Ac 4411 (3) 2, Lih RERY HORNC 27 Hornchurch Urban District Council ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1959 Public Health Department, James Gorman, Council Offices, M.B., Ch.B., D.P.H., F.R.S.H Billet Lane, Medical Officer of Health HORNCHURCH. Essex. Telephone: Hornchurch 52555 Hornchurch Urban District Council ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1959 Public Health Department, James Gorman, Council Offices, M.B., Ch.B., D.P.H., F.R.S.H. Billet Lane, Medical Officer of Health HORNCHURCH, Essex. Telephone: Hornchurch 52555 2 TABLE OF CONTENTS page Members of the Council (as at 31.12.59) 3 SECTION A—Statistics and Social Conditions of the Area 7 SECTION B—Genera] Provision of Health Services for the Area 10 SECTION C—Sanitary Circumstances of the Area ... 13 SECTION D—Housing 24 SECTION E—Inspection and Supervision of Food and Food Premises 26 SECTION F—Prevalence of, and control over, Infectious and Other Notifiable Diseases 39 SECTION G—Factories Acts, 1937 to 1959 45 Index 47 3 MEMBERS OF THE COUNCIL (as at 31.12.59) Councillor H. F. Moss, J.P., Chairman. (1) Councillor C. A. Welch, Vice-Chairman. (1) Councillor Miss C. F. M- Cannon. Mrs. E. H. Dean. (1) Mrs. W. M. Jiggins. Mrs. E. G. Richardson (1) R. A. H. Allen. A. T. Booton. (1) and (3) L. W. Carroll, J.P. (1) and (2) F. W. H. Embleton. A. C. Good. (1) A. J. Hall. D. L. Hammerton. G. F. Hancock. K. T. Hay. W. Hegarty. E. A. Hillman, J.P. H. Holock. (1) S. A. Legg. M. P. V. Leigh. J. S. Macy. (1) N. J. Miles. L. J. Nicholls. (1) G. W. Phillips. A. C. Salinger, J.P. S. B. Sanders. B. K. Snooks. A. J. Twigger. (1) R. E. Whitworth. 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., F.R.S.H. Deputy Medlical Officer of Health: (Part-time) P. X. O'Dwyer, M.B, B.Ch., B.A.O., D.P.H. Chief Public Health Inspector: M. F. G. Randall, M.A.P.H.I. (1) and (2) Public Health Inspectors: J. Goodwin, M.A.P.H.I. (1) (2) and (3) A. V. J. Hutchings, M.A.P H.I. (1) and (2) M. A. Jackson, M.A.P.H.I. (1) E. Oliver, M.A.P.H.I. (1) (2) and (3) F. W. Reeve, M.A.P.H.I. (1) and (2) G. H. Smith, M.A.P.H.I. (1) (2) and (3) S. Whitfield, M.A.P.H.I. (1) and (2) Chief Clerk: J. E. Blay. Clerical Staff: Miss E. Thompson. Miss W. A. Hepburn. Mr. P. R. Cheese (Commenced 28.12.59). Rodent Operative and General Assistant : W. T. Blanchard. 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 and Public Health Inspectors' Joint Board. (2) Certificate of the Royal Society of Health as Inspector of Meat and Other Foods. (3) Certificate of the Royal Society of Health as Smoke Inspector, 5 Public Health Department, Council Offices, Billet Lane, HORNCHURCH, Essex. 12th May, 1960. Telephone: Hornchurch 52555. To the Chairman and Members of the Hornchurch Urban District Council. Mr. Chairman, Ladies and Gentlemen, I beg to present my Report for 1959. Environmental hygiene is in danger of becoming (or has already become?) outmoded and in this connection it is both salutary and refreshing to quote (by kind permission) an extract from the 1958 Annual Report of Dr. Matthew Burn, the Medical Officer of Health of the City of Birmingham, viz.:— "The personal health service is naturally popular as the benefits derived are, in the main, individual. Environmental health on the other hand is general rather than individual and not obviously spectacular in achievement. It has been necessary to ensure that this essential feature of Public Health has not been subjugated by the personal health service. Environmental health services arc highly effective in preventing illness on a large scale and these, together with epidemiology, another 'essential' in the field of public health, are major factors of the preventive machinery of the local authority." In an age when the superlative represents the most modest descriptive term and glamour tends to warp judgment (this of course is not a new happening) any emphasis on the prosaic but effective and necessary services (such as the Environmental health service) is indeed timely. Statistics. As against last year the Birth Rate is slightly down, the Death Rate slightly up and the Infant Mortality Rate at 19.05 is also higher. General Picture. The work of the Department in matters of Housing. Infectious Disease and Food and Drugs pursued a routine course. 6 Clean Air. Our first Smoke Control Area commenced at Cranham on 1st September, 1959, and appeared to work excellently. It is being followed by other and larger areas eventually to cover the complete District. 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., F.R.S.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 1959) 122,600 Number of inhabited houses according to rate books (December 1959) 38,788 Rateable Value (December 1959) £1,759,967 Sum represented by a Penny Rate (December 1959) £6,980 Extracts from Vital Statistics for the Year. Live Births: Number 2,362 Rate per 1,000 population 18.10 Illegitimate Live Births percent of total live births 1.8 Stillbirths: Number 35 Rate per 1,000 total live and still births 14.60 Total Live and Still Births 2,397 Infant Deaths (deaths under 1 year) 45 Infant Mortality Rates: Total infant deaths per 1,000 total live births 19.05 Legitimate infant deaths per 1,000 legitimate live births 18.93 Illegitimate infant deaths per 1,000 illegitimate live births 22.77 Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 14.39 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 11.43 Perinatal Mortality Rate (stillbirths and deaths under 1 week per 1,000 total live and still births) 25.86 Maternal Mortality (including abortion): Number of deaths 2 Rate per 1,000 total live and still births 0.83 Deaths: Number 1,128 Rate per 1,000 population 10.94 DEATH RATE—COMPARISON WITH PREVIOUS YEARS 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 1950 10.4 1958 10.2 1951 10.3 1959 10.9 *Area Comparability Factor returned. The Area Comparability Factor for deaths this year altered from 1.06 to 1.19 and for births remained at 0.94. 8 BIRTH RATE—COMPARISON WITH PREVIOUS YEARS 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 1950 13.6* 1958 18.5 195.1 14.1 1959 18.1 * Area Comparability Factor returned. The Area Comparability Factor might very generally be translated as one which being applied to certain local figures makes them suitable for general comparisons. GENERAL MORTALITY—MAIN CAUSES 1949-1959. Causes of Death 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 Tuberculosis (all forms) 35 29 25 17 21 11 4 5 3 9 5 Cancer 180 155 183 184 211 234 210 253 248 236 247 Infectious diseases 9 3 4 1 3 1 2 0 2 0 2 Cardio-vascular disease 404 441 418 425 602 590 591 682 679 592 560 Influenza 9 3 19 2 14 1 2 7 8 6 12 Pneumonia 31 20 30 49 52 41 49 53 65 58 57 Bronchitis 65 63 69 52 85 54 65 95 79 76 61 Other respiratory diseases 6 3 7 9 10 8 10 7 9 13 14 Gastro intestinal diseases 13 20 16 12 28 13 10 14 10 15 13 Motor vehicle accidents 11 9 14 9 11 10 12 8 10 15 9 All other accidents 8 12 12 4 10 18 18 20 18 15 8 Suicide 3 10 11 10 7 11 11 9 14 8 12 Cardio-vascular disease (560), Cancer (247) and Bronchitis (61) head the list of causes. Cancer of the lung caused 50 deaths as against 49 last year but whilst the male deaths declined by 4 the females increased by 5 from this cause. The Bronchitis deaths were fewer than in any year since 1955. Accidental deaths declined by 13 as against 1958. Two deaths were attributed to Measles—now regarded as unusual. 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 5 3 2 - - - - - - - - 1 3 - - 1 - - 2. Tuberculosis, other 0 0 0 - - - - - - - - - - - - - 3. Syphilitic disease 2 1 1 - - - - - - - - - — 1 1 — — - 4. Diphtheria 0 0 0 - - - - - - - - - - - - - - - 6. Whooping cough 0 0 0 - - - - - - - - - - - - - - - 6. Meningococcal infections 0 0 0 - - - - - - - - - - - - - - - 7. Acute poliomyelitis 0 0 0 - - - - - - - - - - - - - - 8. Measles 2 0 2 — — — 1 — 1 — — — — — — — — — — 9. Other infective and parasitic diseases 2 2 0 — — - - - - - - - - 2 — — — - - 10. Malignant neoplasm, stomach 39 21 18 — — — — — — - — 2 - 6 8 9 4 4 6 11. Malignant neoplasm, lung, bronchus 50 43 7 — — — — — — — — 2 1 23 2 12 3 6 1 12. Malignant neoplasm, breast 23 0 23 — — — — — — — — — 3 — 11 — 7 — 2 13. Malignant neoplasm, uterus 10 0 10 — — — — — — — — — 2 — 2 — 1 — 5 14. Other malignant and lymphatic neoplasms 125 67 58 — — 1 — - 1 1 1 6 7 22 21 19 14 18 14 15. Leukaemia, aleukaemia 4 3 1 - - 2 - 1 - - - - 1 - - - - - - 16. Diabetes 10 6 4 1 — — — — — — — — 1 3 3 1 — 1 — 17. Vascular lesions of nervous system 181 75 103 — — - — — — 1 — — — 16 11 17 26 41 69 18. Coronary disease, angina 167 106 61 — — — — — — — — 3 1 44 7 39 20 20 33 19. Hypertension with heart disease 19 7 12 — — — — — — — — — — — 1 3 2 4 9 20. Other heart disease 152 52 100 — — — — — — — - 2 1 9 6 13 10 28 83 21. Other circulatory disease 41 19 22 — — — — — — — — 1 — 6 4 3 8 9 10 22. Influenza 12 10 2 — — — — — — 1 — 1 — 4 — 2 — 2 2 23. Pneumonia 