C.I. Ac. 4411 (3) HORNCHURCH HORNCHURCH URBAN DISTRICT COUNCIL S ANNUAL REPORT of the Medical Officer of Health FOR THE YEAR 1931 romford: j. e. castle, printer, market place Langtons, Billet Lane, Hornchurch, 23rd April, 1932. To the Chairman and Members of the Hornchurch Urban District Council Mr. Chairman, Madam and Gentlemen, I have the honour to present herewith my Annual Report for the year 1931, which is drawn up on the lines suggested by the Ministry of Health in circular letter 1206. ALFRED BALL, m.d., d.p.h., Medical Officer of Health. 2 Members of the Hornchurch Urban District Council Chairman: Councillor F. H. R. Davis. Vice-Chairman: Councillor C. L. Parker. Councillors:—Mrs. E. M. Field, Messrs. E. G. Bratchell, F. L J. Cole, J. S. Everson, A. Ferguson, C. J. Fielder, J. W. Mathews, E. T. Potter, W. Stanton, B. L. Tarr. Representatives on the Romford Joint Hospital Board Councillor F. H. R. Davis, ex-offico. „ E. G. Bratchell, ,, F. L. J. Cole. Representatives on the Guardians Committee On the Southern Area Guardians Committee are two members of the Council: Councillor E. G. Bratchell, Chairman of the Committee, appointed by the County Council and Councillor F. L. J. Cole, nominated by the Hornchurch Council. In addition Councillor Bratchell is a member of the Public Assistance Committee. Public Health Officers of the Authority (a) Medical. The Medical Officer of Health holds a combined appointment under three Local Authorities, being the Medical Officer of Health for the Hornchurch Urban District Council, the Romford Urban District Council, and the Romford Rural District Council. (b) Sanitary Inspector. There is one whole time Sanitary Inspector, Mr. H. Bousfield, who holds the Sanitary Inspector's Certificate of the Royal Sanitary Institute. This officer carries out the inspection of meat and other foods, and he is also the Inspector under the Petroleum Act, 1928, and the Shops Acts and Regulations, 1912 to 1930. Statistics and Social Conditions of the Area Area of the District in acres (land and inland water) 6,783 Registrar-General's estimate of resident population, 1931 28,590 Number of inhabited houses (end of 1931) according to Rate books 8,757 Rateable value (September, 1931) £216,618 Sum represented by a Penny Rate (September) £773 3s. 2d. 3 Social Conditions The development of new estates still continues and the District has become mainly residential in character. As most of the houses which are being built are occupied by new comers to the District the population is increasing very rapidly. In the south ward, agriculture, market gardening and other outdoor work are the principal occupations. In the north-west ward many persons are employed in transport undertakings (railway, omnibus, &c.) There are no occupations which have any marked influence on the Public Health. Vital Statistics Extracts from Vital Statistics of the year. M. F. Live births: Legitimate 291 271 Illegitimate 5 9 Birth rate per thousand population 20.1 Still births 6 7 Rate per thousand total (live and stillbirths) births 22.0 Deaths 126 112 Death rate per thousand population 8.4 Percentage of total deaths occurring in public institutions 36% Deaths from diseases and accidents of pregnancy and childbirth: (a)—from Sepsis 1 (b)—from other causes 2 Death rate of infants under one year of age: All infants per thousand live births 62.5 Legitimate Infants per thousand legitimate live births 58.7 Illegitimate infants per thousand Illegitimate live births 214.2 Deaths from Measles (all ages) 0 ,, ,, Whooping cough (all ages) 1 ,, ,, Diarrhœa (under 2 years of age 3 There has been no excessive or unusual mortality during the year. Comparison of certain rates with those of England and Wales, London and the smaller towns. Birth rate. Death rate. Infant Death rate. England and Wales 15.8 12.3 66 London 15.0 12.4 65 Smaller towns (population 20,000—50,000) 15.6 11.3 62 Hornchurch 22.0 8.4 62.5 4 General Provision of Health Services for the Area 1. Nursing in the Home (a) For midwifery and nursing in the homes Local Nursing Associations have maintained two district nurse-midwives, one in the Village and one in Harold Wood, and supplied by the Essex County Nursing Association, to the funds of which the County Council contributes. (b) No home nursing of Infectious cases is provided by the Council. 2. Midwives There are 10 midwives living in and engaged in practice in the District. The Essex County Council is the Local Supervising Authority. 