AL. 4394) EDM 40 BOROUGH OF EDMONTON REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1955 Borough of Edmonton With the Compliments of the Medical Officer of Health. Public Health Department, Town Hall, Edmonton, N.9. BOROUGH OF EDMONTON REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1955 BOROUGH OF EDMONTON 1955 His Worship the Mayor - Councillor M. Simpson, J.P. Deputy Mayor - Alderman W. Preye PUBLIC HEALTH COMMITTEE Chairman: Councillor J. E. Cooke. Vice-Chairman: Councillor Mrs. R. A. Smythe. Members: The Mayor (Councillor M. Simpson, J.P.) (Ex Officio) The Deputy Mayor (Alderman W. Preye (Ex Officio) Alderman L. E. Berridge „ Mrs. F. Long, J.P. „ R. W. Ricketts Councillor G. W. Burrows „ Mrs. A. M. Glover „ E. R. Holborn 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health : D. Regan, B.A., B.Sc., M.B., Ch.B., B.A.O., D.P.H.(L'pool.). Deputy Medical Officer of Health: Catherine A. Goggin, M.B., B.Ch., B.A.O., D.P.H. Senior Sanitary Inspector: abc John P. Farrar. District Sanitary Inspectors: abc F. Beilby abc H. W. Grieves a bcd V. C. quin abcd R. H. Sandford (left 30.9.55) abcd E. W. C. George abcd F. A. Freeman (left 15.6.55) abcd J. H. Willis (commenced 18.4.55) ac J. T. Woolford (commenced 27.7.55) ac G. S. Tovey (commenced 8.12.55) Trainee Sanitary Inspectors: T. C. Oliver J. T. Woolford (until 26.7.55) L. C. Hibbs (commenced 7.11.55) Senior Clerk: a F. J. Nash Clerical Staff: H. J. Weldon Miss I. Holloway A. Ballantine Mrs. E. J. Richards Mrs. I. Kavanagh B. English (in H.M. Forces) Shops Act and Street Trading Inspector: A. Robinson a Certificated Sanitary Inspector. b Certificate of Meat and Food Inspector, c Inspector under the Petroleum Acts. d Certificate of Smoke Inspector. 4 PREFACE Public Health Department, Town Hall, Edmonton, N.9 His Worship the Mayor, Aldermen and Councillors of the Borough of Edmonton. Your Worship, Ladies and Gentlemen, I have the honour to present my Annual Report for the year 1955 on the health and sanitary circumstances of the Borough. The Report is compiled in accordance with the requirements of the Ministry of Health Circular 17/55. Death Rate—8.58.—This remains low and compares favourably with the death rate in Middlesex and England and Wales. Its effect on the population of the District is offset by a continuing low Birth Rate. Birth Rate—12.07.—This remains low and is a direct reflection on the difficulty of young people to obtain suitable living accommodation at a reasonable cost. Housing for such people remains a difficult problem notwithstanding the relief given by the New Towns. Some people are so desperate to get accommodation that they are willing to accept anything rather than continue to live in one or two rooms. Infant Mortality Rate—17.52.—This has risen slightly since 1954, but compares favourably with that of England and Wales. It is becoming increasingly difficult to get mothers to visit clinics for checking the condition of their children. This is mainly due to the shortage of Health Visitors and also the failure of the working mother to see her doctor in time. The Neo Natal Rate also contributes its share to the rise in infant deaths. Neo Natal deaths are usually a deep and abiding problem. The Neo Natal Rate is 14.19. 5 Maternity Mortality Rate—1.63.—Although the actual Maternity Mortality Rate is low it shows an increase on 1954. The team work which exists between the Hospitals' Staff and the Local Health Authority Staff contributes very much to this satisfactory state. It is to be hoped this co-operation will long continue. Poliomyelitis.—During the year the continued recurrence of this disease gave a very uneasy feeling. The incidence of this disease is greatest during the months of July and August; in 1955 we had sixteen confirmed cases, but our maximum came in October (7) and 2 cases appeared as late as November. It is to be hoped that a remedy will soon be discovered to prevent or at least inhibit this dread disease. Housing.—We are continuing with our efforts to deal with the Slum Clearance Programme and the Clearance Area Compulsory Purchase Order in respect of the Snells Park Area was confirmed by the Minister of Health and Local Government. This must be a source of relief to the majority of the tenants of the properties concerned, the Local Authority and certainly to me to know that this heterogenous collection of buildings will at last be cleared and replaced by new habitations. Much more still remains to be done throughout the Borough. Your staff are. however, much hampered by the continuous changes and vacancies which are occurring amongst your Inspectorate. A lot of work is involved in inspecting, issuing notices, the issue and revocation of certificates of disrepair, compiling a detailed report of the older properties in the district, clean food investigations of shops, factories and restaurants. No sooner is one Scheme started when it is slowed or hampered by the departure of some of your Inspectors. At the moment there are two vacancies and the sharing of the work amongst the remaining Inspectors is disturbing to say the least of it. Your Training Scheme for Sanitary Inspectors is progressing favourably, but it will never make up for the loss in the other Inspectorate. If the Council will adhere to choosing candidates from Edmonton and near it, then the trainee is more likely to remain with you for a reasonable time after qualifying. 6 Health Education.—It is necessary and desirable to use every available means in the propaganda for a Health Campaign. There is, however, so much health teaching to be done and there are so few people with so little time to do it all, that it would clearly be advantageous to know if Campaigns entirely conducted through the medium of posters had influenced knowledge and behaviour effectively. My own belief is that the poster system, while it assists, does not bring home the real meaning; there is nothing to equal the spoken word delivered directly to the people concerned. Your Health Visitors and Sanitary Inspectors do everything possible to educate the people in their own homes about health and the means of achieving health. Lecturing to the Parents' and Teachers' Associations has a very good response in this district, but it is found that the parents of the youngest children are more eager and anxious to learn the way to better health than the parents of older children. Adults in factories and other work-places give very little response. On the whole the general standard of the people of Edmonton has improved. The effect of posters on Food Hygiene has in many instances shown a vast improvement. Attention is now being paid in ordinary homes to the dangers of flies and the possibility of food poisoning from re-heated food. The actual increase in knowledge is not very apparent, but the effect on the practical need of handwashing (a) after visiting the lavatory and (b) before handling food is receiving significant consideration. Co-ordination and co-operation in the Health Services while making some progress is not progressing very rapidly. The difficulty lies along the divisions which exist at the top as well as similar divisions existing in the counties and districts. Some effort must be made, if necessary by legislation, to bring hospitals, general practitioners and local health authorities into closer union. It is to be regretted that in some instances environmental health services are being split off from the health services in some districts mainly by the action of the local authorities and local health authorities. The Medical Officer of Health and his department have some duties in the control of Infectious Diseases, Nuisances, Housing, Food Hygiene and Prevention of Air and Water Pollution. There 7 is a great danger that these services will be separated from the health services by appointing one person as Medical Officer of Health of a district and another person as Area Medical Officer. It must be recognised that there are personal welfare services which are so closely allied to the health services that separation from them is artificial and