AC 439 (1) EDM 41 BOROUGH OF EDMONTON REPORT OF THE MEDICAL OFFICER OF HEALTH 1956 BOROUGH OF EDMONTON REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1956 Borough of Edmonton 1956 His Worship the Mayor Alderman W. Preye, J.P. Deputy Mayor Alderman J. Reid PUBLIC HEALTH COMMITTEE Chairman: Councillor J. E. Cooke. Vice-Chairman: Councillor Mrs. R. A. Smythe. Members: The Mayor (Alderman W. Preye, J.P. (Ex Officio) The Deputy Mayor (Alderman J. Reid) (Ex Officio) Alderman G. W. Burrows Mrs. F. Long, J.P. Councillor Mrs. A. M. Glover Mrs. S. J. Halliday E. R. Holborn J. E. Lightfoot 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 Public Health Inspector: abc John P. Farrar. Public Health Inspectors: abc F. Beilby abc H. w. Grieves abcd V. C. QUIN abcd E. w. C. George (left 31.1.56) abcd J. H. Willis ac J. T. woolford ac G. S. Tovey (left 24.5.56) (2 Vacancies) Trainee Public Health Inspectors: T. C. Oliver L. C. Hibbs Senior Clerk: a F. J. Nash Clerical Staff : H. J. Weldon Miss I. Holloway A. Ballantine Mrs. E. J. Richards Mrs. I. Kavanagh Mrs. G. W. Cully (commenced 6.2.56) B. English (in H.M. Forces) D. H. Ratliff (commenced 16.1.56) Shops Act and Street Trading Inspector: A. Robinson a Certificated Public Health 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. This is my last annual report to you. During my period of office from 1935-57 I have seen many changes on the face of Edmonton and some improvements, especially in the health service. Housing.—Some of the worst houses have been taken down to make way for new healthy habitations, fitted with all laboursaving devices. In all, progress has been made for the greater benefit of the people, and I am glad to say that the people have responded to the efforts made on their behalf in a very satisfactory manner, and rapid progress has been made since 1935. Our efforts to deal with the Slum Clearance Programme have continued during the year. Two areas were the subject of Public Inquiry in 1956, namely, Goodwin Road and Angel Road, comprising a total of 102 houses involving 380 persons. It took some time and a great deal of effort to get various sections co-ordinated, and some of the restrictions have still a tendency to linger on. However, the efforts made have borne fruit and it has been a great source of satisfaction not only to me but to my excellent staff of officers in all departments. 5 The following bear testimony to the good work accomplished over the past 22 years as instanced by the table set out below:— Vital Statistics 1956 1955 1935 Birth Rate 12.88 12.07 16.71 Death Rate 9.77 8.58 9.02 Infantile Mortality Rate 22.94 17.52 52.80 Maternal Mortality Rate Nil 1.63 1.80 Not only have the infant mortality and maternal mortality rates decreased, but all sections have shown improvements. Diphtheria, once an annual scourge, has now almost disappeared. Scarlet Fever, once a serious disease, is now difficult to diagnose from simple maladies like sore throats. Tuberculosis.—The fight against tuberculosis is now organised on a sure basis and if continued should bring about the disappearance of this dread disease. It should be mentioned here the excellent co-operation and help given at all times to my department by Dr. Vernon Davies and the entire staff of the Chest Clinic. Under such circumstances a Health Service is bound to succeed and I am personally profoundly grateful to Dr. Davies and his staff for all the services rendered. It should also be borne in mind the very great and fundamental service rendered by the North Middlesex Hospital for the common good of the citizens of Edmonton and others. A human problem of some difficulty often arises for the Medical Officer of Health who has succeeded in establishing good relations with parents, and once parents have learnt to value his advice in connection with their children, they will often bring him their own troubles for solution. These troubles may frequently have nothing to do with his official position, but it is essential, nevertheless, that such troubles should be dealt with by him. This is a field in which every Medical Officer of Health needs all the tact and knowledge at his command and also some understanding of ideas and prejudices commonly held by adults, particularly where their own past education is limited. 6 There is a tremendous tendency for the various sections of a Department in Local Government to become "closed" to other sections and these tendencies are also characteristic of the various committees of the Council. To be effective each member of the health team should know of the work of the other members of the team, besides having some knowledge of the statutory and other resources available. There is, therefore, a necessity for Local Government to establish good relationships and to co-ordinate the various sections into one administrative whole, as only in this way can complete success be achieved. As these are my final words as Medical Officer of Health, I think it would be of interest to readers if I gave an indication as to the scope of some of the services now carried out by the Middlesex County Council in Area No. 1 (Edmonton and Enfield) under the joint administration of Dr. W. D. Hyde and myself. I will therefore attempt to give a very brief resume of the activities with special reference where possible to the Edmonton district. The following services are now provided in clinic establishments in the Edmonton district:— 1. Ante-Natal Clinics. 10. Ophthalmic Clinic. 2. Post-Natal Clinics. 11. Orthoptic Clinic. 3. Infant Welfare Clinics. 12. Orthopaedic Clinic. 4. Relaxation Classes. 13. Paediatric Clinic. 5. Child Guidance Clinic. 14. Speech Clinic. 6. Dental Clinics. 15. Inspection Clinic. 7. Foot Clinics. 16. Vaccination and Immunisation Clinics. 8. Minor Ailments Clinics. 9. Ear, Nose and Throat Clinic. Home Nursing.—This is one of the most important developments of the National Health Service Act, 1946, and 26 nurses are now employed in the area. During 1956 they paid a total of 84,587 visits in Edmonton and Enfield. Midwifery.—The 16 midwives for Area No. 1 do very valuable work in the homes and are now equipped with gas and air and trilene apparatus. The holding of relaxation classes for expectant mothers has become very popular and has proved of inestimable assistance in the education and health of the "mothersto-be." 7 Home Helps.—This is a very essential service to the community, especially to the chronic sick and the aged, and on December 31st, 1956, seven whole-time and 119 part-time women were employed in Edmonton and Enfield. Foot Clinics.—It is interesting to note that the pioneer work of the Edmonton Borough Council in establishing a Foot Clinic in Edmonton in 1946 has been well justified and whereas before the appointed day for the National Health Service Act (5th July, 1948) eight weekly sessions were held in one clinic, there are now fourteen sessions spread over three establishments, serving sections of the district, and one special session held weekly for school children and expectant and nursing mothers. These clinics are always well patronised and are of great value to the residents, especially the old folk who receive treatment at very reduced fees on the production of their pension books. Convalescence.