AC 459 (1) ENF 37 Hrban District Council of Enfield ANNUAL REPORT OF THE Medical Officer of Health (WILLIAM D. HYDE, M.B., Ch.B., D.P.H.) FOR 1953 Hrban District Council of Enfield ANNUAL REPORT OF THE Medical Officer of Health (WILLIAM D. HYDE, M.B., Ch.B., D.P.H.) FOR 1953 3 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, 1953 To the Chairman and Members of the Urban District Council of Enfield. I have pleasure in presenting my Annual Report for 1953. The area of the Urban District is 12,401 acres. The population is approximately 109,300 and the number of inhabited houses 30,352. From a Public Health aspect, Enfield presents a most interesting picture with its almost complete variety of conditions affecting health, including all types of residential properties, industrial areas, and rural areas with agricultural and horticultural properties ; and consequently the Health Department must be fully alive to the most varied methods of Public Health control to meet the problems of such diversity of conditions. In spite of Enfield's fortunate possession of much natural open space, the Council has wisely provided many conveniently situated parks and open spaces, including an up-to-date open-air swimming pool, which contribute materially to the health of the inhabitants, but I wonder at times, if full advantage is taken of these amenities. The activities of the Department have progressed along the usual lines, the main effort being directed to the prevention and control of infectious disease, remedying or demolishing insanitary property, promoting food hygiene, prevention of statutory nuisances and a host of allied functions. The public can discover a health content in most matters which annoy or affect them and our sphere of activity is ever widening. Preventive medicine does not usually lend itself to immediate spectacular results. The prevention of illness or ill-health does not produce publicity but the outbreak of illness does. Fortunately, no serious outbreak of serious illness occurred during the year and some credit to the Department can be taken for prompt preventive action whenever conditions were conducive to the spread of illness in the community. Elsewhere I refer to the help the public can give in selfprotection by Immunisation and Vaccination ; and in many other ways, by the simple adherence to elementary methods of hygiene, 4 the public can do much to improve the health and well-being of the community. In the simple case of a mild type of dysentery which keeps recurring at intervals in the community, observance of simple rules of hygiene should considerably limit its spread. The infection is excreted by the patient and surely, in most cases, it must be within our capabilities to prevent this reaching other members of the family. If it does occur, someone has been careless and the method of transmission needs no comment. The number of notifications of notifiable infectious diseases was somewhat lower than the previous year in spite of the increased number of cases of pneumonia and whooping cough. The number of cases of Scarlet Fever was about half that of the previous year, and Poliomyelitis, to which I refer elsewhere in this report, was less prevalent. With regard to the Enteric Fever group of infections, in which the control of water, milk and food can play an important role, the stage has been reached where only occasional fluctuations in the extremely low incidence draw comments. In fact, there have only been six cases and no deaths during the last nine years. There was, unfortunately, an increase in the number of cases of Respiratory Tuberculosis, but this was accompanied, I am glad to say, by the remarkably low figure of only eleven deaths from the disease. Recent successful vaccination is a safeguard against Smallpox and Public Health workers rely on that in their dealings with cases of Smallpox. It is true that outbreaks of Smallpox are infrequent nowadays, and because of this and the comparatively high mortality rate of the disease, even a single suspected case is given great publicity. I do not think it is fully realised the number of contacts of Smallpox or suspected cases that arrive in the district and who require surveillance. It may be too late to give these contacts adequate protection by vaccination even if the Medical Officer of Health visits and vaccinates immediately he is informed. But what is more unfortunate is the number of such people who have never been vaccinated. Now, primary vaccination in an infant is a comparatively simple and safe procedure, but unfortunately, primary vaccination in older persons may have certain slight risks, but the M.O.H. faced with an unvaccinated contact of Smallpox can but attempt to give adequate protection. This difficulty would be materially reduced if infant vaccination were more popular. Of the 780 primary vaccinations carried out during the year, 592 were in children under the age of 2 years, most of the remainder being 5 in persons over 15 years of age. With the number of live births averaging 1,450 over the last three years, it is estimated that only about 40 per cent. of children are receiving primary vaccination in early childhood. With regard to the vital statistics of the District, the Birth Rate continued its general post-war downward trend and reached the lowest rate recorded this century, namely, 12.38. The Infant Mortality Rate of 17.72 was the lowest yet recorded and I am glad to report no deaths attributable to childbirth. The Death Rate of 10.56 was slightly higher than last year. Over one-fifth of the deaths occurred in persons over the age of 80 years, two women reaching 100 years and one woman 101 years. Although the total deaths were almost equally divided between males and females, only 39 per cent. of the deaths over 80 years were males. These proportions are similar to last year's figures. The Department has always realised the importance of Health Education amongst its duties and this is carried out in a variety of ways. The many contacts of the staff with the public in the course of their normal duties are considered the most important methods, but opportunities are taken to address various organisations and groups of people on health subjects. The Council has also provided in its buildings and on convenient sites throughout the district, notice boards on which posters are displayed, and pamphlets are issued at times on a variety of subjects. Proposed legislation in connection with Housing, Food and Drugs, and Slaughterhouses, together with the awakened national interest in atmospheric pollution, which may lead to greater control, must inevitably increase considerably the volume of work and degree of responsibility of the Department in the near future, and at the time of writing this report, considerable preparatory work in anticipation of the legislation has already been undertaken. In conclusion, I should like once again to record my appreciation of the efforts of the staff of the Health Department during the past year, and to refer especially to the retirement of that well-known and highly respected member of the Department, Mr. A. N. Smith, Senior Sanitary Inspector, who spent his whole working life, 52 years, in the most conscientious service of the Council, and to welcome his successor, Mr. J. C. Lightfoot, who commenced duty in September, 1953. William D. Hyde, Medical Officer of Health. 