3. Laboratory Facilities Under arrangements made by the Essex County Council sputum, swabs and other pathological material are examined by Dr. Beale, the County Pathologist, at the Laboratories, 96 Queen Victoria Street, London, E.C.4. Reports are sent to the Doctors submitting the sample, and a copy is forwarded to the Medical Officer of Health. Water, milk, and other foodstuffs may also be examined in the Laboratories on the instructions of the Local Council. 4. Legislation in Force For details of the Special Orders, adoptive Acts, and Byelaws in force in the District, see page 5 of the Annual Report for the year 1930. 5. Hospitals There are no hospitals within the area of the Council. The Victoria Cottage Hospital, Romford, is available for persons living in the District. Public Assistance cases are admitted to Oldchurch Hospital, Romford. Infectious Diseases. The Romford Joint Hospital Board, which is the responsible authority, has provided an Isolation Hospital at Rush Green, Romford, containing 150 beds, where cases of Diphtheria, Scarlet Fever, Enteric Fever and other infectious diseases are treated. A resident medical Superintendent was appointed in 1929. 5 Additions to the Hospital which were officially opened on 28th February, 1931, included 98 beds contained in three new wardblocks and a new cubicle block, together with the necessary extensions to the administrative block. An entrance lodge, steam laundry, boiler house, mortuary, and Medical Superintendent's house have also been built as part of the scheme. During the year 38 cases of Scarlet Fever, 49 of Diphtheria and 1 of Puerperal Pyrexia were admitted to the Romford Isolation Hospital from this District. Smallpox. The Romford Joint Hospital Board has an agreement with the West Ham Corporation for the reception and treatment of cases of smallpox. An annual payment is made by the Board to the Corporation based on the total population of the area served by the Joint Hospital Board, and in addition a charge is made for the treatment and maintenance and ambulance expenses of each case. No cases of smallpox occurred during the year. Tuberculosis. The County Medical Officer has kindly supplied the following list of Sanatoria, &c., in which most of the Essex patients are treated:— Institution. Type of Case Treated. Black Notley Sanatorium Women and Children— Pulmonary. Men, Women and Children— Non-pulmonary. Harold Court Sanatorium Men—Pulmonary. High Beech Sanatorium Children—Non-pulmonary. Chingford Sanatorium Women—Pulmonary. Colchester Sanatorium Women—Pulmonary. Ilford Sanatorium Men—Non-pulmonary. Lord Mayor Treloar Cripples' Hospital Children—Non-pulmonary. King George Sanatorium, Bramshott Men—Pulmonary and Non- pulmonary. Burrow Hill Colony, Frimley Boys—Pulmonary. Church Army Sanatorium, Farnham Boys—Pulmonary and Glands. Hawthorndene Sanatorium, I.W. Women—Pulmonary. Liverpool Road Hospital Men—Pulmonary (advanced). 6 Oldchurch Hospital, Romford Men and Women—Pulmonary and Non-pulmonary. Papworth Hall Colony Men—Pulmonary. Preston Hall Colony Men—Pulmonary. Royal National Sanatorium, Ventnor Men and Women—Pulmonary. St. Anthony's Hospital, Cheam Men & Women—Mixed cases. St. Joseph's Hospice, Hackney Men and Women—Pulmonary (advanced). Victoria Park Hospital, London Men, Women and Children— Pulmonary. King Edward VII. Sanatorium, Midhurst Men—Pulmonary. He states that 6 adults and one child were sent to Sanatoria under the County Tuberculosis scheme during the year 1931 from this District. 6. Registered Nursing Homes There are two registered nursing homes in the District. The Essex County Council is the Local Supervising Authority. 7. Institutional Provision The Romford Guardians make provision for unmarried mothers, illegitimate infants, and homeless children at the Institution in Romford. 8. Ambulance Facilities (a) The Romford Joint Hospital Board remove cases of notifiable infectious diseases in their motor ambulance which is stationed at the Hospital, Rush Green- (b) Public Assistance cases are removed to Oldchurch Hospital in a motor ambulance provided for the purpose and kept at the Institution. The Romford Urban District Council maintain a motor ambulance for the removal of non-infectious and accident cases in Romford which may be available for Hornchurch on payment of scale charges. 9. Clinics and Treatment Centres These are provided by the Essex County Council. 