by mice 4 65 60 129 Number of infested properties treated by the Local Authority 6 140 — 84 230 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 21 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 action 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 Length 6" 4" 3" Portland Gardens 87 Eastbrook Avenue 12 Dagenham Road 13 Marks Gate Estate 70 472 70 Manor Road 207 Whalebone Lane South 49 Total 70 yds. 840 yds. 70 yds. 408 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 3,800 chemical, bacteriological and biological examinations have been made during the year. " All water going into supply was wholesome." National Assistance Act, 1948—Section 47 It was necessary to issue a certificate under the Amendment Act 1951 to obtain the compulsory removal of an elderly woman living alone. At the end of the statutory period of three weeks the Patient willingly remained in the institution. 20 in other cases the voluntary agreement of the person was eventually obtained and removal arranged through the County Welfare Department. Tents, Vans and Sheds A licence under Section 269 was granted in respect of a caravan to stand on a site on which the occupant was erecting his own bungalow. An application in respect of a site at which the sanitary accommodation and drainage tacilities were considered inadequate was refused. Rag Flock and Other Filling Materials Act, 1951 Three premises have been registered under Section 2 of the Act. One licence for the manufacture and one licence for the storage of rag flock have been issued. After careful overhaul of the various processes in the production of rag flock, the manufacturer who previously was finding difficulty in complying with the soluble impurities test (permitted maximum 1.8%) has solved his problem and all recent samples have been satisfactory. The attention of a manufacturer was drawn to the misdescription of material as "50% Wool Felt." It was pointed out that the Regulations required woollen felt to contain not less than 85% of animal fibre and woollen felt mixture not less than 60%. It was suggested that the material in question should be described as "Rag Flock layered." The manufacturers eventually agreed to alter the description. Samples taken during the year were as follows:— Material Satisfactory Not Satisfactory Rag Flock 3 1 Cotton Felt 3 — Kapok 4 — Kapok mixed with cotton 1 — Woollen Felt — 1 Woollen Mixture Felt 3 — Pet Animals Act, 1951 Five licences authorising the keeping of pet shops have been renewed. 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. 21 FACTORIES ACTS, 1937 & 1948 Inspections. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Factories without mechanical power 20 27 2 — Factories with mechanical power 148 340 25 — Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 18 26 2 TOTAL 186 393 29 — Defects Found. No. of defects No. of Prosecutions instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness - - - - - Overcrowding — — — — — Unreasonable temperature 1 1 — 1 Inadequate ventilation — — — — Ineffective draining of floors — — — — Sanitary Conveniences:— Insufficient 6 3 — — Unsuitable or defective 27 27 — 4 Not separate for sexes — — — — Other Offences 20 13 8 1 — TOTAL 54 44 8 6 — Outwork No. of out workers in August list 16 Nature of work Making, etc., wearing apparel. 22 FOOD AND DRUGS ACT, 1938 Analyses Article Number Examined Number Adulterated, etc. Formal Informal Formal Informal Almonds, Ground 1 2 - - Bread 1 — 1 Cakes 1 2 — — Cake Flour — 1 — — Cake and Pudding Mixtures 1 1 — — Celery Cheese Spread — 1 — — Cheese Spread — 3 — — Cherries (tinned) — 1 — 1 Cherries, Glace — 1 — — Cinnamon, Ground — 1 — — Coffee Preparation — 1 — — Condiment, Non-brewed — 2 — — Cream — 3 — — Custard Powder — 1 — — Fat — 2 — 1 Fish Cake 1 — — — Fruit Pie — 1 — 1 Frying Oil — 1 — — Gelatine 1 — — — Ginger, Ground — 1 — — Herbs 1 2 — Ice Cream — 9 — — Iced Squares — 1 — Iced Lollies — 