—A scheme is in operation whereby patients recovering from illness and needing recuperative care can be sent away, and many Edmonton residents have been able to benefit from this arrangement. Day Nurseries.—This is one sad note in an otherwise happy picture of progress. There are now only two nurseries in the area, one being at Fore Street, Edmonton — this establishment is still being well patronised by the priority type of case eligible for admission. Welfare Foods.—In 1954 the County accepted responsibility for the distribution of welfare foods, formerly undertaken by the Ministry of Food, an advantage to the mothers who can now obtain these commodities in all the infant welfare clinics. Vaccination and Immunisation.—Very rapid advance has been made from the early days when only immunisation against diphtheria was offered, and it is now possible for children to have diphtheria and whooping cough injections as well as vaccination against smallpox. Poliomyelitis injections have only just commenced and, wisely, every precaution is being taken, but we shall very soon be able to offer it to parents for certain classes of children on a wide scale with general practitioners participating in the scheme. B.C.G. vaccination against tuberculosis of the school 8 leavers was commenced in September, 1956, Area No. 1 being amongst the first three in the Couuty of Middlesex to recognise its possibilities by producing a scheme which very speedily received support from the parents. Dental Clinics.—In Edmonton alone there are four dental units capable of carrying out 42 sessions per week, but unfortunately the shortage of dentists seriously handicaps this service, a very sad situation when it affects nursing and expectant mothers, pre-school and school children. There appears to be no immediate solution to the problem. Medical Inspection and care of school children.— Children are examined regularly and in addition the following examinations are now made:— (a) children in the 10 year age group are examined for colour vision and parents notified if vision defects make it unwise for their children on leaving school to follow certain occupations where colour plays an important part; (b) there is a full-time audiometer operator in the area, with special apparatus, who inspects all children in the following age groups: (i) 6 - 7 years, (ii) 8 - 9 years, (iii) 12-13 years. In this way we are able to trace children displaying any signs of deafness and to arrange prompt and adequate treatment. Child Guidance Clinic.—This service, inaugurated by the Edmonton Borough Council, has now blossomed out and been transferred from Weir Hall Clinic to premises of its own in Bush Hill Park, with staff capable of dealing with patients from both Edmonton and Enfield districts. Ear, Nose and Throat Clinic.—A specialist attends the Edmonton Clinic twice per month, and works in close co-operation with the audiometer operator. Ophthalmic Clinic.—An ophthalmic specialist attends the Edmonton Clinic three sessions weekly, and is supported by an orthoptic clinic which is able to carry out treatment recommended by the specialist. 9 Orthopaedic Clinic.—The Edmonton Clinic is opened daily for the treatment of pre-school and school children who require orthopaedic or ultra-violet treatment, and has a visiting specialist three sessions per month. Paediatric Clinic.—One session is held weekly in Edmonton and this Clinic is doing very valuable work in the diagnosis and treatment of children. A very valuable experiment is being carried out, and older children, suffering from persistent enuresis, have been treated with encouraging results and with appreciation from the parents. Speech Clinic.—The clinic in Edmonton carries out very important work in the treatment of speech defects in childhood, thereby saving many children from severe handicaps in adult life. A speech recording machine has been purchased to enable the extent of progress to be demonstrated to parents and children and thereby encourage their treatment. Inspection Clinic.—The Edmonton clinic is still maintained for the cleansing of heads, the treatment of scabies, and education of parents requiring special advice. Swimming classes for asthmatic children.—In view of the number of asthmatic children at the Open Air School it was decided to take some active steps by providing swimming lessons, combined with relaxation exercises and ultra-violet light treatment in an effort to prevent chronic asthmatic conditions. With the co-operation of the physiotherapist at the Edmonton Orthopaedic Clinic and the head teacher at the Open Air School, these classes started in May, 1955, with most encouraging results. These are being held regularly and we hope that with the good conditions at the Open Air School and the extra treatment, this group of children will reduce their absences from school, increase their educational standard, enjoy the pleasures of more normal children, and thereby in adult life become healthy and happy citizens. Public Health Inspectors.—The Sanitary Inspectors (Change of Designation) Act, 1956, provides that Sanitary Inspectors shall in future be designated Public Health Inspectors. This change of designation is welcomed, and is more consistent with the wide range of public health work the Inspectors are now required to undertake. 10 Once again I must report vacancies in the Inspectoral Staff, with the consequent adverse effect on the work of the Department. The training of student public health inspectors continues. Whilst the system of training public health inspectors within the department is to be commended, it can only be regarded as a long term policy and does not solve the immediate shortage problem of qualified inspectors. In conclusion, I should like to pay tribute to the happy relations which have always existed between my department and the General Practitioners of the area. Apart from the many personal kindnesses which I have experienced at the hands of my colleagues, I have always found them willing and anxious to co-operate at all times. I should also like to express my appreciation of the good work for neglected children in the Edmonton district undertaken by the National Society for the Prevention of Cruelty to Children. The work done by the Society is all the more appreciable because it can take effect immediately and by personal contact; it is only in very serious cases that there is need for legal proceedings and therefore delay. Finally, in tendering farewell to my staff, who have always been loyal and affectionate to me, it leaves a gap in the social side of my existence which cannot easily be filled. To them I know it was sufficient recompense to see a good job effectively accomplished. For my part I cannot speak too highly of them and I hope they will accept my humble thanks for their loyalty and devotion to duty at all times. To the Mayor of Edmonton and the members of the Council I say goodbye in the knowledge that we have accomplished much together. There still remains more to be done, but I know that the future is in safe hands. I have the honour to be. Your Worship, Ladies and Gentlemen, D. REGAN, Medical Officer of Health. 