AC 439(1) 1 Div B 2 Library ENF 41 Borough Council of Enfield Midd ANNUAL REPORT OF THE Medical Officer of Health (WILLIAM D. HYDE, M.B., Ch.B., D.P.H.) FOR 1957 Borough Council of Enfield ANNUAL REPORT OF THE Medical Officer of Health (WILLIAM D. HYDE, M.B., Ch.B., D.P.H.) FOR 1957 3 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, 1957. To the Mayor, Aldermen and Councillors of the Borough of Enfield. I have pleasure in presenting my Annual Report for 1957. During the year the East Middlesex Main Valley Sewer was completed in Enfield and two connections were made, one at Painters Lane and the other at Albany Park. The Cuffley Branch Sewer was also completed in Enfield, a connection made at Whitewebbs Road, and sewerage of part of the Crews Hill area was commenced. This welcome progress in the East Middlesex Main Drainage Scheme has solved the most pressing of our problems. The modernisation of the old Public Lavatory at Nags Head Road was completed and plans made for the replacement of the old facilities in Turkey Street. Continued progress is thus being maintained in the provision of new public lavatories and the modernisation of those that have become outdated. The opportunity was taken during the year to re-organise the male staff engaged in the cleaning of these premises. The number of men employed was reduced from seven to four; two light vans were provided and the alternating shift system was continued. This resulted in more frequent visits to premises by the staff with consequent improvement in cleanliness and supervision and a reduction in the amount of wilful damage, which has been a source of worry for so long. We can only hope that this reduction in damage will be maintained. Continued efforts were made in the sphere of Food Hygiene and again it is encouraging to note the many improvements effected, although the simple hygienic principles involved in safe food handling still require to be observed by many food handlers. 4 The vital statistics of the district show a satisfactory situation. The Birth Rate is up, the Death Rate is down, and the Infant Mortality Rate has reached its lowest ever figure of 10.26, the previous lowest being 17.4 in 1954. Most of the deaths took place in the first week of life and special investigation into, and consideration of, perinatal deaths is now receiving National attention. Deaths from cancer of the lungs and bronchus numbered 52 (3 less than last year) and deaths from Respiratory Tuberculosis numbered 8 (2 less than last year). Whatever one's smoking habits may be, I do not see how one can fail to accept the Medical Research Council's findings as establishing a causal relationship between smoking and lung cancer, and to base advice and habits on these findings. The very low figure of 8 deaths from Tuberculosis, the lowest figure ever recorded (it was 60 twenty years ago, and 50 in 1946) is in contrast to the depressing figure of 52 for cancer of the lungs and bronchus. It is also encouraging to note the reduction in new notified cases of respiratory tuberculosis from 56 last year to 27 this year. I make special mention of this achievement in the case of Tuberculosis as it is one hundred years since the birth of the late Sir Robert Philip, the originator in Edinburgh in 1887 of the Tuberculosis Dispensary method of treating the tuberculous family. Many factors, including environmental, have contributed to the encouraging progress made in the fight against tuberculosis and efforts must not be relaxed if we wish to reach a completely successful conclusion. Unfortunately there were 18 cases of suicide, 10 deaths due to accidents in the home and 5 fatal road accidents to Enfield residents. As so many of the fatal home accidents are precipitated by a fall, it is important that old people's residences should be so planned and arranged as to reduce the risk to a minimum, and appliances and fitments should be designed and installed with this object in view. With regard to infectious disease, there were 5 cases of poliomyelitis, one of which proved fatal. None of the patients had been immunised. There was a moderate increase in the number of cases of scarlet fever and whooping cough, a considerable increase in the number of cases of measles, and decreases in the number of cases of food poisoning and dysentery. Excluding pneumonia, the only deaths from notifiable infectious diseases were 1 from poliomyelitis and 8 from tuberculosis. As a result of cases of smallpox occurring in nearby districts 5 at the end of June, many contacts of the cases were found to reside in Enfield. Twenty-seven families were involved and almost one hundred members of these families were visited and vaccinated immediately their risk of infection was known. Each person was visited or inspected daily for sixteen days, and in spite of several suspicious developments, no cases of smallpox occurred. The procedure of prompt vaccination of all contacts and the establishment of a "vaccination barrier" around all contacts, must have played an important part in limiting the outbreak. Reference should be made to the considerable progress made in regard to vaccination against poliomyelitis by the end of the year when 3,431 children had received two injections and 292 had received one injection. In conclusion, I should like to express my appreciation of the staff of the Health Department and to refer especially to the retirement on 31st December, 1957, after 50 years' service with the Council, of Mr. S. Coulter, Chief Clerk, and after 47 years' service with the Council, of Mr. H. Wiggett, Public Health Inspector. Both Officers served the district conscientiously in their respective spheres of activity during their long service. William D. Hyde, Medical Officer of Health. 