Borough Council of Enfield ANNUAL REPORT OF THE Medical Officer of Health (WILLIAM D. HYDE, M.B., Ch.B., D.P.H.) FOR 1956 Borough Council of Enfield ANNUAL REPORT OF THE Medical Officer of Health (WILLIAM D HYDE, M.B., Ch.B., D.P.H.) FOR 1956 3 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, 1956. To the Mayor, Aldermen and Councillors of the Borough of Enfield. I have pleasure in presenting my Annual Report for 1956. An impetus was given to the drive for clean and safe food during the year by the introduction of new legislation leading to considerable improvements in food premises as recorded elsewhere in this Report. Although these improvements are very important, I must repeat that they can only be successful in preventing food infection if food handlers are aware of the simple hygienic principles involved in safe food handling, and, what is more important, are willing to observe these principles strictly. Just as you can take a horse to water but cannot make it drink, so too can you take a food handler to the newly provided water supply but you cannot make him wash his hands. I have referred in this paragraph to food infection rather than food poisoning, as it has rightly been stated that food infection more aptly describes the condition in most cases. It was hoped to see during the year greater progress in, if not completion of, that part of the East Middlesex Main Drainage Scheme which would remedy unsatisfactory conditions in the District. Difficulties, however, have been experienced and delays have occurred, but it must be hoped that completion will not be long postponed, and also that a large proportion of the cesspools in the District will become redundant in the near future. In recent years, considerable progress has been made in the provision of new Public Lavatories, and modernisation of those that have become outdated. During the past year, one new Public Lavatory was opened in Green Street, and plans made for the modernisation of the old facilities in Nags Head Road. There are now 18 Public Lavatories situated at convenient sites in the District. Not all have yet been provided with the up-to-date hand-washing facilities which are so important, but the wilful damage which constantly takes place on these premises is apt to be discouraging. 4 With regard to the more personal health services which have a bearing on the prevention of Infectious Disease, mention should be made of the inauguration of vaccination against Poliomyelitis. 4,411 children between the ages of 2 years and 9 years were registered by their parents to receive vaccination, but material was available to vaccinate only 443 children by two injections. For a variety of reasons 43 children received only one injection. The complete safety of the vaccine supplied was proved and no untoward reactions occurred. Although it is too early to assess completely the efficiency of the vaccine, no vaccinated child has developed Poliomyelitis up to date. Reference should also be made to the Report of an investigation undertaken by the Medical Research Council which established the value of B.C.G. vaccination (Bacille Calmette—Guerin) in the prevention of Tuberculosis, and showed that the vaccination of school-leavers may be expected to reduce the number of cases of Tuberculosis occurring between the ages of 14 years and 17 years by about half. During the year under review, preparations were, therefore, made to offer B.C.G. vaccination to about 1,500 school children between their 13th and 14th birthdays. It is felt that this procedure will add an impetus to the progress already made in combatting Tuberculosis in the District. With regard to infectious disease I am glad to report that, as has been the case for several years, there were no cases of diphtheria, smallpox, encephalitis, nor typhoid fever, and that there were only three cases of poliomyelitis and two of meningococcal infection. The number of notifications of respiratory tuberculosis and scarlet fever were as low as they have ever been, and there were only 10 deaths from respiratory tuberculosis and one death from poliomyelitis. The encouragingly low figure of 10 deaths from respiratory tuberculosis indicates the success being achieved in combatting this disease and focuses attention on the alarming situation arising with regard to cancer of the lung and bronchus which accounted for 55 deaths during the year, an increase of 3 over last year. Of these 55, only 3 were females and 5 of the males and 1 of the females were under the age of 50 years. There was an increase in the number of cases of whooping cough but, as expected, a very marked reduction in the number of cases of measles. There was also an increase in that mild but troublesome form of diarrhoea, Sonne Dysentery. This infection tends to be seasonal 5 and spreads rapidly and easily, but, as I have stressed on previous occasions, a lapse in personal hygiene must occur before this spread can take place. Surely, we can make an effort to adhere to the simple hygienic measures necessary for its control. A survey of the vital statistics of the district shews quite a satisfactory situation, although the Infant Mortality Rate is not so low as last year. The "Enfield Show," held in the Town Park, has been a popular annual event for some years now, and it was decided this year to include a Health Exhibition Stand, designed to capture the interest of the fairly large and representative section of the public attending the event, yet bearing in mind that they were seeking entertainment rather than education. From this point of view the Exhibition was presented in as animated a manner as possible, illustrating in humorous vein some of the subjects with which the Health Department has to deal, such as Food Hygiene, Smoke Abatement, Rodent Control, Infectious Disease, Control of Insect Pests, and, of a more personal nature, Home Safety, Nutrition, and Dental Care. Illuminated and working models were used where available. The enthusiasm with which the public viewed the Stand amply fulfilled our hopes and we considered that we had achieved our desired objective in effectively dispensing information on Health matters in a palatable manner to a susceptible gathering. Although several members of the staff played an active and helpful part, I wish to record with thanks the enthusiasm and efficiency of Mr. S. N. Dance, Senior Clerk in the Department, who undertook the major share of the work connected with the Exhibition. In conclusion, I should like once again to express my appreciation of the efforts of the staff of the Health Department and to refer especially to the service of Mr. Coulter, Chief Clerk, who is approaching a period of 50 years service with the Council. William D. Hyde, Medical Officer of Health. 