2 Library FIN 3 THE Metropolitan Borough of Finsbury ANNUAL REPORT on the Public Health of Finsbury for the Year 1953 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, b.c. THE Metropolitan Borough of Finsbury ANNUAL REPORT on the Public Health of Finsbury for the Year 1953 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, n.c. 1954 2 HEALTH COMMITTEE Chairman: Councillor J. TROTTER Vice-Chairman: Alderman Mrs. C. P. FENN Alderman J. T. BELLAMY (21st May—2nd July, 1953) Councillor C. A. ALLEN, J.P. (21st May—2nd July, 1953) „ A. ASHTON „ Miss A. T. CALLAGHAN „ Mrs. S. CLIFFE „ A. J. COMAN (21st May—2nd July, 1953) „ J. CROSSLEY „ W. J. DAVIES „ E. I. JONES „ J. SCOTT „ O. THOMPSON 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. (Deputy Chief San.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. R. F. Griffiths, M.S.I.A. R. E. Richards, M.S.I.A. (Student Sanitary Inspector 2.2.53—17.12.53) (Sanitary Inspector from 18.12.53) 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 (resigned 12.9.53) F. W. Haynes A. Phillips (returned from National Service 23.11.53) L. R. Bugden (resigned 20.6.53) J. R. Dalton (from 1.7.53) 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 1953 on the work of the Public Health Department. 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 fall in the Birth Rate from 19.1 in 1952 to 18.9 which is, however, still above the rate of 15.5 for England and Wales and 17.5 for London. The Borough was fortunate to have during 1953 a crude Death Rate of only 9.9. This is the lowest Death Rate ever recorded here and well below the previous record of 11.7 in 1950. It is also well below the rate of 11.4 for the whole country and 12.5 for London. The pleasing record of 16.2 in 1952 in regard to Infant Mortality was not maintained though the rate remained at 22.2. I regret also to state that there were 3 deaths among illegitimate infants. I have analysed the deaths in greater detail on this occasion and have shewn that deaths from fascular lesions of the central nervous system (i.e., the various forms of apoplexy) and from diseases of the heart (other than coronary) were much fewer than might be expected from the national rates, but that those from cancer of the lung and coronary disease, two diseases which have increased in frequency during the past few years, have been a somewhat more frequent cause of death in Finsbury than elsewhere. But in particular, I feel I ought to draw attention to the high death rate from Bronchitis especially in women aged 65-74. As in addition the notification rate for Pneumonia was 1.7 per 1,000 as against the national rate of 0.8, it may well be that there are environmental factors which encourage the development of respiratory diseases. 5 Although there were no serious outbreaks of infectious disease, 1 feel that I ought to refer to the large number of cases of Measles and Whooping Cough that occurred. The cases of measles were probably rather more seriously ill than in recent epidemics, but recovery was mostly full and rapid and the disease more an inconvenience than a threat to health. On the other hand Whooping Cough is always liable to affect adversely the sufferers, and is now the most serious infectious disease in its effects on communal health. The very high relative notification rate 10.2 per 1,000 as against 3.6 for the country is, I am convinced, due in considerable part at least to the ready diagnostic facilities available. The publication by the Registrar General of the 1951 Census returns during the year has provided detailed information regarding the Borough which is invaluable for purposes of comparison with other districts and for measuring the progress in Health and improvement in the environment. The department had been hampered by not having had such data available for many years. Some of the more important information is reproduced in this report. It is seen that there are 1,544 or 9 per cent. of men over 65 and 3,293 or 18 per cent. of women over 60—altogether 4,837 persons or 14 per cent. of the population of the pensionable ages. The relief of overcrowding has been more dramatic than many persons have realised. The number of persons living at a density of more than 2 per room which is an accepted index was 29.4 in 1931 and is now only 3.4 although it is still above the average for London which is 2.5. Once again it is with pleasure that I acknowledge the continued and generous support of the Chairman and Members of the Health and other Committees of the Council and the loyal help and co-operation of my staff. To all I am greatly indebted and offer my sincere thanks. 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 35, 37° The Registrar-General's mid-year estimate is: Home Population 35,640 Population Density. Number of Persons per Acre 61 Marriages Registered 324 Rateable Value. £1,009,831. Product of a Penny Rate £4,015. General Rate for the year 21s. 2d. in the pound. Area Comparability Factor. Births 0.86 Deaths 1.02 Live Births. The total number of live births belonging to the Borough was 675 including 46 illegitimate births and consisting of 325 males and 350 females, giving a rate of 18.9 per 1,000 civilian population. The birth rate for England and Wales was 15.5 per 1,000 home population and 17.5 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 15. This figure represents 2.17 per cent. of the total births. Expressed as a proportion of the population the figures are 0.42 per 1,000 civilian population for Finsbury as against 0.38 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 Males 8 1 9 Females 6 — 6 14 1 15 7 Deaths. The total number of deaths belonging to the Borough registered during 1953 was 352, consisting of 184 males and 168 females, giving a general death rate of 9.88 per thousand of the civilian population. The corresponding rate in the Administrative County of London was 12.5 and of the total population of England and Wales was 11.4. Comparative Statistics, 1947-1953. 1947 1948 1949 1950 1951 1952 1953 Population 36,120 35,640 36,010 35,810 35,620 35,740 35,640 Birth rate (per 1,000 population) 22.2 18.9 18.6 17.3 17.9 19.1 18.9 Death rate (do.) 14.9 11.9 13.7 11.7 14.3 13.4 9.9 Maternal mortality (per 1,000 live births) 1.3 0.0 3.0 0.0 0.0 0.0 0.0 Death rate, infants under 1 (do.) 32.0 32.6 25.3 19.4 21.9 16.2 22.2 Death rate of illegitimate infants under 1 (per 1,000 illegitimate live births) 47.6 60.0 76.9 27.02 24.4 0.0 65.2 Still-births (percentage of total births) 1.6 2.3 2.3 1.6 1.9 2.0 2.2 T.B. death rate per 1,000 inhabitants (all forms) 1.25 0.72 0.56 0.39 0.59 0.61 0.31 Illegitimate births 42 50 52 37 41 41 46 Deaths in Age Groups. It is possible this year owing to the publication of the Census report to calculate the death rates in the several age groups. It is seen from the table below that the death rates between the ages of 15 and 25, 45 and 65, and for females between 65 and 75 were higher in Finsbury than those in England and Wales, whereas the opposite relationship has held in all other age groups. It may also be observed that the female rate for ages 65-74 is above the male rate in Finsbury which is contrary to the recognized feature of a higher male mortality at all ages. The death rate, therefore, in this group should be watched carefully especially as 10 out of the 36 deaths were due to Bronchitis, to which cause attention will be called in a later paragraph. 