ENF38 34/8/6 Urban District Council of Enfield ANNUAL REPORT OF THE Medical Officer of Health (WILLIAM D. HYDE, M.B., Ch.B., D.P.H.) FOR 1954 Urban district Council of Enfield ANNUAL REPORT OF THE Medical Officer of Health (WILLIAM D. HYDE, M.B., Ch.B., D.P.H.) FOR 1954 3 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, 1954. To the Chairman and Members of the Urban District Council of Enfield. I have pleasure in presenting my Annual Report for 1954. The area of the District is 12,401 acres. The population is approximately 109,200 and the number of inhabitated houses 30,685. In my last report I referred to proposed legislation in connection with Housing, Food and Drugs, and Slaughterhouses, together with the awakened national interest in atmospheric pollution, and I now wish to refer to the Housing Repairs and Rents Act, 1954 and the Slaughterhouses Act, 1954 which both came into force during the year. The Housing Repairs and Rents Act, 1954 makes further provisions as to clearance and re-development, reconditioning of unfit houses, and repairs increases in respect of controlled dwellinghouses, etc. A start was made during the year on a survey of housing in the District in order that, as required by the Act, proposals for dealing with houses which appear to be unfit for human habitation and liable to demolition could be submitted to the appropriate Minister. That part of the Act dealing with repairs increases in respect of controlled houses, has also involved considerable work in dealing with applications for Certificates of Disrepair from tenants who do not consider that the conditions justifying an increase of rent are fulfilled. The Government re-affirmed its intention to bring about a moderate concentration of slaughtering facilities throughout the country, but as this is a long-term policy, the Slaughterhouses Act, 1954 was passed. This made it the duty of the Local Authority to secure that sufficient slaughtering accommodation is available for the requirements of the district, to be responsible for licensing private slaughterhouses, and if necessary the provision of temporary public slaughterhouses during the interim period. There are no 4 public slaughterhouses in the district, but application for a licence for premises formerly used as a private slaughterhouse was received and granted after repairs and alterations had been carried out. This slaughterhouse is dealing with a large volume of work and the Council's Sanitary Inspectors are spending a considerable amount of time inspecting the meat, not only during the day but in the evenings and at weekends. With regard to the vital statistics of the District, the general post-war downward trend of the Birth Rate ceased and there was a slight increase in the rate from last year's lowest recorded rate of this century of 12.38 to 12.62. The Infant Mortality Rate of 17.40 was the lowest yet recorded and I am glad again to report no maternal deaths attributable to childbirth. The Death Rate of 11.26 was higher than last year. Again over one-fifth of the deaths occurred in persons over the age of 80 years, one man and one woman reaching 99 years, two women reaching 96 years, and two women reaching 95 years. Although the total deaths were almost equally divided between males and females, only 41 per cent. of the deaths over 80 years were males. These proportions are similar to last year's figures. A disturbing feature of the death statistics is the continuing increase in deaths from cancer, particularly cancer of the lung and bronchus, and much more marked in males than females. This trend appears to be general and not local in nature. The number of notifications of notifiable infectious diseases was very much less than the previous year, mainly due to the almost total absence of Measles, and a marked reduction in Scarlet Fever, Pulmonary Tuberculosis, Pneumonia and Whooping Cough. Apart from 18 deaths from Tuberculosis and 35 from Pneumonia, the only other death from notifiable infectious disease was 1 from Whooping Cough. Last year I referred to an increase in the number of cases of Respiratory Tuberculosis, accompanied by a remarkably low figure of deaths from the disease. This year I am glad to report a marked reduction in cases from 143 to 85. Only 28 of these were in females, and this represents a reduction of 43, the main improvement being in the age groups 15-45 years. Although last year's remarkably low figure of 11 deaths has risen this year to 18, only 2 of which were females, the deaths were mainly in the older age groups, and the figure of 18 is comparatively low. In general, the activities of the Department have progressed along the usual lines, the main effort being directed to the prevention and control of infectious diseases, remedying or demolishing insanitary property, promoting food hygiene, prevention of statutory 5 nuisances and a host of other functions. Although it is my continued regret that those environmental health services are separated from the important personal health services for which I am responsible, as close a liaison as is possible in the circumstances, is maintained, and if there be any difficulties, I endeavour to ensure that these will be of overlapping rather than of gaps. 