6 URBAN DISTRICT COUNCIL OF ENFIELD A. A. F. Tatman, Esq., J.P Chairman A. M. Eeles, Esq. Vice-Chairman Mrs. G. M. Jay, J.P. Mrs. E. M. Rowland A. D. Bates, Esq. W. G. Bowyer, Esq. D. R. J. Boxall, Esq. E. W. Burville, Esq. L. J. Collop, Esq. W. H. Cook, Esq. J. Cottenham, Esq., J.P. F. C. Cunneen, Esq. G. Deacock, Esq. L. H. Harris, Esq. A. G. Hayward, Esq. E. T. Hendrick, Esq. W. J. Howes, Esq., J.P. E. E. Leesmith, Esq. W. E. Lonsdale, Esq. E. L. Mackenzie, Esq. E. C. H. Mardell, Esq. L. Nicolls, Esq. C. Partington, Esq., J.P. M.R.S.T. G. H. Platten, Esq. P. L. Purnell, Esq., J.P. E. J. Rayment, Esq. P. Robson, Esq., J.P. A. H. Saunders, Esq. E. J. Tong, Esq. L. F. Wass, Esq. HEALTH COMMITTEE Mrs. G. M. Jay, J.P. Chairman L. H. Harris, Esq. Vice-Chairman also Mrs. Rowland, also Messrs. Boxall, Collop, Cottenham, Leesmith, Mardell, Platten and Rayment. 7 PUBLIC HEALTH STAFF Medical Officer of Health : Acting Deputy do. Senior Sanitary Inspector : Chief Sanitary Inspector : Dr. W. D. Hyde, M.B., Ch.B., D.P.H. Dr. Margaret R. Gilmour, M.B., Ch.B., D.P.H. Mr. A. N. Smith (Retired 18th September, 1953). Mr. J. C. Lightfoot, M.R.San.I., M.S.I.A., Cert. of R.San.I. for Inspection of Meat and Other Foods, Smoke Inspector's Certificate. Diploma, Sanitary Science. (Appointed 21st September, 1953). Sanitary Inspectors : Mr. H. Wiggett, Mr. A. Ramsden, Mr. D. C. Turner, Mr. C. Day, Mr. G. E. A. Laney and Mr. N. Smith. Shops and Housing Inspector: Mr. M. Wilson (Resigned 23rd January, 1953). Rodent Investigator : Mr. P. W. Partridge. Chief Clerk : Mr. Sydney Coulter. Senior Clerk : Mr. S. N. Dance. General Clerks : Mr. J. W. Viggers, Miss J. Pinkham and Miss D. M. Smith (Appointed 10th August, 1953). Shorthand-Typist: Miss H. E. Grout (Transferred to Clerk's Dept. 6th July, 1953). Mrs. I7. I. Dufton. STATISTICS AND SOCIAL CONDITIONS OF THE AREA POPULATION The population as estimated by the Registrar General is 109,300. The number of inhabited houses at the end of 1953, according to the Rate Books, was 30,352. Explanatory Note : Definition of "Houses"—Structurally separate dwellings including flats. The rateable value of the District is £916,288 The net product (after allowing for cost of collection) of a penny rate is £3,750 AREA Area (in acres) 12,400 NEW HOUSES The number of houses erected during the course of the year was 413. 8 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. Live Births:— Total Male. Female. Legitimate 1,305 660 645 Illegitimate 49 26 23 Birth-rate—12.38 per 1,000 population. Still Births:— Total. Male. Female. Legitimate 19 12 7 Illegitimate 1 — 1 Rate per 1,000 total births—14.55. Total. Male. Female. Deaths 1,155 562 593 Death-rate—10.56 per 1,000 population. Number of women dying in, or in consequence of, childbirth:— Deaths. Rate per 1,000 Total Births. From Puerperal Sepsis — 0.00 From other Puerperal causes – 0.00 – 0.00 Death-rate of Infants under one year of age:— All infants per 1,000 live births 17.72 Legitimate infants per 1,000 legitimate live births 17.62 Illegitimate infants per 1,000 illegitimate live births 20.40 Deaths from Cancer (all forms) 230 Deaths from Cancer (Lungs and Bronchus) 35 Deaths from Tuberculosis (Respiratory) 11 Deaths from Tuberculosis (Other forms) 1 9 BIRTH, DEATH AND INFANT MORTALITY RATES. Birth-rate. Death-rate. Mortality rate Infant Live Still England and Wales 15.5 22.4 11.4 26.8 London 17.5 21.0 12.5 24.8 160 County Boroughs and Great Towns (including London) 17.0 24.8 12.2 30.8 160 Smaller Towns 15.7 21.4 11.3 24.3 ENFIELD 12.38 14.55 10.56 17.72 DEATHS The number of deaths assigned to Enfield for 1953 was 1,155, an increase of 95 on last year. The more prevalent causes of death during the year and the previous year were :— Cause of Death 1953 1952 All Ages:— Malignant Disease (Cancer) 230 197 Diseases of Heart 342 340 Other Diseases of Circulatory System 61 52 Pneumonia 66 42 Bronchitis 77 63 Vascular Lesions of Nervous System 166 164 Tuberculosis of Respiratory System 11 19 Children Under 1 Year:— Premature Birth 7 8 Congenital Malformations 1 3 Pneumonia 1 4 Bronchitis 2 1 Gastritis 1 3 Atelectasis 7 6 The net death-rate for the District is 10.56 per 1,000 population. Two-hundred-and-thirty-three deaths registered were of Enfield persons over 80 years of age, 90 being males and 143 females, one man dying at the age of 96, two women at the age of 95 years, two at 96 years, two at 100 years, and one at the age of 101 years. 10 TABLE I. Causes of Death during Year 1953. Causes of Death. Males. Females. Total. Whooping Cough Diphtheria — — — Tuberculosis of Respiratory System 9 2 11 Other Forms of Tuberculosis — 1 1 Syphilitic diseases — 3 3 Influenza 10 6 16 Measles — — Other infective and parasitic diseases — — — Ac. Polio-myelitis 2 — 2 Meningococcal infections — — — Malignant Neoplasm of stomach 18 18 36 Malignant Neoplasm, lung, bronchus 31 4 35 Do. of breast — 31 31 Malignant Neoplasm, uterus — 8 8 Other Malignant and Lymphatic Neoplasms 57 63 120 Leukaemia, aleukaemia 1 3 4 Diabetes 1 2 3 Vascular lesions of nervous system 59 107 166 Coronary disease, angina 87 47 134 Hypertension with heart disease 12 12 24 Other Heart disease 87 97 184 Other Circulatory disease 25 36 61 Bronchitis 41 36 77 Pneumonia 29 37 66 Other diseases of Respiratory system 6 2 8 Ulcer of stomach and duodenum 13 5 18 Gastritis, Enteritis and Diarrhoea 1 3 4 Nephritis and Nephrosis 6 5 11 Hyperplasia of prostate 7 — 7 Pregnancy, Childbirth and Abortion — — — Congenital Malformations 1 1 2 Suicide 3 — 3 Motor Vehicle accidents 4 1 5 All Other accidents 13 11 24 Other defined and ill-defined diseases 39 52 91 Homicide and operations of war — — — Total 562 593 1,155 11 TABLE II. Infant Mortality Net Deaths from stated causes at various Ages under One Year of Age. Causfs of Death. Under 1 week. 1 to 2 weeks. 2 to 3 weeks. 3 to 4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under One Year of Age All Causes—Certified 18 – – 1 19 3 1 – 1 24 Uncertified – – – – – – – – – – Bronchitis 1 1 – – 2 Pneumonia (all forms) 1 – – – 1 — – – — 1 Gastritis — – – – — 1 – – — 1 Enteritis — – – 1 1 — – – — 1 Atelectasis 7 – – – 7 — – – — 7 Congenital Malformation 1 – – – 1 — – – — 1 Premature Birth 7 – – – 7 — – – — 7 Other Causes 2 – – – 2 1 – – 1 4 Totals 18 — — 1 19 3 1 – 1 24 Net Births in the year :—Legitimate: Live births, 1,305 ; Stillbirths, 19. Illegitimate: Live births, 49; Still-births, 1. Net Deaths in the year Legitimate Infants, 23; Illegitimate, 1. It will be seen from Table II that of the 24 infants who died before attaining the age of 1 year, 19 died within the first four weeks of life, and of this number 18 deaths occurred in infants under 1 week. The infant mortality rate for the District is 17.72 and this figure compares most favourably with the rest of the country. 