8 Death rates per 1,000 living in each age group. Ages 0-4 5-14 15-24 25-44 45-64 Males Females 65-74 75+ 65-74 75 + Finsbury 6.16 0.25 1.40 1.37 12.8 32.8 106 36.6 81.4 England and Wales 6.25 0.46 0.87 1.71 10.5 53.3 137 32.4 109.1 (The figures for Finsbury relate to 1953, those for England and Wales to 1952 the latest year for which they are available; the national figures, however, show little yearly change apart from a slight downward trend.) Causes of Death— 1953. 0— 1— 5— 15— 25— 45— 65— 75— Total M. F. M. F. 1. Tuberculosis, respiratory — - — — 3 6 — — 2 — 11 2. Tuberculosis, other - - - - - - - - - - - 3. Syphilitic disease — — — — — 3 — 1 — 1 5 4. Diphtheria — — — — — — — — — — — 5. Whooping Cough - - - - - - - - - - - 6. Meningococcal infections - - - - - - - - - - - 7. Acute poliomyelitis — — — — — — — — — — — 8. Measles — — — — — — — — — — — 9. Other infective and parasitic diseases — — — — — — — — — — — 10. Malignant neoplasm stomach — — — 1 1 2 1 4 — 1 10 11. Malignant neoplasm lung, bronchus — — — — 2 15 2 — — — 19 12. Malignant neoplasm breast - - - - - 2 - - - - 2 13. Malignant neoplasm uterus - - - - - 2 - - - — 2 14. Other malignant and lymphatic neoplasms — — 1 2 1 7 5 7 2 1 26 9  0— 1— 5— 15— 25— 45— 65— 75— Total M. F. M. F. 15. Leukaemia, aleukaemia — — — 1 — — — — — — 1 16. Diabetes — — — — — 1 — 1 — 1 3 17. Vascular lesions of nervous system — — — — — 11 1 6 4 11 33 18. Coronary disease, angina — — — — — 18 7 7 12 8 52 19. Hypertension with heart disease — — — — — 1 2 3 — 3 9 50, Other heart disease — — — — 2 8 1 6 7 9 33 21. Other circulatory disease — — — — 1 — 1 5 2 2 11 22. Influenza 1 — — — — 4 1 1 1 — 8 23. Pneumonia 2 1 — — — 2 4 3 1 7 20 24. Bronchitis — 1 — — 1 13 10 1 7 13 46 25. Other diseases of respiratory system — — — — — 1 — 1 — — 2 26. Ulcer of stomach and duodenum — — — — 1 1 — 1 — 1 4 27. Gastritis, enteritis and diarrhoea 1 — — — — — — — — — 1 28. Nephritis and nephrosis — — — — — — — — — — — 29. Hyperplasia of prostate — — — — — 1 — — 1 — 2 30. Pregnancy, childbirth, abortion — — — — — — — — — — — 31. Congenital malformations 3 — — — — — — — — — 3 32. Other defined and illdefined diseases 8 1 — 1 2 5 — 6 4 3 30 33. Motor vehicle accidents — — — — — — — 1 — 1 2 34. All other accidents — 1 — 1 — 4 — 2 2 1 11 35. Suicide — — — 1 1 1 1 — 2 — 6 36. Homicide and operations of war — — — — — — — — — — — Totals 15 4 1 7 15 108 36 56 47 63 352 10 Death Rates per 10,000 Population from some Principal Causes. Tuberculosis 3.1 (2.1); Cancer of lung 5.3 (3.4), Cancer of breast 0.3 (1.9); All other Cancers 10.1 (13.6); Vascular lesions of central nervous system 9.3 (15.8); Coronary Disease 14.6 (13.9); Other heart diseases 11.8 (22.5); Bronchitis 12.9 (6.2); Accidents 3.1 (2.0); Suicide 1.7 (1.0). The figures in brackets refer to England and Wales for 1952. The rates from Tuberculosis, Cancer of the lung and particularly Bronchitis, were considerably higher than the average for the country, and those from Coronary Disease, Accidents and Suicide were slightly higher. On the other hand the rates from other Cancers and particularly Cancer of the breast, vascular lesions of the central nervous system and other heart diseases were considerably lower. Years of Life Lost. A suggestion has been made that a better mental picture can be obtained of the effect of the several causes of death by a consideration of the years of life lost than of the deaths in age groups. The Registrar General has prepared a table on this basis for 1952 of which the following is an abstract:— Abridged List No. Cause of Death Death Kate per 10,000 population Years of life lost per 10,000 population Ages 15-64 Total to age 85 All causes M. 150 (122) 815 (834) 2,888 (2,526) F. 122 (105) 612 (549) 1,998 (1,730) 1 Tuberculosis of respiratory system. M. 8 (3) 50 (37) 173 (91) F. 3 (1) 53 (26) 106 (49) 10-15 Cancer (all sites) M. 30 (22) 118 (113) 526 (414) F. 25 (18) 117 (98) 431 (335) 17 Vascular lesions of C.N.S. M. 9 (14) 9 (30) 103 (186) F. 8 (18) 4 (32) 62 (197) 18 Coronary disease M. 23 (18) 87 (66) 401 (307) F. 10 (10) 8 (16) 92 (109) 19, 20 All other cardio-vascular disease. M. 17 (20) 97 (40) 306 (257) F. 21 (25) 30 (40) 195 (253) 23, 24 Bronchitis and pneumonia. M. 27 (13) 77 (93) 411 (280) F. 20 (8) 123 (53) 373 (147) 26 Ulcer of stomach and duodenum M. 2 (2) 15 (11) 52 (38) F. 2 (1) 8 (2) 36 (8) 33, 34 Accidents M. 5 (4) 49 (97) 127 (177) F. 3 (2) 14 (27) 59 (58) Figures in brackets are those for England and Wales. 11 The table shows the high relative loss of working years by cancer, coronary disease, other heart diseases, and bronchitis and pneumonia especially among females. The figures have been adjusted for the age and sex difference between Finsbury and the country as a whole. The table brings out the following points:— (1) The working years lost by men in Finsbury has been less than the average, but the reverse held for women, and for both sexes the total years of life lost, supposing 85 to be the normal age of death, were greater in Finsbury. (2) The years of life lost through deaths from bronchitis and pneumonia were strikingly greater than for the country (except that the working years lost by men were fewer) and the same relation applied also to Tuberculosis, and all cancers in both sexes and coronary and other heart diseases in men though not to the same extent. (3) The years of life lost through deaths from vascular lesions of the central nervous system and from accidents in both sexes, and from coronary and other heart diseases in women, have been considerably fewer in Finsbury. Maternal Mortality. There were no maternal deaths during the year. 12 Inquests. Inquests were held on 22 residents during the year. The causes of death found were:— Natural causes: (Male 69 years) 1 Road Accidents: (Females 77 and 72 years) 2 Rail Accident: (Male 50 years) 1 Misadventure: (Males 79, 76, 53, 52 and 23 years) 5 Accidental Falls: (Male 82 years and Females 80, 74 and 72 years) 4 Home Accident other than Falls: (Male 20 months) 1 Open Verdict: (Male 52 years) 1 Asphyxia (during Epileptic Fit): (Male 51 years) 1 Suicide: (Males 77, 76, 74, 53 and 24 years and Female 40 years) 6 22 Infant Mortality. There were 15 deaths amongst infants under one year of age and the Infant Mortality rate based on 1,000 live births was 22.2. Of these deaths 8 occurred in the neonatal period. The neonatal mortality rate was 11.7. The comparative infant mortality rates for London and England and Wales were 24.8 and 26.8 respectively. 13 Infant Mortality, 1953—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 l yr. Influenza — — — — — — 1 — — 1 Meningitis 1 — — — 1 — — — — 1 Diphtheria — — — — — — — — — — Pneumonia — — — — — — 1 — 1 2 Diarrhoea and Enteritis — — — — — 1 — — — 1 Congenital malformation — — — 1 1 1 1 — — 3 Birth Injury and other diseases of early infancy 2 — — — 2 — — — — 2 Immaturity 3 1 — — 4 — — — — 4 Other defined causes — — — — — — 1 — — 1 6 1 — 1 8 2 4 — 1 15 Census, 1951. During the year the Registrar General's Report on the County of London, based on the 1951 Census, was published. Certain information relating to Finsbury has been abstracted and is reproduced as an Appendix to this Report together with other data for comparison. 