EDM 44 Library Borough of Edmonton Annual Report of the Medical Officer of Health for the Year 1959 BOROUGH OF EDMONTON 1959 His Worship the Mayor Councillor J.A.G. Beattie, J.P. Deputy Mayor Councillor J.V. Stanton. PUBLIC HEALTH COMMITTEE Chairman: Councillor Mrs. R.A. Smythe Vice-Chairman: Alderman Mrs. F. Long, J.P. Members: THE MAYOR (Councillor J.A.G. Beattie, J.P.,) (Ex Officio) THE DEPUTY MAYOR (Councillor J.V, Stanton) (Ex Officio) Councillor J.E. Cooke „ E.R. Holborn „ J.E. Lightfoot „ R.B. Moore „ 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 D G. Rawlinson (Commenced 2.3.59) J.P. Farrar (Returned temporarily 7.1.59 - 28.2.59) Public Health Inspectors: ABC H.W.Grieves (Returned temporarily 19.1.59) A B C D V.C. Quin (Left 3.3.59) A B C D J.H. Willis AC T.C. Oliver A C L.C. Hibbs AC R.A. Royle (Commenced 27.4.59) AC A.G. Watmore (Commenced 25.5.59) ABC M.R. Ruocco (Commenced 13.7.59) Trainee Public Health Inspectors: G.F. Bateman J.G. Cummins Senior Clerk: A F.J. Nash Clerical Staff: H.J. Weldon A.F. Ballantine (Retired 21.9.59) Mrs. E.J. Richards Mrs. N.E. Young D.J. Faithfull (Commenced 26.1.59) F. Okusanya (Commenced 23.2.59) R. Taylor (Commenced 10.8.59) 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, Though the vital statistics for 1959 are less favourable than in previous years there were nevertheless the signs of improvement in the health of Edmonton. The number of cases of Pulmonary Tuberculosis notified fell from 58 to 49 and there was no increase in the number of cases on the register. The number of cases of Food Poisoning notified fell sharply, and there was a marked increase in the number of parents who accepted immunization (against Diphtheria or Whooping Cough) for their children. On the other hand Edmonton suffered both a Dysentery epidemic and an Influenza epidemic, there were sporadic cases of Poliomyelitis during the summer, there was an increase in the number of deaths from accidents, and both the general death rate and the infant mortality rate rose. As was reported in the 1958 report Mr. Farrar retired at the end of 1958 and Mr. G. Rawlinson succeeded him as Senior Public Health Inspector on the 2nd March, 1959. Mr. Farrar returned in a temporary capacity to fill the gap during January and February and I was more than grateful for his assistance. The staff of Public Health Inspectors was, as I mentioned in the 1958 report, considerably depleted by the end of 1958 and for the first two months of 1959 there were only four Public Health Inspectors, and for the months of March and April only three permanent inspectors. Mr. Grieves however returned from retirement to assist us, and the vacancies were progressively filled during the succeeding months. The department was therefore able to carry out a full programme of work for almost the whole of the second half of the year. During the year among other work 300 houses were represented for slum clearance and a large smoke control area was surveyed. 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 1959 94,420 Number of inhabited houses and separate dwellings at the end of 1959 28,371 Number of inhabited houses and separate dwellings at the end of 1958 28,202 Rateable value, April 1959 £1,613,321 Estimated product of 1d. rate in the £ for the year ending 31st March, 1960 £6,620 Rate in the £ for the year ending 31st March, 1960. 19s. 4d. The population continues to fall at the rate of about 1,000 people a year. This is partly due to the fact that those who move out of Edmonton have more children in the family than those who move into it, but this is not the whole story. There is still a net loss of families to surrounding areas and this may well go on for the next year or two. TABLE II VITAL STATISTICS M. F. Total Grand Total Live Births Legitimate • • • 612 619 1,231 Illegitimate • • • 32 22 54 1,285 (Percentage of live births) 4.20 Birth rate per 1,000 population 13.60 Corrected birth rate 13.60 Still Births Legitimate • • • 10 11 21 Illegitimate • • • 1 1 2 23 Still birth rate per 1,000 total live and still births 17.58 Deaths Number • • • 523 509 1,032 Rate per 1,000 population 10.92 Corrected death rate per 1,000 population 12.12 Maternal mortality rate per 1,000 total live and still births NIL 6 TABLE III COMPARATIVE STATISTICS Birth Rate Live Still Death Rate Infant Mortality Rate England and Wales 16.5 20.7 11.6 22.0 Middlesex 14.7 15.9 10.6 19.4 Edmonton (Crude) 13.60 17.58 10.92 23.34 Edmonton (Corrected) 13.60 — 12.12 - INFANT MORTALITY TABLE IV Infant Mortality (Legitimate) 23.55 (Illegitimate) 18.51 Total 23. 34 Neo-natal Mortality 20.23 Early Neo-natal Mortality 18.67 Peri-natal Mortality Rate (Stillbirths and deaths under 1 week combined per 1,000 live and stillbirths) 35.93 The number of children who died was 30 all legitimately born, 10 being males and 20 females. 26 of the deaths were in the first month of life, giving a neo-natal mortality of 20.23. The peri-natal mortality is the number of deaths under 1 week and still births per thousand live and 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 Premature Birth 2 - - - 2 - - - - 2 Birth Injury 1 - - — 1 - - - - 1 Foetal Asphyxia 3 - — - 3 - - - - 3 Congenital malformations 3 - — - 3 - - - - 3 Totals: 9 - - - 9 1 — — — 10 7 TABLE VI FEMALES 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 Congenital malformations 3 — — — 3 — 2 — — 5 Atelectasis 3 - - - 3 - - - - 3 Premature Birth 7 - - - 7 - - - - 7 Birth Injury 2 - - - 2 - - - - 2 Home Accidents 1 - 1 - 2 — - 1 — 3 Totals: 16 - 1 - 17 - 2 1 - 20 The third wave of the influenza epidemic hit Edmonton in 1959 and it seems probable that damage from the influenza virus played a part in the increase in the general death rate, the increase in still births, and the increase in the infant mortality rate. Most of the babies who died died under the age of one month and, of these, all but one died under the age of one week. This suggests that a contributory cause was maternal ill-health. It will be seen that one of the slightly older children died of pneumonia and this also might well have followed on an influenzal infection. It is also possible that the cases of foetal asphyxia, apart from one which was due to an abnormality of pregnancy, might have been due to direct influenzal infection of the foetus. ACCIDENTS The Home Accidents during the year were as follows Date Sex Age Probable Cause 27th January F 79 Coal Gas Poisoning. 7th February F 85 Suppurative Bronchitis following burns received in a fire at her home. 12th February F 84 Suppurative Bronchitis associated with carbon monoxide poisoning from coal gas. 13th March F 20 days Fractured skull with laceration of the brain. Mother, being herself ill, fell down the stairs whilst carrying baby. 22nd April F 88 Multiple contusions sustained in fall at home. 8 Home Accidents (Cont'd) Date Sex Age Probable Cause 19th July F 7 months Cerebraloedema and haemorrhage fell to floor at home. 14th September F 58 Coal gas poisoning. 20th October F 78 Fractured skull due to fall down stairs. 1st November F 87 Coal gas poisoning. 11th November F 87 Collapse of lung due to fracture of ribs when she fell down stairs. 4th December F 83 Pneumonia following fracture of femur due to fall at home. 26th December F 3 weeks Asphyxia. It will be seen that coal gas poisoning and falls account for all but two of the deaths. The child who died of asphyxia on Boxing Day may have suffocated or it may have been an artificially fed child and developed an allergic reaction to cows milk sufficient to cause asphyxia or it may have been asphyxiated by a virus infection. The old lady who was burned almost certainly had no guard in front of her fire, but to what extent the deaths from coal gas poisoning and falls were preventable it is difficult to say. There were three deaths from drowning, A boy of eight was drowned in July and a boy of six in June, while a man of 66 bathed in the Lea on the 30th of December. In the case of the elderly man possibly the drowning followed cramp. There were two deaths from electrocution, two from railway accidents and three from falls outside. Since two of the main roads into London and one of the main roads round it run through Edmonton there continue to be quite a number of fatal road accidents. In 1959 there were 10, 7 in males and 3 in females. Only one of these deaths was in a child under the age of 15, which indicates that the Road Safety Officer's campaign among the school children is having considerable effect. Even in the age group 15 to 25, generally regarded as an age of recklessness, there was only one death. In Edmonton it is the more experienced members of the community who seem to suffer road accidents. ANGINA (Coronary Disease) This disease takes a heavy toll, but the deaths have fallen slightly. Table VII shows that some of the victims died surprisingly early, 4 being under the age of 45 and 10 under the age of 55. Angina accounts for over an eighth of all the deaths in Edmonton and it is undoubtedly a widespread disease in the town. Although those who are heavy for their height 9 have a higher incidence of coronary disease, it may not be simply due to over-eating and too little exercise. It is quite possible that bacteria or viruses may begin the process of fatty change in the arteries which leads in time to angina. BRONCHITIS AND PNEUMONIA The third wave of the influenza epidemic was the most severe. The number of cases of bronchitis and pneumonia rose only slightly from 131 to 135, but there was a change in the ratio of the two diseases. In 1958 there were 72 cases of bronchitis which lead to death and 59 cases of pneumonia which were fatal. In 1959 there were 72 fatal cases of pneumonia and 63 fatal cases of bronchitis. A number of younger people died from pneumonia despite the many anti-biotics now available. CANCER OF THE LUNG There was no increase in deaths from Lung Cancer. The majority of cases that caused death were again in men, since smoking even of cigarettes is more a male weakness than a female one. The real cost in money of a packet of cigarettes is practically the same as in 1939, if the reduction in buying power of the 1959 income is taken into account. The tax on tobacco should be at least double its present rate, and should be progressively raised until it is as difficult to afford a packet of cigarettes as half a bottle of whiskey. HYPERTENSIVE HEART DISEASE The deaths from this cause have risen in