11 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 1956 98,110 Number of inhabited houses and separate dwellings at the end of 1956 28,108 Number of inhabited houses and separate dwellings at the end of 1955 28,773 Rateable Value, April, 1956 £1,486.440 Estimated product of Id. in the £ for the year ending March 31st, 1957 £6,100 Rates in the £ for the year ending March 31st, 1957 14s. l0d. VITAL STATISTICS. Live Births. M. F. Total Grand Total Legitimate 650 568 1,218 Illegitimate 19 27 46 1,264 Birth-rate per 1.000 of population 12,88 Stillbirths. Legitimate 13 14 27 29 Illegitimate 1 1 2 Total of live and stillbirths 1,293 Rate per 1.000 total births 22,42 Deaths. Number 515 444 959 9.77 Rate per 1,000 population Maternal Mortality. Rate per 1,000 total Deaths live live and stillbirths Toxaemias of Pregnancy — Complication of Pregnancy and Delivery — — Death rate of Infants under one year of age. M. F. Total Number 21 8 29 All infants per 1,000 live births 22.94 Legitimate infants per 1,000 legitimate live births 22.98 Illegitimate infants per 1,000 illegitimate live births 21.74 Deaths from Cancer (all ages) 214 Measles (all ages) — Whooping Cough (all ages) — Diarrhoea (under 2 years of age) — 12 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 6 7 13 Tuberculosis, other 1 1 2 Syphilitic disease 2 ... 2 Diphtheria ... ... ... Whooping Cough ... ... ... Meningococcal infections 1 ... 1 Acute Poliomyelitis ... ... ... Measles ... ... ... Other infective and parasitic diseases ... 1 1 Malignant neoplasm, stomach 13 13 26 Malignant neoplasm, lung, bronchus 55 8 63 Malignant neoplasm, breast ... 24 24 Malignant neoplasm, uterus ... 4 4 Other malignant and lymphatic neoplasms 45 52 97 Leukaemia, aleukæmia 3 ... 3 Diabetes 1 3 4 Vascular lesions of nervous system 35 72 107 Coronary disease, angina 98 50 148 Hypertension with heart disease 11 14 25 Other heart disease 49 83 132 Other circulatory disease 17 14 31 Influenza 1 2 3 Pneumonia 23 18 41 Bronchitis 52 16 68 Other diseases of the respiratory system 4 3 7 Ulcer of stomach and duodenum 10 4 14 Gastritis, Enteritis and Diarrhoea ... 3 3 Nephritis, and Nephrosis 5 6 10 Hyperplasia of Prostate 5 ... 5 Pregnancy, childbirth, abortion ... ... ... Congenital malformations 6 6 12 Other defined and ill-defined diseases 50 26 76 Motor Vehicle Accidents 6 ... 6 All other accidents 7 11 18 Suicide 10 4 14 Homicide and operations of war ... ... ... TOTALS 515 444 959 13 The two following tables give the deaths of those registered during the 52 weeks ended 31st December, 1956. 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 6 ... ... ... ... ... ... 3 ... 3 ... ... Tuberculosis, other 1 ... ... ... ... ... ••• ... ... 1 ... Syphilitic disease 2 ... ... ... ... ... ... ... ... 2 ... ... Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal infections 1 1 ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... Other infective and parasitic diseases ... ... ... ... ... ... ... ... ... ... ... ... Malignant neoplasm, stomach 14 ... ... ... ... ... ... ... 2 5 5 2 Malignant neoplasm, lung, bronchus 51 ... ... ... ... ... 1 5 8 21 12 4 Malignant neoplasm, breast ... ... ... ... ... ... ... ... ... ... ... ... Malignant neoplasm, uterus ... ... ... ... ... ... ... ... ... ... ... ... Other malignant and lymphatic neoplasms 46 ... ... ... ... ... ... 6 7 4 13 15 Leukaemia, aleukæmia 3 1 ... ... ... ... ... ... 1 1 Diabetes 1 ... ... ... ... ... ... ... ... ... ... 1 Vascular lesions of nervous system 36 2 ... ... ... ... ... 1 4 4 16 10 Coronary disease, angina 100 ... ... ... ... ... ... 2 18 22 30 28 Hypertension with heart disease 13 ... ... ... ... ... ... ... ... 2 5 6 Other heart diseases 49 ... ... ... ... ... ... 1 1 8 13 26 Other circulatory disease 15 ... ... ... ... ... ... 1 2 2 3 7 Influenza 1 ... ... ... ... ... ... ... ... ... ... 1 Pneumonia 24 1 ... ... ... ... 1 1 2 3 4 12 Bronchitis 62 1 ... ... ... ... ... 1 5 14 17 14 Other disease of respiratory system 6 ... ... ... ... ... 1 1 1 ... ... 3 Ulcer of stomach and duodenum 9 ... ... ... ... ... ... ... 3 1 3 2 Gastritis, Enteritis and Diarrhoea ... ... ... ... ... ... ... ... ... ... ... ... Nephritis and nephrosis 5 ... ... ... ... ... 1 ... 1 1 ... 2 Hyperplasia of prostate 2 ... ... ... ... ... ... ... ... ... 2 ... Pregnancy, childbirth, abortion ... ... ... ... ... ... ... ... ... ... ... ... Congenital malformations 6 5 ... ... ... ... ... ... 1 ... ... ... Other defined and ill-defined diseases 48 8 ... ... ... ... 2 2 4 8 12 12 Motor Vehicle Accidents 5 ... ... ... ... ... 3 ... ... ... 1 1 All other accidents 7 ... ...... ... ... ... 1 ... 1 1 1 3 Suicide 10 ... ... ... ... 2 1 1 2 2 1 1 Homicide and operations of war ... ... ... ... ... ... ... ... ... ... ... ... TOTALS 512 19 ... ... ... 2 11 25 63 104 138 150 14 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 7 ... ... ... ... ... ... 2 1 1 1 2 Tuberculosis, other 1 ... ... ... ... ... ... 1 ... ... ... ... Syphilitic disease ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal infections ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... Other infective and parasitic diseases ... ... ... ... ... ... ... ... ... ... ... ... Malignant neoplasm, stomach 12 ... ... ... ... ... ... ... 3 4 ... 5 Malignant neoplasm, lung, bronchus 8 ... ... ... ... ... ... ... ... 4 3 1 Malignant neoplasm, breast 24 ... ... ... ... ... ... 2 7 4 9 2 Malignant neoplasm, uterus 4 ... ... ... ... ... ... ... 1 2 ... 1 Other malignant and lymphatic neoplasms 62 ... ... 1 ... 2 ... 4 8 8 14 12 Leukaemia, aleukæmia ... ... ... ... ... ... ... ... ... ... ... ... Diabetes 3 ... ... ... ... ... ... ... ... 1 1 1 Vascular lesions of nervous system 76 ... ... ... ... ... ... 1 ... 9 23 43 Coronary disease, angina 50 ... ... ... ... ... ... ... 2 7 14 27 Hypertension with heart disease 19 ... ... ... ... ... ... 1 ... ... 2 16 Other heart diseases 80 ... ... ... ... ... 1 3 1 7 14 54 Other circulatory disease 13 ... ... ... ... ... ... ... 3 2 4 4 Influenza 2 ... ... ... ... ... ... ... ... ... 1 1 Pneumonia 18 ... 1 ... 1 ... ... ... 1 ... 4 11 Bronchitis 16 ... ... ... ... ... ... ... ... 2 3 11 Other disease of respiratory system 3 ... ... ... ... ... ... ... 1 2 ... ... Ulcer of stomach and duodenum 4 ... ... ... ... ... ... ... ... ... 1 3 Gastritis, Enteritis and Diarrhoea 4 ... ... ... ... 1 ... ... ... ... 2 1 Nephritis and nephrosis 5 ... ... ... 1 1 ... ... 2 ... ... 1 Hyperplasia of prostate ... ... ... ... ... ... ... ... ... ... ... ... Pregnancy, childbirth, abortion ... ... ... ... ... ... ... ... ... ... ... ... Congenital malformations 5 4 ... 1 ... ... ... ... ... ... ... ... Other defined and ill-defined diseases 22 5 ... ... 1 1 ... ... 3 3 1 8 Motor Vehicle Accidents ... ... ... ... ... ... ... ... ... ... ... ... All other accidents 11 ... ... ... 1 1 ... 1 1 2 ... 5 Suicide 4 ... ... ... ... ... 1 ... 2 ... ... 1 Homicide and operations of war ... ... ... ... ... ... ... ... ... ... ... TOTALS 443 9 1 2 4 6 5 15 36 58 97 210 15 INFANTILE MORTALITY. The deaths of infants under one year of age were as follows :— M. F. Total Legitimate 20 8 28 Illegitimate 1 – 1 21 8 29 The death rate of all infants per 1,000 live births was 22..')4 The death rate of all infants under one month of age per 1,000 live births was 15.82. 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 Myeloid Leukæma ... ... ... ... ... ... ... ... 