AC 4411HORNCHURCH Hornchurch Urban District Council. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH 1935. ALFRED BALL, M.D., D.P.H. Medical Officer of Health. Hornchurch Urban District Council. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH 1935. ALFRED BALL, M.D., D.P.H. Medical Officer of Health. W. 4 W Ltd , Romford. 3 COUNCIL OFFICES, HORNCHURCH, Essex. 15th May, 1936. To the Chairman and Members of the Hornchurch Urban District Council. Mr. Chairman, Ladies and Gentlemen, I have the honour herewith to present my Annual Report on the Vital Statistics and Sanitary Circumstances of the District for the year 1935. Estate development is still very active in the District and about 10,670 houses have been built and occupied since Hornchurch obtained Urban powers 10 years ago. Perusal of this report will show that the Public Health is satisfactory and that the District is a healthy one which attracts many new inhabitants. A survey of the houses under the Housing Act, 1935, has shown that there is but little overcrowding. I wish to thank the members of the Council for the support which they have accorded me in my work and to acknowledge the assistance which I have received from my fellow officers. ALFRED BALL, M.D., D.P.H. Medical Officer of Health. 4 MEMBERS OF THE COUNCIL. Councillor F. H. R. Davis, J.P., Chairman. Councillor J. W. Mathews, Vice-Chairman Councillor Mrs. E. M. Field. Mrs. F. Sherring. ,, O. P. W. Ashdown. ,, R. W. Beard, J.P. ,, G. C. Cardnell. ,, A. G. Champion. F. L. J. Cole. ,, F. D. K. Farnan. ,, A. Ferguson. ,, A. C. Holmes. Councillor T. Martin. ,, W. H. F. Maunder. ,, C. L. Parker. ,, E. T. Potter. ,, D. A. Ramsay. ,, B. L. Tarr. ,, H. H. Wake. ,, T. F. Willoughby. ,, J. R. Wren. REPRESENTATIVES OF THE COUNCIL ON THE ROMFORD JOINT HOSPITAL BOARD. Councillor F. H. R. Davis, ex-officio ,, Mrs. F. Sherring. Councillor F. L. J. Cole. ,, D. A. Ramsay. ,, T. F. Willoughby. REPRESENTATIVES OF THE COUNCIL ON THE ROMFORD AND HORNCHURCH JOINT SEWERAGE COMMITTEE. Councillor Mrs. E. M. Field. ,, F. H. R. Davis. ,, F. D. K. Farnan. Councillor J. W. Mathews. ,, J. R. Wren. REPRESENTATIVES OF THE COUNCIL ON THE SOUTHERN AREA GUARDIANS COMMITTEE. Councillor Mrs. F. Sherring. ,, F. L. J. Cole. Councillor A. Ferguson. 5 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area in acres (estimated and subject to revision) 19,082 Registrar-General's estimate of the resident population (mid-year) 1935 59,910 Number of inhabited houses (end of 1935) according to Rate books 18,042 Rateable value (September, J935) £465,690 Sum represented by a Penny Rate (September) £1,762 Social Conditions. The district is, to a great extent, residential in character and numerous building estates which are being developed continue to attract new residents and thus to increase the population by migration. There are, however, still large areas in the District in which market gardening, dairy farming, etc., form the chief industries. There are no conditions of occupation or environment which have had a prejudicial effect on health. Vital Statistics. Extracts from the Vital Statistics for the year. Live Births— Male Female Total Rate Legitimate 510 487 1,023 Illegitimate 14 12 Birth rate per thousand estimated population 17.0 Still Births 24 23 47 Rate per thousand total (live and still) births 43.9 Included in the total still births were 2 illegitimate. Deaths 255 252 507 Death rate per thousand estimated population 8.4 Deaths from puerperal causes— (a) from Puerperal Sepsis 2 (b) from other puerperal causes 3 (c) rate per thousand total live and still births 4.6 6 Death rate of infants under one year of age— All infants per thousand live births 57.4 Legitimate infants per thousand legitimate live births 54.7 Illegitimate infants per thousand illegitimate live births 148.1 Deaths from Measles (all ages) 0 ,, ,, Whooping Cough (all ages) 0 ,, ,, Diarrhoea (under 2 years of age) 4 Note : The population figure used in computing the above rates is that estimated by the Registrar General. Area. The acreage, population, and number of persons per acre as enumerated at the Census of 1931 are set out in the table below. Acreage Persons Persons Males Females per acre Hornchurch— Harold Wood Ward 1,156 1,850 1,920 3.3 North West Ward 1,191 6,210 6,444 10.6 South Ward 2,877 1,939 1,631 1.2 Village Ward 1,559 4,068 4,355 5.4 Cranham 1,879 624 616 0.66 Rainham 3,247 2,005 1,892 1.20 Upminster 3,375 2,622 3,110 1.70 Wennington 1,299 189 170 0.28 *Great Warley 2,889 1,226 1,450 0.93 *Rather more than half of the former parish of Great Warley, consisting mainly of agricultural land, was added to the Urban District of Hornchurch by the Essex Review Order, 1934. Since the 1st April, 1934, the Urban District has been divided into the wards named in the table below, which also shows the number of Local Government Electors on the autumn register. Ward No. of Local Government Electors, October, 1935 No. of Councillors Cranham 1,212 1 Emerson Park 4,539 3 Harold Wood 2,910 2 North West 7,630 5 Rainham 3,109 2 Thameside 1,897 1 Town 6,541 4 Upminster 5,250 3 7 Population. The census population of the different parts was enumerated in the years 1911, 1921 and 1931, as follows:— Year 1911 1921 1931 Cranham 489 519 1,240 Hornchurch 9,461 10,891 28,417 Rainham 1,972 2,196 3,897 Upminster 2,468 3,559 5,732 Wennington 364 432 359 Great Warley 2,051 2,088 2,676 At the 1931 census in the Hornchurch Urban District as then constituted the number of persons enumerated in dwellings occupied by Private families was found to be 96 per cent. of the whole. In addition there were 53 persons (0.2 per cent.) in civilian hospitals; 639 persons (2.2 per cent.) in Poor Law Institutions; and 323 persons (1.1 per cent.) in Air Force premises. In the Romford Rural District 96.5 per cent. of the total census population consisted of private families. Births. The number of births registered in the district during the year was 780. • The figures supplied by the Registrar-General which take into