57 23 34 2 5 — — - — — — — 6 6 6 2 9 21 24. Bronchitis 61 41 20 - — — 1 — - — — — - 13 4 11 D 17 10 25. Other diseases of respiratory system 14 11 3 — — 1 — — — — — — 1 4 — 4 2 2 26. Ulcer of stomach and duodenum 7 6 1 - — — — — — — — — — 2 2 1 2 — 27. Gastritis, enteritis and diarrhoea 6 4 2 2 1 — — — — — — 1 — — 1 1 — — 28. Nephritis and nephrosis 11 3 8 — — — — — 1 — 1 3 1 — — 4 — 1 29. Hyperplasia of prostate 3 3 0 - - - - - - - - - - - - - - 3 — 30. Pregnancy, childbirth, abortion 2 0 2 - - - - - - - 1 - 1 - - - - - - 31. Congenital malformations 8 4 4 3 3 - - - l - - 1 - - - - - - - 32. Other defined and ill-defined diseases 86 43 43 15 13 — — — — 1 — — 2 12 8 10 7 3 13 33. Motor vehicle accidents 9 8 1 — — — — — — 2 — 3 — 2 — 1 — 1 34. All other accidents 8 7 1 — — - — — - - — 3 1 1 - 3 - — 35. Suicide 12 6 6 — — - - - - - - 1 1 4 4 1 1 — 36. Homicide and operations of war 0 0 0 - - - - - - - - - - - - - - - - TOTAL 1.128 574 554 2 3 22 4 2 1 3 7 2 27 27 183 100 158 116 171 282 10 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Staffing. It is with much pleasure that 1 note the success of Mr. M. A. Jackson, our Pupil, in securing the Public Health Inspectors' Certificate of the Royal Society of Health and Public Health Inspectors' Joint Board. It is also very gratifying to record that Messrs. J. Goodwin and G. H. Smith obtained the Smoke Inspectors' Certificate of the Royal Society of Health. The establishment of the Department was increased during the year by one Public Health Inspector and a vacancy in the Clerical staff was filled by the appointment of a Junior Clerical Assistant from the Pool of Juniors. Medical Examinations—Staff. Staff arrangements remain as last year. During the year arrangements were made for the examination of 216 (206) employees or prospective employees—63 (58) permanent and 153 (127) temporary. The 1958 figures are given in parentheses. Public Health Propaganda. Our routine talks to local organisations, poster and leaflet displays, occasional film shows and the like continued. The commencement of our smoke control programme demanded an emphasis on this facet of our work. The most interesting personal happening was my attendance at the Summer School of the Central Council for Health Education at Bangor. It should be emphasised that the syllabus—plus the manner in which one found it carried out—dispelled any notion that this might be a holiday in disguise. Meetings with Commonwealth and foreign colleagues in discussion groups, the wide variety of publicity measures dealt with and the general conclusions discussed, represented merely a part of the wide programme. It also showed how much scope there is for co-ordination in the field of propaganda between Health Authorities entrusted with differing functions. Apart from the claims of individual advertisements, television seems to have secured results and unless health material is made palatable its impact is going to be the less. The value of health propaganda is, of course, much more difficult to assess than its commercial counterpart. If a statement is made often enough and publicly enough it may well be that its merits have less influence than its repetition. 11 Perhaps the same applies to a limited extent in visual propaganda methods where flooding a district with one theme for a selected period may be much more profitable than ranging widely but cursorily. The County Council is co-operative in this field and Hornchurch is therefore assisted in discharging what is and will remain a difficult but increasingly necessary duty. Laboratory Facilities. Our arrangements follow the existing lines and include primarily the utilisation of Oldchurch Hospital laboratory (by kind assistance! of Dr. E. A. 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. Ambulance Servicc. 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, Hornchurch. (vii) Suttons Hostel, Hornchurch. (viii) Upminster Road, Rainham. (ix) 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 eight midwives and six 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 eight 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 service is in operation and is administered for the Essex County Health Services by the Area Medical Officer, 34, Cresthill Avenue, Grays. Domestic Helps can be supplied for a period of two weeks in the case of a home confinement, but as there is a great demand for this service, it is essential to apply as early as possible. Where there is illness approval may be given, upon receipt of a medical certificate, for a Help to attend. Domestic Helps are paid by the County Council, but the person assisted is required to contribute towards the cost according to his, or her, means. An assessment form must therefore be completed if it is desired to claim reduction in the charge, otherwise the full standard charge, which is at present 3s. 6d. an hour, will be payable. Care of the Aged. The usual number of cases have cropped up in which the dividing line between statutory and other action is fluid. Painstaking work by the Public Health Inspectors allied to a close and essential liaison with the personal health services of the County succeeded in avoiding any compulsory removal action under Section 47 of the National Assistance Act, 1944. The Home Help Service also plays an important part in this type of work although it must be said that their limits of assistance appear to me as being not quite flexible enough to enable them to deal with the kind of incident which crops up inevitably from time to time and represents the social problem demanding most urgent solution. There remains the occasional instance in which a combination of mental and/or physical disability produces a lamentable state of affairs for which no legal remedy appears appropriate. One wonders how much an intial tendency to sloth, plus it may be, some degree of mental instability (not of course necessarily certifiable) can in the ultimate be so encouraged by the variety of services provided through Central and Local Government as to produce a pathological climax. Inevitably the effect of generosity is on occasion to be taken for granted and taken advantage of and the socially difficult cases which come to notice over the years do nothing to belie this assertion. Home Safety. A close liaison still exists between the local Committee and your Public Health Department. 13 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. Water Supplies. Main: The feature of the year was the remarkable spell of dry weather which confounded even the diehard supporters of the British (in this sense 'English' is perhaps parochial) Summer. The result was a drought which in this District produced inconvenience and one or two isolated situations which were somewhat more serious but transient. Considering the circumstances with which they were confronted it is my personal view that the South Essex Waterworks Company are to be congratulated on the manner in which they successfully met the challenge. Their co-operation is normally of the highest order and one always feels that enquiries are met with understanding and desire to ensure—with us—the fullest public service. Twelve samples were taken by my Department during the year from the main supply. 4 were submitted for chemical and bacteriological examination and 8 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, but owing to the exceptionally high demand during the extreme drought periods, the pressures were at times less than normal. 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 4,130 chemical, bacteriological and biological examinations have been made and all water going into supply was wholesome. In addition, samples were examined for radioactivity. 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 is not plumbo-solvent. No action has been necessary in respect to any form of contamination. The number of dwelling houses supplied as at the 31st December, 1959, was 40,002 and the population as at the 30th June, 1959, as obtained from the Registrar-General, was 122,600. We are unable to state the number of houses supplied by standpipes, but the total is quite insignificant." 