AC4341 cat P.C. HCL. 25.10.55 cum Fin 35 THE Metropolitan Borough of Finsbury ANNUAL REPORT on the Public Health of Finsbury for the Year 1954 By— C. O. S. BLYTH BROOKE, M.D., 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. v.), finsdbury, b.c. 19 5 5 THE Metropolitan Borough of Finsbury ANNUAL REPORT on the Public Health of Finsbury for the Year 1954 By— C. O. S. BLYTH BROOKE, M.D., B.S., D.P.H. Barrister-at-Law. Medical Officer of Health. Finsbury Health Centre, Pine Street, London, E.C.l. Printed by Vail & Co., Lid. (t.u.), Finsbury, e.c, 1955 2 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 on the work of the Public Health Department for the year 1954. The year has been uneventful but I believe that the general health of the inhabitants has continued to improve and there was no serious outbreak of infectious disease. The birth rate was 19.7, a slight rise on that for the preceding years, and the death rate 8.85, the lowest on record. Unfortunately I have to report the first Maternal death since 1949 which makes the rate for this year 1.4: although this is a high figure the rate if averaged over the other years is satisfactory. It is also unfortunate that the Infant Mortality rate rose from between 16 and 22 for the last 4 years well below the national rate to 30, which is slightly above the national rate. This was entirely due to an increase in the number of deaths of infants under one week and is to some extent set off by a remarkable decrease in the stillbirth rate from about 20 to 10. Nevertheless, it cannot be disregarded altogether. The aged have continued to receive the very sympathetic consideration which has been given to them by your Council and by voluntary bodies in the last few years and the various schemes designed to help in their care and wellbeing and to maintain their health have been extended. A new work centre constructed as a result of generous benefactions ideally suited to the purpose of helping a hundred or more elderly persons to preserve their mental and physical health by enabling them to continue in a modified manner their part in the life of the community, was opened by Lord Horder on November 11th. 3 The general sanitary conditions of the Borough including the standards of housing have continued to improve slowly but remain far below those aimed at by all. The coming into force of the Housing Repair and Rents Act had up to the end of the year little influence on the work of the department. 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. 4 HEALTH COMMITTEE Chairman : Councillor J. TROTTER Vice-Chairman : Councillor J. CROSSLEY Alderman J. T. BELLAMY Mrs. C. P. PENN Councillor Miss A. T. CALLAGHAN Mrs. S. CLIFFE W. J. DAVIES E. I. JONES A. E. LEY O. THOMPSON Medical Officer of Health : C. O. S. Blyth Brooke, M.D., 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. (Senior Sanitary Inspector) (Deceased 9.12.54) 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. (To 17.7.54) R. E. Richards, M.S.I.A. Student Sanitary Inspectors : B. G. Payne (from 1.12.54) K. Palmer (from 12.4.54) J. M, South wick (from 22.11.54) 5 Senior Meat Inspector: R. S. Barber, M.S.I.A., Barrister-at-Law Rodent Officer: P. L. Moseley (from 18.10.54) Administrative and Clerical Staff: A. G. Holmes (Assistant Administrative Officer) J. T. Lindsay Miss J. L. Faulkner Mrs. A. H. Bradford A. Phillips F. W. Haynes I. Patience (from 16.8.54) J. R. Dalton 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. Health Centre Caretaker: E. H. James (from 3.8.54) Resident Engineer and Health Centre Keeper : F. W. Battle (to 17.5.54) 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 35,490 Population Density. Number of Persons per Acre 60 Marriages Registered 323 Rateable Value. £1,015,287. Product of a Penny Rate £4,011. General Rate for the year 23s. od. 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 699 including 46 illegitimate births and consisting of 381 males and 318 females, giving a rate of 19.7 per 1,000 civilian population. The birth rate for England and Wales was 15.2 per 1,000 home population. Stillbirths. The total number of stillbirths allocated to the Borough during the year was 7. This figure represents 0.99 per cent. of the total births. Expressed as a proportion of the population the figures are 0.20 per 1,000 civilian population for Finsbury as against 0.37 for England and Wales (total population). They were distributed by sex and legitimacy as follows :— Legitimate Illegitimate Total Males 4 1 5 Females 2 — 2 6 1 7 7 Deaths. The total number of deaths belonging to the Borough registered during 1954 was 314, consisting of 177 males and 137 females, giving a general death rate of 8.85 per thousand of the civilian population. The corresponding rate of the total population of England and Wales was 11.3. Comparative Statistics, 1948-1954. 1948 1949 1950 1951 1952 1953 1954 Population 35,640 36,010 35,810 35,620 35,740 35,640 35,490 Birth ratef per 1,000 population) 18.9 18.6 17.3 17..9 19.1 18.9 19.7 Death rate (do.) 11.9 13.7 11.7 14.3 13.4 9.9 8.6 Maternal mortality (per 1,000 live births) 0.0 3.0 0.0 0.0 0.0 0.0 1.4 Death rate, infants under 1 (do.) 32.6 25.3 19.4 21.9 16.2 22.2 30.0 Death rate of illegitimate infants under 1 (per 1,000 illegitimate live births) 60.0 76.9 27.02 24.4 0.0 65.2 43.48 Still-births (per 1,000 of total births)... 