I EDM 47 Borough of Edmonton ANNUAL REPORT 1962 of the Medical Officer of Health for the year 1962 Borough of Edmonton With the Compliments of the Medical Officer of Health. Public Health Department, Town Hall, Edmonton, N.9. Borough of Edmonton ANNUAL REPORT 1962 of the Medical Officer of Health for the year 1962 BOROUGH OF EDMONTON 1962 His Worship the Mayor Councillor J.E. Cooke, J.P., Deputy Mayor Councillor E.J.C. Smythe. PUBLIC HEALTH COMMITTEE Chairman: Councillor Mrs. R.A. Smythe Vice-Chairman: Councillor M. Kahn Members: THE MAYOR (Councillor J.E. Cooke, J.P.,)(Ex Officio) THE DEPUTY MAYOR (Councillor E.J.C. Smythe) (Ex Officio) Alderman Mrs. F. Long, J.P., Councillor W.P. Doyle „ H.L. Ellis „ E.C. Francis „ E.R. Holborn (Died 18.5.62) „ H.E.H. Lewis „ J.E. Lightfoot „ Mrs. I.F. McNern 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. (Retired 14.1.62) Daphne Sasieni, M.B. , Ch.B., D.(Cbst) R.C.O.G., D.P.H., (commenced 24.6.62 - left 30.9.62) Thomas F.M. Jackson, L.R.C.P., L.RrC.S., L.R.F.P & S., D.P.H., (commenced 5.11.62) . . . Senior Public Health Inspector; A.B.C.D. G. Rawlinson Public Health Inspectors: A.C. J.G. Cummins (commenced 11.12.62) A.C. G.F. Bateman A.C. D.J. Faithfull (commenced 25.7.62) A.B.C. L.C. Hibbs A.C. R.A. Royle (left 3.6.62) A.B.C.D. M.R. Ruocco (left 30.9.62) A.B.C. D.G. Ring A.B.C. J.V. Kaye A.C. H.J. Kemp Trainee Public Health Inspectdrs: J.G. Cummins (until 10.12.62) R. Taylor A. Senior Clerk: F.J. Nash Clerical Staff: C.S. Clark Mrs. E.J. Richards Mrs. N.E. Young D.J. Faithfull (until 24.7.62) Miss I. Bowie A.J. Westney B.T. Barnett (commenced 10.12.62) R.N. Richards (commenced 10.12.62) Shops Act and Street Trading Inspector: A. Robinson Welfare Officer W.J. Sherwood 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, 1962 opened with considerable public interest in Smallpox as a result of a case in St. Pancras and later outbreaks in Birmingham, Bradford and South Wales areas. 3,681 international certificates of vaccination were authorised for persons going out of the country during 1962 and large numbers of Edmonton residents were vaccinated either at their place of work or in the surgeries of their family doctors. There was no spread of smallpox into Edmonton from any of the affected areas. The health of Edmonton was in fact fairly good in 1962. There was a troublesome outbreak of food poisoning originating from meat originally infected at Smithfield and the fogs and frosts of November and December took some toll among the very young and the old and those with weaknesses of the chest and heart. After a rise in 1961 the death rate fell and the birth rate rose again. Edmonton is somewhat more middle-aged than the population of England and Wales as a whole and therefore both birth-rate and death-rate will probably continue to rise. There were a certain number of staff changes in 1962. Dr. Goggin departed to a well-earned retirement on the 15th January and Dr. Daphne Sasieni was Deputy Medical Officer of Health for the months of July, August and September. On November 5th Dr. T.F.M. Jackson became Deputy Medical Officer of Health. In the staff of the Public Health Inspectors Mr. R.A. Royle left us in June 1962 and Mr. M.R. Ruocco left to go to Harlow in September, 1962. Mr. D.J. Faithfull qualified as a Public Health Inspector in July, 1962 and filled the vacancy left by Mr. Royle and Mr. J.G. Cummins qualified as Public Health Inspector in December, 1962 and filled the vacancy left by Mr. Ruocco. Mr. Faithfull's place as Clean Air Assistant was taken by Mr. R.N. Richards in December, 1962 and in December Mr. B..T. Barnett joined the staff as a Temporary Junior Clerk and also began to study for the Public Health Inspectors Diploma. One smoke control area No.5 and one clearance area comprising Millfield Road and part of Windmill Road and a portion of Silver Street in between were represented. A Smoke Control Order was confirmed by the Minister but the Compulsory Purchase Order for the clearance area still awaits confirmation at time of writing. 5 The County Council opened a new clinic in Plevna Road backing on to the Town Hall in September, 1962. At this clinic there are immunisation sessions, ante-natal clinics, minor ailment clinics for school children, physiotherapy, ultra-violet light treatment, specialist clinics and infant welfare sessions. The so-called welfare foods are also available, but at a somewhat higher price than in the past. The new clinic replaced a rather dingy dilapidated building at the side of the Town Hall, Fore Street and the change seems to be greatly appreciated by the mothers and children of Edmonton. Another new clinic cheek by jowl with a library at the junction of Ridge Avenue and Church Street was still being built by the Borough Council for the County Council at the close of the year. Once the new central clinic in Plevna Road was available the County Council was able to surrender to the Borough the temporary building they had taken over in Pymmes Park in 1948. The building was then renovated and altered by the Borough Council and let to the Edmonton Welfare Association at a nominal rent. The Pymmes Park Old Peoples' Club which had been fitting in as best they could for some years in the refreshment rooms at the park moved gratefully into these new premises and the membership of the club rose sharply to 250. This building now known as "Hollywood House" is used as an all-day club for both men and women and chiropody sessions are provided by the Red Cross twice a week. It is hoped that in 1963 or 1964 in co-operation with the County Council and its Area Health Committee, an elderly persons advice clinic may be set up in the premises at present used for chiropody. In November we tried to press further forward with smoke control at family level and a team of two lecturers from the Central Council for Health Education toured the schools in Edmonton for ten days giving illustrated talks on the dangers of smoking. The message appeared to be received and understood even in the Sixth forms, many of the scholars will undoubtedly comply. The death rate has risen but so has the birth rate. Since the number of Doctors, midwives and nurses available to deal with the increased births was no greater than usual, one might have expected some increase in infantile mortality but in fact, the infantile mortality rate is reasonable. The notifications of pulmonary tuberculosis rose but this may well have been due to the visit of the mass radiography unit in the latter months of 1961. 1961 having been almost free from dysentery there were, not surprisingly, a relatively large number of cases in 1962. The main peak of incidents were in March and December and the outbreaks were as usual, centred in schools. The incidence of measles was low and that of whooping cough was lower still. There is no doubt that a trouble free vaccine against measles would ease the lot of both the mother of the toddler and the toddler himself. 6 PART I. SOCIAL AND VITAL STATISTICS TABLE I SOCIAL STATISTICS Area 3,896 acres (6.09 square miles) Population- Census as 1961 92,062 Registrar General's estimate for mid-year 1962 91,440 Number of inhabited houses and separate dwellings at the end of 1962 30,548 Number of inhabited houses and separate dwellings at the end of 1961 30,359 Rateable value, April 1962 £1,673,155 Estimated product of 1d. rate in the £ for the year ending 31st March, 1963 £6,980 Rate in the £ for the year ending 31st March, 1963 22s. 3d. TABLE II VITAL STATISTICS M. F. Total Grand Total Live Births Legitimate 667 615 1,282 1,372 Illegitimate 49 41 90 (Percentage of live births) 6.55 Birth rate per 1,000 population 15.00 Corrected birth rate 15.15 Still Births Legitimate 8 20 28 31 Illegitimate 1 2 3 Still birth rate per 1,000 total live and still births 22.09 Deaths Number 522 487 1,009 Rate per 1,000 population 11.03 Corrected death rate per 1,000 population 11.69 Number Nil Maternal mortality rate per 1,000 total live and still births Nil TABLE III COMPARATIVE STATISTICS Birth Rate Death Rate Infant Mortality Rate Live Still England and Wales 18.00 18.lO 11.90 21.40 Middlesex (Crude) 17.20 15.80 11.00 19.00 Edmonton (Crude) 15.00 22.09 11.03 18.95 Edmonton (Corrected) 15.15 - 11.69 - 7 INFANTILE MORTALITY The figures that follow speak for themselves to some extent. There were 9 deaths from congenital malformations. Some congenital malformations resulted from infection or malnutrition of the mother and unborn baby; some from disease of the mother, but of many we do not yet know the cause. All that can be done at present is to try to give to the expectant mother the best possible ante-natal care. The prevention of prematurity, as far as it is possible, also depends on good ante-natal care, but good infant care both in hospital and subsequently, often saves the life of the premature baby. From then on the mother has a load greater than that of a mother with a child born at the normal time, because the baby that is born too soon lacks many of the nutrients that are taken up by the baby late in pregnancy and these have to be given to the child at the right rate later. Generally speaking the premature child has not caught up with his full term contemporary much before the age of seven years. Pneumonia and bronchitis usually carry off many babies, but only two deaths from this cause was recorded in 1962. As a rule a healthy well-nourished baby may catch bronchitis but does not die of it. TABLE IV Infant Mortality (Legitimate) 20.28 (Illegitimate) Nil Total 18.95 Neo-Nata.l Mortality 12.39 Early Neo-Natal Mortality 10.20 Peri-Natal Mortality Rate (Stillbirths and deaths under 1 week combined per 1,000 live and stillbirths) 32.07 8 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 Accidental Suffocation - - - - - 1 - - - 1 Vaccinia - - - - - - - 1 - 1 Encephalitis - - - - - - 1 - - 1 Pneumonia - - - - - 1 - - - 1 Premature Birth 2 - - - 2 - - - - 2 Birth Injury 2 - - - 2 - - - - 2 Congenital Malformations 2 1 - - 3 1 1 - - 5 Asphyxia 1 - - - 1 - - - - 1 Neonatal Disease 1 - - - 1 - - - - 1 Totals: 8 1 - - 9 3 2 1 - 15 TABLE VI FEMALES Causes of Death Weeks Total in 1 Month 1-3 3-6 6-9 9-12 Total under 1 Yr. 1 2 3 4 Congenital Malformations 2 - - 2 4 - - - - 4 Asphyxia 2 - - - 2 - - - - 2 Premature Birth 1 1 - - 2 - - - - 2 Birth Injury 1 - - - 1 - - - - 1 Intestinal Obstruction - - - 1 1 - - - 1 Pneumonia 1 - - - 1 Totals: 6 1 - 3 10 1 - - - 11 9 VITAL STATISTICS General: As I have said the population of Edmonton is somewhat middle-aged and there are rather less of the under 20's and over 60's than in the full population of England and Wales. The Registrar-General therefore provides correction figures which revise the birth rate and death rate upwards. If, therefore, the Edmonton population had the same structure as that of England and Wales, the birth rate would be 15.15 and the death rate 11.66. If the corrections are sufficient, Edmonton is less fertile than the country as a whole and somewhat healthier, (or rather less prone to death) than the country as a whole. I think it is possible that the housing conditions in Edmonton are now better than the average for England and