14 As a matter of general interest T record the rainfall figures for the year (kindly supplied by the Engineer and Surveyor) and relating to " Langtons." The 1958 figures are shown in parentheses. Amount of rainfall in inches Number of days in which rain fell January 1.64 (1.37) 14 (9) February 0.06 (2.25) 2 (17) March 1.35 (1.10) 15 (13) April 1.96 (1.62) 15 (11) May 0.95 (1.82) 5 (13) June 0.77 (4.99) 11 (16) July 0.83 (2.00) 8 (14) August 1.22 (3.84) 7 (17) September 0.03 (4.77) 1 (11) October 2.50 (2.20) 12 (14) November 2.70 (1.83) 13 (11) December 3.10 (2.64) 25 (18) 17.01 (30.43) 128 (154) Well: Five routine samples were taken from 5 supplies of this type and the results were uniformly unsatisfactory. The houses involved varied from 38 to 555 yards distant from a mains supply with a commensurate cost of mains extension. The significance of a poor well supply is not often appreciated by the users (or does not seem to be) and whether by some process of immunisation or even that the water—as advised—is always boiled, to date no trouble has arisen through these supplies. Apart from actual mains extension it is sometimes possible to improve the well and/or surround to obviate or minimise contamination. Improving housing standards for agricultural workers ensure that where reasonably practicable the well supply will be replaced by main water and the aggregation of farm workers' houses in circumstances permitting modern amenities allows this to be readily secured. In general therefore as is to be expected in a district such as this the well water problem is of minimum proportions. Atmospheric Pollution. Clean Air: The extent and diversity of work naturally increases year by year as is bound to happen if progress is to be made. Smoke Control Areas with their attendant surveys, consideration of grants, propaganda and the like occupy pride of place and will be detailed later. 15 Routine observations, now in their 12th year—through Deposit Gauges, Lead Peroxide Candles and our Volumetric S02 apparatus— propaganda, investigation of specific complaints of pollution and attendance at meetings of outside bodies concerned with pollution problems, occupy cumulatively a great deal of time. They nevertheless serve to provide a complete picture as well as throwing considerable light on how to secure it. Smoke Control Areas: Our first area in Cranham came into force on 1st September, 1959. It comprised 239 houses, i.e., 224 Council houses, 11 privately owned and 4 Police houses. The Council houses comprise 3-bedroom Cornish Unit and 3-bedroom semi-detached and maisonettes. The area is bounded by Front Lane, Brunswick Avenue and Roseberry Gardens and has an acreage of 34.8. The reasons for choosing this area were given in my 1958 report and need not be recapitulated. It is clear that a relatively negligible number of private houses were involved and the grants approved will therefore be of a minor financial order. Preliminary propaganda brought our intentions to the notice of residents long before the operative date, but a public meeting was nevertheless held adjacent to the area and open to any interested party. In the event more officials than members of the public attended but this clearly indicated the absence of dissatisfaction at our choice of area. No complaints of working difficulties had been received by the end of the year and the only—and natural—reaction elicited from time to time was a feeling that the smokeless air programme having started in part of Cranham should rapidly be extended to the district as a whole. Hornchurch is not a black area as envisaged in Ministry of Housing and Local Government Circular 5/59 but the need to clear the air is imperative even when domestic smoke is the major pollutant. May I in this connection once again repeat that apart from gas. electricity and oil, the solid fuel future in securing smokeless air rests principally with coke and not with the many proprietary fuels of the same general type. The merits of one or the other need not be discussed here, the main point is that coke will be the most readily available for some time to come. Future Areas: The area bounded by Ford Lane, Wood Lane, South End Road and Rainham Road, was tentatively selected as our second venture and —after due enquiry—was submitted to the Minister in mid-year for his preliminary approval. 16 This is a much larger area than our first, much more diverse in character, will require many more conversions and hence entail expenditure of a much higher order. It represents a speeding up of the tempo which alone will enable the whole district to be smoke free within a reasonable time. Involved in this area are: — Privately owned dwellings 888 Houses—Council 240 Houses—East Ham C.B.C 228 Maisonettes—Council 139 Flats—Council 139 Flats—East Ham C.B.C. 78 E.C.C. Police Houses 8 R.A.F. Station Houses 67 Church and Church building 1 Schools and School House 3 Shops 19 The acreage is 220. The end of the year saw discussions crystallising on a third area but no definite selection had been made. Discussion with Neighbouring Authorities: Our liaison continues with Romford and Dagenham but no specific lines of mutual progress emerged during the year. Specific Complaints: Various complaints of smoke, fumes or dust from factory or hospital chimneys were received during the year. It will be appreciated that many specialised processes fall to the lot of the Alkali Inspector to control but a sound working liaison exists between us and this naturally greatly assists in tackling our mutual problems. It would be idle to pretend that all problems of this kind are soluble either readily or at the present stage at all. A great deal can be done to minimise cause for complaint but so long as every reasonable step is taken by firms or others to avoid the cause, there may be left a core of trouble which only research and time will enable the authorities to obviate. It should be noted that under the Act St. George's Hospital is Crown property and hence does not come under our direct jurisdiction for Smoke Control purposes. It is, in my view, regrettable that this should be so. Routine Observations: Apart from the removal of one Deposit Gauge from "Langtons" to Scargill School and the placing of a Smoke Filter at the same school, our plans were unaltered. 17 The alterations above noted were designed to provide a picture of the air purity at the school—which is sited in the No. 2 Smoke Control Area — during a sufficient length of time before the area becomes operative as to reflect in some measure the impact of the Area Smoke Control scheme. In effect it is designed to and should provide a controlled contrast between the air as it now is and the air as it will be under smoke control conditions. General: A visit was paid by a Council party to Watson House, North Thames Gas Board's Research Headquarters and a most instructive afternoon resulted. The object was to clear up certain important points in the working of a Smoke Control area and questions concerning coke, gas ignition and a variety of other factors were satisfactorily resolved. Radioactivity. Attention is becoming increasingly directed to this matter which clearly is of an extremely specialised nature. It is perhaps less important that the Local Authority should be deemed self governing in affairs of this kind than that they should be kept informed by whatever Authority is responsible of all factors bearing on the welfare of the area under their control. There is a vast gap between the professional nuclear physicist and the Medical Officer of Health but a certain knowledge of and an abiding interest in this scientific development is inseparable from the work of the latter if he is to discharge adequately the duties for which he is deemed statutorily responsible. He must, therefore, be regarded as an essential member of the team and, in justice alike to himself and his Authority be treated as such. This also implies that a short course, followed after a period of 5 or 6 years by another —even presuming he maintains an interest in the subject in the interim— is not quite good enough. The Medical Officer of Health ought to be able to talk the same language as the nuclear physicist, even though he doesn't talk it quite so well, and the same applies to understanding and appreciating the results of experiment. It is not only the duty of the Medical Officer of Health to interest himself in matters of radioactivity but also of other Authorities involved to ensure that the means are placed at his disposal of translating that interest into channels of practical application. The potential hazards of radioactivity give food for sober thought but they will not be better assessed through either exaggeration or summary dismissal. Drainage and Sewerage. The main issue of the Regional Sewage Scheme has not yet been practically resolved. The Essex River Board has been very active in endeavouring to secure progress as, of course, has this Council. 