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. William D. Hyde, Medical Officer of Health 6 URBAN DISTRICT COUNCIL OF ENFIELD A. M. Eeles, Esq., J.P. Chairman J. Cottenham, Esq., J.P. 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. F. C. Cunneen, Esq. G. Deacock, Esq. A. T. Harniman, Esq. L. H. Harris, Esq. A. G. Hayward, Esq. E. T. Hendrick, Esq. W. J. Howes, Esq., J.P. E. E. Leesmith, Esq. W. F. Lindsell, Esq. W. E. Lonsdale, Esq. E. L. Mackenzie, Esq. E. C. H. Mardell, Esq. J. Murray, Esq. C. Partington, Esq., J.P. M.R.S.T. G. H. Platten, Esq. P. L. Purnell, Esq., J.P. E. J. Rayment, Esq. A. H. Saunders, Esq. A. A. F. Tatman, Esq., J.P. L. F. Wass, Esq. HEALTH COMMITTEE Mrs. G. M. Jay, J.P. Chairman E. J. Rayment, Esq. Vice-Chairman also Mrs. Rowland, also Messrs. Boxall, Collop, Harniman, Harris, Leesmith, Mardell, Murray, Platten and Saunders. 7 PUBLIC HEALTH STAFF Medical Officer of Health : Dr. W. D. Hyde, M.B., Ch.B., D.P.H. Acting Deputy do. Dr. Margaret R. Gilmour, M.B., Ch.B., D.P.H. Chief Sanitary Inspector : 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. Sanitary Inspectors: Mr. H. Wiggett, Mr. A. Ramsden, Mr. D. C. Turner, Mr. C. Day (Resigned 5th August, 1954) Mr. G. E. A. Laney and Mr. N. Smith. Rodent Investigator: Mr. P. W. Partridge. Chief Clerk: Mr. Sydney Coulter. Senior Clerk: Mr. S. N. Dance. General Clerks : Mr. J. W. Viggers (Retired 22nd May, 1954) Miss J. Pinkham (Resigned 24th July, 1954) Mr. E. Gray (Appointed 21st June, 1954) Mrs. I. Curtis (Appointed 16th August, 1954) and Miss D. M. Smith. Shorthand-Typist: Mrs. F. I. Dufton. STATISTICS AND SOCIAL CONDITIONS OF THE AREA POPULATION The population as estimated by the Registrar General is 109,200. The number of inhabited houses at the end of 1954, according to the Rate Books, was 30,685. Explanatory Note : Definition of "Houses"—Structurally separate dwellings including flats. The rateable value of the District is £921,733 The net product (after allowing for cost of collection) of a penny rate is (Estimated) £3,750 AREA Area (in acres) 12,400 NEW HOUSES The number of houses erected during the course of the year was 383. 8 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. Live Births:— Total Male. Female. Legitimate 1,323 666 657 Illegitimate 56 31 25 Birth-rate—12.62 per 1,000 population. Still Births:— Total. Male. Female. Legitimate 35 12 23 Illegitimate 1 — 1 Rate per 1,000 total births—25.44. Total. Male. Female. Deaths 1,230 612 618 Death-rate—11.26 per 1,000 population. Number of women dying in, or in consequence of, childbirth :— Rate per 1,000 Deaths. 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 17.40 Legitimate infants per 1,000 legitimate live births 16.62 Illegitimate infants per 1,000 illegitimate live births 35.71 Deaths from Cancer (all forms) 261 Deaths from Cancer (Lungs and Bronchus) 60 Deaths from Tuberculosis (Respiratory) 18 Deaths from Tuberculosis (Other forms) Nil 9 BIRTH, DEATH AND INFANT MORTALITY RATES. Birth-rate. Death-rate. Mortality rate Infant Live Still England and Wales 15.20 24.00 11.30 25.50 ENFIELD 12.62 25.44 11.26 17.40 DEATHS The number of deaths assigned to Enfield for 1954 was 1,230, an increase of 75 on last year. The more prevalent causes of death during the year and the previous year were :— Cause of Death 1954 1953 All Ages:— Malignant Disease (Cancer) 261 230 Diseases of Heart 366 342 Other Diseases of Circulatory System 52 61 Pneumonia 35 66 Bronchitis 69 77 Vascular Lesions of Nervous System 232 166 Tuberculosis of Respiratory System 18 11 Children Under 1 Year :— Premature Birth 7 7 Congenital Malformations 8 1 Pneumonia 2 1 Atelectasis 5 7 The net death-rate for the District is 11.26 per 1,000 population. Two-hundred-and-fifty deaths registered were of Enfield persons over 80 years of age, 104 being males and 146 females, one man dying at the age of 99, two women at the age of 95 years, two at 96 years, and one at the age of 99 years. 10 TABLE I. Causes of Death during Year 1954. Causes of Death. Males. Females. Total. Whooping Cough 1 — 1 Diphtheria — — — Tuberculosis of Respiratory System 16 2 18 Other Forms of Tuberculosis — — — Syphilitic diseases 1 — 1 Influenza — 1 1 Measles — — — Other infective and parasitic diseases — — — Ac. Polio-myelitis — — — Meningococcal infections — — — Malignant Neoplasm of stomach 18 15 33 Malignant Neoplasm, lung, bronchus 47 13 60 Do. of breast — 20 20 Malignant Neoplasm, uterus — 13 13 Other Malignant and Lymphatic Neoplasms 75 60 135 Leukaemia, aleukaemia 3 2 5 Diabetes 2 8 10 Vascular lesions of nervous system 88 144 232 Coronary disease, angina 122 70 192 Hypertension with heart disease 20 23 43 Other Heart disease 50 81 131 Other Circulatory disease 20 32 52 Bronchitis 40 29 69 Pneumonia 16 19 35 Other diseases of Respiratory system 5 3 8 Ulcer of stomach and duodenum 10 4 14 Gastritis, Enteritis and Diarrhoea 2 3 5 Nephritis and Nephrosis 6 1 7 Hyperplasia of prostate 