AC 4341 LIBRARY FIN 33 THE Metropolitan Borough of Finsbury ANNUAL REPORT on the Public Health of Finsbury for the Year 1952 By— C. O. S. BLYTH BROOKE, M.B., B.S., D.P.H. Barrister-at-Law. Medical Officer of Health. Finsbury Health Centre, Pine Street, London, E.C.I. Printed by Vail & Co., Ltd. (t.u.), Finsbury, e.c. 1953 THE Metropolitan Borough of Finsbury ANNUAL REPORT on the Public Health of Finsbury for the Year 1952 By— C.O.S. BLYTH BROOKE, M.B., B.S., D.P.H. Barrister-at-Law. Medical Officer of Health. Finsbury Health Centre, Pine Street, London, E.C.i. Printed by Vail & Co., Ltd. (t.u.), Finsbury, e.c. 1953 2 HEALTH COMMITTEE Chairman: Councillor Mrs. M. BENJAFIELD Alderman J. SCOTT (from 15.10.52) Vice-Chairman: Councillor J. CROSSLEY Alderman Mrs. V. M. HEAPS Councillor J. T. BELLAMY „ R. A. J. BENNETT „ Mrs. E. B. BROMFIELD „ C. S. BROWN „ Miss A. T. CALLAGHAN „ W. J. DAVIES „ H. DUNGER „ A. J. HAMMOND „ A. E. HAYNES „ S. G. A. JEFFREYS „ W. O'LEARY „ W. TAYLOR „ J. W. TOZER Medical Officer of Health : C.O.S. Blyth Brooke, M.B., B.S., D.P.H., Barrister-at-Law. Deputy Medical Officer of Health : M. Scott Stevenson, M.B., Ch.B., D.P.H. Public Analyst: C. Harcourt Wordsworth, B.Sc. Sanitary Inspectors : H. J. Newdick, M.S.I.A. (Senior S.I.) R. E. Lay, M.S.I.A. A. J. Truslove, M.S.I.A. J. Lewis, M.R.San.I. E. Ditchburn, C.R.S.I. S. C. Metc.alf, M.S.I.A. (Resigned 9.8.52.) R. F. Griffiths, M.S.I.A. (Student Sanitary Inspector 4.2.52—15.7.52) (Sanitary Inspector from 16.7.52) 3 Senior Meat Inspector: R. S. Barber, M.S.I.A., Barrister-at-Law Administrative and Clerical Staff: A. G. Holmes (Assistant Administrative Officer) J. T. Lindsay (Senior Clerk) Miss J. L. Faulkner (First Assistant Clerk) Mrs. A. H. Bradford R. Robertson F. W. Haynes (from 5.5.52) A. Phillips (with H.M. Forces) L. R. Bugden (from 17.3.52) Cleansing Station Nurse and Visitor to the Aged : Mrs. D. I. M. Lloyd, S.R.N. Infectious Disease Visitor : Mrs. R. Pepper, S.R.N. Resident Engineer and Health Centre Keeper : F. W. Battle 4 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Finsbury. Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report for 1952 on the work of the Public Health Department. This report is prepared in an abbreviated form in accordance with the instructions of the Ministry of Health. I am again able to report that the general health of the community has remained good and that there was no serious outbreak of any infectious disease. There was a slight rise in the Birth Rate from 17.9 in 1951 to 19.1 which is the highest rate since 1947. The crude Death Rate was 13.4. This may be regarded as generally satisfactory, although not as good as the very low rate of 11.7 that prevailed in 1950. It is, however, slightly lower than the rate for 1951 which was 14.3. I am particularly happy to be able to report that the Infant Mortality Rate was 16.2. This is considerably lower than the previous record for this Borough, namely 19.4 in 1950, and compares very satisfactorily with the rate of 27.6 for England and Wales as a whole, and with the rate of 23.8 for the Administrative County of London. It must rank as one of the lowest in the country. It is also very pleasing to call attention to the fact that there were no deaths among illegitimate infants. This is the first occasion on which it has been possible to make such a statement, the mortality rate hitherto having always been slightly higher than that for legitimate infants, and at one time as much as nearly one out of every two illegitimate children born. I am again able to report that there were no maternal deaths. There was no material change in the Death Rate from Tuberculosis or in the Still-birth Rate, 5 The severe fog conditions which prevailed in early December was an event of considerable Public Health importance, and led undoubtedly to a large number of deaths and much illness. There can be no doubt that serious attention ought to be given to the prevention of atmospheric pollution generally. There has been little change in the general environmental conditions prevailing in the Borough during the past few years. Finsbury has remained in the forefront in providing services to preserve the health of the aged, and the Part-time Employment Scheme has attracted nation wide attention. Improvement of the housing conditions has received, both from your Council and from my department, continued attention, and although it is impossible to obtain statistical confirmation, I am of opinion that there has been some improvement. We all look forward confidently to considerable further improvement in the course of the next 2 years when some of the Council's housing schemes should reach fruition. It is with pleasure that I thank the Chairman and Members of the Health Committee as well as the other Committees of the Council for their continued and generous support, and I also thank most warmly my staff for their full co-operation and loyal assistance. I have the honour to be Your obedient Servant, C. O. S. BLYTH BROOKE, Medical Officer of Health. 6 SECTION A. Vital Statistics. Area. The area of the Borough is 587 acres. Population. Census 1951. Preliminary Report 35,347 The Registrar-General's mid-year estimate is : Home Population 35,740 Population Density. Number of Persons per Acre 91 Marriages Registered 325 Rateable Value. £974,182. Product of a Penny Rate £3,925. General Rate for the year 20s. 0d. in the pound. Area Comparability Factor. Births 0.96 Deaths 1.01 Live Births. The total number of live births belonging to the Borough was 681 including 41 illegitimate births and consisting of 348 males and 333 females, giving a rate of 19.1 per 1,000 civilian population. The birth rate for England and Wales was 15.3 per 1,000 home population and 17.6 per 1,000 home population for the Administrative County of London. Stillbirths. The total number of stillbirths allocated to the Borough during the year was 14. This figure represents 2.02 per cent, of the total births. Expressed as a proportion of the population the figures are 0.39 per 1,000 civilian population for Finsbury as against 0.34 for the Administrative County of London and 0.35 for England and Wales (total population). They were distributed by sex and legitimacy as follows :— Legitimate Illegitimate Total Males8 1 9 Females 4 1 5 12 2 14 7 Deaths. The total number of deaths belonging to the Borough registered during 1952 was 478, consisting of 253 males and 225 females, giving a general death rate of 13.4 per thousand of the civilian population. The corresponding rate in the Administrative County of London was 12.6 and of the total population of England and Wales was 11.3. Comparative Statistics, 1946-1952. 1946 1947 1948 1949 1950 1951 1952 Population 33,400 35,120 35,640 36,010 35,810 35,620 35,740 Birthrate (per 1,000 population) 20.6 22.2 18.9 18.6 17.3 17.9 19.1 Death rate (do.) 15.6 14.9 11.9 13.7 11.7 14.3 13.4 Maternal mortality (per 1,000 live births) 1.5 1.3 0.0 3.0 0.0 0.0 0.0 Death rate, infants under 1 (do.) 54.0 32.0 32.6 25.3 19.4 21.9 16.2 Death rate of illegitimate infants under 1 (per 1,000 illegitimate live births) 118.0 47.6 60.0 76.9 27.02 24.4 0.0 Still-births (percentage of total births) 3.6 1.6 2.3 2.3 1.6 1.9 2.0 T.B. death rate per 1,000 inhabitants (all forms) 0.96 1.25 0.72 0.56 0.39 0.59 0.61 Illegitimate births 68 42 50 52 37 41 41 8 Causes of Death — 1952. 