18 New Sewers. The Engineer and Surveyor informs me that 5,756 yards of soil sewer of 9 inches, 15 inches and 18 inches diameter were laid during the year. Conversions. Pail closets at 1, 2 and 3, Mashiters Cottages, New Road, Rainham, were replaced by sewer connections. Rivers. The condition of the Ingrebourne on analysis presents an annual and unsatisfactory picture, the remedy for which lies outside our boundaries. No large scale flooding occurred in 1959 but concerted steps are being taken to obviate trouble from the Ravensbourne which on occasion gives householders a great deal of inconvenience. Nature provides the vegetation which impedes the flow of our streams but man provides the less decorative effect by regarding the watercourses all too often as an accessible vehicle for the disposal of bicycle wheels, tyres and a host of other impedimenta. Ditches. The attraction of an open ditch allied to the relative unlikelihood that the action will be specifically brought home to anyone makes it a natural choice for the deposition of unwanted material. The chances of this trouble being caused by persons outside our district are probably greater than in the case of watercourses. Cesspools. The result of sewer construction in Lake Avenue, Abbey Wood Lane and Briscoe Road will be to dispose of 95 cesspools. Cesspools are on the whole a 'silent' nuisance but their presence in an Urban Area can only be justified on grounds of dire necessity. Swimming Pool. The water is sampled regularly and the results have been uniformly satisfactory. Ministry of Health Circular 1/60 requests certain information regarding public swimming baths. This information has kindly been supplied by the Bath Superintendent and Engineer and is reproduced herewith:— "The Swimming Pool, set in the pleasant surroundings of Harrow Lodge Park, is an indoor pool 110ft. x 42ft. and varies in depth from 3ft. at the shallow end to 12ft. 6ins. below the diving stage. It is equipped with 1 and 3 metres spring boards and 3 and 5 metres firm boards and 700 spectators can be seated for swimming events. 19 The Swimming Pool water continues to be maintained at a very high standard of purity and clarity and the building has been kept clean, warm and well ventilated. The water is obtained from the main supply and the high standard of purity is maintained by the plant at the pool comprising 6 vertical sand filters 8ft. 6ins. in diameter, chemical dosage plant for coagulation, aerator and chlorine dosage plant. The plant is operated on the break-point chlorination method of sterilisation and while the turnover period of the pool through the filters is normally 4 hours, this can be reduced to 3 hours during peak periods. Included in the ventilation plant is an adequate air filter system." Paddling Pools. Four samples were taken from each of the four Paddling Pools, i.e., in May, June, July and August, 1959. Six of the samples were ' unsatisfactory'. This does not mean, of course, that they represented any real prejudice to health and reflected, in fact, our habit of sampling on occasion at times of maximum use. The Engineer and Surveyor is in charge of this service and is fully advised by me on the necessary safeguards. Streets Made Up and Taken Over. The Engineer and Surveyor, Mr. V. Williams, has supplied the following list of streets made up and taken over during the year ended 31st December, 1959: — yards Private Streets: Ingrebourne Gardens (part) 187 Ashvale Gardens 243 Hartland Road (part) 150 Stanley Road North 751 Elmer Gardens 438 Brookway 445 Total Length 2,114 Estate Roads: Trent Avenue 306 Nyth Close 189 Dury Falls Close 223 Nightingale Avenue 176 Brookmans Close 230 Kingfisher Road 192 Thames Close 58 River Close 44 Marlborough Gardens (part) 172 South Hall Drive (part) 353 Florence Close 80 Mallard Close 78 Grey Towers Gardens (part) 133 Heron Way (part) 351 Total Length 2.585 20 Disinfestation and Disinfection. No change in our arrangements has taken place within the last year. Rodent Control. During the year the Rodent Operative paid some 317 visits to deal with new infestations. 1,461 routine or revisits were paid. The premises visited comprised 270 dwellings and 47 business premises or factories. A change relevant to your general arrangements meant that domestic infestations were treated free of charge. The revenue accruing from the nominal charge previously made did not in the event justify the work involved. Arrangements concerning business premises remain unaltered, i.e., that payment is made on a basis of work done. Attendance at meetings of No. 3 Essex Workable Area Committee is normally made by the Chief Public Health Inspector so that a wider picture of County progress and procedure is available. The Rodent Operative has attended single day Refresher Courses under the auspices of the Ministry of Agriculture, Fisheries and Food. Farm Work. Eighteen visits were made to farms by the Rodent Operative. Most of our farmers keep a stock of ' Warfarin' rat poison which they use when required and some engage private contractors to do this work. Eleven infestations were found and cleared. Establishments for Massage or Special Treatment. The Essex County Council granted licences, to ten persons during the year authorising them to carry on establishments for massage or special treatment. Heating Appliances (Fireguards) Act 1952 and Regulations 1953. Twenty-four visits were paid during the year. 20 appliances were tested (involving 49 tests) and 2 failed one of the prescribed tests. These two fires were returned to the manufacturers. Two shopkeepers found to be selling unsatisfactory second hand fires withdrew them from sale at our request. Old Metal Dealers (Hornchurch) Order, 1956. At the end of the year 13 persons had registered as Dealers in old metal. 21 Pet Animals Act, 1951. Forty-two visits were paid to the 11 Pet Shops in the District. Rug 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. There are 2 riding establishments known in the District. Diseases of Animals (Waste Food) Order, 1957. All the licences, including those formerly issued by the Ministry of Agriculture, Fisheries and Food, are now issued by this Council. Routine supervision is maintained over the processes and premises involved. A total of 16 licences had been issued up to the end of the year. Agriculture (Safety, Health and Welfare Provisions) Act, 1956. Certain sections of this Act dealing with the provision, maintenance and cleanliness of sanitary conveniences fall to be dealt with under your jurisdiction and arrangements for discharging the necessary duties are being carried out by my staff. Six notices were served during the year. Public Health Inspection of the District. SUMMARY OF PUBLIC HEALTH INSPECTORS' WORK DURING 1959. Inspection of Food and Food Premises (visits paid): Bakehouses 111 Butchers' shops 299 Cafes 173 Confectioners 119 Dairies 5 Fish shops 80 Food complaints 143 Greengrocers' shops 159 Grocers' shops 456 Ice cream vendors and manufacturers' premises 156 Mobile shops (hawkers) 63 Public houses 9 Sampling 504 School canteens 103 22 Slaughterhouse 407 Staff canteens 21 Miscellaneous visits 21 Housing (visits paid): Overcrowding, etc. enquiries 82 Improvement grants 111 Sanitation 68 Structural defects 347 Water supply and pipes 67 Miscellaneous housing visits 186 Re-inspections ... 1,273 General Sanitary Circumstances (visits paid): Atmospheric pollution 517 Camping and fairgrounds, vans, etc 110 Conveniences 33 Drainage and sewerage 673 Dustbins 33 Farms 56 Stables, piggeries, animals, birds, etc 62 Nuisances 242 Paddling pool samples 16 Refuse tips 53 Pest Control 349 Sewage works (effluent samples) 3 Swimming Pool samples 13 Water samples (main supply) 15 Water samples (well) 20 Rivers, streams, ponds, etc 84 Miscellaneous visits 87 Re-inspections 1,225 Factories and Outworkers : Number of visits paid 361 Shops Act: Number of inspections 873 Miscellaneous (visits paid): Diseases of Animals (Waste Food) Order 41 Heating Appliances (Fireguards) Act 24 Pet Animals Act 42 Rag Flock and Other Filling Materials Act 6 Old Metal Dealers 4 Smoke Control Areas 1,774 23 Infectious Disease: Number of visits paid (including contacts) 702 Number of notices served: Informal 304 Statutory 119 The main headings under which work was done may be noted as follows: Housing 2,134 visits Inspection of Food and Food Premises 2,827 „ General Sanitation 3,591 „ Infectious Diseases 702 „ Shops Act Inspections 873 „ Factories and Outworkers 361 „ Public Health Inspectors' Work. Largely due to the claims of smoke control but also aided by the improved standards now existing in food premises, fewer visits were paid under Food Inspection auspices and many more in connection with Atmospheric Pollution. The routine work of a Department always tends to suffer in times of specialised effort and this trend is not material so long as the effect upon the routine does not go beyond a certain limit. The general work of the Inspectorate was, I consider, of a high order. Shops Act, 1950. The number of shops on the register at the end of the year was 1,144. Nineteen notices were served during the year regarding contraventions of the Act. 24 SECTION D. HOUSING Number of New Houses erected during the year: (i) By the Local Authority 25 (ii) By other Local Authorities 10 (iii) By other bodies or persons 691 Number of Houses voluntarily demolished 3 38, 40 and 42, Moor Lane. Number of Demolition Orders made 1 16, Hubbards Chase. Number of Houses demolished following representations 7 5, 6 and 7, Dennises Cottages, Dennises Lane. la, 4, 5 and 6, Harveys