Wales and the incidence of pulmonary tuberculosis may also be slightly below average. The lung cancer death rate is above the national average but the death rate from diseases of the heart and blood vessels appears to be below it. Deaths from accidents are a little below the average; this may be due to the age structure of the population. Cancer of the Stomach: The figures 29 corresponds to the average in the past few years. At one time cancer of the stomach was more common in women, but in the 1962 figures men have the slight majority, 16 to 13. The earliest cases were between 45 and 65 in men and between 65 and 75 in women. The incidence of peptic ulcer in Edmonton is not know to me but the death statistics show the same sex ratio as cancer of the stomach. Cancer of the Lung: In these deaths males predominate. Over 90% of the patients dying from cancer of the lung were men and more than half of these men died before the age of 65. Only one third of the women died before the age of 65. Though there were more deaths from lung cancer in 1962 than in 1961 it was slightly less than in 1960. The figures for England and Wales so far show a steady rise year by year and I can only conclude that the factor mainly associated with this rise must have come to bear on the population of Edmonton sooner than on the population as a whole. It seems highly probable that this factor was an increase in cigarette smoking and that this started in Edmonton in 1939 or 1940. Cancer of the Breast: This disease seems to becoming slightly less common in Edmonton. It is said to be commoner in breasts that have not fed children and the decrease in deaths may therefore be associated with the relative increase in the number of married women since the 30's. 10 Cancer of the Uterus: The Medical Officer of Health of Hendon, Dr. Patton, has analysed the deaths from cancer of the uterus in the Boroughs and Districts of Middlesex during the past five years (1957-1962). The death rate per 10,000 of population is 1. in Brentford & Chiswick; .73 in Edmonton; .55 in Enfield; 1.15 in Southgate; .82 in Tottenham; 1.35 in Wood Green. It may be that in the Boroughs with the lower figures women seek medical advice sooner about gynaecological complaints. Leukaemia: Deaths from leukaemia continue to show a slight rise. It is difficult to relate deaths in the over 25's to the testing of nuclear devices in the early 1950's, but the possibility is there. Diabetes: Deaths shown as from Diabetes were all in late life and it is a moot point whether or not diabetes hastens death. A survey has recently been carried out among the general public in a number of areas to determine how many people have a raised blood sugar without very much marked illness. A good deal of so called sub-clinical diabetes or pre-diabetes was discovered and the expense of these surveys seems undoubtedly worthwhile. This is one activity that the post-1965 London Boroughs might well consider. Vascular Diseases of the Nervous System: These are mainly cases of bleeding into the brain. The bleeding is usually either the result of a congenital weakness of the blood vessel of the brain or an abnormally high arterial blood pressure, breaking through a diseased arterial wall. There were fewer deaths from this cause than in previous years. Coronary Disease: The number of deaths from coronary disease has risen. The sex ratio is two men to every woman. Possibly the women of Edmonton lead a more active life than the men. Between 1960 and 1962 the number of deaths in men increased by 14%, in women by just over 10%. There are of course more men motorists than women motorists in Edmonton, as elsewhere. Hypertension with Heart Disease: The number of deaths from this cause has dropped. It would appear that in Edmonton raised arterial blood pressure has its most disastrous effect on the coronary vessels of the heart rather than on the vessels of the brain or other parts of the body. 11 Pneumonia: The figures show that pneumonia did not by any means act only as the friend (or enemy) of the old. Just over half of the people who died of pneumonia were aged 55 or over. Three were infants, one a girl in her 'teens, two were between the ages of 25 and 45, five between 45 and 65. Pneumonia is still a disease to be reckoned with and more needs to be done towards its prevention. Bronchitis: Much the same can be said about this cause of death. Only 32 of the 67 deaths were persons over the age of 75. One infant was carried off, one school child, and one young man. Bronchitis is much commoner in men, partly because more men work in very dusty conditions and partly because more men smoke cigarettes. Not a single woman died from bronchitis in Edmonton under the age of 65 but nine men died. Between the ages of 65 and 75 there were three times as many deaths from bronchitis among men as among women. As I have said before women who do not wish to be widows should not buy their husbands cigarettes. TABLE VII ACCIDENTS VIOLENT DEATHS 1962 - (Excluding Road Traffic Accidents) Date Sex Age Cause Verdict 27.4.62 M 2/12 Asphyxia while in bed with both parents Misadventure 7.3.62 M 43 Fell down steps Accidental 6.3.62 M 46 Head injuries due to accident Accidental 28.2.62 M 48 Fell from stationary lorry Misadventure 29.9.62 M 59 Struck by train Accidental 27.3.62 M 75 Fell downstairs Accidental 3.4.62 M 75 Fall Accidental 7.12.62 M 75 Coal gas poisoning Accidental 8.2.62 M 78 Fall at home Accidental 25.8.62 M 83 Carbon monoxide poisoning Accidental 6.7.62 M 87 Coal gas poisoning Accidental 10.8.62 F 7 Falling out of train Accidental 25.6.62 F 31 Poisoning by overdose of phenobarbituate Open 8.3.62 F 81 Fall at home Accidental 28.4.62 F 84 Fall Accidental 1.3.62 F 85 Coal gas poisoning Accidental 7.4.62 F 87 Fall Accidental 12 TABLE VIII 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 - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal Infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective & parasitic disease 3 - - - - - - - - 2 - - 1 Malignant neoplasm, stomach 31 - - - - - - - 1 6 12 10 2 Malignant neoplasm, lung, bronchus 71 - - - - - - 1 8 31 23 8 - Malignant neoplasm, breast 16 - - - - - - 3 4 4 1 3 1 Malignant neoplasm, uterus 7 - - - - - - - 3 - 3 - 1 Other malignant & lymphatic neoplasms 88 - - - - - 1 4 9 21 26 21 6 Leukaemia, aleukaemia 8 - - - 1 - - 2 1 1 2 1 - Diabetes 5 - - - - - - - - - 1 3 1 Vascular lesions of nervous system 109 - - - - - - 2 3 18 25 40 21 Coronary disease, angina 188 - - - - - - 4 16 50 56 51 11 Hypertension with heart disease 16 - - - - - - - 1 3 4 2 6 Other heart diseases 153 - - - - - - 2 5 6 33 60 47 Other circulatory disease 47 - - - 1 - - - 2 8 17 15 4 Influenza 2 - - - - - - - - - 1 - 1 Pneumonia 57 2 1 - - 2 - 1 - 4 18 18 11 Bronchitis 66 - - - - - - 1 1 8 23 24 9 Other disease of respiratory system 8 - - - - - - - 1 - - 3 4 Ulcer of the stomach and duodenum 7 - - - - - - - - - 5 2 - Gastritis, Enteritis and Diarrhoea 6 - - - - - - - - - 3 2 1 Nephritis and nephrosis 6 - - - - - - 2 - - 1 3 - Hyperplasia of prostate 2 - - - - - - - - - 1 - 1 Pregnancy, childbirth, abortion - - - - - - - - - - - - - Congenital malformations 11 9 - - - - 1 1 - - - - - Other defined and ill-defined diseases 56 14 - - - 1 - 2 2 12 10 12 3 Motor vehicle accidents 12 - - - 4 - - - 2 - 3 3 - All other accidents 17 1 - - 1 - 1 1 2 1 - 7 3 Suicide 11 - - - - - 2 1 1 3 4 - - Homicide and operations of war - - - - - - - - - - - - - TOTALS 1,005 26 1 - 7 3 5 27 62 178 274 288 134 13 TABLE IX DEATHS BY SEX-GROUPS Cause of Death M F TOTAL Tuberculosis, respiratory 1 1 2 Tuberculosis, other - - - Syphilitic disease - - - Diphtheria - - - Whooping Cough - - - Meningococcal infections - - - Acute poliomyelitis - - - Measles - - - Other infective and parasitic diseases 1 1 2 Malignant neoplasm, stomach 16 13 29 Malignant neoplasm, lung, bronchus, 66 6 72 Malignant neoplasm, breast - 15 15 Malignant neoplasm, uterus - 7 7 Other malignant and lymphatic neoplasms 40 48 88 Leukaemia, aleukaemia 2 7 9 Diabetes 2 3 5 Vascular lesions of nervous system 45 64 109 Coronary disease, angina 120 67 187 Hypertension with heart disease 8 7 15 Other heart disease 44 107 151 Other circulatory disease 22 27 49 Influenza 2 - 2 Pneumonia 21 31 52 Bronchitis 53 14 67 Other diseases of the respiratory system 6 2 8 Ulcer of stomach and duodenum 5 4 9 Gastritis, Enteritis and Diarrhoea 4 2 6 Nephritis and nephrosis 3 3 6 Hyperplasia of prostate 4 - 4 Pregnancy, childbirth, abortion - - - Congenital malformations 6 5 1 1 Other defined and ill-defined diseases 22 42 64 Motor vehicle accidents 10 2 12 All other accidents 11 6 17 Suicide 8 3 11 Homicide and operations of war - - - TOTAL 522 487 1,009 14 TABLE X MALES - DEATHS BY AGE-GROUPS Cause 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 1 - - - - - - - - - 1 - - Tuberculosis, other - - - - - - - - - - - - - Syphilitic disease - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective & parasitic diseases 2 - - - - - - - - 2 - - - Malignant neoplasm, stomach 19 - - - - - - - 1 6 6 6 - Malignant neoplasm,lung, bronchus 64 - - - - - - 1 7 30 20 6 - Other malignant and lymphatic meoplasms 40 - - - - - - 3 3 13 10 8 3 Leukaemia, aleukaemia 1 - - - - - - - 1 - - - - Diabetes 2 - - - - - - - - - - 1 1 Vascular lesions of nervous system 45 - - - - - - 2 3 8 14 12 6 Coronary disease, angina 120 - - - - - - 4 13 43 34 22 4 Hypertension with heart disease 8 - - - - - - - 1 2 1 1 3 Other heart diseases 45 - - - - - - 1 2 3 11 14 14 Other circulatory disease 21 - - - - - - - 1 5 8 5 2 Influenza 2 - - - - - - - - - 1 - 1 Pneumonia 24 1 1 - - 1 - 1 - 3 6 5 6 Bronchitis 52 - - - - - - 1 1 7 18 21 4 Other disease of respiratory disease 6 - - - - - - - 1 - - 3 2 Ulcer of stomach and duodenum 3 - - - - - - - - - 3 - - Gastritis, Enteritis & Diarrhoea 4 - - - - - - - - - 3 1 - Nephritis and nephrosis 3 - - - - - - 1 - - 1 1 - Hyperplasia of prostate 2 - - - - - - - - - 1 - 1 Pregnancy, childbirth, abortion - - - - - - - - - - - - - Congenital malformations 6 5 - - - - - 1 - - - - - Other defined and ill-defined diseases 21 8 - - - 1 - 1 1 4 4 2 - Motor vehicle accidents 10 - - - 3 - - - 2 - 3 2 - All other accidents 11 1 - - - - - 1 2 1 - 5 1 Suicide 8 - - - - - 2 1 1 1 3 - - Homicide and operations of war - - - - - - - - - - - - - TOTALS 520 15 1 - 3 2 2 18 40 128 148 115 48 15 TABLE XI 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 1 - - - - - - - - - 1 - - Tuberculosis, other - - - - - - - - - - - - - Syphilitic disease - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective and parasitic diseases 1 - - - - - - - - - - - 1 Malignant neoplasm, stomach 12 - - - - - - - - - 6 4 2 Malignant neoplasm, lung,bronchus 7 - - - - - - - 1 1 3 2 - Malignant neoplasm, breast 16 - - - - - - 3 4 4 1 3 1 Malignant neoplasm, uterus 7 - - - - - - - 3 - 3 - 1 Other malignant and lymphatic neoplasms 48 - - - - - 1 1 6 8 16 13 3 Leukaemia, aleukaemia 7 - - - 1 - - 2 - 1 2 1 - Diabetes 3 - - - - - - - - - 1 2 - Vascular lesions of nervous system 64 - - - - - - - - 10 11 28 15 Coronary disease, angina 68 - - - - - - - 3 7 22 29 7 Hypertension with heart disease 8 - - - - - - - - 1 3 1 3 Other heart diseases 