7 Sanitary Circumstances of the Area Water The South Essex Waterworks Company maintain a constant supply of water in the populous parts of the District which is satisfactory in quality and has not failed in quantity. Owing to the great increase in the population which they serve the Company are now completing a scheme for obtaining additional supplies of water from the river Stour. A sample of tap water was examined on the 13th May, 1931 by the County Pathologist, and the following report received:— "The water has a good organic quality and from the chemical standpoint wholesome and suitable for drinking and domestic purposes." Drainage, Sewerage, &c. The Council has two sewage disposal works in the District, one on Rainham Road and the other in the valley of the Ingrebourne river. In addition the Romford Urban Council have a disposal works at Bretons Farm, Hornchurch, and the Dagenham Council own the Riverside works in South Hornchurch. Extensions of Sewerage The Surveyor has kindly supplied the following information : New sewers or extensions of existing sewers completed during the year:— SEWERS LAID Soil 12" feet Soil 9" feet Soil 6" feet S.W. 12" feet S.W. 9" feet SW.6" feet Aldborough Road 1,030 1,030 Avenue, The 2,020 2.020 Bedford Gardens 750 750 Belmont Avenue 420 420 Belmont Road 620 620 Beulah Road 470 470 Bowden Drive 200 200 Bruce Avenue 1,920 1,920 Burn Way 500 500 Cedar Road 500 500 Clarence Avenue 650 650 Cranham Road 950 8 Crescent Avenue 550 550 Curtis Road 600 600 Devonshire Road 900 900 Dorrington Gardens 510 510 Gartmoor Avenue 450 450 Glamis Drive 660 660 Glebe Way 350 350 Granton Avenue 950 950 Gt. Gardens Road 400 400 Grey Towers Avenue 650 650 Highfield Road 950 950 Hillview Avenue 700 700 Lewis Road 250 250 Mansfield Road 900 900 Maybrick Road 300 300 New Hall Drive 450 450 Norfolk Road 1,000 1,000 Oak Glen 320 320 Patricia Drive 450 450 Percival Road 670 670 Ravenscourt Drive 400 400 Ravenscourt Grove 950 950 Ringwood Avenue 600 600 St. Georges Ave. 800 800 Sandown Avenue 720 720 Shirley Gardens 650 650 Stanley Road 2,010 2,010 Squirrels Heath Rd. 610 Stafford Avenue 900 900 Victoria Gardens 680 680 Westland Avenue 1,500 1,500 Woodhall Crescent 3,700 3,700 Totals 6" Soil sewers 320 feet 9" Soil sewers 33,060 feet 12" Soil sewers 620 feet 6" Surface-water sewers 320 feet 9" Surface-water sewers 34,620 feet 12" Surface-water sewers 620 feet Extensions and Improvements to Outfall Works No extensions have been made. The underdrains to 3 land beds at the Rainham Road Works have been taken up and relaid. 9 New Streets Streets made up and taken over. feet Globe Road (part) 550 Wren Gardens 258 Haynes Road (part) 1,490 Cromer Road (part) 275 Osborne Road (part) 2470 Wayside Avenue 740 Cavenham Gardens 1,010 Hazelmere Gardens 1,130 Hillcrest Road (part) 1,160 Bush Elm Road 2,030 Hillcrest Road (part) 904 Park Crescent 570 Globe Road (part) 454 Lyndhurst Drive 2,450 Cranham Road 1,120 Kingsley Gardens 840 Haynes Road (part) 690 Total 18,141 feet New Estates which are being developed Hornchurch Hall Estate Crescent Estate Priors Farm Estate Grove Farm Estate Ravenscourt Estate Closet Accommodation Most of the houses in the District are provided with closets connected with sewers including 269 which drain to the Riverside Outfall Works. There are 625 houses which drain to cesspools. Scavenging The collection and disposal of house refuse is carried out under the directions of the Surveyor. The house refuse is removed weekly in horse drawn closed-in vehicles to a tip which is under the control of the Council and where it is covered with earth. The emptying of cesspools is only undertaken by the Council in one area which is remote from any sewer. 10 Sanitary Inspection of the District Report of Sanitary Inspector under Article 19 of the Sanitary Officers' Order, 1926. The following information supplied by the Sanitary Inspector is a classified statement of the number of premises visited, the defects or nuisances discovered, and the action and result of action in regard to these. (a) Nature and Number of Inspections:— Bakehouses 41 Slaughterhouses 88 Cowsheds, Daries, &c. 76 Butchers' Shops 85 Fish Shops 61 Infectious disease enquiries 167 Disinfections 116 Smoke observations (b) Number of Notices served:— Informal 159 Statutory 47 (c) Result of Notices served:— Informal Notices complied with 127 Statutory Notices complied with 36 (d) Outstanding on 31st December, 1931:— Informal Notices 5 