8 — 8 Pregnancy, Childbirth and Abortion — — — Congenital Malformations 3 4 7 Suicide 9 4 13 Motor Vehicle accidents 6 6 12 All Other accidents 11 12 23 Other defined and ill-defined diseases 33 49 82 Homicide and operations of war — — — Total 612 618 1,230 11 TABLE II. Infant Mortality Net Deaths from stated causes at various Ages under One Year of Age. Causes 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 19 1 — 20 2 1 — 1 24 Uncertified — — — — — — — — — — Pneumonia (all forms) 1 — — — 1 — — — 1 2 Enteritis — — — — — — 1 — — 1 Atelectasis 5 — — — 5 — — — — 5 Congenital Malformation 5 1 — — 6 2 — — — 8 Premature Birth 7 — — — 7 — — — — 7 Cerebral haemorhage 1 — — — 1 — — — 1 Totals 19 1 — — 20 2 1 — 1 24 Net Births in the year :—Legitimate : Live births, 1,323 ; Stillbirths, 35. Illegitimate : Live births, 56; Still-births, 1. Net Deaths in the year :—Legitimate Infants, 22; Illegitimate, 2. It will be seen from Table II that of the 24 infants who died before attaining the age of 1 year, 20 died within the first four weeks of life, and of this number 19 deaths occurred in infants under 1 week. The main problem in connection with Infant Mortality is concerned with deaths within the first few weeks of life, mainly the first week, as 20 of the 24 infant deaths occurred during that early period from congenital malformation, premature birth and atelectasis. The infant mortality rate for the District is 17.40 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. 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 1954 709 706 1,415 12.95 0.52 INQUESTS Forty-eight Inquests and two-hundred-and-twenty-four Postmortem examinations without inquests were held during the year. Of these, 227 deaths were due to natural causes, 26 to accidental causes, 14 to suicide, 2 to misadventure, and in 3 cases an open verdict was recorded. FATAL HOME ACCIDENTS. Two years ago I wrote at some length on this 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 62 and 92 years, except 3 persons aged 17,45 and 55 years. The 14 fatal home accidents to Enfield residents involved 9 females and 5 males. The causes of death in six females and three males were falls causing fractured bones followed by lung complications. The cause in the case of one female and one male was coal gas poisoning, in one female the cause was shock due to burns sustained when clothing caught fire, in another to toxaemia due to burns sustained when trying to extinguish flames of a burning mattress, and the cause of one other male was suppurative bronchitis following barbiturate poisoning. 13 The outstanding points in these figures are the fairly high proportion of elderly females, 64 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 again there was only one less fatal accident to Enfield residents in the home than on the streets, 14 fatal home accidents compared with 15 fatal road accidents. In the case of road accidents, the proportion of males to females involved was much greater than that for home accidents, and the average age was much 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 14 cases of suicide, 9 males and 5 females, ages ranging from 21 years to 65 years; the average age being 48 years. The method adopted in seven cases was coal gas poisoning, in one to salicytate poisoning, three males to hanging, and three females to barbiturate 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 SERVICE The County Ambulance Service is operated in two distinct branches, i.e., the Accident Branch and the Sick Removal Branch. The Accident Service operates from Fire Stations and where an ambulance is required for accident or emergency purposes, the Emergency Exchange telephone facilities should be used, whereby calls are routed to the nearest Fire Station. The Sick Removal Service is housed locally in a newly-built depot adjacent to Chase Farm Hospital, where calls are received for both recumbent and sitting cases. 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. 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 three samples of well water were examined bacteriologically. In addition, eight other samples of drinking water other than from wells were bacteriologically examined, and found to be satisfactory. 15 MEDICAL ASSESSMENT OF EMPLOYEES. The following medical examinations or assessments of employees were carried out during the year:— (1) Superannuation Act: Medical examinations 22 Assessments without medical examinations 35 (2) Sick Pay Scheme : Medical examinations 36 Assessments without medical examinations 34 (3) Other Medical Examinations 6 HOUSING Number of new houses erected during the year by :— (a) Local Authority 204 (b) Other Local Authorities Nil (c) Other bodies or persons 179 With State assistance (included in above totals) :— (a) Local Authority 204 (b) Other Local Authorities Nil (c) Other bodies or persons Nil 1. Inspection of Dwelling-houses :— No. of No. of inspechouses. tions. (1) Total number of dwelling-houses inspected for housing-defects (under Public Health, Housing Acts) and number of inspections made 2,796 10,741 (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 753 757 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 80 (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 853 (The number here given is of houses where any insanitary conditions were found.) 