undesirable. In the administration of Health Services both in environmental and personal there are crucial issues at stake. Firstly, the relation of committees to their officers. If the officers respect the authority of their employing body and are loyal at once to the Authority's and their own ethical functions in advice and executive action, and if the Authority trusts its officers and leaves them free to act on the Authority's instructions without any detailed supervision, but right professional basis, then good work is assured. Secondly, the quality of the chief officers must be high. In dealing with health matters this requires sound medical skill and a full comprehension of social relationships together with qualities necessary to good administration and in particular to medical administration. Thirdly, the personal relationship between chief officers must be satisfactory, for, only in a measure to which this is good, will co-operation be really whole-hearted. Lastly, full cooperation must be secured between all members of the various staffs at corresponding levels, otherwise local health service will be seriously restricted in its effectiveness to the people. I should like to express my very best thanks to the members of my Staff for their loyal and friendly co-operation at all times. I should also express my thanks to the Council and especially to the Chairman and Members of the Public Health Committee for the kindness and co-operation given me during the year 1955. I have the honour to be, Your Worship, Ladies and Gentlemen, D. REGAN Medical Officer of Health. 8 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 3,896 Population— Census of 1921 66,809 Census of 1931 77,652 Census of 1951 104,270 Estimated by the Registrar-General for mid-year 1955 99,200 Number of inhabited houses and separate dwellings at the end of 1955 28,773 Number of inhabited houses and separate dwellings at the end of 1954 28,758 Rateable Value, April, 1955 £763,062 Estimated product of £3,125 Rates in the £ for the year ending March 31st, 1956 22s. 2d. VITAL STATISTICS. Live Births. M. F. Total Grand Total Legitimate 598 559 1,157 Illegitimate 19 22 41 1,198 Birth-rate per 1,000 of population 12.07 Stillbirths. Legitimate 12 14 26 Illegitimate - - — 26 Total of live and stillbirths 1,224 Rate per 1,000 total births 21.24 Deaths. Number 415 437 852 Rate per 1,000 population 8.58 Maternal Mortality. Deaths Rate per 1,000 total live and stillbirths Toxaemias of Pregnancy — — Complication of Pregnancy and Delivery 2 1.63 2 1.63 Death rate of Infants under one year of age. M. F. Total Number 8 13 21 All infants per 1,000 live births 17.52 Legitimate infants per 1,000 legitimate live births 18.15 Illegitimate infants per 1,000 illegitimate live births Nil Deaths from Cancer (all ages) 165 „ „ Measles (all ages) — „ „ Whooping Cough (all ages) — „ „ Diarrhoea (under 2 years of age) — 9 The following causes of death are supplied by the Registrar General and refer to deaths which were registered during the calendar year:— Cause of Death M. F. Total Tuberculosis, respiratory 7 1 8 Tuberculosis, other 1 1 2 Syphilitic disease 1 1 2 Diphtheria ... ... ... Whooping Cough ... ... ... Meningococcal infections 1 ... 1 Acute Poliomyelitis 3 ... 3 Measles ... ... ... Other infective and parasitic diseases ... ... ... Malignant neoplasm, stomach 11 13 24 Malignant neoplasm, lung, bronchus 30 8 38 Malignant neoplasm, breast ... 21 21 Malignant neoplasm, uterus ... 5 5 Other malignant and lymphatic neoplasms 45 32 77 Leukaemia, aleukæmia 1 5 6 Diabetes ... 7 7 Vascular lesions of nervous system 32 68 100 Coronary disease, angina 89 46 135 Hypertension with heart disease 7 14 21 Other heart disease 35 95 130 Other circulatory disease 11 17 28 Influenza 2 1 3 Pneumonia 25 22 47 Bronchitis 42 15 57 Other diseases of the respiratory system 8 4 12 Ulcer of stomach and duodenum 9 2 11 Gastritis, Enteritis and Diarrhoea 3 2 5 Nephritis, and Nephrosis 1 1 2 Hyperplasia of Prostate 5 ... 5 Pregnancy, childbirth, abortion ... 2 2 Congenital malformations 2 ... 2 Other defined and ill-defined diseases 26 40 66 Motor Vehicle Accidents 7 2 9 All other accidents 9 7 16 Suicide 2 5 7 Homicide and operations of war ... ... ... TOTALS 415 437 852 10 The two following tables give the deaths of those registered during the 52 weeks ended 31st December, 1955. The slight difference between the following tables in respect of the causes of death and the one supplied by the Registrar General is that the Registrar General is in possession of additional information on the matter. MALES Causes of Death ALL AGES to 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Tuberculosis, respiratory 7 ... ... ... ... ... ... 1 1 2 3 ... Tuberculosis, other 1 ... ... ... ... ... ... ... ... ... ... 1 Syphilitic disease 1 ... ... ... ... ... ... ... ... ... 1 ... Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal infections ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis 3 ... 1 1 ... 1 ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... Other infective and parasitic diseases ... ... ... ... ... ... ... ... ... ... ... ... Malignant neoplasm, stomach 10 ... ... ... ... ... ... ... 3 4 1 2 Malignant neoplasm, lung, bronchus 32 ... ... ... ... ... 1 ... 12 9 8 2 Malignant neoplasm, breast ... ... ... ... ... ... ... ... ... ... ... ... Malignant neoplasm, uterus ... ... ... ... ... ... ... ... ... ... ... ... Other malignant and lymphatic neoplasms 45 ... ... ... ... ... ... 3 5 9 7 21 Leukaemia, aleukaemia 1 ... ... ... ... ... ... ... ... ... 1 ... Diabetes ... ... ... ... ... ... ... ... ... ... ... ... Vascular lesions of nervous system 31 1 ... ... ... ... ... 2 2 5 9 12 Coronary disease, angina 90 ... ... ... ... ... ... 1 12 30 23 24 Hypertension with heart disease 6 ... ... ... ... ... 1 ... ... 1 2 2 Other heart diseases 35 ... ... ... ... ... ... 3 2 6 4 20 Other circulatory disease 11 ... ... ... ... ... ... 2 ... ... 3 6 Influenza 2 ... ... ... ... ... ... ... ... ... ... 2 Pneumonia 28 1 ... ... ... 1 ... 1 2 2 8 13 Bronchitis 43 ... ... ... ... ... ... ... 9 9 17 8 Other disease of respiratory system 7 1 ... ... ... ... ... ... ... 1 2 3 Ulcer of stomach and duodenum 7 ... ... ... ... ... 1 ... ... 3 2 1 Gastritis, Enteritis and Diarrhoea 3 ... ... ... ... ... ... ... ... ... 1 2 Nephritis and nephrosis 2 ... ... ... ... ... ... ... 1 ... ... 1 Hyperplasia of prostate 4 ... ... ... ... ... ... ... ... 1 1 2 Pregnancy, childbirth, abortion ... ... ... ... ... ... ... ... ... ... ... ... Congenital malformations 2 2 ... ... ... ... ... ... ... ... ... ... Other defined and ill-defined diseases 26 2 ... 1 ... ... 1 2 2 2 9 7 Motor Vehicle Accidents 7 ... ... ... ... 2 1 1 ... 2 ... 1 All other accidents 9 1 ... ... ... ... ... ... 2 3 2 1 Suicide 2 ... ... ... ... ... ... ... ... 1 1 ... Homicide and operations of war ... ... ... ... ... ... ... ... ... ... ... ... TOTALS 415 8 1 2 ... 4 5 16 53 90 105 131 11 FEMALES Causes of Death ALL AGES to 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Tuberculosis, respiratory 1 ... ... ... ... ... ... ... ... ... 1 ... Tuberculosis, other 1 ... ... ... 1 ... ... ... ... ... ... ... Syphilitic disease 1 ... ... ... ... ... ... ... ... 1 ... ... Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal infections ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... Other infective and parasitic diseases ... ... ... ... ... ... ... ... ... ... ... ... Malignant neoplasm, stomach 13 ... ... ... ... ... 1 ... ... 2 4 6 Malignant neoplasm, lung, bronchus 8 ... ... ... ... ... ... ... 1 3 2 2 Malignant neoplasm, breast 21 ... ... ... ... ... 1 2 5 7 4 2 Malignant neoplasm, uterus 5 ... ... ... ... ... ... ... 1 1 1 2 Other malignant and lymphatic neoplasms 32 ... ... ... ... 1 ... ... 4 11 7 9 Leukaemia, aleukæmia 4 ... ... ... ... ... ... 1 ... 1 2 ... Diabetes 7 ... ... ... ... ... ... ... ... ... 5 2 Vascular lesions of nervous system 68 ... ... ... ... 1 ... 1 5 6 19 36 Coronary disease, angina 46 ... ... ... ... ... ... 1 3 5 17 20 Hypertension with heart disease 14 ... ... ... ... ... ... ... 