EDM 43 Borough of Edmonton Annual Report of the Medical Officer of Health for the Year 1958 Borough of Cdmonton With the Compliments of the Medical Officer of Health Public Health Department, Town Hall, Edmonton, N.9. BOROUGH OF EDMONTON 1958 His Worship the Mayor Councillor A.J,, Tanner, J.P., Deputy Mayor Councillor J.A.G. Beattie PUBLIC HEALTH COMMITTEE Chairman: Councillor Mrs. R A. Smythe Vice-Chairman: Alderman Mrs. F Long, J.P. Members: THE MAYOR (Councillor A.J. Tanner, J.P.,) (Ex Officio) THE DEPUTY MAYOR (Councillor J.A.G.Beattie) (Ex Officio) Councillor J.E.Cooke " E.R. Holborn " J.E. Lightfoot G.K. McLeod " P.J. Smith " L.J. Warren - 3 - STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: D.A. Smyth, M.B., B.S., D.P.H. Deputy Medical Officer of Health: Catherine A Goggin, M.B., B.Ch., B.A.O., D.P.H. Senior Public Health Inspector: A B C John P Farrar. (Retired 31.12.58.) Public Health Inspectors: ABC F. Beilby (Died 21.8.58.) ABC H.W. Grieves (Retired 22.7.58.) A B C D V.C. Quin A B C D J.H. Willis A C T.C. Oliver A C L.C. Hibbs 3 Vacancies Trainee Public Health Inspectors: G.L. Littlechild (Commenced 24.3.58. Left 30.11.58.) B.J. English (Left 13.1.58.) G.F. Bateman (Commenced 5.5.58.) J.G. Cummins (Commenced 20.12.58.) Senior Clerk: A F.J. Nash. Clerical Staff: H.J. Weldon A.F. Ballantine Mrs. E.J. Richards Mrs. I Kavanagh ) Transferred to Typists' Pool Mrs. G.W. Cully ) December 1958. J.G. Cummins (Commenced 27.1.58, until 19.12.58.) Mrs. N.E. Young (Commenced 3.3.58.) 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 - Public Health Department, Town Hall, Edmonton, N.9. Telephone No: EDMonton 3000. Ext. 16. HIS WORSHIP THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF EDMONTON Your Worship, Ladies and Gentlemen, The state of affairs on which I now report is satisfactory, but not ideal. A good deal of the work of the Public Health Department depends on its 'field' workers, the Public Health Inspectors, and a study of the list opposite shows that there was a shortage of Public Health Inspectors in Edmonton in 1958. The advance towards a better communal health was, therefore, somewhat slower than usual and the vital statistics are not quite so good as usual. I can still say, however, that the health record of the community during the year was a good one. The infant mortality was less than that for England and Wales and about the same as that for Middlesex, the corrected death rate was less than the death rate for England and Wales, and the birth rate, although lower than the England and Wales and Middlesex birth rate, was higher than that for last year. Despite this, the still-birth rate was less than that for last year. On the other hand, there was a maternal death and the deaths from tuberculosis were nearly double those for 1957; there is still room for improvement. - 5 - PART I. SOCIAL AND VITAL STATISTICS TABLE I SOCIAL STATISTICS Area 3,896 acres (6.09 square miles) Population- Census as 1951 104,270 Registrar General's estimate for mid-year 1958 95,118 Number of inhabited houses and separate dwellings at the end of 1958 28, 202 Number of inhabited houses and separate dwellings at the end of 1957 28,158 Rateable Value, April 1958 £1,459,925 Estimated product of 1d rate in the £ for the year ending 31st March, 1959 £5,940 Rate in the £ for the year ending 31st March, 1959 18s. 0d. The Registrar General's estimate of Edmonton's population for midyear 1957 was 96,530. He, therefore, reckons that in twelve months the population had fallen by 1,350 persons; this is due to families moving from Edmonton to Enfield, Southgate, Potters Bar and Waltham Cross, and to the New Towns and Expanding Towns in Hertfordshire, Essex, Sussex and Wiltshire. Since the natural increase in the population is about 300, the Registrar General estimates about 1,500 people or more leave Edmonton each year. Sample checks from other sources seem to corroborate this. The Registrar General does not think this is balanced to any extent by immigration into the Borough, but immigration into the Borough still seems quite common. A true estimate of Edmonton's population will have to await the 1961 census. On the figures as they stand, the decrease in the population, coupled with the increase in the number of houses should have led to a small improvement in health and comfort. TABLE II VITAL STATISTICS Live Births M. P. Total Grand Total Legitimate 641 540 1,181 Illegitimate 26 27 53 1,234 (Percentage of live births) 4.29 Birth rate per 1,000 population 12.96 Corrected birth rate 12.83 Still Births Legitimate 6 13 19 Illegitimate - - - Still birth rate per 1,000 total live and still births 15.16 Deaths Number 499 448 947 Rate per 1,000 population 9.94 Corrected death rate per 1,000 population 11.23 Maternal mortality rate per 1,000 total live and still births 0.79 (1 death) - 6 - TABLE III COMPARATIVE STATISTICS Birth Rate Death Rate Infant Mortality Rate Live Still England and Wales 16.4 21.6 11.7 22.5 Middlesex 14.5 16.3 10.3 18.9 Edmonton (Crude) 12.96 15.2 9.94 17.01 Edmonton (Corrected) 12.83 - 11.23 17.01 INFANT MORTALITY TABLE IV Infantile Mortality (Legitimate) 17.78 (Illegitimate) - Total 17.01 Neo-natal Mortality 12.96 Peri-natal Mortality 25.90 Number of children who died was 21; all legitimately born, 13 being males and 8 females. 16 of the deaths were in the first month of life, giving a neo-natal mortality of 12.96. The peri-natal mortality is the number of deaths and still births per thousand live still births. The causes and ages of death within certain limits are set out in Tables 5 and 6. TABLE V MALES Causes of Death Weeks Total in 1 month Months Total under 1 Yr. 1 2 3 4 1-3 3-6 6-9 9-12 Pneumonia — - 1 - 1 1 — — — 2 Premature Birth 2 1 - - 3 - - - - 3 Other causes 3 - - - 3 - - - - 3 Congenital malformations 2 - - - 2 2 - - 1 5 Totals: 7 1 1 - 9 3 - - 1 13 TABLE VI FEMALES Causes of Death Weeks Total in 1 month Months Total under 1 Yr. 1 2 3 4 1-3 3-6 3-9 9-12 Pneumonia — - - - - - 1 — - 1 Atelectasis 2 - - - 2 - — - - 2 Premature Birth 3 - — - 3 — — — - 3 Other causes 2 - - — 2 - — — — 2 Totals: 7 - - - 7 - 1 - - 8 - 7 - It is obvious from Tables 5 and 6, the main causes of death in infants were pneumonia, premature birth and congenital malformations. Speaking generally, premature birth is due to poor health in the mother, and the poor health may be the result of infection, lack of adequate and proper food or undue physical strain. Pneumonia is an infection and is acquired from the mother or an elder child, but the baby's resistance to it may be lowered by poor nutrition or irritation of the lung by smoke polluted atmosphere. It is likely that if there is a drop in infant deaths, the drop will be mainly in those due to pneumonia and premature birth. Congenital malformations affect the babies of rich and poor alike and will, I am afraid, take their toll for some time. Over the two years 1957 and 1958, of the 98 illegitimate children born only 2 died, giving an illegitimate infantile mortality rate for the two years of 20.4 against the ordinary infantile mortality rate for England and Wales during the two years of 22.75. To say that the general infantile mortality rate could be lowered by improved ante-natal care, therefore, is not to imply that the present standard of ante-natal care is low. To lower the infantile mortality rate it would be essary to improve on an already high standard of ante-natal care, but I am confident that in time this can be done. OTHER DEATHS ACCIDENTS There were 33 deaths from accidents in Edmonton in 1958, compared with 32 in 1957. There was a substantial drop in motor vehicle accidents from 12 to 8, and the increase was therefore due to other causes. 14 deaths were definitely due to home accidents and there were 9 other deaths due to falls, directly or indirectly, which might well have been due to home accidents. Practically all the home accidents are in elderly people and almost all are due to falls, poisoning or burning. Home is a dangerous place for the elderly in Edmonton. The list that follows gives some of the details:- - 8 - LIST 1 HOME ACCIDENTS Date Sex Age Cause of Death 23rd January, 1958. F 70 Contusion of heart following fall at home 25th January, 1958. F 71 Hypostatic pneumonia due to fracture of dorsal vertebrae following fall downstairs. 27th January, 1958. F 81 Suppurative bronchitis following burns sustained when she was burned by a gas fire. 9th June, 1958. F 69 Salicylate poisoning. 22nd August, 1958. F 87 Hypostatic pneumonia following fracture of femur due to fall at home. 27th August, 1958. F 90 Suppurative bronchitis following fracture of femur due to fall at home. 29th August, 1958. F 84 Suppurative bronchitis following fracture of femur due to fall at home. 18th September, 1958. F 36 Coal gas poisoning. 19th September, 1958. F 75 Shock due to burns when clothing caught fire. 25th September, 1958. F 83 Suppurative bronchitis and acute Cystitis following fracture second and third lumbar vertebrae due to fall at home. LIST 2 POSSIBLE HOME ACCIDENTS 2nd January, 1958. F 85 Hypostatic pneumonia following fracture of femur. 