16 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 554 3. Action under Statutory Powers. A.—Proceedings under Sections 9, 10, 11 and 16 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which Notices were served requiring repairs 8 (2) Number of dwelling-houses which were rendered fit after service of formal Notices:— (a) By owners 2 (b) By Local Authority in default of owner 3 B.—Proceedings under Public Health Acts :— (1) Number of dwelling-houses in respect of which Notices were served requiring defects to be remedied 90 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 57 (b) By Local Authority in default of owners Nil The number of house-to-house visitations made was :— Under Housing Regulations, 1925 and 1932 753 Apart from Do. Do. Nil HOUSING REPAIRS AND RENTS ACT, 1954. This Act came into operation on the 30th August, 1954 and apart from making further provision for the clearance and redevelopment of areas of unfit housing accommodation, it also secures or promotes the reconditioning and maintenance of houses, and otherwise amends the enactments relating to housing, the exercise of certain powers relating to land, and rent control. 17 Tenants of controlled houses can now apply for a certificate of disrepair, and where on inspection it can be proved to the satisfaction of the local Authority that either or both of the conditions justifying an increase of rent are not fulfilled, the local Authority shall certify accordingly in a prescribed form and the certificate is deemed to have been in force as from the application therefor. This new provision evoked considerable interest, and from the date of the new Act coming into operation no less than 92 applications for certificates were received up to the end of the year. Of these, 88 were granted and 4 were refused. On completion of the necessary repairs, the owner of the property can apply to the local Authority for revocation of the certificate of disrepair, and subject to the work having been completed satisfactorily, the local Authority shall revoke the certificate. Up to the end of the year 13 revocation certificates were granted. 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 11 Accredited 1 Pasteurised Milk 25 11 Sterilised Milk 79 13 Totals: 121 36 During the year 20 samples of Milk were taken and tested; all were found to be satisfactory. 18 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 1954 :— Article. Total samples procured. Unsatisfactory. Milk (various) 228 24 Cakes 47 — Cooked meat 21 1 Cream 9 — Drugs 6 1 Fish 15 — Fish Cake 2 — Flavoured Milk 3 1 Fruit drink 1 — Fruit Juice 2 — Fruit Syrup 1 — Grape fruit 1 — Herrings in Wine Sauce 1 1 Ice cream 6 — Iced lolly 4 1 Icing sugar 1 — Jams 2 — Jelly 2 — Lard 3 — Liver 3 — Margarine 3 — Marzipan 1 — Meat 4 — Meat paste 1 — Meat Pies 9 — Minced Meat 8 — Mincemeat 1 — Non-brewed Condiment 1 — Oranges 11 — Sausages 24 — Soup 1 — Sweets 2 — Tinned Fruit 1 — Tomato Ketchup 1 — Victoria Plums 1 — Vinegar 46 13 Wines and Spirits 23 — Totals: 496 42 19 With regard to the 42 samples noted as unsatisfactory, the following comments are made : Milk. The 24 samples were all new milk, six farmers being involved. Of eleven samples from one farmer, nine proved to be deficient in fat and two deficient in solids-not-fat. The presence of added water was not confirmed. Seven samples, all from one fanner, proved to be deficient in solids-not-fat. Again the presence of added water was not confirmed. Three samples from one farmer were deficient in fat. In these three cases the vendors were informed and no further action taken except that subsequent samples were procured and found genuine. The remaining three samples were all found to be deficient in fat, but associated samples were genuine and therefore no further action was taken. Cooked Meats. This infringement concerned tinned meat described as "Chopped Ham" but which contained added cereal. An official caution was issued. Drugs. A bottle of cough syrup, purchased privately, contained a fly. As it was uncertain and could not be proved that the fly was in the bottle when it was purchased, a verbal warning was given to the chemist. Flavoured Milk. This consisted of tins of powder described as "Milky Shake" but upon analysis the presence of whole milk was not confirmed. The firm of manufacturers agreed to amend their label and no further action was taken. Pickled Herrings. A sample of "Pickled Herrings in Wine Sauce" was found to be pickled herrings in sauce containing no alcohol. It was found that the packers are in process of amending their labels and no further action was taken. Iced Lolly. This was found to be a sample of iced lolly described as "Cream Lolly," but deficient in fat. An official caution was issued. Vinegar. Of the thirteen unsatisfactory samples of vinegar, twelve were found to be