12 BIRTHS The corrected birth rates for both sexes, live and still births, which takes into consideration those born outside the District and those in the District not rightly recorded to the District, and also the corrected birth rates for the last five years are :— Year. Boys. Girls. Total. Birth-rate per 1,000 Population. Illegitimate Birth-rate per 1,000 Population. 1949 951 811 1,762 15.85 0.56 1950 816 782 1,598 14.31 0.57 1951 775 813 1,588 14.45 0.38 1952 715 747 1,462 13.32 0.38 1953 698 676 1,374 12.57 0.45 INQUESTS Fifty-one inquests and one-hundred-and-twenty-seven Postmortem examinations without inquests were held during the year. Of these, 139 deaths were due to natural causes, 31 to accidental causes, 3 to suicide, 3 to misadventure, and in 2 cases an open verdict was recorded. FATAL HOME ACCIDENTS. Last year I wrote at some length on the subject comparing Enfield figures with the National pattern. This year again in Enfield the emphasis is on fatal accidents to the aged, all being between the ages of 61 and 100 years, except 1 person aged 30 years. The 9 fatal home accidents to Enfield residents involved 7 females and 2 males. The causes of death in four females and one male were falls causing fractured bones followed by lung complications. The cause in one female was traumatic cerebral softening following fall downstairs ; in the case of one female the cause was coal gas poisoning, in another to electrocution, and the cause of one other male was asphyxiation due to inhalation of vomit. 13 The outstanding points in these figures are the high proportion of elderly females, 78 per cent. of the total, and the fact that no children were involved. One hears much more about Road accidents than accidents in the Home, but this year, there was only one less accident to Enfield residents in the home than on the streets, 9 fatal home accidents compared with 10 fatal road accidents. In the case of road accidents, the proportion of males to females involved was greater than that for home accidents, and the average age was lower. The figures I have quoted indicate the continued need for propaganda to impress on the public the need to take every possible precaution to prevent accidents in the home, particularly where the aged are concerned, as an accident resulting in a fall can so frequently lead to fatal complications. It might not be inappropriate to mention here the occurrence of 4 cases of suicide, all males, ages ranging from 22 years to 74 years; the average age being 41 years. The method adopted in all cases was coal gas poisoning. NATIONAL ASSISTANCE ACTS, 1948 AND 1951. No action was necessary during the year under these Acts with regard to the removal to suitable premises of persons in need of care and attention. Such cases as were brought to the notice of the Health Department were dealt with by the Medical Officer of Health in cooperation either with the Medical Practitioners or Welfare Officer, and the patients voluntarily agreed to go to Hospital or suitable Institution. Most old people show a natural reluctance to leave their homes, which sometimes consist of a single room in a dirty and unhygienic state owing to their inability to look after the premises. Some should not be living alone, and although we must not be hasty to criticize, there appears to be in some cases a need for the awakening of responsibility of the family to its aged members. In some instances, where reluctance to leave their homes is encountered, provision of Home Help and District Nurse Services can be arranged and a careful watch on the situation maintained by members of the Health Department Staff, and compulsory removal in the interests of the old person is rarely enforced, as persuasion usually succeeds in the end. 14 AMBULANCE FACILITIES Under the National Health Service Act, 1946, the duty of providing an Ambulance Service devolves upon the County Council, and from the 5th July, 1948 the Middlesex County Council Fire and Ambulance Service has been responsible for the Ambulance Service previously controlled by the Health Department of the Enfield Council. HOSPITAL FOR INFECTIOUS DISEASES During the year, the following cases were admitted from Enfield to South Lodge Hospital. Dysentery 1 Erysipelas 5 Scarlet Fever 82 Meningococcal Infection 4 Poliomyelitis 4 Measles 10 Whooping Cough 9 Gastro-enteritis 15 Chicken pox 2 Food Poisoning 10 Pneumonia 2 Glandular Fever 2 Quinsy 3 Acute Tonsillitis 1 Bilateral Otitis 1 Rubella 1 152 LABORATORY FACILITIES The examination of all specimens is now carried out by the Public Health Laboratory Service either at the Central Laboratory, Colindale, or the branch laboratory situated at the Town Hall Edmonton. The following table sets out the record of examinations carried out and the results. 15 Throat and Nose Swabs. Diphtheria Bacilli — 642 Haemolytic Streptococci 168 Vincent's Angina 15 Negative 459 Faeces. Shigellae 355 2,287 Giardia 63 Salmonella 81 Gastro-Enteritis Coli 22 Protozoa 9 Negative 1,757 Sputum. T.B. Smear 9 129 Other Organisms 52 Negative 68 Pertussis. Cough Plate — 8 Postnasal Swab — Negative 8 Milk. Pasteurised 10 72 Other (Dried) 2 Ice cream 60 Water. Domestic supplies, etc. 22 62 Swimming pools, etc. 40 Miscellaneous. 186 186 3,386 16 WATER SUPPLY The District of Enfield is supplied with water by the Metropolitan Water Board, except for part of the Hadley Wood and Cockfosters area, which is supplied by the Barnet District Water Company. Both of these Authorities take regular and frequent samples for analysis. Copies of these reports are sent to the Health Department, and have shown satisfactory results. There was no cause to suspect any contamination during the year. There are four dwellings in Enfield which receive their water supply other than from a public company; these are under constant supervision. There are no houses in the district which receive their water supplies by means of standpipes. The question of well-water supplies, both in connection with dwelling-houses and industrial premises, throughout the district has received the careful attention of the Department during the year, and every care has been exercised to see that such supplies are not used for drinking purposes where mains water supply is available, and during the year eight samples of well water were examined bacteriologically. In addition, fourteen other samples of drinking water other than from wells were bacteriologically examined. MEDICAL ASSESSMENT OF EMPLOYEES. The following medical examinations or assessments of employees were carried out during the year:— (I) Superannuation Act: Medical examinations 33 Assessments without medical examinations 20 (2) Sick Pay Scheme: Medical examinations 51 Assessments without medical examinations 42 (3) Other Medical Examinations 12 17 HOUSING Number of new houses erected during the year by:— (a) Local Authority 347 (b) Other Local Authorities Nil (c) Other bodies or persons 66 With State assistance (included in above totals):— (a) Local Authority Nil (b) Other Local Authorities Nil (c) Other bodies or persons Nil 1. Inspection of Dwelling-houses:— No. of houses. No. of inspections. (1) Total number of dwelling-houses inspected for housing-defects (under Public Health, Housing Acts) and number of inspections made 2,283 11,760 (2) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932, and the number of inspections made 65 126 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 6 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 776 (The number here given is of houses where any insanitary conditions were found.) 