23 23 16 19 20 22 10 T.B. death rate per 1,000 inhabitants (all forms) 0.72 0.56 0.39 0.59 0.61 0..31 0.34 Illegitimate births 50 52 37 41 41 46 46 Causes of Death— 1954. — 1— 5- 15— 25— 45 65— 75— Total M. F. M. F. 1. Tuberculosis, respiratory - 1 - - - 10 1 - - - 12 2. Tuberculosis, other - - - - - - - - - - - 3. Syphilitic disease - - - - - 1 1 - 1 - 3 4. Diphtheria - - - - - - - - - - - 5. Whooping Cough - - - - - - - - - - - 6. Meningococcal infections - - - - - - - - - - - 7. Acute poliomyelitis - - - - - - - - - - - 8  0— 1— 5— 15— 26— 45— 66— 75— Total M. F. M. F. 8. Measles - - - - - - - - - - - 9. Other infective and parasitic diseases - - - - - 1 - - - - 1 10. Malignant neoplasm — stomach - - - - - 4 3 1 - 2 10 11 Malignant neoplasm — lung, bronchus - - - - 2 14 3 - 2 1 22 12. Malignant neoplasm — breast - - - - 1 1 - - - 2 4 13. Malignant neoplasm — uterus - - 1 - 1 - 1 3 14. Other malignant and lymphatic neoplasms - - - - 1 7 10 5 6 6 35 15. Leukaemia, aleukaemia - - - - — 1 — — — — 1 16 Diabetes - - - - - - - - 1 — 1 17. Vascular lesions of nervous system - - - - - 5 5 10 - 4 24 18. Coronary disease, angina - - - - 1 11 13 9 3 11 48 19. Hypertension with heart disease - - - - - - 3 — 3 4 10 20, Other heart disease — — — — 2 9 3 2 9 8 33 21. Other circulatory disease - - - - - 1 2 3 2 5 13 22. Influenza - - - - - - - - - - - 23. Pneumonia 2 — — — — 3 1 — 2 5 13 24. Bronchitis - - - - - 4 6 2 3 1 16 25. Other diseases of respiratory system - - - - - 1 1 - - - 2 26. Ulcer of stomach and duodenum - - - - - 3 - 1 - - 4 27 Gastritis, enteritis and diarrhoea - - - - - 1 1 - - 1 3 28. Nephritis and nephrosis - - - - 1 2 - - - 1 4 29. Hyperplasia of prostate - - - - - 1 1 - 1 - 3 9  0— 1— 5- 15- 25— 45- 65— 75— Total M. F. M. F. 30. Pregnancy, childbirth, abortion - - - - 1 - - - - - 1 31. Congenital malformations 3 - - - - 1 - - - - 4 32. Other defined and illdefined diseases 16 - - - 3 5 1 1 1 4 31 33. Motor vehicle accidents - - - - 1 1 - 1 - - 3 34 All other accidents - - - - 1 - 1 - - 5 7 35. Suicide - - - - 1 2 - - - - 3 36. Homicide and operations of war - - - - - - - - - - - Totals 21 1 0 0 15 90 56 36 34 61 314 Years of Life Lost. A table has again been prepared this year of the total and working years of life lost by death from some of the more important causes of death. This relates to 1953 and is based on the assumption that the normal span of life is 85 years and that the normal working period extends from the age of 15 to that of 64. Abridged List No. Cause of Death Death Rate per 10,000 population Years of life lost per 10,000 population Ages 15-64 Total to age 85 All causes M. 109 (122) 917 (806) 2,628 (2,491) F. 91 (107) 529 (538) 1,606 (1,717) 1 Tuberculosis of respiratory system M. 5.31 (3) 54 (29) 146 (73) F. 1.08 (1) 19 (20) 41 (39) 10-15 Cancer (all sites) M. 19.50 (22) 225 (112) 557 (415) F. 14.60 (18) 91 (97) 292 (330) 11 Cancerof lung, bronchus Cancer of breast M. 9.45 (6) 87 (35) 265 (131) 12 F. 1.08 (4) 9 (22) 31 (72) 17 Vascularlesions of C.N.S. M. 7.67 (14) 38 (29) 160 (182) F. 10.84 (17) 13 (30) 111 (187) 18 Coronary disease M. 20.10 (18) 71 (65) 350 (305) F. 9.75 (10) 13 (16) 103 (109) 19-20 All other cardio-vascular diseases M. 8.27 (20) 30 (39) 128 (249) F. 15.17 (24) 41 (38) 198 (247) 23-24 Bronchitis and pneumonia M. 22.45 (14) 128 (93) 444 (293) F. 15.17 (9) 61 (54) 210 (157) 26 Ulcer of stomach and duodenum M. 1.18 (2) 20 (9) 43 (34) F. 1.08 (1) - (2) 8 (8) 33-34 Accidents M. 5.31 (4) 70 (90) 163 (170) F. 2.16 (2) — (26) 15 (59) (Figures in brackets are those for England and Wales). 10 The numbers in Finsbury are too small for definite conclusions to be drawn from the local figures and detailed comparison with those for 1952 is not satisfactory on account of considerable variability. On the other hand a general study of the data for the two years for Finsbury and comparing it with that for the whole country would seem to justify the folloiwng impressions. (1) The loss of both working and total years of life by deaths from all causes was rather high in Finsbury, particularly so for men in 1953. (2) Cancer has become responsible for a large proportion of the loss of working life as well as of later years of life. It has been responsible for the loss of more than 50 per cent. more of the working years of men in Finsbury than in the country generally as well as considerably more of total years. This is part due to the high loss from cancer of the lung which was more than twice that for the country. On the other hand the loss of years by women from cancer of the breast was less than half the country average. (3) The loss of years through deaths from the respiratory diseases of Bronchitis and Pneumonia has also been both absolutely and relatively high in Finsbury being considerably more than 50 per cent. greater than for the country at large. The excess in Finsbury being more for women than for men and in the total years of life than in working years. (4) The years lost by men from Tuberculosis, coronary disease and gastric ulcer have been more in Finsbury than in the country generally. (5) The years lost from vascular lesions of the central nervous system by both sexes have been much fewer in Finsbury than in the country, the figures for the former being little more than half the latter. (6) Accidents are a cause of a substantial number of years of life lost but the number in Finsbury has been considerably less than in the whole country. This feature was particularly favourable in the case of women where the rate was well below half the national rate. 11 Maternal Mortality. Unfortunately one maternal death occurred during the year. The maternal death rate was therefore 1.4 but it must be remembered that no maternal deaths had occurred since 1949. This death was in a multiparous woman, aged 32, who in each of six previous pregnancies had toxaemia. She died in St. Bartholomew's Hospital from uraemia due to renal cortical necrosis nine days after parturition. Inquests. Inquests were held on 16 residents during the year. The causes of death found were :— Natural causes : (Males 71 and 42 years) 2 Road Accidents : (Female 68 and Male 53 years) 2 Rail Accident: (Male 43 years) 1 Misadventure : (Females 55 and 78 years) 2 Accidental Falls : (Male 72 and Females 90, 83, 80 and 76 years) 5 Open Verdict: (Male 31 years) .. 1 Suicide : (Male 45 and Females 38 and 60 years) 3 16 Infant Mortality. There were 21 deaths amongst infants under one year of age and the Infant Mortality rate based on 1,000 live births was 30.0. Of these deaths 19 occurred in the neonatal period. The neonatal mortality rate was 27.18. The comparative infant mortality rate for England and Wales was 25.5. 12 Infant Mortality, 1954—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. Tota under l yr. Bronchitis - - - - - 1 - - 1 Congenital malformation 3 - - - 3 1 - - - 4 Birth Injury and other diseases of early infancy 4 1 - - 5 - - - - 5 Immaturity 8 - - - 8 - - - - 8 Other defined causes 3 - - - 3 - - - - 3 18 1 - - 19 1 1 - - 21 13 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 1954. 