0— 1— 5— 15— 25— 45— 65— 75— Total M. F. M. F. Bl. Tuberculosis, respiratory — — — — 4 8 5 — — 2 19 B2. Tuberculosis, other — — 1 1 — — — — — 1 3 B3.a Syphilitic disease — — — — — 1 — 1 — — 2 B8. Diphtheria — — — — — — — — — — — B9. Whooping Cough 1 — — — — — — — — — 1 B10. Meningococcal infections 1 — — — — — — — — — 1 B12. Acute poliomyelitis — — — — — — — — — — — B14. Measles — — — — — — — — — — — B4-7, 11, 13, 15-17. Other infective and parasitic diseases — — — — — 1 — — — — 1 B18. A46 Malignant neoplasm —stomach — — — — 1 4 2 2 2 3 14 A50 Malignant neoplasm —lung, bronchus — — — — — 13 8 1 3 1 26 A51 Malignant neoplasm —breast — — — — — 2 — 1 — 1 4 A52/53 Malignant neoplasm—uterus — — — — 1 2 — 1 — 1 5 A44/57 Other malignant and lymphatic neoplasms — — — — 3 12 4 11 11 6 47 A58 Leukaemia, aleukaemia — — — — — 1 1 — — — 2 B20. Diabetes — — — — — 4 — 4 — — 8 B22. Vascular lesions of nervous system — — — — — 3 5 4 8 9 29 B26pt. Coronary disease, angina — — — — 1 17 12 8 11 9 58 B28. Hypertension with heart disease — — — — — 1 1 — — 4 6 B25, 26pt., 27. Other heart disease — — 1 1 3 5 7 6 13 26 62 B29, 46pt. Other circulatory disease — — — — — 2 2 6 4 9 23 B30. Influenza — — — — — — — — — — — B31. Pneumonia 2 1 — — 1 2 4 5 6 3 24 B32. Bronchitis B46pt. — — — — — 20 13 8 8 9 58 9  0— 1— 5— 15— 25— 45 65— 75— Total M. F. M. F. Other diseases of respiratory system — — 1 — — 4 — — — — 5 B33. Ulcer of Stomach and duodenum — — — — — 5 — 1 — 1 7 B36, 43pt. Gastritis, enteritis and diarrhoea — — — — — — — — — — — B38. Nephritis and nephrosis — — — — — 4 1 — 2 — 7 B39. Hyperplasia of prostate — — — — — — 1 — 5 — 6 B40. Pregnancy, childbirth, abortion — — — — — — — — — — B41. Congenital malformations 2 — — 1 1 — — — — — 4 B19, 21, 23, 24, 34, 35, 37, 42, 43pt, 44, 45, 46pt. Other defined and illdefined diseases 5 — — — 4 13 1 5 3 5 36 BE47. Motor vehicle accidents — — — — 1 1 2 — 1 — 4 BE48. All other accidents — 1 — — — 3 2 1 2 2 11 BE49. Suicide — — — — 1 1 — 2 — 4 BE50. Homicide and operations of war — — — — — — — 1 — — 1 Totals ... 11 2 3 3 20 129 71 66 81 92 478 "B" categories refer to the Abbreviated List of 50 causes for Tabulation of Mortality contained in the Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death, Volume 1. There are no special features revealed by the causes of death statistics to which it is desired to draw attention, apart from the observations which are made on this subject in the introduction. Maternal Mortality. There were no maternal deaths during the year. 10 Inquests. Inquests were held on 21 residents during the year. The causes of death found were:— Natural causes: (Male 46 years and Female 74 years) 2 Road Accidents: (Males 41, 68 and 76 years and Female 61 years) 4 Misadventure: (Males 4, 6 and 62 years and Female 59 years) 4 Accidental Falls : (Males 82, 76, 70 and 69 years and Females 94 and 72 years) 6 Suicide: (Males 77, 75 and 71 years and Female 57 years) 4 Murder: (Female 74 years) 1 21 The number of cases of Suicide is about the same as in previous years. It is satisfactory to note that for the first time for several years none were below 57 years, but on the other hand it is unfortunate to note that there were three cases over 70 years, as there had not been any such cases since 1949. Infant Mortality. There were 11 deaths amongst infants under one year of age and the Infant Mortality rate based on 1,000 live births was 16.2. Of these deaths 6 occurred in the neonatal period. The neonatal mortality rate was 8.81. The comparative infant mortality rates for London and England and Wales were 23.8 and 27.6 respectively. 11 Infant Mortality, 1952—Causes of Death. Cause of Death 0-1 wk. 1-2 wks. 2-3 wks. 3-4 wks. Total under 4wks. 1-3 mths. 3-6 mths. 6-9 mths. 9-12 mths. Total under lyr. Measles - - - - - - - - - - Whooping Cough - - - - - - 1 - - 1 Diphtheria - - - - - - - - - - Pneumonia - - - - - 2 - - - 2 Diarrhoea and Enteritis - - - - - - - - - - Congenital malformation 1 1 - - 2 - - - - 2 Birth Injury and other diseases of early infancy - - - - - - - - - - Immaturity 4 - - - 4 - - - - 4 Meningococcal Infection - - - - - - - - 1 1 Other defined causes - - - - - 1 - - - 1 5 1 - - 6 3 1 - 1 11 The infant mortality rate breaks a new low record for this Borough and represents a reduction of between 16 and 17 per cent, of the previous record in 1950. It is only about one tenth of the rate that prevailed at the beginning of the century, and less than one third of that for 1946. The neonatal mortality rate constituted also a low record and it may be noted that there were no deaths in the first four weeks of life from any causes other than congenital malformations and Immaturity. 12 SECTION B General Provision of Health Services Health Centre. The Council continued to maintain the Health Centre for the administration of the Public Health Services, and arrangements continued in force for the use by the Regional Hospital Board and by the London County Council of those portions of the building which were occupied by services transferred to those bodies under the National Health Service Act, 1946. The Council also continued to act as an agent for the Regional Hospital Board in respect of certain services controlled by them. Laboratory. The Laboratory serves the needs of the Public Health Department in the control of Infectious Disease and the bacterial cleanliness of foodstuffs, and for this purpose was particularly valuable, especially in the diagnosis and control of Whooping Cough. The work was carried out by the laboratory technician who was transferred to the Regional Hospital Board, and has operated in close association with the Central Public Health Laboratory service at Colindale. It has also undertaken work on behalf of the Regional Hospital Board. The arrangements continued to operate whereby in some cases special examination may be carried out by the Archway Group Laboratories, but no use was made of this service in 1952. Work of the Public Health Department Number positive Total Number Examined Total 1951 1952 1951 1952 1952 (1951) Throat and Nose Swabs for Diphtheria — 1 185 199 Sputums for Tubercle Bacilli 85 95 460 428 Post nasal swabs and/or cough Plates for H. Pertussis 68 16 178 114 White Cell counts — — 88 89 Faeces and Rectal Swabs for Salmonella, etc. 270 87 2683 1775 Urine Examination for Typhoid — — — — 2,605 (3594) 13  Number Unsatisfactory Number Poor Total N umber Examined Total 1951 1952 1951 1952 1951 1952 1952 (1951) Milk- Pasteurised 1 — — — 133 138 Jersey — — — — — 11 Tuberculin Tested teurised — — — — 29 20 Sterilised — — — — 51 28 Ice-Cream 6 33 4 3 58 115 Ingredients — — — — — 15 Swabs from churns — — — — — 32 359 (271) Other foods — — — — 26 24 Water— Wells — — — — — 13 Tanks — — — — — 24 Swimming Baths — — — — 15 13 Various — — — — — 5 79 (41) Totals 3,043 (3,906) Work of the Regional Hospital Board For General Practitioners For Various Clinics Totals 1951 1952 1951 1952 1951 1952 Blood Counts ... 114 180 75 66 189 246 Blood Sedimentation Rate estimations 3 1 41 39 44 40 Urine Examinations 21 22 24 30 45 52 Various 9 — — — 9 — Total 287 338 Blood Transfusion. The Council continued to co-operate with the North London Blood Supply Depot of the National Blood Transfusion Service, by arranging Blood Donation Sessions at the Health Centre. Three sessions were held during the year at which 218 donors gave blood. 14 International Certificates of Vaccination and Inoculation. Arrangements continued during the year for the authentication by the Medical Officer of Health of Certificates of Vaccination and Inoculation in the International form. These certificates are required by passengers proceeding abroad from this country and the purpose of the authentication is to provide proof to health authorities abroad that the signature of the person issuing the certificate is that of a registered medical practitioner. 73 certificates were authenticated during the year. Burial or Cremation of the Dead. It is provided under the provisions of Section 50 of the National Assistance Act, 1948, that the Local Authority shall arrange burial or cremation in the case of any person who has died or been found dead in the Borough, in any case where it appears to the authority that no suitable funeral arrangements have been or are being made. During the year six persons were buried or cremated under these provisions. Health Education. Health Education was continued during the year by the exhibition of Public Posters and by the distribution of literature from suitable centres. Mass Radiography posters were exhibited throughout the Borough drawing attention to the facilities available at the NorthEast Metropolitan Regional Hospital Board, Mass Radiography Unit 6D, 20, Golden Lane, E.C.i, and by courtesy of the Borough Treasurer, a circular letter detailing the facilities was enclosed with each rate receipt sent out to the business and industrial firms in the Borough. A series of Health talks, accompanied by the showing of a film, was given by the Medical Officer of Health to groups of "school leavers." These talks were very well received and were considered by all to have been well worth while. 