5th January, 1958. M 88 Suppurative bronchitis following fracture of femur following fall. 25th February, 1958. M 84 Hypostatic pneumonia due to fracture of femur due to fall. 8th March, 1958. F 90 Suppurative bronchitis following fracture of the femur resulting from a fall. 25th May, 1958. F 82 Hypostatic pneumonia and toxaemia due to pressure sores following fracture of the femur due to fall. 3rd August, 1958. F 83 Hypostatic pneumonia following fracture to femur resulting from a fall. 11th August, 1958. F 71 Toxic absorption from pressure sores following fracture of the sacrum resulting from a fall. 13th October, 1958. F 78 Toxic absorption due to pressure sores following fracture of femur due to fall. 29th November, 1958. F 87 Haemorrhage due to fractured ribs due to fall. - 9 - In addition there were two deaths from drowning, one of a man aged 49 and one of a girl aged 11, and a youth of 18 died as a result of a fractured skull when a scaffolding collapsed. ANGINA (Coronary Disease) There was a reduction in deaths due to coronary disease in the 55 to 65 age group, partially balanced by an increase in the 65 to 75 age group. There was a substantial reduction in the deaths from coronary disease in those aged 75 and over, but it may be that some of those who died from respiratory disease partially as a result of the influenza epidemics might otherwise have died from coronary disease. It is too soon to say that deaths from coronary disease have reached their peak in Edmonton and are declining. BRONCHITIS AND PNEUMONIA The second wave of the influenza epidemic though less widespread, was more severe than the first wave. It attacked the old and produced an increase in the number of cases of fatal pneumonia and bronchitis, recurrent fog may well have reduced the resistance of many of the elderly. There should be less fog in future years and the day-to-day soiling of the air should also be less as a result of the smoke control programme. Factory smoke is decreasing, and at least one area in the town will become free from visible smoke each year from 1959 onwards. There is some evidence that the teenagers who are in many ways the most sensible section of the community are forsaking the cigarette. Thirty years hence therefore, bronchitis should be ceasing to be a serious problem. CANCER OF THE LUNG This disease is undoubtedly mainly a disease of smokers. Most of the victims are cigarette smokers but cigarette smoking at the present day is much more common than pipe smoking. It has been suggested that the extrovert type of personality is likely to become a smoker and likely to develop lung cancer and that the two things are coincidental. Investigations so far undertaken however, indicate that pipe smokers are in general even more introverted than non-smokers, and yet show a substantially higher incidence of lung cancer. It is clear that whether or not one is susceptible to lung cancer, tobacco smoking substantially increases one's chances of getting it. The annual increase in deaths from lung cancer is a ghastly tribute to the brilliant advertising campaigns of the tobacco manufacturers. HYPERTENSIVE HEART DISEASE The drop in the deaths from this form of heart disease was again in the 55 to 65 age group. It is difficult to say whether this is due to a - 10 - reduction in the underlying causes (about which we are in any case not very clear) or whether it is due to improved medical care. INFLUENZA The effect of the second wave of Asian Influenza showed itself mainly in deaths from pneumonia and bronchitis. Deaths from influenza occurred mainly in males, one being a boy aged one year and three middle-aged males. LEUKAEMIA The drop in Leukaemia deaths is very satisfactory, but I am unable to account for it. MALIGNANT NEOPLASMS Deaths from cancer of the stomach has dropped, as have deaths from cancer of the uterus. The first fall may be due partly to improved social conditions, and the second is probably due to ante-natal and post-natal care. NEPHRITIS AND NEPHROSIS Since there has been an increase in recent years in the number of cases of scarlet fever and tonsilitis, one might have expected an increase in deaths from nephritis. The death rate however, remains steady and we can be satisfied that our methods of control of scarlet fever are having some effect in preventing this complication. TUBERCULOSIS The deaths were mainly in the middle aged, but two men aged between 35 and 45 died. A patient can endure and overcome pulmonary tuberculosis if he or she co-operates fully with the Chest Physician, but many patients do not, and I suspect that most of the early deaths occur in this type of patient. In the latter part of 1958 the Chest Physician and I had to seek the help of the Magistrates in order to compel a young woman to co-operate fully. She has co-operated fully since, and is now living a normal and healthy life. SUICIDE The number of suicides has risen slightly and some of the successful suicides were quite young, two aged between 25 and 35, and four between 35 and 45. There are obviously many people in the community bearing burdens which they feel to be crushing them, who are not able to find the help they need. - 11 - TABLE VII DEATHS BY AGE-GROUPS 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 to 85 85 and Over Tuberculosis, respiratory 7 - - - - - - 2 1 2 1 1 - Tuberculosis, other - - - - - - - - - - - - - Syphilitic disease - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective and parasitic diseases 3 - - - - - - - 1 - 1 1 - Malignant neoplasm, stomach 26 - - - - - - - 7 5 4 8 2 Malignant neoplasm, lung, bronchus 64 - - - - - - 1 9 23 21 8 2 Malignant neoplasm, breast 19 - - - - - - 2 2 5 4 5 1 Malignant neoplasm, uterus 3 - - - - - - - - 1 2 - - Other malignant and lymphatic neoplasms 88 - - - - 1 - 5 13 21 23 20 5 Leukaemia, aleukaemia 2 - - - - - - - 1 - 1 - - Diabetes 3 - - - - - - - 1 - 2 - - Vascular lesions of nervous system 84 - - - - - 1 2 2 11 23 28 17 Coronary disease, angina 156 - - - - - - 4 20 31 61 32 8 Hypertension with heart disease 14 - - - - - - - - 1 2 9 2 Other heart diseases 138 - - - - - 1 1 6 10 28 54 38 Other circulatory disease 51 - - - - 1 1 - 5 10 13 14 7 Influenza 5 - 1 - - - - - - - 3 - 1 Pneumonia 59 3 - - - - - 1 2 1 12 30 10 Bronchitis 72 - - - - - 1 1 5 16 22 20 7 Other disease of respiratory system 5 - - - - - - - - 1 3 1 - Ulcer of stomach and duodenum 7 - - - - - - - 1 3 1 2 - Gastritis, Enteritis and Diarrhoea 4 - - - - - - - - 1 3 - - Nephritis and nephrosis 7 - - - - - - 1 - 3 1 - 2 Hyperplasia of prostate 5 - - - - - - - - - - 5 - Pregnancy, childbirth, abortion 1 - - - - - - 1 - - - - - Congenital malformations 9 5 - - - - 2 - 1 - - 1 - Other defined and ill-defined diseases 63 13 - - 1 - 5 4 5 9 10 9 7 Motor vehicle accidents 8 - - - - 1 - - 3 1 1 2 - All other accidents 25 - - - 1 1 - 1 1 - 4 11 6 Suicide 10 - - - - - 2 4 - 3 - 1 - Homicide and operations of war - - - - - - - - - - - - - Totals: 938 21 1 - 2 4 13 30 86 158 246 262 115 12 TABLE VIII DEATHS BY SEX-GROUPS Cause of Death M F. TOTAL Tuberculosis, respiratory 5 2 7 Tuberculosis, other - - - Syphilitic disease 1 - 1 Diphtheria - - - Whooping Cough - - - Meningcococcal infections - - - Acute Poliomyelitis - - - Measles - - - Other infective and parasitic diseases 1 2 3 Malignant neoplasm, stomach 16 10 26 Malignant neoplasm lung, bronchus 58 5 63 Malignant neoplasm, breast - 19 19 Malignant neoplasm, uterus - 4 4 Other malignant and lymphatic neoplasms 43 45 88 Leukaemia, aleukaemia - 2 2 Diabetes - 3 3 Vascular lesions of nervous system 35 49 84 Coronary disease, angina 103 53 156 Hypertension with heart disease 8 6 14 Other heart disease 53 85 138 Other circulatory disease 26 25 51 Influenza 4 1 5 Pneumonia 30 29 59 Bronchitis 45 30 75 Other diseases of the respiratory system 5 2 7 Ulcer of stomach and duodenum 7 2 9 Gastritis, Enteritis and Diarrhoea 3 1 4 Nephritis and nephrosis 2 5 7 Hyperplasia of prostate 5 - 5 Pregnancy, childbirth, abortion - 1 1 Congenital malformations 5 5 10 Other defined and ill -defined diseases 30 33 63 Motor vehicle accidents 5 3 8 All other accidents 4 21 25 Suicide 5 5 10 Homicide and operations of war - - - Totals: 499 448 947 _ 13 _ TABLE IX MALES - DEATHS BY AGE-GROUPS 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 to 85 85 and Over Tuberculosis, respiratory 5 - - - - - - 2 - 1 1 1 - Tuberculosis, other - - - - - - - - - - - - — Syphilitic disease - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective and parasitic diseases 1 - - - - - - - - - 1 - - Malignant neoplasm, stomach 16 - - - - - - - 5 4 1 5 1 Malignant neoplasm, lung, bronchus 58 - - - - - - 1 8 20 21 8 - Malignant neoplasm, breast - - - - - - - - - - - - - Malignant neoplasm, uterus - - - - - - - - - - - - - Other malignant and lymphatic neoplasms 43 - - - - 1 - 2 7 12 7 11 3 Leukaemia, aleukaemia - - - - - - - - - - - - - Diabetes - - - - - - - - - - - - - Vascular lesions of nervous system 35 - - - - - - 1 1 5 13 10 5 Coronary disease, angina 103 - - - - - - 4 18 24 38 16 3 Hypertension with heart disease 8 - - - - - - - - 1 1 5 1 Other heart diseases 53 - - - - - 1 1 4 7 14 15 11 Other circulatory disease 26 - - - - 1 1 - 3 5 6 8 2 Influenza 4 - 1 - - - - - - - 3 - - Pneumonia 30 2 - - - - - - 1 1 6 17 3 Bronchitis 45 - - - - - - - 3 14 14 12 2 Other disease of respiratory system 3 - - - - - - - - 1 2 - - Ulcer of stomach and duodenum 5 - - - - - - - - 3 1 1 - Gastritis, Enteritis and Diarrhoea 3 - - - - - - - - 1 2 - - Nephritis and nephrosis 2 - - - - - - - - 2 - - - Hyperplasia of prostate 5 - - - - - - - - - - 5 - Pregnancy, childbirth, abortion - - - - - - - - - - - - - Congenital malformations 5 5 - - - — — - - — — - — Other defined and ill-defined diseases 30 6 - - 1 - 1 3 — 4 7 3 5 Motor vehicle accidents 5 - - - - - - - 1 1 1 2 — All other accidents 4 - - - - 1 - - 1 - - 1 1 Suicide 5 - - - - - 2 1 - 2 - — — Homicide and operations of war - - - - - - - - - - - - - Totals: 494 13 1 - 1 3 5 15 52 108 139 120 37 - 14- TABLE X FEMALES - DEATHS BY AGE-GROUPS 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 to 85 85 and Over Tuberculosis, respiratory 2 - - - - - - - 1 1 — — — Tuberculosis, other - - - - - - - - - - - - - Syphilitic disease - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective and parasitic diseases 2 - - - - - - - 1 - - 1 - Malignant neoplasm, stomach 10 - - - - - - - 2 1 3 3 1 Malignant neoplasm, lung, bronchus 6 - - - - - - - 1 3 - - 2 Malignant neoplasm, breast 19 - - - - - - 2 2 5 4 5 1 Malignant neoplasm, uterus 3 - - - - - - - - 1 2 - - Other malignant and lymphatic neoplasms 45 - - - - - - 3 6 9 16 9 2 Leukaemia, aleukaemia 2 - - - - - - - 1 - 1 - - Diabetes 3 - - - - - - - 1 - 2 - - Vascular lesions of nervous system 49 - - - - - 1 1 1 6 10 18 12 Coronary disease, angina 53 - - - - - - - 2 7 23 16 5 Hypertension with heart disease 6 - - - - - - - - - 1 4 1 Other heart diseases 85 - - - - - - - 2 3 14 39 27 Other circulatory disease 25 - - - - - - - 2 5 7 6 5 Influenza 1 - - - - - - - - - - - 1 Pneumonia 29 1 - - - - - 1 1 - 6 13 7 Bronchitis 27 - - - - - 1 1 2 2 8 8 5 Other disease of respiratory system 2 - - - - - - - - - 1 1 - Ulcer of stomach and duodenum 2 - - - - - - - 1 - - 1 - Gastritis, Enteritis and Diarrhoea 1 - - - - - - - - - 1 - - Nephritis and nephrosis 5 - - - - - - 1 - 1 1 - 2 Hyperplasia of prostate - - - - - - - - - - - - - Pregnancy, childbirth, abortion 1 - - - - - - 1 - - - - - Congenital malformations 4 - - - - - 2 - 1 - - 1 - Other defined and ill-defined diseases 33 7 - - - - 4 1 5 5 3 6 2 Motor vehicle accidents 3 - - - - 1 - - 2 - - - - All other accidents 21 - - - 1 - - 1 - - 4 10 5 Suicide 5 - - - - - - 3 - 1 - 1 - Homicide and operations of war - - - - - - - - - - - - - Totals: 444 8 - - 1 1 8 15 34 50 107 142 78 - 15 - TABLE XI ALL DEATHS BY WARDS Ward Deaths Male Female Bury Street 140 132 Church Street 112 127 Angel Road 101 71 Silver Street 141 114 Vagrants - - Totals: 494 444 LABORATORY SERVICE The following specimens submitted from the Edmonton