1 1 Pneumonia ... ... ... ... ... 1 ... ... ... 1 Bronchitis ... ... ... ... ... ... ... ... 1 1 Premature Birth 6 ... ... ... 6 ... ... ... ... 6 Birth Injury 2 ... ... ... 2 ... ... ... ... 2 Other Causes 2 ... ... ... 2 ... ... ... ... 2 Congenital Malformations 1 2 ... ... 3 1 ... 1 ... 5 Meningococcal Septicæmia ... ... ... ... ... ... 1 ... ... 1 Totals 11 2 ... ... 13 2 1 1 2 19 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 Asphyxia Neonatorum 1 ... ... ... 1 ... ... ... ... 1 Premature Birth 3 ... ... ... 3 ... ... ... ... 3 Congenital Malformations 1 ... ... ... 1 1 ... 2 ... 4 Other Causes 1 ... ... ... 1 ... ... ... ... 1 Totals 6 ... ... ... 6 1 ... 2 ... 9 16 COMPARATIVE STATISTICS Birth-rate Death Rate Infant Mortality Rate Live Still England and Wales 16.70 23.00 11.70 23.80 Middlesex 13.60 18.44 10.00 19.10 Edmonton 12.88 22.42 9.77 22.94 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 difference 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 141 115 123 142 5 ' 4 Church Street 75 54 125 126 3 1 Angel Road 94 90 95 65 4 1 Silver Street 127 115 169 110 7 3 Vagrants ... ... ... ... ... ... 437 374 512 443 19 9 17 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 — — 29 Blood—Haemoglobin Estimation — — 163 Blood—Kahn Reaction — 113 113 Blood—Rhesus Factor — — 112 Blood—Grouping — — 111 Eye swabs for organisms — — 1 Faeces for the presence of pathogens 249 1,676 1,925 Per-nasal Swabs for H. Pertussis — 4 4 Swabs for presence of C. Diphtheriæ: (a) From Suspect Cases — 8 8 (b) From Contacts — — — (c) From Carriers and old cases, etc. — — — Swabs for presence of Haemolytic Streptococci 134 670 804 Swabs for presence of Vincent's Angina — 5 5 Urines — — 116 Vaginal swabs for presence of organisms 3 19 22 Ear swabs — — 3 Breast Milk — — 1 Chinese Frozen Egg for Salmonella Organisms — 2 2 Hairs (Scalp) for Ringworm — 1 1 Penile Swab — — 1 Discharge from Breast — — 0 Pickle, Chutney and Anchovy Paste for Pathogens 3 3 Dried Chinese Egg for Pathogens – 1 1 Swab of Pus from Ankle — — 1 Dog Droppings and Cage Scrapings for Pathogens 2 2 Nasal Swab for Staphylococci 1 — 1 Total 3,431 18 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. The Public Health Inspectors are engaged in the sanitary supervision of the Borough, working under the supervision of the Senior Public Health Inspector. The Senior Public Health Inspector supervises the work of the Borough. Sanitary Conveniences. There are seven public conveniences in the Borough under the supervision of the Senior Public Health 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. it is proposed that the charges for the use of W.Cs. in the men's conveniences be abolished at the beginning of the financial year 1957 Rodent Control. Your Senior Public Health 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 Public Health Inspectors as Rodent Officers. During the year the treatment of business premises by "Warfarin" was continued and has proved very successful. The Public Health 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. 19 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 1956 as a result (a) of notification or (b) otherwise (a) 4 651 ... 32 687 (b) 1 3,669 ... 672 4,342 2. Number of Properties (under 1) found to be infested by rats Major 3 1 ... 8 12 Minor 1 548 ... 7 556 3. Number of Properties (under 1) found to be infested by mice 1 76 ... 10 87 4. Number of Infested Properties (under 2 and 3) treated by the Local Authority 5 624 ... 23 652 5. Number of Notices served under Section 4: (1) Treatment ... ... ... ... ... (2) Structural Works (i.e., Proofing) ... ... ... ... ... 2. Measures of Control. Type of Property. Properties Inspected. No. of Inspections Notices Served. Treatment Completed. Block Treatments Rats, Mice, Local Authority's Premises 5 131 .. 4 1 .. Dwelling Houses 4,320 7,351 .. 574 75 .. Business Premises 704 867 •• 12 10 .. Total 5,029 8,349 •• 590 86 .. 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 and 20th Maintenance Treatments were carried out in the Spring and Autumn of 1956. The results achieved are very similar to those for the past ten years, seeming to indicate that the rat population in sewers is keeping at a level figure, neither increasing nor decreasing. This supports the view put forward at times by the Divisional Rodent Officer that sewer treatments would probably only prevent the rat population from increasing. 20 The Divisional Rodent Officer, at the last district meeting, hinted that before long the method of treatment might be altered to direct-poisoning, using "1080 This method has been used by the Corporation of London, who claim a decided reduction in the rat population of the sewers. If this method is adopted, the work should be carried out by a specialist firm, and it is anticipated that a saving in cost would be achieved, in addition to relieving the labour shortage problem. 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 108 hawkers on the Register at the end of 1956. Disinfection and Disinfestation. The following table gives some idea of the work carried out: — Number of journeys to collect bedding and Spray Verminous premises 410 „ ,, ,, ,, return bedding 243 Rooms disinfected after infectious disease 173 „ „ „ phthisis 21 ,, ,, ,, other cases 47 ,, ,, ,, „ vermin 285 Bedding, clothing, etc., disinfected after infectious disease 1.113 articles ,, ,, ,, ,, ,, phthisis 80,, ,, ,, „ „ „ other cases 589 ,, ,, ,, ,, ,, ,, vermin 462 „ 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 10.737. 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 797. 44 Council properties and 69 other houses were found to be infested; the total number of rooms disinfested was 285. The whole of the work is carried out by the Department, the materials used being insecticides containing D.D.T. as a base. 21 FLOODING During the early hours of Monday, 9th July, 1956, severe flooding occurred in many parts of the Borough, caused by the abnormal rainfall in the London area. The Public Health Inspectors visited the affected areas to ascertain the extent of the flooding and arrangements were made for distribution of carbolic fluid and carbolic powder to the affected premises, when the flood water had subsided Distribution in Public Health Department transport commenced at approximately 4 p.m. and was completed at 10 p.m. Some 750 houses were involved. 100 gallons of fluid and 32 cwt. of powder were distributed. In addition, factories in the Angel Road area were visited by the Public Health Inspector and advised, and disinfectants supplied where requested. Sanction was obtained from the Ministry of Housing and Local Government for expenditure in connection with the loan of Royal Air Force Ground Trolley Heaters for drying out flooded houses. Four R.A.F. Ground Trolley Heaters were supplied together with necessary R.A.F. personnel. The Heaters were used for a total of 275.¼ hours between 11th and 20th July, 1956. 824 houses were primarily inspected. 347 of which were found to require treatment by the Heaters. 