account births during temporary residence of the mother outside the District and therefore included in the Hornchurch figures are :— Males Females Legitimate 510 487 Illegitimate 14 12 The percentage of illegitimate births to the total registered was 2.5. The birth rate calculated on a population of 59,910 is 17.0 per thousand estimated population. A comparison with previous years follows :— 1934 17.6 1929 17.0 1933 18.4 1928 14.9 1932 18.1 1927 16.3 1931 20.1 1926 17.3 1930 16.1 8 Deaths. There were 301 deaths registered in the District during the year, this number including 44 belonging to other districts. The deaths of Hornchurch residents registered as having died mother districts was 250. By subtracting the former and adding the latter a corrected total of 507 deaths is obtained. The figures of Hornchurch residents' deaths which occurred in outside institutions was Oldchurch Hospital, Romford 146 Brentwood and Severalls Mental Hospitals 5 Orsett Institution 13 Other hospitals in Essex 5 Victoria Hospital, Romford 4 Romford Isolation Hospital 9 King George Hospital, Ilford 10 London Hospital 9 Other hospitals in London, etc. 26 Nursing Homes 6 The percentage of deaths of Hornchurch residents occurring in Hospitals or other institutions was 44. The crude death rate calculated on a population of 59,910 was 8.4 per thousand estimated population. A comparison with previous years follows :— 1934 8.4 1929 9.9 1933 7.8 1928 8.4 1932 7.9 1927 9.4 1931 8.4 1926 10.6 1930 8.2 Comparative Mortality after allowing for differences in the Population Constitution. The Registrar-General has supplied a comparability factor by which the crude death rate is to be multiplied in order to give a mortality figure which is strictly comparable with those of other districts to which the same treatment has been applied. The adjusted mortality rate for Hornchurch in the year 1935 thus obtained is 9.3. 9 Deaths Referred to the Coroner. Ruring the year the deaths of 27 male and 17 female persons which occurred in the District were investigated by the Coroner, 34 of them being residents, 8 belonging to other districts and 2 being unknown. In 24 cases an inquest was held. In 12 cases the Coroner certified the cause of death after autopsy and in 8 other cases after inquiry only. The ages at death are shown in the following age-groups :— Age-group Under 1 year Number Age-group Number 6 45 - 54 years 6 1-4 years 1 55 -64 ' „ 5 5-14 „ 2 65 - 74 ,, 4 15-24 ,, 5 75 -84 ,, 7 25 - 34 ,, 2 85 - 94 „ 0 35 - 44 „ ... 6 The deaths which were the subject of an Inquest are classified thus :— Deaths from Violence :— Suicide by coal gas poisoning 7 Suicide by hanging 1 Suicide by jumping from aeroplane 2 Violent deaths of unstated nature (i.e., accidental, suicidal, etc.) — Found drowned 1 Coal gas poisoning 1 Inattention at birth 2 Mechanical suffocation—overlying 1 Accidental injuries by motor vehicles 5 Electric shock—misadventure 1 Deaths from diseased conditions (heart, blood vessels, etc.) 3 Causes of death certified after autopsy :— Heart Disease 7 Cerebral Hæmorrhage 1 Pneumonia 1 Natal Injury 1 Status Lymphaticus 2 Causes of death certified by Coroner after Inquiry:— Heart disease 4 Malignant disease 2 Diseases of the blood vessels 2 10 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 50 1 and under 2 2 2 „ „ 5 10 5 „ „ 15 20 15 ,, ,, 25 17 25 ,, ,, 35 40 35 „ „ 45 52 45 „ „ 55 55 55 ,, ,, 65 66 65 years and upwards 195 Total 507 SENILE DEATHS. The deaths among persons aged 65 years and upwards have been further sub-divided into five-year periods as follows:— Male Female 65 23 20 70 20 27 75 26 21 80 9 27 85 5 10 90 0 6 95 1 0 84 111 MATERNAL MORTALITY. In a table supplied by the Registrar-General, 2 deaths are classed as due to puerperal sepsis and 3 deaths to other puerperal causes. The maternal mortality rate, i.e., the deaths from all puerperal causes, per 1,000 total (live and still) births is 4.67. The corresponding rate in the year 1934 was 6.3; in 1933 it was 1.3; and in 1932 it was 4.7. The maternal mortality rate for England and Wales was 3.93 for the year 1935. 11 The following table shows the causes of death :— Age Cause 24 years 1. (a) Pulmonary embolism, (b) puerperal sapræmia, 2. Obstructed labour. 33 years 1. (a) Heart failure, (b) paralytic ileus, (c) Caesarian section. 34 years 1. (a) Obstetrical shock, (b) post partum hæmorrhage. 36 years 1. (a) Pelvic cellulitis, (b) abortion, (c) acute dicitis. 37 years 1. (a) Pneumonia, (b) ectopic gestation. Three deaths occurred in hospitals and one in a nursing home. INFANTILE DEATHS. During the year 1935 there were 24 male and 26 female deaths of children under one year of age. The infant mortality or rate per 1,000 births was 48; for England and Wales it was 57. The figures for the last 5 years are subjoined. Year No. of deaths under one year Rate 1934 53 57.4 1933 37 51.8 1932 33 53.9 1931 37 62.5 1930 33 72.7 NEONATAL MORTALITY. This term is applied to the deaths of children under one month. There were 31 of such deaths yielding a rate of 30.3 per 1.000 births for the year. Prematurity was responsible for 20 of the total. Of the 19 infantile deaths over 1 month, 6 were due to pneumonia and 4 to debility. The two deaths from inattention at birth were the subjects of inquests on newly-born babies whose bodies were found in the District and whose antecedents could not be traced. It is quite probable that they belonged to other districts. The following table shows the deaths from stated causes at various ages under one year. 12 TABLE—INFANT MORTALITY, 1935. Deaths from stated causes at various ages under one year of age. Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 4 weeks and under 3 months 3 months and under 6 months 6 months and under 9 months 9 months and under 12 months Total Deaths under 1 year Measles Whooping Cough Diphtheria Influenza Tuberculosis Meningitis Convulsions 1 1 Bronchitis Pneumonia 2 2 1 1 6 Diarrhoea and Enteritis 1 1 1 1 3 Congenital Malformation 1 1 1 1 3 Congenital Debility 1 1 3 1 5 Premature Birth 19 1 20 1 21 Injury at Birth 1 1 2 2 Atelectasis 2 2 2 Icterus — Suffocation 1 1 1 Inattention at Birth 2 2 2 Other Causes 1 1 1 1 1 4 13 In the following table the infantile deaths are shown in the different wards; 27 occurred outside the District, most being in hospitals, and these have been allocated to the wards in which the parents resided. Ward Number of deaths In District Outside District. M. F. M. F. Cranham 0 1 0 0 Emerson Park 1 1 4 1 Harold Wood 1 0 2 3 North West 1 3 2 4 Rainham 3 1 0 0 Thameside 3 3 2 1 Town Ward 2 2 3 3 Upminster 0 1 0 2 Deaths from Malignant Disease. There were 70 deaths from carcinoma and other forms of malignant disease : the death rate being 1.1 per thousand population. The ages at death in certain age-groups and the site of the disease are set out below. Years. M. F. 1-14 1 0 15-34 1 1 35-44 0 6 45-54 6 7 55-64 9 8 65-74 3 14 75 -84 4 9 85 and upwards 0 1 24 46 Part affected. N umber. Alimentary tract and glands : M. F. Oesophagus 1 1 Stomach 7 10 Colon 5 4 Capcum 0 1 Bowel 1 1 Rectum 2 2 Gall bladder 0 1 Liver 0 2 Pancreas 0 3 14 Reproductive System and glands : Ovary 2 Uterus 6 Breast 0 10 Respiratory System : Larynx 1 0 Lung 2 1 Miscellaneous: Jaw 1 0 Abdominal 0 1 Prostate 1 0 Rodent ulcer 1 0 Glands of neck 0 1 Sarcoma 2 0 15 VITAL STATISTICS OF WHOLE DISTRICT DURING 1935. Year Population estimated to middle of each year. Births. Total Deaths registered in District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. of Non-residents registered in district. of Residents not registered in district. Under 1 year of age. At all ages. No. Bate. No. Bate. No. Bate per 1,000 Nett Births. No. Rate. 1934 55,798 728 922 17.6 254 4.5 41 231 53 57.4 444 8.4 1935 59,910 780 1023 17.0 301 5.0 44 250 50 48.8 507 8.4 16 BIRTH RATES, DEATH RATES AND ANALYSIS OF MORTALITY. Local figures compared with England and Wales and certain towns. England and Wales London Administrative County. 121 County Boroughs and Great Towns, including London. 140 Smaller Towns (resident populations 25,000-50,000 at 1931 Census). Hornchurch Rates per 1,000 Population. Births:— . Live 14.7 13.3 14.8 14.8 17.0 Still 0.6.2 0.52 0.68 0.64 0.78 Deaths:— All causes 11.7 11.4 11.8 11.2 8.4 Typhoid and Paratyphoid Fevers 0.00 0.00 0.00 0.00 0.00 Smallpox — — — — — Measles 0.03 0.00 0.04 0.03 0.00 Scarlet Fever 0.01 0.01 0.01 0.01 0.00 Whooping Cough 0.04 0.04 0.04 0.03 0.00 Diphtheria 0.08 0.06 0.09 0.07 0.13 Influenza 0.18 0.11 0.16 0.17 0.11 Violence 0.52 0.51 0.45 0.41 0.55 Notifications:— Smallpox — — — — — Scarlet Fever 2.96 2.64 3.19 2.75 3.5 Diphtheria 1.60 2.25 1.96 1.34 1.9 Enteric Fever 0.04 0.05 0.04 0.06 0.05 Erysipelas 0.42 0.45 0.48 0.37 0.31 Pneumonia- 1.15 0.89 1.36 0.98 0.60 17 REGISTRAR-GENERAL'S ABRIDGED LIST OF CAUSES. These figures are corrected for outward and inward transfers. Causes of Death M. F. All causes 255 252 1. Typhoid and paratyphoid fevers 0 0 2. Measles 0 0 3. Scarlet Fever 0 0 4. Whooping cough 0 0 5. Diphtheria 5 3 6. Influenza 5 2 7. Encephalitis lethargica 0 0 8. Cerebro-spinal fever 0 0 9. Tuberculosis of respiratory system 21 16 10. Other tuberculous diseases 4 1 11. Syphilis 0 0 12. General paralysis of the insane, tabes dorsalis 0 1 13. Cancer, malignant disease 24 46 14. Diabetes 1 3 15. Cerebral hæmorrhage, etc. 5 18 16. Heart disease 69 63 17. Aneurysm 1 0 18. Other circulatory diseases 8 8 19. Bronchitis 2 3 20. Pneumonia (all forms) 19 11 21. Other respiratory diseases 3 1 22. Peptic ulcer 2 1 23. Diarrhoea, etc. (under 2 years) 3 1 24. Appendicitis 2 1 25. Cirrhosis of liver 0 1 26. Other diseases of liver, etc. 0 4 27. Other digestive diseases 3 5 28. Acute and chronic nephritis 5 4 29. Puerperal sepsis 2 30. Other puerperal causes 3 31. Congenital debility, premature birth, malformations, etc. 15 19 32. Senility 6 6 33. Suicide 3 7 34. Other violence 19 4 35. Other defined diseases 30 17 36. Causes ill-defined or unknown 0 1 18 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 1. Officers of the Public Health Department. MEDICAL OFFICER OF HEALTH. (Wholetime in Hornchurch since 1st October, 1934) Alfred Ball, M.D., B.S. (Lond.), M.R.C.S. (Eng.), L.R.C.P. (Lond.), D.P.H. (R.C.P.iS.) Lond. SANITARY INSPECTORS. H. Bousfield, San. Insp. Certif. R. San. Institute. L. Acer, Assoc. Royal San. Institute. E. H. Lloyd, ISan. Insp. Certif. R.S.I. & S.I. Joint Board. INSPECTOR FOR SHOPS ACTS, 1912-1934. C. S. Smith, San. Insp. Certif. R.S.I. & S.I. Joint Board. CLERK. J. Blay. 2. Laboratory Facilities. Under arrangements made by the Essex County Council, sputum, swabs and other pathological material are examined by Dr. J. F. Beale, the County Pathologist, at the Laboratories, 91 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. The pathological specimens examined by the County Bacteriologist during the year included :— 350 throat swabs (43 positive, 307 negative). 20 nasal swabs (4 positive, 16 negative). 179 sputum for tubercle bacilli (50 positive, 129 negative). 2 samples of blood for Widal test (both negative). 6 urine. 4 hair for ringworm. 5 miscellaneous. 19 3. Ambulance Facilities. (i) The Council have purchased at a cost of £648 a 17.9 h.p. Talbot six-cylinder motor ambulance, which is kept at the Fire Station, Billet Lane, Hornchurch, and has been in use since the 25th October, 1935. From that date until the 31st December, 1935, 66 calls were received and a total of 841 miles was run. The nature of the cases was :— Accidents 25 Illness 22 Removals 13 Not required or refused 6 66 Origin of calls. Of the total calls 23 were made by the police, 5 by the employers of the injured person, 3 by unknown persons, and in nearly all the remainder by a relative of the patient. Destination. The following table shows the number and the hospitals to which the cases were removed :— Oldchurch Hospital, Romford 26 King George Hospital, llford 10 Victoria Hospital, Romford 4 Queen Mary's Hospital, Stratford 2 London Hospital 1 St. Bartholomew's Hospital 1 Metropolitan