Health Services were examined by the Medical Research Council Laboratory (Edmonton), during the year as follows:- Nature of Examination Positive Negative Total Blood Counts - - 45 Blood - Haemoglobin Estimation - - 154 Blood - Kahn Reaction - - 76 Blood - Rhesus Factor - - 77 Blood - Grouping - - 80 Eye swabs for organisms 1 1 2 Faeces for the presence of organisms 106 737 843 Swabs for presence of C. Diphtheriae: (a) From Suspect Cases - 9 9 (b) From Contacts - 4 4 Swabs for presence of Haemolytic Streptococci 335 1,821 2,156 Swabs for presence of Vincent's Angina - 3 3 Urines - - 138 Vaginal swabs for presence of organisms 5 11 16 Ear swabs - 1 1 Faeces from Hamster - 2 2 Fish Paste - 1 1 Throat and nose for Staphs - - 5 Pus from Pork - 1 1 Vulvar swab 1 1 2 Ham for Staphs - 1 1 Swab from socket (Dental) - 1 1 Pus from boil - 1 1 Spam, Doughnuts, Peaches for Pathogens - - 3 l/3rd pint of milk for Paths - 1 1 Roast Pork for Clostridium Welchii - 3 3 Custard Powder - - 1 Faeces from Guinea Pig - 1 1 Dried Egg - 1 1 Total: 3,628 - 16 - 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 HalfHoliday 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 1,300 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 1,200 Washing facilities, sink water heaters installed 10 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 - Three letters of warning were sent to shopkeepers for contravening this Order. SHOPS ACT, 1950 - PART I Hours of Closing - A letter of warning was sent to a shop-keeper in this connection. SHOPS ACT, 1950 - PART II, SECTION 17(1) Condition of Employment - Two letters of warning were sent to the occupiers of shops where assistants were found working during the occasion of the weekly half-holiday. SHOPS ACT, 1950 - PART IV - SUNDAY TRADING Forty-one shops were visited in addition to supervisory operations and observations. Five contraventions were discovered; a letter of warning was sent in each case. Registers required to be kept under this Act were inspected periodically. 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 periodically inspected. - 17 - MIDDLESEX COUNTY COUNCIL ACT, 1944 - 1950 - STREET TRADING Under the provisions of the Byelaws made by the Council under the above Acts, eleven letters of warning were sent for contravention of certain provisions of the Byelaws, ten to licensed street traders and one to an unlicensed street trader. In one other case, legal proceedings were instituted and fines amounting to 20/-d. and costs of 21/-d, were imposed. The inspection of shops, stalls and other traders' premises coming within the scope of the Act have been carried out throughout the year, including Sundays and evenings. HEATING APPLIANCES (FIREGUARDS) ACT, 1952. The Shops Act Inspector is the Appointed Authorised Officer under the Act. Inspections were carried out under the Act during the year, but no contraventions were found. ENVIRONMENTAL HEALTH HOUSING Table A, which follows below, shows that over 700 houses were made more habitable by formal and informal action on the part of the Public Health Inspectors. This number is more than twice that dealt with in 1957, and reflects great credit on the depleted staff. 58 houses were dealt with in Clearance Areas; the Silver Street and Grove Street Clearance Areas comprising 108122 (even) and 142-174 (even) Silver Street, and 1-23 (odd) and 27-67 (odd) Grove Street, being declared in September 1958. In due time, 184 people were rehoused from these areas. TABLE A Action taken under the Housing and Public Health Acts Number of houses repaired in consequence of informal action 379 Number of notices served under Section 9 Housing Act 1 Number of houses rendered fit after service of notices:- 4 - Number of notices served under Public Health Acts 389 Number of houses repaired after service of notices (a) by owner 221 (b) by Local Authority in default 4 - 18 - TABLE B Defects Remedied Roofs repaired 410 Gutters and rainwater pipes repaired 285 Brickwork or pointing repaired 74 Chimney stacks, etc., repaired or rebuilt 30 Yards or forecourts repaved or repaired 42 Drains examined, tested or exposed 622 Drains cleared, trapped or repaired 468 Drains reconstructed 80 Chambers inserted or built up to ground level 26 Soil and vent pipes, new fixed or repaired 61 W.C's repaired or improved 132 Flushing cisterns repaired or new fixed 54 Sink waste pipes repaired or new fixed 33 New sinks fixed 19 Drinking water cisterns covered, cleansed, repaired - Water fittings repaired 50 Water taken off main or restored 8 Internal walls 230 Ceilings repaired, cleansed, etc. 119 Floors repaired 109 Floors ventilated 24 Dampness remedied 194 Window frames or sashes repaired or renewed 367 Fireplaces, stoves repaired 53 TABLE C RENT ACT, 1957 The above Act came into force on 6th July, 1957, and set out below are details of the applications received during 1958:- Part I-Applications for Certificates of Disrepair (1) Number of applications for Certificates 271 (2) Number of decisions not to issue Certificates 3 (3) Number of decisions to issue Certificates 270 (a) in respect of some but not all defects 171 (b) in respect of all defects 99 (4) Number of undertakings given by Landlords under paragraph 5 of the First Schedule 228 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule - (6) Number of Certificates issued 39 Part II-Applications for Cancellation of Certificates (7) Applications by Landlords to Local Authority for cancellation of Certificates 37 (8) Objections by tenants to cancellation of Certificates 5 (9) Decisions by Local Authority to cancel in spite of tenants' objections Nil (10) Certificates cancelled by Local Authority (1957 Act) 21 (1954 Act) 7 19 FOOD HYGIENE CONTROL SLAUGHTERHOUSES Seven visits were paid and the carcases and organs of 11 pigs killed were inspected during or shortly after slaughter. All were found to be fit for human consumption. MILK SUPPLY Various licences were granted as under Primary Supplementary Pasteurised 42 17 Tuberculin Tested 24 14 Sterilised 96 16 162 47 Supplementary 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, 1958 was 9. FOOD AND DRUGS ACT, 1955-SECTION 16 During the year 26 premises were registered for the Sale and Storage of Ice Cream. Number on Register at end of year:- Manufacturers and Vendors 6 Vendors only 214 During the year no premises were registered for the Preparation or Manufacture of Preserved Food, etc. Number on register at end of year:- 40 UNSOUND FOOD The following is a list of the food surrendered for examination and retained as unfit for human consumption:- Meat 5,728 tins Lamb 119½ lbs. Milk 6,430 do. Mutton 8½ do. Fish 2,732 do. Pork 260½ do. Jams, etc. 1,686 do. Veal 69 do. Soups 1,081 do. Offal 113 do. Beans 2,373 do. Chickens 31 only Beetroot 37 do. Ham l,58¾ lbs. Carrots 344 do. Bacon 29¾ do. Mixed Vegetables 145 do. Whiting 40 do. 20 UNSOUND FOOD-Continued Peas 4,685 tins Skate 8 stone Apples 91 do. Sausages (Pork) 25 lbs. Apricots 1,815 do. Cheeses 499 packets & 44½ do. Blackcurrants 6 do. Yeast 22 cwt. 3 qrs. Cherries 520 do. Fish Paste 99 jars Damsons 3 do. Macaroni 35 tins Grapes 1 do. Meat Paste 94 jars Grapefruit 697 do. Pickle 275 do. Gooseberries 128 do. Puddings 529 tins Greengages 30 do. Sauce 695 bottles Fruit Salad 1,059 do. Spaghetti 196 tins Oranges 2,477 do. Sandwich Spread 158 tins Peaches 216 Trays and 3,734 do. Currants 10 do. Pears 1,484 do. Raisins 7 lbs Pineapple 3,651 do. Margarine 48 lbs Plums 2,077 do. Sugar 6 pkts Prunes 135 do. Salad Cream 493 jars Raspberries 143 do. Tomatoes 3,215 tins Rhubarb 134 do. Fruit Juices 652 tins Spinach 3 do. Beef 545 lbs Strawberries 107 do. Rice 12 do. Tomato Juices 105 do. 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. 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 221 Manufacture of Sausages 24 Manufacture of Sausages and Sale of Pressed, Pickled, Preserved, Potted Meats and other foods 14 Manufacture of Cooked Meat 1 Manufacture of Preserved Foods 1 Butchers 57 Fish Shops 27 Grocers and Provision Dealers 173 Bakers and Confectioners 22 Fruiterers and Greengrocers 61 Dairies 9 Retail Purveyors of Milk 135 Cafes 55 Factory Canteens 70 FOOD SAMPLING The report of the Chief Officer, Public Control Department, Middlesex County Council, on the work carried out in Edmonton during the year 1958 is as follows:- Samples procured in the Borough of Edmonton during the year 1958: Article Total Samples Procured Unsatisfactory Milk (New) 39 1 Milk (Various) 109 3 Butter 14 - Cakes 14 - Cooked Meat 17 - Cream 11 - Cheese 8 2 Drugs 22 - Fish and Fish Products 18 - Fruit - Canned, Dried, etc. 6 - Fruit Squash 5 1 Ice Cream 6 - Liver 10 - Margarine 5 – Meat and Meat Products 50 1 Non-Brewed Condiment 5 2 Preserves 4 - Sausages, Sausage Meat, etc. 13 - Spirits 9 - Vinegar 15 - Miscellaneous 23 - Totals: 403 10 Milk One sample of new milk was found to be slightly deficient in milk fat. This sample was taken from one churn forming part of a delivery of new milk consigned by a farmer to a milk processor in your district; the average composition of the whole consignment was satisfactory and no further action was taken. Three 1/3 pint bottles of school milk were found to be slightly deficient in milk fat. Two of these had been sold by one supplier and the third by a second supplier. In each case other 1/3 pint bottles of milk from the same deliveries were found to be satisfactory and no further action was taken. Cheese A retailer supplied Blue Vein cheese in response to a request for Gorgonzola cheese; the manager of the shop concerned was severely cautioned. A box of assorted processed cheeses was found to contain a different assortment from that described on the label on the outside of the carton. A letter of caution was sent to the manufacturers who undertook to amend suitably all the labels on the large stock of this food which they held ready for distribution. 