6 BOROUGH OF ENFIELD Alderman Mrs. G. M. Jay, J.P Mayor Alderman E. L. Mackenzie Deputy Mayor Aldermen : W. G. Bowyer, Esq. C. Partington, Esq., J.P., D. R.J.Boxall,Esq. M.R.S.T. G. Deacock, Esq. P. L. Purnell, Esq., J.P. A. M. Eeles, Esq. A. H. Saunders, Esq. W. E. Lonsdale, Esq. A. A. F. Tatman, Esq., B.E.M., J.P. Councillors : Mrs. E. M. C. Ellis H. E. Latty, Esq. Miss D. M. Whitehead E. E. Leesmith, Esq. A. E. Antrobus, Esq. W. F. Lindsell, Esq. A. D. Bates, Esq. E. P. Lomer, Esq. J. R. Bentley, Esq. F. L. Mezen, Esq. E. W. Burville, Esq. J. Murray, Esq. A. H. Chambers, Esq. J. C. Pines, Esq., B.E.M. L. J. Collop Esq. S. C. Piper, Esq. W. H. Cook Esq. G. H. Platten, Esq. J. cottenham, esq., J.p. A. L. prout, esq. F. C. Cunneen, Esq. E. J. Rayment, Esq. A. G. Hayward, Esq. E. J. Tong, Esq. E. T. Hendrick, Esq. C. W. C. Turner, Esq., D.F.C. W. J. Howes, Esq. G. H. Watson, Esq. C. H. J. Wicks, Esq. HEALTH COMMITTEE J. Murray, EsqChairman A. H. Chambers, Esq Vice-Chairman also Aldermen Boxall, Lonsdale and Saunders. Councillors Mrs. Ellis and Miss Whitehead ; Antrobus, Collop, Cunneen, Latty, Leesmith, Lomer, Pines, b.e.m., Platten and Wicks. 7 PUBLIC HEALTH STAFF Medical Officer of Health : Dr. W. D. Hyde. Acting Deputy do. Dr. Margaret R. Gilmour. Chief Public Health Inspector : Mr. J. C. Lightfoot. Public Health Inspectors and Inspectors of Meat and Foods: Mr. H. Wiggett, Mr. A. Ramsden, Mr. D. C. Turner, Mr. G. E. A. Laney, Mr. N. Smith, Mr. K. E. Sewell, Mr. E. A. C. Kottman. Rodent Investigator: Mr. P. W. Partridge. Chief Clerk: Mr. Sydney Coulter. Senior Clerk : Mr. S. N. Dance. General Clerks : Mr. E. Gray, Mrs. I. Curtis and Miss D. M. Smith (resigned 3rd October, 1956). Miss J. M. Lacey (Appointed 7th November, 1956). Shorthand-Typist : Mrs. F. I. Dufton (resigned 13th December, 1956) Mrs. C. Meikle (Appointed 31st December, 1956). STATISTICS AND SOCIAL CONDITIONS OF THE AREA POPULATION The population as estimated by the Registrar General is 109,000. The number of inhabited houses at the end of 1956, according to the Rate Books, was 31,485. Explanatory Note : Definition of " Houses "—Structurally separate dwellings including flats. The rateable value of the Borough is £1,769,558 The net product (after allowing for cost of collection) of a penny rate is (Estimated) £7,300 AREA Area (in acres) 12,400 NEW HOUSES The number of houses erected during the course of the year was 498. 8 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. Live Births:— Toted Male. Female. Legitimate 1,309 686 623 Illegitimate 47 25 22 Birth-rate—12.44 per 1,000 population. Still Births:— Total. Male. Female. Legitimate 24 13 11 Illegitimate 2 1 1 Rate per 1,000 total births—18.81. Total. Male. Female. Deaths 1,194 584 610 Death-rate—10.95 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 24.33 Legitimate infants per 1,000 legitimate live births 24.44 Illegitimate infants per 1,000 illegitimate live births 21.27 Deaths from Cancer (all forms) 229 Deaths from Cancer (Lungs and Bronchus) 55 Deaths from Tuberculosis (Respiratory) 10 Deaths from Tuberculosis (Other forms) 1 COMPARABILITY FACTORS In view of the differing sex and age distribution of local populations, the General Register Office supplies factors for adjusting the Birth and Death rates to enable comparisons to be made with the rates for other areas and the country as a whole. The factors are—Births 1.00 and Deaths 0.85. 9 BIRTH, DEATH AND INFANT MORTALITY RATES. Birth-rate. Death-rate. Infant Mortality rate Live Still England and Wales 15.70 23.00 11.70 23.80 enfield 12.44 18.81 10.95 24.33 DEATHS The number of deaths assigned to Enfield for 1956 was 1,194, 26 more than for last year. The more prevalent causes of death during the last 2 years were :— Cause of Death 1956 1955 All Ages:— Diseases of Heart 420 366 Malignant Disease (Cancer) 229 223 Vascular Lesions of Nervous System 170 178 Bronchitis 63 86 Other Diseases of Circulatory System 42 54 Pneumonia 35 46 Tuberculosis of Respiratory System 10 14 Children Under 1 Year :— Atelectasis 4 11 Premature Birth 6 5 Congenital Malformations 6 4 Bronchitis and Broncho-pneumonia .. 6 3 Asphyxia 4 1 The death-rate for the Borough is 10.95 per 1,000 population. Two-hundred-and-ninety-eight deaths registered were of Enfield persons over 80 years of age, 127 being males and 171 females. Nine of the females were aged 95 years or more, two having reached 99 years. It will be seen that 24.87 per cent, of the total deaths were of persons over 80 years of age. 10 TABLE I. Causes of Death during Year 1956. Causes of Death. Males. Females. Total. Tuberculosis of Respiratory System 7 3 10 Other Forms of Tuberculosis 1 — 1 Syphilitic diseases 5 1 6 Diphtheria — — — Whooping Cough — — — Meningococcal infections 1 — 1 Ac. Polio-myelitis 1 — 1 Measles — — — Other infective and parasitic diseases 1 1 2 Malignant Neoplasm of stomach 12 20 32 Malignant Neoplasm, lung, bronchus 52 3 55 Do. of breast 1 33 34 Malignant Neoplasm, uterus — 8 8 Other Malignant and Lymphatic Neoplasms 62 38 100 Leukaemia, aleukaemia 3 2 5 Diabetes 2 1 3 Vascular lesions of nervous system 66 104 170 Coronary disease, angina 84 66 150 Hypertension with heart disease 8 17 25 Other Heart disease 93 152 245 Other Circulatory disease 24 18 42 Influenza 1 3 4 Pneumonia 13 22 35 Bronchitis 39 24 63 Other diseases of Respiratory system 4 4 8 Ulcer of stomach and duodenum 9 6 15 Gastritis, Enteritis and Diarrhoea 3 2 5 Nephritis and Nephrosis 8 2 10 Hyperplasia of prostate 16 — 16 Pregnancy, Childbirth and Abortion — — — Congenital Malformations 5 6 11 Other defined and ill-defined diseases 36 50 86 Motor Vehicle accidents 7 8 15 All Other accidents 16 11 27 Suicide 4 4 8 Homicide and operations of war — 1 1 Total 584 610 1,194 11 TABLE II. Infant Mortality 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 18 4 1 — 23 6 2 1 1 33 Uncertified — — — — — — — — — — Premature