EDM 48 Borough of Edmonton ANNUAL REPORT 1963 of the Medical Officer of Health for the year 1963 Borough of Edmonton ANNUAL REPORT 1963 of the Medical Officer of Health for the year 1963 BOROUGH OF EDMONTON 19 6 3 His Worship the Mayor Councillor E.J.C. Smythe, J.P., Deputy Mayor Alderman C.G. Lacey. PUBLIC HEALTH COMMITTEE Chairman: Councillor Mrs. R.A. Smythe Vice-Chairman: Councillor M. Kahn Members: THE MAYOR (Councillor E.J.C. Smythe, J.P.) (Ex Officio) THE DEPUTY MAYOR (Alderman C.G. Lacey) (Ex Officio) Alderman Mrs. F. Long, J.P., Councillor J.E. Cooke Councillor E.C. Francis Councillor J.E. Lightfoot Councillor Mrs. I.F. McNern Councillor E.G. McNern 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 Thomas F.M. Jackson, L.R.C.P., L.R.C.S., L.R.F.P. & S., D.P.H., Senior Public Health Inspector; A.B.C.D. G. Rawlinson Public Health Inspectors: A.C. J.G. Cummins A.C. G.F. Bateman (left 8.9.63) A.C. M.C. Elkington (commenced 1.11.63) A.C. D.J. Faithfull A.C. A.V. Frisby (commenced 6.8.63) A.B.C. L.C. Hibbs A.B.C. D.G. Ring (left 23.6.63) A.B.C. J.V. Kaye A.C. H.J. Kemp Trainee Public Health Inspectors; R. Taylor A.J. Westney (commenced 12.12.63) Senior Clerk; A. F.J. Nash Clerical Staff; C.S. Clark Mrs. E.J. Richards Mrs. N.E. Young Miss I. Bowie A.J. Westney (until 11.12.63) B.T. Barnett R.N. Richards Miss C. Beardwell (Administrative Trainee) (commenced 18.9.63) C. Langford (commenced 23.9.63) 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 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, 1963 was the year of the long hard winter and such a winter always takes a heavy toll in respiratory disease. Deaths from pneumonia were almost double and those from bronchitis rose by almost a sixth. It is possible that the severe winter may have contributed to the increased infantile mortality, since small babies, particularly premature babies, are very susceptible to chill. The summer of 1963 was notable in Edmonton for an outbreak of food poisoning, originating from a baker's shop. The number of persons at risk seemed likely to be the same as those at risk somewhat later in Aberdeen through shopping at a supermarket, but the number of cases in Edmonton was very much less. This was mainly because typhoid fever has a long incubation period, while food poisoning by Salmonella Typhi-murium has a relatively short one. The alarm sounded earlier in Edmonton therefore, and we were able to begin our detective work earlier and control our epidemic more speedily. In 1963, as I mentioned in the 1962 report, we followed up the visit of the Central Council of Health Education team on the subject of smoking and health, with talks in the schools they had not been able to visit, and a Smokers Advice Clinic for adults. The Smokers Advice Clinic was a pilot project and though it had only moderate success, provided the ground work for a more enlarged and elaborate clinic in 1964, which proved very successful. The male cancer rate in Edmonton remained more or less stationary, and it is possible that the dangers of the cigarette are being appreciated in Edmonton. Pulmonary Tuberculosis reached a low ebb in Edmonton in 1963. Only fifteen cases were notified, a notification rate of .166 per thousand population. This is about half the rate for the County of Middlesex, and is also below the national rate of 1963. In part it reflects the improving social conditions in Edmonton, as a result of slum clearance and redevelopment; in part it reflects the pursuit of cases and contacts by the Health Department and the Chest Clinic. It remains a very positive achievement. However, another old enemy is looming large on the public health scene. This enemy is bronchitis, the "English disease". The bronchitis death rate in women was doubled in Edmonton in 1963, and it is evident that a large part of the population is not yet sturdy enough to withstand a really ferocious winter. In men, the bronchitis rate measured by deaths fell slightly, but the pneumonia death rate was doubled, and in women the pneumonia death rate was increased by two-thirds. The very old over 85 suffered as might have been expected, but there was an increase in respiratory death rates in almost all above the age of 45. The very young suffered also, eight of the infant deaths being attributed to pneumonia. 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 1963 90,770 Number of inhabited houses and separate dwellings at the end of 1963 30,834 Number of inhabited houses and separate dwellings at the end of 1962 30,548 Rateable value, April 1963 £5,339,230 Estimated product of 1d. rate in the £ for the year ending 31st March, 1964. £21,300 Rate in the £ for the year ending 31st March, 1964. 7s. 10d. TABLE II VITAL STATISTICS M. F. Total Grand Total Live Births Legitimate 631 628 1,259 1, 333 Illegitimate 35 39 74 (Percentage of live births) 5.55 Birth rate per 1,000 population 14.68 Corrected birth rate 15.12 Still Births Legitimate 8 3 11 Illegitimate - - - 11 Still birth rate per 1,000 total live and still births 8.18 Deaths Number 511 529 1,040 Rate per 1,000 population 11.45 Corrected death rate per 1,000 population 11.90 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 18.20 17.30 12.20 20.90 Middlesex (Crude) 17.60 15.00 11.40 18.70 Edmonton (Crude) 14.68 8.18 11.45 24.00 Edmonton (Corrected) 15.12 11.90 — INFANTILE MORTALITY It is a sad truth that for many years to come some babies will die before the age of 1 year every year. Sometimes we take statistics for granted; perhaps a quotation from that well-known publicist Paul De Kruif may illuminate the statistics. "I was told that when you begin to be bothered by the passing away of children who don't have to die, your worry may be assuaged by biometrics. My friend, the distinguished biometrician Dr. Raymond Pearl of the Johns Hopkins, proved to me that this parade of more and more little white caskets has its bright side. Dr. Pearl was such a physically huge man and so judicious in talking, that he made you believe him. He pointed out that biometric science only concerns itself with the fate of the human race as an animal species. Forget that those little white coffins hold somebody's hopes, somebody's baby son or daughter, or brother or sister. That is sentiment, but not science. Didn't I realise that it has been proved by slide-rule biometric science, that when you cut down the dying of small babies, if those babies hadn't died when they were very tiny, then more of their cohort born that year would be sure to perish in the years to follow. You only postpone the job of the undertaker by cutting down infant mortality. "Did this hold for older children as well? I dug back into Michigan records of young lives that had begun in the boom days. Here were three miserable little brothers. They had been born in 1922, 1924, 1926, amid the bull market uproar when Detroit promised to be permanently hard, bright and dynamic. We probed into the lives of these three little boys in 1928. They were certainly not fit to keep living. Their father was a victim of paresis; their mother had broken down with dementia-praecox. If you had entered the shack where these three wan waifs lived you would have found the spindly legged rickety boys gnawing at crusts of mouldy bread. "Now it is 1930 and the three little boys must surely be dead because of their deplorable heredity. Now they have the luck to come to the notice of the Children's Aid Society of Detroit, which has money to help maybe one out of every thousand children who are forlorn. When found by the Aid Society, the three little boys had the colour of fungi. If saved now, they would surely die later. But the workers of the Children's Aid Society were ignorant of biometrics. "Now it is 1934 and when you see these youngsters you would swear they were not the same children at all. They live on a farm in the care of a foster mother and father. They raise garden crops on their own plots of ground. They are hungry all the time, but it is from fishing and swimming in the summer and sliding downhill in the winter, and they have all the milk, meat, green vegetables, and eggs their stomachs can hold. The kindness of their foster parents has built this food into their straight, strong, tanned bodies. Who is going to say they will die next year because they were saved three years ago." Paul De Kruif - The Sweeping Wind. There were 32 deaths of infants in Edmonton in 1963 and possibly there need not have been so many deaths. Twenty-five of the children who died were born in hospital, 7 at home. However, more of the children who survived were born in hospital, and actually 889 babes were born in hospital, and 444 born at home. The death rate of the hospital babies is therefore not quite twice that of the home babies, not more than three times the whole rate as might appear at first sight. At present the shortage of hospital beds is such that only those mothers