HORNC 25 Hornchurch Urban District Council ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1957 JAMES GORMAN, M.B., Ch.B., D.P.H., Medical Officer of Health. Hornchurch Urban District Council ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1957 JAMES GORMAN, M.B., Ch.B., D.P.H., Medical Officer of Health. 2 TABLE OF CONTENTS page Members of the Council (as at 31.12.57) 3 SECTION A—Statistics and Social Conditions of the Area 7 SECTION B-General Provision of Health Services for the Area 10 SECTION C—Sanitary Circumstances of the Area 13 SECTION D—Housing 20 SECTION E—Inspection and Supervision of Food and Food Premises 24 SECTION F—Prevalence of, and control over, Infectious and Other Notifiable Diseases 37 SECTION G—Factories Acts, 1937 and 1948 43 Index 44 3 MEMBERS OF THE COUNCIL (as at 31.12.57). Councillor H. Holock, J.P.. Chairman. (1) Councillor W. E. Philo, Vice-Chairman. (1) Councillor Mrs. M. Anfilogoff. „ Miss C. F. M. Cannon. „ Mrs. E. H. Dean. (1) „ Mrs. E. G. Richardson. „ M. A. Andrews. (1) „ R. A. H. Allen. „ E. W. J. W. Bush. „ B. E. E. Cannon. „ J. D. Cantwell. (1) „ L. W. Carroll. (1) and (2) „ F. W. H. Embleton. (Elected 5.10.57) „ E. W. Fryd. „ A. C. Good. (1) „ S. G. Heath-Coleman. „ E. A. Hillman, J.P. „ J. W. G. Hughes. (Resigned 7.8.57) „ R. M. Hunt. (1) „ W. E. Large. „ H. F. Moss. (1) „ A. J. H. Okey. „ G. W. Phillips. „ H. D. M. Rivers. „ A. C. Salinger, J.P. „ S. B. Sanders. „ S. M. Tucker, J.P. „ A. J. Twigger. (1) and (3) „ C. A. Welch. „ G. Welham. „ R. E. Whitworth. (1) „ A. E. Winch. (1) (1) Member of Public Health Committee. (2) Chairman of Public Health Committee. (3) Vice-Chairman of Public Health Committee. 4 OFFICERS OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: James Gorman, M.B., Ch.B., D.P.H. Deputy Medical Officer of Health: (Part-time) P. X. O'Dwyer, MB., B.Ch., B.A.O., D.P.H. Chief Public Health Inspector : M. F. G. Randall, M.A.P.H.I. (2) and (3). Public Health Inspectors : L. Ager, M.A.P.H.I. (1) and (3). (Died on 16.12.57) T. H. Cutler, M.A.P.H.I. (2) (3) and (4) (Resigned 27.1.57) J. Goodwin, M.A.P.H.I. (2) and (3) A. V. J. Hutchings, M.A.P.H.I. (2) and (3) R. J. Morse, M.A.P.H.I. (2) (3) and (4) (Commenced duties 18.3.57) E. Oliver, M.A.P.H.I. (2) (3) and (4) (Commenced duties 18.3.57) S. Whitfield, M.A.P.H.I. (2) and (3) J. M. Williams, M.A.P.H.I. (2) (3) and (4) (Resigned 31.1.57) Student Public Health Inspector: M. A. Jackson. (Commenced duties 1.7.57) Clerical Staff: J. E. Blay (Chief Clerk). Miss E. Thompson. Miss W. A. Hepburn. Rodent Operative and General Assistant : F. J. Gilby. (Died on 7.12.57) Public Analysts : George Taylor, O.B.E., F.R.I.C. J. Hubert Hamence, M.Sc., Ph.D., F.R.I.C. (1) Public Health Inspectors' Certificate of the Royal Society of Health. (2) Public Health Inspectors' Certificate of the Royal Society of Health and Public Health Inspectors' Joint Board. (3) Certificate of the Royal Society of Health as Inspector of Meat and Other Foods. (4) Certificate of the Royal Society of Health as Smoke Inspector. 5 Public Health Department, Council Offices, Billet Lane, HORNCHURCH, 20th May, 1958. To the Chairman and Members of the Hornchurch Urban District Council. Mr. Chairman, Ladies and Gentlemen, I beg to present my Annual Report for 1957. General District Development. A certain slowing down, notably in the provision of new houses by private enterprise, occurred during the year. This was however only relative but in view of the increasing scarcity of building land must progressively be significant. Vital Statistics. A slightly increased birth and reduced death rate with a very pronounced fall in the infant mortality rate represent major satisfactory trends. Infectious Diseases. Measles showed a large increase, whooping cough a substantial decrease, whilst poliomyelitis with 17 cases vice 13 in 1956 also showed a rise. The increase irr the latter disease was entirely reflected by nonparalytic cases. No more significant commentary on the changing picture of epidemiology could be made than that one case of diphtheria was notified during the year and that such a happening demands notice. The last previous case was notified in 1949. Your organisation for dealing with infectious disease is much like an insurance policy relating to which few major claims are made but which nevertheless is a necessary part of your Health Service. Atmospheric Pollution. Our investigation programme continued its activities and our equipment for recording pollution was slightly augmented. The question of smoke control areas was kept under review and will in due course be followed by concrete proposals. Smokeless air is a commodity which each householder can assist in securing by using smokeless fuel. There are manifest difficulties in the way, but legislation should merely assist and supplement efforts which can be made by anyone at any time if the conviction and the will to do so exists. The Clean Air Act does not and does not have to give permission to use smokeless fuel—it merely paves the way for the prohibition of smoke. 6 Food and Drugs. No especial problem presented itself during the year and the average trader's reaction to compliance with the Food Hygiene Regulations was most co-operative. Your Department's work in this field is of very substantial public importance not only in eliciting shortcomings but in discouraging attempts to mislead the public. Housing. Apart from the points noted earlier a significant volume of work was created by the new Rent Act in connection with applications for the issue of Certificates of Disrepair. Our substandard property of a type suitable for demolition is of negligible proportions. Acknowledgments. My best thanks are due to my fellow Council officials in other Departments, and especially to Dr. O'Dwyer, Mr. Randall and Mr. Blay in my own Department. I am. Your obedient servant, James Gorman, M B., Ch.B., D.P.H. Medical Officer of Health. 7 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area in acres (including half of tidal basin) 20,308 Registrar-General's estimate of Home Population (midyear) 1957 117,400 Number of inhabited houses according to rate books (December, 1957) 37,195 Rateable value (December, 1957) £1,522,363 Sum represented by a penny rate (December, 1957) £6,030 Extracts from Vital Statistics for the Year. Births. Number of live births allocated to the district as adjusted for inward and outward transfers 2,121 (1,089 males, 1,032 females) Birth rate per 1,000 Home Population using area comparability factor 17.15 Number of stillbirths allocated to the district 41 (19 males, 22 females) Stillbirth rate per 1,000 Home Population 0.35 Stillbirth rate per 1,000 total (live and still) births 18.95 Deaths. Number of deaths of Hornchurch residents as supplied by the Registrar-General (adjusted for inward and outward transfers) 1,303 (655 males, 648 females) Death rate per 1,000 Home Population using area comparability factor 10.42 Deaths of infants under one year of age 40 (23 males, 17 females) Infant mortality rate (per 1,000 births) 18.85 Deaths of infants under four weeks of age 24 (17 males, 7 females) Neonatal mortality rate (per 1,000 births) 11.31 DEATH RATE—COMPARISON WITH PREVIOUS YEARS. 1942 7.9 1950 10.4 1943 8.9 1951 10.3 1944 9.2 1952 10.4 1945 9.9 1953 13.1 1946 9.0 1954 12.1 1947 8.3 1955 11.6 1948 8.2 1956 10.5 1949 10.6* 1957 10.4 *Area Comparability Factor returned. 8 The Area Comparability Factor for deaths this year varied from 0.93 to 0.94 and for births from 0.97 to 0.95. BIRTH RATE—COMPARISON WITH PREVIOUS YEARS 1942 17.5 1950 13.6* 1943 19.0 1951 14.1 1944 11.9 1952 13.8 1945 18.4 1953 14.8 1946 21.3 1954 14.7 1947 20.7 1955 15.4 1948 17.2 1956 16.7 1949 16.0 1957 17.1 *Area Comparability Factor returned. The A.C.F. might very generally be translated as one which being applied to certain local figures makes them suitable for general comparisons. Deaths in St. George's Hospital. A note was made on this matter as it related to our general rate. It is satisfactory that in future deaths occurring within six months of admission in persons having a permanent address elsewhere than in Hornchurch will be transferred elsewhere—a step which goes far towards confirming my views in a previous report. GENERAL MORTALITY: MAIN CAUSES 1947-1957. Causes of Death 1947 1948 1949 1950 1951 1952 1953 195-4 1955 1956 1957 Tuberculosis (all forms) 38 44 35 29 25 17 21 11 4 5 3 Cancer 142 139 180 155 183 184 211 234 210 253 248 Infectious diseases 2 5 9 3 4 1 3 1 2 0 2 Cardio-vascular disease 344 371 404 441 418 425 602 590 591 682 679 Influenza 3 1 9 3 19 2 14 1 2 7 8 Pneumonia 48 30 31 20 30 49 52 41 49 53 65 Bronchitis 66 36 65 63 69 52 85 54 65 95 79 Other respiratory diseases 12 9 6 3 7 9 10 8 10 7 9 Gastro intestinal diseases 18 14 13 20 16 12 28 13 10 14 10 Motor vehicle accidents 6 7 11 9 14 9 11 10 12 8 10 All other accidents 7 14 8 12 12 4 10 18 18 20 18 Suicide 10 8 3 10 11 10 7 11 11 9 14 Tuberculosis is down to a very low level and no deaths occurred from meningococcal infection, whooping cough or diphtheria. Poliomyelitis unfortunately showed two deaths as against none the previous year. Other features of interest were that cancer of the lung and bronchus caused 54 deaths—48 male, 6 female—as against 59, 51 and 8 respectively the previous year. Cancer in general caused 248 vice 253 deaths and apart from an increase of suicides from 9 to 14 no significant trend is thought to exist in the remaining causes. 