6 BOROUGH OF ENFIELD Alderman E. L. Mackenzie, J.P Mayor Councillor F. C. Cunneen Deputy Mayor Aldermen: Mrs. G. M. Jay, J.P. C. Partington, Esq., J.P., W. G. Bowyer, Esq. M.R.S.T. D. R. J. Boxall, Esq. P. L. Purnell, Esq., J.P. G. Deacock, Esq. A. H. Saunders, Esq. A. M. Eeles, Esq. A. A. F. Tatman, Esq., B.E.M., J.P. Councillors: Miss C. E. Clough W. J. Howes, Esq. 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. E. J. Rayment, Esq. Dr. N. Graham E. J. Tong, Esq. A. G. Hayward, Esq. C. W. C. Turner, Esq., D.F.C. E. T. Hendrick, Esq. G. H. Watson, Esq. C. H. J. Wicks, Esq. HEALTH COMMITTEE J. Murray, Esq. Chairman Miss C. E. Clough Vice-Chairman also Alderman Boxall Councillors Mrs. Ellis, Antrobus, Dr. Graham, Latty, Leesmith, Mezen, Pines, b.e.m., 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 (retired 31st December, 1957), Mr. A. Ramsden, Mr. D. C. Turner, Mr. G. E. A. Laney, Mr. N. Smith, Mr. K. E. Sewell (resigned 24th September, 1957), Mr. E. A. C. Kottman. Rodent Investigator: Mr. P. W. Partridge. Chief Clerk: Mr. Sydney Coulter (resigned 31st December, 1957). Senior Clerk: Mr. S. N. Dance. General Clerks: Mr. E. Gray, Mrs. I. Curtis (resigned 26th July, 1957), Mrs. V. M. Randall (appointed 8th July, 1957), Miss J. M. Lacey (resigned 5th July, 1957), Miss D. A. Harding (appointed 29th July, 1957). Shorthand-Typist: Mrs. C. Meikle. 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 1957, according to the Rate Books, was 32,119. Explanatory Note: Definition of "Houses"—Structurally separate dwellings including flats. The rateable value of the Borough is £1,753,510 The net product (after allowing for cost of collection) of a penny rate is (Estimated) £7,100 AREA Area (in acres) 12,401 NEW HOUSES The number of houses erected during the course of the year was 435. 8 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. Live Births:— Total Male. Female. Legitimate 1,398 686 712 Illegitimate 63 24 39 Birth-rate—13.37 per 1,000 population. Still Births:— Total. Male. Female. Legitimate 29 15 14 Illegitimate 2 1 1 Rate per 1,000 total births—20.77. Total. Male. Female Deaths 1,185 592 593 Death-rate—10.85 per 1,000 population. Number of women dying in, or in consequence of, childbirth:— Deaths. Rate per 1,000 Total Births. From Puerperal Sepsis 2 1.34 From other Puerperal causes 1 0.67 3 2.01 Death-rate of Infants under one year of age:— All infants per 1,000 live births 10.26 Legitimate infants per 1,000 legitimate live births 10.70 Illegitimate infants per 1,000 illegitimate live births 15.87 Deaths from Cancer (all forms) 242 Deaths from Cancer (Lungs and Bronchus) 52 Deaths from Tuberculosis (Respiratory) 8 Deaths from Tuberculosis (Other forms) — 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 0.91. 9 BIRTH, DEATH AND INFANT MORTALITY RATES. Birth-rate. Death-rate. Infant Mortality rate Live Still England and Wales 16.10 22.50 11 50 23.10 ENFIELD 13.37 20.77 10.85 10.26 DEATHS The number of deaths assigned to Enfield for 1957 was 1,185, 9 less than for last year. The more prevalent causes of death during the last 2 years were:— Cause of Death 1957 1956 All Ages:— Diseases of Heart 432 420 Malignant Disease (Cancer) 242 229 Vascular Lesions of Nervous System 130 170 Bronchitis 61 63 Other Diseases of Circulatory System 63 42 Pneumonia 51 35 Tuberculosis of Respiratory System 8 10 Children Under 1 Year:— Atelectasis 3 4 Premature Birth 2 6 Congenital Malformations 6 6 Bronchitis and Broncho-pneumonia 3 6 The death-rate for the Borough is 10.85 per 1,000 population. Three hundred and thirty seven deaths registered were of Enfield persons over 80 years of age, 141 being males and 196 females. 