317 houses were actually treated (30 refusals). Disinfectants were issued throughout the week following the flooding and 240 gallons of fluid and 2½ tons of powder distributed to the affected areas. Further flooding occurred on 6th August, 1956, but not so severe as previously; although water entered many of the houses, no evidence was found that it rose about the floorboards. A total of 45 gallons of carbolic fluid and 10 cwt. of powder was distributed. Petroleum (Regulations) Acts, 1928 and 1936. During the year 12 new licences and 117 renewals were granted by the Council. The following is a list of particulars of quantities, etc., affected by these licences: — Petroleum spirit 447.855 galls. Petroleum mixtures (cellulose) 15.710 galls. Rubber solution 100 lb. &.850 galls. 22 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 1,661 Infectious Diseases 196 Food Poisoning 13 House-to-house 533 Flooding—Primary Visits 815 Revisits 497 Factories with mechanical power 443 Factories without mechanical power 51 Housing Rents and Repairs Act, 1954 140 Housing Act, 1949, Improvement Grants 38 Factories (other) 1 Outworkers 9 Schools 17 Offensive trades – Shops and Stalls 154 Shops Act — Pets Act 13 Sanitary conveniences and urinals 244 Smoke observations 874 Rat infestation 275 Petroleum 336 General inspections 315 Sundry visits 1,953 Cinemas and Halls 19 Stables and Piggeries 55 Moveable Dwellings 29 Sampling Water 13 Sampling Ice Cream 9 Sampling Milk — Sampling Rag Flock 12 Re-inspections 4,957 Inspection of Places where Food is Prepared. Butchers 138 Fish shops 67 Cafes and Restaurants 81 Dairies and milkshops 35 Slaughterhouses 9 23 Bakehouses (Factory) 25 Bakehouses (Workshops) — Ice cream shops 93 Canteens 67 Other food premises 134 Sampling other food 13 Defects Remedied. Roofs repaired 488 Gutters and rainwater pipes repaired 341 Brickwork or Pointing Repaired 142 Chimney Stacks, etc., repaired or rebuilt 34 Yards or forecourts repaved or repaired 68 Drains examined, tested or exposed 630 Drains cleared, trapped or repaired 539 Drains reconstructed 101 Chambers inserted or built up to ground level 75 Soil and vent pipes, new fixed or repaired 49 W.C.s repaired or improved 185 Flushing cisterns repaired or new fixed 73 Sink waste pipes repaired or new fixed 48 New sinks fixed 14 Drinking water cisterns covered, cleansed, repaired 7 Water fittings repaired 93 Water taken off main or restored 9 Internal walls 387 Ceilings repaired, cleansed, etc. 259 Door frames repaired — Floors repaired 130 Floors ventilated 37 Dampness remedied 212 Window frames or sashes repaired or renewed 545 Fireplaces, stoves repaired 89 Coppers repaired 6 New dustbins supplied 7 Premises rat-proofed 24 Improper keeping of animals discontinued 1 Foul accumulations removed 18 Other nuisances abated 283 Moveable dwellings removed 11 New boiler house constructed — New boiler installed — Factory sanitary conveniences inspected 29 improved 4 Other defects remedied 69 Petroleum installations—defects remedied 30 tested 30 Smoke abatement—Boiler plants improved 11 24 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 206 486 6 Factories without mechanical power 7 10 Other premises under the Act (including works of building and engineering and construction but not including workers' premises) 1 1 — — Totals 214 497 6 — 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 4 4 — Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation 1 1 — — Ineffective drainage of floors — — — — — Sanitary Conveniences Insufficient — — — — Unsuitable or defective 47 127 1 — Not separate for sexes — — — — — Other offences 8 8 — — — (Not including offences relating to ou t work) Totals 60 140 — 1 — 25 3. Outwork—Sections 110 & 111 Nature of Work Section no Section III 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. 271 Artificial flowers 9 — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper 23 — — — — — Brush making 55 — — — — — Stuffed toys 14 — — — — Cosaques, Christmas crackers, Christmas stockings, etc 6 — — — — — Curtains and Furniture Hangings 7 — — — — Household Linen 4 — — — Paper Bags 11 — — — — — Umbrellas, etc 1 — — — Brass and Brass Articles 7 — — — Carding etc. of Buttons etc 6 — — — — — Totals 424 — — — — — 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 Twelve samples of rag flock and other filling materials were examined during the year; all proved satisfactory. HOUSING. 1. Re-development Areas. Following representations made by the Medical Officer of Health, the Council on the 27th March. 1956, made Clearance Area Compulsory Purchase Orders under Part 3 of the Housing Act, 1936, comprising the following premises:— (a) Goodwin Road Area Clearance, 1956. 127 to 137 (odd) inclusive. Bounces Road, Edmonton. 26 1 to 7 (odd) inclusive, 11, 17, 21 to 51 (odd) inclusive and 6, 10 to 20 (even) inclusive, 26 to 48 (even) inclusive), Graham Road, Edmonton. 1 to 9 (odd) inclusive, 4. 6, 8, 16, 18, 22 and 24, Cumberland Road, Edmonton. 1 to 7 (odd) inclusive. 11 to 19 (odd) inclusive, 37, 2 to 12 (even) inclusive, 16 to 50 (even) inclusive, Goodwin Road, Edmonton. 57 and 59, Graham Road. Edmonton. 15, 17 and 19. Cumberland Road, Edmonton. Making a total of 98 houses, involving 365 persons. A Public Inquiry was held in June. 1956. The Minister of Housing and Local Government subsequently confirmed the Order with modification. Following representations by the Medical Officer of Health, the Council on 25th September, 1956. made Clearance Area Compulsory Purchase Order under Part 3 of the Housing Act, 1936. comprising the following premises:— (b) The Edmonton (Angel Road Clearance) Housing Compulsory Purchase Order. 1956 46-49 (consecutive). Angel Road. Making a total of 4 houses involving 15 persons. A Public Inquiry was held in January, 1957, and the Minister of Housing and Local Government subsequently confirmed the Order. 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) 1,218 (b) Number of inspections made for the purpose 6,175 (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 533 (b) Number of inspections made for the purpose 1,584 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 284 (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 27 685 (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 271 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 46 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 21 (b) By Local Authority in default of owners 2 B. Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 381 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 298 (b) By Local Authority in default of owners 11 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 116 (b) Part V 1 28 HOUSING REPAIRS AND RENTS ACT, 1954 Certificates of Disrepair. The following table gives details of the cases dealt with during the year 1956:— Certificates granted up to 31st December, 1955 209 Applications received during 1956 15 Certificates granted during 1956 14 Certificates revoked on completion of repairs during 1956 12 Certificates in force at 31st December, 1956 151 SLAUGHTERHOUSES. Nine visits were paid and the carcases and organs of 15 pigs killed were inspected during or shortly after slaughter. None was found to be affected with tuberculosis. Two carcases of which come part or organ was condemned showed a percentage of the number inspected affected with disease, other than tuberculosis, of 13.33. The following organs were surrendered:— Two sets of lungs. 