Hospital 1 Queen Charlotte's Hospital Fast Fnd Maternity Hosnital 1 1 In addition 4 cases were removed from Hospitals and there were 9 other removals. Incidence of calls. Calls per day. 0 23 1 32 2 8 3 3 4 1 5 1 Times at which calls came. 6 a.m. to 6 p.m. 48 6 p.m. to 6 a.m. 18 20 Summary of calls. October (part) 6 November 29 December 31 In addition 39 cases belonging to Hornchurch (including 30 accident and 8 illness) were removed by the Dagenham ambulances running 580 miles, also 23 cases (including 13 accident and 8 illness) were removed by the Romford ambulance running 217 miles. The motor ambulance maintained by the Upminster and Hornchurch Division of the Essex Branch of the St. John Ambulance Brigade has continued to serve the district during the year and the Hon. Treasurer has kindly supplied the following figures relating to cases dealt with by them : Accident cases removed 41 Transport and others 83 124 Mileage 2,308 (ii) Public Assistance cases are removed to Oldchurch Hospital by motor ambulances provided for the purpose and kept at the institution. (iii) The Romford Joint Hospital Board remove cases of notifiable infectious diseases by motor ambulances which are stationed at the Hospital, Rush Green. 4. Nursing in the Home. Local Nursing Associations are established in the following centres.— Hornchurch, Rainham and Wennington, Upminster and Cranham. The local associations are affiliated to the Essex County Nursing Association. 5. Clinics and Treatment Centres. The County Council is the Local Authority for Maternity and Child Welfare and for the medical services among school children. NURSING AND MATERNITY HOMES. There are 7 registered Nursing and Maternity Homes in the District. MIDWIVES. The number of midwives practising in the District, some of whom live just outside, is 25, 21 6. Hospitals. INFECTIOUS DISEASES. The Romford Joint Hospital District was constituted in the year 1899. It includes the Urban Districts of Hornchurch, Dagenham and Romford. The Joint Hospital Board consists of 4 elected representatives from Hornchurch, 5 from Dagenham and 3 from Romford and in addition the Chairman of each District is ex-officio a member. The Hospital Board has provided an Isolation Hospital at Rush Green containing approximately 150 beds. A scheme has been adopted to provide additional beds, which are urgently required, also a new Nurses' Home, extensions to the boiler house, etc. These buildings are now in course of construction. During the year 260 patients were admitted to the Isolation Hospital from this District, including 114 cases of Diphtheria, 119 cases of Scarlet Fever, 1 case of Meningitis, 1 case of Measles, 2 cases of Pneumonia, 3 cases of Erysipelas, 3 cases of Enteric Fever, 1 case of Ophthalmia Neonatorum, 1 case of Pemphigus, 1 case of Pyrexia, 1 case of Peurperal Septicaemia, 1 case of Puerperal Fever and 12 others. In addition 2 cases of Diphtheria and 34 cases of Scarlet Fever were sent for treatment to the London Fever Hospital or to London County Council Fever Hospitals, owing to lack of accommodation in the Romford Isolation Hospital. SMALLPOX. The Romford Joint Hospital Board has an agreement by which cases of Smallpox may be sent for isolation and treatment to the Orsett Smallpox Hospital. The Board paid the sum of £99 as a retaining fee during the last financial year. No case of Smallpox occurred in this District during the year. 7. Legislation.. For a list of Byelaws and adoptive Acts in force in the District see report of the Medical Officer of Health for 1934. New Byelaws with respect to Camping Grounds and Moveable Dwellings were made on 11th June, 1935. Public Health Acts Amendment Act, 1907, sections 47 and 48 and part VI and the Public Health Act, 1925, part VI were adopted during the year. 22 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. Water. The South Essex Waterworks Company provide a constant supply of water which is satisfactory in quality and has been equal to all demands made on the Company. Sewerage and Sewerage Disposal. During the year the works of major importance which have been in course of construction have been 1. Ingrebourne valley sewer. 2. Ravensbourne valley sewer. 3. New tanks, filter beds, etc., at Bretons Farm Sewage Works. The Romford and Hornchurch Joint Sewerage Committee consisting of five members from each District was established in January, 1934. This Committee exercises the functions of a Local Authority relating to the management and control of the disposal of sewage and the common sewers upon the terms and conditions described in the Agreement. It controls the main sewers referred to above and also a 48in. sewer and an 18in. sewer constructed some years ago. When the extensions to the Outfall works at Bretons Farm have been completed and the Ravensbourne and Ingrebourne sewers constructed and connected, the Harold Wood, Upminster, and Rainham Road works will be abolished. Almost the whole of Hornchurch will then be served by two Disposal Works situated in the District, viz. : Bretons Farm, draining the western portion and the Eastern Outfall Works at Berry Farm, draining the remainder. BRANCH SEWERS. The Surveyor has kindly supplied the following list of new sewers or extensions of existing sewers completed during the year; 23 Road s.w. 18in. dia. Soil 12in. dia s.w. 12in. dia. Soil . 