Birth 5 1 — — 6 — — — — 6 Congenital Malformations 3 3 — — 6 — — — — 6 Broncho-pneumonia and Bronchitis 1 — — — 1 4 — — 1 6 Atelectasis 4 — — — 4 — — — — 4 Asphyxia 1 — 1 — 2 1 — 1 — 4 Injury at Birth 3 — — — 3 — — — — 3 Peritonitis and Intussusception — — — — — — 1 — — 1 Teratoma — — — — — — 1 — — 1 Erythroblastosis Foetalis 1 — — — 1 — — — — 1 Gastritis — — — — — 1 — — — 1 Totals 18 4 1 — 23 6 2 1 1 33 Births in the year:—Legitimate: Live births, 1,309; Stillbirths, 24. Illegitimate : Live births, 47 ; Still-births, 2. Deaths in the year :—Legitimate Infants, 32 ; Illegitimate, 1. Of the 33 infants who died before reaching the age of 1 year, 23 died within the first 4 weeks of life, and of this number, 18 occurred in infants under 1 week. The increase in the number of deaths of infants this year is due to an increase in deaths over the age of 4 weeks, largely due to 5 deaths from Broncho-pneumonia and Bronchitis. The infant mortality rate for the Borough is 24.33 and this figure is comparable with that for 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 Borough and those in the Borough not rightly recorded to the Borough, 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. 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 1955 700 684 1,384 12.69 0.44 1956 725 657 1,382 12.67 0.45 INQUESTS Forty-eight Inquests and two-hundred-and-twenty-nine Postmortem examinations without inquests were held during the year. Of these, 230 deaths were due to natural causes, 25 to accidental causes, 7 to suicide, 6 to misadventure, 1 to murder, and in 8 cases an open verdict was recorded. FATAL HOME ACCIDENTS. During the year there were 14 fatal home accidents to Enfield residents, one less than the previous year. Another difference to be noted for the year under review is that 9 deaths occurred in adults between the ages of 49 years and 83 years, three between the ages of 3 years and 16 years, and two under 1 year, in comparison with the previous year when all 15 deaths were between the ages of 74 and 94 years. The precipitating cause of death in six of the adults was a fall leading to fractured bones, followed by lung complications in most cases. In two adults, death was due to coal gas poisoning and the other adult died of burns. One child of 3 years died as a result of a scald and four died from asphyxia; child aged 2 weeks (in bed with mother); child aged 2 months (inhalation of vomit) ; child aged 10 years (hanging); child aged 16 years (in bed). 13 The number of fatal Road accidents to Enfield residents during the year was 15, only one more than in the home, which one ought to be able to look upon as a place of safety. Unfortunately, there were also 8 cases of suicide, equally divided among the sexes, all being over the age of 50 and mostly elderly. The method adopted in 6 cases was coal gas poisoning, in one case drinking of poison and in the other case self-inflicted haemorrhage. It is disquieting to consider the sum total of human misery recorded in these paragraphs and to ponder over the fact that so much of this could, and should, be prevented. 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. 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 depot adjacent to Chase Farm Hospital, where calls are received for both recumbent and sitting cases. 14 WATER SUPPLY The Borough 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 three 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 Borough 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 five samples of well water were examined bacteriologically. In addition, fourteen samples of drinking water other than from wells were bacteriologically examined, and found to be satisfactory. MEDICAL ASSESSMENT OF EMPLOYEES. The following medical examinations or assessments of employees were carried out during the year :— (1) Superannuation Act: Medical examinations 18 Assessments without medical examinations 20 (2) Sick Pay Scheme : Medical examinations 47 Assessments without medical examinations 62 (3) Other Medical Examinations 24 HOUSING Number of new houses erected during the year by:— (a) Local Authority 192 (b) Other Local Authorities Nil (c) Other bodies or persons 296 15 With State assistance (included in above totals) :— (a) Local Authority 192 (b) Other Local Authorities Nil (c) Other bodies or persons Nil 1. Inspection of Dwelling-houses :— No. of inspections. No. of houses. (1) Total number of dwelling-houses inspected for housing-defects (under Public Health and Housing Acts) and number of inspections made 2,233 8,461 (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 303 452 (3) Number of dwelling-houses represented to the Council by the Medical Officer of Health to be in a state so dangerous or injurious to health as to be unfit for human habitation 39 (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 (The number here given is of houses where any insanitary conditions were found.) 596 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 534 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 14 (2) Number of dwelling-houses which were rendered fit after service of formal Notices:— (a) By owners 8 (b) By Local Authority in default of owner 1 16 B.—Proceedings under Public Health Act, 1936 :— (1) Number of dwelling-houses in respect of which Notices were served requiring defects to be remedied 179 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 161 (b) By Local Authority in default of owners 10 The number of house-to-house visitations made was :— Under Housing Regulations, 1925 and 1932 755 Apart from Do. Do. Nil HOUSING REPAIRS AND RENTS ACT, 1954. No. of applications received for Certificates of Disrepair 12 No. granted 11 No. refused 1 No. of applications received for Revocation of Certificates of Disrepair 11 No. granted 11 No. refused Nil 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 16 11 Pasteurised Milk 24 11 Sterilised Milk 82 13 Totals: 122 35 17 FOOD AND DRUGS ACT, 1955 Number and Classes of Food Premises registered under Section 14 of Food and Drugs Act, 1938 and Section 16 of Food and Drugs Act, 1955, 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 262 38 Food Preparing Premises 184 3,921 Dairies 54 74 Slaughterhouses 1 869 Ice-Cream As will be seen from the tabulated statement above, 38 inspections of ice-cream premises were made during the year. During these visits 16 samples of ice-cream were taken and the reports on these samples are summarised as follows :— Grade No. of Samples I 10 II 4 III 1 IV 1 Examined for Pathogenic Organisms, but not graded Nil Total 16 Examination of Foods Number of inspections made of retail shops, stalls and food-preparing premises, etc. 4,281 Number and weight of articles, etc., of foodstuffs condemned as unfit for food :— Articles Foodstuffs Weight—lbs. 1,284 Fruits 1,488½ 513 Vegetables 502¾ 7 Sauces and Pickles 6 122 Fish 884¾ 550 Meats 1,961 18 Articles Foodstuffs Weight—lbs. 2,322 Meat (Fresh) 11,480 4 Poultry 14½ 19 Meat and Fish Pastes 5½ 6 Frozen, etc., Eggs 60 121 Soups 100¼ 13 Cordials, etc. 10½ 6 Cereals 6 2 Custard Powders, etc. 2½ 47 Baby Foods 13 20 Macaroni and Spaghetti .. 