5 males and 10 of the females were aged 95 years or more, 1 male having reached 99 years and 3 females 100, 101 and 105 years. It will be seen that 28.43 per cent, of the total deaths were of persons over 80 years of age. 10 TABLE I. Causes of Death during Year 1957. Causes of Death. Males. Females. Total. Tuberculosis of Respiratory System 7 1 8 Other Forms of Tuberculosis — — — Syphilitic diseases — — — Diphtheria — — — Whooping Cough — — — Meningococcal infections - — — Ac. Polio-myelitis 1 — 1 Measles — — — Other infective and parasitic diseases 1 — 1 Malignant Neoplasm of stomach 20 12 32 Malignant Neoplasm, lung, bronchus 42 10 52 Do. of breast — 23 23 Malignant Neoplasm, uterus — 3 3 Other Malignant and Lymphatic Neoplasms 71 61 132 Leukaemia, aleukaemia 2 1 3 Diabetes 2 5 7 Vascular lesions of nervous system 42 88 130 Coronary disease, angina 109 60 169 Hypertension with heart disease 11 13 24 Other Heart disease 103 136 239 Other Circulatory disease 38 25 63 Influenza 4 6 10 Pneumonia 18 33 51 Bronchitis 40 21 61 Other diseases of Respiratory system 6 2 8 Ulcer of stomach and duodenum 7 4 11 Gastritis, Enteritis and Diarrhoea 1 3 4 Nephritis and Nephrosis 8 5 13 Hyperplasia of prostate 7 — 7 Pregnancy, Childbirth and Abortion — 3 3 Congenital Malformations 2 2 4 Other defined and ill-defined diseases 26 52 78 Motor Vehicle accidents 4 1 5 All Other accidents 10 15 25 Suicide 10 8 18 Homicide and operations of war — — — Total 592 593 1,185 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 9 1 - - 10 2 2 1 - 15 Uncertified - - - - - - - - - - Atelectasis 3 - — - 3 - - - - 3 Pneumonia and Bronchitis 1 - — - 1 1 - 1 — 3 Congenital Malformations 3 - — - 3 1 2 — 6 Prematurity 1 1 — - 2 - — — — 2 Cerebral haemorrhage 1 - — - 1 - - — — 1 Totals 9 1 - — 10 2 2 1 — 15 Births in the year:—Legitimate: Live births, 1,398; Stillbirths, 29. Illegitimate: Live births, 63; Still-births, 2. Deaths in the year:—Legitimate Infants, 15; Illegitimate, —. Of the 15 infants who died before reaching the age of 1 year, 10 died within the first 4 weeks of life, and of this number, 9 occurred in infants under 1 week. The infant mortality rate for the Borough is 10.26 and this figure is a very encouraging one. 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:— 12 Year. Boys. Girls. Total. Birth-rate per 1,000 Population. Illegitimate Birth-rate per 1,000 Population. 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 1957 726 766 1,492 13.66 0.44 INQUESTS Fifty-seven Inquests and two hundred and fifty-five Postmortem examinations without inquests were held during the year. Of these, 248 deaths were due to natural causes, 36 to accidental causes, 18 to suicide, 5 to misadventure, and in 5 cases an open verdict was recorded. FATAL HOME ACCIDENTS. During the year under review there were 16 fatal home accidents to Enfield residents, being 2 more than the previous year. All these accidents occurred amongst adults, 9 being over 80 and 6 between 70 and 80 years of age. The precipitating cause of death in 14 cases was a fall, leading in most instances to fractured bones and followed usually by lung complications. This was an increase of 8 over the previous year's total for this type of accident. The number of fatal Road accidents to Enfield residents during the year was 5. Unfortunately, there were also 18 (10 male, 8 female) cases of suicide, all but one being over the age of 50 years and mostly elderly. The method adopted in 11 cases was coal gas poisoning, hanging 3, carbon monoxide poisoning from exhaust of motor car 1, drowning 1, barbiturate poisoning 1, aspirin poisoning 1. 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. 13 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. 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. 14 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 twelve samples of well water were examined bacteriologically. In addition, twelve 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 9 Assessments without medical examinations 24 (2) Sick Pay Scheme: Medical examinations 44 Assessments without medical examinations 51 (3) Other Medical Examinations 25 HOUSING Number of new houses erected during the year by:— (a) Local Authority 191 (b) Other Local Authorities — (c) Other bodies or persons 244 With State assistance (included in above totals):— (a) Local Authority 191 (b) Other Local Authorities — (c) Other bodies or persons — 1. Inspection of Dwelling-houses:— No. of houses. No. of inspections. (1) Total number of dwelling-houses inspected for housing-defects (under Public Health and Housing Acts) and number of inspections made 2,908 7,250 (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 73 247 15 (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 35 (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 425 (The number here given is of houses where any insanitary conditions were found.) 2. Remedy of defects without service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 404 3. Action under Statutory Powers. A.—Proceedings under Sections 9, 10, 11 and 16 of the Housing Act, 1936, and Sections 9, 10, 12 and 17 of the Housing Act, 1957:— (1) Number of dwelling-houses in respect of which Notices were served requiring repairs 1 (2) Number of dwelling-houses which were rendered fit after service of formal Notices:— (a) By owners 1 (b) By Local Authority in default of owner — B.