non-brewed condiment. These twelve samples were sold in all by seven retailers. In one case the retailer was fined £1 0s. 0d. and ordered to pay £2 16s. 0d. costs; and in another case the retailer was fined £2 0s. 0d. and ordered to pay £2 16s. 0d. costs. In three cases official cautions were issued, and in the remaining two cases follow-up samples proved to be genuine. In the one remaining case the vinegar was found upon 20 ation to contain three dead flies. A letter of caution was sent to the firm. Special Designated Milk. There was one firm licensed by the County Council as dealers/ pasteurisers and dealers/sterilisers. The premises were regularly inspected throughout the year and in all 79 samples of milk taken and submitted to examination. All samples proved satisfactory. Milk Samples for Examination for Tuberculosis. In addition to the foregoing, 36 samples of new milk were taken for bacteriological examination; none was adversely reported upon. CLEAN AND SAFE FOOD 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 Clean Food Campaigns were maintained and, where necessary, improved. The sanitary inspectors paid 1,486 visits to 834 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. PUBLIC HEALTH (MEAT) REGULATIONS, 1924 to 1952 Total number of carcases examined :— Cows 25 Bullocks 439 21 Heifers 152 Calves 299 Swine 1,468 Sheep 4,918 Lambs 1,874 Total 9,175 Number, or parts, found to be diseased 760 Weight of do 8,440½ lbs. SLAUGHTERHOUSES ACT, 1954. This Act came into force on the 5th July, 1954, to make local Authorities responsible, for the time being, for securing that adequate slaughterhouse facilities are available locally; to explain and amend the law with respect to the provision by local Authorities of public slaughterhouses, the making of charges in respect of such slaughterhouses and the grant and renewal of licences under Section 57 of the Food and Drugs Act, 1938; to make further provision with respect to the regulation and restriction of private slaughterhouses and the payment of compensation where a licence or registration in respect of such a slaughterhouse was refused or ceased to be in force. There are no public slaughterhouses in the District and of the privately owned slaughterhouse premises used many years ago for slaughtering, applications were received for only two such premises to be re-licensed. The owner of the smaller of the two premises did not proceed with his intention to re¬open, but the owners of the other slaughterhouse carried out extensive repairs and alterations, and slaughtering of animals takes place every day, including Sundays and the Council's Sanitary Inspectors have to spend a considerable amount of their time, both during the days, evenings and weekends, in visiting the slaughterhouse and examining the carcases. 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. 22 Premises No. No. of Inspections Ice Cream Premises 249 231 Food Preparing Premises 210 1,043 Dairies 54 95 Slaughterhouses 1 466 Ice-Cream As will be seen from the tabulated statement above, frequent inspections of ice-cream premises were made during the year. During these visits 50 samples of ice-cream were taken and the reports on these samples are summarised as follows:— Grade No. of Samples I 39 II 7 III 2 IV 2 Examined for Pathogenic Organisms, but not graded Nil Total 50 Examination of Foods Number of inspections made of retail shops, stalls and food-preparing premises, etc. 1,486 Number and weight of articles, etc., of foodstuffs condemned as unfit for food:— Articles Foodstuffs Weight lbs. 127 tins Apricots 164¼ 4 „ Crushed Apples 1 18 „ Apples 29½ 7 „ Apple and Cranberry 6 22 „ Apricot Jam 39 2 „ Apricots (Dried) 53½ 23 Articles Foodstuffs Weight 16 tins Apricot Pulp 33¼ — Bacon 25 204 „ Beans 183¼ 4 „ Blackberries 4 12 „ Baby Food 3¼ 59 „ Black Currants 62¼ 20 „ Beef 41½ 9 „ Beef-steak Pudding 9 8 „ Beef and Gravy 10 9 „ Berries in Syrup 11¼ 14 „ Blackcurrant Jam 21 9 „ Brawn (Pork) 6¼ 1 „ Bristlings ¼ 29 „ Cherries 47¾ 1 „ Carrots 1 1 box Cat Fish 14 1 tin Crab Paste ¼ 4 tins Crab Meat 2 57 „ Corned Beef 164¾ 40 bags Cabbages 200 160 cartons Coconut Ice 1,120 Corn Flour 7 26 boxes Cheese 8¼ 9 cartons Cheese Spread 2½ — Cheese (Trimmings) 113 — Cod Fillets 63 25 tins Cream 9 19 cartons Cream (Synthetic) Powder 4¾ 1 tin Craw Fish ½ 10 tins Damsons 12½ 436 Eggs 81¾ 1 tin Eggs (Frozen) 14 5 cases Dried Milk 192 6 boxes Dog Fish 84 2 Fresh Meat: Ox Carcases 1,076 1 Pig Carcase 112 2 Calf Carcases 86 1 Beast Carcase 472 — Other Meat 2,636¼ — Offal 4,058 — Figs 4½ 1 tin Fish Paste ¼ 1 „ Fruit Cocktail ½ tins Fruit Pudding 2 24 Articles Foodstuffs Weight lbs. 9 tins Fruit Salad 7¼ 2 „ Greengages 3½ 38 „ Gooseberries 38 51 „ Grape Fruit 59¼ 9 „ Grapes 9 7 „ Grape Fruit Juice 9½ 16 bottles Gravy Browning 6 32 tins Ham 396 11 „ Herrings 10¼ 11 „ Irish Stew 11 22 tins Jam 31 1 bottle Ketchup 1 1 tin Kipper Snacks 1 — Kipper 70 324 tins Luncheon Meat 266½ 1 „ Minced Meat Loaf ¾ 1 „ Lobster ¼ 18 „ Loganberries 30 391 „ Milk—Evaporated 443½ 39 „ do.