13 182 Flour, etc. 190½ 28 Jams 35½ 8 Biscuits 3¼ 1 Fats ½ 25 Cheese 70¾ 414 Cream and Milk 519¼ 18 Puddings 17½ 5,712 = 7 tons 15 cwts. 0 qtrs. 25½ lbs. 17,385½ Total No. of articles, etc., condemned 5,712 No. of Certificates issued in regard thereto 719 Total weight of foodstuffs condemned as unfit for food:— 7 tons 15 cwts. 0 qrs. 25½ lbs. Method of Disposal of Condemned foods All unfit foodstuffs were destroyed in the Council's Refuse Destructor furnaces. PUBLIC HEALTH (MEAT) REGULATIONS, 1924 to 1952 Total number of carcases examined :— Cows 7 Bullocks 289 Heifers 238 Calves 147 Swine 3,936 Sheep 20,382 Lambs 10,160 Total 35,159 19 Whole carcases, parts or organs found to be diseased 2,244 Weight of do. 4 tons 10 cwts. 1 qtr. 8 lbs. Carcases and Offal inspected and condemned in whole or in part Cattle Excluding Cows Cows Calves Sheep and Lambs Pigs Horses Number killed (if known) 527 7 147 30,542 3,936 — Number inspected 527 7 147 30,542 3,936 — All diseases except T uberculosis and Cysticerci (a) Whole carcases condemned — — — 42 3 — (b) Part or organ condemned 147 — 1 1,673 348 — Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 27.89 0.0 0.67 5.61 8.91 0.0 Tuberculosis only : (a) Whole carcases condemned — — — — — — (b) Part or organ condemned 10 — — — 20 — Percentage of the number inspected affected with tuberculosis 1.89 0.0 0.0 0.0 0.50 0.0 Cysticercosis (a)Carcases of which some part or organ was condemned — — — — — — (b) Carcases submitted to treatment by refrigeration — — — — — — (c) Generalised and totally condemned — — — — — — 20 SLAUGHTERHOUSES ACT, 1954. There are no public slaughterhouses in the Borough and only one privately owned slaughterhouse is used. Slaughtering of animals takes place every day, including Sundays, at this one slaughterhouse, and the Council's Public Health Inspectors have to spend a considerable amount of their time, during the days, evenings and weekends, in visiting the slaughterhouse and examining the carcases. FOOD AND DRUGS ACT, 1955. THE FOOD HYGIENE REGULATIONS 1955 and 1956 The Act came into force on January 1st, 1956, and was described as " an Act to consolidate the Food and Drugs Act, 1938, the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1955, and the Food and Drugs Amendment Act, 1954, together with certain other enactments amending and supplementing Part V of the said Act of 1938 in relation to slaughterhouses and knacker's yards." The Food Hygiene Regulations 1955 were made under sections 13 and 125 of the Food and Drugs Act, 1955, and they replace section 13 of the Food and Drugs Act, 1938, and Regulations 19, 20 and 21 of the Public Health (Meat) Regulations, 1924. Most of the Regulations came into operation on the 1st January, 1956, but certain provisions involving alterations to premises or equipment, or substantial changes in existing practices were deferred until 1st July, 1956. The Food Hygiene (Amendment) Regulations, 1956, postponed the coming into operation, in relation to shrimps, prawns, and onions, of regulation 7 of the Food Hygiene Regulations, 1955, which restricts the giving out of food for preparation or packing for the purposes of a food business, on or about domestic premises. As is stated in a Ministry of Health circular, Statutory Regulations by themselves can never achieve the reduction in foodborne disease, that everyone hopes to see. The application of the Regulations will need continual supplementing with publicity and education in order that food handlers and the public may always have before them the importance of good food hygiene practice. 21 Departmental discussion on the effect, interpretation and application of the new legislation took place, and in addition, conferences and meetings were attended in order that a reasonable degree of uniformity of application, in the County, at least, could be achieved. In the Borough itself, bearing in mind this objective, one Public Health Inspector was relieved of most of his other duties and was given the work of co-ordinating the application of the new Regulations. Detailed inspections of 881 food premises were made during the year and record cards completed for all premises. These inspections, of course, consumed a considerable amount of time. The premises inspected included all types of Food shops, Stalls, Canteens, Club kitchens and bars, School, Hospital and Nursing Home kitchens, Wholesale delivery vehicles, Hawkers storages. Public Houses and Old Peoples Homes. The number of visits to food premises under the Food Hygiene Regulations during the year reached a total of 3,875, and I think this effort has produced satisfactory results, in spite of the variety of difficulties that were required to be overcome. One of the most satisfactory achievements has been the provision of water supply and fittings where none previously existed. Furthermore, hundreds of additional fittings have been provided, including sinks and wash hand basins, hot water apparatus, counter and window display screens, refrigerators, clothes lockers and cupboards. In addition, many structural alterations, repairs and decorations have been undertaken and improved lighting and ventilation have been effected in many instances. During the year eight cafes closed for various reasons, but on the other hand, eight new factory canteens are contemplated. Open fronted fish shops have received particular attention during the year and it is our hope to secure the provision of shop fronts or display slab screens throughout the district. 