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 also undertakes work on behalf of the Regional Hospital Board. Work of the Public Health Department Number positive Total Number Examined 1953 1954 1953 1954 Throat and Nasal Swabs for Diphtheria — — 167 92 Sputums for Tubercle Bacilli 90 70 450 424 Nasal swabs for Whooping Cough 125 49 352 110 Blood Counts — — 125 110 Faeces and Rectal swabs for Dysentery 96 191 2,275 2,959 Food Samples for Salmonella, etc. — — — 10 Totals 317 310 3,369 3,705 14  Number Unsatisfactory Number Poor Total Number Examined 1953 1954 1953 1954 1953 1954 Milk- Bottle pasteurised - - - - 23 41 Tuberculin Tested pasteurised - - - - 10 1 Sterilised - - - - 8 5 Homogenised - - - - 1 - Churn pateurised - - - - 51 - Jersey - - - - 5 - South Devon - - - - 1 - Ice-Cream - 10 2 - 18 11 Other Foods 11 1 - 4 42 11 Water— Tanks - - - - 3 4 Taps - - - - 7 4 Wells - 1 - - - 1 Swimming Baths - - - - 5 - 11 12 2 4 174 78 Total Examinations 3,543 3,783 Work of the Regional Hospital Board For General Practitioners For Various Clinics Totals 1953 1954 1953 1954 1953 1954 Blood Counts 179 94 107 63 286 157 Blood Sedimentation Tests 3 9 87 45 90 54 Wasserman & Kalin Tests — 3 — 1 — 4 G.C. Fixation Tests — 3 — 1 — 4 Pregnancy Tests 14 16 — — 14 16 Bacteriological and Pathological Examinations of— Urines 18 11 18 12 36 23 Urethral & Vaginal swabs — 4 — . — — 4 Gum swabs — — — 2 — 2 Eye swabs — 1 — — — 1 Nail & Skin scrapings — — — 1 — 1 Domiciliary visits — 5 — — — 5 Totals 214 146 212 125 426 271 15 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. Four sessions were held during the year at which 289 donors gave blood. 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. 158 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. 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. 16 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 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 as in past years to take a very active interest in work on behalf of old people during 1954. 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. 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. 17 In this way a holiday was provided for 304 persons comprising 31 married couples, 59 men and 183 women, at a total cost to the Council of £2,032. 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 previous reports 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 £1,340 between sixteen organisations. (4) The Finsbury Employment Scheme for the Elderly continued to develop and to expand during the year, and many firms continued to co-operate generously by providing work. It had long been apparent that the premises leased at 352 St. John Street were not sufficiently large or suitable and convenient to serve the increasing needs and appeals had been directed towards securing funds for the purpose of acquiring larger and more satisfactory premises. As a result of generous donations from various charitable sources, it had been possible to erect a substantial prefabricated building on an available site near the Town Hall. This new Work Centre named "Brooke House" at 39/41 Gloucester Way, E.C.i. was formally opened by the Rt. Hon. Lord Horder, G.C.V.O., M.D., B.Sc., in November of last year. This new building will enable the work to be continued under better conditions and to be extended to cater for about twice the number of old people. 18 The Scheme has already attracted intense interest from many parts of the country and from overseas, and many bodies are considering the inauguration of similar endeavours. The Scheme apart from its 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 as often as possible during the year. Every effort was made to give them help and encouragement in looking after themselves. There were two cases of 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. 233 visits were paid during 1954. There is no charge to the aged. The ages of the persons visited ranged from 63 to 95 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. 19 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 service which effects repairs to such 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 aged persons participating in the Finsbury Employment Scheme for the Elderly at "Brooke House," 39/41 Gloucester Way, 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 19,313 meals were served during 1954. As a consequence of the closing of the London County Council Civic Restaurants and the need to find an alternative source of supply for the mid-day meal services for old people, the Committee arranged 20 with the Salvation Army to undertake the provision of the necessary meals at the same charge per meal as that made by the London County Council. 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. Invalid Kitchens of London Aged persons, who were unable by reason of sickness and infirmity to attend one of the Meal Centres run by the various voluntary organisations, were supplied with a meal delivered at their home. This is, however, a restricted service and there is often a waiting list of applicants. The Council made a substantial grant to the Invalid Kitchens of London in respect of this service. 11,254 meals were supplied during 1954. 21 SECTION C. Sanitary Circumstances. Water. The Borough is freely supplied with water by the Metropolitan Water Board. Eight samples of drinking water for bacteriological tests were taken during 1954 by the Sanitary Inspectors. All were found to be satisfactory. Swimming Baths. The Borough Council maintains two modern swimming baths whose waters are efficiently chlorinated. The Northampton Polytechnic maintains a swimming bath in summer which is available to the public at certain times. This also is chlorinated. 