7 — — Jam — 4 — — Jellies 1 — — — Lemonade Crystals and Powder 1 2 — — Meat Pie — 6 — — Medicinal Samples 1 5 — — Milk 49 3 4 3 Milk Bottle — 1 — — Milk Powder—Skimmed — 1 — — Mincemeat — 2 — -— Nutmeg, Ground 1 — — — Olive Oil 1 — — — Paste — 6 — — Peel, Mixed — 1 — — Pepper — 1 — Pepper, Flavoured Compound — 1 — — Sandwich Spread — 1 — — Sauces — 2 — — Sausages 31 1 — 1 Sausage Meat 1 — — — Soup — 1 — — Soya Flour 1 — — - Suet, Shredded 1 4 — — Sugar — 2 — — Sugar Sack 1 — - Sweets 1 5 — 1 Vinegar 2 3 — - Welsh Rarebit - 1 - - 23 Adulterated Samples, etc. Serial No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 2032 Milk Formal 6% deficient in fat. Milk sampled in course of delivery. 2035 Milk Formal 7% deficient in fat. Samples taken in course of delivery — results referred to local Authority in whose area the farm is situate. 2037 Milk Formal 1% deficient in fat. 2048 Milk, Channel Island Formal 5% deficient in fat of the special standard of 4%. Referred to Milk Division of the Ministry. 1198A Fruit Pie Informal Contained a black weevil 3/8" in length which was well embedded in the pastry casing. Manufacturers warned. 1199A Bread, Pieces of Informal Contained foreign matter which was found to be cotton waste. Vendor warned. 1211A Pork Sausage Informal A portion of cooked sausage showed presence of small greyish black discoloured patches which were found to be iron. Vendor warned. 1227A Milk Informal Contained foreign matter and consisted mainly of fat. The bottle was discoloured due to small fragments of metallic iron adhering to the sides of the bottle. Vendor warned. 1242A Cherries (tinned) Informal Had an objectionable metallic smell and distinct metallic taste. No action possible. (Unable to trace vendor.) 1250A Fat Informal Had a dirty appearance due to the pre, sence of miscellaneous dirt of the nature of quartz sand and coal dust. Unable to prove for human consumption. 24 Adulterated Samples, etc.—continued. Serial No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 1251A Milk Informal Contained 1.2 grammes of a blackish deposit consisting of fragments of coal dust and miscellaneous earthy and gritty matter. Also included four fragments of glass. Vendor warned. 1270A Chocolate Informal Filling had fermented —not suitable for human consumpttion. Vendor warned. Stock withdrawn from sale. 1271A Milk Informal Contained a piece of cabbage leaf or sprout. Vendor warned. Clean Food Campaign The numbers and types of food premises in the Borough are as follows:— 7 Bakehouses 22 Bakers and Confectioners 60 Butchers 64 Cafes 63 Canteens 29 Fishmongers 50 Fruiterers and Greengrocers 110 Grocers 19 Licensed Premises 9 Off-licensed Premises 90 Sweets, etc. All food premises are regularly inspected and during the year 3,600 visits were paid. In addition to numerous requests and suggestions during these routine visits, 32 informal notices were served upon owners or occupiers. Legal proceedings under Section 13 were taken against a cafe proprietor in respect of dirty walls and ceilings. There was a fine of £10 on each of three summonses. The number of premises registered under Section 14, apart from those in respect of ice cream, is as follows:— Out of a total of 60 butchers' premises 40 are registered for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food. To these, 836 visits were paid. 25 Out of a total of 29 fish shops 22 are registered for fish frying. To these, 374 visits were paid. Lectures have been given to members of several local organisations. With the co-operation of the Ministry of Agriculture and Fisheries, Infestation Control Division and the County Council a stand was erected at the Dagenham Town Show. Although the attendance on the two days was affected by the bad weather the exhibit proved very attractive and few people passed the stand without a close-up inspection. Unsound Food Numerous complaints were received in respect of articles of food containing a variety of foreign substances. Warning letters were sent in most cases. The normal method of disposing of unsound food is to use the incinerator at the Council's refuse disposal works. Occasionally, when there is a quantity of meat, it is disposed of through the Council's waste food service; the meat is previously cut up and dyed. Milk Under the provisions of The Milk and Dairies Regulations 1949, eight premises are registered as dairies (including one dairy where milk is pasteurised and bottled) and 68 persons with premises in the Borough are registered as distributors. 