108 - - - - - - 1 3 3 22 46 33 Other circulatory disease 26 - - - 1 - - - 1 3 9 10 2 Influenza - - - - - - - - - - - - - Pneumonia 33 1 - - - 1 - - - 1 12 13 5 Bronchitis 14 - - - - - - - - 1 5 3 5 Other disease of respiratory system 2 - - - - - - - - - - - 2 Ulcer of stomach and duodenum 4 - - - - - - - - - 2 2 - Gastritis, Enteritis and Diarrhoea 2 - - - - - - - - - - 1 1 Nephritis and nephrosis 3 - - - - - - 1 - - - 2 - Hyperplasia of prostate - - - - - - - - - - - - - Pregnancy, childbirth, abortion - - - - - - - - - - - - - Congenital malformations 5 4 - - - - 1 - - - - - - Other defined and ill-defined diseases 35 6 - - - - - 1 1 8 6 10 3 Motor vehicle accidents 2 - - - 1 - - - - - - 1 - All other accidents 6 - - - 1 - 1 - - - - 2 2 Suicide 3 - - - - - - - - 2 1 - - Homicide and operations of war - - - - - - - - - - - - - TOTALS 485 11 - - 4 1 3 9 22 50 126 173 86 16 TABLE XII ALL DEATHS BY WARDS Ward Deaths Male Female Bury Street 153 118 Church Street 99 155 Angel Road 97 97 Silver Street 171 115 Vagrants - - Totals: 520 485 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 - - 56 Blood - Haemoglobin Estimation - - 441 Blood - Kahn Reaction - - 171 Blood - Rhesus Factor 132 40 172 Blood - Grouping - - 173 Faeces for the presence of organisms 1136 4248 5,384 Swabs for presence of C. Diphtheriae: (a) From Suspect Cases - 7 7 (b) From Contacts - - - Swabs for presence of Haemolytic Streptococci 55 324 379 Swabs for presence of Vincent's Angina - 4 4 Urines - - 56 Vomit - 1 1 Vaginal swabs for presence of organisms 1 12 13 Eye Swabs - 2 2 Bacon for Staphs - 2 2 Cold Meat for Staphs - 6 6 Sweets for Paths - 5 5 Beef, Lamb, Beef and Pork for Staphs - 4 4 Ham and uncooked gammon for Paths - 6 6 Kitchen utensils for Staphs - 4 4 Groceries from school kitchen for Staphs - 13 13 Desiccated coconut - 1 1 Frozen eggs for Paths 1 8 9 TOTAL: 6,909 17 ENVIRONMENTAL HEALTH HOUSING As a result of the efforts of the Public Health Inspectors 362 houses were repaired. The need was less than in 1961 about 100 less houses needing to be repaired. The Slum Clearance Programme and Redevelopment Programme are therefore beginning to make their marks and there is now no doubt that the housing conditions at Edmonton are improving. One clearance area of moderate size was represented in 1962. This was the Millfield Road/Windmill Road Clearance Area an area of 100 houses in which 399 persons live. TABLE A Action taken under the Housing and Public Health Acts Number of houses repaired in consequence of informal action 267 Number of notices served under Section 9 Housing Act 9 Number of houses rendered fit after service of notices (a) by owner 5 (b) by Local Authority - Number of notices served under Public Health Acts 375 Number of houses repaired after service of notices:- (a) by owner 95 (b) by Local Authority in default - 18 TABLE B RENT ACT, 1957 The above Act came into force on 6th July, 1957, and set out below are details of the applications received during 1962:- Part I - Applications for Certificates of Disrepair (1) Number of applications for Certificates 16 (2) Number of decisions not to issue Certificates - (3) Number of decisions to issue Certificates 16 (a) in respect of some but not all defects 7 (b) in respect of all defects 9 (4) Number of undertakings given by Landlords under paragraph 5 of the First Schedule 16 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule - (6) Number of Certificates issued - Part II - Applications for Cancellation of Certificates (7) Applications by Landlords to Local Authority for cancellation of Certificates 9 (8) Objections by tenants to cancellation of Certificates - (9) Decisions by Local Authority to cancel in spite of tenants' objections - (10) Certificates cancelled by Local Authority 9 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 Half-Holiday Order (Section 4(2) and (6) Butchers), and the Shops Act, 1912, Edmonton Weekly HalfHoliday Order, Section 4(2). All the Orders stand amended by the Shops Act, 1950. There are approximately 1,340 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. 1,531 Washing facilities, sink water heaters installed 12 A number of contraventions were detected. They were of a minor character. 19 SHOPS ACT, 1950 - PART I, SECTION 1(2) Edmonton Weekly Half-Holiday Order - Two letters of warning were sent to shopkeepers contravening this Order. SHOPS ACT, 1950 - PART I Hours of Closing - Action was found necessary in two cases during the year. SHOPS ACT, 1950- PART II, SECTION 17(1) Condition of Employment- One letter of warning was sent to a shopkeeper regarding the employment of an assistant on the afternoon of his Statutory Halfholiday. SHOPS ACT, 1950 - PART II, SECTION 17(2) Non-Exhibition of Notices- One letter of warning was sent in this connection during the year. SHOPS ACT, 1950- PART IV, SUNDAY TRADING Fifty-two 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. MIDDLESEX COUNTY COUNCIL ACT, 1944-1950 - STREET TRADING Under the provisions of the Byelaws made by the Council under the above Acts, twenty-nine letters of warning were sent for contraventions. Legal proceedings were instituted in five cases and fines amounting to £6. 0. Od., with costs of £2. 0. Od., were imposed. Two licences were revoked during the year. Shops, stores and other traders premises coming within the scope of the Act were inspected throughout the year, including Sundays and evenings. CONSUMER PROTECTION ACT, 1961 The Shops Act Inspector is the Appointed Authorised Officer under the Act. Inspections were carried out under the Act during the year and one electric fire which did not comply with the Act was discovered. The fire in question was withdrawn from sale, and was returned by the shopkeeper to the makers for amendment. A warning letter was sent to the shopkeeper. - 20 - BETTING AND GAMING ACT, 1960 The Shops Act Inspector is authorised to carry out inspections under t* gaming provisions of the above Act, to see that permitted premises are proper conducted. Four visits were paid during 1962, and four permits granted. EDMONTON BOROUGH COUNCIL BYELAWS AND HAIRDRESSING ESTABLISHMENTS These regulations were approved by the Minister in 1962 and came into operation on February 1st, 1963. FOOD HYGIENE CONTROL MILK SUPPLY The number of retail purveyors of milk registered at 31st December, 19( was 145. The number of dairies registered at 31st December, 1962 was 9. FOOD AND DRUGS ACT, 1955 - SECTION 16. During the year 8 premises were registered for the sale and storage of ice cream. Number on register at end of year - Manufacturers and Vendors 2 Vendors only 215 Storage 1 During the year six premises were registered for the preparation or manufacture of preserved food, etc. Number on register at end of year 59 - 21 - UNSOUND FOOD The following is a list of the food surrendered for examination and retained as unfit for human consumption Meat 2,012 tins Tomato Juices 117 tins Milk 2,010 do. Margarine 66 lbs. Fish 1,503 do. Lamb 37¼ lbs. Jams etc. 482 do. Mutton 8 lbs. Soups 1,123 do. Beef 462¼ lbs. Beans 1,633 do. Pork 483½ lbs. Beetroot 49 do. Ham 49½ lbs. . Carrots 271 do. Skate 14¾ stone Mixed Vegetables 80 do. Sausages 21½ lbs. Peas 2,517 do. Cheeses 242 packets 31¼ lbs. Apples 13 do. Yeast 10 lbs. Apricots 687 do. Jellies 31 only Blackcurrants 142 do. Fish Paste 92 jars Cherries 163 do. Meat Paste 140 jars Loganberries 84 do. Pickle 205 jars Grapefruit 426 do. Cream 77 tins Gooseberries 60 do. Sauce 269 bottles Greengages 64 do. Spaghetti 258 tins Fruit Salad 1,119 do. Currants 14 pkts. Oranges 591 do. Cake Mix 992 pkts. Peaches 2,753 do. Bovril 73 bottles Pears 1,102 do. Sandwich Spread 17 tins Pineapple 2,659 do. Salad Cream 58 jars Plums 116 do. Tomatoes 3,535 tins Prunes 109 do. Fruit Juices 721 tins Raspberries 57 do. Rice 577 tins Rhubarb 75 do. Eggs 5 tins Strawberries 485 do. Baby Food 325 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. - 22 - 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 61 7 3 5 76 Milk Type Lollies 1 - - - 1 Totals: 62 7 3 5 77 The results may be interpreted as follows Grade 1 - Good Grade 2 - Satisfactory Grade 3 - Poor Grade 4 - Unsatisfactory SUMMARY OF FOOD PREMISES REGISTERED UNDER SECTION 16 OF THE FOOD AND DRUGS ACT, 1955 Manufacture and Sale of Ice Cream 4 Sale only of Ice Cream 232 Manufacture of Sausages 27 Manufacture of Sausages and Sale of Pressed, Pickled, Preserved, Potted Meats and other foods 18 Manufacture of Cooked Meat 13 Manufacture of Preserved Foods 1 Butchers 58 Fish Shops 31 Grocers and Provision Dealers 191 Bakers and Confectioners 22 Fruiterers and Greengrocers 61 Dairies 9 Retail Purveyors of Milk 127 Cafes 46 Factory Canteens 79 EDUCATION ON FOOD HANDLING During July a series of lectures illustrated by films was given to members of the staff of the Town Hall Canteen. A general invitation was issued to the staff of school kitchens and food handling establishments in the Borough generally but the response was poor. None of the cases of outbreaks of food poisoning appeared to be due to bad food handling in shops, cafes or restaurants. The butcher's shop from which the largest outbreak originated was in fact a new and clean shop where standards were good but he was unfortunate enough to have his hams boiled at an infected wholesalers. — 23— WATER The water supply of the Borough has at all timese been satisfactory both in quality and quantity during 1962. The Metropolitan Water Board is responsible for the supply which is piped direct to every dwellinghouse through the Borough and serves the entire population. "The sources of supply are mainly New River water from Hornsey and Stoke Newington works together with some River Thames derived filtered water from Ashford Common group of works via Fortis Green pumping station. Traces of well water from Park well at Marsh Lane, Tottenham, may supply the southern borders of your Borough. "Samples are collected at least five days each week from the works and the summary of the results from the sources are set on out the attached sheet. The water is not plumbo-solvent. "The number of structurally separate dwellings is not recorded but none of the houses are permanently supplied by standpipe. "No new sources of supply were instituted by the Board in your area during 1962, nor were there any extensions of important trunk mains, nor any change in the general scheme of supply to the Borough, but new service mains were laid to the extent of 1,448 yards." SAMPLING OF SWIMMING BATH WATER Not Satisfactory Satisfactory Houndsfield Lido Samples taken for Bacteriological Examination 1 Samples taken for Chemical Examination 1 Knights Lane Baths Samples taken for Bacteriological Examination 7 Samples taken for Chemical Examination 8 - 24 - Average RESULTS OF THE CHEMICAL EXAMINATION OF WATER SUPPLIED TO THE BOROUGH OF EDMONTON FOR THE YEAR 1962. MILLIGRAMMES PER LITRE (unless otherwise stated) Description of Sample Number of Samples Ammonia Nitrogen Albuminoid Nitrogen Oxidised Nitrogen Chlorides as CI Oxygen abs. from Permanganate. 