15 The Council continued to co-operate in the health publicity programme organised by the London County Council, Health Division III. It may also be said that the character of the Health Centre building which houses the Public Health Department was designed to inspire the conception of Health among the many members of the public who use it for one purpose or another. Aged Persons. The Council continued to take an active interest in the work of old people during 1952. A full description of the services available to men over 65 and women over 60 have been given in previous reports, but the services continued to expand during the year. The Part-time Employment Scheme developed very considerably during the year, both in the number of people that have been able to serve and in its usefulness in preserving their health. Many firms have continued to co-operate generously by providing work. It became apparent early in the year that the premises leased at 352, St. John Street were not so sufficiently large or suitable and convenient to serve the increasing needs, and towards the end of the year appeals were directed towards securing further funds for the purpose of acquiring larger and more satisfactory premises. The Scheme has attracted nation wide attention and keen interest from overseas, and apart from the value in the Borough, has served to emphasise the value of employment within the reduced capacity of elderly persons in preserving their well being and health. Under the aegis of the Old People's Welfare Committee, a service of domiciliary chiropody was provided and was of very great service. All the other services on behalf of the aged continued to expand, and during the summer months 290 elderly people were able to benefit from a stay of two weeks in the country or at the seaside, in holiday homes at which accommodation was reserved by the Council, 16 The Council made a grant as in previous years, to voluntary organisations providing meals and recreation for the aged. In 1952 the grants amounted to £847 10s. 0d. The Nurse/Visitor was available for consultation by the aged persons about their various problems, and all those known to the department were visited regularly during the year. Every effort was made to give them help and encouragement in looking after themselves. It was necessary to apply to the Magistrate in two cases for Orders for Compulsory Removal under the National Assistance Acts. 17 SECTION C. Sanitary Circumstances. Water. The Borough is freely supplied with water by the Metropolitan Water Board. No samples of drinking water for bacteriological or chemical tests were taken during 1952 by the Sanitary Inspectors. Swimming Baths. There are 4 indoor swimming baths in the Borough, 3 of which belong to the Council all of which maintain regular chlorination of the water. Bacteriological examination has shown an almost complete freedom from contamination. Sanitary Conditions. The Sanitary conditions of the Borough were subject to routine inspection and investigations were made into the circumstances of all complaints made. The work undertaken apart from that detailed elsewhere in this report is summarized in the following table :— Sanitary Conditions. The following is a summary of work undertaken by the Sanitary Inspectors during 1952. Houses, damp, dirty or dilapidated, remedied 806 Doors, windows, floors, walls, ceilings, sashcords repaired 1,096 Water closet defects remedied 195 Water closets erected 281 Urinal defects remedied 22 Urinals erected 26 Soil pipe and ventilating shaft defects remedied 27 Soil pipe and ventilating shafts erected 69 Yard defects remedied 62 Waste pipe defects remedied 73 Waste pipes erected 91 Water cistern defects remedied 85 Accumulations of rubbish or manure removed 65 18 Sanitary Conditions—continued Dung or dust receptacles repaired or renewed 41 Drains relaid, amended or sealed 130 Drains cleared or tested 100 Rain water pipes cleared, repaired or renewed 49 Water supply to houses reinstated 5 Roofs and gutters repaired 478 Area defects remedied 39 Wash-house defects remedied 32 Animal nuisances abated 2 Stables cleansed or repaired 0 Water supply laid on to upper storeys of house 22 Miscellaneous nuisances abated 110 First visits (complaints, casual visits) 5,263 Re-visits 4,952 Intimation Notices served 877 Nuisance Notices served 89 House inspections 1,694 Complaints received 1,667 Nuisance Notices were served in all instances where necessary, but in most cases co-operation with owners by informal approach and the service of Intimation Notices, secured the abatement of nuisances and in addition on many occasions other improvements in living conditions. In a number of cases, time, additional to that provided for in notices, had to be allowed owing to such circumstances as shortage of material and of labour. It was frequently found that landlords were willing to comply with requirements but experienced delay in securing builders to execute the necessary works. Legal proceedings instituted under the Public Health (London) Act, 1936, for non-compliance with Nuisance Notices only occurred in the cases set out in the following table:— Legal proceedings instituted under the Public Health (London) Act, 1936, for non-compliance with Nuisance Notices only occurred in the cases set out in the following table :— 19 Date Premises Offence Result 25.2.52 162, Central Street Failing to comply with an abatement order. Fined £10. Cost £5 5s. 6.8.52 24, Shene Street Failing to abate nuisances (2 summonses) Order to abate nuisances within 14 days. Fined £10. Costs £5 5s. 15.8.52 140, Farringdon Road Failing to abate nuisances (2 summonses). Order to abate nuisances within 28 days. Costs £2 2s. on each summons. 14.10.52 140, Farringdon Road Failing to comply with Court orders (2) Fined £10. Costs £2 2s. on each summons. 3.10.52 24, Shene Street Failing to comply with Court orders (2) Adjourned 14 days. 17.10.52 24, Shene Street Adjourned hearing. Discharged absolutely Costs £3 3s. 31.10.52 23, Shene Street Failing to abate nuisances (2 summonses) Order to abate nuisances within 21 days. Costs 10s. 6d. 12.11.52 18, Calshot Street. Failing to abate a nuisance. Fined £10. Costs £3 3s 24.11.52 162, Central Street ... Failing to abate a nuisance. Order to abate the nuisance within 21 days. Costs £2 2s. 12.12.52 140, Farringdon Road Failing to abate nuisances (2 summonses). Order to abate nuisances within 3 days. Costs £2 2s. Legal proceedings were also instituted under the London County Council Bye-Laws as set out in the following table — Date Premises Offence Result 6.8.52 256/260, Old Street Installing sanitary accommodation and drainage. 1. Without submitting plans. 