females. The rise is mainly in the over 65's and respiratory infection may possibly have played a part in the fatal heart strains. INFLUENZA Deaths from Influenza like those from Bronchitis and Pneumonia are somewhat higher. Both males and females suffered, but there were slightly more deaths in males. LEUKAEMIA There were more Leukaemia deaths but the figure was still below that for 1957. MALIGNANT NEOPLASMS There was a marked rise in deaths from cancer of the stomach, mainly in women. Cancer of the stomach is a cancer to which women are more subject than men and it may be that the effects of female smoking will be seen in an increase in cancer of the stomach rather than in cancer of the lung. 10 Women in any case tend to pamper their husbands stomachs more than their own. The slight rise in cancer of the uterus is not significant. DIABETES Quite a large number of women died from diabetes. Four were under the age of 65. Though diabetes can now be well controlled by insulin and diet the resistance of diabetic patients to infection is lower than average and infection exacerbates the disease. It is possible that influenza or respiratory infection has played a part in this increase in deaths from diabetes. GASTRITIS, ENTERITIS AND DIARRHOEA This group represents, as I have said before,a pocket of resistance to medical advance which needs to be mopped up. The patients who died were not, as one might expect, babies, but adults, the ages ranging from 25 to 85. These deaths emphasise that control of the diarrhoeal infections is still of great importance. NEPHRITIS AND NEPHROSIS The death rate remains about the same level. Though I would prefer to record no deaths, the figure is lower than that in most Boroughs in Greater London. TUBERCULOSIS All the female deaths and two of the male deaths were in persons over the age of 75. Three men died between 55 and 65 and two between 65 and 75, and it may well be that tuberculosis shortened life in these cases. SYPHILIS Syphilis takes a long time to kill, and the man who died in his 60's had probably had the disease for many years. Despite the opportunities of cure given by anti-biotics syphilis remains a dread disease. It is almost always acquired through close contact with a syphilitic sore. SUICIDE There were fewer suicides, for some reason. Most of the people who took their life in 1959 were old people, and loneliness may well have been one of the causes of their distress. 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 9 - - - - - - - - 3 2 4 - Tuberculosis, other - - - - - - - - - - - - - Syphilitic disease 2 - - - - - - - - - 1 1 - Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal Infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective and parasitic disease - - - - - - - - - - - - - Malignant neoplasm, stomach 39 - - - - - - - 4 3 10 19 3 Malignant neoplasm, lung, bronchus 64 - - - - - 1 - 12 20 22 9 - Malignant neoplasm, breast 18 - - - - - - 3 3 3 1 5 3 Malignant neoplasm, uterus 6 - - - - - - - - 3 2 1 - Other malignant and lymphatic neoplasms 102 - _ - 1 1 1 7 11 21 28 29 3 Leukaemia, aleukaemia 4 - - - - - - - - 4 - - - Diabetes 15 - - - - - - - 1 4 5 5 - Vascular lesions of nervous system 125 - - - - - 1 - 8 19 31 53 13 Coronary disease, angina 151 - - - - - - 4 10 42 47 40 8 Hypertension with heart disease 30 - - - - - - 2 - 2 9 13 4 Other heart diseases 124 - - - 1 - 1 1 6 10 16 47 42 Other circulatory disease 47 - - - - - - - - 7 10 23 7 Influenza 11 - - - - - - - - 4 1 5 1 Pneumonia 72 - - - - 1 1 2 5 6 13 25 19 Bronchitis 63 - - - - - - - 1 13 20 20 9 Other disease of respiratory system 6 - - - - - - - - 1 2 3 - Ulcer of stomach and duodenum 12 - - - - - - - 3 2 3 4 - Gastritis, Enteritis and Diarrhoea 7 - - - - - 1 - - 1 2 2 1 Nephritis and nephrosis 7 - - - 1 - - - - 3 3 - - Hyperplasia of prostate 3 - - - - - - - - 1 - 2 - Pregnancy, childbirth, abortion - - - - - - - - - - - - - Congenital malformations 11 7 - - 2 - - 2 - - - - - Other defined and ill-defined disease 78 20 - 1 1 1 - 3 9 9 17 11 6 Motor vehicle accidents 10 - - - - 1 1 2 1 3 2 - - All other accidents 31 3 - - 3 1 2 2 1 3 4 7 5 Suicide 7 - - - - - 1 - 1 - 4 1 - Homicide and operations of war - - - - - - - - - - - - - Totals: 1054 30 - 1 9 5 10 28 76 187 255 329 124 12 TABLE VIII DEATHS BY SEX-GROUPS Cause of Death M F TOTAL Tuberculosis, respiratory 7 4 11 Tuberculosis, other - - - Syphilitic disease 1 1 2 Diphtheria - - - Whooping Cough - - - Meningcococcal infections - - - Acute Poliomyelitis - - - Measles - - - Other infective and parasitic diseases - - - Malignant neoplasm, stomach 16 23 39 Malignant neoplasm, lung, bronchus 58 6 64 Malignant neoplasm, breast - 20 20 Malignant neoplasm, uterus - 6 6 Other malignant and lymphatic neoplasms 56 46 102 Leukaemia, aleukaemia 4 - 4 Diabetes 2 13 15 Vascular lesions of nervous system 43 73 116 Coronary disease, angina 96 56 152 Hypertension with heart disease 7 19 26 Other heart disease 39 80 119 Other circulatory disease 24 21 45 Influenza 7 5 12 Pneumonia 41 28 69 Bronchitis 36 25 61 Other diseases of the respiratory system 4 2 6 Ulcer of stomach and duodenum 11 1 12 Gastritis, Enteritis and Diarrhoea 1 6 7 Nephritis and nephrosis 3 3 6 Hyperplasia of prostate 3 - 3 Pregnancy, childbirth, abortion - - - Congenital malformations 3 7 10 Other defined and ill-defined diseases 36 42 78 Motor vehicle accidents 7 3 10 All other accidents 14 16 30 Suicide 4 3 7 Homicide and operations of war - - - Totals: 523 509 1032 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 7 - - - - - - - - 3 2 2 - Tuberculosis, other - - - - - - - - - - - - - Syphilitic disease 1 - - - - - - - - - 1 - - Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective and parasitic diseases - - - - - - - - - - - - - Malignant neoplasm, stomach 17 - - - - - - - 3 1 6 6 1 Malignant neoplasm, lung, bronchus 59 - - - - - - - 11 20 21 7 - Other malignant and lymphatic neoplasm: 3 56 - - - 1 1 1 2 3 14 16 17 1 Leukaemia, aleukaemia 3 - - - - - - - - 3 - - - Diabetes 2 - - - - - - - - 1 - 1 - Vascular lesions of nervous system 45 - - - - - 1 - 2 10 11 18 3 Coronary disease, angina 96 - - - - - - 3 9 28 35 20 1 Hypertension with heart disease 10 - - - - - - 1 - 1 4 3 1 Other heart diseases 43 - - - - - 1 1 4 6 3 18 10 Other circulatory disease 24 - - - - - - - - 6 8 6 4 Influenza 7 - - - - - - - - 3 1 3 - Pneumonia 41 - - - - - 1 - 3 4 11 13 9 Bronchitis 36 - - - - - - - 1 11 11 12 1 Other disease of respiratory system 4 - - - - - - - - - 2 2 - Ulcer of stomach and duodenum 11 - - - - - - - 3 2 3 3 - Gastritis, Enteritis and Diarrhoea 1 - - - - - 1 - - - - - - Nephritis and nephrosis 4 - - - 1 - - - - 1 2 - - Hyperplasia of prostate 3 - - - - - - - - 1 - 2 - Pregnancy, childbirth, abortion - - - - - - - - - - - - - Congenital malformations 3 2 - - 1 - - - - - - - - Other defined and ill-defined diseases 36 8 - - 1 - - 3 5 7 9 3 - Motor vehicle accidents 7 - - - - 1 1 1 1 1 2 - - All other accidents 15 - - - 3 1 2 2 1 2 2 2 - Suicide 4 - - - - - - - - - 3 1 - Homicide and operations of war - - - - - - - - - - - - - Totals: 535 10 - - 7 3 8 13 46 125 153 139 31 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 - - - - - - - - - - 2 - Tuberculosis, other - - - - - - - - - - - — Syphilitic disease 1 - - - - - - - - - - 1 - Diphtheria - - - - - - - - - - - - — Whooping Cough - - - - - - - - - - - - — Meningococcal infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective and parasitic diseases - - - - - - - - - - - - Malignant neoplasm, stomach 22 - - - - - - - 1 2 4 13 2 Malignant neoplasm, lung; bronchus 5 - - - - - 1 - 1 - 1 2 - Malignant neoplasm, breast 18 - - - - - - 3 3 3 1 5 3 Malignant neoplasm, uterus 6 - - - - - - - - 3 2 1 — Other malignant and lymphatic neoplasms 46 _ _ _ _ _ — 5 8 7 12 12 2 Leukaemia, aleukaemia 1 - - - - - - - - 1 - - - Diabetes 13 - - - - - - - 1 3 5 4 - Vascular lesions of nervous system 80 - - - - - - - 6 9 20 35 10 Coronary disease, angina 55 - - - - - - 1 1 14 12 20 7 Hypertension with heart disease 20 - - - - - - 1 - 1 5 10 3 Other heart diseases 81 - - - 1 - - - 2 4 13 29 32 Other circulatory disease 23 - - - - - - - - 1 2 17 3 Influenza 4 - - - - - - - - 1 - 2 1 Pneumonia 31 - - - - 1 - 2 2 2 2 12 10 Bronchitis 27 - - - - - - - - 2 9 8 8 Other disease of respiratory system 2 - - - - - - - - 1 - 1 - Ulcer of stomach and duodenum 1 - - - - - - - - - - 1 - Gastritis,. Enteritis and Diarrhoea 6 - - - - - - - - 1 2 2 1 Nephritis and nephrosis 3 - - - - - - - - 2 1 - - Hyperplasia of prostate - - - - - - - - - - - - - Pregnancy, childbirth, abortion - - - - - - - - - - - - - Congenital malformations 8 5 - - 1 - - 2 - - - - - Other defined and ill-defined disease: 3 42 12 - 1 - 1 - - 4 2 8 8 6 Motor vehicle accidents 3 - - - - - - 1 - 2 - - - All other accidents 16 3 - - - - - - - 1 2 5 5 Suicide 3 - - - - - 1 - 1 - 1 - - Homicide and operations of war - - - - - - - - - - - - — Totals: 519 20 - 1 2 2 2 15 30 62 102 190 93 - 15 - TABLE XI ALL DEATHS BY WARDS Ward Deaths Male Female Bury Street 150 139 Church Street 137 131 Angel Road 93 93 Silver Street 155 156 Vagrants - - Totals: 535 519 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 - - 54 Blood - Haemoglobin Estimation - - 212 Blood - Kahn Reaction - - 104 Blood - Rhesus Factor - - 104 Blood - Grouping - - 104 Eye swabs for organisms - 3 3 Faeces for the presence of organisms 490 2,078 2,568 Swabs for presence of C. Diphtheriae: (a) From Suspect Cases - 1 1 (b) From Contacts - - - Swabs for presence of Haemolytic Streptococci 147 1,606 1,753 Swabs for presence of Vincent's Angina - 1 1 Urines - - 93 Vaginal swabs for presence of organisms 2 10 12 Ear swabs - 2 2 Minced meat for organisms - 2 2 Mouth Swabs - 2 2 Throat and nose for Staphs 5 2 7 Gum swabs - 1 1 Ulcer Swabs - 1 1 Tomato Puree (For Bact:) - 1 1 Pus from Eye (Sensitivity) 2 - 2 Swab from Scrotum 1 - 1 Boil for Staphs 4 - 4 Faeces from dog - 1 1 Pork pies for organisms - 2 2 Dried Milk for Paths - 1 1 Tinned Ham for Paths - 1 1 Total: 5,037 16 SHOPS ACT AND STREET TRADING Three local Orders are administered under the Act. They are 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), and 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 similar places in the Borough which are liable to inspection. The Shops Act and Street Trading Inspector submits a monthly report to the Public Health Committee. The following is a short summary of the work carried out during the year:- Visits to shops, licensed street traders etc 1,190 Washing facilities, sink water heaters installed 12 A number of contraventions were detected. They were of a minor character mostly concerned with the exhibition or non-exhibition of notices. SHOPS ACT, 1950 - PART I, SECTION 1(2) Edmonton Weekly Half-Holiday Order - One letter of warning was sent to a shopkeeper contravening this Order. Legal proceedings were instituted in another case and a fine of 10/- and one guinea costs was imposed. SHOPS ACT. 1950 - PART I Hours of Closing - No action was found necessary during the year. SHOPS ACT, 1950 - PART III, SECTION 17(1) Condition of Employment - One shopkeeper was prosecuted and fined one guinea and required to pay two guineas costs for employing assistants on their weekly half-holiday. SHOPS ACT, 1950 - PART IV - SUNDAY TRADING Forty-five shops were visited. No contraventions were discovered. 