9in. dia. S.W. 9in. dia. ft. ft. ft. ft. ft. Redden Court 415 1830 860 1889 Park Lane Curtis Road 146 M aylands 248 1319 1713 Hardley Green Terrace 300 Macdonald Avenue 100 Buttons Lane 501 507 Mellon Gardens 204 Randalls Drive 920 600 Cherry Tree Close 760 1031 Recreation Avenue 610 600 Cotswold Road 140 130 Kent Drive 300 300 Gainsborough Road 470 475 Cautelupe Road 180 Ravenscourt Drive 300 300 Osborne Close 193 218 Road 2, H acton Farm Estate 585 576 Haynes Road 606 608 Dagenham Road 1150 204 663 1830 9194 9193 Miles .038 .125 .308 1.741 1.741 Total 3.875 miles. New Streets—Made Up and Taken Over. Street Length ft. Street Length ft. Church Road 1,150 Bruce Avenue 1,893 The Avenue 2,440 Abbs Cross Gardens 325 Cranham Road (Pt. 2) 660 Norfolk Road 1,220 Woodhall Crescent 1,192 Belmont Road 450 Beverley Gardens 1,052 Clarence Avenue 674 St. George's Avenue 803 Birch Crescent 500 Curtis Road 988 Maple Avenue 790 Manser Road 1,442 Church View 320 Helen Road 820 Hill Rise 430 Ashlyn Grove 496 Grenfell Avenue 1,488 Hazel Rise 610 Cedar Road 440 Percival Road 648 Oak Avenue 452 Lewis Road 297 Beulah Road 550 Total 22,130 = 4.191 miles, 24 Rivers. No action was taken. Closet Accommodation. Most of the houses are provided with water-closets connected with sewers. Public Cleansing. The collection and disposal of house refuse are carried out under the direction of the Surveyor. A fleet of 6 S.D. Freighters was purchased and put into commission as from 1st April, 1935, and the whole system of collection was reorganised. The whole of the refuse is disposed of by controlled tipping on a site in the southern part of the District which is rented by the Council. Shops Act, 1912-1934. There were 746 shops on the register at the end of 1935; in 37 shops there were changes of tenancy, and 11 premises were closed. All the shops were inspected during the year, and the proprietors advised and instructed as to the provisions of the various Acts now in force. In shops where assistants are employed, the Shops Act, 1934, is operative, especially with regard to assistants under the age of 18, and in these cases particulars have been obtained as to the number and sex of assistants, and the number of hours during which they are employed. In all shops where junior assistants are employed, the necessary forms as prescribed by the Shops Act, 1934, are exhibited, and the provisions contained therein are being satisfactorily complied with. Attention has also been given to the facilities afforded to the assistants with regard to sanitary and washing accommodation, and the general sanitary condition of the shops. Evening Closing Hours. Inspections have been carried out during the year in order to enforce, where necessary, the provisions of the Shops (Hours of Closing) Act, 1928. In various instances it has been found necessary to acquaint proprietors of shops of their obligations under this Act, and warnings have been issued in cases found to be exceeding the legal hour. No legal proceedings were taken during the year. 25 Mortuary. The Council provided a mortuary situated in Billet Lane, in the year 1934. This has been used for the reception of dead bodies and the police are in possession of a key. During the year 20 bodies were deposited in it. Sanitary Inspection of the District. Report of the Sanitary Inspectors under Article 19 of the Sanitary Officers' Order, 1926. The following information supplied by the Sanitary Inspectors 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 33 Slaughterhouses 557 Cowsheds, Dairies, etc. 345 Butchers' Shops 142 Fish Shops 66 Infectious disease enquiries 490 Disinfections 340 Workshops (including Factories and Workplaces) 177 Public House Urinals 8 Refuse tips 90 Ice Cream dealers' premises 31 Watercourses 39 Camping sites 20 Other 663 (B) NUMBER OF NOTICES SERVED:— Informal 406 Statutory 44 (C) RESULT OF NOTICES SERVED:— Informal notices complied with 301 Statutory notices complied with 37 (D) OUTSTANDING ON 31st DECEMBER, 1935:— Informal notices 77 Statutory notices 7 Works Completed. WATER CLOSETS:— W.C. flushing cisterns repaired or replaced by new ones 19 W.C.'s renewed 12 W.C.'s repaired 22 Light and ventilation provided to W.C. apartments 1 26 DRAINAGE:— Blocked drains cleared 30 New drains laid and drains relaid and repaired 30 Gullies repaired 28 Sinks and waste pipes repaired or new ones fixed 22 New inspection chambers provided 2 New covers and frames to inspection chambers provided 1 Cesspools emptied 18 GENERAL REPAIRS, ETC.:— Brickwork repointed and walls repaired 61 Roofs, gutters and downspouts repaired or renewed 111 Yards paved and paving repaired 38 Windows and doors repaired or renewed 203 Floors repaired or relaid 23 Airbricks cleared or new ones provided 18 New doorsteps provided 13 Fireplaces, stoves and coppers repaired or renewed 46 Walls and ceilings cleansed and distempered or papered 202 Walls and ceilings repaired 124 Sashcords renewed 60 Dustbins provided 200 Water supply provided and service pipes, etc. repaired 14 Food stores provided and light and ventilation provided to existing food stores 17 Dampness abated 40 Overcrowding abated 2 Staircases repaired 3 Ditches cleansed 5 Accumulations of refuse removed 15 Miscellaneous works carried out 18 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. Furthermore, the names of the children absent from school stated to be suffering from Infectious Disease are reported on Form M.I. 13, by Head Teachers to the Medical Officer of Health. There are 20 schools or separate departments of schools in the District, which are provided by the Essex County Council; also two non-provided schools. 27 SECTION D HOUSING. 1. Number of New Houses Erected During the Year. (i) By the Local Authority 6 (ii) By other Local Authorities 0 (iii) By other bodies or persons 1,441 Total 1,447 2. Inspection of Dwelling Houses during the Year— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,199 (b) Number of inspections made for the purpose 2,690 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 483 (b) Number of inspections made for the purpose 1,639 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 11 (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 402 3. 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 183 4. 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:— By owners 0 By local authority in default of owners 0 28 B. Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 23 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 15 (b) By local authority in default of owners 3 C. Proceedings under sections 19 and 21 of the Housing Act, 1930:— (1) Number of dwelling-houses in respect of which Demolition Orders were made 6 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 9 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 (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 5. Demolished voluntarily in lieu of formal action under Housing Acts 3 29 SECTION E. SUPERVISION AND INSPECTION OF FOOD. 1. Milk Production. There are 19 herds of milch cattle in the District, on farms which are registered under .the Milk and Dairies Order, 1926 These farms are all inspected from time to time and samples of milk are taken by the Sanitary Inspectors for examination as to cleanliness and bacterial content by the County Bacteriologist. A list of the dairy farms showing at which of them the producers holds a licence issued by the County Council to produce Grade A milk under the Accredited Milk Scheme is set out in the following table:— Farm Ward No. of milch cattle Source of water supply to dairy Production of Grade A Milk 1. Cranham 58 S.E. Waterworks — 2. Cranham 16 S.E. Waterworks Yes:under licence of E.C.C. 3. Cranham 36 S.E. Waterworks Yes:under licence of E.C.C. 4. Cranham 22 S.E. Waterworks — 5. Cranham 44 S.E. Waterworks Yes:under licence of E.C.C. 6. Cranham 29 S.E. Waterworks Yes:under licence of E.C.C. 7. Harold Wood 24 S.E. Waterworks Yes:under licence of E.C.C. 8. Harold Wood 5 S.E. Waterworks — 9. Harold Wood 5 S.E. Waterworks — 10. Harold Wood 70 S.E. Waterworks — 11. Harold Wood 65 S.E. Waterworks Yes:under licence of E.C.C. 12. Harold Wood 2 S.E. Waterworks — 13. Harold Wood 13 S.E. Waterworks — 14. Rainham 29 S.E. Waterworks and well water Yes:under licence of E.C.C. 15. Rainham 40 Well water — 16. Rainham 52 S.E. Waterworks — 17. Rainham 40 S.E. Waterworks and well water — 18. Other 33 S.E. Waterworks Yes:under licence of E.C.C. 19. Other 36 S.E. Waterworks — The Milk (Special Designations) Order, 1923, requires that Grade A Milk as retailed shall contain not more than 200,000 bacteria per cubic centimetre and no coliform bacillus in one hundredth of a cubic centimetre. 30 Milk Retailers. There are 22 milk retailers with registered premises in the District, including 8 producers who are registered both as producers and retailers. In addition there are 20 persons registered as milk retailers in Horn church, but whose premises are registered in neighbouring districts. Milk (Special Designations) Order, 1923. The following licences were issued during the year:— Certified milk 2 Grade A (Pasteurised) milk 2 Grade A (Tuberculin Tested) milk 14 Grade A milk 1 Pasteurised milk 14 In addition 15 supplementary licences, 8 for Grade A (Tuberculin Tested) milk, 6 for Pasteurised milk, and 1 for Grade A milk were issued. these being licences required by retailers who hold principal licences in another district and wish to sell the milk in this district from premises elsewhere. Milk Sampling. During the year, 76 samples of milk were examined for cleanliness and bacterial content by the County Bacteriologist. They included 32 samples of graded milk, 26 of which were satisfactory, and 44 samples of raw milk, of which 30 were satisfactory. An excerpt from the report on each sample is given below. Grade of Milk. Number of Bacteria. Presence of B. Coli. Remarks. 1. Pasteurised 9.800 Absent in 1 c.c. Satisfactory. 2. ,, 5,500 Absent in 1 c.c. ,, 3. ,, 240,000 Present in 0.001 c.c. Unsatisfactory. 4. ,, 16,000 Present in 1 c.c. Satisfactory. 5. ,, 15,000 Absent in 1 c.c. ,, 6. ,, 192,000 Present in 0.001 c.c. Unsatisfactory. 7. ,, 2,900 Absent in 1 c.c. Satisfactory. 8. ,, 3,500 Absent in 1 c.c. ,, 9. ,, 53,000 Present in 0.001 c.c. Unsatisfactory. 10. ,, 1,500 Absent in 1 c.c. Satisfactory. 11. ,, 54,000 Present in 0.001 c.c. Unsatisfactory. 12. ,, 13,000 Present in 1 c.c. Satisfactory. 13. ,, 25,000 Absent in 1 c.c. ,, 14. ,, 6,100 Absent in 1 c.c. ,, 15. ,, 11,000 Present in 0.01 c.c. ,, 16. ,, 120,000 Present in 0.001 c.c. Unsatisfactory. 31 Grade of Milk. Number of Bacteria. Presence of B. Coli. Remarks. 17. Pasteurised 14,000 Absent in 1 c.c. Satisfactory. 18. ,, 18,000 Present in 0.1 c.c. ,, 19. ,, 38,000 Present in 0.01 c.c. ,, 20. ,, 12,000 Absent in 1 c.c. ,, 21. ,, 3,600 Absent in 1 c.c. ,, 22. ,, 3,800 Absent in 1 c.c. ,, 23. ,, 30,000 Absent in 1 c.c. ,, 24. ,, 6,000 Absent in 0.1 c.c. ,, 25. ,, 7,200 Absent in 0.1 c.c. ,, 26. Grade "A" 130,000 Present in 0.001 c.c. Unsatisfactory. 27. ,, 2,650 Absent in 1 c.c. Satisfactory. 28. ,, 3,900 Absent in 1 c.c. „ 29. Grade "A" (T.T.) 4,700 Absent in 1 c.c. ,, 30. ,, 11,000 Absent in 1 c.c. ,, 31. ,, 950 Absent in 0.01 c.c. ,, 32. Grade "A" Pasteurised 1,080 Absent in 1 c.c. ,, 33. Ungraded 9,800 Absent in 1 c.c. ,, 34. ,, 17,000 Present in 1 c.c. Excess of cells microscopically. 35. ,, 21,000 Present in 1 c.c. Satisfactory. 36. ,, 24,000 Present in 1 c.c. „ 37. ,, 32.000 Present in 0.01 c.c. ,, 38. ,, 264,000 Present in 0.001 c.c. Unsatisfactory. 39. ,, 23,000 Present in 0.1 c.c. Satisfactory. 40. ,, 11,000 Present in 1 c.c. ,, 41. ,, 8,000 Absent in 1 c.c. ,, 42. ,, 18,000 Present in 0.1 c.c. ,, 43. ,, 32,000 Present in 0.001 c.c. Unsatisfactory. 44. ,, 650,000 Present in 0.0001 c.c. ,, 45. ,, 36,000 Present in 0.01 c.m. Excess of cells microscopically. 46. ,, 24,000 Present in 0.01 c.c. Unsatisfactory. 47. ,, 19,500 Present in 0.01 c.c. Satisfactory. 48. ,, 43,000 Absent in 1 c.c. ,, 49. ,, 78,000 Absent in 1 c.c. Excess of cells microscopically. 50. ,, 6,200 Absent in 1 c.c. Satisfactory. 51. ,, 15,000 Present in 0.1 c.c. ,, 52. ,, 42,000 Absent in 1 c.c. Excess of cells microscopically. 53. ,. 48,000 Present in 0.01 c.c. Satisfactory. 54. ,, 17,400 Absent in 1 c.c. ,, 55. ,, 14,400 Absent in 1 c.c. Excess of cells microscopically. 56. ,, 16,500 Present in 1 c.c. Satisfactory. 32 Grade of Milk. Number of Bacteria. Presence of B. Coli. Remarks. 57. Ungraded 480,000 Present in 0.0001 c.c. Unsatisfactory. 58. ,, 110,000 Present in 0.1 c.c. Satisfactory. 59. ,, 360,000 Present in 0.01 c.c. ,, 60. ,, 360,000 Present in 0.001 c.c. Unsatisfactory. 61. ,, 14,000 Absent in 1 c.c. Satisfactory. 