2. Without giving prior notice Discharged absolutely. Costs £3 3s. 6.8.52 3/9, Memel Street Installing sanitary accommodation and drainage in contravention of the L.C.C. Drainage and Watercloset Bye Laws. Fined 20s. on each of 16 summonses. Costs £3 3s. 20 The presence of harmless rubbish on vacant ground apart from being unsightly leads to the dumping thereon of vegetable and other refuse which may well constitute a danger to health, especially for children who play there. When such deposits were recognised as likely to be injurious to health they were removed by the Council. Common Lodging Houses. The only common Lodging House is that situated at 88, Old Street, which is licensed for 313 beds. Fifteen visits of inspection were made. Canal Boats. Canal boats do not normally halt during their passage along the short stretch of canal in the Borough. No inspections were made. Shops. The number of inspections made under the Shops Act, 1934, during 1952 was 94, and seven Notices were served for contravention. Rag and Bone Dealers. There are 7 premises within the Borough in which this type of business is conducted. Twenty-two visits were made to these premises. Rag Flock. The Rag Flock and Other Filling Materials Act, 1951, came into operation on November 1st, 1951. The purpose of the new Act is to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined. The Act makes it an offence to use the filling materials mentioned in the Act in any specified activity except on premises registered by the local authority. Premises where Rag Flock is manufactured or stored must be licensed by the local authority, and occupier must keep suitable records of his transactions. There is also provision in the Act for the taking of samples of the various materials used and submitting them to a prescribed analyst for examination. Nine samples of various types were taken during the year, all of which proved satisfactory. Regulations have been made by the Minister under the Act relating to the standard of cleanliness for each kind of material to which the Rag Flock and Other Filling Materials Act, 1951, applies, 21 Offensive Trades. The following premises were licensed for the purpose of carrying on offensive trades :— (a) Messrs. J. L. Henson, 137, Whitecross Street, E.C.i. (b) Messrs. F. & W. Warman, Ltd., 5, Eagle Court, E.C.i. (c) Messrs. T. Kendon & Sons, Charterhouse Mews, E.C.i. No offensive trade was carried out by Messrs. J. L. Henson or T. Kendon & Sons, but the premises of Messrs. F. & W. Warman, Ltd., were regularly used as such and were frequently visited. Factories. A register of Factories is maintained which indicates which are designated "Power" and which "Non-Power" Factories. Power: Number added to the Register during 1952 101 Number removed from the Register during 1 952 101 Number on Register at end of 1952 1.372 Number Employed—13,402 men, 14,077 women—27,479 Persons. Non-Power : Number added to the Register during 1952 10 Number removed from the Register during 1952 41 Number on Register at end of 1952 732 Number Employed—971 men, 676 women,—1,647 Persons. Total Number on Register at end of 1952 2,104 Total Number Employed—14,373 men, 14,753 women—29,126 Persons. These factories were visited and inspected when first registered as regards those matters which are the responsibility of the Borough Council. They have been further inspected on receipt of complaints and as far as possible at regular intervals. It has not been possible to visit each factory every year. The general standard of hygiene and compliance with legal requirements was found to be very good; and only occasionally were defects, as set out below, discovered. In such cases notices were served. 22 Number of Inspections—Power Factories 1,614 —Non-Power Factories 350 —Total 1,964 Number of complaints received from H.M. Inspector of Factories 10 Number of complaints received from others 4 Number of Defects discovered:— Want of cleanliness 27 Overcrowding 1 Unreasonable temperature 0 Ineffective drainage of floors 1 In relation to Sanitary Conveniences 78 Various 14 Total 121 Number of Notices served 72 No prosecutions were instituted during the year. Number of notices sent to H.M. Inspector of Factories 87 (The information given here is exclusive of Bakeries and certain other premises which are referred to elsewhere in this report.) Outworkers. Number of firms in the Borough who employ outworkers 211 Number of notifications received of:— 1. Finsbury outworkers employed by Finsbury Firms 281 2. Outworkers in other districts employed by bury Firms 3,383 3. Finsbury outworkers employed by Firms in other districts 99 Total number of notifications received in respect of :— 1. Finsbury outworkers employed by : (a) Finsbury Firms 438 (b) Firms outside Finsbury 165 603 2. Outworkers employed by Finsbury Firms 3,821 23 Outworkers who are sub-contractors are normally occupiers of Premises registered as Factories and inspected as such. Domestic outworkers are visited in their homes to ensure that work is not carried out in unsuitable surroundings. Number of visits to domestic outworkers 81 Number of notices served in respect of unsatisfactory conditions Nil Smoke Abatement. Five complaints were received and 108 observations made during the year in regard to smoke emission. No notices were served. Generally speaking I am of opinion that there has been some diminution of atmospheric pollution in recent years. Verminous Premises and Articles. During the year 454 premises were found to be verminous, and disinfestation measures were carried out. Similar measures have been carried out on certain other occasions on request. In all disinfestation measures were carried out in 483 premises. The measures adopted have been the spraying of the room thoroughly with a D.D.T. Solution on one occasion, and the steam disinfection of the bedding in most cases and whenever considered necessary. As a routine measure for the control of vermin, disinfestation is carried out in the case of tenants moving into the Council's Housing Estates (other than Post-War Estates), or requisitioned property. This was carried out on 164 occasions during the year. The normal routine is for old accommodation of the prospective tenant to be sprayed with a D.D.T. Solution some days before the removal, and at the same time for the proposed new accommodation to be treated in the same way. On the day of removal bedding is collected from the old address, steam disinfected in the Council's ovens, and then removed to the new premises. In the case of Post-War Estates the Council has entered into arrangements for the furniture and effects to be treated with hydrogen cyanide gas before removal to the Estate. 24 Verminous Persons. The Borough Council continued the operation of the Cleansing Station in the Health Centre for the treatment of verminous conditions, including Scabies, and the arrangements whereby school children were treated on behalf of the London County Council under the supervision of a nurse appointed by them. At other times the work was carried out under the supervision of the nurse appointed by the Borough, who also undertook the Home Visiting. Arrangements were also continued during the year by which cases were treated on behalf of the Shoreditch Borough Council. The Service has worked very satisfactorily, but owing to the very small incidence of these conditions, the total numbers have, therefore, been small. Vermin Scabies Total Total number of treatments given to Finsbury cases (other than School children) 105 12 117 Total number of treatments given to Shoreditch cases (other than School children) 13 26 39 Total number of treatments given to School children (all the School children treated were not resident in Finsbury ; a proportion being from adjacent boroughs) 1,184 66 1,250 Total number of Home Visits paid 6 Rodent Control. The Prevention of Damage by Pests Act, 1949, came into operation on March 31st, 1950. The Council employs five rodent operatives under the supervision of the Senior Sanitary Inspector who is designated Rodent Officer. Treatment for the eradication of rats and mice is provided free for private dwelling houses, but otherwise a charge is made to cover the cost. The maintenance treatment of the sewers was carried out during May and December in conjunction with the Borough Engineer's department, and in addition six treatments were given to two specified areas in the Borough. I feel that the rat and mice infestation in the Borough is certainly much less than it was some years ago, but without constant attention it would rapidly grow into a serious problem again. 