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 are 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, seven letters of warning were sent for contraventions. Legal proceedings were instituted in two cases and fines amounting to one guinea with costs of a guinea in each case were imposed. Shops, stores and other traders premises coming within the scope of the Act were inspected 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 and one gas fire which did not comply with the Act was discovered. This was surrendered to the Inspector for destruction by the Council, which was duly carried out. ENVIRONMENTAL HEALTH HOUSING It will be seen from Table A below, that the number of houses in which the Health Department had to take formal or informal action was less than in 1958. In 1958 something over 700 houses required action, in 1959 the number was 490. Apart from this individual action, 390 houses in five areas were represented for slum clearance. The Angel Road South Clearance Area No.l comprising 1 to 45 Angel Road, 1 to 8 Cross Street, 1 to 69 (odd) and 87 Raynham Road, and 2 to 34 (even) Raynham Road were represented on the 9th February, 1959. This area contained 95 houses in which lived 293 persons. On the same date the Angel Road South Clearance Area No.2 comprising 50 to 56 and 59 to 88 Angel Road, 78 to 98(even) & 74,76, and 78a, 78-98(even)Raynham Road, 3 to 21 (odd) and 2 to 16 (even) Woolmer Road and 1 to 61 (odd) Upton Road was represented. This area contained 100 houses with 304 persons. A Public Inquiry, following objections, was held on the 2nd December, 1959, and a compulsory purchase order for the two areas and certain adjoining land was subsequently confirmed with minor modifications. On the 2nd September, 1959, the Hertford Road Clearance Area comprising 55 and 57a, Hertford Road, two houses with five people in them, was represented. On the same date the No.l Town Road Clearance Area comprising 3 to 25 (odd) Town Road, 12 houses containing 33 persons was represented. On the 12th October, 1959, the Barbot Street/Chauncey Street Clearance Area was represented. This included 1 to 23 Rosebery Road, 1 to 68 Barbot Street, 1 to 71 Chauncey Street, 152 to 184 (even) Victoria Road and 133 to 135 (odd) Victoria Road. This area contained 181 houses in which 554 persons lived. 18 During 1959 therefore action was set in hand to permanently improve the housing condition of 1,189 persons. TABLE A Action taken under the Housing and Public Health Acts Number of houses repaired in consequence of informal action 268 Number of notices served under Section 9 Housing Act 1 Number of houses rendered fit after service of notices:- (a) by owner 1 (b) by Local Authority - Number of notices served under Public Health Acts 191 Number of houses repaired after service of notices (a) by owner 221 (b) by Local Authority in default - TABLE B Defects Remedied Roof s repaired 535 Gutters and rainwater pipes repaired 397 Brickwork or pointing repaired 91 Chimney stacks, etc., repaired or rebuilt 28 Yards or forecourts repaved or repaired 49 Drains examined, tested or exposed 516 Drains cleared, trapped or repaired 391 Drains reconstructed 108 Chambers inserted or built up to ground level 54 Soil and vent pipes, new fixed or repaired 43 W.C's repaired or improved 185 Flushing cisrerns repaired or new fixed 40 Sink waste pipes repaired or new fixed 36 New sinks fixed 13 Drinking water cisterns covered, cleansed, repaired - Water fittings repaired 24 Water taken off main or restored 3 Internal walls 344 Ceilings repaired, cleansed, etc 109 Floors repaired 62 Floors ventilated 19 Dampness remedied 267 Window frames or sashes repaired or renewed 504 Fireplaces stoves repaired 70 19 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 1959:- Part I - Applications for Certificates of Disrepair (1) Number of applications for Certificates of Disrepair 96 (2) Number of decisions not to issue Certificates - (3) Number of decisions to issue Certificates 99 (a) in respect of some but not all defects 63 (b) in respect of all defects 36 (4) Number of undertakings given by Landlords under 83 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule _ (6) Number of Certificates issued 18 Part II - Applications for Cancellation of Certificates (7) Applications by Landlords to Local Authority for 7 (8) Objections by tenants to cancellation of Certificates - (9) Decisions by Local Authority to cancel in spite of - (10) Certificates cancelled by Local Authority (1957 Act) 14 (1954 Act) 8 FOOD HYGIENE CONTROL SLAUGHTERHOUSES Seven visits were paid and the carcases and organs of 13 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 43 17 Tuberculin Tested 25 14 Sterilised 95 16 163 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, 1959 was 9. 20 FOOD AND DRUGS ACT, 1955 - SECTION 16 During the year 13 premises were registered for the Sale and Storage of Ice Cream. Number on Register at end of year:- Manufacturers and Vendors 6 Vendors only 225 During the year four premises were registered for the Preparation or Manufacture of Preserved Food, etc. Number on register at end of year:- 44 UNSOUND FOOD The following is a list of the food surrendered for examination and retained as unfit for human consumption:- Meat 5,237 tins Lamb 14 lbs. Milk 3,765 do. Mutton 8 do. Fish 2,895 do. Pork 144 do. Jams, etc. 1,385 do. Offal 301½ do. Soups 1,308 do. Chickens 60 only Beans 2,181 do. Ham 384 tins & 140¾ lbs. Beetroot 113 do. Bacon 15½ do. Carrots 396 do. Turkeys 110 do. Mixed Vegetables 101 do. Roes 3 tins Peas 4,430 do. Whiting 40 stone Apples 31 do. Sausages (Pork) 39 lbs. Apricots 1,874 do. Cheeses 1040 packets & 26½ do. Blackcurrants 20 do. Yeast 22½ do. Cherries 212 do. Fish Paste 178 jars Damsons 15 do. Macaroni 10 tins Loganberries 17 do. Meat Paste 102 jars Grapefruit 1,560 do. Pickle 274 do. Gooseberries 146 do. Puddings 265 tins Greengages 51 do. Sauce 157 bottles Fruit Salad 1,572 do. Spaghetti 230 tins Oranges 1,896 do. Sandwich Spread 26 do. Peaches 5,052 do. Currants 41 do. Pears 2,412 do. Cereals 17 pkts Pineapple 6,389 do. Bovril 10 bottles Plums 558 do. Cream 28 tins Prunes 424 do. Salad Cream 156 jars Raspberries 181 do. Tomatoes 276 lbs & 3,896 tins Rhubarb 107 do. Fruit Juices 833 tins Spinach 25 do. Beef 5 tins & 109½ lbs. Strawberries 156 do. Rice 161 tins Tomato Juices 164 do. Eggs (Frozen 4 boxes Potatoes 12 pkts Nescafe 5 tins 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. - 21 - SAMPLING OF MILK Samples of milk taken for bacteriological examination at the Public Health Laboratory. Grade of Milk Methylene Blue Test Phosphatose Test Passed Failed Passed Failed Pasteurised 6 - 9 - Tuberculin Tested (Pasteurised) 1 - 1 - Total 7 - 10 - In the case of Pasteurised Milk the methylene blue test for keeping quality was declared void on three occasions on account of the high prevailing temperature. SAMPLING OF ICE-CREAM Samples of ice-cream and milk type lollies were taken for bacteriological examination at the Public Health Laboratory as follows:- Provisional Grades 1 2 3 4 Ice-Cream 48 4 2 12 66 Milk Type Lollies 6 3 - - 9 Totals 54 7 2 12 75 There were 12 void tests owing to high temperatures in the Laboratory. The results may be interpreted as follows:- Grade 1 - Good. “ 2 - Satisfactory. “ 3 Poor. “ 4 - Unsatisfactory. The high proportion of Grade 4 samples of ice-cream was due to a series of samples being taken from one dealer who froze an ice-cream mix obtained from another dealer. The dealer subsequently agreed to obtain supplies of manufactured ice-cream from an approved source. - 22 - 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 230 Manufacture of Sausages 25 Manufacture of Sausages and Sale of Pressed, Pickled, Preserved, Potted Meats and other foods 15 Manufacture of Cooked Meat 3 Manufacture of Preserved Foods 1 Butchers 59 Fish Shops 28 Grocers and Provision Dealers 177 Bakers and Confectioners 22 Fruiterers and Greengrocers 59 Dairies 9 Retail Purveyors of Milk 133 Cafes 56 Factory Canteens 72 FOOD SAMPLING The report of the Chief Officer, Public Control Department, Middlesex County Council, on the work carried out in Edmonton during the year 1959 is as follows:- Samples procured in the Borough of Edmonton during the year 1959:- Article Total Samples Procured Unsatisfactory Milk (Various) 144 6 Butter 13 - Cakes and Biscuits 13 - Cooked Meat 16 - Cream 12 - Cheese 7 - Drugs 23 - Fish and Fish Products 20 - Fruit - Canned, Fresh, etc. 31 4 Fruit Squash etc. 6 1 Ice Cream 24 - Liver 13 - Margarine 9 - Meat and Meat Products 39 6 Sausages, etc. 13 - Spirits, etc. 9 - Vinegar and Non-Brewed Condiment 15 1 Miscellaneous 25 5 Totals: 432 23 - 23 - Milk (Various) Four samples of milk supplied to Wilbury Way Primary School were found to be slightly deficient in milk fat. An official caution was sent to the Dairymen concerned. On two different occasions iron rust stains were detected on the inside of a milk bottle, and Chief Officer's cautions were issued. Fresh Fruit On two occasions "seedless" tangerines were purchased from retailers and found to contain seeds. The number of seeds found per fruit was small and the matters were dealt with by sending official cautions. Another firm of greengrocers also sold tangerines purporting to be "seedless", but which were found to contain an average of 21 seeds per fruit. Proceedings were undertaken and fines totalling £20. imposed with £5. costs. Fruit Squash A sample of orangeade was found to be contaminated with hydrogen sulphide. Investigation showed that there had been interaction between the acid in the drink and the vulcanite stopper, and the matter was resolved by sending an official caution to the Soft Drink Manufacturers responsible. Meat and Meat Products A firm of retail butchers was summoned for selling three joints of topside of beef which had been treated with sulphur dioxide preservative. The addition of preservative to fresh meat is prohibited under the Public Health (Preservatives etc. in Food) Regulations 1925 - 1958, and a fine of £6. was inflicted with £5 costs. Two samples of minced beef procured from another butcher were found to contain prohibited preservative. Proceedings were undertaken and a fine of £2. imposed with £4. 