1 1 2 10 Other heart diseases 95 ... ... ... ... ... ... 2 4 4 15 70 Other circulatory disease 16 ... ... ... ... ... ... ... 2 5 4 5 Influenza 1 ... ... ... ... ... ... ... ... ... 1 ... Pneumonia 24 2 ... 1 ... ... ... ... ... 3 3 15 Bronchitis 15 ... ... ... ... ... ... 1 1 ... 5 8 Other disease of respiratory system 4 ... ... ... ... ... ... ... ... 1 1 2 Ulcer of stomach and duodenum 1 ... ... ... ... ... ... ... ... ... 1 ... Gastritis, Enteritis and Diarrhoea 2 ... ... ... ... ... ... ... ... ... 1 1 Nephritis and nephrosis 1 ... ... ... ... ... ... ... ... ... 1 ... Hyperplasia of prostate ... ... ... ... ... ... ... ... ... ... ... ... Pregnancy, childbirth, abortion 2 ... ... ... ... 1 1 ... ... ... ... ... Congenital malformations ... ... ... ... ... ... ... ... ... ... ... ... Other defined and ill-defined diseases 40 10 ... ... ... ... 1 1 4 1 6 17 Motor Vehicle Accidents 2 ... ... ... ... 1 ... ... ... 1 ... ... All other accidents 7 1 ... ... ... ... ... 1 ... 2 ... 3 Suicide 5 ... ... ... ... ... ... ... 2 2 ... 1 Homicide and operations of war ... ... ... ... ... ... ... ... ... ... ... ... TOTALS 436 13 ... 1 1 4 4 10 33 57 102 211 12 INFANTILE MORTALITY. The deaths of infants under one year of age were as follows:- M. F. Total Legitimate 8 13 21 Illegitimate — — — 8 13 21 The death rate of all infants per 1,000 live births was 17.52. The death rate of all infants under one month of age per 1,000 live births was 14.19 A detailed sub-division of the causes, etc., of these DEATHS is as follows:— MALES. Causes of Death One week Second Week Third Week Fourth Week Total under 1 month 1—3 months 3—6 months 6—9 months 9—12 months Total under 1 year Atelectasis 1 ... ... ... 1 ... ... ... ... 1 Pneumonia ... ... ... ... ... 1 ... ... ... 1 Other Diseases of Respiratory System 1 ... ... ... 1 ... ... ... ... 1 Premature Birth ... ... ... ... ... ... ... ... ... Birth Injury 1 ... ... ... 1 ... ... ... ... 1 Other Causes 2 ... ... ... 2 ... ... ... ... 2 Congenital Malformations 2 ... ... ... 2 ... ... ... ... 2 Totals 7 ... ... ... 7 1 ... ... ... 8 FEMALES. Causes of Death One week Second week Third week Fourth week Total under 1 month 1—3 months 3—6 months 6—9 months 9—12 months Total under 1 year Pneumonia ... ... ... ... ... 1 1 ... ... 2 Premature Birth 3 ... ... ... 3 ... ... ... ... 3 Congenital Malformations 1 ... ... ... 1 ... ... ... ... 1 Other Causes ... ... ... ... ... 1 ... ... ... 1 Atelectasis 5 ... ... ... 5 ... ... ... ... 5 Birth Injury 1 ... ... ... 1 ... ... ... ... 1 Totals 10 ... ... ... 10 2 1 ... ... 13 13 COMPARATIVE STATISTICS Birth-rate Death Rate Infant Mortality Rate Live Still England and Wales 15.00 23.10 11.70 24.90 Middlesex 13.00 18.90 9.80 19.40 Edmonton 12.07 21.24 8.58 17.52 The following table gives the number of births and deaths (registered) sub-divided into the four Wards of the Borough. It should be remembered that births are only those which occurred in Edmonton of residents; these are registered in Edmonton. Births which take place outside the Borough are not included; this fact accounts for the differen ce between these figures and those supplied by the Registrar-General. The deaths include those taken place outside the Borough, the information being given by the RegistrarGeneral. Ward Births Deaths Infant Deaths M. F. M. F. M. F. Bury Street 130 119 111 108 3 5 Church Street 70 58 95 135 2 2 Angel Road 79 90 84 67 3 2 Silver Street 115 99 125 126 ... 4 Vagrants ... ... ... ... ... ... 394 366 415 436 8 13 14 LABORATORY SERVICE The following specimens submitted from the Edmonton area were examined by the Medical Research Council Laboratory (Edmonton), during the year as follows:— Nature of Examination Positive Negative Total Blood Counts — — 32 Blood—Haemoglobin Estimation — — 166 Blood—Kahn Reaction — 108 108 Blood—Rhesus Factor 58 48 106 Blood—Grouping — — 108 Blood—Sedimentation Rate — — — Eye swabs for organisms — 2 2 Faeces for the presence of organisms 220 1,389 1,609 Per-nasal Swabs for H. Pertussis — — — Swabs for presence of C. Diphtheriæ: (a) From Suspect Cases — 17 17 (b) From Contacts — 6 6 (c) From Carriers and old cases, etc. — — — Swabs for presence of Haemolytic Streptococci 67 451 518 Swabs for presence of Vincent's Angina — 5 5 Urines — — 136 Vaginal swabs for presence of organisms — — — „ „ „ „ „ Trich. Vag. — 22 22 Swabs from Vesicle — — — Ear swabs — — 5 Sputum for Tubercle Bacilli — — — Pus — — 3 Breast Milk — — 1 Cervical Swab — — 1 Swab from boil — — 1 Serum from eruption — — 1 Blood—Enteric Group — — 3 Powdered Chinese Egg — — 1 Dried Egg Albumin — — 2 Ice Cream for Typhoid Organisms — 1 1 Total 2,854 15 MILK (SPECIAL DESIGNATION) REGULATIONS, 1949. 42 samples of Designated Milks were examined during 1955. Results were as follows:— Pasteurised Milk. 19 samples were examined, all satisfied the Phosphatase Test but 2 failed the Methylene Blue Test. Tuberculin Tested (Pasteurised) Milk. 10 samples were examined and all satisfied both the prescribed tests. Sterilised Milk. 13 samples were examined and all passed the Turbidity Test. SANITARY CIRCUMSTANCES OF THE AREA. The water supply of the Borough has at all times been satisfactory both in quality and quantity. The Metropolitan Water Board is responsible for the supply which is piped direct to every dwelling-house throughout the Borough, and serves the entire population. The co-operation of the Board has at all times been of the fullest. SANITARY INSPECTION IN THE AREA. Seven District Sanitary Inspectors are engaged in the sanitary supervision of the Borough, working under the supervision of the Senior Sanitary Inspector. The Senior Sanitary Inspector supervises the work of the Borough. Sanitary Conveniences. There are seven public conveniences in the Borough under the supervision of the Senior Sanitary Inspector. The free use of W.Cs. at Women's Conveniences was continued throughout the year; free hand-washing facilities are provided in both the males' and females' conveniences and paper towels are supplied. 16 Rodent Control. Your Senior Sanitary Inspector, as Officer-in-Charge, Rodent Control, reported as follows:— The Council have an Assistant Rodent Officer, two Rodent Operators, the part-time services of a Clerk and appointed the District Sanitary Inspectors as Rodent Officers. During the year the treatment of business premises by " Warfarin " was continued and has proved very successful. The new method of rodent control has the advantage that the materials are undetectable by rats and mice, therefore poison shyness does not occur, and the rodents continue to feed until all are dead. Further, no prebaiting is necessary and the baiting is continuous. "Warfarin" destroys the ability of the blood to clot and the rats become weaker and die painlessly from internal haemorrhage. The District Sanitary Inspectors in cases where there was a possibility of the infestation being due to defective drainage visited the premises and tested the drainage and any defects discovered were dealt with through the usual channels. In 80 per cent. of the cases defects were discovered and as one can quite appreciate entailed quite a large amount of work. The following table gives details of the work carried out during the year. 1. Prevalence of Rats and Mice. Type of Property Local Authority Dwellinghouses Agricultural All other (including Business and Industrial) Total 1. Number of Properties inspected by the Local Authority during 1955 as a result (a) of notification or (b) otherwise (a) 5 578 ... 32 615 (b) 18 2,504 ... 1,355 3,877 2. Number of Properties (under 1) found to be infested by rats Major 3 - ... 10 13 Minor 2 499 ... 12 513 3. Number of Properties (under 1) found to be infested by mice 1 59 ... 16 76 4. Number of Infested Properties (under 2 and 3) treated by the Local Authority 6 536 ... 35 577 5. Number of Notices served under Section 4: (1) Treatment ... ... ... ... ... (2) Structural Works (i.e., Proofing) ... ... ... ... ... 17 2. Measures of Control. Type of Property. Properties Inspected. No. of Inspections Notices Served Treatment Completed. Block Treatments Rats. Mice. Local Authority's Premises 23 161 .. 