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 1954. Houses, damp, dirty or dilapidated, remedied 623 Doors, windows, floors, walls, ceilings, sashcords repaired 772 Water closet defects remedied 177 Water closets erected 184 Urinal defects remedied 16 Urinals erected 28 Soil pipe and ventilating shaft defects remedied 34 Soil pipe and ventilating shafts erected 69 Yard defects remedied 40 Waste pipe defects remedied 104 Waste pipes erected 70 Water cistern defects remedied 70 22 Sanitary Conditions—continued. Accumulations of rubbish or manure removed 77 Dung or dust receptacles repaired or renewed 34 Drains relaid, amended or sealed 127 Drains cleared or tested 115 Rain water pipes cleared, repaired or renewed 48 Water supply to houses reinstated 6 Roofs and gutters repaired 268 Area defects remedied 16 Wash-house defects remedied 42 Animal nuisances abated 1 Stables cleansed or repaired 0 Water supply laid on to upper storeys of house 15 Miscellaneous nuisances abated 131 First visits (complaints, casual visits) 5,357 Re-visits 5,177 Intimation Notices served 872 Nuisance Notices served 41 House inspections 2,214 Complaints received 2,000 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. 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: — Date Premises Offence Result 21.7.54 14 Calshot Street Choked drain Hearing adjourned; work subsequently done and summons withdrawn 21.7.54 18, Calshot Street Choked drain; manholecover broken; no water supply to water closets. Hearing adjourned; work subsequently done and summons withdrawn. 23 The Council instituted legal proceedings under the Housing Act, 1936, as follows:— Date Premises Offence Result 24.2.54 276, City Road Using basement room in contravention of a Closing Order. Fined 10'. with £2 2s. costs. 30.3.54 20, Culpeper Street Using basement room in contravention of a Closing Order. Fined 40s. with £2 2s costs. Legal proceedings were also instituted under the London County Council Bye-Laws as set out in the following table — Date Premises Offence Result 19.7.54 352, Goswell Road Contraventions of L.C.C. Drainage and W.C. ByeLaws. Absolute discharge. £2 2s. costs. No legal proceedings were instituted under the Food and Drugs Act during 1954. 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 a 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. 24 Shops. The number of inspections made under the Shops Act, 1950 during 1954 was 159, and one Notice was served for contravention. Rag and Bone Dealers. There are 6 premises within the Borough in which this type of business is conducted. Nine 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. At the end of the year 11 premises were registered for this purpose. 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 are 4 licensed premises in the Borough. 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. Five samples of various types were taken during the year of which all except one were 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. 25 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 1954 82 Number removed from the Register during 1954 84 Number on Register at end of 1954 1,351 Number Employed—13,955 men, 13,688 women—27,643 Persons. Non-Power : Number added to the Register during 1954 7 Number removed from the Register during 1954 18 Number on Register at end of 1954 648 Number Employed—747 men, 591 women,— 1,338 Persons. Total Number on Register at end of 1954 1,999 Total Number Employed—14,702 men, 14,279 women—28,981 Pprsnns 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 863 —Non-Power Factories 218 —Total 1,081 Number of complaints received from H.M. Inspector of Factories 28 Number of complaints received from others 2 26 Number of Defects discovered:— Want of cleanliness 36 Overcrowding — Unreasonable temperature — Inadequate ventilation — Ineffective drainage of floors 1 In relation to Sanitary Conveniences 65 Various 6 Total 108 Number of Notices served 74 No prosecutions were instituted during the year. Number of notices sent to H.M. Inspector of Factories 44 (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 208 Number of notifications received of:— 1. Finsbury outworkers employed by Finsbury Firms 353 2. Outworkers in other districts employed by Finsbury Firms 4,417 3. Finsbury outworkers employed by Firms in other districts 152 Total number of notifications received in respect of :— 1. Finsbury outworkers employed by : (a) Finsbury Firms 495 (b) Firms outside Finsbury 212 707 2. Outworkers employed by Finsbury Firms 4,912 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. 27 Number of visits to domestic outworkers 132 Number of notices served in respect of unsatisfactory conditions NIL Smoke Abatement. This subject received continued attention during the year and Government action following the publication of the Beaver Report is eagerly awaited. A course of lectures and discussions was held on two afternoons in February at the Northampton Polytechnic in co-operation with that body. This was intended for stokers and boilermen and was attended by about a hundred from this and neighbouring Boroughs. 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. The station erected on the roof of the Health Centre to measure monthly deposits and sulphur dioxide pollution was maintained. It will be some considerable time before such recordings can yield significant information owing to the wide variations which occur in meteorological conditions. Twenty complaints were received and 192 observations made during the year in regard to smoke emission. 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 321 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 412 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. 28 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 411 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 when this was necessary. 