22 Fruit Squash A sample of orangeade was found to be contaminated with hydrogen sulphide. The bottle was closed with a vulcanised stopper and it is known that occasionally the vulcanising of such stoppers will break down and the subsequent inter-action with the acid normal to the drink produces hydrogen sulphide. A letter of caution was addressed to the manufacturers who had already instituted a programme for replacing vulcanised stoppers by others made of a plastic material. Meat and Meat Products A complaint was received from a private purchaser concerning a meat pie which, it was alleged, caused sickness. The Public Analyst certified that it was free from arsenical or metallic contamination, but it was not possible to assess its freshness when sold since two weeks had elapsed before the complaint was made to this Department. Non-Brewed Condiment A preliminary sample, followed by a formal sample, was each found to be slightly deficient in acetic acid content. An official caution was sent to the retailer. MERCHANDISE MARKS ACTS, 1887 - 1953 The majority of the inspection work carried out under the provisions of the above Acts relates to ensuring that the requirements of the various Marking Orders made under the provisions of the Act of 1926, and which relate to the marking with an indication of origin of certain imported foodstuffs when exposed for sale or sold, are complied with. Inspections were made at 232 separate premises of 863 displays of meat, apples, tomatoes, poultry, dried fruit and bacon. One traderwas prosecuted in respect of offences for failing to mark imported meat with an indication of origin and also for marking meat with a false indication of origin. Fines totalling £18 were imposed. Two other traders received official cautions for failing correctly to mark imported meat and offal exposed for sale, with an indication of origin. LABELLING OF FOOD ORDER, 1953 This Order requires pre-packed food to be marked with the name and address, or with the registered trade mark, of the packer or labeller. It also requires such food to be labelled with its common or usual name (if any) and with the names of the ingredients of a compounded food. It also controls the manner in which the presence of vitamins and minerals is disclosed and prescribed specific labelling of certain foods. A total of 1,636 articles of pre-packed food was examined at 282 premises to ascertain whether the above requirements were complied with; no serious infringements of this Order were detected. 23 FALSE OR MISLEADING DESCRIPTIONS As in previous years food advertisements and labels have been scrutinised for false or misleading statements and descriptions. Much of this scrutiny of food labels can be combined with inspection work under the Labelling of Food Order. No serious infringements were disclosed. Corrective action was secured in relation to descriptions applied to "milk block", "Double Tea", an imitation cream powder, cakes filled with a mixture of butter and sugar, canned mixed vegetables, raspberry syrup, powdered soup mixes, medium red salmon, gorgonzola cheese spread and cheese spread. SPECIAL DESIGNATED MILK During 1958 my Council issued two Dealer's (Pasteuriser's) and one Dealer's (Steriliser's) licence in respect of premises within your area where milk is processed. These premises were regularly inspected, and compliance with statutory requirements was well maintained. A total of 94 samples of designated milk was taken. One was reported to be unsatisfactory; it failed to satisfy the phosphatase test for adequate heat treatment and the methylene blue test for keeping quality. WATER 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. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 Number on Register at end of year:- Premises where filling materials used 14 Licences granted for storage of rag flock 2 Ten samples of rag flock and other filling materials were examined during the year. All proved satisfactory. SANITARY CONVENIENCES There are seven public conveniences in the Borough under the supervision of the Senior Public Health Inspector. No charge is made for the use of W.C's in the Males and Females Conveniences; free hand-washing facilities are provided and paper towels are supplied. 24 FACTORIES ACTS, 1937 AND 1948 The following work has been carried out under the above Acts:- 1. Inspections for the Purpose of Provisions as to Health Premises Number in Register Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 205 292 9 - Factories without mechanical power 15 5 3 - Other premises under the Act (including works of building and engineering and construction but not including out-workers premises) 3 4 - - Total: 223 301 12 - 2. Defects found Particulars Number of Defects Number 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 1 - - Overcrowding - - - - - Unreasonable temperature - - - - - Inadequate ventilation - - - - - Ineffective drainage of floors - - - - - Sanitary Conveniences- Insufficient ) Unsuitable or ) defective ) 33 29 - 6 - Not separate for ) sexes ) Other offences- (Not including offences relating to outwork) 2 2 1 2 - Totals: 37 33 2 8 - 25 3. Outwork-Sections 110 and 111 Nature of Work No. of Out-workers in August list Ho. 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., 190 - - - - - Artificial flowers 4 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 20 - - - - - Brush making 56 - - - - - Cosaques, Christmas crackers, Christmas stockings, etc. 7 - - - - - Toy painting 35 - - - - - Brass and brass articles 26 - - - - - Electrical fittings 65 - — - - - EmbroideryHousehold linen 2 - - - - - Feather sorting 1 - - - - - Cabinet making 1 - - - - - Leather bags 15 - - - - - Sewing canvas 10 - - - - - FetlingsDiecastings 22 — — — — - Total: 454 - - - - - MIDDLESEX COUNTY COUNCIL ACT, 1950. SECTION II One person and premises was registered during the year. No persons were registered to trade in the Borough where storage premises are located in other districts. There were 86 hawkers on the Register at the end of 1958. ATMOSPHERIC POLLUTION The three deposit gauges at St. David's Hospital, Silver Street, Cuckoo Hall Lane School and the Town Hall continued in use throughout 1958, and the results are shown on the opposite page. 26 SUMMARY OF ANALYSES 1958 Rainfall in inches DEPOSIT IN TONS PER SQUARE MILE Insoluble Deposits Ash Soluble Deposits Total Solids (a) (b) (c) (a) (b) (c) (a) (b) (c) (a) (b) (c) (a) (b) (c) January 2.26 2.38 2.57 16.28 9.09 4.27 3.71 5.83 2.47 4.58 5.47 6.54 20.86 14.56 10.81 February 2.33 2.52 2.33 4.69 9.95 5.85 2.87 6.60 3.71 4.93 6. 89 4.89 9.62 16.84 10.74 March 1.08 1.03 0.93 6.49 10.88 7.24 4.35 7. 81 4.6C 5.14 6.44 5.38 11.63 17.32 12.62 April 1.19 1.42 1.30 4.68 8.37 6.89 2.91 5.47 4.33 4.14 4.80 4.33 8.82 13.17 11.22 May 3.07 2.64 2.28 5.53 6.94 5.39 3.78 4.82 3.7C 4.57 5.31 4.42 10.10 12.25 9.81 June 5.49 4.99 4.91 4.67 6.56 7.45 2.49 3.63 4.35 5.30 6.86 5.63 9.97 13.42 13.08 July 2.35 2.40 3.61 4.60 6.75 5.43 2.30 4.36 3.22 4.39 5.42 7.57 8.99 12.17 13.00 August 3.87 3.92 3.71 5.66 6.07 2.99 3.96 3.98 1.87 4.83 6.53 5.38 10.49 12.60 8.37 September 3.86 3.34 3.31 1.39 4.02 4.48 0.61 2.76 3.23 5.54 5.86 5.61 6.93 9. 88 10.09 October 2.44 2.55 2.44 2.56 4.69 3.65 1.32 2.90 2.26 4.24 5.43 4. 80 6.80 10.12 8.45 November 1.87 1.78 1.70 3.06 6.47 3.02 1.70 3.90 1.56 5.28 4.53 3.91 8.34 11.00 6.93 December 2.95 2.91 2.77 5.01 9.66 6.14 3.35 4.79 4.06 7.36 6.93 5.63 13.37 16.59 11.77 (a) Site No.l. St. David's Hospital (b) Site No.2. Town Hall (c) Site No.3. Cuckoo Hall Lane School It is not unreasonable to deduce from these figures that at least 700 tons of grit and dust fall on Edmonton each year. The figures for June to December 1958 are somewhat less than those for the same period in 1957, and this is due mainly to a reduction in the emission of grit and dust from the factory chimneys. During the year 834 observations of industrial chimneys in the Borough were made by the Public Health Inspectors and nuisances were alleviated in a number of cases. The No.l. Smoke Control Order agreed in principle in 1957 was declared in June 1958, and was to come into force on the 1st June, 1959. This was, of course, the area bounded on the east and north-east by Latymer Road, on the north by Harrow Drive, on the west by the Great Cambridge Road, and on the south by Church Street. It was a small area containing 402 dwelling-houses, 2 industrial premises and 7 other premises. No.2. Smoke Control Area was agreed in principle in June 1958, and was p. somewhat larger area. This was an area bounded on the west by the Borough boundary, on the north by Ridge Avenue and Bury Street, and the east by the Great Cambridge Road, and on the south by Hedge Lane. This area contained about 2,070 houses, of which about 1,500 required conversions of one sort or another to render them capable of burning smokeless fuel, was some 353 acres in extent and immediately adjoined No.l. Area, being separated from it by the Great Cambridge Road. The No.l. Area subsequently came into force without incident and has, I think, been welcomed by the citizens of Edmonton. RODENT CONTROL Your Senior Public Health Inspector, as Officer-in-Charge, Rodent Control, reported as follows:- 27 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. Prevalence of Rats and Mice: Type of Property Total Local Authority Dwelling Houses All other including Business and Industrial Properties inspected as a result of notification 6 596 46 648 Other properties investigated Properties found to be infestec 2 3,077 25 3,104 Rats (a) Major infestations - - 1 1 (b) Minor infestations 3 553 17 573 Mice (a) Major infestations - - - - (b) Minor infestations - 51 10 61 Number of properties treated by Rodent Operators 3 604 28 635 Number of inspections 129 6,719 209 7,057 During the year, maintenance treatment 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 twenty-seventh maintenance treatment was carried out by the '1080' method of direct poisoning. The '1080' treatments were carried out at three months intervals throughout 1958 and a 'test-bait' check with unpoisoned bait was carried out in March 1959. From 1950 to 1957 using the zinc phosphide and arsenious oxide poisons with two prebaitings the average number of 'takes' as compared with the number of manholes baited was 60%. In the 'test' in March 1959, this figure was reduced to 6%. 28 The inference to be drawn is that the number of rats in the sewers has been considerably reduced. DISINFECTION AND PISINFESTATION Number of journeys to collect bedding and spray verminous premises 363 Number of journeys to return bedding 233 Rooms disinfected after infectious disease 238 Rooms disinfected after Phthisis 58 Rooms disinfected after other cases 53 Rooms disinfected after vermin 133 Articles Bedding, clothing, etc., disinfected after infectious disease 2,941 Bedding, clothing, etc., disinfected after Phthisis 98 Bedding, clothing, etc., disinfected after other cases 291 Bedding, clothing, etc., disinfected after vermin 41 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 15,650. 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 264. 