12s. costs. A sample of minced beef obtained from another butcher was found to contain 2 per cent of filler. In view of the small amount involved, the retailer was warned, and no further action taken. Vinegar A sample of non-brewed condiment obtained from a retailer was found deficient in acetic acid. Non-brewed condiment must contain at least 4 per cent of acetic acid. The deficiency was not large and had probably occurred because of a long period of storage, so that the retailer was advised for his future guidance. Miscellaneous Four samples of various Lolly Syrup were found to be contaminated with excess sulphur dioxide. However it was not possible to prove the offence so that further action was not taken. From the same source as the Lolly Syrup an Iced Lolly was obtained, which on analysis disclosed a prohibitve amount of sulphur dioxide. Action taken by my Inspector was considered adequate to meet this particular case. - 24 - MERCHANDISE MARKS ACTS, 1887 - 1953 The majority of the inspection work carried out under the provisions of the above Acts is to ensure compliance with the requirements of the various Marking Orders made under the provisions of the Act of 1926. These Orders apply to the marking of the country of origin on imported foodstuffs, principally meat, apples, tomatoes, dried fruits, bacon, ham, poultry, butter and honey, upon sale and exposure for sale. Inspections were made at 274 premises of 910 displays of these foodstuffs. A firm of butchers was summoned for applying a false indication of the country of origin to meat, and for failing to mark other meat exposed for sale. Fines totalling £21. were imposed with £5.5s. costs. 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 in the case of a compounded food, with the names of the ingredients in descending order of proportion by weight. Furthermore it controls the manner in which the presence of vitamins and minerals is disclosed and prescribes specific labelling of certain foods. A total of 1,214 articles of pre-packed food was examined at 220 different premises to verify compliances with these Regulations. FALSE AND MISLEADING DESCRIPTIONS Food advertisements and labels have been scrutinised for false and misleading statements and descriptions. No serious infringements were disclosed. Corrective action taken within the whole area of the County has equal effect within each County district, and work under this heading is combined with inspections made under the terms of the Merchandise Marks Acts and the Labelling of Food Order. A number of firms have labelled tins of Instant Coffee as "100% Pure Coffee". This product consists of the instantly soluble solids of coffee obtained by a process of dehydration. The insoluble portion of the bean is omitted. Representations have been made to have the description amended so that the product is not claimed to be whole coffee. Other examples where corrective action was sought are set out as follows:- The percentage fat content marking on Continental Cheeses when set out as a percentage "I.D.M.", changed to a comprehensible statement of "Fat on the dry matter". A Continental biscuit marked as "Cheese Filled", which contained a filling only 20 per cent cheese. Such descriptions of Continental soft cheeses as "Super-Creme", "Triple-Creme" and “Cream" etc. amended to indicate the true nature of the product, i.e. whole-milk cheese, cheese spread etc. - 25 - Rice puddings marked as "Creamed Rice", fruit "syrups" labelled as fruit "juices", a "Seedless Fig Bar" which was found to contain crushed seeds, and cheese spreads described As "processed cheese". Slimming claims in respect of lemon juice drinks were challenged. There is no clinical proof that the consumption of lemon juice will reduce weight, and the firms concerned have been requested to indicate that the drink is merely one suitable for inclusion in a slimming diet. The claim that a particular breakfast cereal had twice as much honey as any other cereal was also challenged. Some extravagant claims in respect of medical remedies were challenged and the advertisements withdrawn. SPECIAL DESIGNATED MILK During 1959, 87 samples of designated milks were taken, all of which were certified to be satisfactory. Two Dealers' (Pasteuriser's) licences were issued in respect of premises within your area where milk is processed, and one Dealers' (Steriliser's) licence was issued similarly. The premises were inspected regularly and compliance with statutory requirements well maintained. No infringements were reported during the year. 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. SAMPLING OF SWIMMING BATH WATER Satisfactory Not Satisfactory Houndsfield Lido Samples taken for Bacteriological Examination 2 - ” ” ” Chemical ” 2 - Knights Lane Baths Samples taken for Bacteriological Examination 9 - ” ” ” Chemical ” 11 1 One report on a chemical examination of baths water indicated that the water was of unsatisfactory organic quality. This sample was taken during a prolonged period of heavy bathing loads and further samples showed that the difficulty had been overcome. Complaints of sore eyes after using the Knights Lane Baths were investigated and action was taken which prevented subsequent complaints. - 26 - I am grateful to the Borough Engineer for the following information:- The Swimming Pools operated by the Borough of Edmonton Baths Department comprise Open Air Pool Situated Houndsfield Road, adjacent to Jubilee Park. Immediate surroundings park land and residential area. Operates annually, 15th May to 15th September. Dimensions - 150 ft. x 100 ft. Depth ranging from 3 ft. to 7 ft. 9 ins. Capacity, 500,000 gallons. Rate of turnover 6 hours. Aeration by cascade. Indoor Baths Situated Knights Lane, Establishment houses two pools each 90 ft. x 30 ft. depth ranging from 3 ft. 6 ins. to 6 ft. 6 ins. Capacity 90,000 gallons each pool. Rate of turnover 4 hours. Two pools operate for swimming during Summer. One pool operates for swimming during Winter. Aeration by Air Compressor. The information concerning operation of plant controlling condition of water is common to both establishments. Source of Water - Town Main. (Lea Valley). Treatment - Pressure Filtration. Continuous circulation. Filter beds washed according to demand, at least one wash per week during the winter, two washes per week during the summer. Wash water taken from pools and discharged to waste and replaced from Town Main, (approximately 15,000 gallons Knights Lane. 30,000 gallons Open Air Pool, each operation). Chlorination - By W. & T. A 303 Chlorinator maintaining as near as possible 2 ppm free chlorine. Alkali infusion - A solution of Sodium Carbonate is infused into the filtrate by automatic chemical doser which operates in conjunction with the chlorinator maintaining approximately 7.6 to 7.8 ph. Flocculation - Alluminium Sulphate is added manually to the strainer in the filter line for this purpose. Arrangements are made to install positive feed solution pumps in the near future. Tests - Tests for Free and Combined Chlorine are made by Palin D.P.D. method and for P.H. using Bromothymol Blue or Diphenol Purple. Lovibond comparators with standard fixed colour discs for these tests which are made four times daily. Laboratory Bacteriological and Chemical tests are made periodically throughout the year. - 27 - 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. PUBLIC CONVENIENCES There are seven public conveniences in the Borough under the supervision of the Senior Public Health Inspector. During 1959, a new Convenience in Pymmes Park with entry from Silver Street was under construction. This Convenience was opened early in 1960. No charge is made for the use of any part of any Public Convenience on either Male or Female side. Free hand washing facilities are provided and paper towels are supplied. An additional wash and brush up service is available on the payment of a small charge. There are two Attendants in each Convenience, one on the Male and one on the Female side and premises are kept extremely clean and neat. There is no doubt that the Public Conveniences in Edmonton are among the best in the Metropolitan area. 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 219 250 6 - Factories without mechanical power 15 4 - - Other premises under the Act (including works of building and engineering and construction but not including outworkers premises) 5 12 - - Total: 239 266 6 - - 28 - 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 - - - - - Overcrowding - - - - - Unreasonable temperature - — — — — Inadequate ventilation — — - — — Ineffective drainage of floors - - - - — Sanitary Conveniences Insufficient 6 5 - 1 — Unsuitable or defective Not separate for sexes Other offences (Not including offences relating to outwork) 1 1 - - - Totals: 7 6 - 1 - - 29 - 3. Outwork - Sections 110 and 111 Nature of Work 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. 147 - - - — — Artificial flowers 2 - - — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper 12 - - - - - Brush making 42 - - — — — Cosaques, Christmas crackers, Christmas stockings, etc. 7 - - - - - Toy painting 9 - - — — — Brass and brass articles 1 _ — - - - Electrical fittings 38 — - - - - Embroidery Household linen 10 _ - - - - Feather sorting 1 - - - - — Cabinet making 1 - - - — — Leather bags 25 - - - — — Sewing canvas 2 - - — — Fetlings Diecastings 8 - - - - - Total: 317 - — — — — MIDDLESEX COUNTY COUNCIL ACT, 1950. SECTION II Nine 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 88 hawkers on the Register at the end of 1959. ATMOSPHERIC POLLUTION Three deposit gauges at St. David's Hospital, Silver Street, Cuckoo Hall Lane School and the Town Hall continued to be used. The results are shown overleaf. - 30 - SUMMARY OF ANALYSES 1959 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) Jan. 2.13 2.13 1.83 3.32 5.05 3.24 1.81 3.24 1.82 5.60 5.03 4.82 8.92 10.08 8.06 Feb. 0.06 0.04 0.05 6.73 9.53 5.13 4.02 4.66 3.05 6.58 5.00 5.27 13.31 14.53 10.40 Mar. 1.67 1.47 1.43 5.30 9.48 7.24 3.60 6.51 4.96 5.02 5.63 5.98 10.32 15.11 13.22 Apr. 2.12 2.21 2.20 4.92 8.22 5.36 2.21 5.73 3.60 5.41 6.13 5.41 10.33 14.35 10.72 May. 0.99 1.30 1.24 6.35 7.55 5.48 3.34 5.17 2.99 3.86 3.74 3.34 10.21 11.29 8.82 June 0.38 0.89 0.50 3.10 5.96 3.40 1.58 4.00 2.13 1.55 3.11 1.90 4.65 9.07 5.30 July 0.87 1.22 1.37 5.32 4.29 6.32 3.03 3.03 4.40 2.70 3.24 3.00 8.02 7.53 9.32 Aug. 0.96 1.00 0.76 6.70 4.29 3.00 3.30 2.72 1.85 3.92 3.06 2.84 10.62 7. 