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, however, been small. Vermin Scabies Total Total number of treatments given to Finsbury cases (other than School children) 84 21 105 Total number of treatments given to Shoreditch cases (other than School children) 10 22 32 Total number of treatments given to School children (all the School children treated were not resident in Finsbury; a proportion being from adjacent boroughs) 781 238 1,019 Total number of Home Visits paid Nil 29 Prevention of Damage by Pests Act, 1949. Rodent Control. The Council employs six rodent operatives, who were under the supervision of the Deputy Chief Sanitary Inspector who was designated Rodent Officer, until the 18th October, 1954, when Mr. P. L. Moseley was appointed 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 June 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 591 Number of additional premises found infested 488 Number of houses treated 3,667 Number pf other premises treated 644 Number of visits made to houses 18,658 Number of visits made to other premises 2,940 Numbei 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 :— (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. 30 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 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 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. During the year it was carried out in the following instances for the reasons set out:— Suspected Scarlet Fever 33 Suspected Poliomyelitis 3 Suspected Dysentery and Gastro-enteritis 108 Suspected Measles 48 Suspected Whooping Cough 30 Tuberculosis 24 On behalf of St. Marks and other Hospitals 25 Miscellaneous 47 31 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, 11,554 articles were treated. Goods, mostly clothing, were also disinfected on behalf of certain export firms as follows :— Number of articles 187,210 Number of times disinfecting plant charged 169¾ 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. One body was received into the mortuary during the year. 32 SECTION D. Housing. General. It is estimated that there are 9,622 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. Thirty-two 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. Twenty-one new representations were made in respect of Closing Orders during the year, two being attic rooms, eighteen basement rooms, and one dwelling house. No Demolition Orders were made during the year. 33 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 (4) making demolition or closing orders 1 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 1 Number of Houses in respect of which undertakings were accepted Nil Number of Houses Demolished Nil 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. The Byelaws were subsequently repealed by the Housing Repairs and Rents Act, 1954. 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:— Stafford Cripps Estate 49 flats Bevin Court 118 flats Holford House 12 flats Greenwood House 22 flats Peabody Buildings 16 flats 34 Slum Clearance. Representations were made during 1954 in respect of one area and Clearance Order made during the year in respect of an area represented during 1953. 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 families were rehoused as follows :— Families Rehoused in Council Flats 172 Rehoused in requisitioned property 80 Rehoused from Clearance Areas 18 Families transferred in Council property 216 Families rehoused by London County Council 74 Families rehoused in new Towns 11 Families found own accommodation 354 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. Housing Repairs and Rents Act, 1954. Seven certificates of disrepair were issued up to the end of the year. 36 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 number of food premises in the Borough, by type of business is as under:— Restaurants and Cafes 266 Grocers and Provision Merchants 180 Fish Shops 31 Bakers and Confectioners 36 Sweets, etc. 74 Industrial and Commercial Canteens 183 770 Adulteration of Food. A total of 581 samples of food and drugs were submitted to the Public Analyst during the year. Of these, 4 were formal and 577 were informal samples. Details are appended:— Foods No. of Samples Obtained Milk 73 Cream and Condensed Milks 11 Ice Cream 1 Sausages 21 Meat and Fish Pastes 7 Other Meat Products 69 Butter 4 Margarine, Cooking fat, etc. 17 Cheese 10 Jams, etc. 23 Dried Fruits 18 Cake and Pudding Mixtures, etc. 19 36 Foods (contd.) No. of Samples Obtained Cereals, etc. 9 Flours, etc. 9 Tea, Cofiee, Cocoa, Extracts 18 Sauces, Vinegar, etc. 23 Soups 11 Herbs, Spices and Condiments and flavours 41 Powders (Baking, etc.) 16 Canned Vegetables, Fruits, Fish, etc. 47 Fruit 4 Non-Alcoholic Drinks 7 Confectionery 24 Table jellies and gelatine 7 Various 6 Drugs. Simple Medicines 23 Powders 14 Tablets 20 Ointments, lotions, etc. 29 Total 581 Four informal samples were found to be adulterated as follows :— Saccharin Deficient in saccharin to the extent of 5 per cent. Milk At least 1.5 per cent, added water. Milk 6 per cent, fat extracted. Honey of Borax Deficient in borax to the extent of at least 16 per cent. Formal samples were subsequently taken which all proved to be genuine except in the case of the saccharin tablets. In this case a warning letter was sent to the vendor. 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 were two unsatisfactory reports during 1954. 37 1. Dairies : No. on register at end of 1954 9 2. Distributors : No. on register on 1st January, 1954 124 No. of Transfers approved during 1954 . 7 No. of new applications received and approved 2 During 1954, 3 Distributors were removed from the register. Of these, 1 ceased trading in milk, 1 where the business closed down, and I where the premises were converted to other uses. 3. Designated Milk : No. of licences issued :— Dealers in T.T. Milk 58 supplementary 24 Dealers in Pasteurised Milk 73 supplementary 24 Dealers in Sterilised Milk 83 supplementary . 