—Proceedings under Public Health Act, 1936:— (1) Number of dwelling-houses in respect of which Notices were served requiring defects to be remedied 78 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 47 (b) By Local Authority in default of owners 12 The number of house-to-house visitations made was:— Under Housing Regulations, 1925 and 1932 320 Apart from Do. Do. — 16 HOUSING REPAIRS AND RENTS ACT, 1954. No. of applications received for Certificates of Disrepair 4 No. granted 3 No. refused 1 No. of applications received for Revocation of Certificates of Disrepair 5 No. granted 4 No. refused 1 RENT ACT, 1957 This Act came into operation on 6th July, 1957, and in addition to defining new rent limits according to the rateable values of properties, makes provision which enables tenants of controlled houses to get their houses put into a proper state of repair by the owners. As in the case of the Housing Repairs and Rents Act, 1954, the tenant may apply to the local authority for a Certificate of Disrepair in respect of any defects existing at his house, and is entitled to a reduction in rent while a Certificate, if granted, is in force. An essential difference, however, under the Rent Act, 1957, is that the Tenant initiates action by listing the defects which in his opinion require remedying, and serves a Notice on his Landlord. The sections of the Housing Repairs and Rents Act, 1954, relating to the issue of Certificates of Disrepair, etc., were repealed by the Rent Act, 1957. To 31st December, 1957, 192 applications for Certificates of Disrepair had been received, 38 of which were granted and 2 refused. Two applications for Cancellation of Certificates were received. PUBLIC HEALTH (MEAT) REGULATIONS, 1924 to 1952 Total number of carcases examined:— Cows 77 Bullocks 432 Heifers 226 Calves 214 Swine 1,451 Sheep 20,817 Lambs 9,302 Total 32,519 17 Whole carcases, parts or organs found to be diseased 1,618 Weight of do. 4 tons 3 cwts. I qtr. 23 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) 658 77 214 30,119 1,451 — Number inspected 658 77 214 30,119 1,451 — All diseases except T uberculosis and Cysticerci (a) Whole carcases condemned - - - 24 6 - (b) Part or organ condemned 162 - 1 1,324 78 — Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 24.62 0.0 0.46 4.47 5.78 0.0 Tuberculosis only: (a) Whole carcases condemned 1 1 - - - - (b) Part or organ condemned 10 - — — 12 — Percentage of the number inspected affected with tuberculosis 1.67 1.29 0.0 0.0 0.83 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 — — — _ - — 18 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. 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 80 13 Totals: 120 35 FOOD AND DRUGS ACT, 1955 Number and Classes of Food Premises registered under 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 272 107 Food Preparing Premises 184 4,123 Dairies 54 26 Slaughterhouses 1 926 19 Ice-Cream As will be seen from the tabulated statement above, 107 inspections of ice-cream premises were made during the year. During these visits 38 samples of ice-cream were taken and the reports on these samples are summarised as follows:— Grade No. of Samples I 26 II 2 III 3 IV 1 Examined for Pathogenic Organisms, but not graded Nil Test void 6 Total 38 Examination of Foods Number of inspections made of retail shops, stalls and food-preparing premises, etc 4,037 Number and weight of articles, etc., of foodstuffs condemned as unfit for food:— Articles Foodstuffs Weight—lbs. 892 Fruits 1,160 822 Vegetables 950 31 Sauces and Pickles 5 118 Fish 447 267 Meats 1,478 1,654 Meat(Fresh) 10,688 51 Meat and Fish Pastes 6 49 Soups 43 24 Cordials, etc. 608 5 Cereals 18 5 Baby Foods 1 13 Macaroni and Spaghetti 9 26 Jams 44 1 Fats 76 1 Cheese 8 238 Cream and Milk 249 2 Puddings 20 4,199 =7 tons 1 cwts. 0 qtrs. 18 lbs. 15,810 20 Total No. of articles, etc., condemned 4,199 No. of Certificates issued in regard thereto 618 Total weight of foodstuffs condemned as unfit for food:— 7 tons 1 cwts. 0 qrs. 18 lbs. Method of Disposal of Condemned foods All unfit foodstuffs were destroyed in the Council's Refuse Destructor furnaces. FOOD AND DRUGS ACT, 1955. THE FOOD HYGIENE REGULATIONS 1955 to 1957 During the year, 4,037 visits were made to food premises of all types. There is no adequate alternative to direct contact with food handlers by frequent visits; complacency on the part of some can follow the provision of sink, wash hand basin, clothes locker, etc. Efforts to suitably screen unwrapped foods on counters and in windows from risk of contamination by customers, continued throughout the year. The number of fittings installed and other improvements effected was:—Basins 91; Sinks 28; Hot Water 73; Clothes Lockers 17; Screening 30; Lighting and Ventilation improved 4; Food premises cleansed and repaired 54; Alterations and improvements 20. The importance of refrigeration in the control of Salmonella infection has been stressed and the provision of refrigeration is continually being encouraged within the Borough. Very few food premises are entirely without refrigeration and a number of butchers have provided refrigerated windows; these allow display throughout the year and protect meat from contamination by flies. Two open-fronted fish shops closed during the year, business being transferred to modernised closed fronted shops. One other was fitted with a closed front, and only three shops now remain without adequate protection. Two of these are likely to be modernised in the near future. Major improvements to a number of factory canteens were carried out during the year and four satisfactory new canteens were built. 