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, 1956, was 9. Food and Drug Act, 1955 — Section 16. During the year 11 premises were registered for the Sale and St< of Ice Cream. jrage Number on Register at end of year:— Manufacturers and Vendors 5 Vendors only 182 29 Eight samples of Ice Cream were submitted to the Methylene Blue Test and graded as follows:— Grade 1 7 „ 2 — 3 — 4 1 During the year no premises were registered for the Preparation or Manufacture of Preserved Food, etc. Number on Register at end of year 39 Unsound Food. The following is a list of the food surrendered for examination and retained as unfit for human consumption:— Meat 1.528 tins Lamb 121/2 lb. Milk 2.476 „ Pork 2551/2 Fish 363 „ Offal 82 „ Jams. etc. 631 „ Ducks 3 only Soups 728 „ Chickens 3 only Beans 4,781 „ Ham 122 lb. Beetroot 33 „ Dog Fish 1 stone Carrots 236 „ Haddock 13 „ Mixed Veg. 176 „ Cod 2 1/2 Peas 2,721 „ Skate 211/2 „ Apricots 1,210 „ Rock Eel 3 „ Blackcurrants 9 „ Roes 6 boxes Cherries 376 „ Sausages 11 pks. & 38 lb. Damsons 322 „ Cake 10 only Grapefruit 32 „ Cheeses 23 lb. & 76 pkts. Gooseberries 53 „ Fish Cakes 25 only Fruit Salad 403 „ Fish Paste 22 jars Oranges 124 „ Macaroni 15 tins Peaches 34 „ Meat Paste 35 jars „ Pears 157 „ Pickle 325 Pineapple 188 „ Puddings 44 tins Plums 460 „ Sauce 1,159 botts. Prunes 3 tins & 1,534 lb. Spaghetti 133 tins Raspberries 200 „ Sandwich Spread 125 „ Rhubarb 75 „ Rice 11 „ Strawberries 151 „ Raisins 60 lb. 'Tomatoes 629 „ Sultanas 62 Tomato Juice 134 „ Margarine 3 „ Fruit Juices 140 „ Butter 6 „ Beef 2,208 lb. Salad Cream 75 jars 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. 30 FOOD SAMPLING I am indebted to the Chief Officer, Public Control Department, Middlesex County Council, for the following details of the work carried out in Edmonton during the year 1956:— List of Samples procured in the Borough of Edmonton during the year 1956: Article Total Number Examined Unsatisfactory. Milk, new 90 23 Milk, various 77 1 Butter 15 — Cakes 54 — Cheese 2 — Cooked meats 37 — Cream 19 — Coffee 2 — Drugs 21 — Fish 8 — Fish products 3 — Fruit, fresh 4 1 Fruit, canned 4 — Fruit, dried 4 — Fruit syrup 2 — Fruit squash 3 — Ice Cream 15 1 Lard 2 — Liver 3 — Margarine 4 — Meat 25 1 Meat products 4 — Miscellaneous 19 — Non-brewed condiment 1 1 Preserves 3 — Sausages, etc. 30 — Sweets 2 — Vinegar 3 — Total 456 28 With regard to the 28 samples noted as unsatisfactory, the following comments are made:— Milk. Twenty-one samples from one dairy farmer were all slightly deficient in fat or solids-not-fat. A letter of warning and advice was sent to the farmer. Two samples from another farmer were deficient in fat and solids-not-fat, but associated and subsequent samples proved to be genuine and no further action was taken. A sample of sterilised milk was deficient in fat and solids-not-fat and contained a small percentage of added water. The sterilisers were officially cautioned. 31 Fruit, fresh. Ponds Seedling Plums were displayed under the description " Victorias." A verbal caution was given the greengrocer. Ice Cream. Ice cream, described as "Dairy Ice Cream." contained fat other than milkfat. The manufacturers agreed to amend their label. Meat.* A leg of lamb contained preservative. A follow-up sample was genuine and no further action taken. Non-brewed Condiment. A sample of this product was found to be deficient in acetic acid. Proceedings were instituted and a fine of £3 0s. 0d., plus £7 15s. Od. costs, was imposed. The Food and Drugs Act, 1955, in Section 47, contains new provisions concerning the descriptions which can be applied to certain substances which resemble cream in appearance but are not cream. This has necessitated the making of many inspection visits and the giving of advice to all traders likely to be concerned to ensure that they were fully aware of these new requirements. Merchandise Marks Acts, 1887-1926. 166 inspections of shops were undertaken to ensure that the Marking Orders relating to certain imported foodstuffs made under the Merchandise Marks Act, 1926. were complied with. 584 separate displays of meat, apples, tomatoes, poultry and dried fruit were examined. Verbal cautions were given in respect of minor infringements not being found so serious as to warrant more stringent action. No serious infringements were disclosed. The Labelling of Food Order, 1953. This Order requires that, in general, pre-packed foods shall bear on the label a clear statement of the designation of the food and. in the case of compound foods, the ingredients. It also requires that the name and address of the packer or labeller appears. At 134 premises 431 articles of pre-packed food were examined. No proceedings were taken in respect of any of the infringements and manufacturers took immediate steps to correct unsatisfactory labels as soon as their attention was drawn to them. False or Misleading Descriptions. A considerable amount of work is carried out each year in scrutinising advertisements and the labelling of prepacked food and taking such action as is possible to secure satisfactory amendments in those cases where a label or advertisement contains a false or misleading description of the food to which it relates. This work is of benefit to all districts of Middlesex, irrespective of where the offending advertisement or label is discovered, and during the year under review corrective action has been taken in respect of cherry wine, biscuits, chocolate Easter eggs, flour and sugar confectionery, imitation caviare, blackcurrant punch, fruit juice drinks and creme de menthe. Special Designated Milk. During the year in question two licences were issued by my Council in respect of the use of the special designation "pasteurised" for milk processed within your Borough. Each premise was inspected regularly and compliance with the requirements of the Act or Regulations was maintained in each case. 110 samples were taken, two of which failed the methylene blue test, and official cautions were issued the pasteuriser. 32 Safe Milk. In addition to the foregoing, eight samples of raw milk were procured within your Borough and submitted to test for the presence of tubercle bacilli. None was found contaminated. CLEAN FOOD CAMPAIGN. The offer of a publishing firm to produce a Clean Food and Hygiene Handbook on behalf of the Council has been accepted. 2,500 copies of the booklet will be printed for distribution. A handbook giving a precis of the requirements of the Food Hygiene Regulations was distributed to the factory canteens, cafes and other food premises in the Borough. Unfortunately owing to shortage of staff it was not possible to do as much in this field as 1 would have wished. Summary of Food Premises registered under Section 16 of the Food and Drugs Act, 1955. Manufacture and Sale of Ice Cream 5 Sale only of Ice Cream 182 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 Summary of Food Premises Butchers 63 Grocers & Provision Dealers 191 Fish Shops 30 Dairies 9 Bakers and Confectioners 22 Retail Purveyors of Milk 105 Fruiterers and Greengrocers 60 Factory Canteens 74 Cafes 54 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 8. Game Dealers' Licences. During the year 3 licences to sell Game were renewed. 