87 visits were paid to these premises. During the year 67 samples of milk were submitted for bacteriological examination. Two samples of pasteurised milk failed to pass the Methylene Blue Test. Ice Cream The total number of premises in the Borough registered under the provisions of Section 14, Food and Drugs Act 1938 is 153; of this number two are registered for the manufacture of ice cream. 327 visits were paid to such premises. During the year 12 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 ice cream are required to have enclosed vehicles and carry suitable washing facilities. 62 inspections in connection with itinerant vendors were carried out. Bacteriological Sampling. During the year 42 samples of ice cream were submitted for examination. They were graded as follows: — Grade I Grade II Grade III Grade IV Total 26 14 1 1 42 26 In addition 28 samples of ice lollies were submitted for examination; five were unsatisfactory. In each case the lollies were manufactured outside the Borough. The local authorities concerned were notified. Food Poisoning Outbreaks During the year 8 cases of food poisoning were notified; in only 2 single cases were the causative organisms identified. It will be interesting to see what effect de-rationing of meat has on the incidence of food poisoning. The expected reduction of made-up meat dishes, which are common causes of alimentary infections, gives hope for a diminished incidence of this condition. 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 20 37 152 16 6 4 236 Whooping Cough 76 189 205 286 8 I 1 766 Acute Poliomyelitis:— Paralytic — — 2 — —- 2 4 Non-Paralytic 1 — — — 1 4 6 Measles 41 230 359 456 14 9 3 1,112 Diphtheria — — 1 — — 1 Under 5 years 5-14 15-44 45-64 65 and over Total Pneumonia:— Acute Primary 8 5 9 12 6 40 Acute Influenzal 1 3 4 3 11 Dysentery 4 11 8 1 24 Encephalitis. Acute:— Infective 1 — 1 — 2 Post-Infectious - - - - - — Enteric Fever - - - - - — Paratyphoid Fever — — — — — — Erysipelas 2 — 5 8 3 18 Meningococcal Infection 3 — — — — 3 Food Poisoning 2 2 4 — — 8 Puerperal Pyrexia — — 7 — — 7 Ophthalmia Neonatorum 14 — — — — 14 Pemphigus — — — — — — Malaria (Foreign Origin) — — 4 — — 4 Smallpox — — — — - 27  Notified Admitted to Isolation Hospital, Rush Green Admitted to other Isolation Hospitals Admitted to other Hospitals Registered Deaths Diphtheria 1 1 - — Dysentery 24 — 2 2 — Encephalitis, Acute 2 1 - 1 1 Enteric Fever — — — Erysipelas 18 1 2 — — Food Poisoning 8 1 1 — — Malaria 4 2 1 — — Measles 1,112 5 7 4 — Meningococcal Infection 6 1 1 — 1 Ophthalmia Neonatorum 14 2 - 1 1 Paratyphoid Fever — - — - Pemphigus — - - - — Puerperal Pyrexia 7 4 - 2 — Pneumonia: — Acute Influenzal 11 1 — 1 41 Acute Primary 40 o 4 1 2 Poliomyelitis, Acute:— Paralytic 4 4 — — 1 Non-Paralytic 6 4 2 — Scarlet Fever 236 17 8 3 — Smallpox — — — — — Whooping Cough 766 7 11 2 — DIPHTHERIA IMMUNISATION The following is a summary of the work carried out during the year:— Age (in years) at final injection Children immunised without preliminary testing Children who received a boosting dose Under 1 462 — 1 — 4 384 10 5— 9 106 635 10 — 14 14 276 Total 966 921 Immunisation by General Practitioners. Age (in years) at final injection Children immunised without preliminary testing Children who received a boosting dose Under 1 156 — 1 — 4 182 15 5 — 9 27 190 10 — 14 6 31 Total 371 236 WHOOPING COUGH IMMUNISATION The number of children who received protective doses against Whooping Cough was 423, the majority of these being between the ages of one and four years. 