21 With the ready co-operation of three factory managements, programmes consisting of a talk on food hygiene and the showing of the instructional colour film "Food without Fear" were arranged. Food handlers from other factory canteens nearby were invited to these three meetings and a total of 162 people attended. Each programme took the form of a short introductory talk followed by the film, after which questions were invited. A great amount of effort was expended in encouraging people to attend, but it is difficult to assess the ultimate value of this form of education. Many factory canteen workers are married women with family responsibilities and are unable or unwilling to attend in their own time, whilst Managements are often unable or reluctant to release their personnel during working hours. Samples of washing-up waters and swabs from kitchen utensils and equipment were taken from 68 premises, including restaurants, cafes, school kitchens and sculleries, factory canteens, hotel kitchens, public houses and shops. Altogether 69 samples of washing-up water and 150 swabs from utensils and equipment were examined. In 45 cases results on examination were considered to be unsatisfactory. Advice on washing up technique was given where indicated as necessary by the reports, together with guidance on the selection and proper use of detergents and germicidal agents. Follow up sampling and swabbing was carried out with satisfactory results in every case. FOOD HYGIENE REGULATIONS, 1955 Improvements carried out during the year:— Wash-hand basins installed 91 Sinks installed 28 Hot-water installed 73 Lockers installed 17 Counter or Window screening installed 30 Cleansing and repairing carried out 54 Lighting and ventilation improved 4 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 1957:— Article. Total samples procured. Unsatisfactory. Milk (various) 79 — Milk (new) 176 45 Beer 2 — Butter 24 — Cakes, etc. 25 1 Cheese 8 — Cooked meat 14 — Cream 12 — Drugs 7 — Fish and Fish Products 11 — Fruit, canned and Fresh 3 2 Fruit juice etc. 9 — Ice cream 16 4 Iodine 6 — Margarine 3 — Meat and Meat Products 33 — Non-brewed Condiment 2 — Preserves 3 — Liver 2 — Sausages 11 — Spirits 9 — Sweets 4 — Vinegar 35 6 Miscellaneous 14 — Totals: 508 58 With regard to the 58 samples noted as unsatisfactory, the following comments are made: Milk. The 45 samples of new milk which were unsatisfactory were taken from three different dairy farmers. Three of these samples (from one producer) were found to be deficient both in milk fat and solids-not-fat. There was no evidence of any added 23 water. A letter was sent to the farmer concerned drawing his attention to these deficiencies and the facts were also reported to the Milk Marketing Board, so that the farmer might have the benefit of their advisory service. The remaining 42 samples which were unsatisfactory, were all slightly deficient in milk fat. In the case of one farmer, samples from other churns of milk forming part of the same consignment were all satisfactory and, in the case of the other farmer, follow-up samples taken on subsequent days were found to be satisfactory. Cakes described as "cream horns" were found to contain an imitation cream filling. An official caution was sent to the retailers concerned. Fruit. Two retailers were each found to be describing Packham Triumph Pears as William Pears. Proceedings were instituted against one retailer and a fine of £3 was imposed; an official caution was addressed to the second retailer. Ice Cream. Two samples, purchased from the same manufacturer/retailer were found to be deficient in fat. Proceedings were instituted and the defendant was fined £3 and ordered to pay £2 10s. costs. Two further samples of ice cream bore descriptive labels which were considered to be misleading; this matter is still under investigation. Vinegar. With regard to the six samples of vinegar, it was found that each was non-brewed condiment. Four retailers were involved; three received official cautions and the fourth was cautioned verbally. Merchandise Marks Acts, 1887-1953. 235 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. 