whose pregnancies are risky or likely to be risky, can be admitted to hospital,and it may be therefore that the lower death rate of the home babies is more of a tribute to the selection of mothers for hospital confinement than a condemnation of the care they are given in hospital. TABLE IV Infant Mortality (Legitimate) 25.41 (Illegitimate) NIL Total 24.00 Neo-Natal Mortality 19.50 Early Neo-Natal Mortality 14.25 Peri-Natal Mortality Rate (Stillbirths and deaths under 1 week conbined per 1,000 live and stillbirths) 22.32 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 Gastro-Enteritis - 1 1 - 2 - - - - 2 Pneumonia - 1 - 1 2 - 1 - - 3 Premature Birth 4 - - - 4 - - - - 4 Congenital Malformations 3 - - - 3 1 2 - - 6 TOTALS : 7 2 1 1 11 1 3 - - 15 TABLE VI FEMALES Causes of Death WEEKS Total in 1 Month MONTHS Total under 1 Yr. 1 2 3 4 1-3 3-6 6-9 9-12 Congenital Malformations 2 - 1 - 3 1 - - - 4 Asphyxia Neonatorum 4 - - - 4 - - - - 4 Premature Birth 1 - - - 1 - - - - 1 Hydrops Foetalis 1 - - - 1 - - - - 1 Pulmonary Atelectasis 2 - - - 2 - - - - 2 Pneumonia 2 2 - - 4 - - - 1 5 TOTALS: 12 2 1 - 15 1 - - 1 17 Tables V and VI give the causes of death in detail. Only those deaths listed from congenital malformation were regarded as completely unavoidable. The other conditions which led to death might possibly have been alleviated or prevented had circumstances been different. VITAL STATISTICS General: There were 31 more deaths in 1963 than 1962, an increase of about 3%. The crude death rate increased by .42 per thousand the corrected death rate by .21 per thousand. There was a slight fall in the birth rate, and a marked fall in the still birth rate. The number of illegitimate births went down both absolutely and in relation to total births. Cancer of the Stomach: There were 29 deaths from cancer of the stomach in 1962, 28 deaths in 1963. Again more men died from this disease than women, but it is not possible to say whether the contributory factor was smoking, the consumption of alcohol or some other irritant or irritants. Cancer of the Lung and Bronchus: There is little increase in the number of male deaths from this disease - 66 in 1962, 67 in 1963. Deaths in women rose from 6 to 11, and it seems probable that the lung cancer death rate will increase from now on more sharply in women than in men. There is now no doubt that the main contributory factory to the development of cancer of the lung or bronchus in this country is cigarette smoking, with air pollution by other forms of smoke playing a much slighter subsidiary part. About half of these patients die before the age of 65. I am reasonably certain that at least 30 of them kill themselves by smoking cigarettes. Cancer of the Breast: I said that in 1962 this disease seemed to be coming slightly less common in Edmonton. The number of deaths has in fact fallen from 29 in 1961, to 12 in 1963. Cancer is not winning every battle. Cancer of the Uterus: Though no screening programme has yet been offered to the women of Edmonton, deaths from this disease are also showing a slight fall. Figures for the last three years are 1961 - 11, 1962 - 7, 1963 - 6. Leukaemia: At last there is a fall in the deaths from this disease. There was only 4 deaths from leukaemia in 1963 as against 9 in 1962. Diabetes: Deaths from diabetes was doubled, but only from 5 to 10. The 5 extra deaths were in women. Diabetes remains a weakening disease though most diabetics can lead a normal life. More research in the causes of diabetes are required. Only one infective cause so far, being incriminated: the virus of mumps. This is not, however, thought to be the usual or main cause, and the field for speculation, investigation and discovery remains wide open. Vascular Diseases of the Nervous System: The number of deaths in men from this group of diseases has fallen somewhat from 45 to 36, while the number of deaths in women rose from 64 to 69. The main increase was in women between the ages of 65 and 75. Coronary Disease: Here again there is an increase in the deaths in women. Possibly cigarette smoking is playing a part here, possibly women are eating more. The increase in deaths was both in the 45 to 55 group of women, and in the 65 to 75 group for men. The ratio for men to women dying from coronary disease is now in Edmonton 4 to 3, compared with 2 to 1 in previous years. Hypertension with Heart Disease: A slight non-significant rise in deaths from 15 to 17. Once again however, there is a fall in deaths in men and a rise in deaths of women. Other Heart Disease: This is of course, an omnibus classification, and analysis is difficult. For the record deaths were 152 in 1961, 151 in 1962, 117 in 1963. Many of the form of heart disease classified under this heading have an infectious origin and there has been a marked reduction in infections in the past 20 years in Edmonton. This must have undoubtedly contributed to the reduction in heart disease. Other Circulatory Disease: The deaths from this cause have remained at about the usual level with a total of 52 deaths as against 49 in 1962 and 45 in 1961. The increase is again in female deaths. Influenza: There were four more deaths from influenza in women in 1963, but influenza does not rank high as a cause of death. It can, however, be a serious contributory factor, and many of the deaths from pneumonia were from influenzal pneumonia. Pneumonia: The deaths from pneumonia were almost doubled. There were only 52 deaths from pneumonia in 1962. The bitter weather of the first quarter of the year undoubtedly played a part in reducing resistance to this disease particularly in the over 70's. Bronchitis: There was an increase in the bronchitis death rate, though it was not as marked as the increase in the pneumonia rate. Actually all the deaths were in the age group 55 and over. Peptic Ulcer (Ulcer of the stomach and duodenum). There was a large reduction in deaths from this cause, though it remains a very common disease its incidence seems to be decreasing. Nephritis Nephrosis: There was a slight increase in deaths from this cause. Since these are slowly progressing diseases, mainly triggered off by infection, it is difficult to isolate the past factor responsible for this increase. Accidents: No deaths from burning were reported, but falls and coal gas poisoning continued to kill at home, and there are still deaths from industrial accidents. There were 9 home accidents, 9 road accidents, and 2 industrial accidents which caused death. In 1963 road and industrial accidents were more serious, and caused loss of life in the middle years. TABLE VII ACCIDENTS VIOLENT DEATHS 1963 - (Excluding Road Traffic Accidents). Date Sex Age Cause Verdict 5. 9.63. M 49 Electrocution Accidental 22. 7.63. M 62 Aspirin Poisoning. Open 1. 7.63. M 57 Struck by falling jib of crane. Misadventure 27. 2.63. M 74 Coal gas poisoning. Accidental 15. 1.63. M 81 Fall downstairs. Misadventure 3. 4.63. F 60 Fall. Accidental. 26. 5.63. F 77 Fall at home. Accidental. 24. 8.63. F 78 Fall from chair. Accidental. 4.12.63. F 80 Coal gas poisoning. Accidental. 23. 2.63. F 88 Fall at home. Accidental. 25. 8.63. F 89 Fall at home. Accidental. TABLE VIII DEATHS BY AGE-GROUPS (30.12.62 - 28.12.63) 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 4 - - - - - - - - - 2 2 - Tuberculosis, other - - - - - - - - - - - - - Syphilitic disease 1 - - - - - - - - - 1 - - Diphtheria - - - - - - - - - - - - - Whooping cough - - - - - - - - - - - - - Meningococcal Infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective and parasitic diseases - - - - - - - - - - - - - Malignant neoplasm, stomach 26 - - - - - 1 1 1 5 8 10 - Malignant neoplasm, lung, bronchus 78 - - - - - - 1 8 28 27 13 1 Malignant neoplasm, breast 12 - - - - - - 1 2 3 - 3 3 Malignant neoplasm, uterus 6 - - - - - - 3 1 - 1 1 — Other malignant & lymphatic neoplasms 81 - 1 - 1 2 3 1 7 23 16 21 6 Leukaemia,aleukaemia 4 - - - 1 - - - - 1 2 - - Diabetes 10 - - - - - - 1 - 1 3 5 - Vascular lesion of nervous system 106 - - - — 2 - - 4 15 34 44 7 Coronary disease, angina 202 - - - - - - 3 17 62 48 53 19 Hypertension with heart disease 17 - - - - - - 1 - - 3 4 9 Other heart diseases 120 - - - - - 2 1 4 4 12 50 47 Other circulatory disease 50 - - - - - - 1 1 6 15 20 7 Influenza 5 - - - - - - - - - - 2 3 Pneumonia 103 8 1 - - - 1 - 2 11 18 36 26 Bronchitis 76 - - - - - - - 2 10 28 28 8 Other disease of respiratory system 7 - - - - 1 - 1 1 - - 3 1 Ulcer of stomach & duodenum 4 - - - - - - - 1 - 1 1 1 Gastritis, Enteritis &Diaorhoea 4 2 - - - - - - - - - 2 - Nephritis and nephrosis 8 - - - - - 1 1 - 3 — 2 1 Hyperplasia of prostate 2 - - - - - - - - - - - 2 Pregnancy, childbirth, abortion - - - - - - - - - — — - - Congenital malformations 16 10 - - 1 - 1 2 2 - - - — Other defined and ill-defined diseases 65 12 - 1 - - 1 5 6 12 9 12 7 Motor vehicle accidents 9 - - - - 1 1 - - 2 2 3 - All other accidents 11 - - - - - - - 1 3 1 4 