4hrs at 27°C. Turbidity Units Colour m.m.brown 2 ft. Tube Burgess's Tintometer Hardness (Total) Hardness (non carbonate) PH Value Phosphate as P04 Silicate as Si02 Surface Active Material as Manoxol Sulphate as so4 Natural Fluoride as F. Magnesium as Mg. Electrical Conductivity. Micromhos Nitrite Nitrate New River derived 104 0.043 0.058 5.5 38 0.58 0.1 7 302 64 7.9 0.70 11 0.10 63 0.25 6 630 Ashford Common group River Thames derived 208 0.040 0.076 3.9 30 1.10 0.2 11 272 58 7.9 1.3 10 0.12 61 0.25 6 560 Park 1 0.086 0.030 0.3 26 0.28 0.1 4 252 47 7.3 510 METROPOLITAN WATER BOARD WATER EXAMINATION DEPARTMENT BACTERIOLOGICAL RESULTS- YEARLY AVERAGES, 1962. Source of Supply Number of samples BEFORE TREATMENT AFTER TREATMENT Agar plate count per ml. Coliform count Escherichia coli count Number of samples Agar plate count per ml. Coliform count E.coli count 20-24 hours at 37°C. 3 days at 22°C. Per cent, samples negative in 100 m] Count per 100 ml Per cent samples , negative in 100 ml Count per 100 ml. 20-24 hours at 37°C. 3 days at 22°C. Per cent samples negative in 100 ml. Per cent samples negative in 100 ml. New River derived 512 7.0 100.0 100.0 River Thames derived, Ashford Common group. 1,883 19.2 100.0 100.0 Park 66 0.7 36 86.36 0.5 95.45 0.2 68 0.4 6 100.0 100.0 - 25 - - 26 - 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 PUBLIC CONVENIENCES The public conveniences in Edmonton are completely free and it is possible to wash the hands, soap and paper towels being supplied free in addition to hot and cold water. In order to make sure the service is not abused by the odd destructive citizen each convenience is under the charge of an attendant at the time it is open. There are eight conveniences each with a male and female side and an attendant on each side ,and the standard of cleanliness is extremely good. From time to time we get letters of appreciation from people who have passed through Edmonton and used the conveniences. FACTORIES ACTS, 1961 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 251 133 - - Factories without mechanical power 13 14 _ _ Other premises under the Act (including works of building and engineering and construction but not including outworkers premises) 12 42 - - 276 189 - - - 27 - 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 ) Unsuitable or ) defective ) Not separate for ) sexes ) - 1 - 1 - Other offences - (Not including offences relating to outwork) - - - - - Totals: - 1 - 1 - - 28 - 3.Outwork- Sections 133 and 134 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. 149 - - - - - Artificial flowers 9 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 22 - - - - - Brush making 12 - — — - - Stuffing toys 19 - - - - - Toys and painting boxes 30 - - - - - Brass and brass articles 5 - - - - - Electrical fittings 71 - - - - - Embroidery - Household linen 1 - - - - - Feather sorting 2 - - - - - Button carding 2 - - - - - Leather bags 19 - - - - - Curtains- Furniture making 3 - - - - - Fetlings- diecastings 17 - - - - - Lampshades 11 - - - - - Christmas crackers 6 - - - - - Total: 378 - - - - - MIDDLESEX COUNTY COUNCIL ACT, 1950. SECTION 11 Five persons and premises were registered during the year, and seven persons were registered to trade in the Borough where storage premises located in another district. There were 86 hawkers on the register at the end of 1962. ATMOSPHERIC POLLUTION The deposit gauge at the Town Hall continued to be used. The results are shown overleaf. - 29 - SUMMARY OF ANALYSES 1962 Rainfall in Inches DEPOSIT IN TONS PER SQUARE MILE Insoluble Deposits Ash Soluble Deposits Total Solids (a) (a) (a) (a) Jan. 3.12 2.72 1.05 8.68 11.40 Feb. 0. 55 1.51 0.59 3.00 4.51 Mar. 1.54 8.56 4.84 6.20 14.76 Apr. 1.77 4.53 3.00 4.50 9.03 May 1.38 7.65 4.33 6.28 13.93 June 0.21 3.70 2.55 1.53 5.23 July 3.33 6.23 4.22 4.18 10.41 Aug. 1.30 6.45 4.13 3.37 9.82 Sept. 2.70 8.05 5.69 5.91 13.96 Oct. 1.74 5.06 3.07 5.06 10.12 Nov. 1.52 6.20 3.88 7.73 13.93 Dec. 2.03 9.36 6.17 2.80 12.16 TOTAL 21.19 70.02 43.52 59.24 129.26 (a) Town Hall. Site No.2 Site No.l Discontinued 1.1.62 The deposit gauge does not accurately measure pollution of the air itself. It is the dust and grit falling through the air that it records, and it tends therefore to be pollution from industrial sources that is mainly shown in 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. A third smoke filter was installed at Huxley School on 1st January, 1962. Details of the readings of the 3 recorders are set out overleaf. Two further filters will be installed so as to give adequate information on atmospheric pollution in the Borough; when the new apparatus is installed, the use of the remaining deposit gauge will be discontinued. - 30 - 1962 Concentration of Smoke Micrograms per Cubic metre Concentration of Sulphur Dioxide Micrograms per cubic metre Average daily value Average daily value (A) (B) (c) (A) (B) (C) January 129 154 151 250 228 226 February 83 83 109 188 153 201 March 134 120 129 257 233 235 April 51 52 49.5 85 102 85.5 May 25 44 34 53 82 64 June 12 18 27 131 57 54 July 17 24 26 125 45 59 August 13 24 28 102 48 46 September 39 49 56 167 80 76 October 81 110 105 330 203 123 November 144 204 154 386 300 237 December 254 190 263 540 368 507 (A) Latymer School (B) Mandeville School (C) Huxley School - commenced 1.1.62 As usual there is less smoke during the so called summer months. Even in a bad year when it is appreciably warmer during these months less coal is burnt in the domestic grate. Throughout Greater London the number of smoke control areas continues to increase and we should therefore expect less smoke to be recorded as time goes on. The readings at Latymer School do not show marked reductions on those of 1961, there may be an improvement on this in later years. Most sulphur dioxide pollution is from industrial chimneys and therefore the fall from May to September in sulphur dioxide pollution is not by any means as marked as that for smoke. It has been suggested however that in the absence of smoke sulphur dioxide become a much less serious health hazard. - 31 - The Council has decided to make the Borough wholly Smoke Controlled and it is planned to deal with an area each year. SMOKE CONTROL AREA NO. OPERATIVE DATE ACREAGE NUMBER OF PREMISES Domestic Industrial Commerical Other 1. 1st June, 1959 93 409 1 - 7 2. 1st October, 1960 353 2,070 2 10 10 3. 1st October, 1961 213 1,761 - 15 10 4. 1st October, 1962 152 1,820 13 87 31 5. 1st October, 1963 425 3,817 3 96 17 NO. 5 AREA - Partial survey of this area was carried out during the year- The Order was confirmed by the Minister and will come into force on 1st October, 1963. The area which is situated in the South West Corner of the Borough is 425 acres in extent and is bounded on the South by the Borough boundary with Tottenham, on the East by Bull Lane and Haselbury Road, on the North by Westerham Avenue, the Great Cambridge Road and on the West by the Borough boundary with Southgate. The Area is essentially residential in character and contains 3817 houses, 96 commerical premises, 3 industrial premises and 17 other premises. Of the houses 143 are owned by the Borough Council, the Tottenham Council and the Huxley Estates also own a large number of houses, but the remainder are mainly owner-occupied. Thirty dwellings in Crown ownership are exempt from the Order and the St. David's Hospital also falls within this category; an assurance has already been received from the War Department that their dwellings will conform with the requirements of the Order. The commercial premises are almost entirely shops and the industrial premises are on the Oakthorpe Estate of the London Co-operative Society Limited and Diggins factory. The other premises include four schools, a church and church halls, a branch library and clinic. The Table set out above shows details of confirmed Smoke Control Orders. During the year 372 observations of industrial chimneys in the Borough were made by the Public Health Inspectors. - 32 - RODENT CONTROL Your Senior Public Health Inspector, as Of ficer-in-Charge, Rodent Control, reported as follows An Assistant Rodent Officer and two Operatives carry out rat and mice destruction under the general supervison of the Public Health Inspectors. Domestic premises are treated without charge and business premises on repayment. Wherever 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. Prevalence of Rates and Mice: Local Authority Dwelling Houses All other including Business and Industrial Total Properties inspected as a result of notification 34 849 53 936 Other properties investigated 12 3,013 47 3 ,072 Properties found to be infested Rats (a) Ma.jor infestations - - - - (b) Minor infestations 26 709 43 778 Mice (a) Major infestations - - - - (b) Minor infestations 2 39 12 53 Number of properties treated by Rodent Operators 28 748 55 831 Number of inspections 318 6,501 1,140 — 7,959 RAT DESTRUCTION IN SEWERS The Council's Rodent Operatives continued the treatment of sewers; private contractors previously carried out this work. They continued using "1080" poison in quarterly maintenance treatments. - 33 - DISINFECTION AND PISINFESTATION Number of journeys to collect bedding and spray verminous premises 76 Number of journeys to return bedding 72 Rooms disinfected after infectious disease 74 Rooms disinfected after Phthisis 1 Rooms disinfected after other cases 29 Rooms disinfected after vermin 94 Articles Bedding, clothing etc., disinfected after infectious disease 745 Bedding, clothing etc., disinfected after Phthisis Bedding, clothing etc., disinfected after other cases 1,628 Bedding, clothing, etc., disinfected after vermin 9 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 2,803. 