860 separate displays of meat, apples, tomatoes, poultry, dried fruit, bacon and butter were examined. Inspections were also made to see that the provisions of the Merchandise Marks Act, 1887 were complied with, and no false trade descriptions were used. 13 summonses were issued against one butcher, 12 in relation to Argentine meat bearing a false trade description "English," and one in respect of Argentine meat exposed for sale not marked with an indication of origin; he was fined a total of £65, and ordered to pay £2 2s. 0d. costs. A second butcher was prosecuted in respect of two offences of selling Argentine beef not marked with an indication of origin. In each of these cases the purchaser requested English meat and was supplied with unmarked Argentine beef. He was also prosecuted for two offences of not marking with an indication of origin imported meat exposed for sale and was fined 24 a total of £8, with £2 2s. 0d. costs. A third butcher received official cautions in respect of two offences of selling Argentine beef not marked with an indication of origin and for failing to mark with an indication of origin, Argentine meat exposed for sale. A wholesale dealer sold to a shopkeeper in Enfield a fertiliser which was pulverised sewage sludge. At the time of sale he gave the retailer certain advertising literature which falsely described the composition of the fertiliser. Proceedings were instituted against the wholesaler who was fined £5, and ordered to pay £8 8s. costs. Labelling of Food Order, 1953. At 338 premises 2,272 articles of pre-packed food were examined to see that they bore a label which gave a clear statement of the designation of the food and, in the case of compound foods, the ingredients and also the name and address of the packer or labeller. No infringements of this Order were detected. False or Misleading Descriptions. As in previous years a considerable amount of work has been done in the detailed scrutiny of advertisements and the labels on pre-packed foods, and taking suitable action in those cases where the 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 secured in respect of salmon with potato salad, crystallised jelly, pineapple slices, pure egg mundelech, cherry juice, lime juice, imitation cream, cream filled biscuits, cream filled Easter eggs and cheese. In every case the person responsible agreed to make necessary suitable amendments to labels as the result of representations. In no case was it necessary to institute proceedings. Special Designated Milk. During the year in question one licence was issued by the County Council in respect of the use of the special designation "Pasteurised" and another in respect of the designation "Sterilised" for milk processed in Enfield. Processors' premises were regularly inspected and compliance with requirements of the Act and of the appropriate Regulations was maintained. 56 samples of designated milk were taken all of which were certified as being satisfactory. Safe Milk. In addition to the foregoing, 29 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 64 Grocers and Provision Merchants 227 Butchers 70 Greengrocers 80 Fishmongers 33 Bakehouses 24 Bakers and Confectioners 34 Milkshops and Dairies 89 Ice Cream Retailers 272 Hawkers Fish 8 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 2 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 72 95 26 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASES AND SCHOOLS 1957. 1956. Number of children notified by Head Teachers to be absent from School due to:— (a) Infectious Disease or suspected Infectious Disease 584 276 (b) Contact with Infectious Disease 3 2 Number of School children notified by General Practitioners as suffering from Infectious Disease 981 368 NOTIFIABLE DISEASES DURING THE YEARS 1956 AND 1957. 1957 1956 No. Treated in Hospital Deaths No. Treated in Hospital Deaths. Smallpox — — - — - — Cholera—Plague - - - - - - Diphtheria (inc. Membranous Croup) - - - - - - Diphtheria Carriers - - - - - - Erysipelas 16 2 - 19 1 — Scarlet Fever 126 44 - 54 16 — Typhus Fever — — - — — — Typhoid Fever — — - — — — Paratyphoid Fever - - - - - - Relapsing Fever — — - — — — Continued Fever — — - — — — Puerperal Pyrexia 71 67 - 50 46 — Meningococcal Infection 1 1 - 2 2 1 Poliomyelitis (Paralytic and Non-Paralytic) 5 5 1 3 3 1 Acute-Encephalitis — — - — — — Ophthalmia Neonatorum 13 13 - 8 6 — Respiratory Tuberculosis: New cases 27 - 8 56 - 10 Transfers, etc. 35 44 — Other forms of Tuberculosis : New cases 9 — - 6 — 1 Transfers, etc. 1 2 - Food Poisoning 10 — — 17 4 — Malaria - — — - - — Pneumonia 84 28 51 77 6 35 Dysentery 100 — — 207 4 — Measles 1244 5 — 200 1 — Whooping Cough 246 6 — 188 2 — Totals 1988 171 60 933 91 48 27 HOSPITAL FOR INFECTIOUS DISEASES During the year, the following cases were admitted from Enfield to South Lodge Hospital. Measles 8 Meningococcal Infection 1 Scarlet Fever 44 Poliomyelitis 4 Whooping Cough 6 Gastro-enteritis 12 Influenza 17 Diarrhoea and Vomiting 1 Upper Respiratory Infection 11 Pyrexia 2 Pneumonia 14 Erysipelas 2 Quinsy 5 Bronchitis 2 Others 23 152 DIPHTHERIA For the ninth year in succession no case of Diphtheria occurred in the Borough. DIPHTHERIA IMMUNISATION 1,236 children were immunised for the first time and 2,377 received subsequent reinforcing doses during the year. WHOOPING COUGH IMMUNISATION 1,013 children were immunised against Whooping Cough for the first time during the year, and 263 received subsequent re-inforcing doses. POLIOMYELITIS VACCINATION 3,431 children received two injections of vaccine and 292 children received one injection. 