25 Number of complaints and requests for treatment received 751 Number of additional premises found infested 614 Number of houses treated 2,940 Number of other premises treated 1,026 Number of visits made to houses 16,516 Number of visits made to other premises 5,240 Number of treatments of sewers carried out 8 The Pet Animals Act, 1951. The Pet Animals Act, 1951 came into operation on the 1st April, 1952. The purposes of the Act are — (1) To secure that animals are kept in suitable accommodation adequately supplied with food and drink and are not sold at too early an age : (2) Precautions are taken to prevent the spread of infectious diseases by animals : (3) That steps are taken to guard against fire emergencies. Under the Act, licensing of all shops, including market stalls where pets are sold is necessary. Five licences were issued under the Act in respect of the year. Reception House. The portion of the Health Centre which had in the past been maintained by the Council as a Reception House (for persons who could not remain in their own rooms whilst these were being cleansed after infectious disease, or who had no alternative accommodation in which to reside during housing repairs) continued to be used, by agreement with the North East Metropolitan Regional Hospital Board, for the purpose of accommodating the administrative side of the Mass Radiography Unit. The Islington Borough Council have kindly agreed to provide accommodation for Finsbury residents at their Reception House as and when the occasion should arise. Disinfection. Disinfection is carried out in all cases after infectious disease has occurred when this is considered necessary, and in other cases on request generally after advice has been given that it would be advisable for it to be carried out. 26 During the year it was carried out in the following instances for the reasons set out:— Suspected Diphtheria 6 Suspected Scarlet Fever 87 Suspected Poliomyelitis 2 Suspected Dysentery and Gastro-enteritis 78 Suspected Measles 77 Suspected Whooping Cough 22 Tuberculosis 32 On behalf of St. Marks and other Hospitals 14 Miscellaneous 87 Bedding and clothing were brought to the Disinfecting Station in the Health Centre in these cases, and disinfected with steam. In all, including the cases where this was carried out for the control of vermin, 13,142 articles were treated. Goods, mostly clothing, were also disinfected on behalf of certain export firms as follows:— Number of articles 1,001,713 Number of times disinfecting plant charged 642 Nuisance from Pigeons. Authority was given previously for the catching of pigeons in the streets and open spaces in the Borough. This work has been carried on satisfactorily throughout the year. It must be appreciated that if the number of these birds is not kept under control, they would soon become a public health nuisance. Mortuary. The mortuary attached to the Health Centre remained available for the reception of bodies throughout the year. This mortuary is primarily intended for the isolation of the bodies of those dying from infectious disease and the early removal from overcrowded rooms of bodies of those dying from other conditions when this cannot otherwise be effected. At the present time other facilities are usually made available by undertakers and there have been no deaths from any serious infectious disease. It is, however, of great value to have this provision for use in an emergency. Six bodies were received into the mortuary during the year. 27 SECTION D. Housing. General. It is estimated that there are 9,334 dwellings in the Borough. Unfortunately a very considerable proportion are dilapidated and outworn, and incapable at a reasonable expense of being reconditioned to comply with modern standards. Deterioration is proceeding almost as rapidly as temporary improvements can be effected. Again much of the property was built many years ago and is unsuitable for conversion into the type of accommodation that it is desired to provide at the present time. Until such time as demolition and rebuilding can be carried out on an extensive scale, it is clear that every effort must be exercised to preserve houses wherever possible and prevent the falling off of even those amenities that are available to residents. Most of the work to secure this has been undertaken under the Public Health Act by informal action. Proceedings under the Housing Act. No representations were made and no notices served under Sections 9 and 10 of the Housing Act, 1936 requiring notices to be served. Fifteen House to House inspections were carried out. One representation was made during the year under Section 11 that premises were unfit for habitation and could not at a reasonable expense be made fit. Eight new representations were made in respect of Closing Orders during the year, four being attic rooms and four basement rooms. One Demolition Order was made during the year in respect of one house. Of the representations made under Section 11 in 1949 and mentioned in the last report, one of the houses is still occupied. 28 Tabular Statement prepared in accordance with the Housing Consolidated Regulations, 1932. Number of Houses considered on inspection to be unfit for human habitation 1 Number of Houses wherein defects were remedied by informal action Nil Number of Representations made with a view to : (a) serving notices requiring the execution of works Nil (b) making demolition or closing orders 7 Number of Notices served requiring the execution of repairs Nil Number of Houses rendered fit after service of notices Nil Number of demolition or closing orders made 6 Number of Houses in respect of which undertakings were accepted Nil Number of Houses Demolished Nil Houses let in Lodgings. The register constructed in 1935 was maintained and at the end of the year contained entries in relation to 456 houses. No action was taken during the year under the Byelaws applicable to them. Housing. A list of the new properties which have been completed since the war was given in the 1950 and 1951 reports. During the year the following new flats were completed:— Percival Street 24 flats Slum Clearance. Little progress was made during the year with regard to slum clearance. A number of houses in Bastwick Street remained occupied. The London County Council informed the Council that they did not intend themselves to proceed with the clearance of James' Gardens Area. 29 Delay in dealing with these areas has been due to the difficulty in providing for the rehousing of displaced tenants. It is hoped that as the new building schemes by the Council approach completion, progress will become more rapid. Rehousing. Applications for rehousing by the Borough Council are made to the Housing Department and these are assessed according to their need according to a points scheme. When accompanied by medical certificates to support the application on medical grounds these are referred to the Medical Officer of Health. Enquiries are then made by the Nurse/Visitor into the detailed nature of the family health and the apparent bearing of the accommodation in use on this, and when desirable, an inspection is carried out by the Sanitary Inspector. These reports are then correlated with the medical certificates, and a degree of medical priority is then allotted according to the scheme. A large number of applications were dealt with in this manner. Applications for rehousing by the London County Council are made to that body. Reports are then frequently asked for and supplied in regard to existing overcrowding and sanitary defects. If accompanied by medical certificates, further information is given, on request, to the Divisional Medical Officer of the London County Council, who is responsible for allocating priorities on medical grounds. During the year 286 families comprising 986 persons were rehoused as follows:— Families Persons Rehoused in Council Flats 16 41 Rehoused in requisitioned property 20 55 Rehoused from Busaco No. 5 Clearance Area 61 181 Families transferred in Council property 62 234 Families rehoused by London County Council 88 372 Families rehoused in new Towns 3 10 Families found own accommodation 36 93 Rent and Mortgage Interest Restriction Acts. One certificate of unfitness was issued during the year. One old Certificate was still in operation at the end of the year, 30 SECTION E. Food Food Hygiene. The Food Inspector comments and gives advice to traders and their employees during his visits to the various food premises, as do the Inspectors visiting factories where the canteens are included in their inspections. The local office of the Ministry of Food continues to co-operate by insisting that new retail food premises that require a Food Office Licence are constructed and equipped to the satisfaction of this department before granting a licence. Adulteration of Food. 688 samples were submitted to the Public Analyst during the year, none being found adulterated. Two milk samples were reported as being poor quality, and in 2 instances further samples of Iodine were submitted at the Analyst's request. 