35 5.84 Sep. 0.01 0.01 0.01 7.79 5.91 4.51 5.33 3.91 2.82 2.38 2.14 2.23 10.17 8.05 6.74 Oct. 1.68 2.00 1.37 4.78 7.41 5.74 3.04 4.90 3.87 2.71 6.15 5.93 7.49 13.56 11.67 Nov. 2.41 2.43 2.34 3.73 8.34 6.55 2.18 5.07 3.70 6.50 7.46 6.81 10.23 15.80 13.36 Dec. 3.46 3.28 2.99 4.90 7.35 5.99 2.31 3.99 2.75 7.44 14.78 6.26 12.34 22.13 11.55 (a) Site No.l St. David's Hospital. (b) Site No.2 Town Hall (c) Site No.3 Cuckoo Hall Lane School. Deposit gauges do not accurately measure pollution of the air itself. It is the dust and grit falling through the air that they record, and it tends therefore to be pollution from factories and possibly railway locomotives that is mainly shown in deposit gauge results. There seems to be a decrease in the pollution caused by factories and this impression is confirmed by the deposit gauge results. A more accurate measure of air pollution is given by a volumetric filter which measures smoke and sulphur dioxide in the air. Continuous flow of air is pumped through the instrument and daily the sulphur dioxide is chemically measured and the stain produced by smoke measured by means of a filter paper. Such a recorder was installed at the Latymer School in May and the readings are shown below. Smoke Filter - Latymer School June 1959 - December 1959 Month Milligrams of Smoke per 100 cubic metres of air. Average daily value. Parts of Sulphur dioxide per 100 m. parts of air. Average daily value. June 2.8 2.8 July 2.1 2.4 August 2.5 2.6 September 5.6 2.5 October 10.5 5.4 November 19.5 9.2 December 18.0 10.6 - 31 - The great increase in pollution during November and December shows what a large part is played by smoke from the ordinary house chimney. Factory pollution increases only slightly during the Winter months, but the home fires burn vigorously, and, if coal fires, do as much harm as good. The No. 1 Smoke Control Order came into force on the 1st June, 1959. There have been few contraventions and in all cases the cause has been accidental. Such a small area could not, of course, have any appreciable effect on the smoke filter readings. The survey work on the No.2 Smoke Control Area was completed during 1959 and the Order was made in November. (It was confirmed by the Minister and came into force during 1960). The No.2 Area was, of course, larger containing about 2,070 houses, and immediately adjoined the No.l Area, being separated from it by the Great Cambridge Road. The boundaries were and are on the north Ridge Avenue and Bury Street, on the west the Borough boundary, on the south Hedge Lane and on the east the Cambridge Road. During the year 588 observations of industrial chimneys in the Borough were made by the Public Health Inspectors. RODENT CONTROL Your Senior Public Health Inspector, as Officer-in-Charge, Rodent Control, reported as follows:- An Assistant Rodent Officer and two Operatives carry out rat and mice destruction under the general supervision of the Public Health Inspectors. Domestic premises are treated without charge and business premises on repayment. Where ever possible the poison used in treating infestations is "Warfarin" which is very successful and comparatively harmless to human beings and domestic animals. In cases where rat infestations are suspected to be due to faulty drainage the Public Health Inspector makes a full investigation and where repairs are found to be necessary the matter is taken up with the owner. - 32 - 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 16 645 37 698 Other properties investigated - 3,725 5 3,730 Properties found to be infested Rats (a) Major infestations - - - - (b) Minor infestations 2 487 15 504 Mice (a) Major infestations - - - - (b) Minor infestations 3 47 11 61 Number of Properties treated by Rodent Operators 5 534 26 565 Number of inspections 108 7,217 143 7,468 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 Four maintenance treatments were carried out at three monthly intervals using the '1080' method of direct poisoning. 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%. - 33 - DISINFECTION AND DISINFESTATION Number of journeys to collect bedding and spray verminous premises 352 Number of journeys to return bedding 230 Rooms disinfected after infectious disease 214 Rooms disinfected after Phthisis 10 Rooms disinfected after other cases 54 Rooms disinfected after vermin 241 Articles Bedding, clothing, etc., disinfected after infectious disease 2,264 Bedding, clothing, etc., disinfected after Phthisis 35 Bedding, clothing, etc., disinfected after other cases 386 Bedding, clothing, etc., disinfected after vermin 55 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 6,551. 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 380. Sixteen Council properties and 75 other houses were found to be infested; the total number of rooms disinfested was 241. 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. - 34 - INSPECTIONS The following tabular statement gives the number and the nature of the inspections made during the year:- Complaints 1,394 Infectious Disease 679 Food Poisoning 108 House-to-House 561 Smoke Control Areas 983 Factories with mechanical power 250 Factories without mechanical power 4 Rents Act, 1957 417 Housing Act, 1949 - Improvement Grants 102 Factories (other) 12 Outworkers 15 Schools 53 Offensive Trades 6 Shops and Stalls 148 Shops Act 6 Pets Act 15 Sanitary conveniences and urinals 392 Smoke observations 588 Rat infestation 237 Petroleum 270 General Inspections 452 Sundry Visits 1,416 Cinemas and Halls 41 Stables and Piggeries 9 Movable Dwellings 39 Sampling Water Sampling Ice Cream 87 Sampling Milk 10 Rag Flock Premises 8 Sampling Rag Flock 10 Re-inspections 4,448 INSPECTION OF PLACES WHERE FOOD IS PREPARED Butchers 75 Fish Shops 34 Cafes and Restaurants 81 Dairies and Milkshops 34 Slaughterhouses 7 Bakehouses (Factory) 109 Bakehouses (Workshops) Ice Cream Shops 93 Canteens 48 Other food premises 112 Sampling other food - 35 - DEFECTS REMEDIED Roofs repaired 535 Gutters and rainwater pipes repaired 397 Brickwork or pointing repaired 91 Chimney stacks, etc., repaired or rebuilt 28 Yards or forecourts repaved or repaired 49 Drains examined, tested or exposed 516 Drains cleared, trapped or repaired 391 Drains reconstructed 108 Chambers inserted or built-up to ground level 54 Soil and vent pipes new fixed or repaired 43 W.C.'s repaired or improved 185 Flushing cisterns repaired or new fixed 40 Sink waste pipes repaired or new fixed 36 New sinks fixed 13 Drinking water cisterns covered, cleansed, repaired Water fittings repaired 24 Water taken off main or restored 3 Internal walls 344 Ceilings repaired, cleansed, etc. 109 Door frames repaired Floors repaired 62 Floors ventilated 19 Dampness remedied 267 Window frames or sashes repaired or renewed 504 Fireplaces, stoves repaired 70 Coppers repaired 1 New dustbins supplied 13 Premises rat-proofed 5 Improper keeping of animals discontinued 3 Foul accumulations removed 6 Other nuisances abated 193 Movable dwellings removed 22 New boiler house constructed New boiler installed Factory sanitary conveniences inspected 5 Factory sanitary conveniences improved 7 Factory other defects remedied 3 Petroleum installations - defects remedied 41 Petroleum installations tested 12 Smoke Abatement - boiler plants improved Food Regulations - contraventions remedied 19 - 36 - PETROLEUM (REGULATION) ACTS, 1928-1936 During the year 6 new licences and 111 renewals were granted by the Council. The following is a list of particulars of quantities^ etc., affected by these licences:- Petroleum Spirit 499,008 gallons Petroleum Mixtures 14,843 gallons Rubber Solution 100 lbs and 800 gallons PLACES OF PUBLIC ENTERTAINMENT Forty-one 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 POLIOMYELITIS Most virus infections are endemic with epidemic phases. I mean by this that small numbers of people are infected all the time, but that from time to time larger numbers are infected with cases of flagrant disease occurring. Poliomyelitis like Measles tends to have its epidemic phase about every two years and there were therefore more cases in 1959 than in 1958. There were not many more however for the immunisation programme (against Poliomyelitis) had considerably reduced the level of infection in the epidemic phase in Edmonton. This was not so in all areas and in the Borough of Islington a few miles away there was during the Summer a serious epidemic with a number of fatal cases. The first definite case of Poliomyelitis in Edmonton in 1959 was discovered when a woman of 26 years living in the North Circular Road Area was notified as a case of Paralytic Poliomyelitis on the 7th July. This lady saw her doctor on the 4th July complaining of headache and pains in the back and was ordered to bed. When seen on the 6th July she had pains in both legs, a stiff neck and a high temperature and was removed to Hospital as a case of Paralytic Poliomyelitis. In this case the patient's mother lived in Hornsey, and in that area of Hornsey there had not long before been three cases of Poliomyelitis. On the 10th July the Deputy Medical Officer of Health was called in by the General Practitioner to see a boy of 12 months. In this case the story was that the baby became out of sorts on the 2nd July, was rather better on the 3rd, but on July the 4th was fretful and feverish and thereafter became weaker and limper, until on that day the 10th July he was unable to move his arms and legs. He was removed to Hospital the same day and recovered after some months. In this case, examination of faeces - 37 - specimens from the family showed that mother was infected but not father. It was impossible of course, to say whether the mother had infected the baby or the baby infected the mother. There were no more