14 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. Numerous individual visitors and organised parties both from this Country and Overseas visited the Health Centre during 1953. All reasonable requests to visit the Health Centre were granted as the exchange of views and information thus afforded is of mutual benefit. 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. Work of the Public Health Department N umber positive Total Number Examined Total 1952 1953 1952 1953 1953 (1952) Throat and Nose Swabs for Diphtheria 1 — 199 167 Sputums for Tubercle Bacilli 95 96 428 450 Post nasal swabs and/or cough Plates for H. Pertussis 16 125 114 352 White Cell counts — — 89 125 Faeces and Rectal Swabs for Salmonella, etc. 87 96 1775 2275 Urine Examination for Typhoid — — — — 3,369 (2605) 15  Number Unsatisfactory Number Poor Total Number Examined Total 1952 1953 1952 1953 1952 1953 1953 (1952) Milk— Homogenised — — — — — 1 Churn Pasteurised — — — — 108 51 Bottle Pasteurised — — — — 30 23 Sterilised — — — — 28 8 Tuberculin Tested Pasteurised — — — — 20 10 Jersey — — — — 11 5 South Devon — — — — — 1 Ice-Cream 33 — 3 2 115 18 Ingredients — — — — 15 — Swabs from churns — — — — 32 — 117 (359) Other foods — 11 — — 24 42 Water— Taps — — — — — 7 Tanks — — — — 24 3 Swimming Baths — — — — 13 5 Wells — — — — 13 — Various — — — — 5 — 57 (79) Totals 3,543 (3,043) Work of the Regional Hospital Board For General Practitioners For Various Clinics Totals 1952 1953 1952 1953 1952 1953 Blood Counts 180 179 66 107 246 286 Blood Sedimentation Rate estimations 1 3 39 87 40 90 Urine Examinations 22 18 30 18 52 36 Total 338 412 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 191 donors gave blood. 16 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. 118 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 five 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. The former Empire Marketing Boards were kept posted during the year with special poster sets. An Exhibition Stand situated in the entrance hall of the Health Centre was used to display amongst other publicity matter the display sets issued by the Ministry of Health. A series of talks, on various aspects of Food Hygiene, was given by the Food Inspector to groups of local school children. Enamelled panels, showing details of hospitals with times for attendance where advice or treatment on Venereal Diseases can be obtained, were renewed as necessary in the Council's Public Conveniences. 17 A brochure detailing the various services available to men over 65 years and women over 60 years resident in the Borough, was issued during the year and was much appreciated both by the elderly themselves and by the various statutory and voluntary organisations in the Borough. The Council also 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 deisgned 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 as in past years to take a very active interest in work on behalf of old people during 1953. The services available to men over 65 and women over 60 years included: (1) A Laundry Service for the Chronic Sick who were unable, by reason of ill health, senility, etc., to keep their personal and domestic laundry in a state of cleanliness required to ensure a healthy environment. (2) The Council continued and extended the service designed to preserve the health of the elderly by allowing those sufficiently strong to benefit from a stay of two weeks in the country or at the seaside. Applications were invited by public announcement and through variously interested clubs and societies and these were made to this department. Each applicant was required to contribute a small sum towards the cost, normally ten shillings per week but varied slightly in some cases. Arrangements were then made for the holiday at one or other of the holiday homes run by voluntary organisations. A grant was made to each of the homes to cover the cost including the railway or coach fare and their necessary travelling expenses, less that amount which the individual was required to contribute. 18 Arrangements were made with the co-operation of the Red Cross Society and Women's Voluntary Service for those aged persons who so desired, to save, through the medium of Savings Stamps, the amount or part of the amount they would be required to contribute towards the cost of the holiday. Stamps were on sale at the Health Centre, Red Cross and W.V.S. Centres, and in all a considerable sum was saved by aged persons. In this way a holiday was provided for 300 persons comprising 29 married couples, 59 men and 183 women, at a total cost to the Council of £1,891. The Scheme proved an unqualified success as was evidenced by the large number of appreciative letters received, and in other ways. I repeat once again and emphasise the observations which I made in a previous report on the operation of the scheme. "That a holiday at the seaside or country benefits considerably the permanent health of the individual, builds up the body for the winter months and is of considerable value sociologically. All this apart from the pleasure and enjoyment given to the aged persons at the time." (3) The Council continued to encourage all Voluntary Organisations in the Borough to extend the services available to the aged for meals and recreation. Grants which were made on the basis of reports made to the Council on the work of each organisation amounted in all to £1,165 between sixteen organisations. (4) The Finsbury Employment Scheme for the Elderly continued to develop and to expand during the year. Many firms have continued to co-operate generously by providing work. It became apparent early last 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 appeals were directed towards securing further funds for the purpose of acquiring larger and more satisfactory premises. The necessary funds have now been obtained from voluntary sources, and it is hoped that occupation of the new Work Centre will be possible before the end of next year. The Scheme has attracted nation-wide attention and keen interest from overseas, and 19 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. 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. There were no cases for Compulsory Removal under the National Assistance Acts. Finsbury Old People's Welfare Committee This Committee brings together in deliberation representatives of the various Statutory Bodies and Voluntary Organisations providing facilities for the elderly in Finsbury, and provides under its auspices services as under: Domiciliary Chiropody Service. This service is provided for those aged persons who are unable by reason of senility, chronic sickness, etc., to attend personally the Foot Clinic at the Health Centre, and has proved of great benefit to the elderly. 