22 FOOD AND DRUGS ACT, 1955 The following table gives details of the samples of foods and drugs procured under the above Act in Enfield by the Food and Drugs Authority during 1956 :— Article. Total samples procured. Unsatisfactory. Milk (various) 78 1 Milk (new) 207 55 Biscuits 2 Bread 2 1 Butter 5 1 Cakes, etc. 67 3 Cheese 1 Coffee 2 Cooked meat and Meat Products (other than sausages) 47 - Cream 3 - Egg Pie 1 - Drugs 8 - Fish and Fish Products 4 - Flour, S.R. 1 - Fruit, dried 1 - Fruit, canned 1 1 Ground Almonds 2 - Ice cream 7 - Jelly 3 - Margarine 8 - Meat 16 - Non-brewed Condiment 3 - Orange drink 1 - Preserves 4 - Salad Cream 1 - Sausages and Sausage Meats 28 - Sauces 2 - Soups 2 - Suet 1 - Sweets 2 1 Tomato Juice 1 - Vinegar 3 - Wines and Spirits 29 - Totals: 543 63 23 With regard to the 63 samples noted as unsatisfactory, the following comments are made: Milk. Twenty-seven samples of new milk, procured from one farmer, were found to be deficient in fat and solids-not-fat. There was no evidence of added water, and a letter of advice and caution was sent to the farmer. Ten samples of new milk from another farmer were found to be deficient in fat. Again there was no evidence of added water and a letter of advice and caution was sent to the farmer. The same procedure was taken in the case of two samples from a further farmer, and which were found to be deficient in fat but contained no added water. Five samples, taken from single churns from a consignment, were slightly deficient in fat. The average composition of the whole consignment was satisfactory and no action was taken. Eleven samples, taken from consignments from four different farmers, were all slightly deficient in fat, but it was found that associated and subsequent samples were genuine and no further action taken. A bottle of milk contained pieces of glass. Proceedings were instituted against the processors who had bottled the milk and a fine of £5 Os. Od. plus £3 3s. Od. costs was imposed. Bread. This was a loaf of bread which contained grease. A letter of caution was sent to the bakers. Butter. This sample was submitted by a private purchaser. The butter had been in the possession of the purchaser for two weeks, and was rancid. Cakes. Two samples of cake procured from the same source were found to be gritty, but subsequent samples proved to be up to standard and no further action was taken. The presence of preservative was indicated in a sample of mincepie, but further samples were taken which proved correct and no further action was taken. Fruit, Canned. Canned fruit, described as "Pineapple Tidbits," was found to be deficient in pineapple syrup. An official caution was issued. Sweets. A sample of chocolates described as "Chianti Liqueur Bottles" did not contain chianti. A letter of caution was sent to the importers. The Food and Drugs Act, 1955, in section 47, contains new provisions concerning the descriptions which can be applied to certain substances which resemble cream in appearance but are not cream. This has necessitated the making of many inspection visits and the giving of advice to all traders likely to be concerned to ensure that they were fully aware of these new requirements. 24 Merchandise Marks Acts, 1887-1926. 227 inspections of shops were undertaken to ensure that the Marking Orders relating to certain imported foodstuffs made under the Merchandise Marks Act, 1926, were complied with. 1,104 separate displays of meat, apples, tomatoes, poultry, dried fruit and butter were examined. Verbal cautions were given in respect of minor infringements not being found so serious as to warrant more stringent action. Four summonses were issued against two retailers for failing to mark certain imported foods with the prescribed indication of origin ; convictions were recorded in every case. A fishmonger was summoned for selling a mixture of cod and saithe falsely described on the delivery ticket as " cod." He was convicted. The Labelling of Food Order, 1953. This Order requires that, in general, pre-packed foods shall bear on the label a clear statement of the designation of the food and, in the case of compound foods, the ingredients. It also requires that the name and address of the packer or labeller appears. At 288 premises 915 articles of prepacked food were examined. No proceedings were taken in respect of any of the infringements detected and manufacturers took immediate steps to correct unsatisfactory labels as soon as their attention was drawn to them. False or Misleading Descriptions. A considerable amount of work is carried out each year in scrutinising advertisements and the labelling of pre-packed food and taking such action as is possible to secure satisfactory amendments in those cases where a label or advertisement contains a false or misleading description of the food to which it relates. During the year under review corrective action has been taken in respect of cherry wine, biscuits, chocolate Easter eggs, flour and sugar confectionery, imitation caviare, black-currant punch, fruit juice drinks and creme de menthe. Special Designated Milk. During the year in question one licence was issued in respect of the use of the special designation "Pasteurised" for milk processed within the Borough; a licence also being issued for the same firm in respect of "Sterilised" milk. The premises were inspected regularly and compliance with the requirements of the Act or Regulations maintained in each case. 87 samples were taken, all of which were certified as being satisfactory. Safe Milk. In addition to the foregoing, 33 samples of raw milk were procured within the Borough and submitted to test for the presence of tubercle bacilli. None was found contaminated. 25 NUMBER AND CLASSES OF FOOD PREMISES IN BOROUGH Restaurants and Cafes 61 Grocers and Provision Merchants 213 Butchers 68 Greengrocers 78 Fishmongers 35 Bakehouses 26 Bakers and Confectioners 34 Milkshops and Dairies 86 Ice Cream Retailers 262 Potted Meat Manufacturers 1 Hawkers Fish 6 Fruit and Vegetables 21 Refreshments (Mobile Canteens) 1 Ice Cream 5 Eggs 1 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 5 Hawkers were registered. The following table shows the number of Hawkers' Premises, etc., registered and the number of inspections made by the Public Health Inspectors during the year in connection therewith. No. of Premises, etc., on Register No. of inspections 70 294 26 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASES AND SCHOOLS 1956. 