103 samples were formal samples, and 585 informal. Summary of samples taken:— Foods No. of Samples Obtained Milk 199 Ice Cream 10 Meat Products 105 Butter 8 Margarine, Cooking fat, etc. 16 Cheese 9 Jams, etc. 22 Flours, etc. 11 Tea, Coffee, Cocoa, Extracts 23 Sauces, Vinegar, etc. 26 Herbs, Spices and Condiments and flavours 28 Powders, (baking, etc.) 11 Canned Vegetables, Fruits, Fish, etc. 24 Non-alcoholic Drinks 9 Table jellies and gelatine 13 Various 76 31 Drugs. No. of Samples Obtained Simple Medicines 31 Powders 8 Tablets 22 Ointments, lotions, etc. 37 Total 688 Milk. Domestic consumers in the borough are now supplied solely with milk bottled by the large combines, no milk now being bottled in Finsbury. The increase in the number of dairies from 12 to 13 is due to the construction in Sebastian Street of a distributing depot by a subsidiary of one of the large wholesale concerns. Here some 2,500 gallons of milk per day are handled, 700 gallons being bulk milk in 12 gallon churns which is split up into smaller cans for delivery to restaurants and canteens. In common with the other large depot in Goswell Road, and the ten small dairies, this milk has been regularly sampled in the early morning, for both chemical and bacteriological examination. It may be remembered that in 1951, all the unsatisfactory milk samples were from this bulk milk, and were considered to be due to carelessness. There were no unsatisfactory reports during 1952, and it might reasonably be claimed to be due to the fact that knowledge that the milk might be sampled at any time, led to greater care on the part of persons handling this milk. 1. Dairies : No. on register at end of 1952 13 2. Distributors: No. on register on 1st January, 1952 121 No. of Transfers approved during 1952 7 No. of new applications received and approved 2 3. Designated Milk: No. of licences issued:— Dealers in T.T. Milk S3 supplementary 21 Dealers in Pasteurised Milk 76 supplementary 21 Dealers in Sterilised Milk 84 supplementary 24 32 4. Quality of Milk: No. of samples submitted to Public Analyst 199 No. of samples reported as adulterated Nil The average fat content of the milk samples was 3.5 per cent. The average non-fatty solids content was 8.74 per cent. 5. No. of visits paid to milk premises was 321 Ice-Cream. No. of premises registered for manufacture 24 No. of premises registered for storage and sale 99 No. of premises registered for storage only 1 Although 24 premises are registered for the manufacture of ice cream, only 4 premises were so used during 1952. Six additional premises were registered for the storage and sale of ice cream during the year, and one was registered for storage only. Standard for Ice Cream. The standard of composition which was laid down for the first time by the Food Standards (Ice Cream) Order, 1951 was varied by an Amendment Order, 1952, that came into operation on 7th July, 1952. This order lowered the standard by reducing the minimum fat content required in ice cream to 4 per cent. and the milk solids other than fat to 5 per cent. from the original 5 per cent. and 7½ per cent. respectively. This variation was the natural outcome of the reduction in the amounts of fat and milk powder allowed to manufacturers of ice cream by the Ministry of Food. Ten samples of ice cream were submitted to the Public Analyst and all complied with the prescribed standard. Details of routine samples submitted for bacteriological examination are as follows:— No. of samples submitted 63 No. of samples satisfactory 52 No. of samples poor 3 No. of samples unsatisfactory 8 33 Vendors or manufacturers of all samples where " Poor " and " Unsatisfactory " results were recorded, were visited, and methods of handling or manufacture closely examined to locate possible reasons for those results. In addition to these routine samples, a special series of samples were taken in July and August from one manufacturer who supplied a partly finished product to a firm in an adjoining borough, from where complaints had been received. Over a period of about 10 days, every churn of " mix " made was sampled, with the following results:— No. satisfactory 27 No. unsatisfactory 25 The contents of all churns from which the unsatisfactory samples were taken was re-processed in accordance with the Ice Cream (Heat Treatment) Regulations before being released. The outcome of the investigations into this factory resulted in the voluntary closing down of the plant until alterations had been made in certain equipment, and then the manufacturer concerned arranged for " batch control " by an independent laboratory until the end of the season. Satisfactory results were then consistently obtained. The total number of visits to ice cream premises was 140. Meat Inspection. In the neighbourhood of the Smithfield Meat Market, London, E.C.I, there are a considerable number of wholesale butchers and offal shops, bacon factories, wholesale bacon and provision warehouses, poultry, game and rabbit shops and Public Cold Air Stores, all of which are regularly inspected by the Meat Inspector. A systematic examination for Caseous Lymphadenitis of imported frozen carcases of mutton and lamb was carried out in the Public Cold Air Stores : this often involved an examination of every carcase in a consignment. During the year 127,615 carcases were examined by the Meat Inspector, and of these 6,055 were found to be diseased to such an extent that either the whole or part of the carcases was condemned. 34 500 bags of boneless sides of mutton were also examined, and 337 of these sides were condemned for disease. The number of affected carcases does not take into account those carcases where the lesion was very small or calcified when only the gland and surrounding tissue was removed. A considerable tonnage of Continental and Scandinavian offals was imported into the Borough under Ministry of Food licence, and in many instances condemnation of these offals took place due to improper freezing or salting. Large consignments of Continental tinned ham continued to arrive in the Borough and constant supervision was maintained over these tins, thousands of which had to be condemned due to faulty sterilization in the canning process. On July 1st, the Letchworth Bacon Co., Letchworth, Herts, took over the collection of condemned meat and other foods from Mr. W. Tuvey, Romford, Essex. A total of 2,472 visits were made to the retail butchers shops and stalls during the year. Twenty-four certificates for the export, mostly to U.S.A. and Canada, of sausage casings, tinned hams, meat essence, etc., were issued, and two certificates regarding the hygienic conditions of manufacture of large quantities of sausage casings and tinned ham were given. Bakehouses. The number remained the same as at the end of 1951; 15 basement bakehouses, and 4 above ground. All were visited during the year. Registered Food Premises (other than ice cream). There was one addition to the register during the year, the applicant being engaged in cooking shellfish. Other Food Premises. 