9 REGISTRAR-GENERAL'S ABBREVIATED LIST OF CAUSES OF DEATH IN CERTAIN AGE GROUPS (Corrected for Inward and Outward Transfers) CAUSES OF DEATH ALL AGES AGE GROUPS Under 1 1—4 5—14 15—24 25—44 45—64 65—74 75 and upwards TOTAL MALE FEMALE M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1. Tuberculosis, respiratory 2 0 2 - - - - - - - - - 1 - 1 - - - - 2. Tuberculosis, other 1 0 1 - - - - - - - - - - - - - 1 - - 3. Syphilitic disease 4 2 2 - - - - - - - - - 1 1 - 1 - - 1 4. Diphtheria 0 0 0 - - - - - - - - - - - - - - - - 5. Whoopiug cough 0 0 0 - - - - - - - - - - - - - - - - 6. Meningococcal infections 0 0 0 - - - - - - - - - - - - - - - - 7. Acute poliomyelitis 2 1 1 - - - - - - - 1 - - 1 - - - - - 8. Measles 0 0 0 - - - - - - - - - - - - - - - - 9. Other infective and parasitic diseases 1 0 1 - - - - - - - 1 - - - - - - - - 10. Malignant neoplasm, stomach 35 16 19 - - - - - - - - 1 1 6 2 6 7 3 9 11. Malignant neoplasm, lung, bronchus 54 48 6 - - - - - - - - 3 1 29 2 12 3 4 - 12. Malignant neoplasm, breast 22 1 21 - - - - - - - - - 3 - 11 1 3 - 4 13. Malignant neoplasm, uterus 10 0 10 - - - - - - - - - 1 - 4 - 1 - 4 14. Other malignant and lymphatic neoplasms 127 61 66 - - 1 - - 1 - - 1 3 20 20 16 21 23 21 15. Leukaemia, aleukaemia 5 4 1 - - - - - - - - 1 - 1 1 - - 2 - 16. Diabetes 11 4 7 - - - - - - - - 1 - 2 2 - 2 1 3 17. Vascular lesions of nervous system 169 62 107 - - - - - - - - 3 2 8 15 16 28 35 62 18. Coronary disease, angina 170 104 66 - - - - - - - - 4 - 46 9 33 21 21 36 19. Hypertension with heart disease 27 11 16 - - - - - - - - - - 2 2 5 3 4 11 20. Other heart disease 282 128 154 - - - - - - - - 2 3 16 10 29 23 81 118 21. Other circulatory disease 33 12 21 - - - - - - - - - - 1 2 2 8 9 11 22. Influenza 8 2 6 - - - - - - - - - 1 1 2 1 1 - 2 23. Pneumonia 65 36 29 2 4 2 - - 1 - - - - 7 - 12 5 13 19 24. Bronchitis 79 59 20 2 - - - - 1 - - - - 14 4 18 7 25 8 25. Other diseases of respiratory system 9 9 0 - - 1 - 1 - - - - - 4 - 2 - 1 - 26. Ulcer of stomach and duodenum 6 4 2 - - - - - - - - - - 3 - - 1 1 1 27. Gastritis, enteritis and diarrhoea 4 2 2 - - - - - - - - - - - - - 1 1 - 28. Nephritis and nephrosis 11 5 6 - - - - 1 - - 3 1 1 2 - 1 2 - - 29. Hyperplasia of prostate 5 5 0 - - - - - - - - - - - - 2 - 3 - 30. Pregnancy, childbirth, abortion 0 0 0 - - - - - - - - - - - - - - - 31. Congenital malformations 18 8 10 5 8 - - 1 - - - 1 1 - 1 1 - - - 32. Other defined and ill-defined diseases 101 44 57 14 5 - - - - - - 5 2 1 11 7 8 17 31 33. Motor vehicle accidents 10 8 2 - - - - - - 3 - 3 - 2 1 - 1 - - 34. All other accidents 18 12 6 - - 1 - - - - - 3 - 4 - 2 1 2 5 35. Suicide 14 7 7 - - - - - - - 1 2 3 2 2 3 1 - - 36. Homicide and operations of war 0 0 0 - - - - - - - - - - - - - - - - TOTAL 1,303 655 648 23 17 6 0 3 3 3 6 31 24 173 103 170 149 246 346 10 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Staffing. Mr. J. M. Williams resigned during the year in order to take up the appointment of Chief Public Health Inspector at Pontypool, and Mr. T. H. Cutler resigned during the year to take up the appointment of Deputy Chief Public Health Inspector with the County Borough of Worcester. They were succeeded by Mr. R. J. Morse and Mr. E. Oliver. It is with real regret that the death of Mr. L. Ager, a District Public Health Inspector, is recorded. He saw service originally with the Romford Rural District Council and time served only to reveal the sterling nature of his work in Hornchurch. He was a most unassuming man but there are many individuals in Hornchurch who will feel that they have lost a friend. The death of Mr. F. J. Gilbey, General Assistant and Rodent Operator, also falls to be recorded. Mr. Gilbey was a reliable and conscientious man whose loss is inevitably felt by the Department. Mr. M. A. Jackson commenced with us as a Student Public Health Inspector on the 1st July, 1957. For the whole of the year we were more or less one Public Health Inspector short on our establishment due to circumstances outwith our control but nevertheless influencing the work of the Department. Medical Examinations—Staff. Staff arrangements remain as last year. During the year arrangements were made for the examination of 222 (216) employees or prospective employees—79 (68) permanent and 143 (148) temporary. The 1956 figures are given in parenthesis. Public Health Propaganda. Talks were given to various bodies such as: — The Chamber of Commerce. Holy Cross Youth Club. Murex Canteen Staff. Ardleigh House Day Release Class. Elm Park Branch Women's Co-operative Guild. Local Food Traders Representatives. During the course of the year Food Hygiene figured prominently in the subjects chosen. An 'Aldis' Projector was purchased so that suitable slides and film strips could be used to supplement the value and enhance the interest of the talks. 11 Increasing use is being made of references by the Public Health Committee to the Public Relations Committee of subjects of importance and substantial press publicity has accrued through this channel. The Council's Notice Boards which cover the district extensively are used in a more phased fashion for propaganda subjects of particular interest at particular times. Liaison is maintained with the Local Health Authority on matters having a common interest. Laboratory Facilities. Our arrangements follow the existing lines and include primarily the utilisation of Oldchurch Hospital laboratory (by kind assistance of Dr. Atkinson) with reference to essential specialised investigations always available through the Central Public Health laboratory at Colindale. In the routine examination of milk, water, etc., the Essex County Council's scheme is utilised. It should be said that this scheme is in fact operated very flexibly by the County Council and does undoubtedly provide a service of real assistance to a District Council. Ambulance Service. The arrangements remain the same as last year. Maternity and Child Welfare. The Essex County Council maintained clinics at the following centres throughout the year:— (i) Abbs Cross Lane, Hornchurch. (ii) Athelstan Road, Harold Wood. (iii) Front Lane, Cranham. (iv) Hornchurch Road, Hornchurch. (v) St. Mary's Lane, Upminster. (vi) South End Road, South Hornchurch. (vii) Upminster Road, Rainham. (viii) Westland Avenue, Hornchurch. Nursing and Maternity Homes. The three registered Nursing and Maternity Homes in the district are supervised by the County Council. Midwives and Home Nurses. There are nine midwives and five home nurse/midwives in the district who were appointed by the Essex County Council and are available to act in the capacity of midwife and of maternity nurse under the supervision of a registered medical practitioner. In addition to the home nurse/midwives there are seven home nurses working in the district. 12 Day Nursery. A Day Nursery is established within the district at Diban Avenue, Elm Park. It provides accommodation for 50 children up to five years of age. Domestic Help Service. A domestic help scheme is in operation and is administered for the Essex County Health Services by the Area Medical Officer, 34, Cresthill Avenue, Grays. Care of the Aged. It has been a relatively quiet year in that no major difficulties have arisen in dealing with aged persons, who, whilst not falling within a category requiring care and attention, are nevertheless not wholly able to look after themselves as well as one would wish. Looking back on previous years it is noteworthy that although the aged evince a sturdy suspicion very often towards Institutions and anything that smacks of them, the fact remains that in instances in which they have been persuaded to accept for example, Part III accommodation, time has shown that they have in fact settled down very well to their new scheme of life, so far as one can see, without any regrets. It should also be said that the Social Welfare Department of the County Council through their Area Officer, Mr. Fisher, has always proved most helpful in assisting us to sort out any difficulties involving that department and mine. It is reassuring to know that at any time a sympathetic response from the Social Welfare Department can be relied upon. Home Safety. I continue to represent the Local Home Safety Committee on the National Home Safety Committee. I cannot see any real evidence that the problem of Home Safety is being treated nearly as approaching the importance of Road Safety, and although I must pay a tribute to the interest and knowledge with which the National Home Safety Committee deal with the subject, I still think that much more encouragement could