2. Remedy of defects without service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 582 3. Action under Statutory Powers. A.—Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which Notices were served requiring repairs 2 (2) Number of dwelling-houses which were rendered fit after service of formal Notices:— 18 (a) By owners Nil (b) By Local Authority in default of owner Nil B.—Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which Notices were served requiring defects to be remedied 153 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 120 (b) By Local Authority in default of owners 8 The number of house-to-house visitations made was:— Under Housing Regulations, 1925 and 1932 126 Apart from Do. Do. 36 SLAUGHTER-HOUSES There are six slaughter-houses in Enfield, none of which is in use at present. THE MILK (SPECIAL DESIGNATIONS) (RAW MILK) AND (PASTEURISED AND STERILISED MILK) REGULATIONS, 1949 AND 1950. The following Licences were in operation at the end of the year : Grade. Dealers. Supplementary. Raw Milk : Tuberculin Tested .. 17 10 Pasteurised Milk 24 10 Sterilised Milk 72 12 Totals: 113 1 32 During the year 10 samples of Milk were taken and tested; all were found to be satisfactory. 19 FOOD AND DRUGS ACT, 1938 The following table gives details of the samples procured under the above Act in Enfield by the Food and Drugs Authority during 1953:— Article. Total samples procured. Unsatisfactory. Milk (various) 318 45 Arrowroot 2 — Baking powder 1 — Cakes (various) 30 — Cake mixture 3 — Champagne perry 1 — Chops 18 — Coffee 2 — Coffee and chicory essence 1 — Cooked meat 2 — Cream 13 — Desiccated coconut 1 — Drugs (various) 6 — Fish (various) 11 — Fish paste 1 — Fruit squash 1 — Ginger wine 1 — Ice cream 13 2 Cream lolly 4 1 Isinglass 1 1 Jams 3 — Lard 1 — Marmalade 1 — Meat paste 2 1 Mincemeat 2 — Pineapple 1 — Prawns 1 — Sausages and sausage meat 25 — Soup (tinned) 1 — Spirits (various) 36 — Stewed meat 4 — Sundae sauce 1 — Sweets (various) 4 1 Vinegar 16 3 White Pepper 2 — Totals: 530 54 20 With regard to the samples noted as unsatisfactory 43 milk samples were of "new milk," 5 farmers being involved. Forty-one of the samples had small fat deficiencies and 2 were slightly deficient in solids-not-fat. There was no added water and the milk was, no doubt, genuine but sub-standard. The farmers and the consignees were informed. The remaining 2 unsatisfactory samples of milk were of hot milk procured from one restaurant. The seller was prosecuted and fined £2 with £3 3s. Od. costs. Two samples of ice cream were each slightly deficient in fat. Subsequent samples were of satisfactory standard and no further action was taken. The sample of cream lolly was an (iced) cream lolly 55 per cent, deficient in fat. No action was taken on this particular sample because a further sample of the same product taken in a neighbouring Borough provided a better case and as a result of that sample the firm was prosecuted and fined £2 with £"5 19s. Od. costs. The sample of isinglass adversely reported upon has raised issues of some importance regarding the general labelling of this product and the question is not yet finally resolved. In this particular case the manufacturer, in consultation with The Public Control Officer and the Ministry of Food has, for the time being, agreed to alter the material from which this article is manufactured from an animal source to the bladders of certain fish and until the matter is finally resolved the product which he is marketing is quite satisfactory. The sample of meat paste was unfit for human consumption and the seller was prosecuted and fined £2 and £3 17s. Od. costs. The sample of sweets was of chocolate caramel which was unfit for human consumption. The manufacturer, a firm with an excellent record, received a caution. The 3 samples of vinegar were each in respect of the sale of non-brewed condiment as vinegar. Two traders were involved and official cautions were issued. CLEAN AND SAFE FOOD In my report on the Clean and Safe Food Campaign in 1951 I expressed the view that the Campaign was only the beginning of the Health Department's special efforts to establish and maintain 21 a high degree of food hygiene by the housewife, the trade and the public generally. Throughout the year the staff of the Health Department have striven to ensure that the standards attained as a result of the first and subsequent Campaigns were maintained and, where necessary, improved. The sanitary inspectors paid 1,902 visits to 816 food premises during the year, always taking the opportunity of emphasising the need for constant awareness that particular care in the handling of foodstuffs is essential to ensure "Clean and Safe Food." Although structural alterations, improved layout of premises, modern equipment, additional and convenient sanitary accommodation, plentiful supply of hot water and hand washing facilities, are important, these improvements can only be successful if the staff are aware of the simple hygienic principles involved in safe food handling, and what is more important, are willing to observe them strictly. Although many tangible improvements in premises have been effected through the efforts of the Sanitary Inspectors, there is still evidence of reluctance by staff to make full use of these facilities in the interests of clean and safe food. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASES AND SCHOOLS 1953. 1952. Number of children notified by Head Teachers to be absent from School due to:— (a) Infectious Disease or suspected Infectious Disease 620 462 (b) Contact with Infectious Disease 29 16 Number of School children notified by General Practitioners as suffering from Infectious Disease 1,045 1,226 22 NOTIFIABLE DISEASES DURING THE YEARS 1952 AND 1953. 