Statutory Notices 11 Works completed:— Ditches, ponds and cesspools cleansed 11 Blocked drains cleared 14 New covers and frames provided to inspection and intercepting chambers 4 Accumulations removed 2 Flushing cisterns to W.C.'s repaired or replaced by new ones 15 Walls and ceilings repaired 80 Walls and ceilings cleansed 236 Fireplaces, stoves and coppers repaired or replaced by new ones 47 Cement dishing round gulley traps repaired 11 New locks provided and fixed to doors 4 Dampness abated 39 Yard paving repaired 11 11 Works completed—continued. Fasteners provided to windows 2 Doors repaired or new ones fixed 15 Window sash cords renewed 30 Roofs and gutters repaired 44 Window frames repaired 15 Stairtreads repaired 4 New W.C. pans fixed and seats repaired 5 Dustbins provided 36 Floors repaired 16 Sky-light repaired 1 Water service pipes repaired 1 W.C. basins cleansed 1 Animals discontinued being kept so as to cause a nuisance 1 Rain water guttering cleared and cleansed 1 Waste pipes of scullery sinks repaired 5 Geysers repaired 1 Chimney stacks repaired 1 Drain ventilating pipes repaired or new ones fixed 2 Overcrowding abated 2 Rain water down pipes repaired 1 Slaughter Houses There are 2 registered slaughter houses in the District which are regularly inspected and the animals and carcases examined. 88 visits were paid by the Sanitary Inspector during the year. Offensive Trades The Hornchurch Urban Confirmation Order, 1930, which came into operation on the 24th March, 1930, gave powers to the Council to regulate the trades of a fish frier and of a rag and bone dealer. During the year the Council gave their consent to the establishment of 3 new businesses for the trade of a fish frier There are now 9 persons carrying on this trade in the District. Tents, Vans and Sheds Appropiate action has been taken by the Council to control sheds and hutments. The powers contained in the Byelaws dealing with tents, vans and sheds, are of limited application. There are no underground sleeping rooms, cellar dwellings, or common lodging houses in the District. 12 Cemetery The Council has acquired land adjoining the Church-yard in the Village which will make suitable additional space for the disposal of the dead when it is required. The soil and situation are very suitable for this purpose. There is need for a Public Mortuary in the District. Schools The Sanitary condition of the schools is satisfactory also the water supply which is from the South Essex Waterworks Company. Cases of notifiable infectious diseases occurring amongst school children and any contacts which there may be in the same house are dealt with by exclusion from school, in accordance with the Memorandum on Exclusion from School, 1927. An intimation is sent in every case to the Head Teacher of the school concerned. Futhermore, the names of the children absent from school stated to be suffering from Infectious Disease are reported on Form M. 1. 13, by Head Teachers to the Medical Officer of Health. Rag Flock Act There are no premises in the District on which Rag Flock is manufactured or used. Housing Number of new houses erected during the year (a) Total (including numbers giving seperately under (b) 1,124 (i) By the Local Authority 10 (ii) By other bodies and persons 1,114 (b) With State assistance under the Housing Acts (i) By the Local Authority 10 (ii) By other bodies or persons 0 1. Inspection of dwelling houses during the year:— (1) (a) Total No. of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 459 (b) Number of inspections made for the purpose 1,350 (2) (a) Number of dwelling houses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 154 (b) Number of inspections made for the purpose 593 13 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 154 2. Remedy of defects during the year without service of formal notices:— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 122 3. Action under Statutory Powers during the year:— (a)—Proceedings under sections 17, 18 and 23 of the Housing Act, 1930. (1) Number of dwelling houses in respect of which notices were served requiring repairs 0 (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) By owners 0 (b) By Local Authority in default of owners 0 (b)—Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 33 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) By owners 31 (b) By Local Authority in default of owners 0 (c)—Proceeding under sections 19 and 21 of the Housing