28 VACCINATION CARRIED OUT BY GENERAL PRACTITIONERS Vaccinated. Age at date of vaccination Under 1 286 1—4 51 5 — 14 41 15 or over 77 Total 455 Re-Vaccinated. Age at date of re-vaccination Under 1 — 1—4 4 5 — 14 8 15 or over 87 Total 99 TUBERCULOSIS New Casee 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— — 4 — — — 1 — — — 5— 3 3 1 3 2 — — 1 — 1 — 1 10— — 1 2 1 - - - - - 1 — — 15— 3 1 1 1 1 - - - - - — — 20— 7 6 — — 2 2 1 — — 1 — — 25— 14 4 — 1 7 4 2 2 — - — — 35— 7 2 3 — 4 2 — 4 - - — 45— 5 2 1 2 — 1 — 3 1 - — 55— 8 - - - 2 - - - 2 - - — 65—and upwards 2 1 1 2 - _ - 5 - — 49 24 8 9 20 10 3 3 14 7 — 1 29 Register. Pulmonary Non-Pulmonary Male Female Male Female No. on register 1st January, 1953 521 444 71 76 During the year:— New notifications 49 24 8 9 New cases brought to notice by Registrars' Deaths Returns 5 1 Deaths 14 7 1 Transfers into area 15 10 3 2 Transfers out of area 22 33 3 1 Removed from register as "Recovered" 19 23 4 4 No. on register 31st December, 1953 535 415 75 82 MATERNITY AND CHILD WELFARE Notification of Births 1,958 notifications of live births were received during the year. This number includes 152 children who were born in Rush Green Hospital but whose normal residence is not within the Borough. Stillbirths 18 male and 21 female stillbirths were notified, the corresponding figures for registration being 17 and 21. The rate per 1,000 of total population registered was 0.34, the rate for England and Wales being 0.35. Infant Mortality 49 infants under one year of age died during the year, giving an infant mortality rate of 27.28 per 1,000 live births compared with that of 26.8 for England and Wales and 24.8 for London. The rate amongst legitimate children was 2715 while for illegitimate children it was 30.77. Ophthalmia Neonatorum 14 cases of this disease were notified, all made complete recoveries. There were 51 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. 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 392 Total visits 614 (b) To children under 1 year of age First visits 1,965 Total visits 3,576 (c) To children between the ages of 1 and 5 years Total visits 11,116 (d) Ineffective visits Total visits 3,732 (e) Other visits Total visits 1,807 Grand Total 20,845 Domiciliary Midwifery Service The following is a summary of the reasons for sending for medical aid by midwives:— Perineal Tear 116 Discharging Eyes 54 Post-Partum haemorrhage 20 Prolonged Labour 17 Rise of Temperature 16 Malpresentation 14 Threatened Miscarriage 13 Early Rupture of Membranes 11 Miscarriage 9 Ante-Partum Haemorrhage 8 Unsatisfactory Condition of Infant 8 Toxaemia 6 Inflammation over Veins in Leg 6 Adherent Placenta 5 Jaundice 5 Persistent Vomiting 4 Septic Spots 4 High Blood Pressure 4 Threatened Abortion 3 Premature Baby 3 Premature Labour 3 Bleeding per Vagina 3 Phlebitis 3 Albuminuria 2 Rash on Baby 2 Cyanosed Infant 2 Other Causes 51 392 31 Notices summoning medical aid 392 For (a) Mothers 291 For (b) Infants 101 Notifications that they had been associated with the undermentioned conditions were received from domiciliary midwives:— Substitution of artificial feeding 40 Liable to be sources of infection 4 Stillbirths 7 Laying out dead body 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 1953:— County Midwives Midwives Residing at York House Training Home Salvation Army Midwives Births Attended: As Midwife 262 280 59 As Maternity Nurse 89 7 1 Miscarriages Attended (included in above) 7 25 2 Visits Paid: As Midwife 6,185 7,400 1,675 As Maternity Nurse 1,050 384 32 Ante-Natal 3,079 1,026 329 Ante-Natal Clinics Attended 630 310 51 Gas and Air Administered: As Midwife I50 209 55 As Maternity Nurse 59 7 1 32 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 