1955. Number of children notified by Head Teachers to be absent from School due to:— (a) Infectious Disease or suspected Infectious Disease 276 454 (b) Contact with Infectious Disease 2 15 Number of School children notified by General Practitioners as suffering from Infectious Disease 368 1320 NOTIFIABLE DISEASES DURING THE YEARS 1955 AND 1956. 1956 1955 No. Treated in Hospital Deaths. No. Treated in Hospital Deaths Smallpox — — — — — — Cholera—Plague — — — — — — Diphtheria (inc. Membranous Croup) — — — — — — Diphtheria Carriers — — — — — — Erysipelas 19 1 — 11 — — Scarlet Fever 54 16 — 54 16 — Typhus Fever — — — — — — Typhoid Fever — — — — — — Paratyphoid Fever — — — 3 3 — Relapsing Fever — — — — — — Continued Fever — — — — — — Puerperal Pyrexia 50 46 — 30 28 — Meningococcal Infection 2 2 1 2 2 1 Poliomyelitis (Paralytic and Non-Paralytic) 3 3 1 20 17 3 Acute-Encephalitis — — — — — — Ophthalmia Neonatorum 8 6 — 10 9 - Respiratory Tuberculosis: New cases 56 — 10 97 — 14 Transfers, etc. 44 — Other forms of Tuberculosis: New cases 6 — 1 12 — 1 Transfers, etc. 2 — Food Poisoning 17 4 — 9 — — Malaria — — — — — — Pneumonia 77 6 35 57 5 46 Dysentery 207 4 — 9 — — Measles 200 1 — 2198 2 — Whooping Cough 188 2 — 15 — — Totals 933 91 48 2527 82 65 27 HOSPITAL FOR INFECTIOUS DISEASES During the year, the following cases were admitted from Enfield to South Lodge Hospital. Glandular Fever 1 Meningococcal Infection 1 Scarlet Fever 16 Pneumonia and Whooping Cough 1 Poliomyelitis 3 Whooping Cough 2 Gastro-enteritis 8 Chicken pox 3 Influenza 1 Osteomyelitis 1 Diarrhoea and Vomiting 3 Measles and Pneumonia 1 Erythema 1 Dysentery 2 Meningitis and Appendicitis 1 Pyrexia 1 Pneumonia 1 Erysipelas 1 48 DIPHTHERIA For the eighth year in succession no case of Diphtheria occurred in the Borough. DIPHTHERIA IMMUNISATION 1,331 children were immunised for the first time and 2,142 received subsequent reinforcing doses during the year. These figures show an increase on last year's figures, but I do not consider the number of parents accepting this service for their children is yet sufficiently high to warrant any sense of security. WHOOPING COUGH IMMUNISATION 1,158 children were immunised against Whooping Cough for the first time during the year, and 351 received subsequent re-inforcing doses. It is encouraging to record that these figures again shew an increase. 28 POLIOMYELITIS VACCINATION 443 children received two injections of vaccine and 43 children received one injection. SMALLPOX VACCINATION 743 persons received primary vaccination and 133 re-vaccination. These figures show an increase on last year's totals. POLIOMYELITIS AND ACUTE ENCEPHALITIS. During the course of the year three cases of poliomyelitis occurred in the Borough. Of these, 2 were boys aged 8 and 15 years, and 1 female aged 42 years. Unfortunately 1 case, the boy aged 15 years, proved rapidly fatal. One of the cases was non-paralytic and a follow-up of the remaining case shows good recovery. FOOD POISONING Of the 15 cases of food poisoning which were notified during the year, 13 were single cases, 7 being due to Salmonella Organisms and in 6 cases no causative organism was identified. The remaining two notified cases, together with 2 further cases ascertained during enquiry, constituted a small outbreak of food poisoning due to staphyloccus pyogenes. Two households consisting of 2 persons each were involved, the housewife in each case purchasing pressed brisket beef from an Enfield grocer and becoming ill a few hours after eating some of the meat on the same day. The other member of each family took the remainder of the meat to work in a sandwich lunch on the following day and became similarly ill a few hours later. The severity of the illness necessitated admission to hospital in three cases. The suspected food, pressed brisket beef, was manufactured by a firm in another Borough, and sold by a grocer in Enfield. During the inspection of the grocer's shop it was observed that an assistant, whose duties consisted mainly of slicing cooked meats, had a number of partially healed cuts on his hands. Samples of faeces from one of the patients, and samples of brisket and silverside, contained staphyloccus pyogenes, phage type similar to the type found in swabs taken from the Assistant's fingers. 29 At this time similar incidents were reported by the Public Health Laboratory, all connected with cooked meats supplied by the same manufacturer. It was reported that an employee at the meat manufacturer's premises was found to have a sore on his hand affected by staphyloccoci of the same type as that isolated in the Enfield incident. The factory was closed for a short period to enable thorough cleansing, disinfection, and other measures to be carried out. SONNE DYSENTERY The incidence of mild dysentery due to Shigella Sonnei, showed a considerable increase on last year's figure, 135 cases as against 9 for the previous year, but this is an infection which is likely to occur in great numbers at times, especially as its spread is so easily encouraged by careless personal hygiene. 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. Other Forms Respiratory. Other Forms M. F. M. F. M. F. M. F. Under 1 — — — — — — — — 1 to 5 1 — — — — — — — 5 to 10 2 1 1 — — — — — 10 to 15 — — — — — — — — 15 to 20 4 2 — — — — — — 20 to 25 5 4 — 1 — — — — 25 to 35 6 10 — 1 — — — 35 to 45 2 1 — — — — — — 45 to 55 6 1 — 1 2 2 — — 55 to 65 2 3 — 1 — — 1 — 65 and upwards 5 1 — 2 4 1 — — Totals 33 23 1 5 7 3 1 — No. of cases transferred into the District from other areas : Respiratory 40 Other Forms 2 42 No. of cases restored to Register during the year:— Respiratory 4 Other Forms — 4 30 The following table shows the incidence of Tuberculosis and death-rates from this disease in the various Wards in the Borough during the year. Ward. Estimated Population. No. of Cases. T.B. Case-rate. T.B. Death-rate. Respiratory Other Forms Respiratory Other Forms Respiratory Other Forms Bush Hill Park 10,551 5 1 0.47 0.09 0.00 0.00 Cambridge Road 10,649 8 1 0.75 0.09 0.09 0.00 Chase 7,505 2 — 0.26 0.00 0.26 0.00 Enfield Wash 12,531 6 — 0.47 0.00 0.00 0.00 Green Street 10,649 4 1 0.37 0.09 0.18 0.09 Ordnance 13,400 10 — 0.74 0.00 0.29 0.00 Ponders End 9,869 5 2 0.50 0.20 0.00 0.00 The Town 11,046 3 — 0.27 0.00 0.09 0.00 West 12,244 6 1 0.49 0.08 0.00 0.00 Willow 10,556 7 — 0.66 0.00 0.00 0.00 Total 109,000 56 6 0.51 0.05 0.09 0.009 MASS RADIOGRAPHY. The following tables give the final reports on the Mass Radiography investigation carried out in the Borough during 1955 by the North East Metropolitan Regional Hospital Board's Mass Radiography Unit. Male Female Total Organised Groups 9,425 4,587 14,012 Public Sessions 1,411 2,190 3,601 Schoolchildren 951 707 1,658 Total miniatures taken 11,787 7,484 19,271 Total recalled for large film 338 116 454 Pulmonary Tuberculosis:— Cases notified as result of Mass Xray 10 5 15 Cases regarded as inactive (including 3 under close clinic supervision) 83 25 108 Cases previously known to be tuberculous prior to this examination 5 — 5 Total 98 30 128 31 Male Female Total Other Abnormalities Discovered Included:— Osteochondroma of rib 1 — 1 Cystic lung 1 — 1 Hamartoma 1 — 1 Pneumonia 5 — 5 Bronchiectasis 3 3 6 Emphysema 6 — 6 Pulmonary fibrosis 20 1 21 Pleural thickening or calcification 16 3 19 Abnormalities of diaphragm 4 1 5 Congenital heart abnormality 1 1 2 Acquired heart abnormality 15 18 33 Pneumatocoele 1 — 1 Foreign body in lung 2 — 2 Sarcoidosis 2 1 3 Pneumoconiosis 4 — 4 Bronchial carcinoma 3 — 3 Retrosternal goitre 1 — 1 LABORATORY FACILITIES The examination of specimens is carried out by the Public Health Laboratory Service either at the Branch Laboratory situated at the Town Hall, Edmonton, or the Central Laboratory, Colindale. The following table sets out the record of examinations carried out and the results. Throat and Nose Swabs. Diphtheria Bacilli — Haemolytic Streptococci 94 Vincent's Angina 3 Negative 282 379 32 Faeces. Shigellae 403 Giardia 11 Salmonella 49 Gastro-Enteritis Coli 13 Protozoa — Welchii — Negative 1,694 2,170 Sputum. Tubercle Bacillus — Other Organisms 27 Negative 29 56 Pertussis. Cough Plate — Postnasal Swab — Negative 7 7 Milk. Pasteurised — Tuberculin Tested — Sterilised — Ice cream 16 16 Other Foods. Bacon 1 Biscuits 1 Chocolate bar 1 Chinese Egg Albumen 2 Easter Egg 2 Dried Egg 2 Frozen Egg 4 Pressed brisket of Beef 1 Pressed Silverside of Beef 1 Ham 1 16 33 Water. Domestic supplies, etc. 19 Swimming pools, etc. 6 25 Miscellaneous. 366 366 3,035 PREVENTION OF DAMAGE BY PESTS ACT, 1949. During the year a Rodent Investigating Officer and three operators were engaged on control of rat infestation at dwellinghouses and other premises and of the sewers in the Borough. 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. 1,268 premises were inspected during the year for rat and mice infestation, and of these 542 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 395. During the year the Public Health Inspectors and Rodent Investigating Staff made 4,801 visits concerning rat infestation. All the sewers in the Borough have been systematically examined and the Ministry's scheme for the extermination of rats in sewers has been closely followed. During the investigations 325 manholes were examined and 446 pre-baits and 133 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 10 Number of Council houses disinfested 10 Number of other houses found to be infested 19 Number of other houses disinfested 19 Householders are urged to seek the assistance of the Health Department immediately they suspect the presence of bugs or similar pests. 34 PUBLIC HEALTH INSPECTORS' INSPECTIONS AND VISITS The following report, in condensed form, gives details of the work of the Public Health Inspectors during the year 1956. The total number of inspections made during the year for all purposes was 23,147. Inspections of Premises:— No. of Inspections Housing Act, 1936 452 Housing Repairs and Rents Act, 1954 15 Infectious Disease 255 Tuberculosis 7 Complaint by tenants of insanitary conditions 7,507 Vermin 225 Rag Flock and Other Filling Materials Act, 1951 6 Pet Animals Act, 1951 16 Public Conveniences 124 Schools 22 School Canteens 17 Cinemas, Halls, etc. 13 Fair-grounds 5 Hairdressers 22 Milkshops and Dairies 74 Food Premises 3,875 Food Hawkers' Stands 174 Food Hawkers (Storage) 120 Bakehouses 46 Ice-Cream Shops 38 Public-houses 28 Outworkers' Premises 21 Factories 185 Smoke Observations 369 Visits:— Infectious Diseases 56 Tuberculosis 7 Dysentery 1,142 Food Poisoning 84 Housing Act, 1936 (Sec. 62)—Permitted Numbers 2 Overcrowding 4 Slaughterhouse 869 Shops Act, 1950 65 Improvements Grants 1,008 Builder's Notices 15 C/fwd 16,868 35 B/fwd 16,868 Food Inspections 222 Movable Dwellings 386 Rats 611 Piggeries 32 Stables 9 Well and Mains Water Supplies 19 Swimming Pools 16 Ice-Cream supplies 32 Paddling Pools in Parks 19 Atmospheric Pollution 135 Fireguard Regulations, 1954 5 Wasps' Nests 3 Pet Animals Act, 1951 14 Cesspools 96 Other Visits 398 18,865 Visits by Rodent Dept. Staff:— Rats 4,190 Wasps, Beetles, etc. 92 23,147 Samples taken—Water—Wells 5 Mains 14 Swimming Baths 4 Parks Lakes, etc. 2 Ice-Cream 16 Eggs 6 Miscellaneous Foodstuffs 16 The following list of repairs executed during the course of the year shows that the defects found as the result of the Public Health Inspectors' visits were varied and general in character. Houses or parts of houses cleansed, repaired, etc. 251 Roofs repaired 261 Gutters and downpipes repaired 144 Dampness remedied 167 Floors repaired 78 Yards paved or made good 17 Dustbins provided or renewed 42 Food stores provided 1 Improvements effected in Food premises 889 36 Drains—Examined 315 Tested—Smoke 50 Water 16 Reconstructed 17 Repaired, etc. 247 Vents provided 2 Vents repaired 4 Cesspools abolished 6 Sink wastes repaired 12 New sinks provided 2 Water-closets—New ones provided 5 New pans provided 43 Apparatus repaired or renewed 57 Water—Water laid on or restored 35 Nuisances—Manure, etc., removed 3 Ditches, etc., cleaned out 2 Other nuisances abated—Stoves, etc., repaired or renewed 33 Windows repaired or renewed 123 Caravans removed 54 Overcrowding abated 1 Miscellaneous 69 Wasps Nests destroyed 92 Houses demolished 3 Houses or parts of houses closed or vacated 16 FOOD HYGIENE REGULATIONS, 1955 Improvements carried out during the year:— Wash-hand basins installed 258 Sinks installed 119 Hot-water installed 221 Lockers installed 39 Counter or Window screening installed 112 Cleansing