Act, 1930:— (1) Number of dwelling houses in respect of which Demolition Orders were made 0 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 0 (d)—Proceedings under section 20 of the Housing Act, 1930:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 0 14 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 0 (e)—Proceedings under section 3 of the Housing Act, 1925:— (1) Number of dwelling houses in respect of which notices were served requiring repairs 0 (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) By owners 0 (b) By Local Authority in default of owners 0 (3) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close 0 (f)—Proceedings under sections 11, 14 and 15 of the Housing Act, 1925:— (1) Number of dwelling houses in respect of which Closing Orders were made 0 (2) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling houses having been rendered fit 0 (3) Number of dwelling houses in respect of which Demolition Orders were made 0 (4) Number of dwelling-houses demolished in pursuance of Demolition Orders 0 Inspection and Supervision of Food. (a) Milk Supply. There are 7 producers of milk in the district. Dairy farms and dairies are inspected frequently in connection with the Milk and Dairies Order, 1926. 23 samples of milk were obtained and submitted to the Counties Laboratory for examination and report on bacterial content and cleanliness. 3 of these were not satisfactory and had to be examined again to obtain a better result. Altogether 15 reports were satisfactory and 8 were not satisfactory. In each case the matter was taken up with the producer. Milk Special Designations Order, 1923. Six firms have been granted licences by the Council to sell graded milks in the district, of which 2 retail Certified Milk, 5 retail Grade A (tt) Milk, 2 Grade A Pasteurised Milk, 1 Grade A Milk, and 3 Pasteurised Milk. 15 (b) Meat. There are two slaughter houses in the district which are visited regularly by the Sanitary Inspector for the purpose of inspection of carcasses. Prevalence of and Control over Infectious Diseases. No cases of Smallpox have occurred in the district. The number of Diphtheria cases was slightly less than last year. All were removed to hospital and recovered. There were also fewer cases of Scarlet Fever and of these 76% were treated in hospital, where ordinary uncomplicated cases were detained for about 4 weeks. There is now accommodation for the treatment of cases of Measles and Whooping Cough which, owing to complications such as Pneumonia, are in need of hospital treatment. No cases of Encephalitis, Malaria, Dysentery, Anthrax, Undulant Fever, or Psittacosis were notified. The Schick test and Dick test have not been employed nor have any artificial methods of immunization against Diphtheria and Scarlet Fever. No vaccinations were performed by the Medical Officer of Health under the Public Health (Smallpox Prevention) Regulations, 1917. 118 throat swabs, 99 specimens of sputum for tuberculosis, two samples of blood for Widal reaction and two specimens of hair for ringworm were examined at the laboratory during the year. These arrangements have proved satisfactory. Cancer. There were 25 deaths from various forms of Cancer. The age groups were:— Years. M. F. 35 — 44 1 3 45 — 64 4 4 65 — 74 4 3 75 — 84 1 5 The sites of the disease were:— Uterus 5 Stomach 7 Oesophagus 2 Lung 1 Pancreas 1 Bronchus 1 Colon 5 Rectum 1 Gall Bladder 1 Spine (Sarcoma) 1 16 There are no facilities in this district for the disinfestation of verminous persons and their belongings. After the removal of cases of notifiable infectious diseases to an Isolation Hospital or at the termination of the illness if the patient is treated at home the sick room is disinfected by the use of a formalin spray. Infected bedding is exposed to the fumes in the room at the same time. Only exceptionally is bedding removed to the Isolation Hospital for steam disinfection. Non-notifiable Infectious Diseases occuring in children. Intimations of non-notifiable infectious diseases occurring amongst children attending the elementary schools are received from the Head Teachers. Notices of the exclusion of contacts of notifiable infectious diseases are sent to the Head Teachers. The dust shoots in the district are periodically gassed in order to destroy rats. The occupants of premises on which rats have appeared are advised as to the appropriate measures to take for their destruction. Incidence of