19 Council properties and 61 other houses were found to be infested; the total number of rooms disinfested was 133. The whole of the work is carried out by the Department, the materials used being insecticides containing D.D.T. as a base. PET ANIMALS ACT, 1951. No new licences were granted during the year. Number on Register at end of year 8 29 INSPECTIONS The following tabular statement gives the number and the nature of the inspections made during the year:- Complaints 1,683 Infectious Disease 325 Food Poisoning 75 House-to-House 339 Atmospheric Pollution 150 Smoke Control Areas 340 Factories with mechanical power 292 Factories without mechanical power 5 Rents Act, 1957 839 Housing Act 1949, Improvement Grants 37 Factories (other) 4 Outworkers 6 Schools 7 Offensive Trades 18 Shops and Stalls 70 Shops Act - Pets Act 17 Sanitary conveniences and urinals 331 Smoke observations 835 Rat infestation 221 Petroleum 334 General Inspections 473 Sundry Visits 2,024 Cinemas and Halls 37 Stables and Piggeries 34 Movable Dwellings 46 Sampling Water 3 Sampling Ice Cream - Sampling Milk - Rag Flock Premises 9 Sampling Rag Flock 10 Re-inspections 4,178 INSPECTION OF PLACES WHERE FOOD IS PREPARED Butchers 68 Fish Shops 46 Cafes and Restaurants 96 Dairies and Milkshops 38 Slaughterhouses 7 Bakehouses (Factory) 34 Bakehouses (Workshops) - Ice Cream Shops 50 Canteens 49 Other food premises 189 Sampling other food - 30 DEFECTS REMEDIED Roofs repaired 410 Gutters and rainwater pipes repaired 285 Brickwork or pointing repaired 74 Chimney stacks, etc., repaired or rebuilt 30 Yards or forecourts repaved or repaired 42 Drains examined, tested or exposed 622 Drains cleared, trapped or repaired 468 Drains reconstructed 80 Chambers inserted or built-up to ground level 26 Soil and vent pipes new fixed or repaired 61 W.C's repaired or improved 132 Flushing cisterns repaired or new fixed 54 Sink waste pipes repaired or new fixed 33 New sinks fixed 19 Drinking water cisterns covered, cleansed, repaired Water fittings repaired 50 Water taken off main or restored 8 Internal walls 230 Ceilings repaired, cleansed, etc. 119 Door frames repaired - Floors repaired 109 Floors ventilated 24 Dampness remedied 194 Window frames or sashes repaired or renewed 367 Fireplaces, stoves repaired 53 Coppers repaired - New dustbins supplied 27 Premises rat-proofed 6 Improper keeping of animals discontinued 1 Foul accumulations removed 14 Other nuisances abated 185 Movable dwellings removed 30 New boiler house constructed - New boiler installed - Factory sanitary conveniences inspected - Factory sanitary conveniences improved 33 Factory other defects remedied 4 Petroleum installations-defects remedied 57 Petroleum installations tested 32 Smoke Abatement-boiler plants improved 14 Food Regulations-contraventions remedied - 31 PETROLEUM (REGULATIONS) ACTS, 1928-1936 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 500,498 gallons Petroleum Mixtures 20,713 gallons Rubber Solution 100 lbs. and 800 gallons PLACES OF PUBLIC ENTERTAINMENT Thirty-seven 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. EPIDEMIOLOGY MEASLES Measles spread from Enfield to the north-west corner of the Borough in January. During February and March, it spread mainly in association with the Infants' Schools. In the middle of April, a peak incidence of 42 cases in one week was recorded. Thereafter, measles spread throughout the Borough, but by September, it had died down to a low level. In November, however, it flared up again with renewed violence and in the second week in November, 94 cases were notified in one week. By the end of the year however, the epidemic seemed finally at an end. Table E(l) shows that though there were no deaths, 28 of the 686 children notified as suffering from measles had to be removed to hospital and very nearly half of the cases occurred in children under five. If the American vaccine against measles now under trial proves safe and reliable, it should certainly be made available to parents, whose children are in the second year of life. WHOOPING COUGH The number of cases notified was only a quarter of that for 1957. In a community not given special protection, one expects an epidemic of whooping cough roughly every two years, the 96 cases notified in 1957 represent a modified epidemic. I am hopeful that the 1959 level of incidence will be lower than that of 1957. Perhaps there will be 50 to 60 cases. DYSENTERY As usual, most of the cases were of Sonne Dysentery. The number of cases were not large and the disease was seen as scattered cases and a number of small outbreaks. 32 The first outbreak was discovered as the result of the routine examination of faeces of two new entrants to the Edmonton Day Nursery. One was a boy aged 2¼ years, and the other a girl aged 8 months. Both these children were found to be infected with Sonne bacilli and the girl was admitted to St. Ann's General Hospital in January. It was found that these two children were cared for during the day by a child minder at her own house and that two other children, a boy aged 2 years and a girl aged 4 years, were looked after by her at the same time. These two children were found to be infected and so was their own mother. Further investigation showed that another boy, a playmate of the boy entrant to the Day Nursery, was infected, and so was his mother. The boy entrant's grandmother was found to be infected, as was the lodger at the same address. The first outbreak then, accounts for nearly one-sixth of the cases. The second outbreak occurred at a boarding school for physically handicapped girls. The visiting Medical Officer informed me on the 15th February, that he had three cases of Dysentery in this school, and the condition of one of the cases wag such that he had to remove her to hospital on the previous day. He had already submitted faeces specimens to the laboratory and these proved to be positive. Specimens were taken from all the children at the school and from all the staff. Four girls and one member of the staff were found to be infected with Sonne bacilli. The girls were isolated in the school sick-bay and the member of the staff was moved to hospital and regular disinfection of lavatory seats and the hands of staff and girls was practised. The original source of the outbreak was not discovered, but the measures taken proved sufficient to prevent any further spread of the disease. MENINGOCOCCAL INFECTION One case was notified during the year. OPHTHALMIA NEONATORUM Eleven cases were notified during the year, all in the North Middlesex Hospital. PUERPERAL PYREXIA 110 cases were notified during the year, 105 at the North Middlesex Hospital, and 5 at home. SCARLET FEVER 217 cases were notified in 1958, only one being a return case. Scarlet Fever appears to be on the increase, but the increase seems less marked in Edmonton than elsewhere. TUBERCULOSIS A Mass X-Ray Unit of the North East Metropolitan Regional Hospital 33 Board was in Edmonton during October and November. The unit's visit was publicised on the Council's rate demands, by posters, and in the local press. During the survey, Red Cross cadets distributed leaflets to a number of houses. Between a sixth and a seventh of the adolescent and adult population of the Borough were x-rayed in public sessions and in special sessions in and near the factories. The actual figures were 11,623, men outnumbering women by nearly 50%. Though the number of cases needing supervision or treatment was only 27 (in this context I am referring to cases of pulmonary tuberculosis), these citizens were undoubtedly helped by the visit of the Mass X-Ray Unit. 12, it will be seen, only required occasional clinic supervision, but if not detected might in due course have required hospital treatment; 13 required immediate treatment, but would undoubtedly have required a much longer period of treatment if they had not been diagnosed at this stage. (ANALYSIS OF SURVEY ON PAGE 35) 34 TART. T(1)ANALYSIS OF SURVEY GROUP No. examined Recalled for Large Film Recalled for Clinical Interview Did not attend for Large Film or interview Carcinoma of Bronchus Presumed Healed PULMONARY TUBERCULOSIS Cardiovascu lar lesions Other Abnormali ties Suspect T.B. Not Yet confirmed Occasional Clinic Supervision Close Clinic Supervision Requiring immediate treatment KNIGHTS LANE Male 563 10 7 - - - - - - 1 - 5 Female 528 4 3 - - - - 1 - 2 - - THE ANGEL Male 550 7 5 1 - - - 2 - - - 3 Female 573 9 8 - - 2 - 1 - 2 2 1 KENDAL PARADE Male 481 12 7 - 1 1 - 1 - 1 1 2 Female 565 9 4 - - 2 - 1 - - 1 1 HOUNDSFIELD ROAD Male 161 2 2 - - - - - - 1 — 1 Female 308 3 3 - - 1 1 - - - - 1 "CART OVERTHROW" BOUNCES ROAD Male 641 11 6 - 2 1 - - - - - 3 Female 549 4 1 - - 1 - - - 1 1 - BUSH HILL PARK PARADE Male 209 8 5 - 1 1 - - - 2 1 - Female 318 2 1 - - 1 - - — — — - FACTORY NO. 1. Male 188 4 - 1 - - - — — - — 3 Female 290 2 - - - - - - - - - - TRAMWAY AVENUE Male 130 2 2 - - - - - - - - 2 Female 10 — - - - - - - - - - - HOSPITAL NO.1. Male 518 7 4 - - 3 - 1 - 1 1 1 Female 635 8 6 - - 1 - 3 - 1 1 1 FACTORY NO.2. Male 557 6 4 1 - - — 1 - - - 3 Female 114 - - - - - - - - - - - FACTORY NO.3. Male 2115 22 12 1 1 2 - 1 1 - - 6 Female 664 1 1 - - 1 - - - - - - FACTORY ESTATE Male 563 6 4 - - 1 - - - - 1 2 Female 192 1 1 - - — - - - 1 - - HOSPITAL NO.2. Male 201 5 3 - 1 1 - - - - - 3 TOTALS: MALE 6877 102 61 4 6 10 — 6 1 6 4 34 FEMALE 4746 43 28 - - 9 1 6 - 7 5 4 GRAND TOTAL: 11623 145 89 4 6 19 1 12 1 13 9 38 35 OTHER ABNORMALITIES DISCOVERED WERE:- Male Female Abnormalities of Bony Thorax-Acquired 2 - Pneumonia 4 1 Bronchiectasis 3 - Emphysema 9 - Pulmonary Fibrosis-Non T.B. 12 1 Pneumoconiosis 1 - Sarcoidosis 1 - Pleural Thickening 1 - Diaphragmatic Hernia 1 - Elevation of Diaphragm - 1 Substernal Goitre - 1 The number of cases notified has dropped again from 71 cases of Pulmonary Tuberculosis in 1957 to 58 cases in 1958. Tables T(2) and T(3) give 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. TABLE T(2) Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 year - - — - — - - - 1-5 years - - - - - - - - 5-15 years 2 3 - - - - - - 15-25 years 6 6 - - - - - 25-35 years 5 7 - 1 - - - - 35-45 years 4 4 - 1 2 - - - 45-55 years 5 1 - - - 1 - - 55-65 years 6 2 - - 1 1 - - 65 years upwards 4 3 - 2 2 - - - Totals: 32 26 — 4 5 2 — — In addition, 29 cases of Pulmonary Tuberculosis and 3 cases of NonPulmonary Tuberculosis previously notified in other areas, moved into Edmonton. 