2 Suicide 6 - - - - - 1 - 1 - 4 - — Homicide and operations of war - - - - - - - - - - - - - TOTALS 1033 32 2 1 3 6 12 23 61 189 235 319 150 TABLE IX DEATHS BY SEX-GROUPS (1.1.63 - 31.12.63) Cause of Death M F Total Tuberculosis, respiratory 4 _ 4 Tuberculosis, other - - - Syphilitic disease 2 - 2 Diphtheria - - - Whooping Cough - - - Meningococcal infections - - - Acute poliomyelitis - - - Measles - - - Other infective and parasitic diseases - - - Malignant neoplasm, stomach 17 11 28 Malignant neoplasm, lung, bronchus 67 11 78 Malignant neoplasm, breast - 12 12 Malignant neoplasm, uterus - 6 6 Other malignant and lymphatic neoplasms 39 42 81 Leukaemia, aleukaemia 2 2 4 Diabetes 2 8 10 Vascular lesions of nervous system 36 69 105 Coronary disease, angina 119 79 198 Hypertension with heart disease 5 12 17 Other heart disease 32 85 117 Other circulatory disease 20 32 52 Influenza 1 4 5 Pneumonia 45 53 98 Bronchit is 51 26 77 Other diseases of the respiratory system 7 3 10 Ulcer of stomach and duodenum 2 5 7 Gastritis, Enteritis and Diarrhoea 2 2 4 Nephritis and nephrosis 6 2 8 Hyperplasia of prostate 2 - 2 Pregnancy, childbirth, abortion - - - Congenital malformations 11 5 16 Other defined and ill-defined diseases 22 51 73 Motor vehicle accidents 8 1 9 All other accidents 5 6 11 Suicide 4 2 6 Homicide and operations of war - - - TOTAL 511 529 1,040 TABLE X MALES - DEATHS by AGE-GROUPS (30.12.62 - 28. 12.63) 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 4 - - - - - - - - - 2 2 — Tuberculosis, other - - - - - - - - - - - - - Syphilitic disease 1 - - - - - - - - - 1 - - Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - Acture Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective & parasitic diseases - - - - - - - - - - - - - Malignant neoplasm, stomach 15 - - - - - - 1 - 3 6 5 - Malignant neoplasm, lung, bronchus 67 - - - - - - 1 8 23 25 10 - Other malignant and lymphatic meoplasms 39 - 1 - - 1 3 1 3 8 8 12 2 Leukaemia, aleukaemia 2 - - - 1 - - - - - 1 - - Diabetes 2 - - - - - - - - - - 2 - Vascular lesions of nervous system 37 - - - - 2 - - 3 5 9 16 2 Coronary disease, angina 122 - - - - - - 3 15 47 27 19 11 Hypertension with heart disease 5 - - - - - - 1 - - 2 1 1 Other heart diseases 33 - - - - - 1 - - 2 5 15 10 Other circulatory disease 18 - - - - - - 1 1 2 7 6 1 Influenza 1 - - - - - - - - - - 1 - Pneumonia 48 3 - - - - - - 2 7 8 15 13 Bronchit is 48 - - - - - - - 1 9 19 16 3 Other disease of respiratory system 4 - - - - 1 - - 1 - - 2 - Ulcer of stomach and duodenum 2 - - - - - - - - - 1 1 - Gastritis, Enteritis & Diarrhoea 2 2 - - - - - - - - - - - Nephritis and nephrosis 6 - - - - - 1 1 - 2 - 2 - Hyperplasia of prostate 2 - - - - - - - - - - - 2 Pregnancy, childbirth, abortion - - - - - - - - - - - - - Congenital malformations 11 6 - - 1 - 1 1 2 - - - - Other defined and ill-defined diseases 22 4 - - - - 1 3 3 4 2 2 3 Motor vehicle accidents 8 - - - - 1 1 - - 2 2 2 - All other accidents 5 1 2 1 1 - Suicide 4 - - - - - - - - - 4 - - Homicide and operations of war - - - - - - - - - - - - - TOTALS 508 15 1 - 2 5 8 13 40 116 130 130 48 TABLE XI FEMALES - DEATHS BY AGE GROUPS (30.12.62. - 28.12.63.) Causes of Death 1 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 - - - - - - - - - - - - - Tuberculosis, other - - - - - - - - - - - - - Syphilitic disease - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Other infective and parasitic diseases - - - - - - - - - - - - - Malignant neoplasm, stomach 11 - - - - - 1 - 1 2 2 5 - Malignant neoplasm, lung,bronchus 11 - - - - - - - - 5 2 3 1 Malignant neoplasm, breast 12 - - - - - - 1 2 3 - 3 3 Malignant neoplasm, uterus 6 - - - - - - 3 1 - 1 1 - Other malignant and lumphatic neoplasms 42 - - - 1 1 - - 4 15 8 9 4 Leukaemia, aleukaemia 2 - - - - - - - - 1 1 - - Diabetes 8 - - - - - - 1 - 1 3 3 - Vascular lesions of nervous system 69 - - - - - - - 1 10 25 28 5 Coronary disease, angina 80 - - - - - - - 2 15 21 34 8 Hypertension with heart disease 12 - - - - - - - - - 1 3 8 Other heart diseases 87 - - - - - 1 1 4 2 7 35 37 Other circulatory disease 32 - - - - - - - - 4 8 14 6 Influenza 4 - - - - - - - - - - 1 3 Pneumonia 55 5 1 - - - 1 - - 4 10 21 13 Bronchitis 28 - - - - - - - 1 1 9 12 5 Other disease of respiratory system 3 — - - - - - 1 - - - 1 1 Ulcer of stomach and duodenum 2 _ - - - - - - 1 - - - 1 Gastritis, Enteritis and Diarrhoea 2 - - - - - - - - - - 2 — Nephritis and nephrosis 2 - - - - - - - - 1 - - 1 Hyperplasia of prostate - - - - - - - - - - - - - Pregnancy, childbirth, abortion — - - - - - - - - - - - - Congenital malformations 5 4 - - - - - 1 - - - - - Other defined and ill-defined diseases 43 8 - 1 - - - 2 3 8 7 10 4 Motor vehicle accidents 1 - - - - - - - - - - 1 - All other accidents 6 - - - - - - - - 1 - 3 2 Suicide 2 _ - - - - 1 - 1 - - - - Homicide and operations of war - - - - - - - - - - - - - TOTALS 525 17 1 1 1 1 4 10 21 73 105 189 102 TABLE XII ALL DEATHS BY WARDS Ward Deaths Male e Bury Street 169 114 Church Street 99 168 Angel Road 80 100 Silver Street 160 143 Vagrants - - Totals: 508 525 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 - - 31 Blood - Haemoglobin Estimation - - 424 Blood - Kahn Reaction - - 163 Blood - Rhesus Factor 131 * 33 164 Blood - Grouping - - 164 Faeces for the presence of organisms 310 2153 2463 Swabs for the presence of C. Diphtheriae: (a) From Suspect Cases - 8 8 (b) From Contacts - - - Swabs for presence of Haemolytic Streptococci 46 428 474 Swabs for presence of Vincent's Angina - - 6 Urines - - 57 Vomit - 1 1 Vaginal Swabs for presence of organisms - 9 9 Eyelid Swab - 1 1 Ear Swab - 1 1 Pus - 1 1 Vulval Swab - 1 1 Fresh Cream - 2 2 Fresh Cream Cakes - 2 2 Cream - 1 1 Catering utensils - 39 39 Ice Cream - 1 1 Confectionery (Ingredients) - 14 14 Dried eggs - 2 2 Liquid eggs - 6 6 TOTAL 4035 ENVIRONMENTAL HEALTH. HOUSING. The Angel Road, North Area, containing 130 houses in which 446 people live, was represented in 1963, the Public Inquiry taking place in 1964, and the area being confirmed by the Minister in March 1965. REPAIRS. Repairs made as a result of representations by the Public Health Inspectors, with legal action where necessary, included:- 140 roofs, 123 w.c's, 20 damp-proofings; in total 352 houses were repaired as a result of informal action,and 219 as a result of service of notices. TABLE A. Action taken under the Housing and Public Health Acts. Number of houses repaired in consequence of informal action 352 Number of notices served under Section 9 Housing Act - Number of houses rendered fit after service of notices (a) by owner - (b) by Local Authority -- Number of notices served under Public Health Acts 379 Number of houses repaired after service of notices (a) by owner 219 (b) by Local Authority in default - 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 1963:- Part I - Applications for Certificates of Disrepair (1) Number of applications for Certificates 6 (2) Number of decisions not to issue Certificates - (3) Number of decisions to issue Certificates 6 (a) in respect of some but not all defects 2 (b) in respect of all defects 4 (4) Number of undertakings given by Landlords under paragraph 5 of the First Schedule 5 (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 2 (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 2 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 1,330 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 1511 Washing facilities, sink water heaters installed 7 A number of contraventions were detected. They were of a minor character, mainly in connection with failure to exhibit prescribed notices. 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 - No action was necessary during the year. SHOPS ACT, 1950 - PART II, SECTION 17(1) Condition of Employment - Three letters of warning were sent to shopkeepers regarding the employment of assistants on the afternoon of the 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 Forty-eight 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-seven letters of warning were sent for contraventions. Legal proceedings were instituted in three cases and fines amounting to £10. 4. Od. with costs of £4. 