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 504. Four Council properties and 38 other houses were found to be infested; the total number of rooms disinfected was 94. The whole of the work is carried out by the Department, the materials used being insecticides containing D.D.T. as a base. PET ANIMAL5 ACT, 1951 No new licences were granted during the year. Number on register at end of year 4 - 34 - INSPECTIONS The following tabular statement gives the number and the nature of the inspections made during the year:- DWELLING HOUSES Included in Clearance Areas 602 Individual Unfit (Sec. 16) 14 Unfit but capable of repair (Sec.9) 87 Closing Orders 18 Overcrowding/Permitted Numbers 159 Houses Let-in-Lodgings 24 Standard or Improvement Grants 621 Rent Act Applications 86 Complaints and Nuisances 2,584 Drainage 2,275 Water Closets 111 Yard Paving Water Supply 37 Dustbins 10 Infectious Diseases & Food Poisoning 289 Filth or Vermin 96 Well-Maintained Property FOOD PREMISES Bakehouses 46 Bakers Shops 35 Butchers Shops and Meat Preparation Premises 68 Canteens & Catering Premises 185 Fishmongers 19 Fried Fish Shops 18 Fruiterers and Greengrocers 50 Grocers and General Dealers 215 Market Food Vehicles and Hawkers 259 Public Houses and Clubs 65 Other Food Premises 59 Meat Inspection and Slaughterhouses 1 Other Food Inspection 133 Dairies and Milk Distributors 9 Ice Cream and Ice Lolly Samples 73 Milk Samples Other Food Samples 34 FACTORIES Factories with Mechanical Power 133 Factories without Mechanical Power 14 Other Premises/Construction Work 42 - 35 - SHOPS Routine Inspections 36 CLEAN AIR ACT Smoke Control Areas 3,506 Smoke Observations 372 Furnace Installations and Chimney Height 93 Air Pollution Measurement Recording 284 OTHER VISITS Offices etc 4 Moveable Dwellings 47 Places of Public Resorts and Entertainments 51 Offensive Trades Piggeries and Stables 3 Keeping of Animals including Poultry 6 Offensive Accumulations 131 Watercourses and Culverts 2 Unclassified Nuisances 124 Water Samples 5 Baths Water Samples 16 Schools 3 Rats and Mice Destruction 378 Noise Nuisances 30 Public Conveniences 254 Petroleum Licensing 269 Pet Animal Shops 5 Agricultural and Horticultural Premises - Interviews with Owners, Builders etc 304 Betting and Gaming Act, 1960 7 Rag Flock - Dangerous Building - Tips - Vehicles- Smoke Emission 27 Factory Estate - Sewer - - 36 - DEFECTS REMEDIED Roofs repaired 136 Gutters and rainwater pipes repaired 68 Brickwork or pointing repaired 29 Chimney stacks, etc., repaired or rebuilt 10 Yards or forecourts repaved or repaired 5 Drains examined, tested or exposed 385 Drains cleared, trapped or repaired 243 Drains reconstructed - Chambers inserted or built-up to ground level 9 Soil and vent pipes, new, fixed or repaired 22 W.C's repaired or improved 56 Flushing cisterns repaired or new fixed 18 Sink waste pipes repaired or new fixed 8 New sinks fixed 3 Drinking water cisterns covered, cleansed, repaired 1 Water fittings repaired 14 Water taken off main or restored - Internal walls 48 Ceilings repaired, cleansed, etc 39 Door frames repaired 10 Floors repaired 30 Floors ventilated 3 Dampness remedied 25 Gullies repaired 13 Dangerous fence 2 Sills repaired 16 Doorsteps repaired 5 Window frames or sashes repaired or renewed 63 Fireplaces, stoves repaired 3 Coppers repaired New dustbins supplied 6 Premises rat-proofed - Improper keeping of animals discontinued - Foul accumulations removed 11 Other nuisances abated 7 Moveable dwellings removed - New boiler house constructed - New boiler installed - Factory sanitary conveniences inspected - Factory sanitary conveniences improved 6 Factory other defects remedied 4 Petroleum installations - defects remedied 6 Petroleum installations tested - Smoke Abatement - boiler plants improved - Food Regulations - contraventions remedied 109 Internal doors repaired - - 37 - PETROLEUM (REGULATIONS) ACTS, 1928-1936 During the year 6 new licences and 112 renewals were granted by the Council. The following is a list of particulars of quantities etc., affected by these licences Petroleum Spirit 514,681 gallons Petroleum Mixtures 12,635 gallons Rubber Solution 100 lbs. and 800 gallons PLACES OF PUBLIC ENTERTAINMENT Fifty-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 Notification of the main Infectious Diseases are presented in tabular form below: TABLE A 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 76 19 - - - 1 7 10 49 7 1 - 1 - - Measles 169 - - 6 6 14 8 19 47 31 27 8 2 1 - Whooping Cough 14 - - 2 1 3 - - 5 1 - 1 1 - - Pneumonia 11 6 52 1 1 - - - 1 1 - 2 - 5 - Puerperal Pyrexia 96 - - - - - - - - - 12 68 16 - - Erysipelas 6 - - - - — - — - - - - 1 1 4 Food Poisoning 60 - - 1 5 2 2 3 10 6 3 9 4 13 2 Ophthalmia Neonatorum 2 - - 2 - - - - - - - - - - - Dysentery 658 5 - 18 30 32 46 59 206 73 20 108 36 24 6 The following table indicates the wards from which the various cases were notified: TABLE B Disease Bury Street Ward Church Street Ward Angel Road Ward Silver Street Ward North Mi ddx. Hospital Other Institutions Total Scarlet Fever 31 15 9 21 - - 76 Measles 24 57 54 34 - - 169 Whooping Cough 4 4 1 5 - - 14 Pneumonia 1 1 — 4 5 - 11 Puerperal Pyrexia - - - - 96 - 96 Erysipelas 3 1 2 - — — 6 Food Poisoning 16 27 3 14 - - 60 Ophthalmia Neonatorum 1 - - 1 - — 2 Dysentery 209 100 217 132 - — 658 - 38 - Scarlet Fever There was a moderate outbreak of scarlet fever in the early months of 1962. In the main the patients were schoolchildren. The under-10's were mainly affected and it will be seen that only about a quarter of the cases warranted removal to hospital. Measles 1962 was not a measles year, that is, there was no serious epidemic. It is interesting to note that there is an incidence of measles throughout life and it can still occur in middle-age. Whooping Cough The incidence of whooping cough has been much reduced by immunisation. It remains, however, a domestic nuisance, and often leaves enlarged and scarred tonsils behind. Pneumonia The cases notified are those of acute pneumonia, mainly lobar pneumonia, and as usual the main incidence is in the over-45's. Puerperal Pyrexia Ninety-six cases of puerperal pyrexia suggest that one birth in fourteen leads to some degree of infection. The majority of the notifications of puerperal pyrexia come from hospitals where, despite the many aseptic and antiseptic procedure used, the risk of infection is considerably higher than in a domiciliary confinement In Edmonton the risk to the baby appears to be higher in a hospital confinement than in a domiciliary confinement, but this may be due to the fact that the cases given priority for hospital admission are those where some degree of risk is expected. Erysipelas This remains a disease of the middle-aged and elderly and the numbers remain small. Ophthalmia Neonatorum Two cases is too many. However, two cases of ophthalmia neonatorum compared ninety-six cases of puerperal pyrexia indicate that the risk to the infant's eyes is fairly high and the prophylactic measures taken therefore are fairly effective. - 39 - Dysentery Practically all the cases were Sonne Dysentery. In the first day of the calendar year the main incidence was in two elderly schools, which have had dysentery outbreaks in the past. There was then a spread in the summer term to a new school within half a mile of one of the old schools although the incidence here was not severe. However, from this school the disease then spread to an old school just across the road and the spread in the old school was fast and wide. In Edmonton all children showing any signs of dysentery infection are notified even if there are no symptoms so that in Edmonton most of the dysentery ice-berg is above water. FOOD POISONING (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 - 6 - 6 Sal: Bredeney - 2 37 12 49 Sal: Bredeney 2 - 4 - 4 Sonne 1 - 3 - 3 Total: 6 2 50 12 62 Agent not Identified - - - - - (B) Single Cases Agent Number of Cases Total No. of Cases Notified Otherwise Ascertained Sal: Typhi-Murium 8 - 8 Sal: Bredeney 2 - 2 Total: 10 - 10 Agent not Identified - - - (C) Salmonella Infections, not Foodborne Salmonella (type) Outbreaks No. of Cases Single Cases Total No. of Cases (Outbreaks and Single Cases) Family Other (Outbreaks) Total: - - - - - 40 - Food Poisoning Forty-one of the cases notified and twelve otherwise ascertained should probably be regarded as part of a single outbreak due to Salmonella Bredeney. This appeared to run through the months of September and October, 1962. On the 4th and 5th September there was what at first appeared to be a family outbreak at a house in the north-west of the Borough. During the 4th and 5th September the father of the family and his three children, aged 2 to 6, suffered severe diarrhoea and abdominal pain. The most likely cause appeared to be a knuckle of bacon purchased from the local butcher which had been kept in the refrigerator until the next day and then eaten. The butcher's shop was investigated and samples of meat taken, but examination of staff was not insisted on at this stage. On the 9th September, however, a Metropolitan policeman who lived about four streets away began to suffer nausea, diarrhoea, vomiting and malaise. By the 16th September his symptoms had become extremely severe and his temperature was 104°F and the doctor was called in. He notified the case as one of suspected food poisoning. It was found that the other members of the family apart from the policeman's wife had suffered the same symptons although not so severely. The food eaten on the 8th September included ham from the butcher who had supplied the first family. Further meat samples were taken and found to be negative but faeces specimens were taken from the butcher and his staff and he and ten others were found to be infected. Four other families developed symptons and were found to be infected and in all 19 members of six families appeared to have been directly infected as a result of purchasing meat from this butcher. Food handling standards at the premises were so good, however, that it still seemed possible that staff might have been infected from the meat rather than the reverse. Dr. Galbraith of the Public Health Laboratory Service investigated the butcher's wholesale suppliers without result, but eventually found that ham he had purchased previous to the first case had been cooked for him by a firm in St. John Street, Clerkenwell. This firm was investigated and 2 of the six staff were found to be excretors of Salmonella Bredeney. The bacterium was also found in samples of cooked and raw meats. On the 23rd September a Greek lady working in a cafe in Hertford Road, Edmonton, reported to her doctor complaining of fullness of the stomach. A specimen of faeces showed Salmonella Bredeney. Eight other workers of this cafe and a cafe in the same ownership in the Edmonton Covered Market were found to be infected. All had eaten on the 6th or 7th September ham supplied by a wholesaler who had obtained it from the Clerkenwell firm. On the 12th and 13th October, two children living not far from the Covered Market fell ill with abdominal pains and headaches and nausea and were found to be Salmonella Bredeney excretors and on the 15th October a boy of 9 fell ill with vomiting and headaches and was also found to be Salmonella Bredeney excretor. The Medical Officer of Health of Finsbury sent me a list of the firms in Edmonton supplied by the infected wholesaler as soon as the matter came to his notice and these were all thoroughly investigated. One of these was found to be selling infected ham and the retailer himself was also found to be infected. He had, in fact, had symptons although he had not, as he should have done, notified me of this. Since the end of October there have been no cases of Salmonella Bredeney food poisoning in the Borough of Edmonton. - 41 - TUBERCULOSIS TABLE T(l) Age Periods New Cases _ Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 year - 1 - - - - - - 1-5 years 2 - - - - - - - 5-15 years 2 1 - 1 - - - - 15 - 25 years 2 3 - 2 - - - - 25 - 35 years 1 2 1 2 - - - - 35 - 45 years 1 7 - 1 - - - - 45 - 55 years 5 - - - - - - - 55 - 65 years 6 - 1 - - - - - 65 years upwards 3 - - 1 1 1 - - Totals: 22 14 2 7 1 1 - - In addition, 13 cases of Pulmonary Tuberculosis previously notified in other areas, moved to Edmonton. TABLE T(2) MALES FEMALES TOTAL Respiratory NonRespiratory Respiratory NonRespiratory Added to Register during 1962 34 2 20 7 63 Number of cases notified for the first time during the year 22 2 14 7 45 Number of cases restored to Register having been previously removed 2 - 3 - 5 Number of cases added to Register other than by formal notification 10 - 3 - 13 Removed from Register during 1962 42 4 47 9 102 Number of deaths from Tuberculosis Notified cases 1 - 1 - 2 