and repairing carried out 120 Lighting and ventilation improved 15 Water supply laid on 5 37 NOTICES ISSUED Statutory (Insanitary Conditions) 183 Informal ( Do. ) (P.H. Act) 475 Informal (Insanitary Conditions) (Housing Act) 25 Informal—Food and Drugs Act and Food Hygiene Regulations 383 Other Notices (Infectious Diseases) 1,786 2,852 Other Letters sent 2,383 Number of Certificates issued in connection with plans Nil Number of Certificates issued in connection with disinfection 15 Number of Certificates issued in connection with unsound foods 719 Number of Requisitions for Information dealt with 2,189 Number of Certificates of Disrepair issued under Housing Repairs and Rents Act, 1954 11 Number of Revocations of Certificates of Disrepair issued under Housing Repairs and Rents Act, 1954 11 Result of Service of Statutory and Informal Notices:— Statutory. Informal. Number complied with 163 361 Number outstanding 20 139 183 500 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. 38 DISINFECTION Number of houses disinfected after infectious disease and verminous cases 172 Number of articles of clothing, bedding, etc., disinfected 1,551 Number of Library books disinfected 301 Number of articles of clothing, bedding, etc., destroyed 81 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 1 additional establishment was licensed, and the 6 premises previously licensed by the local authority 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 came into force on the 1st October, 1954. Each of the Public Health Inspectors has been appointed a duly appointed officer under the Act. 39 FACTORIES ACTS, 1937 AND 1948 A register is kept of all the factories in the Borough, and during the year 231 inspections were carried out. 1.—INSPECTIONS for purposes of provisions as to health (including inspections made by Public Health 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 46 — — (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority 355 185 — — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 18 — — — Total 424 231 — — 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 1 1 — 1 — (b) Unsuitable or defective 3 3 — 2 — (c) Not separate for sexes — — — — — Other offences (not including offences relating to Outwork) 1 1 — — — Total 5 5 — 3 — 40 OUTWORKERS Fifty-six lists containing the names and addresses of 785 outworkers were received during the year. Two-hundred-and-thirteen 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 2 — — Fancy Goods 4 — — Wearing Apparel, etc. 219 — — Cardboard Boxes, etc. 10 — — Carding of Buttons, etc. 41 — — Artificial Flowers 7 — — Brush Making and Artist's Materials 176 — — Electrical Cables, etc. 300 — — Christmas Crackers, etc. 5 — — Stuffed Toys, Games and Toys 10 — — Carbon Papers 2 — — Druggist's Sundries 9 — — Total 785 — — 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 Borough. PLACES OF PUBLIC ENTERTAINMENT Number of inspections of sanitary accommodation 13 41 OFFENSIVE TRADES There is only one offensive trade business established in the Borough, and during the year no complaints were received. ATMOSPHERIC POLLUTION CLEAN AIR ACT, 1956 THE SMOKE CONTROL AREAS (AUTHORISED FUELS) REGULATIONS, 1956 The Clean Air Act, 1956 (Appointed Day) Order, 1956, brought into operation on the thirty-first day of December, 1956, certain provisions of the Clean Air Act, 1956, including provisions relating to smoke from furnaces, smoke control areas, the extension of the Alkali, etc., Works Regulations Act, 1906 to cover the emission of smoke, grit and dust from premises controlled, or to be controlled, under that Act, colliery spoilbanks and the constitution of the Clean Air Council. The Smoke Control Areas (Authorised Fuels) Regulations, 1956, also came into operation on the thirty-first day of December, 1956, and declared certain fuels to be authorised fuels for the purpose of the Act, Section 11 of which makes it an offence to emit smoke from any building in a smoke control area, unless it can be shewn that the emission of smoke was not caused by the use of any fuel other than an authorised fuel. As the Act and Regulations only came into operation on the last day of the year, there is, of course, nothing to report on its implementation, although certain preparatory work and discussion took place. During the year another deposit gauge and lead peroxide instrument were erected in a residential area some distance from industry for comparison purposes with the other three sites, and the results of the analyses taken at all four sites are appended. Site No. 1 is at Carterhatch Road, Site No. 2 is at Bilton Way, Site No. 3 is near the Royal Small Arms Factory, and site No. 4 is at Bell Road, Baker Street. The dissolved solids, suspended solids and total solids are recorded in tons per square mile and, for comparative purposes only, the sulphur dioxide in the atmosphere is expressed in milligrammes of sulphur trioxide per day per 100 sq. cm. of lead peroxide exposed. On an average throughout the year there is little difference in the recordings at the four sites, the low figures for total solids for February, March and November coinciding with the three lowest monthly recordings of rainfall during the year. Comparisons with a number of districts in Greater London, are in favour of Enfield. ATMOSPHERIC POLLUTION 43 SWIMMING BATH AND POOL Enfield has two public swimming pools, a relatively modern open-air pool, built in 1932, situated next to the Sports Stadium, and an indoor bath at Enfield Lock, built in 1895, but recently greatly improved by extensions and modernisation. As regards the purification of the water, the up-to-date method of chlorination, filtration and aeration is used at both premises. This gives a safe and pleasant bathing water. Reports on the twice-daily examinations for chlorine and alkalinity of the water are sent to the Medical Officer of Health, and the Public Health Inspectors take samples for bacteriological tests at appropriate intervals. At both the open-air pool and the indoor bath, slipper bath facilities are available. CARAVANS Number of applications received for consent Nil Number of applications granted Nil PUBLIC MORTUARY There is now no public mortuary in Enfield, but use is made at present of a Hospital Mortuary. Printed by Stanlky Woodfield, 8/12 Windmill Hill, Enfield, Middx.