Cottages, Upminster Road. Number of Undertakings accepted to make houses fit for human habitation 1 34, Brentwood Road. Certificates of Disrepair. The following is a summary of Returns under the Rent Act, 1957, made to the Ministry of Housing and Local Government covering the period 1st January to 31st December, 1959. Part I—Applications for Certificates of Disrepair: (1) Number of applications for certificates 32 (2) Number of decisions not to issue certificates 0 (3) Number of decisions to issue certificates: (a) in respect of some but not all defects 21 (b) in respect of all defects 11 (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 22 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule 0 (6) Number of certificates issued 10 Part II—Applications for Cancellation of Certificates: (7) Applications by Landlords for cancellation of certificates 19 (8) Objections by Tenants to cancellation of certificates 9 (9) Decisions to cancel in spite of Tenant's objection 2 (10) Certificates cancelled by Local Authority 21 25 Improvement Grants. In connection with applications under this heading our advice has been sought in 70 instances during the year. Our opinion has then been submitted to the Clerk (copy to Surveyor) for consideration by the Committee when the application for grant came up for determination. Re-Housing—Medical Aspects. My advice was sought during the year on some 141 housing applications respecting which medical recommendations for priority had been submitted by hospitals or private practitioners. Overcrowding. No survey has yet been undertaken specifically but every opportunity is taken during routine house visiting for a wide variety of other reasons, e.g., medical priority enquiries for re-housing and the like, to form a general picture of the trend -which does not appear to be unsatisfactory. Sub-standard Aecomrnodation. A certain amount of relatively sporadic demolition and closure action has taken place but. considering the extent of population of the District, accommodation of this kind does not represent a very material problem. Nevertheless, small blocks of houses, possibly approaching a border-line classification, do deteriorate with age and whilst no large scale activity is to be anticipated, regular observation of the District will unquestionably throw up regularly a certain number of houses in respect of which demolition or closure steps will be recommended to you. Caravans. Relatively little trouble has occurred from this source. One or two open spaces, notably Bridge Road. Rainham, are prone to have a few visitors from time to time, but the only long-standing reminder that the law is not oppressive remains in Rainham where the Lake Avenue site has not yet regained a rural appearance. The present position outlined in previous reports ^hows an improvement but not a resolution of the difficulties. Land Charges Enquiries. During the year 3,966 land charges enquiries were referred to the Department regarding the question of outstanding sanitary notices and/or certificates of disrepair. This is one of the routine unpublicised but time-consuming occupations of the department. 26 SECTION E. INSPECTION AND SUPERVISION OF FOOD AND FOOD PREMISES Food and Drugs Administration. In the following statistics the figures for last year are given within brackets. 290 (294) samples were taken during the year, of which 277 (269) were found genuine (List A), 12 (25) to be sub-standard (List B) and in one instance the result was not to hand. 18 (7) food complaints were referred to the Public Analyst (List C) and 34 (44) food complaints were dealt with informally (List D). The accompanying lists (A and B) indicate the wide variety of food and drugs actually sampled. Sub-standard samples (List B) comprise 8 individual food products and 2 drugs. Apart from the follow-up samples respecting which the results were not to hand by the end of the year, it may reasonably be said that the outcome was satisfactory. This does indicate that manufacturers are normally quite willing to investigate any doubts expressed to them as to description or content and to take action to resolve in material measure well-founded criticisms brought to their notice. It happens of course that official standards may be lacking, e.g., in pork luncheon meat and the question then becomes one of opinion in the light of price, description, content and the like. It is our experience that the informal approach does secure results satisfactory to you, to the manufacturers and, most important of all, to the buying public. Food Complaints referred to Public Analyst—(List C): 18 instances, involved bread in 4 cases, and milk products in 4 cases, the rest including a variety of articles. Legal proceedings were brought and succeeded in 3 instances. Your views on the position were sent to 5 firms and the remainder of the complaints were either not substantiated or did not merit further action. Food Complaints NOT referred to the Public Analyst—(List D): To the number of 34 these reflected a wide range of evident conditions, 12 referred to milk, milk bottles, etc., 5 involved bread and 3 meat or pork pies. It will be noted that 5 prosecutions—all successful—were undertaken and the non-reference to the Analyst does not therefore imply that the complaints were of a less serious order. 27 The difficulty in certain cases is not in establishing due cause for complaint but in deciding, on the facts known to us, where lies the responsibility for providing the initial ground for complaint. It is essential that complaints be brought to the notice of the Public Health Department at once if we are to be given the best chance of dealing adequately with them. The history of what actually does happen to some of the complaints before arriving at this office makes interesting, sometimes surprising but seldom rewarding reading. I would 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. 28 LIST A SAMPLES SUBMITTED TO PUBLIC ANALYSTS AND FOUND TO BE GENUINE Article No. Article No. Almonds, ground 1 Fish Cakes 1 Apricots, dried 1 Fish, creamed 1 Bacon and Mushrooms in White Sauce 1 Fish, sticks 1 Flour 2 Fruit Pie 1 Beans in Tomato Sauce 1 Ginger, ground 1 Beans, Sausages in Tomato Sauce 1 Glucose Syrup 1 Golden Butter Snap 1 Beef Curry 1 Gravy Mix 1 Biscottes 1 Gravy Powder 1 Biskoids 1 Biscuits 1 Hamburgers 1 Hamburgers with gravy 1 Blackcurrant Pie 1 Herrings in Lemon Sauce, filleted 1 Blackcurrant Vitamin C Drink 1 High Protein Cereal 1 Blanc Mange Powder 1 Ice Cream 12 Blue Colour 1 Instant Tea 1 Bouillon Cubes 1 Irish Stew 1 Bread 1 Jam 5 Bubble Gum 1 Jelly 2 Butter Jellied Eels 1 Cake Mixtures Junket Powder 1 Cheese 1 Kool-Ah (Lemon Flavour) 1 Cheese'n Bacon Spread 1 Lancashire Hot Pot 1 Cheese Spread 1 Lard 1 Cheese and Tomato Spread 1 Lemon Barley with Glucose 1 Chicken, sliced 1 Lemon Curd 1 Chicken and Pork Rissoles 1 Lemon Juice I Chutney Pickle 1 Lemon Yellow Colour 1 Cochineal, extract of 1 Loaf, enriched white 1 Coconut 1 Lollies 5 Coconut, coloured 1 Margarine 3 Coconut in Syrup, shredded 1 Marmalade Coffee 2 Marshmallow Cream 1 Condiment, non-brewed 1 Marzipan 1 Corned Beef Loaf 1 Mayonnaise 1 Crab, dressed 1 Meat Pudding 1 Cream Milk 32 Creme de Menthe (confection) 1 Milk, evaporated Milk powder, skimmed 1 Currants 1 Mincemeat 1 Custard Powder 1 Mint Sauce Easy Mix Eccles Cakes 1 1 Mustard Nutmeg, ground 1 1 Faggots 1 Oatmeal 1 Figs 1 Orange Drink 2 Figs, stewing 1 Orange Squash 3 29 Article No. Article No. Peas, dried 1 Brandy 1 Peas, processed 1 Cherry B 1 Pears 1 Gin 1 Pepper 3 Rum 1 Pineapple Preserve 1 Sherry 1 Plum Pudding Whisky 1 Polony 1 Adult Nerve Tonic 1 Pork, minced 1 Baby Cough Linctus 1 Pork Sausage Meat 1 Beltona Brand Lotion 1 Pudding 1 Benzoic Tablets 1 Rice, flaked 1 Camphorated Oil Rice, ground Cascara Elixir 1 Royal Chiffon Strawberry 1 Chilblain Ointment 1 Rum Truffles 1 Chilva Elixir 1 Rusks 1 Cod Liver Oil 1 Salad Cream 2 Cough Treatment 1 Salmon 1 Do-Do Tablets 1 Salmon with butter, potted 1 Ear Drops 2 Sandwich Spread 1 Eucalyptus Oil 1 Sardines 1 Glinteel Lotion 1 Sauerkraut 1 Glycerine 1 Sausages 1 Glycerine, Lemon and Honey Balsam 1 Sausages, beef Sausages, pork 3 Glucose Linctus 1 Saveloys 1 Halibut Liver Oil Caps 1 Savoury Relish 1 Hypophosphates 1 Savoury Biscuits 1 Iodized Throat Lozenges 1 Self-raising flour 3 Kompo 1 Soup 4 Medic-aire-Aerosol 1 Spaghetti 2 Menthol and Eucalyptus Sweets 1 Sponge Drops 1 Sponge Fingers 1 Menthol and Wintergreen with Mustard 1 Sponge filled with Cream 1 Steak and Kidney Pie 1 Mixed Oils 1 Steak and Kidney Pudding 1 Nasal Spray 1 Steak, stewed 3 Neo-Dex Ointment 1 Suet, shredded beef 1 Parrish's Syrup or Chemical Food 2 Sugar 1 Sultanas 1 Pastilles (for sore gums and mouth) 1 Sultana Cake 1 Sweets and Confectionery 4 Quinine Tonic Water 1 Tea 3 Redoxon Ascorbic Acid 1 Tea Break Biscuits 1 Relaxa Tablets 1 Toffee Popcorn 1 Rivella 1 Tomato Juice 1 Settlers 1 Tomato Ketchup 1 Spirit of Salvolatile 1 Trifle Mixture 1 Tonic Yeast 1 Tuna in Jelly 1 Tooth Tincture 1 Turkey minced in Jelly 1 Witch Hazel Distilled 1 Vegetable Juice 1 Worm Syrup 1 Vinegar, malt 1 Total 277 Welsh Rarebit Spread 1 Yeast Extract 1 30 LIST B SAMPLES SUBMITTED TO PUBLIC ANALYSIS AND FOUND TO BE ADULTERATED OR UNDER STANDARD, etc. Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action Taken F.1234 Bath Salts 42% deficient in sodium per carbonate. Manufacturers stated that investigation suggested sodium percarbonate not stable under storage conditions. Steps will be taken to rectify this. —Further sample to be taken. F.1259 Bath Salts. Contained only onefifth of the stated amount of percarbonate. Manufacturers have altered formula and in future products will have a different description. Inf.1730 Steak and Kidney Pie. Fat in pastry portion in state of incipient rancidity. F or m a 1 follow-up sample taken. F.1242 Steak and Kidney Pie. Slight evidence of incipient rancidity. Manufacturers informed that it would be desirable to put some shelf-life on this product. Inf.1756 Breakfast Biscuits. Claim for slimming properties unjustified. Manufacturers withdrew diet sheet which contained slimming claim. Inf. 1774 Glucose Pyramids. Contained insufficient glucose to justify the description. Taken up with Manufacturers who are considering alteration in recipe. Inf. 1800 Pork Luncheon Meat. 10%deficient in meat. As there is no official meat standard for this type of product, no action taken. Inf. 1821 Creamed Rice Milk Pudding. Misdescribed as Creamed Rice Milk Pudding prepared from partly skimmed milk. Manufacturers approached and agreed to amend label. Inf.1840 Loaf. Poor in respect of milk solids. Formal follow-up sample taken and found to be genuine, 31 Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action Taken Inf.1885 Steak Product. Consisted of minced meat—containing 1% of starch and misdescribed as " steak." Manufacturers approached and agreed to alter description. Inf. 1908 Cream Cheese. Contained insufficient fat to justify the description of " Cream Cheese." Formal follow-up sample taken (outside the 1959 period). Inf. 1923 Cinnamon Tablets. Statement of activc ingredients unsatisfactory. Formal follow-up sample taken (outside the 1959 period). LIST C FOOD COMPLAINTS REFERRED TO PUBLIC ANALYSTS Cpt.1722 Bread. Contained foreign matter in the form of a piece of burnt bread and a piece of stale dough. Considered by Council Baker warned. Cpt.1723 Bread. Showed presence of dark streaks of foreign matter due to finely divided burnt dough. Matter considered by Council — Baker warned. Opt.1724 Cheese. Contained foreign matter in the form of coloured paraffin wax in test hole. Matter brought to the attention of the Vendor. Cpt.1725 Milk. Contained fragments of steel wool. Matter considered by Council Bottling Firm warned. Cpt.1726 Sausage. Contained a foreign body in the form of a piece of connective tissue. Manufacturer notified of Analyst's findings. Cpt.1743 Bread. Contained a foreign body in the form of a piece of cement. Matter considered by C o u n c i 1—Baker warned. Cpt.1781 Bananas. Contaminated with a green plastic paint. Investigated fully at retailer's premises and at Banana warehouse. Cpt.1793 Bread. Contained foreign matter in the form of poppy seeds. Investigation showed that seeds used in bread decoration. Cpt.1794 Bacon. Contained a foreign body in the form of rodent excreta. Legal proceedings instituted—V e n d o r fined £5 plus £2 10s. costs. 32 Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action Taken Cpt.1808 Strawberry Jam. Contained the abdomen of a beetle which had been "cooked" in the jam. Matter considered by Council- Manufacturers warned. Cpt.1809 Milk. Contained foreign matter in the form of a milk skim covered with mould growth. Legal proceedings instituted—V e n d o r fined £20. Cpt.1825 Milk. Contained s m a 11 pellets of ferrous metal. Matter taken up with the Manufacturers, possibly a defect when the bottle was made. Cpt.1826 Butter. Contained f o r e i g n matter in the form of a piece of cardboard. Matter taken up with Manufacturer. Cpt.1846 Pork Pie. Contained insect fragments and a small area of mould growth. Legal proceedings instituted—V e n d o r fined £5 plus 2 gns. costs. Cpt.1897 Milk Bottle. Contained fragments of blackish slag fused into the bottom of the bottle. As this foreign matter had been fused into the bottle when bottle was made, no further action taken. Cpt.1898 Soft Fruit Drink (alleged to have caused sickness). Contained a deposit of small yeasts. Investigation did not substantiate complaint. Cpt.1899 Soft Fruit Drink (alleged to have caused sickness). Contained a deposit of small yeasts. Investigation did not substantiate complaint. Cpt.1942 Corned Beef. Showed the presence of black patches of iron sulphide. No further action taken as identity of Manufacturer not available. 33 LIST D FOOD COMPLAINTS WHERE ANALYSIS WAS NOT REQUIRED Complaint Action Milk bottle containing paper. After investigation no action possible, in view of all circumstances. Foreign matter in bun. Matter taken up with Vendor. Foreign matter in loaf. Matter taken up with Baker— foreign matter proved to be brown dough. Mouldy breakfast cereal. Complainant decided to deal with matter herself. Five third pint bottles of milk chipped and damaged. Matter taken up with Dairy concerned. Fish containing worms. Parasites harmless to man—no action. Dirt on surface of third pint bottle of milk. No action—complaint not wholly substantiated. Three bottles of milk — cracked and chipped. Matter taken up with bottling firm. Bottle of milk containing bottle cap. Matter investigated and enquiries made at farm where milk is bottled. Appropriate official of Ministry informed. Mouldy meat pie. Vendor warned regarding storage of cooked meats. Foreign matter in loaf. Baker warned. Third pint bottle of milk containing bottle cap. Matter taken up with Dairy. Unpleasant taste from mixed grill. Matter taken up with Vendor. Dirty bottle of milk. Bottling firm warned. Fly in bottle of milk. Matter taken up with Dairy concerned —- no proof fly was in bottle when delivered to complainant. Third pint bottle of milk containing bottle cap. Matter taken up with Dairy. Bottle of milk containing foreign matter. On investigation found bottle had been returned to Dairy by complainant. "Cream" in eclair alleged to have bitter taste. Complaint not substantiated on investigation. Bacon found to contain maggots. Vendor warned. 34 Complaint Action Three pork pies containing mould growth. Legal proceedings instituted Vendor fined £5. Mould on bottom of chocolate cake. Matter taken up with Vendor and Manufacturer. Baby food alleged to contain carpet beetles. Vendor's premises inspected and no evidence of infestation found. Mouldy Wholemeal sliced loaf. Legal proceedings instituted— Vendor fined £5. Mouldy meat pie. Legal proceedings instituted— Vendor fined £5. Mouldy brown bread. No action possible in view of lapse of time in notifying complaint. Two third pint bottles of milk, cracked and alleged to contain extraneous matter. Matter taken up with bottling firm regarding cracked bottle, no evidence found of extraneous matter. Bottle of milk containing bottle cap. Matter taken up with bottling firm. Bottle of milk alleged to contain extraneous matter. On investigation complaint not substantiated. Bread containing wasp. Bakery concerned notified, but complainant did not wish matter to be brought to litigation. Mouldy apple turnover. Legal proceedings instituted Vendor fined £5. Scones containing nails. Legal proceedings instituted-— Vendor fined £10. Cooked beef and tin of plums alleged to have caused diarrhoea. On investigation complaint not substantiated. Jam tarts alleged to have caused diarrhoea. On investigation complaint not substantiated. Turkey alleged to have bitter taste. Matter amicably settled between Vendor and complainant. Food Premises. The number of food premises in the district may be classified as follows (where more than one trade is carried on at any premises then 35 an entry is made in respect of each trade). The varying types remain remarkably constant as the figures (last year in brackets) show: — Bakehouses 17 (14) Butchers 75 (74) Cafes 53 (53) Confectioners (bread, cakes, etc.) 40 (41) Confectioners (sweets, etc.) 119 (118) Fish Shops 28 (29) Grocers 183 (183) Greengrocers 100 (99) Ice Cream Dealers 291 (279) Ice Cream Manufacturers 3 (3) Food Hygiene Regulations, 1955. Some 65 notices were served as against 94 last year—a satisfactory trend. Essex County Council Act, 1952—Section 105. Notification under Section 105 of the Essex County Council Act. 1952 still assists us to give prior advice to intending traders. 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. Poultry - - 45 9 Meat - 6 57 2 Fish - 2 96 8 Tinned Meat - 14 85 9 Tinned Fish - - 75 8 Tinned Milk - 1 9 8 Tinned Food 1 1 105 15 Miscellaneous Groceries - 1 50 3 Total 2 9 77 14 36 Carcases Inspected and Condemned. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Horses Number killed 419 9 80 2,407 1,310 - Number inspected 419 9 80 2,407 1,310 - All diseases except Tuberculosis and Cysticercosis— Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned 62 3 - 43 31 - Percentage of number inspected affected with disease other than tuberculosis, etc. 14.8 33⅓ - 1.8 2.4 - Tuberculosis only— Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned 7 1 - - 11 - Percentage of number inspected affected with tuberculosis 1.7 11.1 - - .8 - Cysticercosis only— Carcases of which some part or organ was condemned 3 - - - - - Carcases submitted to treatment by refrigeration 3 - - - - - Generalised and totally condemned - - - - - - Slaughter of Animals Act, 1958. Six slaughterman's licences were issued during the year. Ice Cream. During the year 24 applications for registration as vendors and 11 applications for registration of premises for the storage and sale of ice cream were granted. At the end of the year 3 persons and premises were registered for manufacture and 291 for the storage and/or sale of ice cream. Sixty-two samples were taken during the year. 57 proved satisfactory. In addition 17 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. 37 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 67 persons and 86 premises were registered for the manufacture of preserved meat, an increase of 2 persons and 2 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 65 persons and 13 premises had been registered. Milk Distributors. There are 9 milk distributors with 13 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 52 shopkeepers are registered for the sale of bottled milk only. 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 (Pasteurised) 60 Supplementary Pasteurised 7 Dealer's Sterilised 84 Supplementary Sterilised 8 Dealer's Tuberculin Tested 45 Supplementary Tuberculin Tested 6 Milk Sampling. The 98 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 32 samples were submitted to the Public Analysts. Liaison With Other Authorities. Our excellent liaison with the London County Council in respect of the Hornchurch Children's Homes and the Brentwood Group Hospital Management Committee in respect of Harold Wood Hospital regarding the testing of their milk supplies (noted in last year's report) continues. 38 School Canteens. The year saw some decided progress in establishing a standard mutually acceptable to the Education Authority and to this Council concerning the compliance of School Canteens with the Food Hygiene Regulations. Also satisfactory was the notification to you under the Essex County Council Act 1952, Section 105, of new canteens. A procedure now exists whereby new plans are subject to consultation with me, and schools already built are dealt with locally through the Divisional Education Officer. The need for considering points other than of maintenance or decoration should seldom arise if the agreed system is carefully followed. The most important single factor in achieving satisfactory liaison is not based on a legal standard only but on a thoughtful approach and recognition that problems of this nature are of common interest. The fact that school canteens are provided by one Authority and the responsibility for supervising them under the Food Hygiene Regulations is the duty of another, should be of only incidental importance. Shellfish. Samples of peeled prawns, potted shrimps, cockles and winkles were sent for examination during the year with the results as under-noted: — Very satisfactory 3 Satisfactory 2 Fair 6 These results may not be regarded as unequivocally satisfactory, but in view of the circumstances possibly attendant upon products of this kind they should probably not be regarded as particularly unsatisfactory. Slaughterhouses Act, 1958. A comprehensive report was duly made on the existing and future requirements of the population covering their meat supply and the slaughterhouse provisions estimated as necessary to cope with it. It does not seem that this District is likely to require for its own needs any material change. Meat—Cystieercus Bovis Infections. Cysticercus Bovis infections are occasionally found and can be inconvenient. A procedure has been devised for holding and/or refrigeration depending upon the examination results. 39 SECTION F. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER NOTIFIABLE DISEASES Infectious and Other Notifiable Diseases, 1959. Disease Total cases notified No. of Cases hospitalised Dysentery 10 7 Erysipelas 11 5 Food Poisoning 22 3 Infective Hepatitis 11 4 Measles 2,590 19 Ophthalmia Neonatorum 2 0 Pneumonia 35 3 Poliomyelitis (non-paralytic) 3 3 Scarlet Fever 246 8 Typhoid Fever 1 1 Whooping Cough 63 1 The main feature of the year was possibly the absence of cases of paralytic Poliomyelitis and a reduction in non-paralytic cases from 8 to 3. It being a Measles epidemic year the number of cases increased tenfold as compared with 1958 and the incidence of Scarlet Fever almost doubled. Measles has lost much of its sting and with its complications controlled as they now are even an epidemic creates no alarm. This, however, is a disease as yet uncontrolled by any preventive inoculations. Scarlet Fever in my view is overdue for removal from the list of infectious diseases. Should circumstances change it could well be restored. At present it is merely a particular type of infection, the incidence of which is in no wise reflected by the number of notifications since a vast number of streptococcal sore throats are never brought to medical notice. Its control is made well nigh impossible because of the impracticability of maintaining a bacteriological check on the cases and because of the absence of any logical minimum isolation period (not to mention the fact that many so called isolation arrangements are to say the least of doubtful adequacy). Like some other infectious diseases, it is an example of the theoretical and the practical control being incompatible. It is gratifying to note the year's findings on Poliomyelitis, although with a disease so unpredictable, the figures represent exactly what they stand for, i.e., the record for one year, and cannot be interpreted in terms of further outlook. It is also pleasing to see that at any rate sporadically keen public interest is being shown in immunisation. I believe that public health staffs enquiring into cases and interviewing close contacts should have been given a really practical degree of priority in protection. I cannot 40 imagine that the impact upon the general immunisation arrangements would have been significant nor that the public would have been anything but appreciative that due recognition should have been given to these staffs for the essential part which they still play in preventive medicine. These Inspectors carry out what is at times quite a difficult job conscientiously and with a high degree of efficiency. It is a pity that what I regard as bare justice should not have been done to their role in the matter of affording the maximum protection against the hazards to which they are in some degree exposed. I don't think that the matter should be judged on a basis of how many Inspectors happen to have taken poliomyelitis as this argument would not be necessarily conclusive. Food Poisoning. In 19 out of 22 notified cases no causative organism was ascertained. This illustrates the complexity of dealing with this matter as a precise problem. Although certain cases may come to light late many are brought to our notice as suspects and at a stage when full investigation is possible. No serious outbreak was involved and the character of the disease was one of relatively isolated attack. The fact that no organism was found to cause the illness does not invalidate the supposition that certain of the cases may well have been rightly considered—after investigation—as having an origin in food. Typhoid Fever. One case notified occurred after a holiday abroad. It was not seemingly very exceptional as others in the same party had been ill. It is interesting to speculate on the results were a majority of cases of gastro-enteritis among returned Continental holiday makers to be investigated bacteriologically. As it is some form of upset is frequently accepted as normal and dietetic in origin—and maybe it is less, disturbing to leave it at that. Psittacosis. A suspected avian case was brought to my notice (having occurred in another district). No positive findings were elicited either to cause or confirm the case and no human cases are known to have occurred. Unless there is some legal requirement which demands that records of avian purchases are maintained by the dealer and available to us, it is well nigh impossible to make anything of source investigation. That apart, of course, detailed investigation of avians or humans is a lengthy process and the very variable incubation period, the possible 'carrier' state in birds, the variety of birds which may be affected, all conspire to embarrass control measures. Whether notification of the disease or renewed legislation on bird importation should be invoked, is a matter for argument. 