be given centrally to bring the day-to-day problem of Home Safety measures before all local Councils (not merely Local Health Authorities) and appropriate interested —or disinterested—bodies in the country as a matter upon which some action must be taken. National Assistance Act, 1948. No formal action was taken under Section 47 of this Act during the year. As each annual report seems to repeat this phrase, it might well be emphasised now and again that effective action so far has been proved possible short of legally invoking this Section. Every so often instances crop up when the circumstances seem very likely to necessitate having recourse to the Act but time and patience have so far achieved the desired end. 13 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. Water Supplies. Twelve samples were taken by my Department during the year from the main supply, four were submitted for chemical and bacteriological examination and eight for bacteriological examination only. In each case a satisfactory report was received. The South Essex Waterworks Company have kindly supplied the following particulars concerning the main supply for the district:— "The water supply of the whole of your area has been satisfactory in quality and quantity. Bacteriological and chemical examinations are made of the raw water, of the water in its various stages of treatment and of the water going into supply. A total of over 3,890 chemical, bacteriological and biological examinations have been made and all water going into supply was wholesome. In addition, analyses have also been made of samples obtained from consumers' taps in the various parts of the Company's district, including that of your Council and all proved to be satisfactory. The water supplied is not plumbo-solvent. No action has been necessary in respect to any form of contamination. The number of dwelling houses supplied as at 31st December last was 38,170 and the population as at 30th June 1957, as obtained from the Registrar-General was 117,400. We are unable to state the number of houses supplied by standpipes, but the total is quite insignificant." The few houses in the area without a main water supply had their number further depleted during the course of the year by the provision of a main supply to Flint House. Atmospheric Pollution. Smoke Control Areas: This matter at the moment rests at a stage of general discussion and observation. Public opinion will doubtless be watched together with trends elsewhere and in due course the policy as to creation of these zones will be discussed in more precise terms. 14 Clean Air Act, 1956: During the year two applications in connection with the furnace arrangements were received under Section 3. One of these was approved; one was refused. In each case the advice of the National Industrial Fuel Efficiency Service was sought before a final decision was made. Observations Scheme: No change has taken place in the number or distribution of the various instruments which we operate for day-to-day atmospheric findings. These remain at three Deposit Gauges at "Langtons," Hornchurch; Lambs Lane School, Rainham and Oglethorpe School, Cranham; four Lead Peroxide Candles at "Langtons," Hornchurch, Lambs Lane School, Rainham, Oglethorpe School, Cranham and Redden Court School, Harold Wood and one Volumetric SO2 apparatus sited at the Public Health Department, Billet Lane. An "Eel" Reflectometer has been purchased which will enable future smoke stains to be read much more accurately and with an elimination of the error which inevitably must characterise non-automatic readings. It can clearly be argued that the pollution in arry district is either the result of drift from outside or the result of locally produced pollution through either (a) industry or allied causes or (b) housing. Hornchurch is no exception. So far as concerns external sources you have of course no control over them. So far as concerns local industry it is in my view a negligible producer of smoke. So far as concerns housing I think that cumulatively it produces a substantial amount of smoke. This is a story from which the deductions need be neither difficult nor confused. Sewerage. The Surveyor informs me that 4.1 miles of soil sewer and 4.1 miles of surface water sewer were laid during the year. Cesspools. The cesspool position received general discussion last year and as the same criteria appear relevant still it is not proposed again to dwell on it. It is, however, clear that the replacement of cesspools by main drainage is fully understood to be a matter of fundamental policy and although present restrictions do not facilitate any wide-spread improvements of this kind the sooner householders with cesspools in urban areas can be given the option of such replacement the better. When that time comes it should also be largely unnecessary to have cesspools as part of the normal provision of new houses. It is certain that this is the ideal which the Council would wish to secure and if the occupiers of houses with cesspools do not perhaps always see eye to eye with them initially it is pretty certain that after a year or two experience will have made them converts to this viewpoint. 15 Adoption of Private Streets. The Engineer and Surveyor, Mr. V. Williams, has supplied the following list of private streets adopted during the year ended 31st December, 1957: — ROAD Length feet Access Road—rear of High Street 368 Isis Drive 651 Pentire Close 223 Corbets Avenue 947 Court Way 261 Granger Way 478 Birkdale Avenue 273 Little Aston Road 249 Stour Way 1,020 Barton Road 517 Clayton Avenue 1,000 Westlyn Close 303 Firham Park Avenue 599 Royston Road 390 River Drive 955 Elmhurst Drive 1,285 Coombe Road 857 Fleet Avenue 1,294 Fleet Close 358 Dart Close 443 Dee Close 210 Halidon Rise 903 Elgin Avenue 644 Thurso Close 599 Severn Drive (part) 1,897 Humber Drive (part) 533 Mersey Avenue 466 Service Road—East side—Hall Lane 1,467 Tamar Close 138 Clyde Crescent 1,008 Kennet Close 282 Blyth Walk 204 The Rodings 241 Helford Way 368 The Leas 135 Crouch Valley 140 Rossall Close 595 Humber Drive (part) 1,062 Gainsborough Road 780 Avelon Road 942 Cumberland Avenue 310 Grove Park Road 345 Guysfield Drive (part) 171 Matlock Gardens 340 Sunningdale Road 876 Hesselyn Drive 353 Dawson Drive 435 16 ROAD Length feet Mermagen Drive 317 Esmond Close 108 Hayes Drive 1,076 Kingaby Gardens 453 Murrgo Park Road 1,509 Eugene Close 268 Service Road (A. 127) Belgrave Avenue to termination 400 Jersey Road 140 Ravenscourt Close 263 Marlborough Gardens 1,332 Dorkins Way 643 34,424ft. = 6.5 miles River Pollution. The annual story falls to be repeated of how the Ingrebourne is far from an amenity to the district and how the Regional Sewerage Scheme is still receiving consideration. It can probably be re-emphasised that whether a Sewage Works produces good, bad or indifferent effluent that effluent still is not desirable as a major constituent of a stream especially one running through an urban district from end to end. There could be no greater mistake in this connection than to presume that a good effluent passed into a watercourse is beyond reproach irrespective of what dilution that watercourse is able to afford it. Swimming Pool. The Swimming Pool, during the first complete year of operation, proved highly popular, 285,224 patrons being admitted for swimming and a further 25,134 spectators. Included in the swimmers total are 67,352 visits by school children, attending in classes and during the year 1,368 children gained primary and some, higher certificates of the Hornchurch Schools Swimming Association. This may not at first appear high, but when it is realised that most of the children attended each week over the period, the percentage of certificates is very large. In addition, Hornchurch Swimming Club have done yeoman service with instruction and towards the end of the year obtained the services of a well known Olympic coach to deal with the advanced swimmers. From a practical point of view, the Swimming Pool water has been maintained at a high standard of purity and clarity and the building kept warm and well ventilated. 17 ACTUAL FIGURES FOR REFERENCE Adult Bathers 57,523 Junior Bathers 132,305 Adult Spectators 16,565 Junior Spectators 8,569 Adult Transfers 561 Junior Transfers 238 Adult Book Tickets 1,752 Junior Book Tickets 3,276 Hornchurch Swimming Club 22,187 We co-operate with the Bath Superintendent and Engineer in maintaining a high standard of quality. Nineteen samples were taken by us during the year and submitted for bacteriological and chemical analysis. Crematorium. The new Crematorium to serve South Essex was formally opened in July. It is administered by the South Essex Crematorium Joint Committee the constituent members being the Hornchurch Urban District Council, Romford Borough Council and the Thurrock Urban District Council, each represented by three members. Paddling Pools. Four samples were taken from each of the four Paddling Pools, i.e., in May, June, July and August, 1957. Disinfestation and Disinfection. The trends in disinfection have changed over the years and the necessity for disinfestation now seldom arises. Apart from the concurrent disinfection at the time of illness which is now normally practised in place of the former disinfection at the end of the illness (or terminal disinfection) occasions do arise when bedding or something of that nature is dealt with. The problem of disinfestation has been minimised by the high standards of housing in the district. Rodent Control. The advice of the Rodent Operative continues to be appreciated and during the year 145 new infestations and 1,158 routine and re-visits were made. Establishments for Massage or Special Treatment. The Essex County Council granted licences to nine persons during the year authorising them to carry on establishments for massage or special treatment. 