4. Od. were imposed. Five 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. BETTING AND GAMING ACT, 1960 The Shops Act Injector is authorised to carry out inspections under the gaming provisions of the above Act, to see that permitted premises are properly conducted. Eight visits were paid during 1963, and eight 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, 1963, was 155. The number of dairies registered at 31st December, 1963 was 9. FOOD AND DRUGS ACT, 1955 - SECTION 16 During the year 3 premises were registed for the sale and storage of ice cream. Number on register at end of year - Manufacturers and Vendors 2 Vendors only 208 Storage 1 During the year three premises were registered for the preparation or manufacture of preserved food, etc. Number on register at end of year 60 FOOD POISONING A copy of the report on the Food Poisoning outbreak which occurred from 23rd June - 9th July, 1963, is given later in the Epidemiology Section. It is an example of the results of poor food hygiene in a bakery. This bakery does not appear to subject its staff to any form of medical examination, and the staff are not properly instructed in hygienic practices. We did not find contamination of any of the food on sale, or any of the raw materials, but the mixing bowls, sinks and benches were grossly contaminated. Five members of the staff of the bakery were found to have bacteria of the same strain as that which caused the outbreak in their gut. As practically every one of the 37 persons who fell ill had eaten food bought at the bakery, circumstantial evidence against the bakery is very strong. The fact that one of the affected bakery staff was in the habit of washing his hands with the aid of the cloth which was used to wash down the baking benches, is the most important piece of evidence. This bakery has now been cleaned up, and is much improved, but neither this baker for the majority of food premises in Edmonton has taken advantage of the Public Health Laboratories offer to screen their staff bacteriolcgically. UNSOUND FOOD The following is a list of the food surrendered for examination and retained as unfit for human consumption:- Meat 2,464 tins Tomato Juices 113 tins. Milk 1,469 do. Butter 19 lbs. Fish 1,493 do. Lamb 697½ lbs. Jams etc. 413 do. Mutton 560 lbs. Soups 944 do. Beef 2,189¾ lbs. Beans 1,171 do. Pork 706¼ lbs. Beetroot 46 do. Ham 45½ lbs. Carrots 190 do. Skate. 35 stone. Mixed Vegetables 260 do. Sausages 23½ lbs.. . Peas 2,652 do. Cheeses (26 packets) 42 lbs. Apples 34 do. Yeast 186 lbs. Apricots 507 do. Jellies 18 only Blackcurrants 72 do. Fish Paste 152 jars Cherries 99 do. Meat Paste 193 jars. Loganberries 19 do. Pickle 78 jars. Grapefruit 328 do. Cream 760 tins. Gooseberries 50 do. Sauce 142 bottles. Fruit Salad 761 do. Spaghetti 62 tins Oranges 575 do. Pastry Mix 45 pkts. Peaches (35 boxes) 1,601 do. Cake Mix 77 pkts. Pears 668 do. Bovril 38 bottles Pineapple 1,282 do. Marmite 3 jars. Plums 134 do. Salad Cream 69 jars. Prunes 170 do. Tomatoes 3,466 tins. Raspberries 59 do. Fruit Juices. 319 tins. Rhubarb 34 do. Rice 448 tins. Strawberries 98 do. Eggs 8 tins. Blackberries 36 do. Baby Food 191 tins. Redcurrants 9 do. Walnuts 8 lbs. Macaroni 24 do. Crab 31 tins. Vegetable Juices. 25 do. Potato Chips 212 pkts. Cereals 101 pkts. Puddings, Pie Fillings etc. 1,099 pkts. Salt 3 pkts. Sweets 62 pkts. The food examined and condemned by the Officers of the Public Health Department is disposed of either at the Council's Refuse Disposal Incinerating Plant, or the Council's Refuse Disposal Pit. SAMPLING OF ICE-CREAM Samples of ice-cream were taken for bacteriological examination at the Public Health Laboratory as follows:- Provisional Grades 1 2 3 4 Ice-Cream 28 3 4 - 35 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 2 Sale only of Ice-Cream 208 Manufacture of Sausages 27 Manufacture of Sausages and Sale of Pressed, Pickled, Preserved, Potted Meats and other foods 16 Manufacture of Cooked Meat 16 Manufacture of Preserved Foods 1 Butchers 56 Fish Shops 23 Grocers and Provision Dealers 168 Bakers and Confectioners 24 Fruiterers and Greengrocers 50 Dairies 9 Retail Purveyors of Milk 137 Cafes 45 Factory Canteens 81 WATER The water supply of the Borough has at all times been satisfactory both in quality and quantity during 1963. 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 the 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 out on the attached sheets. The water is not plumbo-solvent. The number of structurally separate dwellings is not recorded but none of the houses is permanently supplied by standpipe. No new sources of supply were instituted by the Board in your area during 1963. A length of 15" main was laid between the Great Cambridge Road and Fore Street via Pymmes Park to improve the supply in the eastern parts of the Borough, and a length of 18" main was in process of being laid from the Great Cambridge Road to Hertford Road via Harrow Drive and Bury Street; an improvement of supply by re-zoning will be effected in the south-east part of the Borough when this main is completed. New service mains were laid to the extent of 2,524 yards". SAMPLING OF SWIMMING BATH WATER Satisfactory Not Satisfactory Knights Lane Baths Samples taken for Bacteriological Examination 3 Samples taken for Chemical Examination 2 Fluoridation of the Metropolitan Water supply is still awaited. At the end of 1962 the Minister of Health made it clear that he was ready to approve proposals from Local Health Authorities to make arrangement for water undertakings for the fluoridation of water. The Middlesex County Council have ascertained the views of the Borough and District Councils, and have submitted proposals in 1963 to the Minister. The Metropolitan Water Board, however, though they have made the necessary preliminary assessments of costs and practicability and found that no difficulty will arise, are not willing to move as yet and it is probable they will not move until after completion of the reorganisation of Local Government in Greater London. AVERAGE RESULTS OF THE CHEMICAL EXAMINATION OF WATER SUPPLIED MILLIGRAMMES PER LITRE (unless otherwise stated) Description of Sample Number of Samples Ammoniacal Nitrogen Albuminoid Nitrogen Nitrate Nitrogen Chlorides as Cl. Oxygen abs. from KMn04 4 hrs. at 27°C. Turbidity Units Colour (Burgess) Scale ness (Total) Hornsey 52 0.079 0.053 5.2 38 0.62 0.1 6 306 Stoke Newington 52 0.092 0.061 5.2 37 0.61 0.1 6 306 Thames derived North of River 206 r 0.180 0.080 3.8 32 1.20 0.3 11 282 Park Well 2 0.110 0.020 0.3 26 0.68 0.2 5 264 METROPOLITAN WATER BOARD - - BACTERIOLOGICAL RESULTS - YEARLY AVERAGES, 1963 Source of Supply Number of samples BEFORE TREATMENT Agar plate count per ml. Coliform count Escherichia coli count 20-24 hours at 37°C 3 days at 22°C. Per cent. samples negative in 100 ml. Count per 100 ml. Per cent samples negative in 100 ml. Count per 100 ml. Hornsey Stoke Newington Thames-derived North of River Park Well 65 0.4 22 95.38 0.1 98.46 - JVO TO THE BOROUGH OF EDMONTON FOR THE YEAR 1963. ness (non carbonate) PH Value Phosphate as P04 Silicate as Si02 Surface Active Material as Manoxol OT Sulphate as so4 Natural Fluoride as F. Magnesium as Mg. Sodium as Na Potass ium as K Elect rical Conductivity Micromhos 70 7.8 1.1 12 - - - - - - 620 68 7.9 1.0 11 - - - - - - 620 68 7.9 1.3 12 0.07 60 0.30 5 25 5.2 570 56 7.4 - - - - - - 20 6.3 530 WATER EXAMINATION DEPARTMENT AFTER TREATMENT 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 ml. Per cent samples negative in 100 ml. 256 3.9 100.0 100.0 256 5.0 100.0 100.0 1,930 14.4 99.43 99.43 69 0.1 4 100.0 100.0 .. JVO. 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 253 87 - - Factories without mechanical power 10 18 - - Other premises under the Act (including works of building and engineering and construction but not including outworkers premises) 14 67 - 277 172 - - 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 ) - 3 - 3 - Other offences - (not including offences relating to outwork) - - - - - Totals: - 3 - 3 - 3. Outwork - Sections 133 and 134 Nature of Work No. of Outworkers in August list No. of cases of default in sending list 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. 151 - - - - - Artificial flowers 9 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially or paper 23 - - - - - Brush making 11 - - - - - Stuffing toys 19 - - - - - Toys and painting boxes 31 - - - - - Brass and brass articles 5 - - - - - Electrical fittings 72 - - - - - Embroidery - Household linen 1 - - - - - Feather sorting 2 - - - - - Button carding 2 - - - - - Leather bags 18 - - - - - Curtains - Furniture making 3 - - - - - Fetlings - diecastings 18 - - - - - Lampshades 11 - - - - - Christmas crackers 6 — - — - - Total: 382 - - - - - MIDDLESEX COUNTY COUNCIL ACT, 1950. SECTION 11 Four persons and premises were registered during the year, and two persons were registered to trade in the Borough where storage premises located in another district. There were 81 hawkers on the register at the end of 1963. SMOKE CONTROL 3. The deposit gauge at the Town Hall continued to be used. The results are as follows:- SUMMARY OF ANALYSES Deposit Gauge 1963 Rainfall in Inches DEPOSIT IN TONS PER SQUARE MILE Insoluble Deposits (inc.Ash) Soluble Deposits Total Solids. Jan. 0.69 7.51 4.83 12.34 Feb. 0.51 7.23 4.97 12.20 Mar. 2.49 13.44 3.82 17.26 Apr. 2.05 9.01 7.01 16.02 May 1.42 8.21 4.44 12.65 June 1.63 6.55 5.25 11.80 July 0.96 4.07 3.15 7.22 Aug. 2.65 7.91 7.13 15.04 Sept. 1.79 5.23 3.91 9.14 Oct. 1.37 8.44 5.63 14.07 Nov. 4.21 8.51 9.88 18.39 Dec. 0.61 7.98 4.79 12.77 TOTAL 20.38 94.09 64.81 158.90 The deposit gauge is a measure of deposit and records in the main