192 197 Number of patients needing treatment 176 179 Attendances for treatment 261 255 Number of patients who have completed treatment 110 133 Number of Extractions 521 260 Number of Fillings 53 80 Number of Anaesthetics administered: (a) local 85 45 (b) general 119 133 Number of Scalings or scaling and gum treatment 25 — Number of Silver Nitrate treatment — 6 Number of Dressings 4 6 Number of X-ray examinations 2 — Number of Dentures provided: (a) full 33 — (b) partial 23 — 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 4 Nursery Assistants 9 Nursery Students 8 Total 28 33 Total Attendances at Nurseries for 1953: Goresbrook Nurseiy Under 2 years of age 2,829 Over 2 ,, ,, ,, 5,653 Chadwell Heath Nursery . Under 2 ,, ,, ,, 2,070 Over 2 ,, ,, ,, 7,042 Kingsley Hall Nursery Over 2 ,, ,, ,, 3,531 Total 21,125 Premature Infants Live premature births occurring in the Area:— 31bs. 4ozs. or less 31bs. 5ozs.41bs. 6ozs. 41bs. 7ozs.4Ibs. 15ozs. 51bs.51bs. 8ozs. Born alive at home and nursed entirely at home 1 4 22 Born alive at home and transferred to hospital 1 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 - - - - Born in hospital 7 13 29 39  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 1 3 1 4 1 1 - 3 — 1 — 13 4 2 Tuberculosis, other - - - - - - - - - - - - - - - - - - - - - - - 2 3 Syphilitic disease - - - - - - - - - - - - - - - - - - - - - - - - 4 Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - 5 Whooping Cough — — - — — -- - — — — — - — — — — — — — — — — — — 6 Meningococcal infections - - - - - - - - - - - - - - - - - - - - - - 1 — 7 Acute Poliomyelitis — — — — — — — — 1 — — — — — — — — —• — — — — 1 — 8 Measles — - - - - - - - - - - - - - - - - - - - - - - - 9 Other infective and parasitic diseases — — — — -- — 1 — — 1 1 — — — 1 —1 — - - - - - 3 1 10 Malignant neoplasm, stomach — - - - - - - - - — 1 — 1 1 1 4 3 3 8 3 1 4 15 15 11 Malignant neoplasm, lung, bronchus — — — — — — — — — — — — — 16 1 13 — 7 1 - — 36 2 12 Malignant neoplasm, breast — — — — — — — — — — — 1 — 3 — 4 — 5 — 2 — 2 — 17 13 Malignant neoplasm, uterus — - — — — — — — — — — 1 — 1 — 1 — — — — — 3 14 Other Malignant and lymphatic neoplasms . — — — —i — 1 — — — -- 1 2 4 2 10 10 9 5 16 5 7 9 47 34 15 Leukaemia, aleukaemia - — -- — — — 3 — — — — — — — 2 1 - — — 1 — — 5 2 16 Diabetes - — — — — — — — - - - - - — — — — — — — 1 — 1 — 17 Vascular lesions of nervous system - - - . — — — — — — — — 3 1 2 6 12 10 5 10 12 30 31 18 Coronary disease, angina —. — — — — — 2 — 13 1 24 9 12 12 7 6 58 28 19 Hypertension with heart disease — — — — — — 2 1 3 3 2 4 6 8 13 20 Other heart disease . - - - - - - - - - 1 1 2 1 5 3 4 6 9 16 15 23 36 50 21 Other circulatory disease - — -— — — — - - - - - - - 3 — 3 3 4 4 7 7 17 14 22 Influenza - — — — — - - - - - - - — — 1 - 2 — 2 — 3 3 5 23 Pneumonia 8 2 — — - 1 — — — 1 — — — — 2 1 4 I 4 6 8 20 20 24 Bronchitis 1 — — — — - - - - - - - - — 7 1 15 1 21 5 6 6 50 13 25 Other diseases of respiratory system - — — — — — — — — — — 2 1 - — - 1 — 1 1 1 1 4 4 26 Ulcer of stomach and duodenum - - - - - — — - — — 1 — - - 2 — 2 1 4 2 — 1 9 4 27 Gastritis, enteritis and diarrhoea 1 5 — — — — — — — — — - — — — — — 2 — — 1 7 28 Nephritis and nephrosis - — - — — — 1 — — — 1 1 1 — 3 1 — 1 1 1 — 4 7 29 Hyperplasia of prostate — — — — — — — — — — — — — — — 1 — — — — — 1 — 30 Pregnancy, childbirth and abortion — — - - - - - - - - - - - - - - - - - - - - - - 31 Congenital Malformations 10 3 1 — - - - - - - - - - - - - 1 1 — 1 — — 13 5 32 Other defined and ill-defined diseases 11 9 — — — — 1 1 1 2 2 1 — 3 5 5 11 5 3 5 7 12 41 43 33 Motor vehicle accidents — — — — — — 2 — 2 1 — — — — I — — — 1 — 2 — 8 1 34 All other accidents — — — 1 --- 2 — 2 1 — — — — — — 2 — — 1 1 2 8 4 35 Suicide - - - - - - - - - - - - — 2 — 1 — — — 1 — 4 - 36 Homicide and operations of war - - - - - - - - - - - - - 1 - - - - - - - - - 1 31 19 2 - 3 2 9 5 6 6 9 9 17 14 76 40 105 56 107 77 72 102 437 330