1,837 visits were made to food premises during the year. All proposed new restaurants and cafes were visited and reported on to the Ministry of Food, Food Executive Officer. These premises 35 have to be to the satisfaction of this Health department before the Food Office grant permission for the premises to open. Food premises other than caterers are not so rigidly controlled, and prospective occupiers are not bound to consult this department before commencing business. Many of course, do so, and all others are visited as soon as their existence becomes known. Street Markets. Much food is handled in the Street Markets and the appropriate Department issued licences for 229 stalls during the year. In each case any storage accommodation used for foodstuffs was inspected throughout the year. Licensed Premises and Public Houses. There were 133 licensed premises in the Borough, 123 of which were Public Houses. 114 inspections were carried out. Pharmacy and Poisons Act. Forty-six applications for names to be placed or retained in the Council's list of sellers of part II poisons were approved by the Council. Each of the premises concerned were visited during the year. Unsound Food. Considerable quantities of unsound foodstuffs were confiscated or surrendered during the year as the following summary shows:— Meat—diseased 61,656 lbs. Meat—unsound 21,318 „ Meat—products 569 ,, Bacon 18,600 „ Offals—diseased and unsound 30,212 „ Poultry 7,701 „ Game 465 .. Rabbits 4,18I „ Cereals 1,947 ,, Tinned foodstuffs 65,995 ,, Fish 594 ,, Cheese 1,144 ,, Dried Fruit.. 3,245 ,, Other foodstuffs 6,263 ,, Total 223,890 lbs. 99.95 Tons, 36 Food Poisoning. Twenty-five cases of Food Poisoning were notified during the year. There were no deaths. There were no outbreaks of Food Poisoning due to identified causes during the year. One outbreak due to an unidentified cause occurred as under:— Domestic 2 cases Notified .. Suspected cause: (September) Sausages eaten at home. Apart from the outbreak detailed above, the following individual cases were investigated : Agent identified. 1 (October) Salmonella Kentucky Agent not identified. 2 in March 1 in June 3 in September 1 in December Agent not identified but possible cause. Tinned Salmon (Grade 3) January Eggs March (2 cases) Pigs' Tails March Chicken March Eels May Boiled Bacon Sandwich May Fish September Boiled Bacon September Dinner eaten at School September Sausages October Pork December (2 cases) Chicken Sandwiches December Tinned Luncheon Meat December 37 SECTION F. Infectious Diseases. General. There has been no major epidemic of infectious disease during the year. The incidence of acute primary pneumonia, however, was almost double that of the preceding year. All cases notified were visited by the Infectious Diseases Nurse/Visitor and energetic measures taken wherever indicated to ensure adequate minimization of danger of infection to others. Number of visits by Infectious Disease Visitor 2,441 The following table shows the cases of notifiable diseases of which information by notification or otherwise was received in the several age periods set out:— All Ages Under 1 year 1-4 yrs. 5-14 yrs. 15-24 yrs. 25-44 yrs. 45-64 yrs. 65 + Cases treated in Hosp. Acute Influenzal Pneumonia 1 1 1 Acute Primary Pneumonia 43 — 16 4 4 5 6 8 36 Diphtheria 1 — — 1 — — — — 1 Dysentery 74 11 38 14 4 6 1 — 47 Erysipelas 8 — 1 — 1 — 5 1 4 Food Poisoning 25 — 8 1 2 7 6 1 — Gastro enteritis (under 2 years) 25 17 8 — — — — — 22 Measles 488 25 254 198 7 4 — — 65 Meningococcal Infection 1 1 — — — — — — 1 Ophthalmia Neonatorum 9 9 — — — — — — 3 Puerperal Pyrexia 5 — — — 1 4 — — 2 Poliomyelitis (Paralytic) 1 — 1 — — — — — 1 Scabies 11 — 1 7 3 — — — Scarlet Fever 81 — 33 46 2 — — 67 Tuberculosis (Pulmonary) 91 2 8 5 17 31 20 8 — Tuberculosis (Non-Pulmonary) 9 — — 2 2 3 — 2 — Whooping Cough 82 16 47 19 — — — — 29 955 81 415 297 43 60 39 20 279 Incidence Rates. The rates per thousand of the population are set out below, together with the corresponding rates for England and Wales, the larger towns, the smaller towns, and London as a whole for comparison:— 38 (Notification Rates (Comparative Table) per 1,000 population.) Finsbury England and Wales 160 C.B's. and great towns including London 160 smaller towns, Res. population 25,000 to 50,000 at 1951 census London Adm. County Typhoid Fever 0.00 0.00 0.00 0.00 0.00 Paratyphoid Fever 0.00 0.02 0.02 0.03 0.01 Meningococcal infection 0.03 0.03 0.03 0.03 0.02 Scarlet Fever 2.27 1.53 1.75 1.58 1.56 Whooping Cough 2.29 2.61 2.74 2.57 1.66 Diphtheria 0.03 0.01 0.01 0.03 0.01 Erysipelas 0.22 0.14 0.15 0.12 0.14 Smallpox 0.00 0.00 0.00 0.00 — Measles 13.65 8.86 10.11 8.49 9.23 Pneumonia 1.23 0.72 0.80 0.62 0.57 Acute poliomyelitis (including polioencephalitis)— Paralytic 0.03 0.06 0.06 0.06 0.06 Non-paralytic 0.00 0.03 0.03 0.02 0.03 Food Poisoning 0.70 0.13 0.16 0.11 0.18 Diphtheria. There was one case of nasal diphtheria in a child of five, who was admitted to hospital for seven weeks with a sore nose but who, otherwise, was not ill. The child had not been immunised. The rest of the family had swabs taken, but there were no other cases. Meningococcal Infection. There was one unnotified case in a baby of 9 months. No information about the case was received until after the infant had died in hospital. Typhoid and Paratyphoid. There were no cases of typhoid notified in the borough. A boy attending a school in the borough, but living outside it, developed typhoid and recovered. The school was kept under supervision, but no further cases developed. There were no cases or contacts of paratyphoid. 39 Poliomyelitis. One case of acute poliomyelitis in a child of four was notified. It was thought at first to be non-paralytic but later developed paralysis of the back and right leg. She is making a good but slow recovery. Two other people who had been in contact with poliomyelitis while on holiday were supervised, but remained well. Smallpox. There were no cases or contacts. Psittacosis There was one case in a man of 48. He was notified while in hospital. Enquiries were made, but no recent contact with a source of the disease could be proved. The man had been a regular soldier and spent some time abroad. His present job as a porter involved the handling of goods from abroad. Rubella. There were 276 cases, mostly children, and none were seriously ill. There was one case in an expectant mother working in a Nursery and, in view of the risks involved, she was excluded from work. Dysentery. Of the 77 notified cases of dysentery, three were subsequently withdrawn. 47 cases were removed to hospital, and eleven of these were of moderate severity. Of the 10 adults affected, two were probably infected by their children. 33 cases occurred in the day nurseries and in the case of the two members of the nursery staff living outside the borough, precautions were taken by their own local authorities. All the cases made an uneventful recovery. Whooping Cough. There were 82 (two of which were un-notified) cases in the year, including one death in an infant of 2 months who unfortunately also developed gastro-enteritis. 5 cases were severe, 32 moderately severe, and the remainder were mild. With the exception of the baby, the rest made a good recovery and there were no complications. 40 Measles. There were 483 notified cases and 5 unnotified, making a total for the year of 488. Ten of these were adults, 14 severe, 156 moderately severe, and 318 mild cases. 65 cases were removed to hospital mostly on account of unsuitable home conditions. The following complications were reported:— 7 developed broncho-pneumonia, 24 bronchitis, 4 conjunctivitis, and 2 adenitis. There was a general increase in the number of cases from the beginning of April. The June to September quarter included the greatest number of cases, the most severely ill and the greatest number developing complications. There were no deaths. Food Poisoning. 25 sporadic cases were reported in the whole year. None of these was serious, and in no case was the origin of the infection known for certain. One child of 2 years was removed to hospital and was there found to be infected by Salmonella Kentucky. All made an uneventful recovery. Gastro-enteritis—under 2 years. There were 25 cases and 22 of these were removed to hospital chiefly on account of the home conditions. There were no deaths. Gastro-enteritis—over 2 years. 