the larger particles of dust and grit. Pollution of the air itself is better measured by volumetric filters. These instruments measure the smoke and sulphur dioxide in a sample of air each day. A continuous flow of air passes through the instrument, through a pump, and the sulphur dioxide is chemically measured and the stain produced by smoke measured by means of a filter paper. The readings are taken every 24 hours. Details of these readings are set out over leaf. 1963 Concentration of Smoke Micrograms per cubic Metre. Average daily value. Concentration of Sulphur Dioxide, Micrograms per Cubic Metre. Average daily value. (A) (B) (C) (A) (B) (C) January 165 276 198 325 445 251 February 125 217 220 557 1104 380 March 61 85 80 187 166 169 April 46 55 58 132 156 122 May 26 - 54 74 - 66 June 17 36 21 69 48 64 July 12 19 28 58 24 53 August 20 28 31 11 57 55 September 17 43 45 19 51 65 October 50 430 63 65 106 143 November 74 - 95 106 - 194 December 84 - 90 178 - 232 (A) Latymer School. (B) Mandeville School. (C) Huxley School. The 1963 readings make it very clear that the worst fouling of the air is by the domestic chimney. The highest readings in each case were during the months of January and February, when the weather was cold and those who were able to obtain coal piled it on the home fire as high as they could. The pollution contributed by factory chimneys is probably represented by the September figures, and it can be seen that the addition of the smoke from the home chimneys at least doubles the reading. 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 Commercial 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 6. 1st June 1964. 639 5,435 12 164 50 NO. 6 AREA - A 10% sample survey of houses in this area was carried out during the year. The area is 639 acres in extent and it is situated in north western part of the Borough, it is bounded on the east by Hertford Road, on the south by Bury Street, the Enfield Branch line of British Railways, the Great Cambridge Road, Bury Street West, Church Street and Ridge Avenue on the west, by the Borough boundaries with Southgate and Enfield and on the north by the Borough boundary with Enfield. Its somewhat unusual shape is due to the fact that it is a combination of two areas in the original smoke control area programme. The area is essentially residential in character. It contains 5,435 houses including 327 Council-owned houses, 12 industrial premises, mainly small workshops and garages, 164 commercial premises, mostly shops, public houses etc. and 50 other premises including schools, churches, halls, clubs etc. most of the houses are owner-occupied but there are a number of tenanted houses mainly in the eastern part of the area. Of the 327 Council owned houses, 88 have been erected since 1956; conversions are not required at these houses, nor at 60 other Council-owned houses. It was planned to bring this area into operation as a Smoke Control Area on 1st October, 1964, but as the result of objections to the Order being received, a Public Inquiry was held on 17th December, 1963. The Order was confirmed on 3rd April, 1964, and will become operative on 1st June, 1965. The table set out above shows details of confirmed Smoke Control Orders. During the year 544 observations of industrial chimneys in the Borough were made by the Public Health Inspectors. RODENT CONTROL Your Senior Public Health Inspector, as Officer-in-Charge, Rodent Control, reported as follows:- An Assistant Rodent Officer and two Operatives carry out rat and mice destruction under the general supervision of the Public Health Inspectors. Domestic premises are treated without charge and business premises on repayment. 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 Rats and Mice: Local Authority Dwelling Houses All other including Business and Industrial Total Properties inspected as a result of notification 30 744 54 828 Other properties investigated 5 2,309 33 2,347 Properties found to be infested Rats (a) Major infestations 1 - - 1 (b) Minor infestations 24 539 41 604 Mice (a) Major infestations - - - - (b) Minor infestations 4 26 9 39 Number of properties treated by Rodent Operators 29 665 50 744 Number of Inspections 383 6,663 454 7,500 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. DISINFECTION AND DISINFESTATION Number of journeys to collect bedding and spray verminous premises 84 Number of journeys to return bedding 76 Rooms disinfected after infectious disease 77 Rooms disinfected after Phthisis - Rooms disinfected after other cases 53 Rooms disinfected after vermin 113 Articles Bedding, clothing etc., disinfected after infectious disease 585 Bedding, clothing etc., disinfected after Phthisis - Bedding, clothing etc.; disinfected after other cases 1,229 Bedding, clothing etc., disinfected after vermin 32 Bedding, clothing etc., drying after flooding 133 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 2,373. 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 482. Seven Council properties and 42 other houses were found to be infested; the total number of rooms disinfected was 113. The whole of the work is carried out by the Department, the materials used being insecticides containing D.D.T. as a base. PET ANIMALS ACT, 1951 No new licences were granted during the year. Number on register at end of year 4. INSPECTIONS The following tabular statement gives the number and the nature of the inspections made during the year:- DWELLING HOUSES Included in Clearance Areas 439 Individual Unfit (Sec. 16) 24 Unfit but capable of repair (Sec. 9) 21 Closing Orders 18 Overcrowding/Permitted Numbers 76 Houses Let-in-Lodgings 18 Standard or Improvement Grants 834 Rent Act Applications 64 Complaints and Nuisances 3,305 Drainage 1,260 Water Closets 149 Yard Paving 5 Water Supply 88 Dustbins 20 Infectious Diseases and Food Poisoning 245 Filth or Vermin 123 Well-Maintained Property 53 House Purchase 14 Mortgage Enquiry 13 FOOD PREMISES Bakehouses 25 Bakers shops 43 Butchers Shops and Meat Preparation Premises 52 Canteens and Catering Premises 203 Fishmongers 9 Fried Fish Shops 25 Fruiterers and Greengrocers 29 Grocers and General Dealers 107 Market Food Vehicles and Hawkers 233 Public Houses and Clubs 32 Other Food Premises 56 Meat Inspection and Slaughterhouses 6 Other Food Inspection 148 Dairies and Milk Distributors 14 Ice Cream and Ice Lolly Samples 26 Milk Samples 4 Other Food Samples - Surrendered Food 8 FACTORIES Factories with Mechanical Power 87 Factories without Mechanical Power 18 Other Premises/Construction Work 67 SHOPS Routine Inspections 33 Betting Shops 6 CLEAN AIR ACT Smoke Control Areas 5,757 Smoke Observations 544 Furnace Installations and Chimney Height 113 Air Pollution Measurement Recording 288 OTHER VISITS Offices etc. 15 Moveable Dwellings 39 Places of Public Resorts and Entertainments 57 Offensive Trades - Piggeries and Stables 1 Keeping of Animals including Poultry 1 Offensive Accumulations 81 Watercourses and Culverts 10 Unclassified Nuisances 75 Water Samples 2 Baths Water Samples 2 Schools 2 Rats and Mice Destruction 307 Noise Nuisances 34 Public Conveniences 95 Petroleum Licensing 305 Pet Animal Shops 10 Agricultural and Horticultural Premises - Interviews with Owners, Builders etc. 404 Betting and Gaming Act, 1960 13 Rag Flock 6 Dangerous Building 1 Tips 2 Vehicles - Smoke Emission - Factory Estate - Sewer - Pest Control 19 DEFECTS REMEDIED Roofs repaired 140 Gutters and rainwater pipes repaired 142 Brickwork or pointing repaired 21 Chimney stacks, etc., repaired or rebuilt 24 Yards or forecourts repaved or repaired 10 Drains examined, tested or exposed 363 Drains cleared, trapped or repaired 94 Drains reconstructed - Chambers inserted or built-up to ground level 5 Soil and vent pipes, new fixed or repaired 38 W.C.'s repaired or improved 123 Flushing cisterns repaired or new fixed 27 Sink waste pipes repaired or new fixed 26 New sinks fixed 2 Drinking water cisterns covered, cleansed, repaired 3 Water fittings repaired 35 Water taken off main or restored 4 Internal Walls 99 Ceilings repaired, cleansed, etc. 85 Doors frames repaired 10 Floors repaired 24 Floors ventilated 1 Dampness remedied 20 Gullies repaired 38 Dangerous fence 1 Sills repaired 15 Doorsteps repaired 2 Window frames or sashes repaired or renewed 67 Fireplaces, stoves repaired 13 Coppers repaired - New dustbins supplied 6 Premises rat-proofed - Improper keeping of animals discontinued - Foul accumulations removed 11 Other nuisances abated 18 Moveable dwellings removed - New boiler house constructed - New boiler installed - Factory sanitary conveniences inspected 1 Factory sanitary conveniences improved 2 Factory other defects remedied 2 Petroleum installations - defects remedied - Petroleum installations tested - Smoke Abatement.