Number of deaths from Tuberculosis - Non-notified cases - - - - - Number of deaths, other causes - Notified cases 9 - 3 - 12 Number of cases, left district, recovered etc. 32 4 43 9 88 - 42 - TABLE T(3) The non-respiratory forms of Tuberculosis notified were: Part of Body affected Males Females Kidney 1 3 Neck Glands - 2 Epididymitis 1 - Abdomen - 1 Groin - 1 TABLE T(4) The number of cases of Tuberculosis on the Register at the end of 1962 was: Males Females Total Pulmonary forms 661 461 1,122 Non-pulmonary forms 68 97 165 729 558 1,287 TABLE T(5) The corresponding figures at the end of 1961 were: Males Females Total Pulmonary forms 669 488 1,157 Non-pulmonary forms 70 99 169 739 587 1,326 TABLE T(6) Corresponding figures for previous years were: 1960 734 587 1,326 1959 746 610 1,356 1958 748 616 1,364 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 - 43 - Tuberculosis The number of cases on the Register continues to fall and the notifications of pulmonary tuberculosis are also falling. In 1957 the notifications rate was about 10% above that for the County of Middlesex, while in 1962 it was slightly lower than the County rate. The improvement is due to vigorous work by the local Chest Clinic and its staff, to case finding by the Mass X-Ray Unit and to the progress of the slum clearance and smoke control programmes. Examination of Table T.l shows that tuberculosis is still a risk throughout life and that B.C.G. vaccination has not entirely reduced the risk in the teens and twenties. Women tend to contract tuberculosis in early middle-age while in men it is more common in later years. Epidemic Vomiting In November 1962 there was an outbreak of epidemic vomiting at the Open Air School, Edmonton. 60 children were affected. Exclusion of all affected children for one week appeared to halt the epidemic and there has been no further instances of this disease in this school. Smallpox 3,681 International Certificates of Vaccination were issued by the Edmonton Health Department during 1962. This was in part a reflection on the smallpox outbreaks in London, Birmingham, Wales and Yorkshire. Influenza Vaccination Influenza vaccination was offered free to employees and staff and in October 312 people were vaccinated. There were at that time 1,100 employees and staff. Between the 1st November 1962 and 31st March, 1963, 21 of the 312 persons vaccinated suffered from respiratory disease while 128 of the 788 persons not vaccinated suffered from respiratory disease. The rate of respiratory disease in the unvaccinated was about twice that in the vaccinated. Judging by the medical certificates the protection against influenza was even better since 38 of the unvaccinated suffered from influenza and only 8 of the vaccinated. In 1962/63 there was, of course, an exceptionally severe winter and the protection given to the vaccinated was therefore particularly useful. - 44 - - 45 - IMMUNIZATION CARRIED OUT IN EDMONTON DURING 1962. Number of children who completed a full course of primary immunisation Number of children who received a secondary (reinforcing) injection (see (a)) Born in Years Diph- therij only Whooping Cough only Tetanus only Combined Diphtheris and Whooping Cough Combined Diphtheria and Tetanus Combined Diphtheria Tetanus and Whooping Cough Diphtheria only Whooping Cough only ret anus only Combined Diphtheria and Whooping Cough Combined Diphtheria and Tetanus Combined Diphtheria Tetanus and Whooping Cough (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) 1962 - - - 7 38 372 - - - - - - 1961 4 - 1 14 44 477 - - - - 2 44 1960 - - 2 - 3 27 - - 1 - 2 94 1959 - - 28 3 12 2 4 - - 4 11 1958 7 - 26 1 5 5 178 - - 4 22 22 19531957 61 _ 53 1 9 9 683 - 1 22 46 49 19481952 4 - 27 - 2 7 21 - - 3 2 4 TOTAL 76 - 137 23 104 909 884 4 2 29 78 224 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 1962, and of Smallpox and Poliomyelitis vaccination for the same year. NOTE: (a) i.e. subsequently to primary immunisation at an earlier age. VACCINATION AGAINST POLIOMYELITIS EDMONTON - Number of persons vaccinated. Under 1 year of age 1 year 2-19 years 20-29 years Others Total Salk - 1st injection 18 _ 1 3 5 27 Salk - 2nd injection 264 _ 250 178 295 987 Salk - 3rd injection 2566 Salk - 4th injection 465 Oral - 1st dose 468 _ 123 60 104 755 Oral - 2nd dose 398 _ 105 44 96 643 Oral - 3rd dose 385 _ 128 64 148 725 Oral reinforcing after 2 Salk injections 771 Oral reinforcing after 3 Salk injections 464 VACCINATIONS AGAINST SMALLPOX carried out in Edmonton during 1962. Age Persons Vaccinated or Re-vaccinated Re- Vaccination Vaccination Cases specially reported during the period Generalised Vaccinia Post vaccinal encephalomyelitis Deaths from complications of vaccination other than those in cols.(4) and (5) (1) (2) (3) (4) (5) (6) Under 1 218 - 1 642 1 2-4 579 54 5-14 1704 938 15 and over 3536 5175 Total 6679 6168 - 46 - MIDDLESEX COUNTY COUNCIL ACT, 1955 ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT: During 1962 eleven existing licences were renewed. COUNCIL'S EMPLOYEES During 1962 a total of 58 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, 16 were 'not at home' and 4 had already resumed dutv. Also during the year, the following medical examinations or assessments were made prior to appointment to permanent posts Medical examinations 34 Assessments without medical examinations 79 Medical assessments (not appointed) 74 FLUORIDATION During 1960 and 1961 the Council had from time to time pressed the Ministry of Health for a clear answer on the advisability of fluoridation of water supplies. It had, in fact, almost gone so far as to say that the Ministry should get on with it. When the report on the five years trial came up therefore, I immediately reported to the Public Health Committee and as a result of this, the Council decided to make their wholehearted support of a desire for fluoridation of the metropolitan water supply know to the Metropolitan Water Board and the Middlesex County Council. Fluoridation of the metropolitan water supply is still awaited but I feel sure that it is likely to be introduced before or at the latest at the end of 1965. The relevant part of my report to the Health Committee is as follows "in Watford, Kilmarnock and at Gualchmai part of Anglesey, the average number of carious teeth per child has been markedly reduced in the younger age groups, both absolutely and by comparison with the controlled areas. (The control areas were Sutton, Ayr and the other half of Anglesey). The proportion of children completely free from caries is substantially increased, and the proportion of children with ten or more carious teeth has been greatly reduced. In 1955/56 children aged 3 years had on an average in the study areas 3.8 carious teeth. In 1961, the average for this age group was 1.29 carious teeth. Corresponding figures for 4 year old children were 5.39 in the 1955/56 period and 2.31 in 1961 and for 5 year old children 5.81 in 1955/56 and 2.91 in 1961. Caries were reduced in 6 and 7 year old children but not to the same extent from 6.49 carious teeth on average to 4.81 carious teeth in the 6 year olds, and from 7.06 carious teeth to 6.05 carious teeth in 7 year olds." - 47 - The Research Committee has therefore reached the conclusion that no harmful effects from the addition one part per million fluoride to drinking water has been demonstrated by any of the extensive medical evidence which they collected and reviewed. In their opinion the general raising of the fluoride content in drinking water to this level is safe" The teeth act as the body's portcullis against its meals, and strengthening of the teeth strengthens the whole body, while weakening of the whole body weakens the teeth. I personally regard fluoridation of water as an important health matter as vaccination against poliomyelitis or as BCG vaccination against tuberculosis. It will save tens of thousands of children from torture and terror in the night. HEALTH EDUCATION Home Safety 'The disease of accidents' said Professor A.J.H. Raynes in 1961 'accounts for some 23,000 deaths in England and Wales every year'. 'Accidents occurring in the home account for over a third of all these deaths, injuries a little more than those incurred in some form of travel.' (About 2^ m. per year) A Home Safety Poster Competition was held in the Edmonton schools in the Autumn term of 1961, the subject of Fire Prevention. Each schoolboy or girl submitting a poster received a red and white ball pen bearing the slogan 'Fire.' Prevented^ 212 entries were received from 17 junior schools and one senior school and the best senior school poster and the best junior school pooster received a prize from the Council and also went on to compete in the County competition. The best poster from each school also received a prize and there were prizes given to highly commended entries. The prizewinners were presented with their prizes by the Mayor in the Council Chamber on the 13th February 1962. 2,000 copies of the fire prevention code had been distributed to the libraries and 2,000 copies to the Edmonton Trades Council and a home safety bulletin had been produced in the Health Department and sent to all school children. During 1962 Health Education was mainly background in nature on home safety. Posters were displayed on the dangers of gas and poisons and book marks were distributed to libraries. The libraries are now getting a little saturated with book marks. The report of the Royal College of Physicians of London on smoking in relation to cancer of the lung and other diseases 'Smoking and Health' came out in 1962 and every opportunity was taken to reinforce its impact. Posters were shown both on our own and commercial boards and the Librarian reluctantly accepted further book marks, leaflets and pamphlets, and advantage was taken of the Central Council of Health Education offer of a mobile team to talk particularly to the younger generation. It was decided to take the unit for eight school days and to deal with as many schools as possible in the time. The team reinforced and critically assessed - 48 - by the new Deputy Medical Officer of Health T.F.M. Jackson, visited the Edmonton junior and senior schools from the 21st to the 30th November, 1962. About 5,900 scholars heard for themselves the health hazards associated with smoking. Doctor Jackson reported on the teams visit as follows 'The lecturers employed flannelgraphs and demonstrated a specimen of lung removed in post mortem from a case of cancer of the lung. The film of a lecture by Doctor C.H. Wood of London University's Occupational Health Department was also used for children in the older age groups. Some of the facts and figures given are worth quoting. Each day 20 people are killed in road accidents in this country whereas 60 individuals die daily from cancer of the lung. Tobacco smoke contains a number of irritants some of which are carcinogens which have not only been isolated from the smoke but have actually produced cancer in experimental animals such as white mice. The irritants of the smoke are probably responsible for much of our bronchitis, which of itself accounts for 30,000 deaths annually. In 1930 of every