cases notified during the summer. On the 15th October however, a boy of five was admitted to Hospital as a case of Encephalitis. On the 22nd October his mother who slept in the same room for a period was admitted to the same Hospital with the same diagnosis. Both appeared to recover and were discharged. Faeces specimens had been taken while they were in Hospital, but the examination of the faeces for virus takes some time. The Laboratory was unable to give a definite report until the 17th November. On the 17th November the Laboratory reported that Polio-virus Type 1. had been isolated from the boy. In view of the fact that both the boy and his mother had exactly the same symptoms and signs, these two cases were regarded as cases of Poliomyelitis. All the four cases of Poliomyelitis notified in 1959 were from the Southern part of the Borough. DYSENTERY Practically all the cases of Dysentery notified in 1959 were of Sonne Dysentery though there was an odd case or two of infection with the parasite Giardia. There was something of an epidemic of Sonne Dysentery in England in 1959 and it was not to be expected that Edmonton would escape. As usual the younger children were mainly affected. In January there were five cases in the All Saints Infants School and four cases in the Croyland Road Infants School. Though two schools were involved these nine cases really amounted to a family outbreak plus a few contacts of that family. The family was fairly large and there were members of the family at each school. In February there were five family outbreaks of Sonne Dysentery. Members of two families attended the Brettenham Road Infants School and one the Edmonton Day Nursery. There was also a further outbreak within the Borough which did not in the main involve at the time Edmonton residents. On February 20th a child from Tottenham was admitted to the John Gilpin Ward of the North Middlesex Hospital. She was found to have not only the disease for which hospital admission had been sought, but also Diarrhoea. The condition proved to be Sonne Dysentery and this spread to a Staff Nurse, a Nursing Auxilliary and six of the children in the Ward. The ward was closed for a fortnight and no further cases developed in the hospital. One of the six children infected was an Edmonton child and she was removed from hospital before the result of the bacteriological examination was known. There was, however, no spread to the family or to relatives or to relatives workmates. In March the Dysentery appeared in the Eldon Road Infants School and began to spread steadily. Special precautions were therefore taken in this school. The Teachers paid special attention to the supervision of the washing of the children's hands and hands were rinsed with antiseptic after washing. The lavatory seats were swabbed with antiseptic twice daily and the teachers checked periodically on the children's health and unusual symptoms. - 38 - In the Edmonton Schools any child suffering from Diarrhoea is excluded from school until Sonne Dysentery has been bacteriologically disapproved. The child is given a faeces container and the parents bring the filled container with a completed form to the Public Health Laboratory at the Edmonton Town Hall. If Sonne Dysentery or some other condition is found the child is then referred to the family doctor. This method saves "false alarms". It does occasionally happen that a child is away from school and is described by the parents as having had a bilious attack or a "tummy upset", when in fact there has been diarrhoea. A busy head teacher may well not enquire further and such children on occasion are found to be sources of Sonne Dysentery infection. The epidemic in the Eldon Road Infants School lasted until the end of June and 50 children were infected in all out of a total of about 350. About half of these had diarrhoea, the other half had little or no symptoms. In July there was a small outbreak at St. Edmund's Junior School and about six cases were discovered and in December there were three cases at Haselbury Infants School, one of which was severe enough to warrant removal to the hospital. There were in all, including the giardia cases, 285 new Dysentery infections in 1959. This is a substantial number but considering that the number of children in Edmonton under 10 years of age is about 12,000, not a large proportion. PARATYPHOID FEVER A woman of 67 developed symptoms of enteritis, and her own doctor found on investigation that she was suffering from Paratyphoid Fever (b). As her daughter-in-law was a catering worker, she was removed to hospital. Her daughter-in-law was free from infection, but her son was infected, and he was admitted to hospital for a course of treatment. Both cases cleared up under treatment in hospital, and there was no further infection, either in this family or elsewhere in the Borough. WHOOPING COUGH A small epidemic of whooping cough began in October, and 39 cases were notified in the final quarter of the year. Three children were sufficiently ill to require removal to hospital. The disease is becoming much more common to school children, mainly Infants' School children, and mothers whose children have been immunised and escaped whooping cough would be well advised to see that the child has a booster injection against whooping cough as well as against diptheria, before he or she starts school. - 39 - SCARLET FEVER There were a large number of cases of scarlet fever in Edmonton in 1959 and most of the cases were in children attending the Infant and Junior Schools. In most cases the disease was not serious but in some children the infection persisted in the nose or throat for several weeks. Exclusion of cases and contacts in the family was sufficient to prevent serious spread in most schools but in one school the number of cases of sore throat in the entry class (5 years old) became excessive. The noses and throats of all the children attending school in the class were therefore swabbed and bacteriologically examined and 6 children were found to be fairly heavily infected with haemolytic streptococci. These children were excluded from school and treated by their family doctors and there was no further spread of epidemic sore throat in this class or indeed in this school. 1958 seems to have been the peak year for scarlet fever notifications when there were 224 cases but 1959 runs close with 207. If is possible that an influenza epidemic tends to be followed by an increased incidence of scarlet fever. Both diseases affect the throat and secondary infection is very common in influenza. MEASLES The 1958 Measles epidemic continued into 1959 and did not really end until April, There were occasional cases during the summer months and then a small epidemic during October, November and December. The Measles cases notified during 1959 tended to be milder than those notified during 1958. A Central Council of Health Education leaflet on Measles is now sent to the parents of each child known to be suffering from the disease and most parents appear to appreciate the information given in this leaflet. TUBERCULOSIS In 1959 the increase in the number of cases of tuberculosis on the register was at last halted. There was a slight decrease in the number on the register at the end of 1959 compared with 1958. The actual figures are 1,356 for 1959, 1,364 for 1958. The tide of tuberculous infection in Edmonton has therefore begun to ebb. Judging by notifications, however, the reduction is mainly in infection in women. Over the years 1957 to 1959 the notifications of pulmonary tuberculosis in men were for 1957 - 39, for 1958 - 32, and for 1959 - 37. In women, however, the notifications for 1957 were 32, for 1958 - 26, and for 1959 - 12. Further it is in the main in men over the age of 35 that pulmonary tuberculosis occurs, though it is true that the casualties in the 15 to 25 year group are heavier in the young men than in the young women. The main task now seems to be to reduce infection in middle-aged and elderly men. - 40 - Tables T(l) and T(2) 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 (1) Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 year - - - - - - - - 1-5 years - - 1 - - - - - 5-15 years 2 1 - - - - - - 15-25 years 4 1 - 1 - - - - 25-35 years 1 4 2 2 - - - - 35-45 years 5 3 - - - - - - 45-55 years 7 1 1 - - - - - 55-65 years 11 - - - 4 - - - 65 years upwards 7 2 - - 3 2 - - Totals: 37 12 4 3 7 2 - - In addition, 29 cases of Pulmonary Tuberculosis previously notified in other areas, moved into Edmonton. TABLE T(2) MALES FEMALES TOTAL Respiratory NonRespiratory Respiratory NonRespiratory Added to Register during 1959. 59 4 25 3 91 Number of cases notified for the first time during the year 37 4 12 3 56 Number of cases restored to Register having been previously removed 4 - 2 - 6 Number of cases added to Register other than by formal notification 18 - 11 - 29 Removed from Register during 1959 62 3 29 5 99 Number of deaths from Tuberculosis - Notified cases 6 - 2 - 8 Number of deaths from Tuberculosis - Non-notified cases 1 - - - 1 Number of deaths, Other causes - Notified cases 10 - 4 1 15 Number of cases, left district, recovered, etc. 45 3 23 4 75 - 41 - The non-respiratory forms of Tuberculosis notified were:- Part of Body Affected Males Females Renal Tract. 1 - Cervical Glands - 1 Bones and joints 2 - Genito - urinary system 1 2 TABLE (3) The number of cases of Tuberculosis on the Register at the end of 1959 was:- Males Females Total Pulmonary forms 674 512 1,186 Non-pulmonary forms 72 98 170 746 610 1, 356 TABLE (4) The corresponding figures at the end of 1958 were:- Males Females Total Pulmonary forms 677 516 1,193 Non-pulmonary forms 71 100 171 748 616 1, 364 TABLE (5) Corresponding figures for previous years were:- Males Females Total 1957 736 608 1,344 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 - 42 - FOOD POISONING There was one outbreak in an industrial canteen the details of which are given on the following page. In the family outbreaks it was not possible to obtain specimens of infected food, but a history of faulty hygiene was obtained in a number of cases. It is possible that in many of these cases the original source of infection is a carrier within the family. A slip in normal precautions leads to infection of the family's food and there is then a family outbreak. In some cases perhaps the food handler poisons only himself or herself and only one case is notified. (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 1 - 2 - 2 Sal: 'C' 2 - 4 - 4 Sal: 'B' 1 - 2 - 2 Sal: Newport 1 - 2 - 2 C1. Welchii - 1 - 13 13 Total: 5 1 10 13 23 Agent not Identified 3 - 7 - 7 (B) Single Cases Agent Number of Cases Total No. of Cases Notified Otherwise Ascertained Sal: Typhi-Murium 13 - 13 Sal: Group 'B' 2 - 2 Sal: Group 'C' (Thompson) 7 - 7 Sal: Newport 2 - 2 Sal: Dublin 1 - 1 Staphylococci (including toxin) 1 - 1 C1. Welchii 1 - 1 Total: 27 - 27 Agent not Identified 3 - 3 (C) Salmonella Infections, not Foodborne Salmonella Type Outbrfeaks No. of Cases Single Cases Total No. of Cases. (Outbreaks and Single Cases) Family Other (Outbreaks) Sal: Typhi-Murium - 1 2 1 3 Total: - 1 2 1 3 - 43 - Report on Individual Food Poisoning Outbreak (Summary of Details) 1. Food causing Outbreak Agent causing Outbreak ? Braised steak. Clostridium Welchii - type V. Heat resistant. 