6*2. ,, 12,000 Present in 1 c.c. „ 63. ,, 86,000 Present in 0.1 c.c. ,, 64. ,, 42,000 Present in 0.01 c.c. ,, 65. ,, 34,000 Present in 0.01 c.c. Excess of cells microscopically. 66. ,, 70,000 Present in 0.01 c.c. Satisfactory. 67. ,, 21,000 Present in 0.01 c.c. ,, 68. ,, 11,000 Absent in 1 c.c. ,, 69. ,, 12,000 Present in 1 c.c. ,, 70. ,, 30,000 Present in 1 c.c. ,, 71. ,, 48,000 Present in 0.1 c.c. Excess of cells microscopically. 72. ,, 54,000 Present in 0.001 c.c. Unsatisfactory. 73. ,, 40,000 Present in 0.1 c.c. Satisfactory. 74. ,, 2,600 Absent in 1 c.c. ,, 75. ,, 12,000 Present in 0.01 c.c. ,, 76. ,, 13,000 Present in 0.01 c.c. ,, Graded Milk 32. 26 satisfactory. 6 unsatisfactory. Ungraded Milk. 44. 30 satisfactory. 7 unsatisfactory. and 7 count satisfactory but microscopically there was an excessive number of cells. When an unsatisfactory report is received the retailer is cautioned and investigations are made with a view to obtaining better results. Milk and Dairies (Consolidation)) Act, 1915. The County Medical Officer states that two samples of milk produced on farms, and seven other samples of milk taken in schools to which it had been supplied under the Milk-in-schools Scheme were submitted to the biological test during the year. In every instance the report was negative, i.e., satisfactory. 2. ICE CREAM. Essex County Council Act, 1935. Part XI. Ice cream vendors or manufacturers are required to be registered by the local Council under section 158 of the Act which was adopted by the Council by resolution on 20th February, 1934, and came into force three months later. During the year 37 applications for registration were granted. At the end of the year 78 persons were registered as vendors in the District and 1 as a wholesale manufacturer only. 33 3. Meat. There are 6 slaughterhouses, 4 registered and 2 licensed, which are visited regularly by the Sanitary Inspectors and the carcases inspected. Carcases and viscera inspected during the year:— Cattle 524 Pigs 958 Sheep and lambs 3,086 The following table shows the meat or viscera which being found upon inspection to be unfit for human food was surrendered and destroyed:— Bovines— No. Beasts' carcases and organs 2 Calfs' carcases: and organs 4 Heads 36 Livers 49 Pluck 3 Hearts 2 Kidney 1 Lungs 49 Brisket 3 Foreribs 1 Flank 1 Side 1 Leg 1 Beef, 69lbs. Pigs- Carcases 3 Heads 12 Pluck 4 Mesentery 1 Sheep— Carcases 11 Livers 19 Legs 2 SLAUGHTER OF ANIMALS ACT, 1933. In September, 1934, the Council resolved that section 1 of this Act shall apply to all bovines including sheep and lambs. This Act requires animals to be stunned or slaughtered by a mechanically operated instrument so that they shall be rendered insensible to pain until death occurs. It is now necessary for all slaughtermen to be registered by the Council under section 3 of the Act. 15 applications for licences under the Act were received during the year and all were granted. Meat Traders. There are 45 Butchers' shops in the District which are inspected by the Sanitary Inspectors. 34 SECTION F. PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASE. Scarlet Fever. 216 case of Scarlet Fever giving a rate of 3.5 per 1.000 of the population were notified as compared with 226 and a rate of 4.3 in 1934 and 209 and a rate of 5.4 in the year 1933. The case rate in England and Wales was 2.96. Most of the cases were mild in character. There were no deaths. 153 cases were admitted to hospital including 119 to Rush Green where the uncomplicated cases were detained in hospital about 28 days. Antiscarlet serum was administered to all severe cases and to other cases admitted early in the disease. Diphtheria. The number of cases of Diphtheria notified was 119 giving a rate of 1.9 per 1,000 of the population. The case rate in England and Wales was 1.6. In the year 1934 there were 158 cases and a case rate of 3.02 per 1,000. There were 8 deaths from this disease as follows:— Sex. Ages in years. Male 2, 3, 5, 5, 9. Female 5, 8, 13. The cases notified in each ward during each month of the year are shown in the following table:— 35 TABLE SHOWING SCARLET FEVER AND DIPHTHERIA CASES OCCURRING IN EACH MONTH. Total Cranham. Emerson Park Harold Wood North-West Rainham Thameside Town Upminster S.F. Diph. S.F. Diph. S.F. Diph. S.F. Diph. S.F. Diph. S.F. Diph. S.F. Diph. S.F. Diph. S.F. Diph. January 14 11 2 2 5 2 6 1 1 6 February 13 19 7 1 2 5 4 3 2 2 5 1 March 7 4 3 2 2 1 3 April 21 17 1 1 3 3 2 4 8 1 11 4 May 17 4 5 1 2 2 1 1 3 6 June 12 10 2 1 4 2 2 3 2 1 1 1 July 19 6 3 2 2 1 3 1 7 1 5 August 14 4 2 1 1 2 2 2 6 1 1 September 21 7 2 1 4 1 2 3 11 1 2 1 October 33 8 2 3 1 5 5 1 1 2 18 3 November 18 21 2 1 3 3 1 1 10 8 7 3 December 27 11 3 2 4 4 1 1 4 11 2 6 216 119 14 10 22 5 13 8 38 26 18 17 6 24 77 27 28 2 36 IMMUNISATION AGAINST DIPHTHERIA. Active immunisation against Diphtheria was carried out during the year amongst the younger children attending Public Elementary Schools. Eleven schools or Departments of schools including seven of the Infants' and Junior Mixed schools or Departments of schools in the District were visited and the parents of the children circularised, those who were desirous of having their children immunised being asked to sign a consent form and to return it to the Head Teacher. The Essex County Council which is the Education Authority in Hornchurch signified their approval of this work and allowed the use of the Treatment centres and other premises. I am much indebted to the County Medical Officer who assisted very considerably by arranging that I should have the services of the School Nurses and Health Visitors during the time that the treatment was being carried out and to the Head Teachers who granted facilities and helped very materially by assembling the children and in many other ways. In communications addressed to parents emphasis was laid on the greater importance of the treatment amongst the young children but the scheme included children of all ages, consequently mothers were invited to bring children under school age also the brothers and sisters, if any, in the Senior Departments. In the following table are set out the number of children attending Infants' and other schools together with the number of acceptances. Children attending Senior schools who accompanied and were treated at the same time as their young brothers and sisters are not included. School. Approximate No. on Rolls. No. of acceptances. 