33 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 1,293 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 1,180 Washing facilities, sink water heaters installed 7 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.—No action necessary during the year. Shops Act, 1950—Part I—Hours of Closing. No action necessary during the year. Shops Act, 1950, Part II, Section 17(1)—Conditions of Employment. A letter of warning was sent to the occupier of a shop where an assistant was found working during the occasion of the weekly half-holiday. Shops Act, 1950, Part IV—Sunday Trading. Thirty-eight 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. Y oung 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, six letters of warning were sent for contravention of certain provisions of the Byelaws. five to licensed street traders and one to an unlicensed street trader. 34 In three other cases legal proceedings wre instituted and fines amounting to 10s. Od. and costs of 4s. 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 recently fixed gas fire was found not to comply with the Regulations (fireguard defective). An interview with the manager of the firm who fixed the appliance quickly resulted in the offending fire being fitted with the requisite guard. PREVALENCE OF INFECTIOUS DISEASE. Measles and Whooping Cough. These diseases were made compulsorily notifiable in October, 1939. 50 cases of Measles and 231 cases of Whooping Cough were notified during the year. There were no deaths from these diseases. Diphtheria. No cases were notified during the year. No cases were notified during 1955. Scarlet Fever. Continued to occur throughout the year in a mild form. There were 109 cases compared with 64 in 1955; there were no deaths. "Return" cases numbered two, 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. 35 Enteric Fever. Seven cases of Paratyphoid "B" were notified during the year. In five of the cases, involving three families, the consumption of cakes containing imitation cream purchased from the shops of a certain baker and confectioner in the Borough was strongly suspected to be the source of infection. Investigation of the remaining two cases failed to reveal the source of infection. Dysentery. During the year 185 cases of Dysentery were notified—125 Sonne, 21 Giardia. 19 Salmonella Typhi-murium. 3 Salmonella Thompson. 3 Salmonella Newport. 1 Salmonella Minnesota. 1 Salmonella Dublin. 1 Salmonella Group C. and 11 upspecified. Following the occurrence of nine cases of Sonne Dysentery in seven different classrooms at an infants' school (eight of the patients have school meals), a visit was paid to the school and the school canteen; 11 teachers in ihe infants department and 16 members of the school meals staff submitted faeces specimens, all of which proved negative, with the exception of the one submitted by the children's supervisor. In all, 46 cases were notified among the children at the school, including home contacts attending the Junior and Senior Departments. Inspection of the meals canteen revealed no faults in the canteen facilities; the washing facilities in the infants' school adequate, but the flushing arrangements to both sets of conveniences were found to be unsatisfactory. This matter was taken up with the Borough Education Officer. The action taken to deal with the outbreak followed the control measures detailed in my Report for 1950. 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 Staff of the Health Department. Meningococcal Infection. Two cases were notified during the year. There was one death. Ophthalmia Neonatorum. 34 cases were notified during the year. 31 in North Middlesex Hospital and 3 at home. Of this total 13 were Edmonton cases. 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. 96 cases were notified during the year (1 at home and 95 in North Middlesex Hospital. Of this total 20 were Edmonton cases. During 1955 164 cases were notified. 36 Food Poisoning. In March, 1956, investigations were carried out at a local factory following a report that 15 employees had complained of sickness during the night and the meal eaten the previous day was suspected. Sixty meals were served. The canteen manageress and 13 of the affected persons still at work were interviewed and details obtained as to dates and times of the symptoms, and particulars of food eaten. Two samples of food from the suspected meal were submitted for bacteriological examination and organisms of the food poisoning and dysentery groups were not found. Specimens of faeces were obtained from six of the affected persons and in two instances food poisoning organisms were found. It was thought by the Bacteriologist that the outbreak was probably caused from infection of the stock used at the meal, but unfortunately at the time of the investigation no stock was available for sampling. Two subsequent samples of the stock taken showed the presence of organisms which indicated that the stock had not been sterilised during cooking. The matter was taken up with the Caterers and suggestions made as to the preparation and storage of stock. Also every assistance and advice was offered to the Caterers on Food Handling and Kitchen Hygiene. No further cases were reported from the factory. Eight cases (not-fatal) were notified during the year, as follows:— Case No. Sex Age Suspected Cause of Illness Organism Responsible. 1 M. 55 ? Fried Fish Unknown 2 M. 26 Unknown Salmonella Typhi-murium 3 F. 53 Unknown Salmonella Typhi-murium 4 M. 26 Unknown Salmonella Typhi-murium 5 F. 39 Unknown Unknown 6 M. 11 Unknown Unknown 7 F.. 22 Unknown Unknown 8 M. 26 Unknown Unknown Pneumonia. 78 cases were notified during the year. Poliomyelitis. During the year 4 confirmed cases of Poliomyelitis (3 Paralytic and 1 Non-Paralytic) occurred in the Borough. Notifications were received in July (3) and December (1). There were no deaths from this disease. 16 caseswere notified in 1955. 37 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 109 78 ... ... 5 8 4 14 63 11 2 2 ... ... ... Measles 50 3 ... 5 9 3 7 5 15 4 2 ... ... ... WhoopingCough 231 8 ... 23 25 18 23 31 98 10 1 1 1 ... ... Pneumonia 78 4 41 ... 1 1 3 ... 3 1 1 13 8 27 20 Puerp. Pyrexia 96 95 ... ... ... ... ... ... ... ... 15 70 11 ... ... Erysipelas 18 6 ... ... ... 1 ... ... ... ... ... 3 3 9 2 Food Poisoning 8 1 ... ... ... ... ... ... ... 1 ... 4 1 2 ... Poliomyelitis 4 4 ... ... ... 1 ... ... 1 1 1 ... ... ... Ophth- Neonatorum 34 31 ... 34 ... ... ... ... ... ... ... ... ... ... ... Dysentery 185 6 ... 6 6 9 15 8 63 15 6 27 13 14 3 Meningococcal Infection 2 1 1 ... 1 ... ... ... ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... Paratyphoid 'B' 7 ... ... ... ... ... ... 5 ... ... ... ... 2 ... Typhoid Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Malaria ... ... ... ... ... ... ... ... ... ... ... ... 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 16 23 29 41 ... ... 109 Measles 7 6 8 29 ... ... 50 Whooping Cough 106 37 20 68 ... ... 231 Pneumonia 36 10 13 19 ... ... 78 Puerperal Pyrexia ... ... ... 1 95 ... 96 Erysipelas 13 1 3 1 ... ... 18 Food Poisoning 4 1 ... 3 ... ... 8 Poliomyelitis 1 1 ... 1 ... ... 4 Ophth-N eonatorum 1 1 ... 1 31 ... 34 Dysentery 27 25 101 32 ... ... 185 Meningococcal Infec. 1 l ... ... ... 2 Diphtheria ... ... ... ... ... ... ... Paratyphoid 'B' 3 ... 