18 Heating Appliances (Fireguards) Act 1952 and Regulations 1953. During the year 29 appliances were tested (involving 56 tests) and all were satisfactory. Old Metal Dealers (Hornchurch) Order, 1956. At the end of the year 13 persons had registered as Dealers in old metal. Periodic visits were paid by the Public Health Inspectors. Pet Animals Act, 1951. Fifty-three visits were paid to the 10 licensees of the Pet Shops in the district. Rag Flock and Other Filling Materials Act, 1951. Two addresses in the urban district are registered pursuant to the provisions of Section 2 of this Act. Two samples were taken during the year and satisfactory reports were received. Riding Establishments Act, 1939. The two premises were inspected on a half-yearly basis and were both found to be satisfactory. Public Health Inspection of the District. SUMMARY OF PUBLIC HEALTH INSPECTORS' WORK DURING 1957: Inspection of Food and Food Premises (visits paid): Bakehouses 96 Butchers' shops 293 Cafes 230 Confectioners 153 Dairies (including Pasteurising Plant) 64 Fish Shops 123 Food complaints 112 Grocers' shops 681 Greengrocers' shops 177 Ice Cream Vendors and Manufacturers' premises 106 Mobile shops (hawkers) 43 Public Houses 30 Sampling 649 School Canteens 86 Slaughterhouse 310 Staff Canteens 29 Miscellaneous visits 43 19 Housing (visits paid): Overcrowding etc., enquiries 119 Improvement Grants 16 Sanitation 67 Structural defects 446 Water supply and pipes 63 Miscellaneous housing visits 215 Re-inspections 1,155 General Sanitary Circumstances (visits paid): Atmospheric Pollution 166 Camping and Fairgrounds, vans, etc 95 Conveniences 16 Drainage and sewerage 339 Dustbins 51 Stables, piggeries, animals, birds, etc 75 Nuisances 212 Paddling pool samples 17 Refuse tips 24 Pest Control 196 Swimming Pool Samples 7 Water samples (main supply) 39 Rivers, streams, ponds, etc. 43 Miscellaneous visits 36 Re-inspections 292 Factories and Outworkers: Number of visits paid 472 Shops Act: Number of inspections 626 Miscellaneous (visits paid): Heating Appliances (Fireguards) Act 7 Massage establishments 3 Pet Animals Act 53 Rag Flock and Other Filling Materials Act 4 Infectious Disease: Number of visits paid (including contacts) 914 20 Number of notices served: Informal 315 Statutory 111 The main headings under which work was done may be noted as follows: Housing 2,081 visits Inspection of Food and Food Premises 3,225 „ General Sanitation 1,608 „ Infectious Diseases 914 „ Shops Act Inspections 626 „ Factories and Outworkers 472 „ SECTION D. HOUSING Number of New Houses erected during the year: (i) By the Local Authority 271 (ii) By other Local Authorities 30 (iii) By other bodies or persons 1,110 Number of Houses voluntary demolished: 22. 82 84, 86, 88, 90 and 92, Billet Lane. 141 and 145, Billet Lane. 128, 130 and 132, High Street. 10 and 12, North Street. 26 and 28, North Street. 121, 123, 125, 127, 129, 131 and 133, North Street. Number of Houses voluntary closed: 10. 2, Billet Lane. 169, 171 and 173, High Street. "The Bungalow," Moor Hall Farm. 36, 38, 40 and 42, North Street. "Barn Cottage," Ockendon Road. Number of Closing Orders made: 1. 34, Brentwood Road. Number of Demolition Orders made: 18. 70, 72, 74, 76, 78 and 80, Billet Lane. "Danny's Bungalow," Bird Lane. 5, 6 and 7, Dennises Cottages, Dennises Lane. "Lake House," Lake Avenue. "Keeling House," Ockendon Road. 1, 2, 3 and 4, Keelings Cottages, Ockendon Road. 205, Rainham Road. 2, Harveys Cottages, Upminster Road. 21 Number of Houses demolished following representations: 18. 116, 118 and 120, Ardleigh Green Road. "Boa Vista," Berwick Road. 70, 72, 74, 76, 78 and 80, Billet Lane. "Lake House," Lake Avenue. 32, North Street. "Reelings House," Ockendon Road. 1, 2, 3 and 4, Reelings Cottages, Ockendon Road. 2, Harveys Cottages, Upminster Road. Number of Houses represented but in abeyance at end of year: 1. 15, Staverton Road. Certificates of Disrepair. The following is a copy of a Return under the Rent Act, 1957, sent to the Ministry of Housing and Local Government for the period 6th July to 31st December 1957: Part I—Applications for Certificates of Disrepair: (1) Number of applications for certificates 115 (2 withdrawn by tenants). (2) Number of decisions not to issue certificates 2 (3) Number of decisions to issue certificates (a) in respect of some but not all defects 78 (b) in respect of all defects 23 (4) Number of undertakings given by landlords under Paragraph 5 of the First Schedule 49 (5) Number of undertakings refused by Local Authority under proviso to Paragraph 5 of the First Schedule 8 (6) Number of Certificates issued 42 Part II—Applications for Cancellation of Certificates: (7) Applications by landlords to Local Authority for cancellation of certificates 2 (8) Objections by tenants to cancellation of certificates — (9) Decisions by Local Authority to cancel in spite of tenant's objection — (10) Certificates cancelled by Local Authority 1 Improvement Grants. In connection with applications under this heading our advice has been sought in 25 instances during the year. Our opinion has then been submitted to the Surveyor for consideration by the Committee when the application for grant came up for determination. 22 Re-Housing—Medical Aspects. My advice was sought during the year on some 155 housing applications respecting which medical recommendations for priority had been submitted by hospitals or private practitioners. As against several years ago the picture in this connection has changed very greatly, coincident with the betterment of housing conditions generally throughout the district It is relatively seldom now that one finds a case in which the purely medical aspects are so outstanding as to demand unusual priority. Overcrowding. The overall housing position still does not appear to warrant making any especial detailed investigation into the overcrowding circumstances of the district. It is, however, becoming more practicable to discourage individual house overcrowding where full investigation into the circumstances establish that no very good or practical reason exists for permitting the overcrowding and where the overcrowding appears likely to be of a more or less permanent nature with the attendant danger that a single bad case of overcrowding allowed to persist without comment may well encourage a succession of other equally unsatisfactory extensions. Caravans. The large individual site noted in last year's report at Rainham still persists and provides an emphatic answer to any misconceptions that what a Local Authority doesn't like it metaphorically waves a wand and makes disappear. Land Charges Enquiries. During the year 4,003 land charges enquiries were referred to the department regarding the question of outstanding sanitary notices and Certificates of Disrepair. This is one of the routine unpublicised but time-consuming occupations of the department. Temporary Accommodation. The general development of the district has now got to the stage of embracing "in-filling" as the number of substantial plots of land available for development dwindles steadily. This situation has of course its repercussions on the week-end bungalow type of accommodation since development of a modern nature provides an alternative and even more attractive proposition than the mere ownership of what may be little more than a shack. To some extent circumstances have been in our favour in our efforts to rid the district of this temporary sub-standard accommodation and the overall situation in the post-war years has shown a steady improvement. 