28 SMALLPOX VACCINATION 1,652 persons received primary vaccination and 592 re-vaccination. These figures show an increase on last year's totals, due no doubt, to the proximity of cases of smallpox in the middle of the year. POLIOMYELITIS AND ACUTE ENCEPHALITIS. During the course of the year 5 cases of poliomyelitis occurred in the Borough. Of these 3 were boys, 2 being aged 6 years and one aged 13 years and 2 girls aged 5 years and 1½ years. Unfortunately one case, the boy aged 13 years, proved fatal. All the cases were of paralytic type. FOOD POISONING Of the 10 cases of food poisoning which were notified during the year, 6 were single cases, 2 being due to Salmonella Organisms and in 4 cases no causative organism was identified. The remaining four notified cases constituted a small outbreak of food poisoning due to coagulase—positive staphylococci 'phage 53+. Within a short time of consuming tinned sild in tomato these cases all members of one family became acutely ill with symptoms of food poisoning. The remains of the contents of the tin of sild were examined bacteriologically and a profuse growth of coagulase staphylococci 'phage 53+ was isolated. Bacteriological examination of faeces from the affected family produced a similar growth of organism. SONNE DYSENTERY The incidence of mild dysentery due to Shigella Sonnei, showed a decrease on last year's figure, 100 cases as against 135 for the previous year, but this is an infection which is likely to vary considerably in incidence, 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. 29 Age Periods. New Cases. Deaths. Respiratory. Other Forms Respiratory. Other Forms M. F. M. F. M. F. M. F. Under 1 - - - - - - - - 1 to 5 - - - - - - - - 5 to 10 — 2 — 1 — — — — 10 to 15 1 2 - - - - - - 15 to 20 - - - 1 — — — — 20 to 25 2 3 1 - - - - - 25 to 35 4 1 2 1 — — — — 35 to 45 — 3 1 — 1 1 — — 45 to 55 3 2 2 1 — — — 55 to 65 1 — — — 1 — — — 65 and upwards 3 — — — 4 — — — Totals 14 13 4 5 7 1 — — No. of cases transferred into the District from other areas: Respiratory 35 Other Forms 1 36 No. of cases restored to Register during the year:— Respiratory 5 Other Forms — 5 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 1 3 0.09 0.25 0.09 0.00 Cambridge Road 10,649 3 3 0.28 0.28 0.09 0.00 Chase 7,555 2 — 0 26 0.00 0.13 0.00 Enfield Wash 12,531 6 — 0.47 0.00 0.07 0.00 Green Street 10,649 1 — 0.09 0.00 0.00 0.00 Ordnance 13,450 3 1 0.22 0.07 0.14 0.00 Ponders End 9,869 3 — 0.30 0.00 0.10 0.00 The Town 11,096 2 — 0.18 0.00 0.00 0.00 West 12,294 1 — 0.08 0.00 0.00 0.00 Willow 10,556 5 2 0.47 0.18 0.09 0.00 Total 109,200 27 9 0.24 0.08 0.07 0.00 30 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 104 Vincent's Angina 2 Negative 386 492 Faeces. Shigellae 211 Giardia 6 Salmonella 38 Gastro-Enteritis Coli — Protozoa — Welchii 7 Negative 1,082 1,344 Sputum. Tubercle Bacillus - Other Organisms 25 Negative 57 82 Pertussis. Cough Plate — Postnasal Swab — Negative — — 31 Milk. Pasteurised 6 Tuberculin Tested — Sterilised — Ice cream 38 44 Other Foods. Chicken noodle soup 1 Cheese 3 Ham 4 Beef 13 Veal 2 Pork luncheon meat 2 Rice pudding 1 Custard powder 2 Salad 4 Lamb 2 Pilchards 3 Gravy 1 Cooked meat 1 Beef dripping 1 Sausages 1 Tinned sild 7 Butter 1 49 Water. Domestic supplies, etc. 31 Swimming pools, etc. 6 37 Miscellaneous. 396 396 2,244 32 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. 1,141 premises were inspected during the year for rat and mice infestation, and of these 412 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 380. During the year the Public Health Inspectors and Rodent Investigating Staff made 5,844 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 461 manholes were examined and 431 pre-baits and 115 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 17 Number of Council houses disinfested 17 Number of other houses found to be infested 24 Number of other houses disinfested 24 Householders are urged to seek the assistance of the Health Department immediately they suspect the presence of bugs or similar pests. 33 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 1957. The total number of inspections made during the year for all purposes was 24,976. Inspections of Premises:— No. of Inspections Housing Acts, 1936 and 1957 320 Housing Repairs and Rents Act, 1954 and Rent Act, 1957 523 Infectious Disease 455 Tuberculosis 6 Complaint by tenants of insanitary conditions 7,371 Vermin 483 Rag Flock and Other Filling Materials Act, 1951 5 Pet Animals Act, 1951 21 Public Conveniences 43 Schools 104 School Canteens 38 Cinemas, Halls, etc. 29 Fair-grounds 7 Hairdressers 83 Milkshops and Dairies 26 Food Premises 4,037 Food Hawkers' Stands 71 Food Hawkers (Storage) 24 Bakehouses 48 Ice-Cream Shops 107 Public-houses 14 Outworkers' Premises 15 Factories 353 Smoke Observations 450 Visits:— Infectious Diseases 242 Tuberculosis 2 Dysentery 