5 1 .. Dwelling Houses 3,082 5,914 .. 493 44 .. Business Premises 1,387 1,478 .. 15 13 .. Total 4,492 7,553 .. 513 58 .. During the year maintenance treatments of the sewers took place by the Borough Engineer's Department, and I am indebted to the Borough Engineer for the following report:— RAT DESTRUCTION IN SEWERS The 19th maintenance treatment of sewers was completed in July, showing the following results:— No. of manholes baited 766 No. of prebait takes 380 No. of poison takes 362 The percentage of prebait takes to the number of manholes baited is 50%. Previous percentages average at 54% and the inference drawn is that the rat population seems to be fairly static. During the 18th treatment—an experiment in warfarin baiting of sewers was made in a number of manholes—in conjunction with the Ministry of Agriculture and Fisheries, but the results were not very favourable as compared with normal treatments. Warfarin baiting has been carried out in the Birkenhead district and was claimed to be very satisfactory. The Ministry has now given an indication that further large scale experimenting throughout the country is likely to be put in hand at an early date. Middlesex County Council Act, 1950, Section II. Section II of this Act, which relates to Hawkers of Food and their Premises, came into operation on the 1st of April, 1951. Two persons and premises were registered during the year. No persons were registered to trade in the Borough where storage premises are located in other districts. There were 128 hawkers on the Register at the end of 1955. 18 Disinfection and Disinfestation. The following table gives some idea of the work carried out:— Number of journeys to collect bedding 230 „ „ „ „ return bedding 200 Rooms disinfected after infectious disease 110 „ „ „ phthisis 23 „ „ „ other cases 47 „ „ „ vermin 293 Bedding, clothing, etc., disinfected after infectious disease 745 articles „ „ „ „ „ phthisis 213 .. „ „ „ „ „ other cases 564 „ „ „ „ „ „ vermin 146 ., The Council distribute a disinfecting powder and fluid to residents who apply for same at the Town Hall Yard. During the year, the applicants numbered 5,416. One hour daily is allowed for such distribution with the exception of Fridays and Saturdays. A Formalin Chamber is used for the disinfection of books, leather goods, etc., articles that would be damaged by steam. The number of books and other articles thus disinfected was 417. Eight Council properties and 111 other houses were found to be infested; the total number of rooms disinfested was 293. The whole of the work is carried out by the Department, the materials used being insecticides containing D.D.T. as a base. Petroleum (Regulations) Acts, 1928 and 1936. During the year 6 new licences and 114 renewals were granted by the Council. The following is a list of particulars of quantities, etc., affected by these licences:— Petroleum spirit 434,784 galls. Petroleum mixtures (cellulose) 18,108 galls. Rubber solution 100 lb. & 850 galls. Mortuary. The use of the Council's Mortuary for the reception of bodies was discontinued after 31st March, 1953, and by arrangement with the North East Metropolitan Regional Hospital Board, on and after 1st April, 1953, all bodies which would normally have been received at the Council's Mortuary are received at the Prince of Wales's Hospital. Tottenham. Mortuary. Inspections. The following tabular statement gives the number and the nature of the inspections made during the year:— Complaints 1,932 Infectious Diseases 203 Food Poisoning 7 House-to-house 272 19 Factories with mechanical power 989 Factories without mechanical power 15 Housing Rents and Repairs Act, 1954 271 Housing Act, 1949, Improvement Grants 56 Factories (other) 7 Outworkers — Schools 13 Offensive trades 2 Shops and Stalls 82 Shops Act — Pet Shops 19 Sanitary conveniences and urinals 240 Smoke observations 842 Rat infestation 242 Petroleum 328 General inspections 542 Sundry visits 2,002 Cinemas and Halls 40 Stables and Piggeries 133 Moveable Dwellings 108 Sampling Water 6 Sampling Ice Cream 42 Sampling Milk 40 Sampling Rag Flock 2 Re-inspections 6,059 Inspection of Places where Food is Prepared. Butchers 213 Fish shops 77 Cafes and Restaurants 350 Dairies and milkshops 62 Slaughterhouses 17 Bakehouses (Factory) 29 Bakehouses (Workshops) — Ice cream shops 218 Canteens 67 Other food premises 227 Defects Remedied. Roofs repaired 565 Gutters and rainwater pipes repaired 380 Brickwork or Pointing Repaired 202 Chimney Stacks, etc., repaired or rebuilt 55 Yards or forecourts repaved or repaired 86 Drains examined, tested or exposed 548 Drains cleared, trapped or repaired 437 Drains reconstructed 96 Chambers inserted or built up to ground level 50 20 Soil and vent pipes, new fixed or repaired 59 W.C.s repaired or improved 225 Flushing cisterns repaired or new fixed 91 Sink waste pipes repaired or new fixed 60 New sinks fixed 24 Drinking water cisterns covered, cleansed, repaired 7 Water fittings repaired 38 Water taken off main or restored 8 Internal walls 587 Ceilings repaired, cleansed, etc. 387 Door frames repaired 1 Floors repaired 174 Floors ventilated 78 Dampness remedied 467 Window frames or sashes repaired or renewed 745 Fireplaces, stoves repaired 103 Coppers repaired 1 New dustbins supplied 15 Premises rat-proofed 38 Improper keeping of animals discontinued 2 Foul accumulations removed 28 Other nuisances abated 502 Moveable dwellings removed 88 New boiler house constructed 1 New boiler installed 1 Places of Public Entertainment. Forty inspections of cinemas and other places of entertainment were made in accordance with the Circular of the Ministry of Health of 1920. Conditions were found to be generally satisfactory. FACTORIES ACTS, 1937 & 1948 The following work has been carried out under the above Act:— 1. Inspections for the Purpose of Provisions as to Health. Premises Number in Register Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 203 989 44 — Factories without mechanical power 27 13 2 — Other premises under the Act (including works of building and engineering and construction but not including outworkers' premises) 7 7 — — Totals 237 1,009 46 — 21 2. Defects Found. Particulars Number of defects No. of defects in respect of which prosecutions were instituted Found Remedied Referred to H.M. Inspector by H.M. Inspector Want of cleanliness 2 2 — — — Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary Conveniences: Insufficient 6 6 — — — Unsuitable or defective 255 107 — — — Not separate for sexes — — — — — Other offences (Not including offences relating to outwork) 2 2 — — — Totals 265 117 — — — 3. Outwork—Sections 110 & 111 Nature of Work Section 110 Section 111 No. of Outworkers in August list No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing apparel, making, etc. 261 — — — — — Artificial flowers 6 — — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper 29 — — — — — Brush making 45 — — — — — Stuffed toys 19 — — — — — Cosaques, Christmas crackers, Christmas stockings, etc. 15 — — — — — Curtains and Furniture Hangings 4 — — — — — Household Linen 2 — — — — — Textile Weaving 1 — — — — — Feather Sorting 1 — — — — — Umbrellas, etc. 1 — — — — — Brass and Brass Articles 1 — — — — — Carding etc. of Buttons etc. 8 — — — — — Totals 393 — — — — — 22 Rag Flock and Other Filling Materials Act, 1951. This Act came into force on the 1st November, 1951. Number on Register at end of year:— Premises where filling materials used 14 Licences granted for storage of rag flock 2 HOUSING. 1. Re-development Areas. Following representations made by the Medical Officer of Health, the Council on the 13th April, 1954, made Clearance Area Compulsory Purchase Orders under Part 3 of the Housing Act, 1936, comprising the following premises:— (a) Snells Park (No. 1) Clearance Area. 1954. 1 to 29 (odd numbers inclusive), 10 to 32 (even numbers inclusive), 34a, 38 to 48 (even numbers inclusive) and 52 to 78 (even numbers inclusive), Snells Park. 2 to 12 (even numbers inclusive) Grove Street. 