36 TABLE T(3) MALES females TOTAL Respiratory NonRespiratory Respiratory NonRespiratory Added to Register during 1958 59 1 45 7 112 Number of cases notified for the first time during the year 32 - 26 4 62 Number of cases restored to Register having been previously removed 12 - 5 1 18 Number of cases added to Register other than by formal notification 15 1 14 2 32 Removed from Register during 1958 47 1 40 4 92 Number of deaths from Tuberculosis- Notified cases 5 - 2 - 7 Number of deaths from Tuberculosis- Non-notified cases - - - - - Number of deaths, Other causes- Notified cases 8 - 1 1 10 Number of cases, left district, recovered, etc. 34 1 37 3 75 The non-respiratory forms of Tuberculosis notified were:- Part of Body Affected Males Females Glands of neck - 3 Spine - 1 TABLE T(4) The number of cases of Tuberculosis on the Register at the end of 1958 was:- Males Females Total Pulmonary forms 677 516 1,196 Non-pulmonary forms 71 100 171 748 616 1,367 37 TABLE T(5) The corresponding figures at the end of 1957 were:- Males Females Total Pulmonary forms 665 511 1,176 Non-pulmonary forms 71 97 168 736 608 1,344 TABLE T(6) Corresponding figures for previous years were:- Males Females Total 1956 722 603 1,325 1955 706 599 1,305 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 It will be seen that in latter years there has been a steady increase in the number on the register but that despite this increase in the possible pool of infection, it has been possible to reduce slowly but steadily the number of new cases each year. POLIOMYELITIS No cases were notified during the year. Like measles, poliomyelitis tends in any one district or Borough to have waves of incidence about every two years, i.e. alternate years. There were no cases notified in 1958, but that does not mean that there will be no cases notified in Edmonton in the future despite an effective campaign of immunisation against poliomyelitis. PNEUMONIA 40 cases were notified during the year. 38 FOOD POISONING There were 85 notifications of suspected food poisoning during the year. 52 of these occurred in outbreaks, 33 as single cases. There were three outbreaks due to the Bacillus (Clostridium) Welchii and one due to Staphylococcal infection, and a further four to Salmonella infections. I will comment on only two of these, the CI. Welchii infection at a long stay hospital and a family outbreak due to Staphylococcal infection. CI. Welchii Outbreak at Local Hospital On 10th March, the Medical Officer of a local long stay hospital notified me by telephone that he had 20 patients suffering from diarrhoea. The first patient had started to feel ill about 8 p.m. on Sunday, 9th March, and similar symptons had appeared in the other patients through the night. None of the patients suffering from diarrhoea, as it happened, had gone out for a meal on a Saturday or Sunday* (Most of the patients at this hospital are not seriously disabled by their chronic illness). It was discovered that for lunch on Sunday, 9th March, the patients had had roast pork which had been cooked on Saturday. Hie roast pork had been kept in an ordinary meat safe during the interval of 20 to 24 hours. It had been warmed up on a hot plate and then covered with a hot gravy. All the pork and gravy and pork dripping had been used and none was available for examination. Faeces specimens were obtained from all those affected and CI. Welchii were found in four of the specimens. (CI. Welchii is a sporing bacillus and its spores are resistant to heat). It is found quite frequently in the soil and in the gut and flesh of domestic animals). A specimen of roast beef taken on 16th December was found to be contaminated with Staphylococci but CI. Welchii was not found. The cooking arrangements were reorganised and from then on all meat was refrigerated and kept down to 31b. joints before cooking and eaten on the day it was prepared. Arrangements were put in hand for the supply of pressure cookers. There have been no further outbreaks at this hospital. Family Staphylococcal Outbreak In this outbreak the food at fault appeared to be cooked ham. The food was cooked by the housewife on 30th August, 1958, and a portion was eaten by her husband and son the same day. The remainder of the ham was stored under a colander on top of the washing machine until Tuesday evening (2nd September). The ham was then removed from the top of the washing machine and eaten by the husband and son at about 10.15 p.m. Vomiting and blood-stained diarrhoea followed in the small hours. Staphylococcus Aureus was isolated from the faeces of the husband and son and from the ham. The housewife had discharging boils on her hands and arms. - 39 - (A) Particulars of Outbreaks Agent Number of Outbreaks Number of Cases Total No. of Cases Family Outbreaks Other Outbreaks Notified Otherwise Ascertained Sal: Typhi-Murium 3 – 8 – 8 Sal: Oranienburg 1 – 2 – 2 Staphylococci (including toxin) 1 – 1 1 2 Cl. Welchii 2 1 29 – 29 Totals: 7 1 40 1 41 Agent not Identified 3 – 10 – 10 (B) Single Cases Agent Number of Cases Total No. of Cases Notified Otherwise Ascertained Sal: Typhi-Murium 16 – 16 Sal: Group "B" 6 – 6 Sal: Enteritidis 2 – 2 Totals: 24 – 24 Agent not Identified 9 – 9 (C) (C) Salmonella Infections, not Foodborne Salmonella Type Outbreaks No. of Cases Total No. of Cases. (Outbreaks and Single Cases) Family Other (Outbreaks) Single Cases Sal: Typhi-Murium 1 2 – 2 Totals: 1 2 – 2 Epidemic Vomiting On the afternoon of Thursday, 12th June, the Headteacher of an Infants' School in the north west of the Borough reported that she had a number of children in the School suffering from vomiting. I visited this School expecting to find an outbreak of food -poisoning. The children were found to 40 suffer mainly from vomiting and abdominal discomfort and the incidence was as great in children not staying to school meals as those who did. The first case had occurred on the 6th June, 3 more children had fallen ill on 10th June and on 12th June 13 children had vomited,some of them more than once. I decided therefore this was an outbreak of epidemic vomiting. Nose and throat swabs and faeces specimens were taken from a sample of the children and proved negative. The children affected were excluded from school for one week, but 45 more children fell ill during the 24 hours from 4 p.m. on 12th June to 4 p.m. on 13th June. These 45 were excluded and their brothers and sisters and their immediate neighbours in class. 61 more children fell ill during the week-end, 12 more on the 17th, one more on the 18th, one more on the 19th, 3 on the 23rd, one on the 26th and one on the 27th, in addition, three of the School Welfare workers became ill on the 16th June and were excluded. The Junior School on the same campus got off more lightly with 20 cases on 16th June, 15 on 17th June and 2 on the 18th. Smaller numbers were involved at two other Schools in the northern half of the Borough, 18 children at one Infants' School and 19 at one Junior School. By the end of June the epidemic seemed to be at an end but a further school was affected in September with about 60 cases, and there were a further 6 cases at the original school. Notification of the main Infectious Diseases are presented in tabular form below:- Disease Total No. of Cases Number 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 217 146 – – 6 12 20 311 21 24 3 – – – – Measles 686 28 – 19 59 71 66 983 52 16 4 – 1 – – Whooping Cough 25 1 – 3 4 1 3 2 12 – – – – – – Pneumonia 40 8 59 3 – – 1 - 2 4 2 1 3 15 9 Puerperal Pyrexia 110 107 – – – – _ – – 16 84 10 – – Erysipelas 6 – – – – – - _ - – – – – – 3 3 Food Poisoning 85 6 – 3 3 3 3 2 7 10 2 16 10 20 6 Poliomyelitis – – – – – – - _ - – – – – – – – Ophthalmia Neonatorum 11 11 – 11 – – - _ – – – – – – – Dysentery 51 2 – 4 4 11 2 2 3 6 5 8 3 3 Meningococcal Infection 1 1 – – – 1 – – – – – – – – Acute Encephalitis 3 3 1 – – – – - – 1 – 1 -– – 1 41 IMMUNIZATION The Area Medical Officer for Area No.l. Middlesex (Edmonton and Enfield) has kindly given me the following details of immunization against Diphtheria and Whooping Cough during 1958:- Age Children who completed a full course of primary immunization Children given a reinforcing injection Diphtheria only Diphtheria and Whooping Cough Whooping Cough only Diphtheria only Combined Diphtheria and Whooping Cough Whooping Cough only (2) (3) (4) (5) (6) (7) Under 1 96 386 28 – – – 1 46 279 15 – – – 2-4 27 22 5 175 21 31 5-14 33 4 3 494 54 14 15 and over – – – 2 1 – Total: 202 691 51 671 76 45 Most diphtheria epidemics in recent years have been associated with schools, and the numbers of children given a reinforcing injection are therefore important. The number of school children protected is sufficient to ensure that any epidemic of diphtheria is likely to be small and non-fatal. It will be observed that 856 children under the age of 4 were protected against diphtheria, about 68% of those newly at risk per annum. 745 children under the age of 4 were protected for the first time against whooping cough, about 63% of those newly at risk per annum. Since the whooping cough vaccine is slightly less effective in preventing whooping cough than the diphtheria toxoid in preventing diphtheria, it is probable that 80 to 85% of those at risk need to be protected by the vaccine before the disease can really be banished from homes and schools. Whooping cough is, however, becoming a much less serious problem as a result of the immunization programme. HEALTH EDUCATION (A) HOME SAFETY After careful consideration of tne subject for some months, the Public Health Committee decided that Home Safety education would be better run by the Public Health Committee itself than by a voluntary Home Safety Committee Separate provision was made in the estimates for expenditure on Home Safety education, and the Home Safety programme started with a public meeting on 24th April 1958, in the Town Hall. The speaker was Miss Barbara Naish, Manager of the Home Safety Department of the Royal Society for the Prevention of Accidents and her subject was "Twenty Questions on Home Safety". Her department pub- 42 lishes a Twenty Questions Quiz leaflet and she went through this leaflet expanding the various points. After her talk a comedy film "Accidents Will Happen", featuring Richard Hearne as 'Mr. Pastry' was shown. Posters on burns and scalds and falls were displayed on the Health Department's four poster-boards during April. During May., Home Safety Quiz posters were sent to all the schools, together with advice on their use and in July, Home Safety was featured in the Health Department Exhibition as part of the Charter Celebrations Local Government Exhibition. (Saturday, 5th July, 1958). During July, also, a duplicated Home Safety Bulletin, mainly in rhyme and illustrated by line drawings, was sent out to the Infant and Junior Schools. One bulletin was sent to every two children. This led to difficulties, and when the second issue was sent out in November 1958, one copy was sent for each child above the Infants' First Year. A national "Guard that Fire'' campaign was initiated in October 1958, and the Borough co-operated in this. Posters were displayed, stickers were displayed in the shops and on certain of the Corporation vehicles, and a Home Safety Poster Competition was held in the Infant and Junior Schools. 