1953 1952 No. Removed. Deaths. No. Removed. Deaths. Smallpox — — — — — — Cholera—Plague — — — — — — Diphtheria (inc. Membranous Croup) — — — — — — Diphtheria Carriers — — — — — — Erysipelas 19 6 — 25 6 — Scarlet Fever 178 84 — 343 123 — Typhus Fever — — — — — — Typhoid Fever — — — — — — Paratyphoid Fever — — — 2 2 — Relapsing Fever — — — — — — Continued Fever — — — — — — Puerperal Pyrexia 51 46 — 48 46 — Meningococcal Infection 7 7 — 4 4 — Poliomyelitis (Paralytic and Non-Paralytic) 10 9 2 16 16 1 Acute-Encephalitis — — — — — — Ophthalmia Neonatorum 15 15 — 1 1 — Pulmonary Tuberculosis 143 — 11 126 — 19 Other forms of Tuberculosis 15 — 1 16 — 2 Food Poisoning 26 14 — 10 — — Malaria — — — — — — Pneumonia 100 9 66 37 2 42 Dysentery 164 3 — 181 — — Measles 1316 11 — 1491 30 — Whooping Cough 456 10 — 246 7 — Totals 2500 214 80 2546 237 64 The above figures are in respect of Civilians and NonCivilians. The following table shows the number of houses in which cases of infectious diseases occurred during the year. In many instances, more than one family were occupying the houses. Disease 1 case 2 cases 3 cases 4 cases 5 cases 6 cases Scarlet Fever 146 13 2 – – – Measles 802 203 28 6 — — Whooping Cough 269 68 14 1 1 — Dysentery (Sonne) 74 23 10 2 — 1 Food Poisoning 15 1 – 1 1 — Poliomyelitis 8 1 – – — — 23 The following table shows the number of notifications of cases of Infectious Disease per 1,000 civilian population in Enfield as compared with England and Wales, 160 County Boroughs and Great Towns including London, 160 Smaller Towns with resident population 25,000-50,000 (1951 Census) and London Administrative County. ENFIELD. England and Wales. 160 C.B.s and Great Towns including London. 160 Smaller Towns Resident Pop. 25,000-50,000 1951 Census. London Adm. County. Typhoid Fever 0.00 0.00 0.00 0.00 0.01 Paratyphoid Fever 0.00 0.01 0.01 0.01 0.01 Meningococcal Infection 0.06 0.03 0.04 0.03 0.03 Scarlet Fever 1.62 1.39 1.50 1.44 1.02 Whooping Cough 4.17 3.58 3.72 3.38 3.30 Diphtheria 0.00 0.01 0.01 0.01 0.00 Erysipelas 0.17 0.14 0.14 0.13 0.12 Smallpox 0.00 0.00 0.00 0.00 — Measles 12.04 12.36 11.27 12.32 8.09 Pneumonia 0.91 0.84 0.92 0.76 0.73 Acute Poliomyelitis (including Polio-encephalitis) Paralytic 0.08 0.07 0.06 0.06 0.07 Non-Paralytic 0.01 0.04 0.03 0.04 0.03 Food Poisoning 0.23 0.24 025 0.24 0.38 Puerperal Pyrexia 37.11(a) 18.23(a) 24.33(a) 12.46(a) 28.61(a) (a) Per 1,000 Total (Live anfl Still) Births. DIPHTHERIA For the fifth year in succession no case of Diphtheria occurred in the District. DIPHTHERIA IMMUNISATION 1,251 children were immunised for the first time and 2,216 received subsequent reinforcing doses during the year. The figure for primary immunisation is lower than last year's figure. The number of parents accepting this service for their children is not yet sufficiently high to warrant any sense of security. WHOOPING COUGH IMMUNISATION 766 children were immunised against Whooping Cough for the first time during the year, and 46 received subsequent re-inforcing doses. 24 VACCINATION 780 persons received primary vaccination and 181 re-vaccination. POLIOMYELITIS AND ACUTE ENCEPHALITIS. During the course of the year ten cases of poliomyelitis occurred in the District, varying in severity from slight to one fatal case. The ages ranged from 8 months to 32 years, the age distribution being 2 cases under five years, 2 between 5 and 14 years and 6 between 15 and 32 years. Six of the cases were male and four female. They were distributed over the district, but two of the adult cases were in the same household and developed the illness within a few days of each other. The first case to be notified during the year occurred in March. No further cases occurred until the end of July when four cases occurred, followed by another four cases in August, and a further one in October. Apart from the two adult cases in the same household, no evidence of association between cases could be found. FOOD POISONING Twenty-six cases of food poisoning were notified during the year, of which 16 were single cases, 15 due to "Salmonella typhimurium "and 1 due to" Salmonella St. Paul." In addition, 4 cases were notified in one household, but no agent was identified. Several mild cases were also reported in connection with a meal served in a non-residential establishment. Investigations suggested that meat pie infected with heat resistant CI. Welchii was responsible. A few mild cases were also reported from a residential establishment, and investigations also showed a number of symptomless cases, due to Salmonella typhi-murium, but no conclusive evidence as to source of infection was secured. SONNE DYSENTERY The incidence of mild dysentery due to Shigella Sonnei, showed a reduction of 17 cases on last year's figures. It is believed that the spread of infection was reduced to some extent, by the steps taken to exclude contacts from Day Nurseries, Schools and certain occupations, and by the intensive search for contacts, followed by bacteriological investigation, and control of those found to bo positive, but it put a considerable strain on the Department and the Laboratory. 25 TUBERCULOSIS. The successful visit of the Mass X-Ray Unit which is controlled by the Regional Hospital Board illustrates successful co-operation in the National Health Service in spite of multiplicity of control and responsibility. In 1952 the Public Health (Tuberculosis) Regulations 1952 came into operation. These had the effect of revoking and replacing the 1930 Regulations, but re-enacted the provisions for the notification of Tuberculosis by Medical Practitioners to the Medical Officer of Health of the district. The new regulations no longer require a Medical Officer of Health to keep a register of tuberculosis notifications, nor do they provide for information of a tuberculous patient entering or leaving a sanatorium or hospital being sent to the Medical Officer of Health of the district to which the patient belongs. The Minister of Health felt that the 1930 Regulations had become outdated and at variance with the present structure and operation of the Tuberculosis Services, as by S.28 of the National Health Service Act, 1946, statutory responsibility for preventing tuberculosis and for the care and after-care of tuberculous persons is placed upon Local Health Authorities. At the same time, the Minister stated that District Councils have statutory functions as Sanitary Authorities under the Public Health Acts, or as Housing Authorities, some of which may have an important part in preventing the spread of tuberculous infection. In addition to the Local Sanitary Authority and Local Health Authority, many other bodies would appear to be concerned in the welfare of the tuberculous patient. First of all, there is the General Practitioner who is the patient's personal medical attendant. The Regional Hospital Board provides the Specialist staff for diagnosis and treatment in Clinics and Hospitals, and Mass X-Ray Units. The Local Health Authority is mainly responsible for prevention, care and after-care by provision of Health Visitors and Welfare Officers to the homes, occupational therapy, re-habilitation as in colonies or sheltered workshops, hostels for homeless, loan of equipment, extra nourishment, home nursing, tuberculin testing and X-Ray of contacts and B.C.G. vaccination. The National 26 Assistance Board and the Ministry of Labour (e.g., re-training and change of occupation) play their part, as also do the Voluntary Bodies. The Local Sanitary Authority has certain powers, some of which it shares with the Local Health Authority, which can be used in the prevention of spread of Tuberculosis. These include powers to prevent a person suffering from tuberculosis of the respiratory tract and who is in an infectious state from employment involving the handling of milk or food. Powers are also available in certain circumstances, to remove a tuberculous