3, 11 to 17 (odd numbers inclusive) and 45 to 55 (odd numbers inclusive) Fore Street. Making a total of 65 houses involving 289 persons. (b) Snells Park (No. 2) Clearance Area, 1954. 2 to 8 (even numbers inclusive) Snells Park. Making a total of 4 houses, involving 36 persons. A Public Inquiry was held in October, 1954. The Minister of Housing and Local Government subsequently confirmed the No. 2 Order without modification, and the No. 1 Order subject to certain modifications. Following representations by the Medical Officer of Health, the Council on 21st January, 1955, made Clearance Area Compulsory Purchase Order under Part 3 of the Housing Act 1936, comprising the following premises:— (c) The Edmonton (Trafalgar Place Clearance) Housing Compulsory Purchase Order 1955. 1-10 (consecutive) Trafalgar Place Making a total of 10 houses involving 57 persons. A Public Inquiry was held in May, 1955, and the Minister of Housing and Local Government subsequently confirmed the Order. Following representations by the Medical Officer of Health, the Council on 23rd June, 1955, made Clearance Area Compulsory Purchase Order under Part 3 of the Housing Act 1936, comprising the following premises:— 23 (d) The Edmonton (Claremont Street Clearance) Housing Compulsory Purchase Order, 1955. 10 and 12 Claremont Street. Making a total of 2 houses involving 7 persons. The property was purchased by agreement without the Order being submitted to the Minister. Following representations by the Medical Officer of Health, the Council on 21st July. 1955, made Clearance Area Compulsory Purchase Order under Part 3 of the Housing Act. 1936, comprising the following premises:— (e) The Edmonton (Alpha Road Clearance) Housing Compulsory Purchase Order, 1955. 7-21 (odd numbers inclusive) Alpha Road. Making a total of 8 houses involving 11 persons. The Order was subsequently confirmed by the Minister of Housing and Local Government. 2. Action taken under the Housing and Public Health Acts. (1) Inspection of Dwelling-houses during the year. (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts)1.714 (b) Number of inspections made for the purpose 7,186 (2) (a) Number of dwelling-houses (including under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 272 (b) Number of inspections made for the purpose 726 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 126 (4) Number of dwelling-houses (exclusive of those referred to above under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 828 (2) Remedy of Defects during the year without service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 372 24 3. Action under Statutory Powers during the year. A. Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which notices were served requiring repairs 29 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 25 (b) By Local Authority in default of owners 1 B. Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 411 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 277 (b) By Local Authority in default of owners 5 C. Proceedings under Sections 11 and 13 of Housing Act, 1936: (1) Number of dwelling-houses in respect of which demolition orders were made — (2) Number of dwelling-houses demolished in pursuance of demolition orders — D Proceedings under Section 12 of the Housing Act, 1936: (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made — (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — E. Proceedings under Section 25 of the Housing Act, 1936: Number of dwelling-houses demolished as a result of Clearance Area procedure: (a) Part III 89 (b) Part V 1 Housing Repairs and Rents Act, 1954 This Act came into operation in 1954 and among the requirements Local Authorities have to submit to the Minister of Housing and Local Government is an estimate of the total number of houses unfit for human habitation and suitable for demolition, together with their proposals for dealing with the same. 25 The following proposals were approved by the Council for submission to the Ministry of Housing and Local Government in accordance with Section 1 of the Act:— Part 1. The Total Problem. (i) Estimated number of houses unfit for human habitation within the meaning of Section 9 of the Housing Repairs and Rents Act, 1954, and suitable for action under Section 11 or Section 25 of the Housing Act, 1936 1,150 (ii) Period in years which the Council think necessary for securing the demolition of all the houses in (i) 6 years Part 2. Orders already made, etc. (iii) Number of houses in (i) in clearance areas and already covered by operative clearance or compulsory purchase orders or owned by the local authority 301 (iv) Number of houses which are already in clearance areas and for which clearance or compulsory purchase orders have been submitted to the Minister but have not yet become operative 78 Part 3. Action in the first five years. (v) Number of houses which are already in clearance areas and for which clearance or compulsory purchase orders are to be made or which are to be purchased by agreement within the five years Nil (vi) Number of houses which are to be included in clearance areas still to be declared and which within the five years will be owned by the local authority or will have been included in a clearance order or a compulsory purchase order submitted to the Minister 771 (vii) Number of houses under (iii), (iv), (v) and (vi) to be patched (if necessary) and retained within the five years under Section 2 of the Housing Repairs and Rents Act, 1954, for temporary accommodation — (viii) Number of houses under (iii), (iv), (v) and (vi) to be demolished in the five years 900 (ix) Number of houses (including those already comprised in operative demolition orders) to be demolished in the five years as a result of action under Section 11 of the Housing Act, 1936 — In approving the above proposals the Minister requested the Council to submit a statement of their programme for the first year beginning 1st September, 1955, including the number of houses to be included under Part 3 of the Housing Act, 1936. The number of houses which can be dealt with during the period above referred to will depend entirely on the Inspectoral Staff available for this work, but I estimate that in normal circumstances it will be possible to submit seven Orders dealing with 387 houses. The programme was approved by the Council for transmission to the Ministry. 26 SLAUGHTERHOUSES. Seventeen visits were paid and the carcases and organs of 42 pigs killed were inspected during or shortly after slaughter. None was found to be affected with tuberculosis. 8 carcases of which some part or organ was condemned showed a percentage of the number inspected affected with disease, other than tuberculosis, of 19.04. The following organs were surrendered:— 7 sets of lungs, 1 pluck. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. Various licences were granted as under:— Primary Supplementary Pasteurised 41 20 Tuberculin tested 24 17 Sterilised 98 19 163 56 Suplementary licences are granted to retailers who live outside the Borough but who sell milk in the Borough ; the primary licence is granted by the Authority in which the premises are situate. The number of Dairies registered at 31st December, 1955, was 10. Food and Drug Act, 1938 — Section 14. During the year 15 premises were registered for the Sale and Storage of Ice Cream. Number on Register at end of year: — Manufacturers and Vendors 8 Vendors only 188 32 samples of Ice Cream were submitted to the Methylene Blue Test and graded as follows:— Grade 1 20 „2 6 „ 3 3 „ 4 3 During the year no premises were registered for the Preparation or Manufacture of Preserved Food, etc. Number on Register at end of year 39 27 Certificates of Disrepair. The following table gives details of the cases dealt with during the year 1955:— Certificates granted up to 31st December. 