201 visits were paid during 1953. There is no charge to the aged. The ages of the persons visited ranged from 63 to 94 years. There is no doubt that the Committee is to be congratulated on providing this service which meets a long felt need and helps the aged and infirm to get about and do things for themselves. It is interesting to record that during the year numerous voluntary donations of small amounts were received by the Committee from aged persons receiving domiciliary chiropody service, as an expression of their appreciation of the service provided and the benefits secured. Mending Scheme for the Aged. This Scheme provides in association with the Finsbury Employment Scheme for the Elderly a Mending Service for the aged. There is a definite need for this srevice which effects repairs to such 20 items of clothing as socks, underclothes, etc., and is particularly useful in respect of the Male aged living alone. Substantial use was made of the Scheme during the year. There is no charge to the aged. Provision of Wireless Facilities. The Committee continued to finance the provision of a Wireless Relay Service for the use of the sixty aged persons participating in the Finsbury Employment Scheme for the Elderly at 352, St. John Street, E.C.i. The " Wireless for the Bedridden Society." The Committee continued to act as Sponsor in respect of applications received from bedridden or housebound Finsbury aged persons desiring wireless facilities provided by the above Society. S.O.S. Card Scheme. The S.O.S. Card Scheme operated by the Committee in the Borough has functioned very successfully on several occasions. The purpose of the scheme is to enable old people living alone to contact someone outside their home in an emergency. Visiting of the Aged in Hospital. Arrangements have been made for members of the voluntary organisations represented on the Committee to visit Finsbury aged persons accommodated in hospital, who are not receiving regular visits from friends and relations. Meal Services. Mid-day dinner facilities continued to be provided by various voluntary organisations for aged persons resident in Finsbury and a total of 25,416 meals were served during 1953. In addition to the above services the Committee provided in association with the various Voluntary Organisations numerous social and recreational facilities for the aged during the year. 21 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 1953 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. Investigations into various methods for the bacteriological examinations of swimming baths waters and the effects of chlorination were undertaken by Dr. E. Windle Taylor on behalf of the Public Health Laboratory Service Water Sub-Committee in co-operation with the department, and by courtesy of the Principal of the Northampton Polytechnic Institute in the baths attached to it. Some valuable findings were recorded and these were published by the Ministry of Health in their monthly bulletin for December. 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 1953. Houses, damp, dirty or dilapidated, remedied 760 Doors, windows, floors, walls, ceilings, sashcords repaired 1,075 Water closet defects remedied 173 Water closets erected 420 Urinal defects remedied 14 Urinals erected 21 Soil pipe and ventilating shaft defects remedied 16 Soil pipe and ventilating shafts erected 84 Yard defects remedied 39 22 Sanitary Conditions—continued. Waste pipe defects remedied 95 Waste pipes erected 70 Water cistern defects remedied 50 Accumulations of rubbish or manure removed 62 Dung or dust receptacles repaired or renewed 29 Drains relaid, amended or sealed 177 Drains cleared or tested 75 Rain water pipes cleared, repaired or renewed 76 Water supply to houses reinstated 2 Roofs and gutters repaired 486 Area defects remedied 26 Wash-house defects remedied 42 Animal nuisances abated 0 Stables cleansed or repaired 0 Water supply laid on to upper storeys of house 6 Miscellaneous nuisances abated 105 First visits (complaints, casual visits) 4,602 Re-visits 5,279 Intimation Notices served 802 Nuisance Notices served 82 House inspections 2,024 Complaints received 1,777 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: — 23 Date Premises Offence Result 25.2.53 18, Cynthia Street Failing to abate nuisance. £1 1s. costs. Order to abate nuisance within 14 days. 11.3.53 2, Culpeper Street Failing to abate nuisances. 14 days' adjournment. 25.3.53 2, Culpeper Street Failing to abate nuisances. Order to abate nuisances within 14 days. £3 3s. costs. 22.7.53 19, Cynthia Street Failing to abate nuisances. Order to abate nuisances within 21 days. £2 2s. costs. 20.11.53 17, Baron Street Failing to abate nuisance. Order to abate nuisance within 14 days. £2 2s. costs. 23.11.53 22, Penton Street Failing to abate nuisances. Order to abate nuisances within 14 days. £1 1s. costs. 23.11.53 16, Cynthia Street Failing to abate nuisance. Order to abate nuisance within 14 days. £1 1s. costs. 23.11.53 22, Cynthia Street Failing to abate nuisance. Order to abate nuisance within 14 days. £1 1s. costs. 23.11.53 138, Farringdon Road Failing to abate nuisance. Order to abate nuisance within 14 days. £1 1s. costs. Legal proceedings were instituted under the Food and Drugs Act as set out in the following table:— Date Premises Offence Result 13.4.53 1, Sebastian Street Fat abstracted to the extent of at least 11.6 per cent. Fined £2, with £3 3s. costs. 9.11.53 33, Baron Street Tea—unfit for human consumption. 3 Summonses. 2 dismissed. On third summons, fined £5 and £5 5s. costs. 17.7.53 124, Central Street Contraventions of Section 13, Food and Drugs Act, 1938. Each defendant fined £3 for each offence (£12) and £3 3s. costs. Legal proceedings were also instituted under the London County Council Bye-Laws as set out in the following table— 24 Date Premises Offence Result 29.5.53 7, Crawford Passage Contraventions of L.C.C. Drainage and W.C. ByeLaws. Absolute discharge. £3 3s. costs. 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. Eighteen 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 1953 was 98, and one Notice was served for contravention. Rag and Bone Dealers. There are 7 premises within the Borough in which this type of business is conducted. Twenty-four 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. 25 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. 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. No offensive trade was carried out by Messrs. J. L. Henson, 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 1953 135 Number removed from the Register during 1953 154 Number on Register at end of 1953 1,353 Number Employed—13,97 5men, 13,825 women—27,800 Persons. Non-Power : Number added to the Register during 1953 9 Number removed from the Register during 1953 82 Number on Register at end of 1953 659 Number Employed—762 men, 589 women,— 1,351 Persons. Total Number on Register at end of 1953 2,012 Total Number Employed—14,737 men, 14,414 women-—29,151 Persons. 26 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. Number of Inspections—Power Factories 1,418 —Non-Power Factories 402 —Total 1,820 Number of complaints received from H.M. Inspector of Factories 20 Number of complaints received from others 2 Number of Defects discovered:— Want of cleanliness 45 Overcrowding 3 Unreasonable temperature 1 Inadequate ventilation 4 Ineffective drainage of floors 4 In relation to Sanitary Conveniences 62 Various 18 Total 137 Number of Notices served 87 No prosecutions were instituted during the year. Number of notices sent to H.M. Inspector of Factories 90 (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 27 Number of notifications received of:— 1. Finsbury outworkers employed by Finsbury Firms 342 2. Outworkers in other districts employed by Finsbury Firms 4,091 3. Finsbury outworkers employed by Firms in other districts 122 Total number of notifications received in respect of:— 1. Finsbury outworkers employed by : (a) Finsbury Firms 552 (b) Firms outside Finsbury 216 - 768 2. Outworkers employed by Finsbury Firms 4,643 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 279 Number of notices served in respect of unsatisfactory conditions Nil Smoke Abatement. Much attention was directed to this subject during the year and a comprehensive report was made to the Health Committee on many aspects. Plans were made for lectures to be given to stokers and boiler men in the Northampton Polytechnic in 1954, and tentative arrangements for research into certain problems were made. The Council is represented on both the National Smoke Abatement Society and the London and Home Counties Smoke Abatement Advisory Council. On the latter body I have the honour to serve as a member of the executive committee. In July a station was erected on the roof of the Health Centre to measure monthly deposits and sulphur dioxide pollution. It will be some considerable time before such recordings can yield significant information owing to the wide variations which occur in meteorological conditions. Twenty-four complaints were received and 145 observations made during the year in regard to smoke emission. 