27 4. Quality of Milk : No. of samples submitted to Public Analyst 73 No. of samples reported as adulterated 2 The average fat content of the milk samples was 3.52 per cent. The average non-fatty solids content was 8.66 per cent. 5. No. of visits paid to milk premises was 118 Ice-Cream. No. of premises registered for manufacture 24 No. of premises registered for storage and sale 109 No. of premises registered for storage only 2 Although 24 premises are registered for the manufacture of ice cream, only 3 premises were so used during 1954. Five additional premises were registered for the storage and sale of ice cream during the year. Standard for Ice Cream. One sample of ice-cream was submitted to the Public Analyst and complied with the prescribed standard. Details of routine samples submitted for bacteriological examination are as follows :— No. of samples submitted 11 No. of samples satisfactory 1 No. of samples poor Nil No. of samples unsatisfactory 10 38 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 II. No legal proceedings were instituted under the Food and Drugs Act, 1938, during 1954. Meat Inspection. In the neighbourhood of the Smithfield Meat Market, there is a considerable number of wholesale butchers and offal shops, bacon factories, bacon and provision warehouses, poultry, game and rabbit shops and Public Cold Air Stores, all of which are regularly inspected by the meat inspector. The Ministry of Food relinquished control of meat and offal on July 5th of this year and many butchers shops near the Market were re-opened or taken over for the " boning-out " of cow and bull beef. These carcases of cow and bull beef are generally of poor quality and are principally used for manufacturing purposes. Owing to the nature of these carcases a rigid inspection of them is made by the meat inspector before they are "boned-out" for disease or unsoundness. A systematic examination for Caseous Lymphadenitis of imported frozen carcases of mutton and lamb was carried out by the meat inspector and 12,515 carcases were examined and 185 carcases were found to be diseased to such an extent that either the whole or part of the carcase was condemned. A consignment of Australian boneless briskets of beef was examined for Onchocerciasis Gibsoni and about 20 per cent. were found to contain the "worm nodule." Where the nodule was found, the affected area was removed. On April 1st, Messrs. Henson and Burbidge Ltd. contracted to undertake the disposal and collection of unsound meat and food condemned in the Borough. Consignments of Continental and Scandinavian offals and hams continue to be imported into the Borough and condemnations often take place. 39 A total of 2,314 visits were made to the retail butchers shops and stalls during the year. 59 certificates for the export of sausage casings, meat essence, etc. were issued, mostly to the U.S.A. and the Continent. Underground Bakehouses. A bakehouse is said to be an "underground bakehouse" if any room used for baking, or any process incidental thereto, is so situated that the surface of the floor is more that 3 feet below the surface of the footway of the adjoining street, or of the ground adjoining or nearest to the room. On July 1st, 1938 it became the duty of the Borough Council, under the Factories Act, 1937, during this year and every fifth succeeding year afterwards, to carry out an inspection of basement bakehouses in respect of which a " certificate of suitability " had been issued under the old Factory and Workshop Act of 1901. The quinquennial review of the 17 remaining premises has been carried out this year. Each was inspected bearing in mind the recommendations of the Health Committee made in April 1939, with regard to the construction, lighting, ventilation and other hygienic respects. It was found that of the 17 premises concerned, 3 had already been closed by the owners, 9 were suitable for use with regard to the respects referred to in Section 54 of the Act and 5 were not considered suitable. In 2 of the 5 cases considered unsuitable the owners undertook to carry out extensive works to bring the bakehouses up to the required standard and they were subsequently granted "certificates of suitability." The remaining 3 bakehouses have now been closed. Eleven basement bakehouses remain in use in Finsbury and attention has been drawn to the fact that the examination and certification under the Factories Act 1937 in no way relieves the persons affected from compliance with the provisions of the Food and Drugs Act 1938, in particular with respect to cleanliness of persons employed and the premises and utensils used therein. 40 Registered Food Premises (other than ice cream). Seventy food premises were registered at the end of 1954. All were registered for the preparation or manufacture of sausages, or potted, pressed, pickled or preserved meat, fish or other preserved food. Other Food Premises. 2,056 visits were made to food premises during the year, which includes inspections of restaurants, canteens, registered food premises, etc. Prospective occupiers of food premises are not bound to consult this department before commencing business, but 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 226 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. 91 inspections were carried out. Pharmacy and Poisons Act. Forty-four 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 9,494 lbs. Meat—unsound 27,640 „ Meat—products 1,765 „ Bacon 32,201 „ 41 Offals—diseased and unsound 43,145 lbs. Poultry 8,324 „ Game 352 „ Rabbits 22,248 „ Tinned foodstuffs 41,408 „ Bottled Fruit, Pickles, etc. 102 „ Dried Fruit 42 „ Confectionery 1,052 „ Preserves 133 „ Cheese 495 „ Fruit and Vegetables 412 „ Fats 119 „ Fish 133 „ Cereals 1,045 „ Other Foodstuffs 5,479 „ Total 194,580 „ 86.86 Tons Food Poisoning. Thirty-one eases of Food Poisoning were notified during the year. There were no deaths. There were four outbreaks of Food Poisoning due to identified causes during the year. One outbreak due to an unidentified cause occurred as under:— Domestic (March). 3 cases notified. Suspected cause: Sausages. Apart from the outbreak detailed above, the following individual cases were investigated : Agent identified: 1 in January Salmonella (? type) 1 in February do. 1 in May Salmonella Typhi-murium 1 in September do. 1 in October do. 1 in October Salmonella " Thompson " 42 Agent not identified : 1 in February 1 in March 1 in April 1 in August 1 in September 1 in November 1 in December Agent not identified but possible cause : Mackeral March Pork April Ham Sandwich May Tinned Steak December 43 SECTION F. Infectious Diseases. General. There were several minor outbreaks of Dysentery during the year and measles continued with a high incidence but otherwise there were no striking features with regard to infectious disease. 