8 cases were notified. They were treated in hospital and made a good recovery. Scabies. Eleven cases were notified. Pneumonia. 45 cases were notified and one subsequently withdrawn. Of these 37 were removed to hospital and there were 4 deaths in elderly people. Two deaths occurred in the first quarter of the year, one in the second, and one in the fourth. One child of a year old was subsequently notified as suffering from pulmonary tuberculosis. 41 Infective Hepatitis. Two families in the borough developed infective hepatitis. The first outbreak occurred in October and 3 children were involved. The second occurred in December when one child developed the disease, but there was a history of two other cases in the same school, although the children concerned lived outside the borough. No other incidents occurred of moving any of the cases, and the families were kept under close supervision. Ophthalmia Neonatorum. Nine cases were notified and all responded well to treatment. Puerperal Pyrexia. Five cases were notified. They all did well and there were no deaths. Erysipelas. Eight cases were notified. They were all mild and all recovered. Scarlet Fever. There were 80 notified and one unnotified case. 67 were removed to hospital because of home conditions. One developed the complication of adenitis and all made a good recovery. Tuberculosis. The total number of new cases entered in the register during the year was 100. The distribution by sex and age, and according as to whether the case was of Pulmonary or Non-Pulmonary Tuberculosis, was :— 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65 + Total Pulmonary M 1 2 0 1 3 4 13 4 7 7 5 47 F 1 6 1 3 3 7 9 5 3 3 3 44 Non-Pulmonary M 0 0 1 0 0 1 1 0 0 0 0 3 F 0 0 0 1 0 1 2 0 0 0 2 6 Total 2 8 2 5 6 13 25 9 10 10 10 100 42 The Non-Pulmonary cases include :— 3, Renal; 1, Spine ; 1, Left Knee ; 1, Peritoneum ; 1, Right Shoulder ; 1, Left Hip Joint; 1, Right Preauricular Gland. The numbers and distribution as shown by the Table are very similar to those for 1951. The notification rate for all forms of Tuberculosis was 27.98 per 10,000. The total number of cases remaining on the register after adjustments for deaths and transfers was on the 31st December, 1952, as follows:— Males Females Total Pulmonary 150 120 270 Non-Pulmonary 11 17 28 161 137 298 The full details of each case obtained by the Tuberculosis Visitor were, by kind co-operation of the London County Council, made available to and any preventive measures possible co-ordinated with those of the Borough Council. Each case was visited with a view to tracing the source of infection, the conditions which may have influenced its development, the actual spread which may already have taken place, and the means that could be adopted or advised to prevent further danger of spread as well as to give help and advice. Disinfection was carried out whenever thought advisable and on request. There were eighteen deaths from Pulmonary Tuberculosis as set out:— 0- 15- 45- 65+ All ages Male 0 1 6 5 12 Female 0 3 1 2 6 Total 0 4 7 7 18 There were three deaths from Non-Pulmonary Tuberculosis as follows:— Male aged 24—Kidney Female aged 5—Meningitis Female aged 89—Spine. 43 The Tuberculosis Death Rate from all forms was 0.6 per thousand, the rate remaining about the same as in recent years. The trend for deaths to occur at a later age than before has continued. In five cases the cases had not previously been notified : none of them as far as is known had been under the care of a doctor and the diagnosis was only made on postmortem examination and four of them were over the age of 65, two of them being cases of renal and spinal Tuberculosis respectively. I should like to acknowledge the willing co-operation and facilities for the inter-change of information which have been provided by the Chest Physician, Dr. W. D. R. Thompson, and his staff. Finsbury Chest Clinic. (Information kindly providedby Dr. W.D.R. Thompson, Chest Physician). In the year 1952 a total of 2,624 persons attended the Chest Clinic. Of this total 151 were seen as Contacts of notified cases. The number of new cases of tuberculosis taken on the register amounted to 66. This figure comprised 61 respiratory and 5 nonrespiratory. Of the 61 respiratory, 42 cases were infectious. The number of notified cases shown on the register at 31st December, 1952, are as follows:— Respiratory Non-respiratory Totals Grand Total M. W. Ch. M. W. Ch. M. W. Ch. 130 96 27 6 14 6 136 110 33 279 In the year 1951—the grand total was 281. During 1952, 22 deaths were recorded, and 4 of these were the direct result of the fog which descended on London before Christmas. In addition, 6 un-notified took place—2 of these being non-respiratory. 28 cases were removed from the register as recovered, and a further 36 were transferred to other clinics out of the area. Comment must be made here—with regard to these transfers—in that the 44 London County Council are re-housing the tuberculosis patients as quickly as possible. Most of those transferred were re-housed by the L.C.C. in many of the new estates outside the Metropolitan area. The total number of cases x-rayed in the clinic during 1952 was 1,385. The L.C.C. Tuberculosis Health Visitor—seconded to the Chest Clinic—made 1,053 visits to homes in the Borough during the year. Each case was visited with a view to tracing the source of infection, and advising on the prevention of the disease spreading, and on giving any other assistance where necessary. Disinfection was carried out—by the Finsbury Borough Council —in a large number of cases. Mass Radiography Unit 6D. (Information kindly provided by Dr. W. D. R. Thompson, Medical Director.) The Mass Radiography Unit 6D has maintained its usual services throughout the year under review, during which it examined 29,786 males, and 21,122 females, totalling 50,908. This represented an aggregate of over seventeen hundred firms. For the major part of the year, the Unit operated at the Mass Radiography Centre, 20, Golden Lane, E.C.1, where it examined workers and residents in the City of London and the Metropolitan Boroughs of Finsbury, Shoreditch and Stepney. At a meeting held on the 10th September, 1952, of the Health Committee of the Metropolitan Borough of Finsbury it was resolved that the circulation of firms in Finsbury should be extended to smaller firms. In the past the circulation has been limited to large firms. It was also agreed that posters drawing attention to the Mass Radiography Service should be displayed throughout the Borough. These posters were provided by the Unit, while a copy of the circular letter was enclosed with each rate receipt sent out by the Borough Treasurer. The helpful co-operation by the Borough of Finsbury is highly appreciated. 45 As a result of this circulation, by the end of the year nearly one hundred and fifty firms (over 3,000 examinees) had been X-rayed, besides a large number of individuals. During the relatively brief period during which the Unit was mobile, it carried out Surveys of firms within its zone, and included the undermentioned Finsbury firms:— British Drug Houses, Ltd., Graham Street, City Road, N.1. Messrs. Blades, East & Blades, Ltd., Leonard Street, E.C.1. The Mass Radiography Service is free, speedy, reliable and confidential. It enables groups of people to have a chest X-ray with a minimum amount of inconvenience. Its aim is to discover tuberculosis and other chest ailments in the early stages, when a cure can more easily be secured. All examinees are notified the result of their examination. Firms and individuals who wish to avail themselves of this Service, or to obtain further information, should communicate with the Organising Secretary, Mass Radiography Unit 6D, Finsbury Health Centre, Pine Street, London, E.C.i. (Telephone Numbers : TERminus 2121, Ext. 92, or TERminus 6184.)