- boiler plants improved - Food Regulations - contraventions remedied - Internal doors repaired 3 PETROLEUM (REGULATIONS) ACTS, 1928-1936 During the year 5 new licences and 113 renewals were granted by the Council. The following is a list of particulars of quantities etc., affected by these licences:- Petroleum Spirit 528,576 gallons. Petroleum Mixtures 15,755 gallons. Rubber Solution 100 lbs. and 800 gallons. PLACES OF PUBLIC ENTERTAINMENT Fifty-seven inspections of cinemas and other places of entertainment were made in accordance with the Circular of the Ministry of Health of 1920. Conditions were found to be generally satisfactory. EPIDEMIOLOGY 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 87 19 - - 3 8 10 12 42 8 1 1 1 1 - Measles 1593 - - 40 141 219 191 209 262 22 4 4 1 - - Whooping Cough 141 - - 10 17 20 22 20 47 3 2 - - - - Pneumonia 39 6 52 2 1 - 1 1 1 1 - 4 3 17 8 Puerperal Pyrexia 69 - - - - - - - - - 11 52 5 1 - Erysipelas 6 - - - - - - - - - - 1 3 1 1 Food Poisoning 64 - - 3 1 5 2 2 8 11 11 7 3 10 1 Ophthalmia Neonatorum 1 - - 1 - - - - - - - - - - - Dysentery 120 5 - 5 7 7 3 5 44 7 5 25 9 3 - Paratyphoid Fever 1 - - - - - - - - - - 1 - - - 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 Middx. Hospital Other Institutions Total Scarlet Fever 29 8 19 31 - - 87 Measles 605 415 157 416 - - 1593 Whooping Cough 77 14 20 30 - - 141 Pneumonia 17 6 8 8 - - 39 Puerperal Pyrexia - - - 2 67 - 69 Erysipelas 3 1 1 1 - - 6 Food Poisoning 21 29 8 6 - - 64 Ophthalmia Neonatorum - - - 1 - - 1 Dysentery 57 14 29 20 - - 120 Paratyphoid Fever - - - - 1 - 1 EPIDEMIOLOGY (Continued) Measles and dysentery were the main infectious diseases notified, dysentery affecting mainly the primary schoolchildren and measles the underfives. Whooping cough is still more commonly seen before the age of five years than after, but is now quite a frequent cause of absence from infant school departments. The number of cases of pulmonary tuberculosis on the register i.e. regarded as not yet cured, again fell. The number of new cases added was a new low record and was mainly due to the intensive ward survey by the Mass X-Ray unit in 1961. Even allowing for this having in turn increased the 1962 notifications and reduced the 1963 notifications by 6 or 7 (i.e. 6 or 7 cases were picked up in 1961 and notified in 1962 who would possibly have normally sought treatment in 1963), there is a reduction of 30% on the 1961 and 1962 notifications. Preliminary figures for 1964 show that the 'loan' has not been repaid:- 1964, and the Edmonton tuberculosis rate is 40% below the national rate. Smallpox 538 International Certificates of Vaccination were issued by the Edmonton Health Department during 1963. 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 - 1 33 4 37 Sal: Typhi-Murium 2 - 4 - 4 Sal: Heidelberg 4 - 11 - 11 Total: 6 1 48 4 52 Agent not identified - - - - - (B) Single Cases Agent Number of Cases Total No. of Cases Notified Otherwise Ascertained Sal: Typhi-Murium 7 - 7 Sal: Heidelberg 3 - 3 Sal: Eastbourne 1 - 1 Sal: St. Paul 1 - 1 Total: 12 - 12 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: - - - - - REPORT ON FOOD POISONING OUTBREAK 1. Food causing outbreak Pastry - confectionery and bread Agent causing outbreak Salmonella-typhi-murium Phage Type I (a) 2. Cases forming outbreak, which occurred from 23rd June to 9th July, 1963 Notified - 33 Total 37 Otherwise ascertained - 4* Fatal - None (*One child became ill at its home in Radlett, Herts, and was subsequently diagnosed 'there' as suffering from Salmonella typhi-murium food poisoning. The child attends a Cripples' School in Edmonton where other cases arose.) 3. Clinical features Average interval ingestion to onset (hours) - Impossible to say with accuracy. Main symptoms In some, headache, fever, nausea, abdominal pains and diarrhoea. In others, fever and diarrhoea. Still others had fever, malaise, weakness in the limbs, diarrhoea and abdominal pains. Severity of Illness Half of the patients were severely ill. An infant of 11 months was admitted to hospital with pyrexia and nuchal rigidity. A seven year old boy became delirious. Duration of illness - One week on the average 4. Results of Laboratory Investigations (Summary) Cases - Faeces positive for Salmonella typhi-murium Phage 1 (a) in all cases Food Samples Specimen Eggs - as below Date of Arrival 4.7.63 Date of Report 8.7.63 REPORT Lab No. 6251-55/63 Main Bakery, Edmonton. 6251 English Egg - ready for use ) 6252 Australian Egg - open, part used) No 6253 Australian 38 ZM 22 - to be used) pathogens 6254 English F0506M - to be used ) isolated 6255 English F0500M - to be used ) Specimen Eggs Date of Arrival 4.7.63. Date of Report 8.7.63. REPORT Lab No. 6270-71/63 Main Bakery, Edmonton. 6270 Superfine Pasteurised Spray ) No Dried Egg Albumen ) pathogens 6271 Burton Burwhites ) isolated Specimen Cream Date of Arrival 10.7.63. Date of Report 16.7.63. REPORT Lab No. 6620-1/63 Main Bakery, Edmonton. 6620 Farma Cream Product) No intestinal pathogens 6621 Mertona U.P.M. ) isolated Specimen As below Date of Arrival 4.7.63. Date of Report 8.7.63. Lab No. 6297-2/63 Branch Bakery, Enfield. 6297 Shredded Coconut ) 6298 Dessicated Coconut ) 6299 Butter Cream ) No pathogens 6300 Reconstituted Fondant ) isolated 6301 Marshmallow Preparation ) 6302 Whole Liquid Egg ) Food Handlers: One of the Edmonton cases was a butcher's assistant. Both he, and five other food handlers employed in a local bakery and in its branch shops, were found to have Salmonella typhi-murium Phage Type I (a) in their stools. Other Specimen As below Date of Arrival 11.7.63. Date of Report 16.7.63. REPORT Lab No. As below Main Bakery, Edmonton 6686 Scale tin ) 6687 Baking tin (6) ) No intestinal 6688 Baking tin (7) ) pathogens 6691 Baking Bench ) isolated 6692 Pastry knife ) 6681 Cream bag ) 6682 Aluminium mixing bowl (1)) Profuse mixed growth of 6683 Aluminium mixing bowl (2)) 6684 Small mixing bowl ) bateria. No intestinal 6685 Beater ) pathogens isolated. 6689 Sink (1) ) These utensils, sinks 6690 Sink (2) ) and bench need mush more 6693 Bench Surface ) thorough cleansing. 6674-80 Bakery Cloths Profuse mixed growth of bacteria. No intestinal pathogens isolated. These cloths were destoyed as they were unsuitable for use in a bakery. Specimen As below Date of Arrival 15.7.63. Date of Report 20.7.63. REPORT Lab No. 6820-31/63 Main Bakery, Edmonton 6820 Swab - working bench (bakery ) 6821 Dough divider ) 6822 Tart punch ) 6823 Large flat bakery tray ) 6824 Dustbin (pastry room) ) 6825 Working bench (pastry room) ) No 6826 Taps (pastry room) ) intestinal 6827 Work bench sieves (pastry room) ) pathogens 6828 W.C. chain, door handles and light switch ) isolated. 6829 Sink (washing room) ) 6830 Buckets (pastry room) ) 6831 Sink (tea room) ) 5. Origin and Preparation of Food causing Illness In all but two of the original cases, a common factor emerged ALL had eaten cakes and (or) bread purchased directly from the Bakery or from one of the branch shops in the district. Very many cafes and Public Houses in the area also receive supplies from the Bakery. 6. Place at which food causing illness was consumed:- In the private homes of patients, also at a Cripples' School. Estimated Number of Consumers at Risk Impossible to say, as the Bakery firm concerned has a number of branches locally and also supplies shops, restaurants, cafes and firms throughout the area. (If the firm supply around 40,000 of the Edmonton population (which would be a reasonable estimate), an estimate of the number of infections would be in the region of 1 in 200 or 1 in 600 of those at risk). 7. Probable Origin of Infection or Contamination of Food All investigations pointed to the infection arising from a bakery firm. When specimens were taken from all members of the bakery staff, the staffs of branch shops and from the vanmen, it was found that an apprentice-baker and a female packer of cakes (occasionally of bread) were positive for Salmonella typhl-murium yet symptom-free. A female assistant at a branch shop across the road from the bakery was likewise a symptomatic but harbouring Salmonella typhi-murium in her faeces. A mother and daughter employed as part-time counter hands at another of the branch shops, had previously had symptoms, and both were positive for Salmonella typhi-murium. The trainee-baker, a boy of fifteeen, had only recently joined the firm. One month previous to this, he had suffered from a febrile headache which might well have been a Salmonella typhi-murium bacteraemia. On joining the firm he was given various tasks including packing cakes into trays, squirting jam and cream into pastry and sticking cherries onto buns and cakes. He was also responsible for washing down the bakery benches (tables) etc. (common trays may have been used for pastries and bread). Contributory Factors: (a) The personal standards of hygiene practised by the apprenticebaker particularly in post-defaecation toilet. His method of washing his hands was to run them under a tap then wash them with one of the half-dozen