1 3 ... ... 7 Typhoid Fever ... ... ... ... ... ... ... Malaria ... ... ... ... ... ... ... 38 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 1956:— 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 45 662 — — — — 1 38 118 1 — — 2—4 34 54 3 73 249 5—14 132 12 — 1.023 86 — 15 and over — — — — — — Total 249 846 4 1,096 335 — CANCER. The incidence of Cancer relative to the various organs of the body is given as under. Males Females. Breast — 24 Uterus — 4 Lung, Bronchus 55 8 Stomach 13 13 All other sites 45 52 113 101 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:— 39 The work of the Association during the year under review has continued to grow in the field of social welfare, and this has been especially marked in the "Meals-on-Wheels" Service, Welfare Foods Service, Foot Clinic and the increased membership of the Old People's Clubs. Meals on Wheels.—During 1956 the number of meals delivered to physically handicapped and house-bound old people was over 12,000. 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.—2,709 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 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 continued throughout the year. House-bound cases are also catered for. There has been an increase in the use of this service. Radio Repair Service.—In this service there has been increased activity during the year. More than 75 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 service 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.—This service in its own quiet way brings a great deal of happiness to many old people who suffer from foot ailments who now regularly attend the Chiropodist. 40 It is not generally realised that a large number of old people become house-bound simply because of neglected minor foot troubles which is not their own fault. Obesity, heart-trouble, rheumatism and such other "restrictive illnesses" prevent many of the older people from attending to their feet, consequently a minor complaint such as a simple in-growing toenail when neglected can cause unnecessary suffering. The Foot Clinic Service provided alternatively, on Mondays, at the William Preye Club and the Red Cross Centre are doing excellent work, and in addition the British Red Cross Society attend many old people in their homes. During the year this service has also increased and to assist in its work the Association have granted £50 to the British Red Cross Society. Edmonton, as a token of their appreciation for the services given to the old people. "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. Information and Assistance.—A number of editions of “The NewsLetter" have been circulated to the Clubs and interested organisations, which is the best means of getting information quickly to the greatest number of people possible. The William Preye Club.—There was never any doubt in the mind of the Association for the need for the Club but it was not anticipated that within less than 18 months it would have to restrict the membership to 250 members. The present membership of the Club is now over 200 members, with an average daily attendance of 40-50 members. The most popular day of the week is Friday, when a whist drive is held, but there is always a large attendance for the Sewing Corner on Tuesdays and Thursdays. The Management Committee have held monthly meetings and encouraged the members in their activities, and the outstanding events of the past year have been the “Autumn Fair" which raised over £82; the Christmas Party for members; the purchase of the billiard table; the donation of £100 from the Funds of the Edmonton Borough Council towards the cost of running the Club; the visit of Lt.-General Sir Arthur Dowler, Secretary of the King George VI Foundation, who considered that the Club was "a model of its kind in London' and "only one better in the country the visit of the Student Matrons from all parts of the country, and a number of other distinguished visitors. 41 The Association would like to record its thanks and appreciation to the Management Committee and the Officers, and especially to the Voluntary Wardens of the Club for their work during the past year, and hope that their success will be a spur to great efforts in the future. Pymmes Park Club.—In November last, the Executive of the Association accepted with pleasure the invitation of the Edmonton Borough Council to use the Pymmes Park Refreshment Rooms as a "Winter Club" for the old people in that part of the Borough. With a "supplementary grant" from the Edmonton Borough Council and the loan of furniture from the Women's Voluntary Services, the Club opened on the 17th December last, and up to the end of February had enrolled 100 members. A Committee of Voluntary Wardens has been formed and is doing excellent work in the provision of a small library, card-games, radio, tea and biscuits, and the gift of a small billiard table has added to the attractions of the Club. It was evident in the rapid growth of the membership of the urgent need for the Club, and the Edmonton Borough Council have now decided that the Club can maintain its continuity throughout the year by the use of part of the vestibule during the summer months. This news was received with great satisfaction by the members as many new friendships have been formed in the short time the Club has been opened. 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. One new licence was granted and 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. 42 Age Periods New Cases Deaths Respiratory Non-respiratory Respiratory Non-respiratory M. F. M. F. M. F. M. F. Under 1 year 1 ... ... ... ... ... ... ... 1— 5 years 1 1 ... ... ... ... ... ... 5—15 „ 3 2 ... ... ... ... ... ... 15—25 „ 9 8 3 1 ... ... ... ... 25—35 „ 8 10 1 2 3 1 ... ... 35—45 „ 7 4 1 1 3 2 ... 1 45—55 „ 14 3 1 3 1 ... 55—65 „ 6 3 ... ... ... 2 ... 65 years upwards 6 1 1 ... ... 4 1 ... 55 32 7 4 9 10 1 1 In addition, 27 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 was:— Males Females. New cases (respiratory) 55 32 (non-respiratory) 7 4 Transferred cases (respiratory) 13 14 (non-respiratory — — 75 50 There were three non-notified deaths. The non-respiratory forms of tuberculosis notified were:— Males Females. Other bones and joints 2 — Glands — 1 Kidney 2 — Spine 1 2 Meninges 1 — Pericardium 1 — Periosteum — 1 43 The number of cases of tuberculosis on the Register at the end of 1956 was:— Males Females Total. Pulmonary forms 655 509 1 325 Non-pulmonary forms 67 94 161 722 603 1,325 The corresponding figures at the end of 1955 were:— Males Females Total. Pulmonary forms 642 502 1,144 Non-pulmonary forms 64 97 161 706 599 1,305 Corresponding figures for previous years were:— Males Females Total. 1954 701 608 1,309 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 COUNCIL'S EMPLOYEES. During 1956 a total of 447 visits was paid to those employees who had been on the sick list for longer than a fortnight and when necessary, at fortnightly intervals. Of these, 82 were "not at home" and 54 had already resumed duty. Also during the year, the following medical examinations or assessments were made prior to appointment to permanent posts:— Medical examinations 18 Assessments without medical examinations 66 Medical assessments (not appointed) 129 44