28 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 368 premises were found or suspected 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 478 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 208 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. 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. 29 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) 100 20 120 Total number of treatments given to Shoreditch cases (other than School children) 5 8 13 Total number of treatments given to School children (all the School children treated were not resident in Finsbury; a proportion being from adjacent boroughs) 1,029 70 1,099 Total number of Home Visits paid 2 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 Deputy 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 two treatments were given to one specified area 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. Number of complaints and requests for treatment received 706 Number of additional premises found infested 776 Number of houses treated 4,097 Number of other premises treated 943 Number of visits made to houses 24,030 Number of visits made to other premises 5,016 Number of treatments of sewers carried out 4 The Pet Animals Act, 1951. The purposes of this Act which came into operation on the 1st April, 1952, are:— 30 (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. Four licences were issued under the Act in respect of the year, and supervision maintained at each of the premises concerned. Heating Appliances (Fireguards) Act, 1952. This Act received the Royal Assent on 1st August, 1952, and came into force on 1st October, 1953. The Act prohibits the sale or letting of unguarded domestic electric fires, gas fires or oil heaters, empowers authorised officers of local authorities to inspect and test appliances kept on any premises for sale or letting and imposes penalties for contraventions. This new legislation has been delegated to the Public Health Department for enforcement. 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. 31 During the year it was carried out in the following instances for the reasons set out:— Suspected Diphtheria 3 Suspected Scarlet Fever 78 Suspected Poliomyelitis 6 Suspected Dysentery and Gastro-enteritis 54 Suspected Measles S3 Suspected Whooping Cough 103 Tuberculosis 30 On behalf of St. Marks and other Hospitals 17 Miscellaneous 34 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, 13,840 articles were treated. Goods, mostly clothing, were also disinfected on behalf of certain export firms as follows :— Number of articles 1,146,863 Number of times disinfecting plant charged 686 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. No bodies were received into the mortuary during the year. 32 SECTION D. Housing. General. It is estimated that there are 9,405 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. Twelve House to House inspections were carried out. Two representations were made during he year under Section 11 that premises were unfit for habitation and could not at a reasonable expense be made fit. Sixty-seven new representations were made in respect of Closing Orders during the year, four being attic rooms, fifty-seven basement rooms, and six dwelling houses. Three Demolition Orders were made during the year in respect of three houses. Of the representations made under Section 11 in 1949 and mentioned in the last report, one of the houses is still occupied. 33 Tabular Statement prepared in accordance with the Housing Consolidated Regulations, 1932. Number of Houses considered on inspection to be unfit for human habitation 6 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 6 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 2 Houses let in Lodgings. The register compiled in 1935 was maintained and at the end of the year contained entries in relation to 427 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:— Old Street 169 flats Slum Clearance. Representations were made during 1953 in respect of four areas and Clearance Orders subsequently made during the year. 34 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 frequendy 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 families were rehoused as follows:— Families Rehoused in Council Flats 86 Rehoused in requisitioned property 22 Rehoused from Clearance Areas 46 Families transferred in Council property .. 121 Families rehoused by London County Council 74 Families rehoused in new Towns — Families found own accommodation 170 Rent and Mortgage Interest Restriction Acts. No certificate of unfitness was issued during the year. One old certificate was still in operation at the end of the year. 35 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. The number of food premises in the Borough, by type of business is as under:— Restaurants and Cafes 289 Grocers and Provision Merchants 182 Fish Shops 31 Bakers and Confectioners 36 Sweets, etc. 71 Factory Canteens 175 784 Adulteration of Food. 449 samples were submitted to the Public Analyst during the year. One milk sample was reported as fat abstracted, and in 8 samples of buttered rolls, margarine was found to be used. Warning letters were sent. 37 samples were formal samples, and 412 informal. Summary of samples taken:— Foods No. of Samples Obtained Milk 84 Ice Cream 12 Meat Products 63 Butter 4 Margarine, Cooking fat, etc. 12 36 Foods (contd.) No. of Samples Obtained Cheese 2 Jams, etc. 13 Flours, etc. 5 Tea, Coffee, Cocoa, Extracts 6 Sauces, Vinegar, etc. 14 Herbs, Spices and Condiments and flavours 29 Powders, (baking, etc.) 13 Canned Vegetables, Fruits, Fish, etc. 11 Non-alcoholic Drinks 24 Table jellies and gelatine 18 Various 67 Drugs. Simple Medicines 24 Powders 12 Tablets 20 Ointments, lotions, etc. 16 Total 449 Milk. Domestic consumers in the borough are now supplied solely with milk bottled by the large combines, no milk now being bottled in Finsbury. There was one unsatisfactory report during 1953. 