cloths (rags) used to wash down the baking benches at the end of the day. (b) His complete ignorance of the Food Hygiene Regulations. (c) The generally poor standard of hygiene throughout the establishment filthy sinks, lack of clean as opposed to soiled and grimy towels, absence of soap etc. Remarks: In all probability the boy of fifteen was already infected with Salmonella typhi-murium when he began his apprenticeship at the Bakery. He was certainly responsible for preparing many of the cream and jam pastries and doughnuts which were either bought on the premises or sent out to other branches in the district. Twelve children at a School for Cripples and one nurse, were found to have Salmonella typhi-murium. Only five of the former had symptoms, the nurse was symptom-free. Whilst the school was not supplied with cakes from the Bakery,they did supply the bread eaten by the staff and patients. Hence, although it cannot be readily established that the bread was infected, it is easy enough to assume that it was. It might have been contaminated with floury dusts from trays which had been used for infected pastries, or alternatively, a bread slicer or packer may have had a fleeting infection which was not detected at the stage of investigation. TUBERCULOSIS TABLE T(1) Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 year - - - - - - - - 1 - 5 years - - - - - - - - 5 - 15 years - 1 - - - - - - 15 - 25 years 1 - - - - - - - 25 - 35 years 1 1 - 2 - - - - 35 - 45 years 2 - - - - - - - 45 - 55 years 3 1 - 1 - - - - 55 - 65 years 3 1 - 2 - - - - 65 years upwards 1 — - - 2 — — - Totals: 11 4 - 5 2 - - - In addition, 14 cases of Pulmonary Tuberculosis and 1 case of Non-Pulmonary Tuberculosis, previously notified in other areas, moved to Edmonton. TABLE T(2) MALES FEMALES TOTAL Respiratory NonRespiratory Respiratory NonRespiratory Added to Register during 1963. 20 - 15 6 41 Number of cases notified for the first time during the year. 11 - 4 5 20 Number of cases restored to Register, having been previously removed. 1 - 3 - 4 Number of cases added to Register other than by formal notification 8 - 8 1 17 Removed from Register during 1963 46 2 30 4 82 Number of deaths from Tuberculosis - Notified cases 2 - — - 2 Number of deaths from Tuberculosis - Non-notified cases 2 - - - 2 Number of deaths, other causes - Notified cases 13 - 1 - 14 Number of cases, left district, recovered etc. 29 2 29 4 64 TABLE T(3) The non-respiratory forms of Tuberculosis notified were: Part of Body affected Males Females Spine _ 2 Glands - Groin. — 1 Genito-Urinary Tract. - 2 TABLE T(4) The number of cases of Tuberculosis on the Register at the end of 1963 was: Males Females Total Pulmonary forms 635 446 1,081 Non-pulmonary forms 66 99 165 701 545 1,246 TABLE T(5) The corresponding figures at the end of 1962 were: Males Females Total Pulmonary forms 661 461 1,122 Non-pulmonary forms 68 97 165 729 558 1,287 TABLE T(6) Corresponding figures for previous years were: 1961 739 587 1,326 1960 734 598 1,332 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 IMMUNIZATION CARRIED OUT IN EDMONTON DURING 1963 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 Diphtheria only Whooping Cough only Tetanus only Combined Diphtheria and Whooping Cough Combined Diphtheria and Tetanus Combined Diphtheria Tetanus and Whooping Cough Combined Diphtheria, nup Whooping Cough and tis (QUAD¬) RALIN) theris only Whooping Cough only Tetanus only Combined Diphtheria and Whooping Cough Combined Diphtheria and Tetanus Combined Diphtheria Tetanus and Whooping Cough Combined Diphtheria Tetanus Whooping Cough and Poliomyeli tis (QUADRALIN) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) 1963 - - - 4 47 388 15 - - - - - - - 1962 6 - - 21 43 - 12 - - - - 14 102 9 1961 - 1 - 2 2 499 - 1 - - 1 26 180 - 1960 - - 1 - 2 18 - 2 - 1 - 7 33 1 1959 3 - 17 - 3 9 - 120 - 2 1 56 38 1 19541958 26 - 35 - 28 1 - 663 1 2 10 91 86 1 19491953 7 - 18 - 3 7 - 21 - 2 4 3 7 1 TOTAL 42 1 71 27 128 922 27 807 1 7 16 197 446 13 NOTE: (a) i.e. subsequently to primary immunisation at an earlier age. IMMUNISATION The Area Medical Officer for Area No. 1 Middlesex (Edmonton and Enfield) has kindly given me the following details of immunization against Diphtheria and Whooping Cough during 1963, and of Smallpox and Poliomyelitis vaccination for the same year. VACCINATION AGAINST POLIOMYELITIS EDMONTON - Number of persons vaccinated during 1963 Age Group No. of Persons who have received Total 2nd Injection of Salk. Vaccine or 3rd Injection of Quadruple Vaccine 3rd Dose of Oral Vaccine Children born in 1963 21 74 95 " " " 1962 88 607 695 " " " 1961 13 107 120 Children & young persons born in years 1943-60 14 131 145 Young persons born in years 1933-42 26 108 134 Others 16 94 110 Totals 178 1121 1299 Persons Receiving Reinforcing Doses No. given 3rd dose of salk vaccine or 4th injection of quadruple vaccine 324 No. given 4th dose of salk vaccine or 5th injection of quadruple vaccine 195 No. given reinforcing dose of oral vaccine after:- 2 salk doses 129 3 salk doses or 3 oral doses or 2 salk doses plus 2 oral doses 783 VACCINATIONS AGAINST SMALLPOX carried out in Edmonton during 1963. Age Persons Vaccinated or Re-vaccinated Cases specially reported during the period Vaccination ReVaccination 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 1 121 - 1 176 - 2-4 64 12 5-14 32 38 15 and over 41 94 Total 434 144 MIDDLESEX COUNTY COUNCIL ACT, 1955 ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT: During 1963 - one new licence was granted and eleven existing licences were renewed. COUNCIL'S EMPLOYEES During 1963 a total of 218 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 , 52 were 'not at home' and 32 had already resumed duty. Also during the year, the following medical examinations or assessments were made prior to appointment to permanent posts:- Medical examinations 39 Assessments without medical examinations 132 Medical assessments (not appointed) 92 Health Education The normal routine of letters to parents of 3 months old children on immunisation and vaccination, and the distribution of a leaflet on measles to each where measles had been notified was continued. Four schools not visited by the Central Council of Health Education team were visited class by class and heard a talk by the Deputy Medical Officer of Health and were shown films. Many children asked us to help their parents, and a small smoker's clinic was therefore arranged at Edmonton Town Hall. The groups met weekly, were given talks and shown film strips and then joined in discussion. Numbers varied from 10-12, and the cure rate was about 20%, after 4 sessons. Although this was not regarded as satisfactory the clinic aroused some interest and a re-organised clinic, using physiotherapy, films and guest speakers achieved greater success in 1964. Poster publicity on health education dealt with home safety, cigarette smoking, water safety and home safety was also highlighted in bookmarks distributed by the library service and by a poster competition in primary schools. EDMONTON WELFARE ASSOCIATION AND THE CARE OF OLD PEOPLE 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 Association, 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 model constitution, 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 opportunity to thank the voluntary organisations for their magnificent work - The British Red Cross Society, Women's Voluntary Service, Toc. H, Citizen's 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. 1 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. As an indication of the growth of the work of the Association the Edmonton Borough Council appointed an Assistant to the Welfare Department. The work of the Welfare Assistant has been principally concerned with social welfare visiting, and the work of the two all-day clubs, especially Pymmes Park Club Handicraft Section and evening facilities. 