1954 148 Applications received during 1955 50 Certificates granted during 1955 61 Certificates revoked on completion of repairs during 1955 57 Certificates in force at 31st December, 1955 149 Unsound Food. The following is a list of the food surrendered for examination and retained as unfit for human consumption:— Meat 654 tins Pork 202 lb. Milk 2,279 „ Veal 15 „ Fish 211 „ Offal 1,348 „ Jams, etc 387 „ Chickens 1 only Soups 354 „ Ham 297 lb. Beans 661 „ Bacon 30 „ Beetroot 14 „ Dog Fish 18 stone Carrots 219 „ Haddock 20 „ Mixed Veg. 61 „ Plaice 13 „ Peas 1,582 „ Skate 2 „ Apples 26 boxes and Whiting 1 box 12 tins Sugar 2 lb. Apricots 293 „ Cakes 4 slabs and Blackcurrants 99 „ 70 lb. Cherries 99 „ Cereals 1 pkt. Damsons 1 „ Cheeses 1851/4 lb. and Grapefruit 67 „ 25 pkts. Grapes 8 „ Chocolate Spread . 3 tins Fruit Salad 162 „ Fish Paste 5 „ Oranges 133 „ Macaroni 30 „ Peaches 120 „ Meat Paste 12 jars Pears 217 „ Pickle 191 „ Pineapple 312 „ Puddings 23 Plums 281 „ Sauce 657 botts. Raspberries 99 „ Spaghetti 107 tins Rhubarb 94 „ Sandwich Spread 43 jars Strawberries 117 „ Sweets 14 lb. Tomatoes 138 „ Baby Food 6 tins Tomato Juice 56 „ Biscuits 1 pkt. and Fruit Juices 15 „ ½ lb. Beef 1,635 lb. Eggs (Frozen) 95 lb. Lamb 155 „ Suet 7 pkts. The food examined and condemned by the Officers of the Public Health Department is disposed of either at the Council's Refuse Disposal Incinerating Plant or the Council's Refuse Disposal Pit. CLEAN FOOD CAMPAIGN. In October. 1955, a Public Meeting was held in the Edmonton Town Hall. The speakers were Dr. A. J. Dalziel Ward and Dr. W. Emrys Davies. Deputy Medical Director and Education Officer respectively of the Central Council for Health Education. 28 The meeting, which lasted for approximately two hours, was extremely interesting and many facts emerged which were of great significance to all concerned with Clean Food. Despite the publicity given, the meeting was very poorly attended. The survey of food premises commenced in 1952 was continued during 1955. 1 he statement set out below shows the nature and number or the inspections made and the work carried out during the year:— Inspections Visits to Cafes, etc 318 „ Industrial Canteens 57 „ „ Other Food Premises 55 „ „ Fish Shops 15 „ „ Ice Cream Shops 105 „ „ Butchers 51 „ „ Dairies 2 Work Done Roofs repaired 1 Walls cleansed and redecorated 20 Ceilings cleansed and redecorated 20 Windows repaired or cleansed 3 Floors repaired or cleansed 3 Equipment and/or fittings cleansed 9 „ „ „ „ renewed or repaired 25 Additional sinks provided 9 Defective sinks replaced — Drains repaired or cleansed 1 Refuse bins replaced or provided — Washing-up methods improved 3 Sanitary accommodation improved 3 Ventilation improved 6 Indicating notices re hand-washing provided 77 Personal washing facilities provided 1 Provision of food display cabinets 3 Lighting improved 3 Summary of Food Premises registered under Section 14 of the Food and Drugs Act, 1938. Manufacture and Sale of Ice Cream 8 Sale only of Ice Cream 188 Manufacture of Sausages 24 Manufacture of Sausages and Sale of Pressed. Pickled, Preserved, Potted Meats and other foods 13 Manufacture of Cooked Meat 1 Manufacture of Preserved Foods 1 29 Summary of Food Premises. Butchers 62 Grocers & Provision Dealers 196 Fish Shops 31 Dairies 10 Bakers and Confectioners 22 Retail Purveyors of Milk 109 Fruiterers and Greengrocers 63 Factory Canteens 72 Cafes 61 Pet Animals Act, 1951. This Act, which came into operation on 1st April, 1952, regulates the sale of pet animals, and provides that no person shall keep a pet shop except under the authority of a licence granted by the Borough Council. During the year no new licences were granted. Number on Register at end of year was 9. Game Dealers' Licences. During the year 3 licences to sell Game were renewed. SHOPS ACT AND STREET TRADING. The Department administers three local Orders under the Act: The Edmonton Hairdressers and Barbers (Late Day) Order, 1947, made under the Shops (Hours of Closing) Act, 1928; The Shops Act, 1912, Edmonton Weekly Half-holiday Order, Section 4(2) and (6) (Butchers); The Shops Act, 1912, Edmonton Weekly Half-holiday Order, Section 4(2), all the Orders stand amended by the Shops Act, 1950. There are approximately 1,295 shops and places other than shops in the Borough which are liable to inspection. The Shops Acts and Street Trading Inspector submits a monthly report to the Public Health Committee, and the following is a short summary of the work carried out during the year. Visits to Shops, Licensed Street Traders, etc 1,340 Washing facilities, sink water heaters installed 17 Contraventions were in the main of a minor character, mostly concerned with the exhibition of notices. Shops Act, 1950—Part I, Section 1(2). Edmonton Weekly Half-holiday Order.— A letter of warning was sent to the occupier of a shop where the above Order was being contravened in that the shop was not closed for the serving of customers on a Monday afternoon. Shops Act, 1950—Part I—Hours of Closing. One letter of warning was sent to the occupier of a shop to the effect that the shop was not closed for the serving of customers not later than 8 p.m. on a Friday. 30 Shops Act, 1950, Part II, Section 17(1)—Conditions of Employment. Legal proceedings were instituted against a firm for employing an assistant on the occasion of the weekly half-holiday and fines amounting to £1 0s. Od. were imposed. In addition, letters of warning were sent to the occupiers of 5 shops where assistants were found working during the occasion of their weekly half-holiday. Shops Act, 1950, Part IV—Sunday Trading. Thirty-five shops were visited in addition to supervisory operations and observations. Two contraventions were discovered; a letter of warning was sent in each case. Registers required to be kept under this Act were inspected periodically. An application under Section 53 of the Act was received for registration of a shop to be opened for the serving of customers until 2 p.m. on Sundays, from a person having a conscientious objection to trading on a Jewish Sabbath. The application was granted. Young Persons (Employment) Act, 1938. Cinemas and Boot and Shoe Repairing are the only occupations where young persons are being employed under the above Act. The Registers kept at these premises were perodically inspected. Middlesex County Council Act, 1944-1950—Street Trading. Under the provisions of the Byelaws made by the Council under the above Acts, twelve letters of warning were sent for contraventions of certain provisions of the Byelaws. three to licensed street traders and nine to unlicensed street traders, one of whom was a shopkeeper. In two other cases legal proceedings were instituted and fines amounting to £2 0s. Od. and costs of £3 3s. Od. were imposed. The inspection of shops, stalls and other traders' premises coming within the scope of the Acts has been carried out throughout the year, including Sundays and evenings. Heating Appliances (Fireguards) Act, 1952. The above-named Act came into operation on the 23rd March. 1953. Regulations made thereunder which came into operation on 1st October. 1953, require fireguards to be fitted to gas fires, electric fires and oil heaters. Standards of construction and fitting for guards and the tests to be employed are set out in the Schedule and the necessary apparatus for testing the guards has been obtained. Under Regulations 5, heating appliances, other than imported appliances, manufactured before the date of the coming into operation of the Regulations and not fitted with the requisite guard may be sold or let until the end of September, 1954. The Shops Act Inspector has been appointed the Authorised Officer under the Act. During the year one electric fire exposed for sale was found not to comply with the Regulations. The appliance was subsequently fitted with the requisite guard. 31 PREVALENCE OF INFECTIOUS DISEASE. Measles and Whooping Cough. These diseases were made compulsorily notifiable in October, 1939. 1,754 cases of Measles and 115 cases of Whooping Cough were notified during the year. There were no deaths from these diseases. Diphtheria. No cases were notified during the year. One case was notified during 1954. Scarlet Fever. Continued to occur throughout the year in a mild form. There were 64 cases compared with 133 in 1954; there were no deaths. "Return" cases numbered one, allowing for an interval of 28 days between a patient returning home from the Isolation Hospital and the onset of the disease in another inmate of the house. Smallpox. No cases of smallpox were notified during the year. Enteric Fever. 