person to Hospital. Finally, and possibly the most practicable measure, is the power to give sympathetic consideration to re-housing of tuberculous families to prevent if possible the infection being passed on to other susceptible members of the family, for in some instances, unsatisfactory living conditions are directly responsible for the spread of infection to other members of the family. The following table gives particulars of the ages of the new cases notified and deaths from this disease during the year. Age Periods. New Cases. Deaths. Respiratory. NonKespiratory Respiratory. i NonRespiratory. M. F. M. F. M. F. M. F. Under 1 – – – – – – – – 1 to 5 1 – – – – – – – 5 to 10 3 3 – 2 – – – – 10 to 15 1 3 1 – – – – – 15 to 20 5 11 – 2 – – – – 20 to 25 16 17 3 1 – – – – 25 to 35 13 15 1 4 – – – – 35 to 45 14 15 – – 2 – – 1 45 to 55 8 4 – – 3 – – – 55 to 65 7 – – – 2 – – – 65 and upwards 4 3 – 1 2 2 – – Totals 72 71 5 10 9 2 – 1 27 The following table shows the incidence of Tuberculosis and death-rates from this disease in the various Wards in the District during the year. Ward. Estimated Population. No. of Cases. T.B. Case-rate. T.B. Death-rate. Pulm. Other. Pulm. Other. Pulm. Other. Bush Hill Park 10,580 8 2 0.75 0.18 0.00 0.00 Cambridge Road 10,678 20 4 1.87 0.37 0.00 0.09 Chase 7,530 10 1 1.32 0.13 0.00 0.00 Enfield Wash 12,564 20 2 1.59 0.15 0.15 0.00 Green Street 10,678 13 – 1.21 0.00 0.09 0.00 Ordnance 13,436 20 1 1.48 0.07 0.07 0.00 Ponders End 9,896 14 – 1.41 0.00 0.50 0.00 The Town 11,076 17 – 1.53 0.00 0.09 0.00 West 12,277 11 1 0.89 0.08 0.08 0.00 Willow 10,585 10 4 0.94 0.37 0.00 0.00 Total 109,300 143 15 1.30 0.13 0.10 0.01 MASS RADIOGRAPHY Reference was made in my Annual Report last year to the fact that another Mass X-Ray Campaign was carried out yi Enfield by the North-East Metropolitan Regional Hospital Board and the mobile unit operated at Halls and Factories throughout the District from the 9th October, 1952 well into 1953, and 17,766 persons were examined. The usefulness of the work undertaken by the Unit and the encouraging response by Enfield residents is shewn by the figures in the accompanying table. I feel I cannot let this opportunity pass without paying a tribute to Dr. Hugh Ramsay and his staff for the efficient manner in which the Survey was carried out. 28 NORTH EAST METROPOLITAN REGIONAL HOSPITAL BOARD Mass Radiography Unit 6A Wanstead Hospital MASS RADIOGRAPHY SURVEY ENFIELD DISTRICT 1852-1953 Final analysis of figures Male Female Total Total number X-rayed by miniature 10,632 7,134 17,766 Recalled for large film 417 243 660 Groups Schoolchildren no. of miniatures 931 744 1675 Recalled for large film 13 11 24 School Staffs no. of miniatures 60 46 106 Recalled for large film 2 1 3 Organised Groups (factories, offices, ctc.) Number of miniatures 7231 3814 11045 Recalled for large film 285 113 398 Public Sessions no. of miniatures 1605 2469 4074 Recalled for large film 68 118 186 pulmonary Tubcrculosis Inactive primary 144 87 231 Active Post primary 19 16 35 Inactive Post primary 141 48 189 The active cases were discovered in the following groups School Staff – 1 1 Organised Groups 8 9 17 Public Session 8 6 14 Among interesting abnormalities were : Pneumonia 4 1 5 Bronchiectasis 16 2 18 Cardiovascular Lesions (congenital) 1 3 4 Cardiovascular Lesions (acquired) 22 25 47 Pleural effusion (non t.b.) 2 1 3 Pneumokoniosis 4 – 4 Reticulation of unknown aetiology 1 – 1 Transposition of viscera 1 – 1 Diaphragmatic Hernia 1 1 Intrathoracic Cyst 1 – 1 Lung Abscess 1 – 1 Neurofibroma 1 1 2 Bronchial Carcinoma 3 – 3 Unable to classify Did not attend for repeat miniature 18 9 27 Did not attend for large film 14 10 24 Did not attend for clinical interview 1 – 1 Did not attend clinic 2 – 2 29 PREVENTION OF DAMAGE BY PESTS ACT, 1949. During the year a Rodent Investigating Officer and four operators were engaged on control of rat infestation at dwellinghouses and other premises and of the sewers in the district. The Council provides this service to the occupiers of all dwellinghouses free of charge ; industrial and business premises are dealt with at the request of the proprietors who pay the full cost of any disinfestation undertaken at their premises. 606 premises were inspected during the year for rat and mice infestation, and of these 548 were found to be affected. The total number of treatments carried out by the Department (including domestic, business and factory premises, and re-infestations) was 431. During the year the Sanitary Inspectors and Rodent Investigating Staff made 5,482 visits concerning rat infestation. All the sewers in the district have been systematically examined and the Ministry's scheme for the extermination of rats in sewers has been closely followed. Experience gained during these investigations has proved extremely useful to the Department, and it has been possible to trace any colony or heavy infestation; such infestations as were discovered were confined to small areas far apart from one another. During the initial investigations 492 manholes were examined and 428 pre-baits and 78 poison-baits were laid. The necessary follow-up treatment continues so that the rat population of the sewers may be kept under control. ERADICATION OF BED BUGS Number of Council Houses found to be infested 13 Number of Council houses disinfested 13 Number of other houses found to be infested 22 Number of other houses disinfested 22 Householders are urged to seek the assistance of the Health Department immediately they suspect the presence of bugs or similar pests. 30 SANITARY INSPECTORS' INSPECTIONS AND VISITS The following report, in condensed form, gives details of the work of the Sanitary Inspectors during the year 1953. The total number of inspections made during the year for all purposes was 21,983. The following table shows the number of inspections carried out by the Sanitary Inspectors during the year. Inspections of Premises:— No. of Inspections Housing Act, 1936 127 Infectious Disease 477 Tuberculosis 107 Complaint or otherwise 10,795 Vermin 264 Rag Flock and Other Filling Materials Act 6 Pet Animals Act 16 Public Conveniences 347 Ice-Cream Shops 347 Schools 35 Cinemas, Halls, etc. 41 Fair-grounds 5 Hairdressers 20 Milkshops and Dairies 130 Food Preparing Premises 1,255 Food Hawkers' Stands 39 Food Hawkers (Storage) 66 Bakehouses 65 Outworkers' Premises 17 Factories 45 Smoke Observations 169 Visits:— Infectious Diseases 1,123 Tuberculosis 42 Housing Act, 1936 (Sec. 62)—Permitted Numbers 36 Shops Act 29 Improvements Grants 152 Builder's Notices 21 Exhumations 2 Food Inspections 157 Gipsy Vans 63 C/fwd 15,998 31 B/fwd 15,998 Rats 762 Overcrowding 16 Piggeries 25 Stables 17 Well Water Supplies 8 Other Visits 369 Visits by Rodent Dept. Staff :— 17,195 Rats 4,720 Wasps, Beetles, etc. 68 21,783 Samples taken—Water—Wells 8 Mains, etc 14 Swimming Baths 19 Parks Lakes etc 21 Milk (Liquid) 10 Do. (Dried) 2 Ice-Cream 60 Rag Flock Nil Miscellaneous Foodstuffs 9 The following list of repairs executed during the course of the year shows that the defects found as the result