23 Sub-Standard Accommodation. Our five-year programme proceeded steadily on its way and at the end of the year approximately some 20 properties remained to be dealt with. It is evident and true that this district enjoys a high standard of housing but it is also evident that the increase of modern house development tends to bring into snarp relief the disparity existing between extremes of "satisfactory houses." On the one hand you have the house which in appearance one would practically write off in these modern days as being unfit for habitation. A different story however falls to be told when you try to translate the condition of that house into terms of legal disrepair. On the other hand you have—to quote an average example—an ordinary Council house with all reasonable amenities readily to hand. The time is far removed when any real complacency on the present housing situation can be justified and the position of a housewife who has to bring up her young family under circumstances which are legally satisfactory but nevertheless may include an absence of a really adequate hot water supply—of a water closet inside the house—of any fixed bath whether or not in a separate room—of a satisfactory food store and of adequate lighting, still gives one food for thought. In other words, the more rapid the pace that is set in modern housing the greater the gap necessarily created between a modern house and its outmoded counterpart. The general impact of housing upon health is very real. On items of actual detail however our ground may be less secure or less susceptible to proof. Damp, for example, is the recognised villain of the housing scene and one can rely upon recourse being had to it when an explanation is needed for anything from the common cold to much more serious conditions. I am not personally convinced that mere word association provides an adequate compensation for what I think in fact is often lack of precise knowledge of the cause of illness. It seems, however, likely that in this as in other fields if a statement finds its way into a sufficiency of books and is sufficiently often repeated, it achieves what appears to be a form of justification—not to say truth—by repetition. I consider that it is much more sensible to say that a house should not be damp and should not be defective on ordinary accepted standards rather than to attempt to justify an assertion that demonstrable illness is associated with any particular housing defects. Housing conditions should in other words produce relative ease of life rather than merely avoid defects which allegedly produce positive harm to health. 24 SECTION E. INSPECTION AND SUPERVISION OF FOOD AND FOOD PREMISES Food and Drugs Administration. During the year some 328 samples were taken and of these 22 were unsatisfactory in some particular. In addition 16 food complaints were submitted to the Public Analyst with the results noted. The general pattern of our sampling programme has been divided between Food and Drugs. It may be that the future will see an increasing emphasis being laid on the chemical constituents of food and the chemical shortcomings of food but this represents a subject the full potentiality of which is only commencing to be known but which having once entered our picture is not likely readily to leave it. The sub-divisions of the work detailed later relate to: — (1) Samples submitted to the Public Analyst and found to be genuine 306 (2) Samples submitted to the Public Analyst and found to be sub-standard, etc 22 (3) Food complaints referred to Public Analyst 16 (4) Food complaints not warranting reference to Public Analyst 36 A full range of products was sampled and a somewhat higher figure than last year of unsatisfactory results was obtained. The action taken is also noted. The degree to which any products were unsatisfactory was usually not of a serious order and this explains the relative lack of legal proceedings. It will be noted that of the general complaints 11 related to bread and 26 to milk. It should be explained that the mere recital of the complaint, findings and subsequent action provide very often what may well be a distorted view of the affair since a decision is made in the light of a great deal of additional information not possible to reproduce here. One factor of major importance is that complaints often arrive at this department at a stage so late that legal action has been rendered virtually impossible. I should however say that complaints emanating from members of the public are responsible and interest of this kind assists our work and is appreciated. 25 Many of the milk complaints naturally originate from our largest consumers the schools. It is a matter for some regret that it has not been possible to take legal action more frequently in this connection but it is peculiarly difficult to establish a chain of events suggesting reasonable proof of guilt and hence the action taken by us indicates a measure of informality apparently somewhat out of proportion to the numerical strength of the complaints. I must express my indebtedness to the Public Analysts, Mr. George Taylor, O.B.E., F.R.I.C., and Dr. J. Hubert Hamence, M.Sc., Ph.D., F.R.I.C. for their helpful and ready advice in the many difficulties which necessarily crop up in this highly specialised branch of our work. SAMPLES SUBMITTED TO PUBLIC ANALYSTS AND FOUND TO BE GENUINE Article No. Article No. Almonds, ground 2 Frankfurters 1 Almond, marzipan 1 Frizets 1 Beef, braised 1 Fru-Grains 1 Beef Steak 1 Fruit Lollies 6 Beef Steak with gravy 1 Fruit mixed dried 1 Blackcurrant Syrup 2 Ginger Beer 1 Butter 2 Ginger, ground 1 Cheese Biscuits 1 Grape Nuts 1 Cheese Spread 2 Honey 2 Cheese Spread with Ham 1 Horseradish Sauce 1 Cheese and Onion Spread 1 Ice Cream 25 Chicken Fillets 1 Jam 3 Chicken and Lentils, strained 1 Jelly 3 Lard 1 Chicken, minced 1 Lemon Cheese 1 Cockles 1 Lemon Curd 2 Coconut, desiccated 1 Lemon Mousse 1 Condiment, non-brewed 4 Lemonade Powder 1 Crab, dressed 1 Lime Juice Cordial 1 Cream 4 Liver Paste 1 Cream sponge sandwich 1 Lollies 8 Crisp bread 1 Margarine 2 Curry Powder 2 Marzipan 1 Custard Powder 1 Meringue Powder 1 Dietary Food 1 Milk 47 Egg Macaroni Noodles 1 Milk, condensed 4 Egg Vermicelli 1 Milk, evaporated 1 Figgerolls 1 Mincemeat 1 Fish Cakes 1 Mix-a-Shake (Pineapple Flavour) 1 Fish Paste 1 Fish Spread 1 Mushrooms, creamed 1 Flour 3 Mushroom Ketchup 1 Forcing (Thyme & Parsley with Beef Suet forcemeat) 1 Mustard 1 Mustard, preparation 1 26 Article No. Article No. Mussels 1 Port 1 Nut Oil 1 Rum 1 Onions, pickled 1 Whisky 2 Oranges 3 Yeast 1 Orange drink 1 Almonds, Sweet Oil of 1 Orange Juice 1 Ammoniated Tincture of Quinine 1 Orange Squash 1 Parsley and Thyme 1 Aspirin Tablets 1 Pea-Nut Butter 1 Asthma Remedy 1 Pears 1 Beecham's Powder 1 Pineapple Shortcake Biscuits 1 Blood Mixture 1 Blood Purifier 1 Plums, English red 1 Blue Ointment 1 Potato Puffs 1 Brimstone and Treacle 1 Protein Food 1 Bronchial Mixture 1 Prunes 1 Camphorated Oil 1 Puddings 2 Catarrh Pastilles 1 Pudding Mixture 1 Children's Cooling Powders 1 Rice, creamed 1 Children's Tonic 1 Rice, ground 1 Chlorodyne Cough Syrup 1 Roselle 1 Chronic Catarrh Syrup 1 Salad Dressing 1 Cocaine Eye Lotion 1 Salmon Spread 1 Concentrated Medicinal Essence of Cinnamon 1 Sausages, Beef Sausages, luncheon 1 Cough Syrup 1 Sausages, pork 4 D.D.D. Balsam 1 Self-raising flour 3 Daisy Tablets 1 Shortbread Biscuits 1 Digestive Syrup 1 Soup, Cream of Tomato 1 Elsworthy Linctus 1 Soup, Tomato 1 Emulsion of Acriflavine 1 Soups 4 Eye Lotion 1 Soya Flour 1 Fever Mixture 1 Spaghetti 1 Friars Balsam 1 Spinach 1 Glycerine and Borax 1 Suet 1 Glycerine, Lemon and Honey Pastilles 1 Suet, shredded beef 1 Sugar 1 Haliborange Tablets 1 Sugar and Honey Coated Cereal 1 Health Salt 1 Indigestion Tablets 1 Sweets 4 Infant Powder 1 Tarragon Mayonnaise 1 Iodised Table Salt 1 Tart Mixture 1 Kompo (Cough Mixture) 1 Tomato Juice 1 Laxative Chewing Gum 1 Tomato Juice Cocktail 1 Lime flavoured Sulphur Tablets 1 Vinegar, malt 3 Vinegar, white wine 1 Linseed Compound 1 Wafers 1 Liquid Paraffin 1 Welsh Rarebit 1 Medicinal Charcoal 1 Brandy, Ginger 1 Mentholated Balsam 1 Cherry Brandy 1 Mustard Ointment 1 Dubonnet 1 Nerve Herbs 1 27 Article No. Article No. Nerve Tonic 1 Sloan's Liniment 1 Oil of Eucalyptus 1 Soap Spirit 1 Opiate Linctus of Squills for Infants 1 Surgical Spirit 1 Thermal Embrocation 1 Parrish's Food 1 Throat Specific 1 Peptabs 1 Tonic Water 1 Perni cream 1 Vitamin Capsules 1 Quincabel 1 Vitaminised Iron Tablets 1 Raspberry Leaf Tablets 1 Yellow Basilicon 1 Relaxa Tablets 1 Zinc and Starch Dusting Powder 1 Rheumatic Tablets 1 Sal Volatile, spirit of 1 Total 306 Senna Pods 1 Sleepwell Tablets 1 28 SAMPLES SUBMITTED TO PUBLIC ANALYSTS AND FOUND TO BE ADULTERATED OR UNDER STANDARD, etc. Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action taken Inf.1246 Inhalant. Stated to be a preventative against Influenza which claim could not be justified. Matter taken up with Manufacturer and discussed with Ministry of Health. Inf.1258 Jam, Raspberry. Had moulds present on surface of jam. Remainder of stock withdrawn from sale by wholesaler. Inf.1269 Fruit Products (blackcurrant). Substantially deficient in sugar but no indication given that it was for diabetic purposes. Matter taken up with Manufacturer and Ministry of Food, but as sample described as "a special food product " no further action was recommended by Clerk. F.1071 Oranges. Contained 25 p.p.mill. Thiourea in peel and 5 p.p.mill. Thiourea in juice. Legal proceedings instituted. Case dismissed Court took sympathetic view as defendant giving up business that day. Defendant to pay costs 2 gns. Inf. 1278 Soup -Creamed Tomato. 