million people who died, 35 died from cancer of the lung. In 1940, the figure had risen to 125 and in 1950, the figure was 275. In 1960 it had risen still further to 480 deaths per million. Each year as more and more people smoke, so the figures of deaths from this painful killer disease increase steadily. Surveys conducted in 16 countries including United Kingdom, United States of America over a period of 30 years show that of non-smokers, 1 in 300 will die of lung cancer. Of average smokers (10 cigarettes per day) 1 in 25 will die of lung cancer and of heavy smokers (those smoking 20 or more per day) 1 in 8 will die of lung cancer. Twenty cigarettes daily cost about £80 per year. Smokers are more likely to develop coronary artery disease. Smoking is also associated with the slow healing of stomach ulcers. From the smoke of 140 cigarettes an actual tar deposit can be distilled. Those who wish to uphold the cigarette as being in no way connected with lung cancer, attribute the rise in mortality from the disease to atmospheric pollution. However, while there is slightly more lung cancer in towns than in rural areas, countries such as Iceland is worth considering. The air there is very pure and virtually free from atmospheric pollution. Nevertheless with the introduction of tobacco to Iceland, the Icelanders began to show an increased incidence of lung cancer similar to the pattern in other cigarette smoking nations. - 49 - It is interesting to record that three quarters of all doctors have given up smoking. From 1956 to 1960, the cigarette manufacturers spent £38 m. on advertising while the Government spent only £5,000 on anti-smoking propaganda. It is impossible at this stage to forecast the long term success of the unit's visit to Edmonton. Nonetheless the interest shown by staff and scholars alike gives some indication that the speakers made a tremendous impact on all who heard them. Four schools have not been visited and Doctor Jackson subsequently paid very successful visits to them on his own. In 1963 a Smokers' Clinic was started in Edmonton and a number of our first clients had, we found, been sent by their children as a result of the talks in the schools. EDMONTON WELFARE ASSOCIATION AND THE CARE OF OLD PEOPLE Laundry Service This is carried out by the Borough Council as a disinfection Service. It is a Laundry Service for incontinent persons, and the majority of these patients are elderly. Collection and delivery are weekly or twice-weekly as required by the patient, and during 1962 6,477 articles were laundered. Twenty-two people were catered for at one time or another during 1962. Edmonton Welfare Association. The highlight of the Welfare Association's year was undoubtedly the move into Hollywood House in September 1962. The Borough Architect's staff made a remarkable job in transforming a rather utilitarian army type hut used by the Middlesex County Council for minor ailment clinics and consultant clinics into a very pleasant community centre for old people. The Work Centre was in the end replaced by a handicraft class which fulfilled the same purpose and the retirement clinic still awaits the benison of the Middlesex Local Medical Committee. Annual Report of the Association - 1062-63 In reviewing the work of the Association for the past year, there is constant evidence of the increased need of our services, and in paying its tribute to the magnificent work of the voluntary organisations, and in point of fact all the organisations affiliated to the Associations, we are sensible of the obvious truth that, without their co-operation and happy team work, which has been the symbol of our success, many of the present services would be seriously curtailed or cease to function. We have to report that the Association, and its method of working under a - 50 - model institution, continued to provide interest to a number of Local Authorities and we are always pleased to receive the many visitors who are sponsored through the National Old People's Welfare Council and the London Council of Social Service. It gives great pleasure to the Association to have this annual opportunity to thank the voluntary organisations for their magnificent work - The British Red Cross Society, Women's Voluntary Service, Toe H, Citizens' Advice Bureau, St. John Ambulance Brigade, and the growing interest of the Churches of all denominations. We also record our close and happy co-operation with the M.C.C. Area Welfare Department, Superintendent Health Visitor, M.C.C. No.l Area; Ministry of Pensions and National Insurance; National Assistance Board; Almoners of North Middlesex Hospital; League of Hospital Friends; local Doctors and the Officers and Staff of the Edmonton Borough Council. Through this generous measure of co-operation and willing help, 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. Some new friendships have been formed and new interests of lasting happiness. This is the measure and purpose of our work together, and with true humility we all can be proud of the results. Given hereunder is a brief report of the work of some of the services of the Association during 1962/63. (a) MEALS-ON-WHEELS SERVICE During the year 1962 the Meals Service delivered not less than 12,890 meals, this is slightly lower than the previous year, but the figures are never static. It is considered that the maximum capacity of the service is 1,000 meals per month, i.e. 12,000 per year, but we have never refused an emergency case. The Association offer a very sincere tribute to all the ladies of the Women's Voluntary Service on the Meals-on-Wheels Service. In the worst winter in living memory they never failed the old people they serve. On a number of occasions they had to walk over the snow and ice-bound streets to deliver the meal; and to Mrs. Everett, the Meals Organiser of the W.V.S., we offer a special tribute for her untiring work on this admirable service. We also offer our thanks to Mrs. Smith and her staff at the Town Hall Canteen, who prepare the meals, and the Council Transport Staff - Mr. C. Ball and Mr. R. Thompson for their help and co-operation. (b) ENTERTAINMENT AND RECREATION The Edmonton Borough, through the Municipal Entertainments Department, have continued to maintain a very comprehensive and most enjoyable programme of concerts to the Old People's Clubs. This year both Pymmes Park Club, and William Preye Club enjoyed this service. In addition, there have been the Special Old Tyme Dances, a great favourite, and on a number of occasions "House Full" notices have had to be put up; special concerts at the Summer Theatre in Pymmes Park, and the "high-light" of the year are the "All Star" Variety Concerts at the Regal and Granada. There have - 51 - been also free admission to Quiz Shows etc., and reduced prices at special Celebrity Concerts, and Edmonton Old People's Clubs took part in the All London Old People's Talent Contest. The Edmonton Borough Council, and the Staff of the Entertainments Department in particular, can be assured that the old people are very appreciative of these facilities, and we offer the Council our sincere thanks. (c) VISITING SERVICE A great deal of valuable work is being done by the Old People's Clubs; Red Cross; Toe H and other voluntary organisations in visiting sick house-bound old people. Many of these cases are referred to the Welfare Organiser by the National Assistance Board; Citizens Advice Bureau; Area Health Department and other agencies. The visit by a member of an Old People's Club may mean that ultimately the lonely old person will join the Club, and from this contact new friendships are formed of a lasting nature, and the problem of loneliness in that particular case is solved. (d) HOLIDAYS As in previous years, we have obtained all available information of "off Season" holidays, at a reduced price for old people, and this has been circulated to the Clubs, affiliated organisations and the press. There have been a greater number of personal enquiries and enquiries by post this year, from old people anxious to take advantage of these facilities. 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 this holiday with their friends. (e) INFORMATION AND ASSISTANCE The constant need for our services is shown most vividly in the number of people, both young and old., who seek information and assistance. The enquiries cover the whole range of our work in the field of social welfare, and we are conscious of the value of our team work as an Association, in that we are able to consult with each other to advise and assist these people with problems. For old people the major problem today is housing, and a special survey on the housing needs of old people in Edmonton would pin-point the problems of many old people in their need for "housing security". 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, affiliated organisations, doctors, press and other interested bodies. - 52 - (f) LIBRARY DELIVERY SERVICE Today there are 54 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, and the Borough Librarian will be happy to extend the service to all house-bound people of any age. (g) WELFARE FOOD SERVICE This year is again a record year in the sale of Welfare Foods to old people:Bovril - 2,919 jars; Ovaltine - 3,285 tins; Marmite - 1,057 jars, at a total sale value of £1,109. 6s. 3d. A new food - Horlicks - has been added to the service. The Association is deeply appreciative of the excellent work of Mrs. D.N. Dixon, Divisional Director, British Red Cross Society, Edmonton,and her staff for operating this service on behalf of the Edmonton Welfare Association. There is no doubt that the Welfare Foods Service, at cost price, makes a definite contribution to the health and well-being of the old people. The extension of this service by delivery of supplies to the Old People's Clubs on the day they meet, more especially during the recent winter months, was greatly appreciated and Mrs. Dixon and her staff can be assured that the extra work involved is very worth while. (h) HAIRDRESSING SERVICE The concessions offered by the Members of the Edmonton Branch of the London and Provincial Hairdressers' Association are greatly appreciated by the old people, who take full advantage of the reduced prices. This service is of special value to the ladies, as it has a real tonic effect. The offer of more help for domiciliary cases would be appreciated. In this field wonderful work is done by the Members of Toe H., but further help would be appreciated. (i) ALL-DAY CLUBS The William Preye Club. The constant success of the William Preye Club as a centre for elderly people is a proud tribute to the work of the Officers and Voluntary Wardens, all Members of the Club, which is acknowledged to be one of the best of its kind in the country. At the Annual General Meeting all the Officers were once again re-elected unanimously, which is a true indication of the happy atmosphere at the Club. The Club had a most successful Annual Outing and "end of the year" tea-party. As in previous years the Sale of Work, and Open Day were a great success, which - 53 - is only possible by the work of the ladies of the Serving Counter and the Weekly Whist