of the Sanitary Inspectors' visits were varied and general in character. Houses or parts of houses cleansed, repaired, etc 238 Roofs repaired 237 Gutters and downpipes repaired 113 Downpipes disconnected from drains – Dampness remedied 117 Ventilation provided under floors – Floors repaired 39 Yards paved or made good 8 Dustbins provided or renewed 63 Food stores provided – Food stores cleansed, etc – Drains—Examined 221 Tested—Smoke 43 Water 20 Reconstructed 11 Repaired, etc 202 Vents provided 1 Vents repaired 5 Cesspools abolished – 32 Cesspools repaired 61 Sink wastes repaired 16 New sinks provided 2 Water-closets—New ones provided 19 New pans provided 29 Apparatus repaired or renewed 38 Water—Cistern provided – Cisterns cleansed, covered, etc 4 Wells cleansed, repaired, etc 3 Wells closed 7 Water laid on or restored 5 Nuisances—Fowls, etc., removed 1 Manure, etc., removed 4 Ditches, etc., cleaned out Other nuisances abated—Stoves repaired or renewed 57 Windows repaired or renewed 147 Gipsy vans removed 30 Overcrowding abated 1 Miscellaneous 77 Wasps Nests destroyed 68 Houses demolished 12 NOTICES ISSUED Statutory (Insanitary Conditions) 159 Informal ( Do. ) 554 Other Notices (Infectious Diseases) 4,356 5,069 Other Letters sent 2,396 Number of Certificates issued in connection with plans Nil Number of Certificates issued in connection with disinfection 4 Number of Certificates issued in connection with unsound foods 757 Number of Requisitions for Information dealt with 2,023 Number of Certificates issued under Rent Restrictions Acts, 1920 to 1939 3 Result of Service of Statutory and Informal Notices:— Statutory. Informal. Number complied with 128 406 Number outstanding 31 148 159 554 33 INTERVIEWS A considerable amount of the time of the staff of the Health Department is taken up in interviewing members of the public who call at the offices for advice on matters concerning health and complaints as to the condition of their houses. During the course of the year 473 members of the public were afforded such interviews. DISINFECTION Number of houses disinfected after infectious disease and verminous cases 272 Number of articles of clothing, bedding, etc., disinfected 3,381 Number of Library books disinfected 415 Number of articles of clothing, bedding, etc., destroyed 69 RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951. The Act controlling premises in which these materials are used came into force on 1st November, 1951. Six premises have been registered for the manufacture of new articles containing filling materials. PET ANIMALS ACT, 1951 This Act, which controls the keeping of a pet shop, came into force on the 1st April, 1952. During the course of the year the 4 premises licensed by the local authority in 1952 were re-licensed. THE HEATING APPLIANCES (FIREGUARDS) ACT, 1952. The above Act requiring fireguards to be fitted to gas fires, electric fires and oil heaters of types so designed that they are suitable for domestic use, and so constructed that without a guard there is likelihood of injury by burning, or of ignition of clothing by reason of contact with, or proximity to the heating element or flame, came into operation on the 23rd March, 1953, and the regulations made under this Act come into force on the 1st October, 1954. Each of the Sanitary Inspectors has been appointed a duly appointed officer under the Act. 34 FACTORIES ACT, 1937 A register is kept of all the factories in the District, and during the year 110 inspections were carried out. 1.—INSPECTIONS for purposes of provisions as to health (including inspections made by Sanitary Inspectors). Premises. Number on Register. Number of Inspections. Written notices. Occupiers prosecuted. (1) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 51 30 – – (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority 357 80 – – (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 18 – – – Total 426 110 – – 2.—Cases in which DEFECTS were found. Particulars. Number of cases in which defects were found. Number of cases in which prosecutions were instituted. Found. Remedied. Referred. To H.M. Inspector. By H.M. Inspector. Want of cleanliness (S.l) – – – – – Overcrowding (S.2) – – – – – Unreasonable temperature (S.3) – – – – – Inadequate ventilation (S.4) – – 1 – – Ineffective drainage of floors (S.6) – – – – – Sanitary Conveniences (S.7) (a) Insufficient – – – – – (b) Unsuitable or defective 4 3 – 7 – (c) Not separate for sexes 1 – – – – Other offences (not including offences relating to Outwork) 2 1 – – – Total 7 4 1 7 – 35 OUTWORKERS Fifty-nine lists containing the names and addresses of 602 out-workers were received during the year. One-hundred-andseventy-four addresses of outworkers were forwarded to other districts. The following table gives details of the work carried out:— Outwork. Nature of Work. No. of Outworkers. Prosecutions. Notices served. Carpets, Bedding, etc. 1 – – Shoe Designs and Ornamentations 1 – – Down Quilts 2 – – Making Wearing Apparel, etc. 166 – – Cardboard Boxes, etc. 12 – – Feather sorting and mounting 3 – – Carding of Buttons, etc. 2 – – Artificial Flowers 7 – – Brush Making and Artist's Materials 121 – – Electrical Accessories 140 – – Xmas Crackers, etc. 1 – – Stuffed Toys, Games and Toys 85 – – Household Linen 4 – – Chemists' Sundries 6 – – Handbags 2 – – Furriers 2 – – Table Stationery 5 – – Boots and Shoes 4 – – Rubber Goods 4 – – Ladies Belts 1 – – Knitting Wools 2 – – Carbon Papers 4 – – Plastic Mouldings, etc 21 – – Leather Dressing and Gloves 4 – – Hosiery Repairs 2 – – Total 602 – – HAIRDRESSERS AND BARBERS' PREMISES. Byelaws were made in 1937 for the purpose of securing the cleanliness of any premises used for the purpose of carrying on the business of a hairdresser or barber and of the instruments, towels, and materials used in such premises. These byelaws have proved useful in maintaining a high standard in the premises in the district. 36 PLACES OF PUBLIC ENTERTAINMENT Number of inspections 41 OFFENSIVE TRADES There is only one offensive trade business established in the district, and during the year no complaints were received in connection therewith. ATMOSPHERIC POLLUTION. Complaints of atmospheric pollution were again confined to a few specific areas, the main trouble being restricted to two particular sources where intermittent regression in the conditions kept occurring, and where continual efforts were made to try to improve circumstances. Structural alterations at one source of trouble are under consideration and it is hoped that these proposals will prevent further pollution during the coming year. Towards the end of the year, a decision to instal equipment for measurement of atmospheric pollution at selected sites in the district was taken, and the apparatus should be installed in the near future. SWIMMING BATHS AND POOL Enfield has two public swimming pools, a relatively modern open air pool, built in 1932, situated next to the Sports Stadium, and indoor baths at Enfield Lock, built in 1895. Within the limits of their construction, both baths are maintained at a high level of efficiency