2. Cases forming outbreak which occurred from 9.30 p.m. on June 4th, 1959 till 7.20 a.m. on June 5th Notified - nil. Otherwise ascertained - 13. Total - 13. 3. Clinical Features Average interval ingestion to onset 13 hours. Main symptons Pains in stomach and diarrhoea. Severity of Illness Moderate. Duration of Illness On average, 8 hours, but 10 hours in some cases. 4. Results of Laboratory investigation Cases for positive 6 negative 1 Food Handlers - 1 positive. 5. Origin and Preparation of Food thought to have caused illness Steak was delivered by a local butcher, on the 3rd June at 11.30 a.m. It was prepared for the oven at 9 a.m. 4th June and was cooked for 2½ hours. The method of preparation of the gravy was that the meat was strained, mixed with Bisto and flour and mixed with braised steak again. Rest of gravy placed in jug on counter for diners to help themselves. Meat was sliced at 11.30 a.m. placed on individual plates and plates were left on hot plate until 12.30 when they were collected by the individual diners. 6. Place at which food causing illness was consumed. Industrial Canteen. 7. Estimated number of consumers at risk 40. 8. Probable origin of infection or contamination of food Only person handling steak was Cook/Supervisor who although she did no more than taste the steak, was shown to be carrying C1.Welchii. 9. Contributory Factors Warming of food on a hot plate; also poor standard of food hygiene and food handling in canteen kitchen. - 44 - 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 194 103 - - 2 5 10 21 120 31 4 1 - - - Measles 666 5 - 22 67 88 76 111 288 11 - 3 1 - - Whooping Cough 46 3 - 4 1 6 8 6 20 - 1 - - - - Pneumonia 52 14 69 3 2 - - - 1 3 1 6 5 18 13 Puerperal Pyrexia 141 138 - - - - - - - - 18 102 21 - - Erysipelas 10 1 - - - - - - - - - 1 1 8 - Food Poisoning 50 8 - 3 1 2 2 - 5 2 4 16 4 9 2 Poliomyelitis 4 4 - - 1 - - - 1 - - 2 - - - Ophthalmia Neonatorum 3 3 - 3 - - - - - - - - - - - Dysentery 280 12 - 7 21 13 17 16 92 23 10 52 15 10 4 Meningococcal Infection - - - - - - - - - - - - - - - Acute Encephalitis 1 1 - - - - - - 1 1 - 1 - - 1 Paratyphoid 'B' 2 2 - - - - - - - - - 1 - - 1 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 North Middx. Hospt. Other Institutions Total Scarlet Fever 58 45 28 63 - - 194 Measles 147 75 222 222 - - 666 Whooping Cough 12 6 7 21 - - 46 Pneumonia 14 5 15 18 - - 52 Puerperal Pyrexia - 1 - 2 138 - 141 Erysipelas 8 - 1 1 - - 10 Food Poisoning 16 8 12 14 - - 50 Poliomyelitis - - 1 3 - - 4 Ophthalmia Neonatorum - - - - 3 - 3 Dysentery 140 20 58 62 - - 280 Acute Encephalitis - - - 1 - - 1 Paratyphoid 'B' - 2 - - - - 2 - 45 - 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 1959:- 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 (1) (2) (3) (4) (5) (6) (7) Under 1 83 468 26 - - - 1 71 325 9 - - - 2-4 26 30 6 209 27 13 5-14 76 13 2 910 80 4 15 and over — — — — — — Total: 256 836 43 1, 119 107 17 VACCINATION AGAINST POLIOMYELITIS TABLE I. EDMONTON - Number of persons vaccinated with two injections: Year in which vaccinated CATEGORY Totals Children born in years 1943 to 1960 Young persons born in years 1933 to 1942 Persons born before 1933 who have not passed their 40th birthday Others 1956 280 - — - 280 1957 2,498 - - - 2,498 1958 8,023 554 124 15 8,716 1959 4,936 5,007 300 79 10,322 Totals: 15,737 5, 561 424 94 21,816 TABLE II. EDMONTON - Number of persons vaccinated with third injection: 1956 - - — - — 1957 - - - - - 1958 4,033 - 25 10 4; 068 1959 7,871 1,443 513 171 9,998 Totals: 11,904 1,443 538 181 14,066 - 46 - The population of Edmonton is over 90,000, but during 1959 vaccination was only available to those born after the year 1932. The total number of persons vaccinated with two injections up to the end of 1959 represents about 54% of the population eligible. The number of persons vaccinated with all three injections up to the end of 1959 represents just under 42% of the population eligible. The measure of protection given to the community is shown in the reduction of notifications of Poliomyelitis. MIDDLESEX COUNTY COUNCIL ACT, 1955 ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT: Four new licences were granted during 1959 and eight existing licences were renewed during the year. LAUNDRY SERVICE: In pursuance of the Council's powers of disinfection under the Public Health Act, a laundry service for incontinent persons was started in May, 1959 in co-operation with the laundry section of St, Ann's Hospital, Tottenham. Collection and delivery was up to twice weekly as required, and by the end of 1959 2,330 articles had been collected; laundered and delivered back. During this period 13 households were catered for. In the main this service is made use of by aged persons, but it is not restricted to the old, and the Borough is prepared to deal with soiled linen from persons of all ages if necessary, HOME SAFETY: Prizes for the 1958 Home Safety Competition were presented by the Mayor at the January meeting of the Council. In April, 1959 and again in September 1959, 7,000 Home Safety bulletins containing home safety rhymes, puzzles, and pictures were sent out to the infant and junior schools. Home Safety posters were displayed on the public boards of the Public Health Department in January and February, and in October, November and December. Some small boards were also hired from a commercial firm in October and November. During November and December in co-operation with Edmonton Welfare Association a quiz on falls was carried out in the Old People's Clubs and in three of these this was combined with a film show. Further mention of this is made in the Welfare Organiser's report on the Welfare Association. The Home Safety Poster Competition in the schools in Autumn, 1959 was restricted to the subject of falls. 120 entries were received, many of good standard, and prizes were given to the best entry from each school and the best entry in the infant, junior and senior groups. - 47 - HEALTH EDUCATION A film show on tuberculosis and smoke control was held on the 26th March, in the Town Hall. It was attended by members of the St. John's Old Age Pensioners Association, and also members of certain other old people's clubs. CARE OF THE AGED - EDMONTON WELFARE ASSOCIATION: The work of the Council itself and of the voluntary organisations in the Borough dealing with old people is co-ordinated by the Edmonton Welfare Association. The annual report for the period 1959/60 is given below. In reviewing the work of the Association for the past year, there is ample evidence of the increased need of our services, and we owe a great debt of gratitude to the voluntary organisations for their continued cooperation and team work, without which many of the services would cease to function. It is accepted that the Edmonton Welfare Association is a model of its kind in the country to-day, and we are delighted to receive the many visitors, who are sponsored by the London Council of Social Service etc., who come to see our method of working. The Association, once again, acknowledge with sincere thanks the magnificent work of the voluntary organisations - British Red Cross Society; Women's Voluntary Service; Toc H; Salvation Army, and the Citizens' Advice Bureau - and we take the opportunity this year of acknowledging the excellent work of the voluntary workers in the Old People's Clubs. We are also recording our close and happy co-operation with the National Assistance Board; Ministry of Pensions and National Insurance; Ministry of Labour; Almoners of North Middlesex Hospital; local Doctors; M.C.C. Area Welfare Officer and the Superintendent Health Visitor, M.C.C. No.l. Area; League of Hospital Friends, and the Officers and Staff of the Edmonton Borough Council. Through this measure of co-operation, working together 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. Surely this is the primary purpose of our work together, and we can be justly proud of the results. Given hereunder is a brief report on the work of some of the services of the Association during 1959-60. MEALS-ON-WHEELS SERVICE: During the year 1959, the Meals Service delivered no less than 13,454 meals. This is a new record, being 524 more than in 1958. Whilst the maximum capacity of the service is 1,000 meals per month, we have never refused an emergency call, and we are satisfied that every case is in genuine need of this important service. - 48 - The 'Hot-Lock' containers have proved their worth, particularly in the winter months as all meals, from the first to the last person in the delivery round has the meal served in a hot condition, and there have been many expressions of appreciation for this improvement in the service. A further development has been the introduction of roast-meat dinners. Once it was established that the roast-meat dinner was acceptable to the old people, it has been decided to make this a weekly event as many of the house-bound old people have little or no opportunity of a roast-meat dinner. It is gratifying to note that there has been an improvement in the number of voluntary workers coming forward to assist the Women's Voluntary Service, and the Association offer a sincere tribute to all the ladies on this service, and especially to Mrs, E. Everitt, Meals Organiser, whose untiring efforts are the mainspring of the success we now record. We also offer our thanks to the Edmonton Borough Council's catering staff and transport staff for their willing help and co-operation. ENTERTAINMENT AND RECREATION: As in previous years the Entertainments Department of the Edmonton Borough Council have continued to maintain a comprehensive programme of concerts to the Old People's Clubs, and, in addition, there have been a series of special concerts during the summer months at the Open Air Theatre in Pymmes Park. 