700 children contributed posters to the competition and each child was given a Home Safety pencil bearing the slogan "The A„B.C. of Home Safety - Avoid Being Careless". Savings Certificates were given for the best poster from each school and also for the best in each group, and the prizes were presented by the Mayor after the Council Meeting in January, 1959. In addition to this, I contributed an article on Home Safety to the local press (Tottenham and Edmonton Herald) in April, and an article on winter hazards, which, of course, included matter on Home Safety, in October. (B) GENERAL Poster publicity on Food Hygiene, Lung Cancer and Tuberculosis was carried out throughout the year. The Health Department exhibits at the Local Government Exhibition in the Jubilee Park on Saturday, 5th July, were housed in a large marquee and demonstrated Food Hygiene, Smoke Control, Rodent Control and Home Safety. Food Hygiene stand included two 6' stands and a number of specimens kindly loaned by the Borough of Hackney, material provided by the Food Hygiene Laboratory Colindale, and photographs purchased from the Central Council of Health Education in addition to some of our own material. An illuminated exhibit on Rodent Control was provided by the Ministry of Agriculture and Fisheries and the Smoke Control exhibit consisted of a stand provided and staffed by the Coal Utilisation Council and a small stand of our own. The exhibits aroused considerable interest and at least 2?000 people visited the tent. During September and October publicity was given to the visit of the Mass X-Ray Unit. As I have said, the visit was publicised on the Council's Rate Demand and by distribution of leaflets, by leaflets and bookmarks in the Libraries, by posters and by an article by myself in the Tottenham and Edmonton Herald. A film show on 8th October at the Town Hall, dealing with respiratory disease (Programme - "Arthur Askey and The Nose Has It", "Guilty Chimneys", "Inside Story" (of Tuberculosis), "X-Ray Inspector" and a film strip on the use of "Smokeless Fuel"), was attended by about 40 people, A Health "Brains Trust" on 15th October was attended by about 30 people. The small audience at the 43 latter meeting got good value since the "Brains Trust" consisted of Sir Frederick Messer , M.P., Dr. Horace Joules - Medical Superintendent at the Central Middlesex Hospital, Dr. M. Thomas - Pathologist, Edmonton Public Health Laboratory and Mrs. VILE. Duncan - Publications Officer of the Central Council of Health Education, with Dr. T. Jones - Headmaster of Latymer School, Edmonton, as Chairman. However, a good many of the population of Edmonton got some valuable information second-hand through the account of the Brains Trust in the columns of the Tottenham and Edmonton Weekly Herald. Health Education in Edmonton would undoubtedly be much more effective if it was run by one authority and one department of that authority. At present the co-operation between the County Council and the Public Health Department is good, but there are inevitably times when the two programmes are 'out-of-step'. If the Health Visitors were under my general supervision, I feel sure that a much wider and more effective programme of Health Education could be carried out. WELFARE OF THE ELDERLY A great deal of help, both medical and social, is given to the elderly people in the Borough by General Practitioners and by the paid Officers of the County Council, mainly Health Visitors and Welfare Officers. National Assistance officials, also, act not only as paymasters but as social advisers. Nevertheless, the bulk of the work for old people in the Borough is carried out by Voluntary Workers and Associations, co-ordinated in the Edmonton Welfare Association. The report of the Secretary for 1958/59 gives a fair picture of what is being done. The work of the Association for the year under review has, once again, been one of steady progress, which is proof of the need for the services provided by the Association. In paying its tribute to the magnificient work of the voluntary organisations affiliated to the Association, we are sensible of the fact that, without their co-operation and team work, many of the services now provided would virtually cease to exist. The Constitution, and method of working together as a team, has put the Association in the position today of being a model of its kind, and we are constantly asked to receive visitors and give information and advice as to how the 'wheels go round'. It gives great pleasure to the Association to acknowledge with grateful thanks the work of the voluntary organisations - British Red Cross; Women's Voluntary Service; Toe H; Salvation Army and the Citizens' Advice Bureau. We also take this opportunity of expressing to Mr. H.B. Heafield, M.C.C. Area Welfare Officer and Miss S.J. Briggs, Superintendent Health Visitor, M.C.C. No.l Area, our sincere appreciation of their assistance in our work over many years. We also value the co-operation of the National Assistance Board, Ministry of Pensions and National Insurance, Almoners, North Middlesex Hospital, local Doctors, etc. 44 Through this co-operation, in the field of social welfare in the Borough of Edmonton, a great number of people of all ages, have been given help and happiness and for some new friendships and new interests of lasting value. This surely is the measure and purpose of our work. Given hereunder is a brief report on the work of some of the services of the Association - MEALS-ON-WHEELS SERVICE; During the year 1958 no less than 12,630 meals were delivered, and during the first four months of this year, January to April inclusive, 4,538 meals have been delivered. Time has proved that whilst the maximum capacity of the service is 1,000 meals per month, as emergencies arise the service is 'stretched' as indicated in the figures above. Early this year the Executive authorised, on receipt of a supplementary grant of £90 from the Edmonton Borough Council, the purchase of four 'Hot-Lock' containers, and these are now in operation. The primary purpose of the 'containers' is to keep the food warm to the last person on the delivery round. This, of course, makes the meal more palatable and obviates waste. It is necessary, however, to have two persons on each vehicle, one for serving the meal from the 'Hot-Lock' and the other to deliver it. It is the intention of the Meals Organiser and the Welfare Organiser to visit all the Old People's Clubs to try and recruit additional helpers- This is suitable work for older people as the person serving the meal from the 'Hot-Lock' only has to hand the cans to the person delivering the meal, and the approximate time for the complete journey, from loading up to return with the empty cans, is 2 hours. Through the introduction of this new system, we shall be able to maintain our reputation of being one of the most outstanding Meals Services in London. To facilitate the delivery of the meals under this new hygienic system, the Edmonton Borough Council made a grant to the Edmonton Welfare Association to purchase a more suitable van in the place of the old van which needed extensive overhaul and was not suitable for the 'Hot-Lock' service. During the period under review, any cases of doubt have been referred to the M.C.C. Area Health Visiting Service for investigation and report. It can be accepted, therefore, by the Association, that the provision of meals to the people on this service are fully justified. The Association acknowledge with sincere thanks the outstanding work of the Women's Voluntary ServJ.ce, especially the invaluable services of Mrs. E. Everitt, Meals Organiser, who voluntarily give so much of their time to this service, for without them the "Meals-on-Wheels" service would cease to function. Our thanks are also due to the Edmonton Borough Council's catering staff and transport staff who assist in this excellent work. ENTERTAINMENT AND RECREATION; The Municipal Entertainments Department of the Edmonton Borough Council have continued over the year to maintain 45 a comprehensive programme of concerts to the Old People's Clubs, and in addition, there has been a series of special concerts during the summer months at the Summer Theatre. The 'All-Star Variety' show and the special Cinema Show are two of the high lights of this work which also included special Olde Tyme Dances, free admission to plays, quiz .contests, etc. The facilities for entertainment provided by the Edmonton Borough Council are greatly appreciated by the old people. VISITING SERVICE: This service is the most difficult to maintain owing to the lack of suitable volunteers to undertake this important work. However, the cases referred to the Association are often sent on to the Old People's Clubs in the particular locality from which the enquiry is received, and the Clubs report back the need of any special welfare services. In a number of cases, lonely old people have consequently taken up membership in the Club. Voluntary workers are urgently needed in this service, especially to visit house-bound old people who live alone. HOLIDAYS: As in previous years, there have been many enquiries with regard to 'off-season' holidays at reduced prices for old people, and full information has been sent to all the Old People's Clubs and interested organisations, of the facilities available. Many of the Old People's Clubs arrange for parties of their members to go away together under these special facilities, and there is no doubt that they derive great benefit from this happy association in new surrouidings. INFORMATION AND ASSISTANCE: The Town Hall continues to receive a large number of cases of people in need of information and assistance on a wide variety of problems. Many of these cases are referred to us by the local Doctors, Hospitals, National Assistance Board, Police, etc., and an endeavour is made to treat each case individually with courtesy, sympathy and understanding. During the year a number of editions of the "News Letter" have been circulated, giving information quickly and briefly to the greatest