and cleanliness. Reports on the twice-daily examinations for chlorine content and alkalinity of the water are sent to the Medical Officer of Health, and Sanitary Inspectors take samples regularly for bacteriological tests. As regards the purification of the water, the most up-to-date method of break-point chlorination with continuous filtration and aeration is installed at the open air pool and this works satisfactorily and undoubtedly gives a safe and pleasant bathing water. The old indoor swimming bath of Enfield Lock still uses the " Fill-and-empty " system, changing the water twice a week and chlorinating with a proprietory solution twice a day. This method 37 is of course, not nowadays installed because it cannot achieve the same clarity and purity of water which more modern methods of continuous filtration and chlorination provide, and the Council decided to install a modern filtration and chlorination plant which should be in operation during the summer of 1954. SCHOOLS The sanitary condition of the County Schools in the District is under the constant supervision of the Sanitary Inspectors and any defects found are immediately brought to the notice of the Authorities concerned. The sanitary conveniences at all the voluntary schools are attended to daily by an employee of the Health Department. PUBLIC HEALTH (MEAT) REGULATIONS, 1924 to 1952 Total number of carcases examined Nil Number, or parts, found to be diseased (in Butchers' shops) 117 Weight of do. do. do. 2,272 lbs. Number of Certificates issued 90 FOOD AND DRUGS ACT, 1938 Number and Classes of Food Premises registered under Section 14 of Food and Drugs Act, 1938, number of dairies registered under the Milk and Dairies Regulations, 1949, and number of inspections made in regard thereto. Premises No. No. of Inspections Ice Cream Premises 239 347 Food Preparing Premises 210 1,255 Dairies 52 130 Ice-Cream As will be seen from the tabulated statement above, frequent inspections of ice-cream premises were made during the year. 38 During these visits 60 samples of ice-cream were taken and the reports on these samples are summarised as follows:— Grade No. of Samples I 44 II 8 III 8 IV Nil Examined for Pathogenic Organisms, but not graded Nil Total 60 Examination of Foods Number of inspections made of retail shops, stalls and food-preparing premises, etc. 1,902 Number and weight of articles, etc., of foodstuffs condemned as unfit for food UNSOUND FOODSTUFFS—1953 Articles Foodstuffs Weight lbs. 42 tins Apricots 77¼ 30 „ Crushed Apples 26½ 3 „ Apples 21¾ 1 pkt. All-Bran ¾ 54 tins Apple and Cranberry 47¾ 1 „ Apricot Pulp 11½ 219 „ Beans 216¼ 25 „ Blackberries 24½ 7 „ Baby Food 1¾ 34 „ Black Currants 35¾ 5 „ Bananas 8½ 21 „ Barley (Patent) 15½ 21 „ Beef 38¼ 1 „ Blackcurrant Jam 1½ 4 „ Brawn (Pork) 3 464 „ Cherries 455¾ 16 „ Carrots 14 3 „ Custard Powder 21 1 pkt. Corn Flakes ¾ 1 tin Crab Paste ¼ 39 Articles Foodstuffs Weight lbs. 32 tins Corned Beef 95 18 bars Chocolate 4½ 1 tin Coconut ¾ 2 boxes Currants 100 63 „ Cheese 8½ – Cheese (Trimmings) 6½ – Cod Fillets 182 7 tins Cream 2½ 4 Chickens 12 1 tin Calvesfoot Jelly ¾ 144 „ Cod-roe Spread 13½ 49 „ Damsons 80¼ 88 Duck Eggs 22 1 case Dried Milk 56 6 Boxes Dog Fish Fresh Meat: 84 – Pork 229¼ – Pigs Kidneys 2 – Beef 1,724½ – Lamb 39¾ – Mutton 52½ – Minced Meat 30 – Veal 38 – Ox Liver 49 – Beef bones 23 – Ox Tails 20 – Beef Suet 10 – Ox Tongues 54 1 tin Fish Paste ¼ 41 bottles Fruit malt Syrup 41 1 bag Flour 113 4 tins Fruit Salad 4 36 „ Greengages 47½ 23 „ Gooseberries 25 ¾ 34 „ Grape Fruit 56 1 „ Guavas 1 10 „ Grapes 14½ 1 „ Grape Fruit Juice 1 16 pkts. Granose Rolls 5 9 tins Ham and Veal Loaf 32¾ 23 „ Ham 262¾ 6 „ Herrings 5¾ – Halibut 24 40 pkts. Herbs 10 40 Articles Foodstuffs Weight lbs. 23 tins Jam 34 16 Jellies 4 – Kippers 126 157 tins Luncheon Meat 393¾ 12 „ Minced Meat Loaf 9¼ 6 „ Lobster 2½ 2 „ Loganberries 2½ 314 „ Milk—Evaporated 379¾ 109 „ do.—Condensed 161¾ 15 „ Marmalade 57 1 „ Matzo Meal 1 40 jars Meat Paste 7½ 1 tin Mustard 3 1 pkt. Nut Poppets ¼ 9 tins Ox Tongues 54 2 „ Ox Livers 2 22 „ Oranges 19 5 „ Orange Juice 6¼ 57 „ Peaches 111½ 54 „ Pears 94½ 89 „ Pine-Apple 104¼ 852 „ Plums 1,464½ 447 „ Peas 398¼ 57 „ Prunes 108½ 1 „ Pudding 1 24 „ Pork 121 5 „ Peas Pudding 5 33 tins Pilchards 26 – Pearl Barley 92 3 tins Pork and Beans 3 1 bag Potato Flour 26 144 tins Potted Meat 55¼ 4 „ Peach Pulp 45 8 „ Roes 2¼ 11 „ Rabbits 11 – Rabbits 228 1 tins Rhubarb 1¼ 13 Raspberries 14 1 pkt. Ryvita ½ 1 tin Red Currants 1 – Rolled Oats 46 127 tins Stewed Steak 127 75 „ Sardines 18¼ 28 „ Soup (Tomato) 26¾ 41 Articles Foodstuffs Weight lbs. 6 tins Soup (Chicken) 5¾ 4 „ do. (Vegetable) 4 20 „ do. (Ox-tail) 20 4 „ do. (Brown Windsor) 2¾ 29 „ Strawberries 30¾ 1 „ Sweetcorn 1 7 „ Sausages 6¾ — do. 119 6 pkts. Shredded Wheat 6 39 tins Salmon 22 4 „ Steak and Vegetables 4 29 bottles Salad Cream 29 48 Sauce 48 3 boxes Sultanas 82½ 84 tins Spinnach 126 1 „ Spaghetti ½ — Skate 147 1 tin Shrimps (Peeled) ¼ 1 jar Sandwich Spread ¼ 1 pkt. Semolina 1 — Split Peas 94 1 tin Salmon Spread ¼ 274 „ Tomatoes 305¾ 3 Turkeys 55¼ 1 pkt. Tea ½ 19 tins Veal 110 10,204½ lbs. =4 tons 11 cwts. Oqtrs. 11½ lbs. Total No. of articles, etc., condemned 5,189 No. of Certificates issued in regard thereto 667 Total weight of foodstuffs condemned as unfit for food:— 4 tons 11 cwts. 0 qrs. 11½ lbs. Method of Disposal of Condemned foods Some of the contents of tins of food and such fresh meat and other foodstuffs as were considered suitable and fit for animal feeding were disposed of for pig-food, and all other unfit foodstuffs were destroyed in the Council's Refuse Destructor furnaces. 42 NUMBER AND CLASSES OF FOOD PREMISES IN DISTRICT Restaurants and Cafes 88 Grocers and Provision Merchants 167 Butchers 72 Greengrocers 79 Fishmongers 28 Bakehouses26 Bakers and Confectioners 35 Milkshops and Dairies 81 Ice Cream Retailers 239 Potted Meat Manufacturers 1 Hawkers Fish 16 Fruit and Vegetables 44 Refreshments 4 Ice Cream 3 Meat and Other Foods Although there are 6 slaughterhouses in the district, none are now in use for slaughtering purposes, and therefore no examinations or inspections of animals or carcases were carried out during the year. MIDDLESEX COUNTY COUNCIL ACT, 1950 SECTION II The provisions of the above require all Hawkers of Meat, Fish, Fruit and Vegetables and Storage Premises used in connection therewith to be registered by the Council; during the year 12 Hawkers were registered. The following table shows the number of Hawkers' Premises, etc., registered and the number of inspections made by the Sanitary Inspectors during the year in connection therewith. No. of Premises, etc., on Register No. of inspections 94 105 43 CARAVANS Number of applications received for consent Nil Number of applications granted Nil REMOVAL OF HOUSE REFUSE CESSPOOL EMPTYING SEWER FLUSHING The above services are under the control of the Engineer and Surveyor's Department. PUBLIC MORTUARY There is now no public mortuary in Enfield, but use is made at present of a Hospital Mortuary. Printed by Stanley Woodfield, 8/12 Windmill Hill, Enfield, Middx.