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 2,809 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 Hosp. Acute Pneumonia 41 1 12 6 1 5 8 8 41 Dysentery 212 8 103 56 8 34 2 1 100 Erysipelas l2 — — — — 4 5 3 4 Food Poisoning 31 4 5 1 3 12 5 1 2 Gastro enteritis (under 2 yrs.) 31 23 8 — — — — — 28 Measles 309 16 170 122 1 — — — 57 Whooping Cough 93 26 51 15 — 1 — — 42 Ophthalmia Neonatorum 5 5 — — — — — — 4 Puerperal Pyrexia 4 — — — 2 2 — — 4 Scabies 31 1 3 18 4 3 2 — — Scarlet Fever 30 2 20 8 — — — — 22 Tuberculosis (Pulmonary) 55 — 4 3 18 10 17 3 — Tuberculosis (Non-Pulmonary) 3 — — — 3 — — — — Poliomyelitis (Non-Paralytic) 1 — — — — — — — — 858 86 376 229 40 71 39 16 304 44 Incidence Rates. The rates per thousand of the population are set out below::— Finsbury Notification Rates per 1.000 population. Typhoid Fever 0.00 Paratyphoid Fever 0.00 Meningococcal Infection 0.00 Scarlet Fever 0.84 Whooping Cough 2.62 Diphtheria 0.00 Erysipelas 0.34 Smallpox 0.00 Measles 8.71 Pneumonia 1.15 Acute poliomyelitis :— Paralytic 0.00 Non-paralytic 0.03 Food Poisoning 0.87 Diphtheria. There have been no cases or contacts during the year. Smallpox. There have been no cases or contacts during the year. Typhoid Fever. There have been no cases or contacts during the year. Paratyphoid Fever. Two boys attending the same school but living in other boroughs developed paratyphoid B. All contacts were kept under supervision and no further cases developed. Ophthalmia Neonatorum. Five cases were notified. They all responded well to treatment and no blindness developed. Puerperal Pyrexia. There were 4 notifications but no deaths. Meningococcal Infections. There were two contacts from a house in which a child had died of cerebrospinal meningitis. They were both kept under supervision and remained well. 45 Malaria. One soldier who had returned from Korea was treated in hospital. Erysipelas. Twelve cases were notified in which the disease occurred on the face and 3 on the leg. In no case was the infection severe. They were treated in hospital and recovered well. Poliomyelitis. There was one notified case of non-paralytic poliomyelitis which made a good recovery and the contacts remained healthy. Four contacts of other known cases, 2 men and 2 children, were kept under supervision and remained well. Pneumonia. Forty-one cases were notified in the year. All were removed to hospital and there were no deaths. Scarlet Fever. Thirty cases were notified and they were all very mild. Twentytwo were treated in hospital and no case developed complications. Whooping Cough (Pertussis). There was a total of 93 cases of which 42 were removed to hospital. Four were very severely affected, 47 moderately, and in 42 cases the disease was only mild. There were no deaths but the following complications were reported : 1—collapsed left lung. 1—conjunctival ecchymosis. 2—bronchitis 1—broncho-pneumonia Measles. Notifications remained relatively low until the last quarter of the year when there was an outbreak and 245 notified cases. The total for the year was 309 and of these 57 were removed to hospital mostly because of home conditions. In 150 cases the disease was moderately severe and in 2 it was very severe. The following complin cations were reported:— 46 4—bronchitis 2—pneumonia 2—laryngitis 1—cervical adenitis. There were no deaths from measles. Scabies. Thirty-one cases were notified. Dysentery. 212 cases of Sonne dysentery were notified, 36 of these being adults from which 17 were probably infected by their children. In 36 cases the disease showed moderately severe symptoms and the rest being mild. 100 cases were removed to hospital mostly on account of difficult home circumstances. 71 of the cases occurred in the Council's day nurseries, 19 in a hospital and 18 from small outbreaks in two schools. Gastro-enteritis (under 2 years). 31 cases were notified but none was severe and 28 were admitted to hospital and all recovered. Gastro-enteritis (over 2 years). 14 cases occurred but they were not severely affected and no further cases resulted from them. Rubella. Only 5 cases of german measles were known to the Public Health Department, as this disease is not notifiable. All the cases were mild and there was no known contact with an expectant mother in the first four months of her pregnancy. Chickenpox. 125 cases were notified. None was severe and there were no complications. Mumps. 134 cases occurred, all except one were mild. One case, however, developed mild mumps encephalitis and orchitis but has subsequently made a good recovery. 47 Infective Hepatitis. Five mild cases were notified this year. There was no contact between them and no further cases resulted from these. Epidemic Enteritis. There was an outbreak at the beginning of the year involving 31 children and the parents of three of these children. The patients were quite ill for 2—3 days and a few relapsed after about 14 days. All recovered and the school was kept under supervision until it was clear of infection. No organism was isolated and the source of the infection remained obscure. Food Poisoning. There were 31 cases notified as food poisoning during the year and one unnotified case. In 14 cases the infection was found to be due to Sal. Newport, in one case to Sal. Thompson. Eight of the cases occurred in one family but investigation failed to reveal the source of the infection. In another case, involving a baby of 9 months, the dried milk was under supervision, and this baby infected his mother with the same organism. A man and wife were both taken ill after eating some ham on which was demonstrated a growth of staphylococci. The Sal. Newport was isolated from a case who was already an inpatient in hospital ; the source of infection was unknown. From all the cases any suspicious articles of food were examined bacteriologically but failed to produce any definite information about the source of infection. Tuberculosis. The total number of new cases entered in the register during the year was 81. The distribution by sex and age, and according as to whether the case was of Pulmonary or Non-Pulmonary Tuberculosis, was:— 0- 1- 5- 0- 15- 20- 25- 35- 45- 55- 65 + Total Pulmonary M 0 2 1 0 4 4 5 9 8 9 5 47 F 0 2 1 1 2 10 6 3 1 0 3 29 Non-Pulmonary M 0 0 0 0 0 0 0 0 0 0 0 0 F 0 0 1 0 0 1 2 1 0 0 0 5 Total 0 4 3 1 6 10 13 3 9 9 8 81 48 The Non-Pulmonary cases include:— 1 Meningitis; 1 Cervical Adenitis; 1 Lymphadenitis; 1 Peritonitis; 1 Salpingitis. The notification rate for all forms of Tuberculosis was 22.82 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, 1954, as follows:— Males Females Total Pulmonary 169 111 280 Non-Pulmonary 7 16 23 176 127 303 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 ten deaths from Pulmonary Tuberculosis as set out:— Males: 69, 64, 62 (2), 60, 54, 53 and 48. Females: 60 and 2. There were no deaths from Non-Pulmonary Tuberculosis. 