number of people possible through its distribution to the Old People's Clubs, affiliated organisations, etc. LIBRARY DELIVERY SERVICE: This admirable and efficient service with its bi-weekly delivery of books to the physically handicapped and house-bound old people, is greatly appreciated, and we record our thanks to the Libraries staff for their courteous and willing service. Today there are 47 people enjoying this service. WELFARE FOOD SERVICE; During the year the sales of welfare foods have increased - Ovaltine 1,510 tins; Bovril 986 bottles; and Marmite, which is in its first year of sale - 222 bottles. The Executive asked th^t an examination be made as to how far the distribution arrangements could be extended, and a system has now been introduced by which Old People's Clubs advise, in advance, the British Red Cross Society, who then deliver the order on the day that the Club concerned meets. Whilst the British Red Cross maintain control over the distribution, the new arrangements give a wider distribution and is greatly appreciated by the Old People's Clubs. The Association record their 46 sincere thanks to the British Red Cross Society for operating this service by acting as distributing agents on behalf of the Association. HAIRDRESSING SERVICE: This service continues to receive many demands upon the members of the London and Provincial Hairdressers' Association Edmonton Branch - who operate the scheme in the Borough, and the concessions they give and work they do for the old people are greatly appreciated. RADIO REPAIR SERVICE: The Association are grateful to the members of the London District 'operating unit' of the Radio Society of Great Britain for their continued service. Our spare sets are out on loan to old people whilst their set is under repair, and this is greatly appreciated by old people who are house-bound and living alone as the radio is their only companion. PROVISION OF SHORT-STAY ACCOMMODATION FOR OLD PEOPLE: The Executive of the Association appointed a 'Pilot' Sub-Committee to examine information collated on this problem. The evidence submitted proved that the problem was not an easy one to solve as the potential number of old people who would be concerned in such a scheme was in the region of 350 cases known to local Doctors, and obviously would be much greater if the proposals were advertised. At the moment, the major difficulty is to obtain financial assistance from the appropriate Government Department, and these aspects of the problem are still under consideration. LECTURE COURSE ON THE "WELFARE OF OLD PEOPLE": By arrangement with the London Council of Social Service, under the King George VI Social Service Scheme, a course of six weekly lectures were given at the Town Hall to representatives from the voluntary organisations; Salvation Army, Churches and Old People's Clubs. Each lecturer was an expert in their particular field, and it was acknowledged by the London Council of Social Service and those who attended the Course, that it was an outstanding success. A great deal of value was obtained by using the second part of the lecture as a 'study group' to discuss points raised by the lecturer as they were related to local circumstances. A report on the points raised by the 'study group' has been presented to the Executive for their consideration. CLUBS: The William Preye Club: This Club, by its continued success, has proved that it is now accepted as an important social centre for old people. There is no doubt that its success is mainly due to the excellent work of the Voluntary Wardens and the Officers, and they can be justly proud that the Club is recognised by the London Council of Social Service and the National Council for Old People's Welfare as one of the show places in London for people working in this particular field of social welfare. This is indicated by the number of 'official visitors' the Club has received during the past year. Two visitors of special importance were two officers from the National Council for Old People's Welfare, one an architect, and the purpose of their visit was to see whether the grant of £1,000 from the King George VI Memorial Fund had been 47 perly spent. Their verdict was - " ... This is one of the best Clubs we have visited in the country! ". They paid a particular tribute to the happy atmosphere at the Club, and complimented the Officers on the work they were doing. The Autumn Fair raised over £150, and from the proceeds the Club gave a tea-party to 140 members. The Executive of the Association have expressed their thanks to the Club for donating the sum of £100 towards the cost of running the Club. It is acknowledged that the Sewing Corner and the weekly Whist Drive are the most profitable sources of income to the Club. The financial position of the Club is very sound. The Association would like to record its thanks and appreciation to the Management Committee, Officers, Voluntary Wardens of the Club for their excellent work which is giving so much pleasure to a great number of people. Pymmes Park Club for Old People: The Club has continued to meet the need for a meeting place for the old people in this part of the town. The average daily attendance is 20 members. Whilst the Club provides social recreation for its mainly male membership, efforts have been made to recruit women members but without success. The erection of the billiard table during the winter months has been greatly appreciated by the members. The Inter-Club Matches with the William Preye Club have given great pleasure to both Clubs. A successful outing was arranged during the summer months, the members paying only 2/6d. towards the cost. The annual tea-party was attended by 50 members and was voted a great success. The Association record their thanks to the Management Committee, Officers and Voluntary Wardens of the Club for their services during the year. FOOT SERVICE: The Foot Clinic Service, provided on alternative Mondays at the William Preye Club and the Red Cross Centre, are doing excellent work, and they report that no less than 1,430 treatments were given during the year under review. Many of the old people appreciate the importance of early treatment for foot ailments, and the speed in which appointments are given, helps in the efficiency of the service. As a token of appreciation of the services given in this excellent work, the Association have made a grant of £50 to the British Red Cross Society, Edmonton. PUBLIC BATHS - RED CROSS SERVICE TO ELDERLY AND INFIRM: The Red Cross have continued to provide a Red Cross Nurse each week at the Baths to assist elderly and infirm old people attending the Baths. This service is greatly appreciated but would warrant greater publicity, and appropriate action is being taken to that end. OTHER SERVICES: All the other services are working satisfactorily, but there is still an acute shortage of voluntary workers to make these more effective. CONCLUSION: The Association, working through the Executive Committee, with its wide representation of interests in the field of social welfare, has shown once again the importance for the need of these services in the Borough of Edmonton. The true measure of our achievements has been the result of close co-operation and liaison with all the voluntary organisations working together as a team for the common good. 48 The Association and its affiliated organisations go forward together to maintain and expand the services, and thereby serve the people to the best of their ability. ACKNOWLEDGEMENTS: The Association wish to acknowledge and offer its sincere thanks to - Mr. D.C. Jardine and his colleagues of the Radio Society of Great Britain, for their work in the "Radio Repair Service". Mr. J. Ross and his colleagues of the Edmonton Branch of the London and Provincial Hairdressers' Association for their work in the "Hairdressing Service". The Chairman and Directors of BOVRIL; the Chairman and Directors of OVALTINE and the Chairman and Directors of MARMITE, for their special concessions to the Association, and their prompt and courteous attention at all times. The Manager, Marks and Spencer, Fore Street, Edmonton, N.18, for his special services to the Association. The Head Teachers, Staff and pupils of the Cuckoo Hall Junior School; Raynham Junior School; Houndsfield Junior School and the Fleecefield Primary School, for their gifts which gave so much pleasure to the old people. To the Editor of the "TOTTENHAM AND EDMONTON WEEKLY HERALD" for their publicity and interest in the work of the Association, and especially to all the VOLUNTARY WORKERS in the Borough of Edmonton who so willingly give so much of their time to the work of the Association. COUNCIL'S EMPLOYEES During 1958, a total of 422 visits were paid to those employees who had been on the sick list for longer than a fortnight and when necessary, at fortnightly intervals. Of these, 83 were 'not at home' and 57 had already resumed duty. Also during the year, the following medical examinations or assessments were made prior to appointment to permanent posts Medical examinations 66 Assessments without medical examinations 101 Medical assessments (not appointed) 123 CONCLUSION In conclusion, I should like to pay tribute to three members of the staff who left the Council's service during 1958. Mr. H.W. Grieves retired 49 on 22nd July, 1958, after nearly 22 years' service in the Department. He had trudged around his district for more than 20 years without complaint and to some good effect. Mr. F. Beilby unfortunately died on 28th August, 1958. He had served in the Department since 1926, first as Housing Inspector and then as Public Health Inspector and although his health was never good he played a most useful part in the work of the departments. Mr, J.P. Farrar retired on 31st December, 1958, after more than 40 years' service with the Council. He had served the Council during two World Wars and had seen Edmonton grow in size, become industrialised and gain Borough status. During the past 20 years in particular, the work of the department owes much to him. I would also like to thank the Chairman and Members of the Public Health Committee for their help and advice during 1958, to thank the other Chief Officers and Members of their departments for their co-operation and assistance, and to thank very warmly my Deputy and all the Staff and workers of the Public Health Department. In the years to come, I am now sure we shall make steady and substantial progress. I have the honour to be, Your Worship, Ladies and Gentlemen, D. A. SMYTH, Medical Officer of Health. 50