—Condensed 60¼ 16 „ Marmalade 31 - Milk Powder 154 17 tins Meat and Gravy 17½ 30 „ Meat Loaf 25 8 „ Nescafe 1½ 4 „ Nuts (Cashew) 2 1 „ Ox Tongues 6 100 Oranges 72¼ 2 „ Orange Juice 2 2 „ Potato Salad 2 94 „ Peaches 202½ 70 „ Pears 135½ 86 „ Pine-Apple 88 260 „ Plums 499 408 „ Peas 434 — Peas (Split) 60 14 tins Prunes 10 1 „ Strained Prunes and Semolina ¼ 11 jars Pea-nut Butter 6½ 1 tin Plum and Apple Pudding 1 4 „ Peas Pudding 4 61 „ Pilchards 55¾ 3 „ Pork and Beans 13 25 Articles Foodstuffs Weight 6 jars Pickle (Branstone) 5¾ 1 „ Pickle (Rajah) 1 — Prawns 21 1 jar Picalilli 1¼ 1 tin Roes ¼ 10 tins Rabbits 10 — Roast Pork.. 27 3 tins Rhubarb 3 17 „ Raspberries 20¼ 1 carton Raisins 30 24 tins Raspberry Jam 36 — Rolled Oats 33 132 tins Stewed Steak 132 36 „ Sardines 9½ 25 „ Soup (Tomato) 20½ 6 „ Soup (Meat) 6 7 „ Soup (Chicken) 6¼ 11 Soup (Vegetable) 9¼ 9 „ Soup (Ox-tail) 5½ 1 „ Soup (Kidney) ¾ 1 „ Soup (Mock Turtle) 1 6 ,, Soup (Onion) 6 2 „ Soup (Mulligatawny) 2 6 „ Soup (Mushroom) 3¾ 42 „ Strawberries 45 1 Sweetcorn 1 2 „ Sausages 1¼ — do. 55 4 tins Steak, Kidney and Gravy 3 79 „ Salmon 58½ 3 „ Steak and Vegetables 3 1 „ Steak and Onions 1 2 11 Steak (Caserole) 2 1 bottle Salad Cream ¼ 5 tins Stewed Mutton 5 3 „ Steak and Kidney Pudding 3 1 „ Sausages and Beans ½ 19 „ Spaghetti 16¾ — Skate 70 1 tin Shrimps (Peeled) ¼ 2 tins Scotch Broth 2¼ 191 „ Tomatoes 244¼ 1 „ Tomatoe Juice 1 1 Turkey 11¼ — Sliced Tongue 6 26 Articles Foodstuffs Weight lbs. 6 tins Tongue 36 4 „ Tunafish 1¾ 12 „ Veal 63¼ 8 „ Vegetable Salad 5½ 4 „ Youngberry Jam 4 15,552½ lbs. =6 tons 18 cwts. 3 qtrs. 12½ lbs. Total No. of articles, etc., condemned 5,019 No. of Certificates issued in regard thereto 911 Total weight of foodstuffs condemned as unfit for food:— 6 tons 18 cwts. 3 qrs. 12½ 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. NUMBER AND CLASSES OF FOOD PREMISES IN DISTRICT Restaurants and Cafes 88 Grocers and Provision Merchants 169 Butchers 73 Greengrocers 81 Fishmongers 29 Bakehouses 26 Bakers and Confectioners 35 Milkshops and Dairies 83 Ice Cream Retailers 249 Potted Meat Manufacturers 1 27 Hawkers Fish 17 Fruit and Vegetables 47 Refreshments 4 Ice Cream 6 MIDDLESEX COUNTY COUNCIL ACT, 1950 SECTION 11 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 4 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 107 65 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASES AND SCHOOLS 1954. 1953. Number of children notified by Head Teachers to be absent from School due to:— (a) Infectious Disease or suspected tious Disease 416 620 (b) Contact with Infectious Disease 8 29 Number of School children notified by General Practitioners as suffering from Infectious Disease 314 1,045 28 NOTIFIABLE DISEASES DURING THE YEARS 1953 AND 1954. 1954 1953 No. Removed. Deaths. No. Removed. Deaths. Smallpox - - - Cholera—Plague - - - - - - Diphtheria (inc. Membranous Croup) - - - - - - Diphtheria Carriers - — — — — - Erysipelas 20 2 — 19 6 - Scarlet Fever 132 51 178 84 Typhus Fever — — — — — - Typhoid Fever — — — — — - Paratyphoid Fever - - - - - - Relapsing Fever — - - - - - Continued Fever — — - — Puerperal Pyrexia 44 43 - 51 46 - Meningococcal Infection — — - 7 7 - Poliomyelitis (Paralytic and Non-Paralytic) 3 3 - 10 9 2 Acute-Encephalitis — — - — — — Ophthalmia Neonatorum 18 18 - 15 15 — Pulmonary Tuberculosis 85 — 18 143 — 11 Other forms of Tuberculosis 10 - - 15 - 1 Food Poisoning 16 2 — 26 14 — Malaria — — — Pneumonia 54 1 35 100 9 66 Dysentery 167 1 — 164 3 — Measles 37 — 1316 11 — Whooping Cough 204 6 1 456 10 — Totals 790 127 54 2500 214 80 The above figures are in respect of Civilians and NonCivilians. 29 HOSPITAL FOR INFECTIOUS DISEASES During the year, the following cases were admitted from Enfield to South Lodge Hospital. Dysentery 1 Erysipelas 2 Scarlet Fever 51 Bronchitis, with Meningeal symptoms 1 Poliomyelitis 2 Mumps 4 Whooping Cough 6 Gastro-enteritis 6 Chicken pox 1 Food Poisoning 2 Pneumonia 1 Glandular Fever 1 Quinsy 1 Acute Tonsillitis 5 Stomatitis 1 Infective Hepatitis 1 86 DIPHTHERIA For the sixth year in succession no case of Diphtheria occurred in the District. DIPHTHERIA IMMUNISATION 1,324 children were immunised for the first time and 2,238 received subsequent reinforcing doses during the year. These figures are slightly higher than last year's figures, but the number of parents accepting this service for their children is not yet sufficiently high to warrant any sense of security. WHOOPING COUGH IMMUNISATION 1,001 children were immunised against Whooping Cough for the first time during the year, and 164 received subsequent re¬inforcing doses. It is encouraging to record that these figures shew a considerable increase on those for last year. 30 VACCINATION 743 persons received primary vaccination and 187 re-vaccination. POLIOMYELITIS AND ACUTE ENCEPHALITIS. During the course of the year three cases of poliomyelitis occurred in the District, and were of a mild type. Two of the cases were boys, aged 5 and 7 years, and the third was a girl of 1 year. The first case to be notified during the year occurred in July. No further case occurred until the end of October followed by another one in December. No evidence of association between cases could be found, and none of the cases proved fatal. FOOD POISONING Sixteen cases of food poisoning were notified during the year, of which 8 were single cases. 