28% deficient in fat. Formal follow-up sample taken. F.1078 Soup —Creamed Tomato. 37% deficient in fat. Legal proceedings instituted but summons withdrawn Section 108(1) of the Food and Drugs Act, 1955 applying. Inf.1284 Flour 36% deficient in creta praeparata and 66% deficient in Vitamin B1. Formal follow-up sample taken. F.1079 Flour. 36% deficient in creta praeparata. Control sample normal. No further action taken. Inf.1280 Balm. Contained twice the stated quantity of Methyl Salicylate. Matter considered by Council, no further action taken. Inf.1296 Food Colour (clear blue). Not one of the permitted blue colours under the new Regulations. Not an offence under the present Regulations. 29 Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action taken Inf. 1309 Ice Cream Lolly. 24% deficient in fat. Formal follow-up sample taken with satisfactory result. F.1105 Condiment non-brewed. 5% deficient in acetic acid. Warning letter and advice given to manufacturer. Follow-up sample taken and found to be genuine. Inf. 1375 Lemon Cheese. Contained insufficient egg to justify the description. Formal follow-up sample taken. F.1123 Lemon Cheese. Contained insufficient egg to justify the description. Matter taken up with Manufacturers and further enquiries pursued with their Analyst. Inf.1385 Meat Loaf. Meat content included half its weight in tripe. Formal follow-up sample taken. F.1138 Meat Loaf. Contained substantial proportion of tripe. Matter brought to the attention of the F.1145 Meat Loaf. Contained substantial proportion of tripe. priate Danish trade authority with regard to the description of the samples. Inf.1389 Tablets. An inappropriate description of Chlorophyll and iron. Matter brought to the Manufacturer's attention who agreed to amend label. Inf.1395 Milk. 7% deficient in fat. Formal follow-up sample taken and found to be genuine. Inf.1442 Grape Juice. No statement of the amount of minerals or vitamins. Matter brought to the attention of the retailing company (foreign produce with no manufacturer's name) Withdrawn from sale. Inf. 1450 Vienna Sausages. Meat content included tripe. Matter brought to the attention of the appropriate Danish trade authority. Inf.1452 Rice Pudding. Prepared from skimmed milk powder but skimmed milk not stated in ingredients. Formal follow-up sample taken (after 1957 period). Matter taken up with manufacturer's who agreed to amend label. 30 FOOD COMPLAINTS REFERRED TO PUBLIC ANALYSTS. Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action taken Cpt.1250 Bread. Contained a lump of stale dough. Matter considered by Council — Baker warned. Cpt.1262 Milk. Contained a rusty metal bolt. Legal proceedings instituted Vendor/Bottling firm fined £10. tinder Section 2, Food Drugs Act, 1955. Cpt.1267 Peppermint Lozenge. Contained a small tin tack. Matter considered by Council — Manufacturer warned. Cpt.1289 Crystal Mint Sweets. Contained foreign matter in the form of traces of sugar dyed red. Matter considered by Council — no further action (traces only minute). Cpt.1290 Chocolate Nut Crunch. Contained a portion of a cigarette. Legal proceedings instituted Manufacturer fined £5 plus costs. Cpt.1310 Bread — slice of. e Contained rodent excreta. Legal proceedings instituted Bakery fined £5 plus costs. Cpt.1311 Milk. Contained a " milk skin " covered with mould growth. Matter considered by Council - Milk bottling company warned Cpt.1335 Bread. Contained a garden moth. Matter considered by Council Baker warned. Cpt.1341 Bread. Contained fragments of an insect. Matter considered by Council Baker warned (Insect fragments too broken and small to identify). Cpt.1369 Milk. Contained foreign matter in the form of greyish brown filament — like matter consisting of a milk film covered with masses of mould growth. Matter considered by Council - Bottling firm warned. Cpt.1371 Bread. Contained foreign matter in the form of bread darkened by the presence of oily matter. Matter considered by Council Bakery firm warned. Cpt.1393 Milk. Bottle contaminated with paint or similar material. Matter referred to local authority in whose district milk was bottled. 31 Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action taken Cpt.1396 Milk. Contained a piece of erasing rubber. Matter considered by Council Bottling firm warned. Cpt.1403 Milk. Contained a mass of mould growth. Matter brought to the attention of the bottling dairy and to the local authority in whose district dairy is situated. Cpt.1417 Milk. Contained foreign matter in the form of mortar or cement. Matter brought to the attention of the bottling dairy and to the local authority in whose district dairy is situated. Cpt.1448 Ground Almonds. Contained rodent excreta. Follow-up inspection at retailer's premises revealed no evidence of rodent infestation. No further action due to circumstances of the complaint. FOOD COMPLAINTS WHERE ANALYSIS WAS NOT REQUIRED. Complaint Action Mouldy iced vanilla slice. Vendor and supplier warned. Insect in tin of processed peas. Matter taken up with Canners. Alleged mould in white loaf. Matter taken up with Bakery Firm. Fly in tin of baked beans. Evidence insufficient to prove fly was in tin. Nail in packet of tea. Matter taken up with manufacturer. Cheese alleged to contain hair. No action possible—"hair" probably muslin used to wrap cheese. Bread containing extraneous matter. Referred to local authority of adjoining area where bakery situated. Cockroach in slice of bread bought in Works' canteen. On investigation, found that evidence had been destroyed, no action therefore possible. Mouldy loaf. Matter taken up with Bakery concerned. Mouldy loaf. Matter taken up with Bakery concerned. 32 Complaint Action Brown dough in a white loaf. Matter taken up with Bakery concerned. Bad eggs. Matter taken up with Vendor. Mouldy apple tart. Matter taken up with Bakery concerned. Mouldy pork pies. Vendor warned to keep check on sale of perishable commodities. Insect in tin of blackberries. Matter taken up with Manufacturer. Ham alleged to have caused sickness. No evidence to substantiate allegation. Piece of cigarette carton in pint bottle of milk. Dairy company warned. Milk bottle badly worn and etched. Dairy company asked to ensure that bottles very badly worn are removed from stock. Dirty condition of milk bottles and caps generally insecure. Matter taken up with Vendor and with producer. Third pint bottle of milk with bottle neck broken. No glass in milk—no action. Pint bottle of milk containing extraneous matter which on examination proved to be a cement deposit. Matter taken up with Dairy company. Dirty pint milk bottle. Matter taken up with Dairy company. Third pint bottle containing milk bottle top. Matter taken up with Dairy company. Glass in third pint bottle of milk. Investigated—no further action. Pint bottle of milk containing extraneous matter. Matter taken up with Dairy company. Third pint bottle of milk containing milk bottle top. After due consideration no action taken. Third pint bottle of milk—neck of bottle badly broken. After due consideration no action taken. Third pint bottle of milk containing milk bottle top. After due consideration no action taken. Third pint bottle of milk alleged to contain house fly. Impossible to state if fly in milk when bottle received by complainant—no action. Insect in third pint bottle of milk. After due consideration no action taken. Drinking straw in third pint bottle of milk. After due consideration no action taken. Glass in third pint bottle of milk. After due consideration no action taken. 33 Complaint Action Glass in third pint bottle of milk. After due consideration no action taken. Glass in third pint bottle of milk. Dairy company warned and local authority where dairy situated informed. Glass in third pint bottle of milk. Dairy company warned and local authority where dairy situated informed. Two crates of milk delivered to local school found to be sour. Matter taken up with Dairy company concerned. Food Premises. The number of food premises in the district may be classified a follows (where more than one trade is carried on at any premises the an entry is made in respect of each trade): Bakehouses 19 Butchers 73 Cafes 54 Confectioners (bread, cakes etc.) 37 „ (sweets, etc.) 118 Fish shops 29 Grocers 177 Greengrocers 97 Ice Cream Dealers 281 Ice Cream Manufacturers 14 Food and Drugs Act, 1955—Food Hygiene Regulations 1955. Eighty-two notices were served during the year on owners or occupiers of premises coming within the scope of these Regulations. Our Inspectors during the year made substantial progress with the detailed administration of these Regulations and had in so doing full co-operation from the vast majority of the traders. The number of notices served during the year, 82, reflects this co-operation very forcibly as compared with the 280 notices served in 1956 when the administration of the Regulations was in its relative infancy. Both in public relations work and in approaches to individual traders full emphasis has been given to the necessity for complying in spirit and letter with the Regulations. A meeting was held towards the end of the year with a representative number of food traders (including employees) and whilst interest was aroused on the subject the positive attendance was such that—if this meeting was a true index—one can only be happy to know that such a percentage of food traders in the district have a standard of knowledge concerning the Regulations and food hygiene generally which does not demand any substantial refreshment. I know quite well that no one time or day can please everybody but equally it can be said that 'where there is a will there is a way' and the attendance on this as on previous occasions was discouraging. 