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 Edmonton Borough Council can be assured that the old people greatly appreciate these facilities. VISITING SERVICE: There has not been any improvement in the recruitment of voluntary workers for this invaluable service, but a great deal of work has been done by the individual Old People's Clubs. Whilst a number of visits referred to us by the National Assistance Board, Citizens' Advice Bureau and other agencies, have been carried out, in the majority of cases these, after the initial inquiry, have been referred to the Old People's Club in the district concerned. It is pleasing to note that in a number of cases lonely old people have taken up membership in the Clubs. The Association is particularly anxious that its services should be widely known so that house-bound old people should avail themselves of the facilities available to them, and one important aspect of this work is the regular social visits to the house-bound old people who live alone. HOLIDAYS: Information has been circulated to all the Old People's Clubs and affiliated organisations of the off-season holidays at reduced prices for old people. There have been a greater number of personal inquiries from old people anxious to take advantage of these facilities, and several Old People's Clubs have arranged for parties of their members to go away to the sea-side, and they return greatly benefited from the holiday with their friends. - 49 - INFORMATION AND ASSISTANCE: During the year under review, the number of people seeking information and assistance has grown. The inquiries have covered a wide variety of problems, but for the old people generally housing continues to be a major problem. The National Assistance Board, Citizens' Advice Bureau, Hospitals, Doctors and Police refer many cases to us, and it is essential that every case be treated with courtesy, sympathy and understanding. Information of a general character is sent by the 'NEWS LETTER' quickly and briefly through its distribution to the Old People's Clubs and affiliated organisations. LIBRARY DELIVERY SERVICE: To-day there are 60 physically handicapped and house-bound old people enjoying this excellent service, and the Borough Librarian and his staff are to be congratulated on the efficiency of this bi-weekly delivery of books to those unable to visit the Public Libraries. We know how greatly this willing and courteous service is appreciated. WELFARE FOOD SERVICE: This service has broken all previous records by the sale of - Bovril 1,132 bottles, Ovaltine 1,692 tins and Marmite 324 jars, and the Association record its grateful thanks to Mrs. D.M. Dixon, Divisional Director, British Red Cross Society, Edmonton, for operating this service on behalf of the Association. The distributing of these welfare foods for sale at the Old People's Clubs has been of great benefit to them, especially in the winter months, and the Red Cross know that the old people appreciate the additional work involved. It is hoped that all the Clubs in the Borough will take advantage of this admirable service which undoubtedly has made a contribution to the health of the old people. HAIRDRESSING SERVICE: The concessions offered by the members of the Edmonton Branch of the London and Provincial Hairdressers' Associations are greatly appreciated, and this is proved by the many demands it receives from the old people who take advantage of reduced price hairdressing. HANDICRAFTS: The Association took part in the organisation of the 2nd Old People's Handicraft Exhibition held at the Guildhall, Westminster London, S.W.l., and the Borough of Edmonton submitted 51 exhibits and received 12 awards. PREVENTION OF ACCIDENTS IN THE HOME: In co-operation with the Medical Officer of Health, the Association took an active part in the 'Prevention of Accidents in the Home' campaign. The quiz programmes produced valuable information which has been forwarded to the Royal Society for the Prevention of Accidents, and we sincerely appreciate the help of the Eastern Gas Board and the Eastern Electricity Board for their help and cooperation . - 50 - CLUBS: The William Preye Club: The continued success of this Club is testimony to the excellent work of the Officers and Voluntary Wardens; and they can be justly proud of the fact that it is acknowledged to be one of the best Clubs of its kind in the country. By their own efforts, through the Autumn Fair, Sewing Corner and Weekly Whist Drive; which are the most profitable sources of income to the Club, they gave an Annual Tea Party to 145 members. This year the Edmonton Borough Council are to re-decorate the premises and lay a new floor, and the Club are going to meet the cost of renovating the easychairs and re-covering the billiard table. As in previous years the Club has made a donation of £100 towards the cost of running the Club. The Association would like to record its thanks and appreciation to the Management Committee, Officers and the Voluntary Wardens of the Club for their excellent work which has made the William Preye Club such an important social centre in the lives of many old people. Pymmes Park Club for Old People: Despite its 'housing problem' this Club has maintained its success as a social centre in the southern area of the Borough. This has been due in no small measure to the work of the Officers and the Voluntary Wardens, particularly the outstanding work of Mr. R. Newton. The Club held a very successful outing, and the Annual Tea Party was a truly memorable occasion. The inter-club games matches with the William Preye Club have provided great pleasure to both Clubs, and their 'Musical Afternoons' have been a high-light in a very happy and successful year. The Association record their thanks to the Management Committee, Officers and Voluntary Wardens for their services during the year. FOOT SERVICE: The Foot Service Clinics operated by the British Red Cross Society on alternate Mondays at the William Preye Club and Red Cross Headquarters, Church Street, Edmonton, are continuing to provide an essential and excellent service to the old people who need urgent chiropody treatment. During the year under review the Foot Clinics gave no less than 1,284 treatments, and a number of these cases were brought to the Clinics by Red Cross Ambulance. It is imperative that old people with foot ailments should have early treatment, and it is the speed and efficiency of this service which have earned the Red Cross high praise for their work. As a token of appreciation for the services given in this field of social medicine, the Association have made a grant of £50 to the British Red Cross Society, Edmonton. - 51 - PUBLIC BATHS - RED CROSS SERVICE TO ELDERLY AND INFIRM: The Red Cross have continued to provide a Red Cross Nurse each week at the Public Baths, Knights Lane, Edmonton, N.9. to assist elderly and infirm old people attending the Slipper Baths. The Edmonton Borough Council have provided special safety rails in two baths to assist the aged person in getting in and out of the bath. Whilst this service is greatly appreciated, full use is not made of these excellent facilities, and wider publicity would be appreciated, especially by the Old People's Clubs. OTHER SERVICES: The work of the Radio Repair Service has been, we hope temporarily, suspended, but we are grateful to Martin's Radio Limited, The Broadway, Edmonton, N.9. for their help and kindness in dealing with emergency cases. During the year the members of the Association, particularly the Women's Voluntary Service and the Old People's Clubs, have played their part in His Worship the Mayor's World Refugee Year Appeal, especially in collecting for the Mammoth Jumble Sale, with excellent results. All the other services are working satisfactorily, but there is plenty of opportunity for more voluntary workers. CONCLUSION: The Association, working through the Executive Committee, can be justly proud of its achievements during the past year. With its wide representation of its interests in the field of social welfare, they have their finger on the pulse of the need for these services in the Borough of Edmonton, and their importance for the social well-being of the people they serve. Working together as a team for the common good, the Association and its affiliated organisations go forward with confidence to face the problems of another year, and by maintaining and expanding the services it provides, thereby rightly earns the place it has now in the field of social welfare. ACKNOWLEDGMENTS: The Association wish to acknowledge and offer its sincere thanks to: - 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 members of the Edmonton Branch of the London and Provincial Hairdressers' Association for their work in the 'Hairdressing Service'. The Head Teachers, Staff and Pupils of the schools in Edmonton for their many gifts which give so much pleasure to the old people. - 52 - To the Editor of the TOTTENHAM AND EDMONTON WEEKLY HERALD for the publicity and continued 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 1959, a total of 508 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, 85 were 'not at home' and 69 had already resumed duty. Also during the year, the following medical examinations or assessments were made prior to appointment to permanent posts Medical examinations 45 Assessments without medical examinations 82 Medical assessments (not appointed) 107 CONCLUSION My thanks are due to the Chairman and Members of the Public Health Committee for their help, advice and criticism during 1959, to the other Chief Officers of the Council, and members of their departments, to the Deputy Medical Officer of Health and to all the staff and workers in the Public Health Department. I should particularly like to thank the three public health inspectors, two of them very new to the job, who carried out most of the work during the early months of 1959, and also the new Senior Public Health Inspector, Mr. Rawlinson, who has worked unceasingly since his appointment and has almost succeeded in 'making bricks without straw'. I have the honour to be, Your Worship, Ladies and Gentlemen, D.A. SMYTH, Medical Officer of Health. - 53 -