3 cases were notified in each of two households, and two in another. Of the 16 cases, 12 were due to "Salmonella Typhi-murium," and in the remaining 4 no agent was identified. SONNE DYSENTERY The incidence of mild dysentery due to Shigella Sonnei, showed an increase of 3 cases on last year's figure of 164. 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 be positive, but it put a considerable strain on the Department and the Laboratory. 31 TUBERCULOSIS. 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. NonRespiratory Respiratory. NonRespiratory. M. F. M. F. M. F. M. F. Under 1 - - - - - - - - 1 to 5 1 1 — — — — — — 5 to 10 2 2 — 1 — — — — 10 to 15 — — — — — — — — 15 to 20 4 1 - - - - - - 20 to 25 12 6 - 2 1 25 to 35 13 10 2 2 — — — 35 to 45 8 4 1 — 1 45 to 55 9 1 — 5 1 _ 55 to 65 6 3 2 3 65 and upwards 2 — — — 6 1 — — Totals 57 28 3 7 16 2 — — 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 .. 10,570 6 0.56 0.00 0.09 0.00 Cambridge Road 10,668 12 2 1.12 0.18 0.18 0.00 Chase 7,520 3 2 0.39 0.26 0.00 0.00 Enfield Wash 12,554 11 2 0.87 0.15 0.00 0.00 Green Street 10,668 9 — 0.84 0.00 0.18 0.00 Ordnance 13,426 10 — 0.74 0.00 0.07 0.00 Ponders End 9,886 12 — 1.21 0.00 0.50 0.00 The Town 11,066 7 2 0.63 0.18 0.27 0.00 West 12,267 11 2 0.89 0.16 0.16 0.00 Willow 10,575 4 — 0.37 0.00 0.18 0.00 Total 109,200 85 10 0.77 0.09 0.16 0.00 32 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. Throat and Nose Swabs. Diphtheria Bacilli — Haemolytic Streptococci 177 Vincent's Angina 8 Negative 593 778 Faeces. Shigellae 538 Giardia 32 Salmonella 50 Gastro-Enteritis Coli 20 Protozoa — Negative 1,683 2.323 Sputum. T.B. Smear — Other Organisms 25 Negative 43 68 Pertussis. Cough Plate — Postnasal Swab Negative 1 1 Milk. Pasteurised 20 Tuberculin Tested 1 Sterilised 1 Ice cream 50 72 33 Other Foods. Dried egg powder 1 Cooked sausages 1 Tins of corned beef 4 Cheese spread 1 7 Water. Domestic supplies, etc. 11 Swimming pools, etc. 6 17 Miscellaneous. 307 307 3,573 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. 790 premises were inspected during the year for rat and mice infestation, and of these 638 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 501. During the year the Sanitary Inspectors and Rodent Investigating Staff made 6,655 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 34 vestigations 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 498 manholes were examined and 474 pre-baits and 74 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 9 Number of Council houses disinfested 9 Number of other houses found to be infested 18 Number of other houses disinfested 18 Householders are urged to seek the assistance of the Health Department immediately they suspect the presence of bugs or similar pests. SANITARY INSPECTORS' INSPECTIONS AND VISITS The following report, in condensed form, gives details of the work of the Sanitary Inspectors during the year 1954. The total number of inspections made during the year for all purposes was 22,780. 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 757 Infectious Disease 195 Tuberculosis 4 Complaint or otherwise 9,572 Vermin 213 Offensive Trades 1 Rag Flock and Other Filling Materials Act, 1951 6 Pet Animals Act, 1951 18 C/fwd 10,766 35 B/fwd .. 10,766 Public Conveniences 318 Ice-Cream Shops 231 Schools 86 Cinemas, Halls, etc. 17 Fair-grounds 5 Hairdressers 13 Slaughterhouses 466 Milkshops and Dairies 95 Food Preparing Premises 1,043 Food Hawkers' Stands 30 Food Hawkers (Storage) 35 Bakehouses 52 Outworkers' Premises 18 Factories 84 Smoke Observations 146 Visits:— Infectious Diseases 1,132 Tuberculosis 4 Housing Act, 1936 (Sec. 62)—Permitted Numbers 52 Shops Act, 1950 53 Improvements Grants 431 Builder's Notices 29 Exhumations 3 Food Inspections 174 Movable Dwellings 167 Rats 530 Overcrowding 21 Piggeries 37 Stables 15 Well Water Supplies 8 Paddling Pools in Parks 12 Atmospheric Pollution 40 Fireguard Regulations, 1954 2 Other Visits 374 16,489 Visits by Rodent Dept. Staff:— Rats 6,125 Wasps, Beetles, etc. 166 22,780 Samples taken—Water—Wells 3 Mains, etc. 8 Swimming Baths 4 Parks Lakes etc. 2 36 Milk (Liquid) 22 Ice-Cream 50 Rag Flock Nil Miscellaneous Foodstuffs 7 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. 