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. 49 Finsbury Chest Clinic. (Information kindly provided by Dr. W. D.R. Thompson, Chest Physician). During the year 1954, a total of 2,405 patients were seen in the Chest Clinic. Of this total, 111 attended, for the first time, as Contacts of notified cases, and a further 316 were re-examined as routine contact checks. The number of new cases of tuberculosis taken on the clinic register amounted to 45, of which 44 were pulmonary, and 1 nonrespiratory. Of the pulmqnary cases, 27 proved to be infectious. In addition to these cases, a further 20 notified patients were transferred into the borough from other clinics and hospitals. The number of notified cases shown on the register at 31st December, 1954, are as follows:— Respiratory Non-respiratory Totals Grand Total M. W. Ch. M. W. Ch. M. W. Ch. 136 87 17 3 6 3 139 93 20 252 In the year 1953—the grand total was 257. During 1954, there were 10 deaths, 9 males and 1 female, the same total figure as in the previous year. Of the cases removed from the register during 1954, a total of 30 were recovered, 27 were transferred to other areas outside Finsbury and 1 case was lost sight of. The total number of cases x-rayed during the year was 1,182. The London County Council Tuberculosis Health Visitor, seconded to the Chest Clinic, made 944 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. Disinfection was carried out, by the Finsbury Borough Council, in a large number of cases. 50 Mass Radiography Unit 6D. (.Information kindly provided by Dr. W. D. R. Thompson, Medical Director.) Mass Radiography Unit 6D has maintained its usual services during 1954 in the zone 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 61,671, comprising 36,238 males and 25,433 females, which is an increase of about 2.5 per cent, on the previous year's figures. Half-way through 1954 the Ministry of Health introduced a new method of statistical information required from Mass Radiography Units, so that it is not now possible to indicate the number of cases found with active Tuberculosis, but for the year under review 1,413 cases were discovered with tuberculous lesions. For the major part of the year the Unit was static at the Mass Radiography Centre, 20 Goldern Lane, E.C.i, during which period the Unit has examined organised groups of workers, and also residents within its zone. Over fifteen hundred firms have utilised the services of the Unit. When the Unit was "mobile" a number of large firms, which could provide suitable accommodation for the X-ray equipment and a sufficiency of examinees to ensure that the "Survey" would be economical, were visited. From 31st May to nth June, 1954, the Unit operated in the Health Centre, Pine Street, E.C.I, by kind permission of the Health Committee of the Borough Council. Prior to the visit firms in Finsbury were circulated, with particular concentration upon firms in the northern section of the Borough, as those in the southern area are adequately catered for when the Unit is at 20 Golden Lane, E.C.I. Firms desirous of participating in the Survey were asked to return to the Unit the numbers of their volunteers, when detailed programmes, of appointments were prepared and dispatched to the firms concerned. Nearly 130 firms responded to this circulation with a total aggregate of 2,161 examinees. When appointments were not kept alternative dates were offered whenever possible. General practitioners within the Borough were also circulated. 51 Besides the above circulation, posters were displayed throughout the Borough and several thousand leaflets were distributed to Housing Estates and the General Public. Posters and leaflets drew special attention to the Public Sessions (where no appointments were necessary) for men and women. It must be admitted that the attendances at the Public Sessions were surprisingly low and, therefore, disappointing. All examinees attending Mass Radiography Unit 6D, are notified the result of their examination, but they are asked to bring a stamped addressed envelope for this purpose. The aim of any Mass Radiography Unit is to discover tuberculosis or other chest ailments in the early stages, when they are more easily curable. By the adoption of the appointments system the Unit can examine large numbers with the minimum of inconvenience, and a great saving in examinee's time. The Service is free, reliable and confidential. The Organising Secretary, Mass Radiography Unit, Finsbury Health Centre, Pine Street, London, E.C.I. (Telephone Nos. Terminus 2121, Ext. 92 or TERminus 6184) will be pleased to send full particulars of the Service to interested firms and individuals. 52 APPENDIX "A." List of special reports submitted to the Health Committee by the Medical Officer of Health during 1954:— January 6 Aged Persons—Grants for Meals and Recreation. ,, 6 Transport Organisation—Organisation and Methods. Report. February 3 Census 1951. April 7 Underground Bakehouses—Factories Act 1937. May 12 Conference. "The Care of Old People." Bournemouth, ist April, 1954. June 9 Finsbury Employment Scheme for the Elderly- ,, 9 Report on the Royal Sanitary Institute Congress, Scarborough, 27th—30th April, 1954. October 11 Report on Staff. ,, 11 Aged Persons Holiday Scheme 1954. „ 11 Review of Manual Staff. ,, 11 The Sanitary Inspectors' Conference, 1954— Delegate's Report. November 8 Absences through sickness—Five year period. ,, 8 "Charter for the Aged."