7 cases of Paratyphoid " B " were notified during the year. In the first 2 cases, the patients (mother and daughter), had been on holiday in Essex and the source of infection was suspected to be shellfish collected on the foreshore. Another case was found to be a paracolon infection. Examinations revealed that the source of infection was tortoises, which were later destroyed by the R.S.P.C.A. Investigations of the remaining 4 cases failed to reveal the source of infection. Dysentery. During the year 142 cases of Dysentery were notified—90 Sonne, 20 Giardia, 21 Salmonella Typhi-murium, 2 Salmonella Thompson, 4 Salmonella Manhattan, 1 Amoebic and 4 unspecified. The control measures, detailed in my Report for 1950, were maintained, and again I wish to record my appreciation of the co-operation and assistance I received from the General Practitioners, Dr. M. Thomas and Staff of the Public Health Laboratory Service (Edmonton). Education Department and Teachers, and the Staff of the Health Department. Meningoccal Infection. Two cases were notified during the year. Ophthalmia Neonatorum. 91 cases were notified during the year. 86 in North Middlesex Hospital and 5 at home. Of this total 32 were Edmonton cases. 32 Puerperal Pyrexia. The Puerperal Pyrexia Regulations 1951 which came into operation on 1st August. 1951. replace Regulations previously in force, and modify the definition of Puerperal Pyrexia. 164 cases were notified during the year (6 at home and 158 in North Middlesex Hospital). Of this total 43 were Edmonton cases. During 1954 120 cases were notified. Food Poisoning. Following the report of an outbreak of suspected food poisoning at a local Engineering works in October. 1955, investigations were carried out at the factory premises when 83 affected persons, who were still at work, the canteen manager and staff were interviewed and details obtained as to the dates and times of their symptoms and particulars of food eaten. Articles of food from the preceding day's meal at the canteen were sampled and forwarded to the Public Health Laboratory, Colindale, also the canteen staff and some of the affected persons were asked to submit specimens of faeces. Twenty-seven such specimens were examined and the bacteriological reports on all the specimens showed " Pathogens and parasites not found. No common organism found. Bact. Alkaligenes present in two healthy persons." Some 230 employees (approximately 10%) were affected, but it would appear that the illness was due to a virus infection of unknown origin causing an outbreak of " Winter Vomiting " or " Epidemic Nausea and Vomiting." From the report on the bacteriological examination of the foodstuffs the outbreak " pointed to an airborne rather than a foodborne infection." 15 cases (non-fatal) were notified during the year, as follows:— Case No. Sex Age Suspected Cause of Illness Organism Responsible 1 F. 44 ? Pork Luncheon Mea t Unknown 2 M. 55 Unknown Unknown 3 F. 36 Unknown Unknown 4 M. 1 Unknown B. Coli 5 M. 20 Unknown Unknown 6 M. 32 Unknown Unknown 7 M. 6 ? Meat Pie Salmonella Typhi-murium 8 F. 66 ? Meal including chicken and ice cream Salmonella Group C. 9 F. 61 Re-heated chicken and pork CI. Welchii 10 M. 74 ditto CI. Welchii 11 F. 24 ditto CI. Welchii 12 F. 23 Unknown Unknown 13 F. 16 ? Pork Sausages Unknown 14 F. 50 ditto Unknown 15 F. 12 ditto Unknown 33 Pneumonia. 101 cases were notified during the year. Poliomyelitis. During the year 16 confirmed cases of Poliomyelitis (13 Paralytic and 3 Non-Paralytic) occurred in the Borough. Notifications were received in April (1), August (3), September (3), October (7) and November (2). There were three deaths from this disease. One case was notified in 1954. The following table gives the age, incidence, etc., of those suffering from notifiable diseases, excluding Tuberculosis which is dealt with separately. It must be noted that the figures in the second column "No. removed to hospital" includes those already under treatment at a hospital, for instance, the North Middlesex Hospital. This remark applies more particularly to the infections associated with parturition and includes puerperal pyrexia and ophthalmia neonatorum. The number of deaths from Pneumonia includes all forms of this disease. Disease Total No. of Cases No. Removed to Hospital Deaths - to 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 and over Scarlet Fever 64 47 ... ... ... 3 6 6 35 10 4 ... ... ... ... Measles 1754 23 ... 42 157 164 209 256 888 20 9 9 ... ... ... Whooping Cough 115 4 ... 7 9 15 12 16 49 5 ... 1 1 ... ... Pneumonia 101 16 47 4 1 1 ... 3 7 2 3 17 13 26 24 Puerp. Pyrexia 164 158 ... ... ... ... ... ... ... ... 13 116 35 ... ... Erysipelas 10 3 ... ... ... ... ... ... ... ... 1 3 3 2 1 Food Poisoning 15 ... ... ... 1 ... ... ... 1 1 1 4 2 3 2 Poliomyelitis 16 16 3 2 3 1 1 ... 7 1 ... 1 ... ... ... Ophth- Neonatorum 91 86 ... 91 ... ... ... ... ... ... ... ... ... ... ... Dysentery 142 7 ... 5 6 11 10 13 28 15 6 22 10 11 5 Meningococcal Infection 2 2 ... 1 1 ... ... ... ... ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Paratyphoid 'B' 7 7 ... ... 1 ... ... ... ... ... 1 2 1 2 ... Typhoid Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 34 The following table indicates the Wards from which the various cases were notified:— Disease Bury Street Ward Church Street Ward Angel Road Ward Silver Street Ward N. Middx. Hosp. Other Instns. Total Scarlet Fever 19 14 11 20 ... ... 64 Measles 499 396 368 491 ... ... 1754 Whooping Cough 39 20 11 45 ... ... 115 Pneumonia 56 12 21 12 ... ... 101 Puerperal Pyrexia 3 ... 1 2 158 ... 164 Erysipelas 8 1 ... 1 ... ... 10 Food Poisoning 4 2 7 2 ... ... 16 Poliomyelitis 1 7 4 4 ... ... 16 Ophth-Neonatorum 3 ... 2 ... 86 ... 91 Dysentery 25 18 31 66 2 ... 142 Meningococcal Infec. 1 ... ... 1 ... ... 2 Diphtheria ... ... ... ... ... ... ... Paratyphoid 'B' ... 4 2 1 ... ... 7 Typhoid Fever ... ... ... ... ... ... ... Malaria ... ... ... ... ... ... ... IMMUNISATION. As and from 5th July, 1948, immunisation against Diphtheria and Whooping Cough became the responsibility of the Middlesex County Council. Set out below are details of the Treatment given during 1955:— Age Children who completed a full course of primary immunisation Children given a reinforcing injection Diphtheria only Combined Diphtheria and Whooping Cough Whooping Cough only Diphtheria only Combined Diphtheria and Whooping Cough Whooping Cough only (1) (2) (3) (4) (5) (6) (7) Under 1 69 521 — — — — 1 26 211 2 — — — 2—4 17 50 3 160 168 — 5—14 127 12 — 1.053 46 — 15 and over 1 — — — — — Total 240 794 5 1,213 214 — CANCER. The incidence of Cancer relative to the various organs of the body is given as under:— Males Females Breast — 21 Uterus — 5 Lung, Bronchus 32 8 Stomach 10 13 All other sites 45 32 87 79 35 WELFARE OF OLD PEOPLE The Edmonton Welfare Association consists of members of the Borough Council and Voluntary Organisations together with representatives of the old people's clubs. The Borough Council's Welfare Officer acts as Welfare Organiser to the Association. The Association's primary purpose is to co-ordinate the activities of the aforementioned bodies within one organisation, but it must be made quite clear that its acitvities in no way take the place of the services provided by the Middlesex County Council, but are in fact complementary thereto. Set out below is a brief report of some of the Welfare Services now in operation, the information being extracted from the Annual Report of the Association:— Meals on Wheels.—During 1955 the number of meals delivered to physically handicapped and house-bound old people was 11,565. Acknowledgment is paid to the outstanding work of the team of voluntary workers from the W.V.S. and to the Council's catering staff. Recreation.