41 International Certificates of Vaccination or Inoculation. 493 certificates were stamped during the year. Although cogent reasons may exist as to why the practice is not followed, it would superficially seem distinctly advantageous if a supply of blank certificates was kept at this office as is understood to be the case with Travel Agents, etc. 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 1959: — Diphtheria Immunisation: Completed primary immunisations 1,831 Boost injections 1,147 Whooping Cough hrununisation: Completed primary immunisations 1,651 Boost injections 136 Combined Diphtheria I Pertussis Immunisation: Completed primary immunisations 449 Boost injections 61 Poliomyelitis Vaccination: Completed 2 primary injections 5,738 Boost injections 20,398 Smallpox Vaccination: Primary vaccinations 1,853 Re-vaccinations 300 Tuberculosis. Respiratory. The number of new notifications dropped substantially from 54 to 41. Non-Respiratory. The notifications increased from three to five. The site of infection and age of the non-respiratory cases was as under: — Cervical glands Females 20 and 14 Right kidney Female 25 Renal tract Male 69 Lymph glands Male 31 (groin) Inward Transfers: These totalled 35 as against 38 last year. Deaths: There were 5 this year as compared with 9 in 1958. 42 Cases on Register: The number of cases of tuberculosis on the register at the end of the year was as follows: — Respiratory: Males 547 Females 468 Non-Respiratory: Males 49 Females 30 Total 1,094 Romford Chest Clinic. I am indebted to Dr. S. Thompson, the Consultant Chest Physician, for the following notes: — "During the year 1959 the incidence of tuberculosis has again fallen and also the death rate, though the numbers on the register continue to rise owing to transfers into the area which were actually higher than the new notified local cases. In addition, owing to the decreased death rate, more cases are obviously retained on the register for general supervision. It has been found possible to close further institutional beds during the year and the local cases, both male and female, are largely accommodated at Broomfield Hospital and Dagenham Chest Hospital, whilst the Children's Unit at High Wood Hospital. Brentwood, has been transferred to Black Notley Hospital. Owing to the good results obtained by B.C.G. vaccination, the scheme is being extended and all these cases are followed up at prescribed intervals, so that the more severe forms of the disease, such as tuberculous meningitis and miliary tuberculosis, are very rare. Large numbers of cases with abnormal chest X-rays continue to be referred for investigation from the Mass Radiography Units and these are followed up for as long as they are willing to attend for this purpose. Contact examinations also are tending to increase, and as a result of all this work it was found necessary to ask for the appointment of an additional full-time Health Visitor to which the County Council agreed, and she commenced her duties towards the end of the year." Mass Radiography Unit—Clinical Evaluation. Six cases of active Tuberculosis were ascertained. Five cases of Bronchial Carcinoma were detected. Although the number of photographs taken ran into several thousands (8,508) it is clear that a significant result was obtained. 43 CASES OF AND DEATHS FROM TUBERCULOSIS, 1959 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 - - - - - - - - - - - - - - - - 5—14 years 1 — — 1 — 1 — - 1 2 — — — — — — 15—24 „ 3 4 - 1 2 3 — - 5 8 — — — — — — 25—44 „ 12 6 1 1 13 12 — 1 26 20 — 1 — — — 1 45—64 „ 8 4 - — 2 1 — - 10 5 3 — — — 3 — 65 and over 3 — 1 — — — — — 4 — - 1 — — — 1 Totals 27 14 2 3 17 17 - 1 46 35 3 2 — - 3 2 44 INTERVAL BETWEEN NOTIFICATION AND DEATH OF FATAL CASES OF TUBERCULOSIS, 1949—1959 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 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 1958 1 1 — — 1 — — 1 5 9 1959 — — — — 1 1 — 2 1 5 45 SECTION G FACTORIES ACTS 1937 to 1959. Prescribed particulars on the administration of the Factories Act, 1937. PART I OF THE ACT. 1. Inspections for purposes of Provisions as to Health. Premises No. on Register No. of Ispections 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 27 12 4 - (ii) Factories not included in (i) in which Sec. 7 is enforced by the L.A. 290 224 17 - (iii) Other premises in which Sec. 7 is enforced by the L.A. 32 40 2 — Total 349 276 23 — 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) 1 1 — — — Overcrowding (Sec. 2) — — — — — Unreasonable temperature (Section 3) — — — — — Inadequate ventilation (Section 4) - — — — — Ineffective drainage of floors (Section 6) - — - — — Sanitary Conveniences (Section 7) (a) Insufficient 1 — — — — (b) Unsuitable or Defective 21 8 - 4 - (c) Not separate for sexes — — — — — Other offences against the Act — — 11 — — Total 23 9 11 4 — 46 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 unwhole- Making.etc. 133 some premises. 47 INDEX Page Acknowledgments 6, 27 Acreage 7 Adoption of Private Streets 19 Aged, Care of 12 Agriculture (Safety, Health & Welfare Provisions) Act, 1956 21 Ambulance Service 11 Atmospheric Pollution 6, 14 Births 7 Birth Rates 7 —Area Comparability Factor 7, 8 —Comparative 8 —Illegitimate 7 Canteens, School 38 Caravans 25 Care of the Aged 12 Certificates of Disrepair 24 Cesspools 18 Clean Air Act, 1956 6,14 Clinics, Child Welfare 11 Contents, Table of 2 Conversions (Pail Closets) 18 Day Nursery 12 Deaths 8, 9 —Age Groups 9 —Causes of 9 —Infantile 7 —Main Causes 8 —Maternal 7 Death Rates 7 —Area Comparability Factor 7,8 —Comparative 7 —Early Neonatal 7 —Infant 7 —Neonatal 7 —Perinatal 7 Diphtheria Immunisation 41 Diseases of Animals (Waste Food) Order, 1957 21 Disinfection 20 Disinfestation 20 Ditches 18 Domestic Help Service 12 Drainage and Sewerage 17,18 48 Page Essex County Council Act, 1952— Section 103 37 Section 105 35 Establishments for Massage or Special Treatment 20 Factories Acts, 1937 to 1959 45 —Defects 45 —Inspections 22,45 —Outwork 46 —Prescribed Particulars 45 Fireguards 20 Food Poisoning 40 Food— Complaints 32 Hawkers 37 Inspection of 21 Meat Inspection 36, 38 Premises 34 Preserved 37 Unsound 35 Food and Drugs Act, 1955 26 —Administration 26 —Food Hygiene Regulations 35 —Public Analysts 4,27 —Sampling 26,27 General Sanitary Circumstances 22 Heating Appliances (Fireguards) Act, 1952 and Regulations. 1953 20 Home Nurses and Mid wives 11 Home Safety 12 Hornchurch Urban District Council Act, 1936, Section 90 37 Houses— Inspection of 22 Number erected 24 Number inhabited 7 Housing 24 —Caravans 25 —Certificates of Disrepair 24 —Closure and Demolition 24 —Improvement Grants 25 —Overcrowding 25 —Rehousing (medical aspects) 25 —Sub-standard Accommodation 25 —Visits paid 22 49 Page Ice Cream 36 —Registration 36 —Sampling 36 Immunisation and Vaccination Statistics 41 Improvement Grants 25 Infectious and Other Notifiable Diseases 39 —Hospitalisation 39 —Notifications 39 —Visits paid 23 Informal Notices Served 23 International Certificates of Inoculation/Vaccination 41 Laboratory Facilities 11 Land Charges Enquiries 25 Maternity and Child Welfare 11 Maternity Homes 11 Measles 8,39 Meat Inspection 36, 38 —Carcases Inspected and Condemned 36 Medical Examinations 10 Members of the Council 3 Metal Dealers 20 Midwives and Home Nurses 11 Milk- Distributors 37 Sampling 37 Special Designations 37 National Assistance Act, 1948, Section 47 12 New Streets 19 Nursing and Maternity Homes 11 Officers of the Public Health Department 4 Old Metal Dealers 20 Outworkers 22,46 Paddling Pools 19 Pail Closets 18 Penny Rate Product 7 Pet Animals Act, 1951 21 Poliomyelitis 39 —Vaccination 41 Population 7 Preface 5 Psittacosis 40 Public Analysts 4,27 50 Page Public Health— Inspection 21,23 Inspectors 4,23 Propaganda 10 Radioactivity 17 Rag Flock and Other Filling Materials Act, 1951 21 Rainfall 14 Rateable Value 7 Rent Act, 1957— Certificates of Disrepair 24 Riding Establishments Act, 1939 21 Rivers 18 Rodent Control 20 Scarlet Fever 39 School Canteens 38 Sewerage 17, 18 Shellfish 38 Shops Act, 1950 22,23 Slaughter of Animals Act, 1958 36 Slaughterhouses Act, 1958 38 Smoke Control Areas 15 Staff 4 —Medical Examinations 10 Staffing 10 Statutory Notices Served 23 Stillbirths 7 —Rates 7 Streets Made Up and Taken Over 19 Swimming Pool 18 Table of Contents 2 Tuberculosis 41 —Incidence and Mortality 43 —Mass Radiography 42 —Notification/Mortality Interval 44 —Chest Clinic 42 Typhoid Fever 40 Vaccination Statistics 41 Vital Statistics 7 Water— Sampling 13 Supplies 13 Well 14 Whooping Cough Immunisation 41