Drive. The Club made its annual donation of £100 to the Edmonton Welfare Association towards the cost of running the Club, and they are hoping that this year they will see the start of the extension to the Club, for which they have invested £500 in Edmonton Corporation Stock towards furnishing and equipment. There is no doubt that the Club have had a very happy and successful year, and the Association would like to record its thanks and sincere appreciation of the valuable work of the Management Committee, Officers and Voluntary Wardens, and specially record its thanks to Mr. William Preye who, on his retirement from the Chairmanship, was made a Life President of the Club. Hollywood House - Pymmes Park Club. The Pymmes Park Club moved into its new premises in September, and was officially opened by His Worship the Mayor, Mr. Cr. J.E. Cooke, J.P., in the presence of a distinguished gathering of 140 people, on 27th October, 1962. In November a Special Service of Dedication was held by the Mayor's Chaplain - Rev. Edmonds - with clergy from local churches, Congregational Church, and Salvation Army assisting. The Club membership very swiftly rose from 65 members, about 60 men and 5 ladies, to 250 members, about 170 ladies and 80 men, within a few weeks, and the agreed maximum membership is 250, and there is now a waiting list with priority to applicants who are not members of any other old people's club. In January, 1963, His Worship the Mayor - Mr. Cr. J.E. Cooke, J.P., gave a tea-party at the Club for the school children and teachers to see the Club and meet the Members, and to thank them for raising the sum of £170 towards the cost of furnishing the Club and the Centre. There is no doubt that the Pymmes Park Club is an outstanding contribution to the well-being of the older people in the Borough of Edmonton, and our thanks are due to the Edmonton Borough Council for their generous financial help, which has made the conversion of the premises possible for so worthy a cause. A new development of the Club activities is the arrangement made with the Management Committee, Officers and Members of the Club to open the premises for an Evening Club - from May to September inclusive - Tuesdays to Fridays from 6 p.m. to 9 p.m., at a charge of 1d. per visit. On the first evening the Club had 40 visitors, and there is no doubt that with its beautiful setting in Pymmes Park the Club will be a major attraction for the older citizens who visit the Park. The other activities at Hollywood House are:- (i) Foot Clinic for Old People. This Foot Clinic, operated by the Edmonton Branch of the British Red Cross Society, is to be designated - 54 - as a gift from the school children of Edmonton, who raised the bulk of the money for the equipment and furnishing, and a suitable plaque will be placed in the Waiting Room. The first session of the Clinic started on the 26th March, and the service is of special benefit to old people living in the southern part of the Borough. (ii) Retirement Medical Clinic. It is hoped to use the Clinic as a Retirement Medical Clinic for old people, for four days per week, and active consideration is being given to this project by the Honorary Secretary, Dr. D.A. Smyth, and the Deputy Medical Officer of Health, Dr. T.F. Jackson. (iii) Work Centre. With the completion of the alterations and furnishings it is hoped that the Work Centre will commence early in July. The primary purpose of the Work Centre will be to provide "occupational therapy" for the older people recommended to the Work Centre from the Medical Retirement Clinic. Gentle exercise is of paramount importance to old people, and through the Work Centre, apart from any other advantages, this would be an ideal place to start such exercises. (j) FOOT SERVICE The Foot Service Clinics operated by the British Red Cross Society, Edmonton, on alternative Mondays at the William Preye Club and the Red Cross Headquarters, continue to provide an essential service to the old people who need chiropody treatment. During the year under review, the Foot Clinics gave no less than 1,295 treatments, and 111 domiciliary visits. The number is growing rapidly with the opening of the new Foot Clinic at Hollywood House, Pymmes Park. Quite a large number of cases were brought to the Clinics by the Red Cross Ambulance. It is imperative that old people with foot ailments should have early treatment, and it is the courtesy and efficiency of this service which has earned the British Red Cross Society, Edmonton, the gratitude of its patients. As a token of appreciation for the special services given by the Red Cross to old people, the Edmonton Welfare Association have made a grant of £125 to the British Red Cross Society, Edmonton. (k) PUBLIC BATHS - RED CROSS SERVICE TO THE ELDERLY AND INFIRM The British Red Cross have continued to provide both a Male and Female Nurse each week at the Public Baths, Knights Lane, Edmonton, N.9, to assist elderly people and infirm old people attending the Slipper Baths. The Edmonton Borough Council have provided special safety rails in two baths, which are greatly appreciated. Further publicity of these facilities which are available would be appreciated at Old People's Clubs, whose members have difficulty, owing to age or infirmity, in having a bath. - 55 - (1) OTHER SERVICES AND ACTIVITIES (1) Radio Repair Service. This excellent work is now operated by Martin's Radio Ltd., Edmonton, and we are grateful to Mr. Jolly and his staff for their unfailing help and kindness in the repair of radio sets for old people. (2) Easter Gifts and Harvest Festival Gifts. The Association are grateful to the school children and their parents, for the wonderful array of eggs, fruit flowers, vegetables, groceries etc., which they send us for distribution to the old people. The many letters of thanks received at the schools show how much the old people appreciate the kindly thoughts of the young people. (3) "Budgies" for Lonely Old People. This is a new scheme that has already brought happiness to a number of lonely old people through the kindness of the members of the Edmonton Cage Birds' Scoiety. In thanking the Society for their generous gifts, we also thankthe kind people who sent us cages• (4) Gas Cookers for Handicapped Persons. In co-operation with the Eastern Gas Board, The Broadway, Edmonton, we have dealt with a number of applications for a special type of gas cooker for handicapped old people. This is a first class scheme with little or no cost to many of the old people, and its importance should be more widely known. (5) Gifts of Material to Sewing Corner. Peggy Page Limited, and Gor-Ray Limited, have been most generous in sending off-cuts of material for the Sewing Corner at the William Preye Club, and we offer them our special thanks. (6) Visits: Visitors & Lectures. The Association have received, during the year, a number of visitors sponsored through the London Council of Social Service and the National Old People's Welfare Council. We remember especially the visitors from Edmonton, Canada; the young foreign students; the County Secretaries on a special training course, the Mayor and Mayoress of Finsbury, with the Town Clerk and Medical Officer of Health. The Welfare Organiser has also given a number of lectures, by invitation, on the work of the Association. CONCLUSION The Association, working through the Executive Committee, can be justly proud of its achievements during the past year. With its wide representation of interests, in the field of social welfare, they know of the need for these services in the Borough of Edmonton, and their importance for the social wellbeing 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 - 56 - rightly earns the place it has achieved 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 f Association for their assistance 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. 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. - 57 - EDMONTON WELFARE ASSOCIATION EXECUTIVE COMMITTEE 1962-63 EDMONTON BOROUGH COUNCIL His Worship the Mayor - Mr, Coun. J.E. Cooke, J.P. (Chairman). Deputy Mayor - Mr. Coun. E.J.C. Smythe. Alderman J.A.G. Beattie. Alderman T.H. Joyce. Alderman E.S. Taylor. Councillor Miss K. Harvey. Councillor Mrs. P.L. Hawkins. Councillor Mrs. I. McNern. VOLUNTARY ORGANISATIONS TOC H. - Mr. G.W. Knight. BRITISH RED CROSS SOCIETY - Mrs. D.M. Dixon - Divisional Director. WOMEN'S VOLUNTARY ORGANISATIONS - Mrs. M. Prescott - Centre Organiser. ST. JOHN AMBULANCE BRIGADE - Mr. R. C. Howard - Divisional Superintendent. OLD PEOPLE'S CLUBS - Mr. L. Nippress. CHURCHES - Rev. Eric Rees. CITIZENS ADVICE BUREAU - Mr. B. Goddard, M.B.E. ROTARY CLUB OF EDMONTON - Mr. E.W. Butterworth. CO-OPTED MEMBERS: Miss S.J. Briggs - Superintendent Health Visitor M.C.C. No.l Area. Mrs. E. Everitt - W.V.S. Meals Organiser. Mr. H.B. Heafield - M.C.C. Area Welfare Officer, Enfield. Mr. C.G. Richman, B.A., - Chairman Local Committee N.A.B. Coun. Mrs. Rita Smythe. Miss Dorothy M. Oswald. VICE PRESIDENTS Mr. A.J. Hollywood. Mr. Howard S. Watts. OFFICERS Honorary Secretary - Dr. D.A. Smythe , Medical Officer of Health. Honorary Treasurer - xMr. C.G. Gadsby, Borough Treasurer. Honorary Architect - A. Wilkinson, Esq., A.R.I.B.A., Borough Architect. Welfare Organiser - Mr. W.J. Sherwood, M.I.W., Welfare Officer. EDMONTON BOROUGH COUNCIL - 58 - CONCLUSION 1962 with all its ups and downs beginning with smallpox and ending with fog and frost was a successful year for the Edmonton Health Department. I would like once again to pay tribute to all the staff in the Department. First I would like to thank the two Deputy Medical Officers of Health, Doctor Sasieni who cheerfully put in a three months stint before going on to the Central Council for Health Education in order that I might take a sorely needed summer holiday and then Doctor T.F. Jackson who started working like a dynamo the moment he came to the Health Department and has been working ever since. I would again like to thank Mr. Rawlinson, Senior Public Health Inspector for a further enthusiastic and industrious year's work and Mr. Nash my Senior Clerk whose burden was greatly increased during the time from January to June when there was no Deputy Medical Officer of Health. As the report of the Welfare Association indicates, Mr. Sherwood, the Welfare Organiser also put in a very hard and effective year's work. Many thanks however, are due to all members of the staff including the Public Health Inspectors, the Drivers, the Rodent Operatives, Shops Inspector and all the office staff. I am very grateful for their efforts. I must also thank the Chairman and Members of the Public Health Committee, the Mayor and all Members of the Council for their advice and help and thank the other chief officers and their departments for the co-operation given to the Public Health Department. Lastly, I would like to thank the public for their co-operation, for if the public did not co-operate with us, we should not get very far. I have the honour to be, Your Worship, Ladies and Gentlemen, D. A. SMYTH. Medical Officer of Health. - 59 - Printed and Published by the Edmonton Borough Council Town Hall, Edmonton, N.9.