34 Unsound Food. During the year the following foods were voluntarily surrendered to the Public Health Inspectors as being unfit for human consumption:— Tons Cwts. Lbs. Ozs. Meat — 5 69 8 Fish — 6 7 — Tinned Meat — 14 86 8 Tinned Fish — — 71 8 . Tinned Milk — 7 98 2 Tinned Food — 17 78 — Miscellaneous Groceries — 6 86 6 Skim Milk Powder — 1 — — 3 - 49 - Carcases Inspected and Condemned. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Horses Number killed 505 8 85 1,550 1,273 — Number inspected 505 8 85 1,550 1,273 — All diseases except Tuberculosis and Cysticercosis- Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned 31 1 - 12 8 - Percentage of number inspected affected with disease other than tuberculosis, etc. 6.1 % 12.5% - 0.8% 0.6% - Tuberculosis only— Whole carcases condemned — — — — — — Carcases of which some part or organ was condemned 14 - - - 14 - Percentage of number inspected affected with tuberculosis 2.8% — — - 1.1% — Cysticercosis only— Carcases of which some part or organ was condemned 5 - - - - - Carcases submitted to treatment by refrigeration 5 - - - - - Generalised and totally condemned - - - - - - 35 Slaughter of Animals Acts, 1933 to 1954. Eight slaughterman's licences were issued durirrg the year. Ice Cream. During the year 25 applications for registration as vendors, one as a manufacturer and 14 applications for registration of premises for the storage and sale of ice cream and one for the manufacture, storage and sale of ice cream were granted. At the end of the year 14 persons and premises were registered for manufacture and 281 for the storage and/or sale of ice cream. Eighty-six samples were taken during the year. 81 proved satisfactory. In addition 40 samples were taken under the Food and Drugs Act, for examination by the Public Analysts. The quality of the ice cream sold locally remains in general of a highly satisfactory order. Preserved Food Manufacturers. Section 90 of the Hornchurch Urban District Council Act, 1936, requires registration of preserved food manufacturers and premises. At the end of the year 63 persons and 82 premises were registered for the manufacture of preserved meat, an increase of 10 persons and 10 premises. Regular supervision is maintained over them. Essex County Council Act, 1952, Section 103. This section which deals with the registration of hawkers of food and their premises came into force on 1st April 1953 and at the end of the year 47 persons and 13 premises had been registered. Milk Pasteurising Plant. The only plant operated in the district ceased operation on 31.10.57. 43 methylene blue and phosphatase test samples were examined and found to be satisfactory. Milk Distributors. There are 13 milk distributors with registered premises in the district. There are also 13 firms registered as milk distributors in Hornchurch whose premises are registered in other districts. In addition 44 shopkeepers are registered for the sale of bottled milk only. Cleanliness of Milk Bottles. A dirty milk bottle re-circulated full is a reflection on the Company concerned primarily but may also be a reflection on the person who misused it originally and returned it dirty. No system of "spotters" is foolproof but if the small careless section of the public were nearly as careful to return bottles rinsed or at least not misused as the dairies are to send them out clean much less cause for complaint would arise. 36 The Milk (Special Designation) (Raw Milk) Regulations 1949-54, and The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949-53 : The number of licences issued by the Council during the year was as follows:— Dealer's (Pasteuriser's) 1* Dealer's (Pasteurised) 56 Supplementary Pasteurised 7 Dealer's Sterilised 76 Supplementary Sterilised 8 Dealer's Tuberculin Tested 40 Supplementary Tuberculin Tested 6 * Ceased an 31.10.57. Milk Sampling. The 134 samples of milk taken from the dairies and in the streets during the course of delivery to customers throughout the year were submitted to the Counties Public Health Laboratories for testing. In each case a satisfactory report was received. In addition 48 (1 unsatisfactory) samples were submitted to the Public Analysts and 5 (all satisfactory) for biological examination. Liaison With Other Authorities. Our excellent liaison with the London County Council in respect of the Horn church Children's Homes and the Brentwood Group Hospital Management Committee in respect of Harold Wood and Harold Court hospitals regarding the testing of their milk supplies noted in last year's report continues. School Canteens. Efforts were being made at the end of 1956 to secure a completion of the works considered necessary for full compliance with the Food Hygiene Regulations, 1955. This still represents the position at the end of 1957. Game Dealer's Licence. One Game Dealer's licence was issued during the year pursuant to Section 27(1) of the Local Government Act, 1894. 37 SECTION F. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER NOTIFIABLE DISEASES Infectious and Other Notifiable Diseases, 1957. Infectious and Other Notifiable Diseases, 1957. Disease Total cases notified No. of Cases hospitalised Diphtheria 1 1 Dysentery 26 13 Erysipelas 9 1 Food Poisoning 19 3 Infective Hepatitis 33 1 Measles 1,686 18 Ophthalmia Neonatorum 4 0 Pneumonia 57 7 Poliomyelitis— Paralytic 8 8 Non-paralytic 9 9 Puerperal Pyrexia 2 1 Scarlet Fever 197 11 Whooping Cough 157 8 Apart from Measles—630 last year—and Scarlet Fever 167 last year—which show a rise, whooping cough 298 in 1956 which showed a fall and the increase in non-paralytic poliomyelitis cases, no special statistical comment is indicated. Poliomyelitis Paralytic cases:— The 8 cases comprised females aged 31, 29, 23, 3 and 1 year and 3 males of 48, 18 and 7 years. The average hospital stay of all cases excluding the fatal ones was 66 days and varied from 166 to 34. Two cases—a male of 48 and a female of 28 died. At the end of the year 2 cases had been completely cured and 4 were progressing satisfactorily and attending hospital for physiotherapy. Non-paralytic cases:— The cases followed the usual course with the minimum hospital stay and the only incident of note was the fact that two members of the same family contracted the non-paralytic form of the disease within a week of one another. Dysentery and Food Poisoning. No significant outbreak occurred during the year, single cases being merely involved. There is possibly an appreciable amount of undiagnosed dysentery abroad with symptoms so slight that doctors are not consulted. 38 The following is a copy of the Annual Return of Food Poisoning notifications for the year 1957 which is sent to the Ministry of Health in accordance with statutory requirements:— 1 st Quarter 2nd Quarter 3rd Quarter 4th Quarter TOTAL 6 4 5 4 19 Outbreaks due to Identified Agents: Total Outbreaks: Nil. Total Cases: Nil. Outbreaks of Undiscovered Cause: Total Outbreaks: Nil. Total Cases: Nil. Single Cases: Agent Identified: 3. Unknown Cause: 16. 