1. Dairies: No. on register at end of 1953 10 2. Distributors : No. on register on 1st January, 1953 123 No. of Transfers approved during 1953 6 No. of new applications received and approved 5 During 1953, 4 Distributors were removed from the register. Of these 3 premises were demolished and 1 where the premises were converted to other uses. 3. Designated Milk : No. of licences issued:— Dealers in T.T. Milk 51 supplementary 22 Dealers in Pasteurised Milk 69 supplementary 24 Dealers in Sterilised Milk 79 supplementary 26 37 4. Quality of Milk : No. of samples submitted to Public Analyst 80 No. of samples reported as adulterated 2 The average fat content of the milk samples was 3.57 per cent. The average non-fatty solids content was 8.71 per cent. 5. No. of visits paid to milk premises was 196 Ice-Cream. No. of premises registered for manufacture 24 No. of premises registered for storage and sale 106 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 1953. Nine additional premises were registered for the storage and sale of ice cream during the year, and none registered for storage only. Standard for Ice Cream. Seven 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 16 No. of samples satisfactory 14 No. of samples poor Nil No. of samples unsatisfactory 2 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. The total number of visits to ice-cream premises was 60. Legal proceedings instituted under the Food and Drugs Act, 1938, are enumerated in detail in Section " C" Sanitary Circumstances. Meat Inspection. There is in the neighbourhood of the Smithfield Meat Market a considerable number of wholesale butchers and offal shops, bacon 38 factories, wholesale bacon and provision warehouses, game and rabbit shops and Public Cold Air Stores, all of which were regularly inspected by the Meat Inspector. A systematic examination of Caseous Lymphadenitis of imported frozen carcases of mutton and lamb was carried out at the Cold Air Stores : this often involved a 100 per cent. examination of the entire consignment. During the year the Meat Inspector examined 113,196 carcases for this disease and of this number he condemned 86 whole carcases and 4,277 parts of carcases. Another consignment of 192 sides of mutton were examined and 5 sides were found to be diseased. Sixty-seven bags of boneless Australian forequarters of beef were examined for Onchocerciasis Gibsoni, and in about 80 per cent, of the quarters the presence of the " worm nodule " was encountered. Where the nodule was found, the affected area was removed. The disposal and collection of unsound meat and food condemned in the Borough continues to be collected by The Letchworth Bacon Co., Letchworth, Herts., who render down the foodstuffs for technical purposes. Consignments of Continental and Scandinavian offals and tinned hams were imported into the Borough, and in many instances condemnation of the offals and tinned hams took place. A total of 2,616 visits were made to the retail butchers' shops and stalls during the year. Forty-nine certificates for the export of sausage casings, meat essence, etc., were issued, mostly to U.S.A. and the Continent. Bakehouses. The number remained the same as at the end of 1952; 15 basement bakehouses, and 4 above ground. All were visited during the year. Registered Food Premises (other than ice cream). Seventy food premises were registered at the end of 1953. There was one addition during the year. All were registered for the preparation or manufacture of sausages, or potted, proved, pickled or preserved meat, fish or other preserved food. 39 Other Food Premises. 1,348 visits were made to food premises during the year, including 72 inspections of registered food premises. All proposed new restaurants and cafes were visited and reported on to the Ministry of Food, Food Executive Officer. These premises 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. 104 inspections were carried out. Pharmacy and Poisons Act. 45 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 44,782 lbs. Meat—unsound 20,210 „ Meat—products 144 ,, Bacon 24,658 „ Offals—diseased and unsound 17,275 ,, Poultry 10,383 „ Game 504 ,, Rabbits 4,096 „ 40 inned foodstuffs 67,730 lbs. Fish 126 „ Cheese 135 ,, Dried Fruit 89 ,, Other foodstuffs 8,312 „ Total 198,444 lbs. 88.59 Tons. Food Poisoning. Twenty-eight 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 (September). 4 cases notified. Suspected cause: Pork/Pork Dripping. Apart from the outbreak detailed above, the following individual cases were investigated: Agent identified: 1 (November). Salmonella Enteritidis (Variety Jena). Agent not identified: 1 in January. 1 in February. 1 in March. 3 in April. 2 in July. 2 in August. 1 in November. 1 in December. Agent not identified but possible cause: Pork and Turkey eaten cold January Oxtail January Dinner eaten at school February Patient asthmatical and allergic to certain food February Sausages February Stuffed Heart May Fish or Egg June Salad June Boiled Bacon August Patient asthmatical and allergic to certain food September Sausages October 41 SECTION F. Infectious Diseases. General. There was a big increase in the number of cases of whooping cough during the year, and the incidence of measles also remained high. 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 2,761 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 Un1 yr. 1-4 yrs. 5-14 yrs. 15-24 yrs. 25-44 yrs. 45-64 yrs. 65 + Cases treated in Hos. Acute Pneumonia 61 7 15 6 2 7 16 8 50 Dysentery 51 3 17 13 4 7 4 3 32 Erysipelas 7 — — — — 2 5 — 5 Food Poisoning 28 — 5 4 2 13 2 2 4 Gastro enteritis (under 2 yrs.) 24 19 5 — — — — — 21 Measles 461 35 301 116 6 2 1 — 63 Whooping Cough 364 56 197 107 3 1 — — 117 Ophthalmia Neonatorum 6 6 — — — — — — 6 Puerperal Pyrexia 5 — — — 2 3 — — 5 Scabies 10 — 3 3 2 2 — — — Scarlet Fever 67 — 33 31 3 — — — 61 Tuberculosis (Pulmonary) 80 — 4 6 11 30 21 8 — Tuberculosis (Non-Pulmonary) 10 — 1 3 3 2 1 — — Poliomyelitis (Non-Paralytic) 1 — — — 1 — — — 1 Malaria 1 — — — 1 — — — 1 1,176 126 581 289 40 69 50 21 366 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:- 42 (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 0.01 Paratyphoid Fever 0.00 0.01 0.01 0.01 0.01 Meningococcal infection 0.00 0.03 0.04 0.03 0.03 Scarlet Fever 1.88 1.39 1.50 1.44 1.02 Whooping Cough 10.21 3.58 3.72 3.38 3.30 Diphtheria 0.00 0.01 0.01 0.01 0.00 Erysipelas 0.20 0.14 0.14 0.13 0.12 Smallpox 0.00 0.00 0.00 0.00 — Measles 12.93 12.36 11.27 12.32 8.09 Pneumonia 1.71 0.84 0.92 0.76 0.73 Acute poliomyelitis (including polioencephalitis)— Paralytic 0.00 0.07 0.06 0.06 0.07 Non-paralytic 0.03 0.04 0.03 0.04 0.03 Food Poisoning 0.79 0.24 0.25 0.24 0.38 The Public Health (Infectious Disease) Regulations, 1953. These Regulations, which supersede the Public Health (Infectious Disease) Regulations, 1927, and the Infectious Diseases (London) Regulations, 1927, came into operation on 1st April, 1953. The new Regulations are similar to the old, but amplify the precautionary measures provided for in the revoked Regulations against Food Poisoning:— (1) by relating these to typhoid fever, paratyphoid fever or other salmonella infections, dysentery and staphylococcal infection likely to cause food poisoning; (2) by applying these measures in general to persons shown to be carriers of these diseases as well as to persons suffering from them; (3) by preventing such persons not only from continuing employment involving the handling of food or drink, but also from entering such employment; and (4) by enabling a local authority to authorise the Medical Officer of Health to issue notices in emergency, in order to check the spread of these diseases. 