—Through the Council's Entertainments Committee a comprehensive programme of concerts to the old people's clubs has been carried out. and in the summer months special afternoon concerts were arranged in the Summer Theatre. Visiting. — The Voluntary Social Visitors have been fully occupied throughout the year and special mention is made of the work of the British Red Cross Society in this connection. Holidays.—Information has been circulated to the old people's clubs and other interested organisations of the off-season holidays available to old people at reduced prices. Library Service.—The Libraries Department of the Council provide books to house-bound, physically handicapped and old people. Welfare Food Service.—1.158 sales of Bovril and Ovaltine were made to the old people who have been ill during the winter months. Tribute is paid to the Red Cross. Edmonton, who act as distributing agents on behalf of the Association. Hairdressing Service.—Arrangements have been made with the Edmonton Branch of the London and Provincial Hairdressers' Association for Old Age Pensioners, both men and women, to have hairdressing at reduced prices. House-bound cases are also catered for. There has been an increase in the use of this service. 36 Radio Repair Service.—Since this service was introduced, the first of its kind in the country, 46 radio sets of Old Age Pensioners have been repaired by the "operating unit" under the direction of Mr. D. C. Jardine, London District Representative of the Radio Society of Great Britain. There is no charge to the Old Age Pensioner. The appreciation of the services rendered by the members of the " operating unit" is recorded by the Association. Foot Service.—640 old people received treatment through the Edmonton Red Cross Foot Service. Transport is arranged in special cases. "S.O.S." Card Service—Provides for the issue of "S.O.S." Cards to physically handicapped and aged persons living alone who may become seriously ill and require immediate medical attention. The cards are issued only on the authority of the Medical Officer of Health and a register of cards issued is kept in the Public Health Department. The Area Health Department maintains close contact with the old people through the work of the Health Visitors who are also able to advise the old people of the other Welfare Services available in the Borough. Twenty-six persons have been registered under this scheme. Guide of Welfare Services.—The Association has published a booklet "Guide to Welfare Service Available to Old People in the Borough of Edmonton" and distribution of the same throughout the Borough has been in progress for some time, and it is evident from this distribution that there is now a wider knowledge of all the Welfare Services both voluntary and statutory available to the local residents. One of the chief problems of old age is loneliness, and we believe that through companionship and service to others, by the cultivation of friendship and outside interests, comes happiness and contentment which thereby defeats loneliness. It is acknowledged that the old people's clubs in the Borough are doing magnificent work in this direction, but we have by no means yet been able to locate all the lonely old people whose life is bound by the four walls of their home. This knowledge should be the spur to greater effort. There is no field of human endeavour that gives greater satisfaction and reward than giving voluntary service, and a very sincere welcome awaits the volunteer in the many activities now in operation in the Borough of Edmonton for the common good. 37 NATIONAL ASSISTANCE ACT, 1948. Section 47—Removal to suitable premises of persons in need of care and attention. No action was necessary during the year under this Section. Several cases were dealt with by the Public Health Department, and admission to suitable premises was obtained without recourse of legal action. MIDDLESEX COUNTY COUNCIL ACT, 1944. Establishments for Massage or Special Treatment. Six existing licences were renewed during the year. TUBERCULOSIS. The table below gives details of the ages and sex of new cases of Tuberculosis, also deaths from the disease ; this latter figure includes the deaths of non-notified cases. Age Periods New Cases Deaths Respiratory N on-respiratory Respiratory Non-respiratory M. F. M. F. M. F. M. F. Under 1 year 2 ... ... ... ... ... ... ... 1— 5 years 2 1 ... ... ... ... ... ... 5—15 „ 2 3 ... 1 ... ... ... 1 15—25 „ 10 14 1 ... ... ... ... ... 25—35 „ 11 9 1 2 ... ... ... ... 35—45 „ 15 3 ... 3 1 ... ... ... 45—55 „ 16 4 ... 3 1 ... ... ... 55—65 „ 8 3 ... 2 2 ... ... ... 65 years upwards 2 ... ... 1 3 1 1 ... 68 37 2 12 7 1 1 1 In addition, 22 cases of pulmonary tuberculosis and no cases of nonpulmonary tuberculosis previously notified in other areas, moved into Edmonton. The total number of names added to the Register for the first time during the year, excluding of course, non-notified deaths was:— Males Females New cases (respiratory) 68 37 (non-respiratory) 2 12 Transferred cases (respiratory) 11 11 (non-respiratory — — 81 60 There were no non-notified deaths. 38 The non-respiratory forms of tuberculosis notified were:— Males Females Other bones and joints — 2 Glands 1 7 Kidney — 1 Genito-Urinary System 1 — Meninges — 1 Rectum — 1 The number of cases of tuberculosis on the Register at the end of 1955 was:— Males Females Total Pulmonary forms 642 502 1,144 Non-pulmonary forms 64 97 161 706 599 1,305 The corresponding figures at the end of 1954 were: Males Females Total Pulmonary forms 627 512 1,139 Non-pulmonary forms 74 96 170 701 608 1,309 Corresponding figures for previous years were: — Males Females Total 1953 668 598 1,266 1952 635 567 1,202 1951 570 536 1,106 1950 519 498 1,017 1949 509 468 977 1948 500 452 952 1947 442 405 847 1946 417 375 792 1945 389 332 721 1944 370 319 689 1943 411 355 766 1942 348 304 652 1941 355 293 648 1940 349 313 662 1939 357 301 658 1938 363 297 660 1937 336 260 596 1936 315 252 567 1935 330 265 595 39 MASS RADIOGRAPHY The North East Metropolitan Regional Hospital Board Mass Radiography Unit visited the Borough during April. May and June, 1955, and set out below is the final analysis of the investigation kindly supplied by the Medical Director:— Male Female Total Total Number X-rayed by Miniature graphy 6.097 4,667 10,764 Recaliled for large films 228 137 365 Organised Groups (Factories, Offices, etc.) Number of Miniatures 4.592 2,675 7,267 Recalled for Large Film 170 74 244 Public Sessions Number of Miniatures 946 1,320 2,266 Recalled for Large Film 43 52 95 Schoolchildren Number of Miniatures 549 658 1,207 Recalled for Large Film 15 11 26 School Staff Number of Miniatures 10 14 24 Recalled for Large Film — — — Total Miniatures 6,097 4,667 10,764 Total Large Film 228 137 365 Cases of Pulmonary Tuberculosis (a) Number of cases notified as a result of this survey 10 7 17 (b) Cases not notified, i.e., cases kept under observation at chest clinics or discharged. This section also includes cases already notified having progressive lesions under treatment, or healed lesions 52 34 86 40 In the following groups:— Male Female Total Organised Groups (a) Notified 4 4 8 (b) Not notified 37 21 58 Public Sessions (a) Notified 5 3 8 (b) Not notified 14 11 25 Schoolchildren (a) Notified 1 — 1 (b) Not notified 1 2 3 Other abnormalities include: Bronchiectasis 3 — 3 Bronchial Carcimona 4 — 4 Diaphragmatic Paralysis (Unknown Aetiology) — 1 1 Mamatoma 1 — 1 Diaphragmatic Hernia 4 — 4 Heart Abnormalities (congenital) 1 1 2 Heart Abnormalities (acquired) 4 15 19 Benign Tumours, Lungs and Mediastinum — 2 2 Sarcoidosis 1 1 2 Intrathoracic Goitre — 1 1 Neurofibroma (provisional diagnosis) — 1 1 Mucocoele 1 — 1 COUNCIL'S EMPLOYEES. During 1955 the Medical Officer of Health paid a total of 388 visits to those employees who had been on the sick list for longer than a fortnight and when necessary, at fortnightly intervals. Of these, 70 were " not at home " and 42 had already resumed duty. Also during the year, the following medical examinations or assessments were made prior to appointment to permanent posts:— Medical examinations 19 Assessments without medical examinations 58 Medical assessments (not appointed) 37 41