598 Food Poisoning 128 Housing Act, 1936 (Sec. 62)—Permitted Numbers 5 Overcrowding 19 Slaughterhouse 926 Shops Act, 1950 54 Improvement Grants 1,117 Builder's Notices 7 C/fwd 17,731 34 B/fwd 17,731 Food Inspections 200 Moveable Dwellings 281 Rats 555 Piggeries 65 Stables 29 Well and Main Water Supplies 24 Swimming Pools 9 Paddling Pools in Parks 8 Atmospheric Pollution 113 Cesspools 18 Other Visits 589 19,622 Visits by Rodent Dept. Staff:— Rats 5,254 Wasps, Beetles, etc. 100 24,976 Samples taken—Water—Wells 12 Mains 12 Swimming Baths 9 Parks Lakes, etc. 8 Ice-Cream 26 The following list of repairs executed during the course of the year shows that the defects found as a result of the Public Health Inspectors' visits were varied and general in character. Houses or parts of houses cleansed, repaired, etc. 194 Roofs repaired 183 Gutters and downpipes repaired 110 Dampness remedied 112 Floors repaired 38 Yards paved or made good 9 Dustbins provided or renewed 29 Improvements effected in Food premises 297 35 Drains—Examined 247 Tested—Smoke 37 Water 14 Reconstructed 10 Repaired, etc. 216 Vents provided 1 Vents repaired 30 Sink wastes repaired 25 New sinks provided 2 Water-closets—New ones provided 4 New pans provided 35 Apparatus repaired or renewed 49 Water—Water laid on or restored 14 Nuisances—Manure, etc., removed 3 Ditches, etc., cleaned out 3 Other nuisances abated—Stoves, etc., repaired or renewed 25 Windows repaired or renewed 139 Caravans removed 81 Overcrowding abated 1 Miscellaneous 78 Wasps Nests destroyed 95 Houses demolished 3 Houses or parts of houses closed or vacated 34 NOTICES ISSUED Statutory (Insanitary Conditions) 74 Informal (Do.) (P.H. Act) 345 Informal (Insanitary Conditions) (Housing Act) 29 Informal—Food and Drugs Act and Food Hygiene Regulations 158 Other Notices (Infectious Diseases) 3,464 4,070 36 Other Letters sent 2,098 Number of Certificates issued in connection with plans Nil Number of Certificates issued in connection with disinfection 42 Number of Certificates issued in connection with unsound foods 618 Number of Requisitions for Information dealt with 2,363 Number of Certificates of Disrepair issued under Housing Repairs and Rents Act, 1954 and Rent Act, 1957 41 Number of Revocations of Certificates of Disrepair issued under Housing Repairs and Rents Act, 1954 2 Result of Service of Statutory and Informal Notices:— Statutory. Informal. Number complied with 26 404 Number outstanding 48 128 74 532 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. DISINFECTION Number of houses disinfected after infectious disease and verminous cases 262 Number of articles of clothing, bedding, etc., disinfected 2,198 Number of Library books disinfected 288 Number of articles of clothing, bedding, etc., destroyed 86 37 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. There are five registered premises in the District. 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 7 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. FACTORIES ACTS, 1937 AND 1948 A register is kept of all the factories in the Borough, and during the year 353 inspections were carried out. 1.—INSPECTIONS for purposes of provisions as to health (including inspections made by Public Health Inspectors). 38 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 89 - - (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority 358 264 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 18 - - - Total 427 353 — — 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.1) - - - - - 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 4 4 - - - (c) Not separate for sexes - - - - - Other offences (not including offences relating to Outwork) — 1 — 1 — Total 4 5 — 1 — 39 OUTWORKERS Seventy-three lists containing the names and addresses of 471 outworkers were received during the year. 239 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. Umbrellas 1 - - Curtains and Furniture Hangings 1 - - Fancy Goods — - — Wearing Apparel, etc. 100 - — Cardboard Boxes, etc. 32 - — Carding of Buttons, etc. 27 - — Artificial Flowers 6 - — Brush Making and Artist's Materials 97 - - Electrical Cables, etc. 197 - - Christmas Crackers, etc. 4 - — Stuffed Toys, Games and Toys 1 - — Plastic Baby Goods 1 - — Druggist's Sundries 2 - — Furniture and Upholstery 2 - — Total 471 - — 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 36 40 OFFENSIVE TRADES There are now no offensive trade businesses established in the Borough. ATMOSPHERIC POLLUTION CLEAN AIR ACT, 1956 The full provisions of the Act and various Regulations were not in force during 1957, but, certain preliminary action, including a proposal for a Smoke Control Area, was taken. Analyses of deposit gauges and lead peroxide instruments at the four sites in the Borough were continued. 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 Stanley Woodfield, 8/12 Windmill Hill, Enfield, Middx. BOROUGH OF ENFIELD URBAN DISTRICT COUNCIL OF ENFIELD With the Medical Officer of Health's Compliments PUBLIC OFFICES, ENFIELD.