43 The Health Committee resolved that the Medical Officer of Health (and in his absence the Deputy Medical Officer of Health) be generally authorised to issue notices in emergency, in order to check the spread of the diseases specified. Diphtheria. There were no cases of diphtheria during 1953. Meningococcal Infection. There were no cases notified and no contacts. Typhoid and Paratyphoid Fevers. There were no cases of contacts of these diseases. Poliomyelitis. One case of non-paralytic poliomyelitis in a boy aged 15 years was notified; he made a good recovery. A child, who was a contact from a hospital outbreak, was kept under supervision and remained well. In two other cases the diagnosis of poliomyelitis was subsequently withdrawn. Smallpox. There were no cases or contacts. Psittacosis There were no cases or contacts. Rubella. Ten cases of Rubella, or "German Measles," were notified. There was no notification of a case occurring in an expectant mother. Dysentery. There were 51 notified cases of Sonne dysentery during the year. Nineteen of these occurred in an outbreak in a hospital, and twelve in an outbreak in a day nursery. 32 of the patients were admitted to hospital but none of them were very ill. There was one unnotified case in a residential nursery. All the cases made an uneventful recovery. 44 Whooping Cough. There were 356 notified cases and 8 unnotified cases of pertussis during the year. Of these, 17 were severe, 207 moderately severe and 140 were mild cases. Only 3 of the cases were adults and there were no deaths. The following complications were reported: 7 developed bronchitis, 3 partial collapse of a lung, and 3 developed gastro-enteritis. Measles. There were 460 notified cases and 1 unnotified case. Sixty-three were admitted to hospital. Of all these cases, 6 were severely ill, 152 were of moderate severity and 303 were mild cases. The following complications were reported:— 10 developed bronchitis, 2 broncho pneumonia, and 1 bronchitis and emphysema. There were no deaths. Food Poisoning. Twenty-eight sporadic cases were reported in the whole year. None of these was serious and all made an uneventful recovery. In one case the agent was identified as Salmonella Enteritidis (Variety Jena). In no other case was the origin of the infection known for certain. Gastro-enteritis—under 2 years. Twenty-four cases were notified and 21 of these were admitted to hospital and made a good recovery. Three of the cases had very severe symptoms, 14 moderately severe, and 7 only mild symptoms. There were, unfortunately, two deaths of infants in a residential nursery who, although their home addresses were in the borough, had not lived here for some time. These two cases were unnotified. Gastro-enteritis—over 2 years. Ten cases were brought to the notice of the department. One of these was severely ill but all made an uneventful recovery. Scabies. Ten cases were notified. 45 Pneumonia. Sixty-one cases were notified and there were 3 deaths in the first quarter of the year in elderly males. One notified case was subsequently found to be suffering from pulmonary tuberculosis. Infective Hepatitis. There were 9 cases brought to the notice of the department in the year, 4 in the first quarter, 1 in the second, and 4 in the last quarter of the year. Three cases in this last group were in the same school. Ophthalmia Neonatorum. Six cases were notified and all responded well to treatment. Puerperal Pyrexia. Five cases were notified. None of these were of any significance. Erysipelas. Seven cases were notified. They were all mild and all recovered. Scarlet Fever. There were 66 notified cases, and 1 unnotified case. 61 of these were admitted to hospital. One developed the complication of adenitis and another otitis media, but all made a good recovery. Malaria. One case was notified in a resident of Finsbury receiving treatment for the disease in the Hospital for Tropical Diseases. He was a soldier recently returned from Korea. Tuberculosis. The total number of new cases entered in the register during the year was 90. 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 0 2 4 0 1 5 11 7 9 9 7 55 F 0 2 2 0 0 5 9 3 1 2 1 25 Non-Pulmonary M 0 0 2 0 1 0 1 0 0 0 0 4 F 0 1 1 0 0 2 1 0 1 0 0 6 Total 0 5 9 0 2 12 22 10 11 11 8 90 46 The Non-Pulmonary cases include:— 3, Neck Glands; 2, Meningitis; 1, Rib; 1, Peritonitis; 1, Abdomen ; 1, Left Knee ; 1, Right Kidney. The notification rate for all forms of Tuberculosis was 25.25 per 10,000. There has been little change in this rate or the distribution of the cases as recorded above since 1946. The total number of cases remaining on the register after adjustments for deaths and transfers was on the 31st December, 1953, as follows:— Males Females Total Pulmonary 159 113 272 Non-Pulmonary 9 14 23 168 127 295 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 eleven deaths from Pulmonary Tuberculosis as set out:— Males: 81, 79, 64, 62, 60, 56 (2), 44 and 38. Females: 58 and 42. There were no deaths from Non-Pulmonary Tuberculosis. The Tuberculosis death rate from all forms was just over 0.3 per 1,000, that is only about half the same rate in the preceding year, but owing to the small numbers involved, wide fluctuations are liable to occur. Although this fall in the rate is satisfactory, the rate still remains well above the corresponding rates for England and Wales and for London. 47 In four cases there had been no previous notification; none of them as far as is known had been under the care of a doctor, and in one case diagnosis was made only on postmortem examination. All were cases of pulmonary tuberculosis as follows:— Males: 79, 56 and 38. Female: 68 years. 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 provided by Dr. W. D.R. Thompson, Chest Physician). During the year 1953 a total of 2,501 patients attended the Chest Clinic. Of this total 128 were seen—for the first time—as Contacts of notified cases, and a further 200 were re-examined as routine Contact checks. The number of new cases of tuberculosis taken on the clinic register amounted to 51; of these, 45 were respiratory, and 6 non-respiratory. The number of notified cases shown on the register at 31st December, 1953, are as follows:— Respiratory Non-respiratory Totals Grand Total M. W. Ch. M. W. Ch. M. W. Ch. 129 94 16 4 8 6 133 102 22 257 In the year 1952—the grand total was 279. During 1953, there were 10 deaths recorded, and 4 unnotified deaths. In the previous year there were 22 and 6 respectively. Forty-three cases were removed from the register as recovered, and a further 32 were transferred to other clinics out of the area. The total number of cases x-rayed in the clinic during 1953 was 1,300. 