269 Roofs repaired 193 Gutters and downpipes repaired 111 Downpipes disconnected from drains — Dampness remedied 164 Ventilation provided under floors — Floors repaired 72 Yards paved or made good 14 Dustbins provided or renewed 84 Food stores provided — Food stores cleansed, etc. 3 Drains—Examined 259 Tested—Smoke 63 Water 14 Reconstructed 19 Repaired, etc. 203 Vents provided 1 Vents repaired 6 Cesspools abolished — Cesspools repaired — Sink wastes repaired 18 New sinks provided 6 Water-closets—New ones provided 4 New pans provided 47 Apparatus repaired or renewed 57 Water—Cistern provided — Cisterns cleansed, covered, etc. 5 Wells cleansed, repaired, etc. 1 Wells closed — Water laid on or restored 15 Nuisances—Fowls, etc., removed Manure, etc., removed 2 Ditches, etc., cleaned out 1 Other nuisances abated—Stoves repaired or renewed 36 Windows repaired or renewed 166 Gipsy vans removed 66 Overcrowding abated 1 Miscellaneous 86 Wasps Nests destroyed 151 37 Houses demolished 4 Houses or parts of houses closed 3 NOTICES ISSUED Statutory (Insanitary Conditions) 116 Informal ( Do. ) (P.H. Act) 534 Informal (Insanitary Conditions) (Housing Act) 90 Other Notices (Infectious Diseases) 2,067 2,807 Other Letters sent 2,718 Number of Certificates issued in connection with plans Nil Number of Certificates issued in connection with disinfection 10 Number of Certificates issued in connection with unsound foods 911 Number of Requisitions for Information dealt with 2,508 Number of Certificates issued under Rent Restrictions Acts, 1920 to 1939 3 Number of Certificates of Disrepair issued under Housing Repairs and Rents Act, 1954 79 Number of Revocations of Certificates of Disrepair issued under Housing Repairs and Rents Act, 1954 13 Result of Service of Statutory and Informal Notices:— Statutory. Informal. Number complied with 89 449 Number outstanding 27 175 116 624 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 321 members of the public were afforded such interviews. 38 DISINFECTION Number of houses disinfected after infectious disease and verminous cases 240 Number of articles of clothing, bedding, etc., disinfected 1,423 Number of Library books disinfected 414 Number of articles of clothing, bedding, etc., destroyed 96 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 four premises licensed by the local authority in 1952 were re-licensed, and two further applications for licences were received during the year. The premises and conditions having proved to be satisfactory, the licences were granted. 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 came into force on the 1st October, 1954. Each of the Sanitary Inspectors has been appointed a duly appointed officer under the Act. 39 FACTORIES ACT, 1937 A register is kept of all the factories in the District, and during the year 136 inspections were carried out. 1.—INSPECTIONS for purposes of provisions as to health (including inspections made by Sanitary Inspectors). Premises. Number on Register. Inspections. Number of Written notices. Occupiers prosecuted. (1) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 51 59 - - (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority 354 77 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 18 - - - Total 423 136 — — 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) - - Ineffective drainage of floors (S.6) - - Sanitary Conveniences (S.7) - - - - - (a) Insufficient - - - - - (b) Unsuitable or defective 7 7 7 (c) Not separate for sexes - - - - - Other offences (not including offences relating to Outwork) — — 1 — — Total 7 7 1 7 — 40 OUTWORKERS Fifty-two lists containing the names and addresses of 658 out-workers were received during the year. One-hundred-andtwelve 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. Curtains and Furniture Hangings 4 - - Fancy Goods 2 — — Files and Albums 1 — — Making Wearing Apparel, etc. 210 — — Cardboard Boxes, etc. 9 — — Feather sorting and mounting 6 — — Carding of Buttons, etc. 1 — — Artificial Flowers 8 — — Brush Making and Artist's Materials 206 - - Electrical Accessories 181 — — Xmas Crackers, etc. 13 — — Stuffed Toys, Games and Toys 6 — — Sports Accessories 3 — — Handbags 2 — — Table Stationery 1 — — Boots and Shoes 2 — — Carbon Papers 3 — — Total 658 — — 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. PLACES OF PUBLIC ENTERTAINMENT Number of inspections .. .. .. .. .. 17 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 progressing and it is hoped that these will prevent further pollution during the coming year. During the second half of the year, equipment for the measurement of atmospheric pollution was installed at three points in the eastern part of the district and monthly analyses were carried out. No evidence of marked atmospheric pollution was recorded during that period. It is hoped to extend the scope of these investigations in the coming year, when it should be possible to make a more accurate assessment of the situation. 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. As regards the purification of the water, the up-to-date method of break-point chlorination with continuous filtration and aeration has been in operation at the open-air Pool for many years, and this gives a safe and pleasant bathing water. Up to, and including, the 1953 season, the indoor baths used the "Fill-and-empty" system, but a modern chlorination, filtration, and aeration plant is now in operation and working satisfactorily. Reports on the twice-daily examinations for chlorine content and alkalinity of the water of both baths are sent to the Medical Officer of Health, and Sanitary Inspectors take samples regularly for bacteriological tests. 42 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.