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 interest 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 1963/64. (a) MEALS-ON-WHEELS SERVICE During the year 1963 the Meals Service delivered 13,991 meals, this is over 1,000 more than the previous year, but the figures are never static. In December 1963 however the Executive decided to extend the Meals Service up to 100 per day, i.e. 400 per week, excluding emergency calls, and in the first 5 months of 1964 - that is January to May inclusive the Women's Voluntary Service have delivered no less than 8,447 meals - May was a record month with 2,001. This increase in the service necessitated an almost complete reorganisation in the routes; additional voluntary workers and additional transport but the "waiting list" was there, and many of the old people were in great need of the service - once the Executive gave authority to act the service went into operation. The Association offer a very sincere tribute to all the ladies of the Women's Voluntary Service and especially to Mrs. E. Everitt, Meals Organiser, whose untiring work is the sheet anchor of this service. We also offer our thanks to Mrs. P. Smith and her staff at the Town Hall Canteen who prepare the meals, and the Council's transport staff for their help and co-operation. (b) ENTERTAINMENT AND RECREATION The Edmonton Borough Council 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 Type 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 been also free admission to Quiz Shows etc., and reduced prices at special Celebrity Concerts and Edmonton Old People's Club 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; Toc 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. An important development in this Service has been the work of the Welfare Assistant, especially on emergency calls, and subsequent follow-up action. There is almost daily contact with the W.V.S., on such cases, through the Mealson-Wheels Service, and the extension of the Meals Service means more ground is covered. (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 than ever, 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 seaside, 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. 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. (f) LIBRARY DELIVERY SERVICE Today there are 59 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 is another record year in the sale of Welfare Foods to old people: BOVRIL 2,502 bottles OVALTINE 2,808 tins MARMITE 722 jars HORLICKS 583 jars BENGERS 72 jars Bengers is a new food which has been added to the service during the year and the total value of all the foods distributed is £1,148. 4s. 3d. 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 winter months, is greatly appreciated and Mrs. Dixon and her staff can be assured that the extra work involved is very worth while in this essential service. (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 Toc H., but further help would be appreciated. (i) SPECIAL TRANSPORT SERVICE Through the kindness of the Edmonton Borough Council in providing the use of a mini-bus on two afternoons per week a special transport service for housebound and recently sick old people belonging to two of the largest Old People's Clubs was introduced. In most cases the old people had not left their homes for several months, and this special transport service has given great pleasure to them. The Association offer their sincere thanks to Councillor Mrs. P.L. Hawkins for acting as escort, since the inauguration of the scheme, to one of the Clubs. It is hoped with the introduction of a new vehicle and the appointment of a full-time driver to the Association to develop this special service for housebound old people to visit the Clubs. (j) 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 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 at the Annual Tea-Party to the Voluntary Wardens, the Mayor, Mr. Councillor E.J.C. Smythe, J.P., announced that the Edmonton Borough Council had given authority to proceed with the extension to the Club. This has brought great happiness to all members, especially Mr. W. Rowe, the Honorary Secretary, who has worked so hard to bring the scheme to fruition. The extension will provide a Main Games Room, Sun Lounge and little Theatre to seat 150 people, and the Club are to make a special contribution of £500 (which is invested in Edmonton Corporation Stock) towards the cost of any special furnishings. 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. Hollywood House - Pymmes Park Club; 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 this is proved by the fact that they have a maximum membership of 250, and a short waiting list. Arrangements were made for evening sessions during the summer months and these proved highly successful, and will be continued this year on three evenings per week from 6. 0 p.m. to 9. 0 p.m. The introduction of a Handicraft Class has been an outstanding success. Thirty-six members had joined, and worked happily together under a qualified teacher. The class had completed some work and the proceeds of the sale had been used to start a fund to buy future needs of handicraft materials. Through the Chairman of the Management Committee - Alderman T.H. Joyce, the Club had received donations to the total of £75 from "The Fitton Trust" for the special needs of the Club, and it was agreed by the Management Committee that the latest gift of £25 be spent on £5 for material for the handicraft class and £20 towards the cost of a microphone and loudspeaker equipment. The Association would like to record its thanks and sincere appreciation of the valuable work of the Management Committee, Officers, especially Mr. W. Dicker and Mrs. Caffel, and its Voluntary Wardens, who have made this a very happy and successful year for the Club. (k) FOOT SERVICE The Foot Service Clinic operated by the British Red Cross Society at Hollywood House, Pymmes Park; Red Cross Headquarters and the William Preye Club are now accepted as an essential service to the well-being of the old people who are in need of chiropody treatment. During the year under review 1,292 treatments have been given and a large number of domiciliary visits paid. Quite a large number of cases are 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. (1) 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, Knight's 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 to two baths, which are greatly appreciated. (m) EMERGENCY FUEL SUPPLY With the aid of a grant from the Edmonton Borough Council under the National Assistance Act, 1948, Amended 1962, provision was made for a supply of fuel in 28 lb. packs at cost price to sick housebound old people, should an emergency arise through a severe winter. Whilst there has been very little demand for this service and arrangements made to sell the stock at cost to sick old people, and housebound old people, it is obvious that this is a service that should be maintained during the winter months. This scheme had wide publicity through the Press and local Doctors etc., and should an emergency arise it can be operated with the minimum of delay. (n) 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' Society. In thanking the Society for their generous gifts, we also thank the 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 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 well-being of the people they serve, and no matter what changes are ahead the people of Edmonton can be assured that there will be no loss or deterioration in any of these services. Working together as a team for the common good, the Association and its affiliated organisation go forward with confidence to face the problems of another year, and by maintaining and expanding the services it provides, thereby rightly earning the place it has achieved in the field of social welfare. ACKNOWLEDGEMENTS 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; The Chairman and Directors of BENGERS; The Chairman and Directors of HORLICKS; for their special concessions to the Association, and their prompt and courteous attention at all times. The Members of the Edmonton Branch of the London and Provincial Hairdressers' Association for their 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 willingly give so much of their time to the work of the Association. EDMONTON WELFARE ASSOCIATION EXECUTIVE COMMITTEE 1963-64 EDMONTON BOROUGH COUNCIL His Worship the Mayor - Mr. Councillor E.J.C. Smythe, J.P. (Chairman) Deputy Mayor - Mr. Alderman C.G. Lacey Mr. Alderman T.H. Joyce Mr. Councillor E.C. Francis Councillor Miss K. Harvey Councillor Mrs. P.L. Hawkins Councillor Mrs. I. McNern Mr. Councillor A.H. Rowson 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 - Mr. W.W. Ashton CITIZENS ADVICE BUREAU - Mr. B. Goddard, M.B.E. ROTARY CLUB OF EDMONTON - Mr. E.W. Butterworth CO-OPTED MEMBERS Miss M. Radford - Superintendent Health Visitor M.C.C. No. 10 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. Councillor Mrs. Rita Smythe Miss Dorothy M. Oswald VICE PRESIDENTS Mr. A.J. Hollywood (Died 30th August, 1963) Mr. Howard S. Watts OFFICERS Honorary Secretary - Dr. D.A. Smyth, Medical Officer of Health - E.B.C. Honorary Treasurer - Mr. C.G. Gadsby, Borough Treasurer - E.B.C. Honorary Architect - Mr. A. Wilkinson, Borough Architect - E.B.C. Welfare Organiser - Mr. W.J. Sherwood, M.I.W., Welfare Officer, E.B.C. CONCLUSION 1963 was a busy year for the Health Department, and showed definite progress in slum clearance and a welcome reduction in tuberculosis. The year began with a hard winter and ended mild, leaving the population diminished but relatively healthy. I thank all the members of the Department for a hard year's work. I have the honour to be, Your Worship, Ladies and Gentlemen, D.A. SMYTH. Medical Officer of Health. Printed and Published by the Edmonton Borough Council, Town Hall, Edmonton, N.9.