48 The L.C.C. Tuberculosis Health Visitor—seconded to the Chest Clinic—made 1,059 visits to homes in the Borough during the year. Each case was visited with the view to tracing the source of infection, and advising on the prevention of the disease spreading. Advice and other assistance was given 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.) During 1953 the Mass Radiography Unit 6D has provided its normal Service to the area for which it is responsible, viz., the City of London and the Metropolitan Boroughs of Finsbury and Shoreditch. The total number examined during the year was 60,225, comprising 33,913 males and 26,312 females. Active tuberculosis has been found in 85 cases, which represents 1.4 per thousand examined. The Unit was static at the special accommodation provided by the City of London—The Mass Radiography Centre, 20, Golden Lane, E.C.1—for a large part of the year, during which period it examined workers and residents within the zone of the Unit. A very large number of firms, both small and large, as well as private individuals, were X-rayed at the Centre. During the period when the Unit was "mobile" a number of City firms were visited which could offer suitable accommodation for X-ray equipment and could provide a sufficiency of examinees to ensure that such a Survey would be economical. No Finsbury firms were visited during the "mobile" period as it is proposed during 1954 to instal the Unit in Finsbury, e.g., the Finsbury Health Centre, to which firms will be invited to send their staffs. The procedure of prior appointments has been continued by the Unit as it is a method particularly appreciated by firms who realise the considerable saving in examinees' time, resulting from this procedure. All examinees receive the result of their examination. 49 The aim of the Mass Radiography Service is to discover tuberculosis and other chest ailments in the early stages when such ailments are more easily curable. By its means, large numbers can be X-rayed with a minimum of inconvenience. The Service is free, speedy, reliable and confidential. The Organising Secretary, Mass Radiography Unit, Finsbury Health Centre, Pine Street, London, E.C.1 (Telephone Nos.: TERminus 2121, Ext. 92 or TERminus 6184) is pleased to send full particulars of the Service to firms and individuals on application. APPENDIX "A." County of London Census Report, 1951. The report of the Registrar General for the County of London was published during the year. In the following tables some of the information with regard to Finsbury is reproduced together with other data for comparison:— Intercensal Variations and Densities. 1901 1911 1921 1931 1951 London Population 101,463 87,923 75,995 69,888 35,370 — Persons per acre 190 149 129 119 60.3 44.7 No. of structurally separate dwellings occupied — — 10,889 10,369 8,702 — No. of rooms occupied — Approx. 53,700 49,617 47,641 35,479 — No. of persons per room — 1.59 1.49 1.42 0.96 0.83 Percentage of persons living at density more than— 3 per room — 13.5 10.1 10.6 0.3 0.3 2 per room — 39.9 34.0 29.4 3.4 2.5 1½ per room — 64.1 58.5 52.2 16.1 12.1 1 per room — 80.1 77.1 72.5 42.4 32.7 Percentage of families living at density more than— 3 persons per room — — 5.7 5.6 0.2 0.2 2 persons per room — — 21.1 17.4 1.7 1.4 1 ½ persons per room — — 42.8 36.3 9.2 7.6 1 person per room — — 59.7 54.2 26.7 20.8 50 Table 21—Ages (quinary) by Marital Condition Age Last Birthday Persons Males Females Total Single Married Widowed and Divorced Total Single Married Widowed and Divorced All Ages 35,370 16,919 7,728 8,429 762 18,451 7,705 8,362 2,384 0—4 3,081 1,651 1,651 — — 1,430 1,430 — — 5—9 2,122 1,071 1,071 — — 1,051 1,051 — — 10—14 1,917 929 929 — — 988 988 — — 15—19 2,056 865 860 5 — 1,191 1,104 87 — 20—24 2,954 1,351 959 392 — 1,603 801 797 5 25—29 3,301 1,660 581 1,070 9 1,641 411 1,198 32 30—34 2,665 1,380 320 1,049 11 1,285 276 969 40 35—39 2,540 1,311 257 1,021 33 1,229 261 918 50 40—44 2,455 1,238 248 948 42 1,217 228 923 66 45—49 2,415 1,203 218 939 46 1,212 275 825 112 50—54 2,307 1,062 189 810 63 1,245 228 827 190 55—59 1,930 864 124 682 58 1,066 200 617 249 60—64 1,780 790 107 593 90 990 151 506 333 65—69 1,483 633 96 422 115 850 120 347 383 70—74 1,144 466 69 283 114 678 77 218 383 75—79 772 291 33 157 101 481 64 102 315 80—84 311 113 14 41 58 198 27 23 148 85—89 114 38 2 15 21 76 12 5 59 90—94 20 3 — 2 1 17 1 — 16 95 and over 3 — — — — 3 — — 3 5i Table 27.—Social Class Distribution of Occupied and Retired Males aged 15 and over. Administrative Area Total Males (Occupied and Retired) Aged 15 and over Social Class* Proportions per 1,000 Total i II III IV v I ii III iv v London 1,172,918 46,423 152,742 635,944 139,116 198,693 40 130 542 119 169 Finsbury Met. Borough 12,972 151 1,019 6,745 2,109 2,948 12 78 520 163 227 * Social Class = I Professional, etc., Occupations. II Intermediate Occupations. III Skilled Occupations. IV Partly Skilled Occupations. V Unskilled Occupations. Table ii.—Private Households by Size, Rooms Occupied and Density of Occupation in (a) All Dwellings, (b) Shared Dwellings. Number of Persons in Households Number of Households Occupying the Following Number of Rooms Total Households 1 Room 2 Rooms 3 Rooms 4 Rooms 5 Rooms 6 Rooms 7 Rooms 8 or 9 Rooms 10 or more Rooms Total Households 1,315 4,287 3,367 2,439 584 296 73 43 12 12,416 *Finsbury 106 345 271 197 47 24 6 3 1 1,000 *London 96 189 300 209 113 60 18 11 4 1,000 *Distribution per 1,000 households by rooms occupied 1951. 52 Table L.—Housing of Private Households. Administrative Area Structurally Separate Dwellings Households Occupied and Vacant Occupied Number Percentage Vacant Unfurnished Rooms per Dwelling Percentage with 1 or 2 rooms only Number Percentage Sharing a Dwelling Rooms per household Percentage occupying 1 or 2 rooms only Persons per Household Percentage of 1 person households 1951 1931 1951 1931 London 820,918 1.0 4.76 5.75 13.2 1,120,710 47.8 3.39 28.6 2.82 3.46 19.7 Finsbury M B. 8,909 1.1 4.08 4.59 26.2 12,416 48.1 2.86 45.1 2.75 3.54 23.4 Table 10.—Dwellings, Rooms and Households. Structurally Separate Dwellings Number of Rooms 1 Room 2 Rooms 3 Rooms 4 Rooms 5 Rooms 6 Rooms 7 Rooms 8 or 9 Rooms 10 or more Rooms All Sizes Total Total Dwellings occupied and vacant 409 1,993 2,215 1,464 507 945 526 601 249 8,909 36,461 Number of Private Households therein 371 1,914 2,184 1,579 661 1,849 1,259 1,677 922 12,416 — 53 Table 13.—Private Households according to possession of certain Household Arrangements. Total Number of Households Households with Household Arrangements as follows :— (E. = Having exclusive use; S. = Sharing with another household ; N. = Entirely without) Piped Water Cooking Stove Kitchen Sink Water Closet Fixed Bath Households Per cent. S. or N. Households Per cent. S. or N. Households Per cent. S. or N. Households Per cent. S. or N. Households Per cent. S. or N. s. N. S. N. S. N. S. N. S. N. (a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) All Households 12,416 5,148 313 44 (31) 387 284 5 (8) 2,441 1,533 32 (16) 5,866 46 48 (35) 777 9,201 80 (62) All five arrangements, E. Stove, E.; Sink, E. Bath, S. or N.; Other four arrangements, E. Sink, S. or N.; Water Closet, S. or N. Households Per cent. Households Per cent. Households Per cent. Households Per cent. (a) (r) (s) (t) (u) (v) (w) (x) (y) All Households 2,206 18 (33) 8,377 67 (83) 2,741 22 (20) 3,522 28 (15) Comparative figures for the Administrative County of London are shown in brackets. 54 APPENDIX "B." List of special reports submitted to the Health Committee by the Medical Officer of Health during 1953:— January 14 Report on the Fog in Finsbury during December, 1952. February 11 Holiday Home—Hospital Annexe. February 11 Part-time Employment Scheme for the Aged— Management. June 10 Part-time Employment Scheme for the Aged— Progress Report. June 10 Royal Sanitary Institute Health Congress. October 7 Fluoridation of Public Water Supplies. October 7 Review of Manual Staff. November 4 20th Annual Conference of the Smoke Abatement Society—Delegate's Report. November 4 The Sanitary Inspectors' Conference, 1953— Delegate's Report. November 4 Aged Persons—Holiday Scheme, 1953. November 4 Report on Smoke Pollution.