1. Junior Mixed and Infants' 565 190 2. Infants' Department 340 175 3. Junior Mixed and Infants' 425 251 4. Junior Mixed Department 549 161 5. Infants' Department 266 97 6. Mixed 187 94 7. Mixed 130 41 8. Junior Mixed and Infants' 447 132 9. Junior Mixed and Infants' 329 187 10. Boys' Department 628 165 11. Girls' Department 619 132 37 In the following table are shown the numbers of persons treated, also those Schick tested before and after treatment. The adults who were treated were almost all teachers in the Infants' Departments. YEAR 1935. Immunisation against Diphtheria. 1. Primary Schick test. Result. No. tested. Negative. Positive. Adults 26 13 13 School children 860 231 629 Children under 5 years of age 0 0 0 TOTAL 886 244 642 Measles and Whooping cough. During the year the incidence of Measles and Whooping Cough was light, few cases being reported1 by Head Teachers to have occurred amongst school children. There were no deaths in the District from these diseases. 2 cases were admitted to hospital. Ophthalmia Neonatorum. Two cases of Opthalmia Neonatorum were notified and were treated in hospital. Both recovered with no scarring of the cornea. Public Health Act, 1925. No action was taken during the year under section 66 of this Act. 2. Number treated. Completed. Incomplete. Adults 11 2 School children 1403 94 Pre-school children 260 29 TOTAL 1674 125 3. Schick tested after treatment. No. tested. Result. Negative. Positive. Adults 3 3 0 School children 273 256 17 Pre-school children 23 23 0 TOTAL 299 282 17 38 TABLE SHOWING THE CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1935. NOTIFIABLE DISEASE Total Number of cases notified in age-groups. Total cases notified in each Ward. No. removed to Hospital Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Cranham Emerson Park Harold Wood North-West Rainham Thameside Town Upmin8ter Smallpox 0 0 Scarlet Fever 216 0 46 139 12 17 1 1 14 22 13 38 18 6 77 28 153 Diphtheria 119 1 16 80 11 10 1 0 10 5 8 26 17 24 27 2 116 Enteric Fever 3 1 2 1 1 1 3 (with Paratyphoid) Puerperal Fever 6 2 4 1 2 3 4 Puerperal Pyrexia 6 2 4 1 2 2 1 1 Pneumonia 37 1 11 6 2 10 4 3 0 2 2 11 12 2 8 0 9 Erysipelas 19 1 0 3 1 7 5 2 0 3 2 1 4 0 6 3 8 Ophthalmia Neonatorum 2 2 1 1 2 39 Tuberculosis. The notifications of cases of Tuberculosis included 42 males and 25 females suffering from Pulmonary, and 13 males and 6 females suffering from Non-Pulmonary forms of the disease. The 42 deaths included those of 5 pulmonary and 2 non-pulmonary cases which were not notified. New cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. Age periods. Under M. F. M. F. M. F. M F. 1 1 3 1 5 2 4 2 1 15 8 4 3 1 3 3 1 25 11 12 2 1 6 6 1 35 11 6 1 6 4 45 8 1 3 4 1 55 4 1 3 65 42 25 13 6 21 17 4 No action was taken under the Public Health (Prevention of Tuberculosis) Regulations, 1925, or under section 62 of the Public Health Act, 1925 (relating to the compulsory removal to hospital of persons suffering from Tuberculosis). 40 SECTION G. FACTORY AND WORKSHOP ACT. There are 31 factories on the register at which the trades carried on are as follows:— Garages 3 Timber yards and factories 2 Metal works 1 Printers 5 Typewriters and office furniture 1 Factory bakehouses 2 Factory bootmakers 3 Blacksmith 1 Sausage making 1 Wax tapers and candles 1 Confectioner 1 Chemical manufacturer 1 Sand and gravel pit 2 Perfume manufacturer 1 Iron foundry 1 Leather belt manufacturer 1 Miller 1 Wooden house and shed constructor 1 Assembling tractors 1 Breeze block manufacturer 1 There are 74 workshops on the register at which the trades carried on are as follows:— Garages 19 Furrier 1 Blacksmiths 3 Sausage making 4 Boot repairers 10 Saddler 1 Bakehouses 11 Cycles and motor repairs 4 Carpenters and joiners 9 Builder 1 Wearing apparel making 6 Plumber 1 Undertaker 1 Fish gutting 3 The following is a list of workplaces in the District:— Timber yard 1 Sand and ballast pits 4 Builder's merchants 3 Tea rooms 17 Miscellaneous 8 HOME OFFICE TABLES. 1. Inspection of Factories, Workshops and Workplaces. Premises. Inspections. Written notices. Prosecuted. FACTORIES 43 0 0 WORKSHOPS 68 0 0 WORKPLACES 66 0 0 TOTAL 177 0 0 41 2. Defects found in Factories, Workshops and Workplaces. Number of Defects. Particular's. Found. Remedied. Nuisances under Public Health. Acts— Sanitary accommodation insufficient 0 1 (outstanding 1934). 3. Homework. Outworkers' lists, section 107. Nature of work. Lists received from employers. Wearing apparel 39 Making or repairing umbrellas 2 Making of stuffed toys 1 No notices were served under section 108. 42 SECTION H. RAINFALL DURING THE YEAR. I am indebted to Mr. F. Alderson, the Surveyor, for the subjoined information on rainfall as recorded at the Sewage Disposal works on the Rainham Road, and the Eastern Outfall works at Berry Farm, Great Warley. Amount of rainfall in inches. No. of days in which rain fell. Rainham Road Works:— January 1.07 11 February 1.83 13 March .44 7 April 2.73 18 May 1.21 9 June 2.84 19 July .97 6 August 1.79 10 September 1.99 19 October 1.91 13 November 3.30 18 December 2.21 20 TOTAL 22.29 163 Eastern Outfall Works:— January 1.03 12 February 1.55 14 March .32 6 April 2.92 17 May 1.17 8 June 2.33 19 July .46 5 August 2.26 7 September 2.17 17 October 1.74 13 November 3,68 19 December 2.01 22 TOTAL 21.64 159 During the year 1934 rain fell at the Rainham Road Works on 139 days, the total rainfall being 17.51 inches, and at the Eastern Outfall Works rain fell on 133 days, the total rainfall being 16.58 inches. In the year 1933 the corresponding figures recorded at the Rainham Road Works were 141 days and 16.79 inches.