Notifiable Infectious Diseases during the year. Cases Notified. Admitted to Hospital. Total Deaths Smallpox 0 0 0 Scarlet Fever 54 41 1 Diphtheria 50 50 0 Enteric Fever (including Paratyphoid) 2 2 0 Puerperal Fever 1 1 1 Puerperal Pyrexia 2 2 0 Pneumonia 6 1 — Erysipelas 6 2 2 Acute Poliomyelitis 1 1 0 Ophthalmia Neonatorum 0 0 0 Included in the above are 2 cases of Scarlet Fever and 1 of Diphtheria which occurred among the children in the Cottage Homes, and were moved to a London County Council Hospital. Ophthalmia Neonatorum. There was no case of Ophthalmia Neonatorum during the year. 17 Analysis of Cases in stated Age Groups. Year Scarlet Fever Diphtheria Under 1 — 1 1 1 2 2 2 1 3 3 5 4 - — 5—9 27 20 10—14 8 8 15—19 4 1 20—34 5 9 35-44 2 — 45—64 2 3 65 and upwards — — 54 50 Tuberculosis. New Cases Deaths Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary Age periods. M. F. M. F. M. F. M. F. Under 1 2 1 1 2 1 1 5 3 1 10 1 1 15 3 1 1 20 4 4 1 25 4 9 2 1 4 35 4 5 2 1 45 4 3 2 1 1 55 1 65 and over 1 2 Totals 20 23 5 6 8 6 3 3 Public Health (Prevention of Tuberculosis) Regulations, 1925. No action taken. Public Health Act, 1925, Section 62. No action taken. 18 Registrar General's Short Table of Causes of Death. Corrected for inward and outward transfers. The following figures are supplied by the Registrar General. Causes. M. F. 1 Typhoid and paratyphoid fevers 2 Measles 3 Scarlet Fever 1 4 Whooping Cough 1 5 Diphtheria 6 Influenza 3 7 7 Encephalitis 8 Cerebro-spinal fever 9 Tuberculosis of respiratory system 8 6 10 Other tuberculous diseases 3 3 11 Syphilis 1 12 General paralysis of the insane, tabes dorsalis 13 Cancer, malignant disease 9 16 14 Diabetes 1 1 15 Cerebral Haemorrhage, &c. 3 3 16 Heart disease 19 21 17 Aneurysm 1 18 Other circulatory diseases 4 1 19 Bronchitis 2 3 20 Pneumonia (all forms) 9 10 21 Other respiratory diseases 2 3 22 Peptic ulcer 1 23 Diarrhoea, &c. (under 2 years 3 24 Appendicitis 1 25 Cirrhosis of liver 2 26 Other diseases of liver, &c. 2 2 27 Other digestive diseases 4 2 28 Acute and chronic nephritis 7 2 29 Puerperal sepsis 1 30 Other puerperal causes 2 31 Congenital debility, premature birth, malformations, &c. 9 7 32 Senility 6 8 33 Suicide 3 34 Other violence 8 4 35 Other defined diseases 14 8 36 Causes ill-defined or unknown 1 Special Causes (included in No. 35 above):— Smallpox Poliomyelitis Polioencephalitis Total 126 112 19 Deaths in certain Age-groups during the whole year In the following table the deaths are given in stated age-groups. Age No. of Deaths Under 1 year 37 1 and under 2 3 2 ,, ,, 5 4 5 ,, ,, 15 4 15 „ „ 25 7 25 „ „ 35 18 35 „ „ 45 13 45 „ „ 55 18 55 ,, ,, 65 29 65 „ „ 75 47 75 „ upwards 58* Total 238 * Including 11 males and 17 females between 80 and 89 years of age, and 2 males and 1 female of 90 years and over. Infantile Mortality The following table shows the causes of death and the distribution in age groups of the infants who died under one year of age. Ages Under 1 week Prematurity, 2; Injury or lack of attention, 2; Asphyxia, 3. Over 1 week and under 1 month Prematurity, 3; Congenital Malformation, 1; Pneumonia, 1. Over 1 month and under 3 months Prematurity, 1; Cong. Debility, 1; Cong. Malformation, 3; Pneumonia, 1; Gastroenteritis, 1; Erysipelas, 1; Asphyxia, 1. Over 3 months and under 6 months Pneumonia, 2; Influenza, 1; Intussusception, 2; Whooping Cough, 1; Cerebral Diplegia, 1; Syphilis, 1. Over 6 months and under 12 months Pneumonia, 4; Gastro-enteritis, 2; Tuberculous Meningitis, 2. 20 Rainfall during the Year I am indebted to Mr. F. Alderson, the Surveyor, for the subjoined information on the rainfall as recorded at the Sewage Disposal works on the Rainham Road. Total of rainfall in inches No. of days in which rain fell January 1.20 17 February 1.65 20 March 0.20 3 April 3.49 17 May 2.44 13 June 1.18 9 July 2.67 14 August 3.64 16 September 1.22 11 October 0.71 7 November 2.07 14 December 0.57 10 22.04 151 During the year 1930 rain fell on 165 days, the total rainfall being 22.26 inches, and in the year 1929 the corresponding figures were 132 days and 19.07 inches. On the Administration of the Factory and Workshop Act, 1901. 1. Inspection. Inspections. Number of Written Notices. Prosecutions. Premises. Factories 11 0 0 Workshops 33 1 0 Workplaces 3 0 0 Totals 47 1 0 2. Defects. Nuisances under the Public Health Act:— Found. Remedied. Want of cleanliness 1 1 Total 1 1 3. Outwork in unwholesome premises, Section 108.—None.