19 (Salmonella Typhimurium: 2). (Salmonella Enteritidis: 1). Diphtheria. The notified case of diphtheria was in a woman of 49 who after commencing with influenzal symptoms later developed a throat membrane without apparent glandular involvement. A C. diphtheriae gravis infection was ascertained bacteriologically but apparently responded speedily to treatment as negative swabs were relatively rapidly obtained; convalescence was slow. The two primary contacts both remained well. Immunisation and Vaccination Statistics. I am indebted to Dr. W. T. G. Boul, Area Medical Officer, for the following information concerning immunisation and vaccination statistics applicable to the Urban District for the year 1957: — Diphtheria Immunisation: Completed primary immunisations 1,508 Boost injections Whooping Cough Immunisations: Completed primary immunisations 1,296 Boost injections 115 Combined Diphtheria I Pertussis Immunisation-. Completed primary immunisations 457 Boost injections 70 Poliomyelitis Vaccination: Completed vaccinations (2 injections) 4,160 Acceptances 4,000 (approx.) Smallpox Vaccination: Primary Vaccinations 1,918 Re-vaccinations 489 39 Tuberculosis. Although the new respiratory cases notified this year showed a slight drop and the non-respiratory cases an increase, the most significant general observation must be that once again this year the deaths showed a decrease to what must be the lowest figure yet recorded in this district of 3. Not only have the total in the deaths declined from a maximum of 35 notified cases in 1944 to 2 in 1957, but in this year only 1 death occurred within 4 years of notification. The cases ascertained after death have also declined from 12 in 1951 to 1 this year, surely an index of an increasing trend towards earlier ascertainment. The number of cases on the register does not reflect the increase in the deaths since many cases are added through coming to live in this area after contracting the disease. Tuberculosis may be said to be largely controlled but certainly not eradicated. The number of cases of tuberculosis on the register at the end of the year was as follows:— Respiratory: Males 476 Females 425 Non-Respiratory: Males 49 Females 28 978 Romford Chest Clinic. I am indebted to Dr. S. Thompson, the Consultant Chest Physician, for the following notes:— "The Romford Chest Clinic serves the Borough of Romford and the Urban District of Hornchurch and is primarily a diagnostic centre for all forms of chest diseases. During the past winter for example during the epidemic of Influenza a large number of patients have been referred either with complications or to ensure that their chests were healthy before the general practitioner certified them fit to resume work. In addition to general chest work, all notified cases of tuberculosis in the areas are kept on the Register and are examined at regular intervals. Any new cases of tuberculosis which are diagnosed are recommended to the appropriate hospital or sanatorium for specialist treatment. On their return home after hospital treatment it is frequently necessary to maintain the treatment already initiated in the hospital and this is carried out and supervised by the staff of the Chest Clinic. Rehabilitation forms an important part of the work and the Chest Physicians maintain close 40 liaison with the District Rehabilitation Officer at the Employment Exchange so that patients may be found suitable work as soon as their medical condition allows. During the period of absence from work whilst undergoing treatment, the Chest Physician's maintain liaison with the N.A.B. and by virtue of the nature of the illness special allowances are made. In addition to the official sources of financial help Romford and Hornchurch Tuberculosis Care Association have meetings at monthly intervals to consider recommendations from patients who are unable to work and who find themselves temporarily in financial difficulties. Another important section of the work of the Chest Clinic is in the prevention of tuberculous infection and all contacts of known cases of tuberculosis are examined at regular intervals and in the case of children and young adults they are offered B.C.G. vaccination in order to reduce the incidence of tuberculosis in later life. As a result of these activities a most gratifying fall in both the incidence rate and the death rate has taken place during the past 12 years. Fifty years ago Tuberculosis accounted for 12% of all deaths, 30 years ago it was reduced to 8%, 10 years ago to 5% and in 1955 to only 2%. Another factor of the reduced incidence and more rapid treatment has been the abolition of the waiting list for treatment in hospital, and indeed, many Chest Hospitals and Sanatoria now have empty beds." 41 CASES OF AND DEATHS FROM TUBERCULOSIS, 1957 AGE GROUPS NEW CASES INWARD TRANSFERS TOTAL NO. OF CASES ADDED TO REGISTER DEATHS TOTAL DEATHS RESPIRATORY NONRESPIRATORY RESPIRATORY NONRESPIRATORY RESPIRATORY NONRESPIRATORY M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Under 5 years - 1 - 1 - - - - - 2 - - - - - - 5—14 years 1 2 1 1 1 1 - - 3 4 - - - - - - 15—24 „ 1 6 - 2 3 12 1 2 5 22 - - - - - - 25—44 ,, 15 8 3 2 18 17 4 1 40 28 - 1 - - - 1 45—64 „ 13 1 - - 3 2 - - 16 3 - 1 - - - 1 65 and over 7 1 - - 1 1 - - 8 2 - - - 1 - 1 Totals 37 19 4 6 26 33 5 3 72 61 - 2 - 1 - 3 42 INTERVAL BETWEEN NOTIFICATION AND DEATH OF FATAL CASES OF TUBERCULOSIS, 1947—1957 YEAR Within one month From 1—3 months From 3—6 months From 6—12 months From 1—2 years From 2—3 years From 3—4 years From 4 years and upwards Not Notified TOTAL 1947 1 5 1 1 7 5 3 10 5 38 1948 4 4 2 3 4 4 2 12 9 44 1949 1 1 1 3 9 2 2 10 6 35 1950 - 1 3 2 - 4 2 10 7 29 1951 3 - - 1 2 - 2 5 12 25 1952 - 1 - - 2 - 2 7 5 17 1953 2 - 1 1 1 2 2 8 4 21 1954 - - - 1 2 - - 5 3 11 1955 1 - - - - - 1 1 1 4 1956 1 - - - - - 3 1 5 1957 — — — 1 — — — 1 1 3 43 SECTION G. FACTORIES ACTS 1937 and 1948. Ministry of Labour and National Service Form 572. PART I OF THE ACT. 1. Inspections. Premises No. on Register No. of Inspections No. of written notices No. of occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by L.A's 29 21 7 - (ii) Factories not included in (i) in which Sec. 7 is enforced by the L.A. 247 329 31 - (iii) Other premises in which Sec. 7 is enforced by the Local Authority 35 32 3 - Total 311 382 41 - PART VIII OF THE ACT. OUTWORK—Sections 110 and 111. Nature of No of Outworkers Work in August list Wearing Apparel— No instances of work in unwholeMaking, etc 138 some premises. 2. Cases in which Defects were Found. Particulars Found Remedied Referred Prosecutions To H.M. Inspector By H.M. Inspector Want of cleanliness (Sec. 1) 7 4 — 1 — Inadequate ventilation (Section 4) 1 1 - - - Sanitary Conveniences (Section 7) (a) Insufficient 1 1 - - — (b) Unsuitable or Defective 36 29 - 12 - Other offences against the Act — — 3 — — Total 45 35 3 13 — 44 INDEX Page Acknowledgments 6,25 Acreage 7 Adoption of Private Streets 15 Aged, Care of 12 Ambulance Service 11 Atmospheric Pollution 5, 13 Births 7 Birth Rates 7 —Area Comparability Factor 8 —Comparative 8 Canteens, School 36 Caravans 22 Care of the Aged 12 Certificates of Disrepair 21 Cesspools 14 Clean Air Act, 1956 5, 13 Clinics, Child Welfare 11 Contents, Table of 2 Crematorium 17 Day Nursery 12 Deaths 7 —Age Groups 9 —Causes of 9 —Infantile 7 —Main Causes 8 —St. George's Hospital 8 Death Rates 7 —Area Comparability Factor 8 —Comparative 7 —Infant 7 —Neonatal 7 Diphtheria 38 Disinfection 17 Disinfestation 17 Domestic Help Service 12 Drainage and Sewerage 14 Dysentery and Food Poisoning 37 Essex County Council Act, 1952, Section 103 35 Establishments for Massage or Special Treatment 17, 19 45 Page Factories Acts, 1937 and 1948— Defects 43 Form 572 (Revised) 43 Inspections 19,43 Outwork 19,43 Fireguards 18, 19 Food Poisoning and Dysentery 37 Food— Complaints 24, 30, 31 Hawkers 35 Inspection of 18 Meat Inspection 34 Premises 18,33 Preserved 35 Unsound 34 Food and Drugs Act, 1955 6, 24 —Administration 24 —Food Hygiene Regulations, 1955 33 —Public Analysts 4,25 —Sampling 25 Game Dealers 36 General District Development 5 General Sanitary Circumstances 19 Heating Appliances (Fireguards) Act, 1952 and Regulations 1953 18, 19 Home Nurses and Mid wives 11 Home Safety 12 Horn church Urban District Council Act, 1936, Section 90 35 Houses— Inspection of 19 Number erected 20 Number inhabited 7 Housing 6,20 —Action under Statutory Powers 20 —Applications for rehousing (medical aspect) 22 —Caravans 22 —Certificates of Disrepair 21 —Closing and Demolition Orders 20 —General District Development 5 —Improvement Grants 21 —Overcrowding 22 —Sub-standard Property 23 —Temporary Accommodation 22 —Visits paid 19 46 Page Ice Cream 35 —Registration 35 —Sampling 35 Immunisation and Vaccination Statistics 38 Infectious and Other Notifiable Diseases 5, 37 —Hospitalisation 37 —Notifications 37 —Visits paid 19 Informal Notices Served 20 Laboratory Facilities 11 Land Charges Enquiries 22 Maternity and Child Welfare 11 Meat Inspection 34 —Carcases Inspected and Condemned 34 —Slaughtermen's Licences 35 Medical Examinations 10 Members of the Council 3 Metal Dealers 18 Mid wives and Home Nurses 11 Milk- Bottles 35 Distributors 35 Pasteurising Plant 35 Sampling 36 Special Designations 36 National Assistance Act, 1948, Section 47 12 New Streets 15 Nursing and Maternity Homes 11 Officers of the Public Health Department 4 Old Metal Dealers 18 Outworkers 19,43 Paddling Pools 17 Penny Rate Product 7 Pet Animals Act, 1951 18, 19 Poliomyelitis 37 Population 7 Public Health Propaganda 10 Preface 5 Public Analysts 4,25 Public Health Inspection 18 Public Health Inspectors 4 Rag Flock and Other Filling Materials Act, 1951 18, 19 Rateable Value 7 47 Page Rent Act, 1957— Certificates of Disrepair 21 Riding Establishments Act, 1939 18 River Ingrebourne 16 River Pollution 16 Rodent Control 17 School Canteens 36 Sewerage 14 Shops Act, 1950 (visits paid) 19 Slaughter of Animals Acts, 1933 to 1954 35 Smoke Control Areas 13 Staff 4,10 —Medical Examinations 10 Staffing 10 Statutory Notices Served 20 Stillbirths 7 —Rates 7 Swimming Pool 16 Table of Contents 2 Temporary Accommodation 22 Tuberculosis 39 —Incidence and Mortality 41 —Notification/Mortality Interval 42 —Romford Chest Clinic 39 Vital Statistics 5, 7 Water Supplies 13