AC-4411(3) HORNC 28 Hornchurch Urban District Council ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1960 Public Health Department, Council Offices, Billet Lane, HORNCHURCH, Essex. Telephone: Hornchurch 52555 James Gorman, M.B., Ch.B., D.P.H., F.R.S.H. Medical Officer of Health Hornchurch Urban District Council ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1960 Public Health Department, Council Offices, Billet Lane, HORNCHURCH, Essex. Telephone: Hornchurch 52555 James Gorman, MB., Ch.B., D.P.H., F.R.S.H, Medical Officer of Health 2 TABLE OF CONTENTS page Members of the Council (as at 31.12.60) 3 SECTION A—Statistics and Social Conditions of the Area 7 SECTION B—General Provision of Health Services for the Area 11 SECTION C—Sanitary Circumstances of the Area 15 SECTION D—Housing 30 SECTION E—Inspection and Supervision of Food and Food Premises 32 SECTION F—Prevalence of, and control over, Infectious and Other Notifiable Diseases 43 SECTION G—Factories Acts, 1937 to 1959 52 Index 55 3 MEMBERS OF THE COUNCIL (as at 31.12.60) Councillor C. A. Welch, J.P., Chairman. (1) Councillor Mrs. E. H. Dean, Vice-Chairman. (1) Councillor Mrs. W. M. Illingworth. (1) Mrs. W. M. Jiggins. A. T. Booton. (1) E. W. Bull. (1) L. W. Carroll, J.P. (1) F. W. H. Embleton. A. C. Good. (1) and (2) A. J. Hall. A. R. Hall. D. L. Hammerton. G. F. Hancock. K. T. Hay. W. Hegarty. E. A. Hillman, J.P. H. Holock. S. A. Legg. M. P. V. Leigh. J. S. Macy. (1) N. J. Miles. H. F. Moss. (1) J. F. Moultrie, J.P. L. J. Nicholls. (1) and (3) G. W. Phillips. F. J. Powell. (1) A. C. Salinger, J.P. S. B. Sanders. B. K. Snooks. A. J. Twigger. (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 Medical 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: E. J. Day, M.A.P.H.I., (1) and (2) (Commenced 15.8.60). J. Goodwin, M.A.P.H.I., (1) (2) and (3) (Resigned 26.6.60). A. V. J. Hutchings, M.A.P.H.I. (1) and (2) M. A. Jackson, M.A.P.H.I., (1) and (2). 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. P. R. Cheese. Rodent Operative and General Assistant : W. T. Blanchard. Public Analysts: George Taylor, O.B.E., F.R.I.C. (Died 28.2.60). J. Hubert Hamence, M.Sc., Ph.D., F.R.I.C. P. S. Hall, B.Sc., F.R.I.C. (Appointed 18.5.60). (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. 25th May, 1961. 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 on the health of the district for the year 1960. The work of the Department during the year continued to expand. Although the emphasis on certain aspects may vary from district to district, for example, in some older districts slum clearance may dominate the picture, in other new and rapidly expanding districts such as ours, problems of an equally diverse and particular character arise. Our work in other words lacks neither variety or scope. Clean Air. This subject will be mentioned in greater detail in the appropriate portion of the report which follows. It need only be said here that we are determined that insofar as it rests within our power the process of making Hornchurch smoke free will lack neither continuity nor enthusiasm. It must, however, be said that in the ultimate the pace will depend not only upon the efforts of the local staff but upon the celerity with which our representations are determined by the Minister. Food and Drugs. The details submitted later in the Report will indicate the sphere of our activities in this regard. It can in some respects be frustrating work. I am left with the impression from time to time that the blandishments of the advertiser carry somewhat greater success than the efforts made, at any rate, by this Department to ensure that the public gets what it thinks it is getting. Infectious Diseases. No serious outbreak of infectious disease occurred within the district during the year. 6 Population. As against mid-year 1959 when the population was 122,600, the latest figures for mid-year 1960 show the population to be 124,590. Royal Commission on Local Government in Greater London. The report of the Royal Commission was published in the Autumn and proved a document with a very important potential bearing on this district. It is of course gratifying that the Commission considered that Hornchurch with extended powers should remain as an individual Authority, for example, without any question of linking up with any other Authorities and the subsequent developments in this matter will clearly be awaited with the greatest interest. Sewerage. The Minister has specifically requested that this report should provide an indication of the adequacy of the arrangements for sewerage and sewage disposal in the district. I have accordingly made particular note of this matter in some detail later. 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 1960) 124,590 Number of inhabited houses according to rate books (December 1960) 39,970 Rateable Value (December 1960) £1,811,656 Sum represented by a Penny Rate (December 1960) £7,330 Extracts from Vital Statistics for the Year. Live Births: Number 2,437 (1,234 males, 1,203 females) Rate per 1,000 population 18.38 Illegitimate Live Births per cent of total live births 2.6 Stillbirths: Number 41 (19 males, 22 females) Rate per 1,000 total live and stillbirths 16.50 Total Live and Still Births 2,478 Infant Deaths (deaths under 1 year) 46 (26 males, 20 females) Infant Mortality Rates: Total infant deaths per 1,000 total live births 18.87 Legitimate infant deaths per 1,000 legitimate live births 18.54 Illegitimate infant deaths per 1,000 illegitimate live births 31.25 Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 15.59 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 13.95 Perinatal Mortality Rate (stillbirths and deaths under 1 week per 1,000 total live and still births 30.36 Maternal Mortality (including abortion): Number of deaths Nil Deaths: Number 1,117 (572 males, 545 females) Rate per 1,000 population 11.02 8 DEATH RATE—COMPARISON WITH PREVIOUS YEARS. 1945 9.9 1946 9.0 1947 8.3 1948 8.2 1949 10.6* 1950 10.4 1951 10.3 1952 10.4 1953 13.1 1954 12.1 1955 11.6 1956 10.5 1957 10.4 1958 10.2 1959 10.9 1960 11.0 *Area Comparability Factor returned. The Area Comparability Factor for deaths this year altered from 1.19 to 1.23 and for births remained at 0.94. BIRTH RATE—COMPARISON WITH PREVIOUS YEARS 1945 18.4 1946 21.3 1947 20.7 1948 17.2 1949 16.0 1950 13.6* 1951 14.1 1952 13.8 1953 14.8 1954 14.7 1955 15.4 1956 16.7 1957 17.1 1958 18.5 1959 18.1 1960 18.3 * 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. 9 GENERAL MORTALITY—MAIN CAUSES 1950-1960. Causes of Death 1950 1951 1952 1953 19.54 1955 1956 1957 1958 1959 1960 Tuberculosis (all forms) 29 25 17 21 11 4 5 3 9 5 10 Cancer 155 183 184 211 234 210 253 248 230 247 235 Infectious diseases 3 4 1 3 1 2 0 2 0 2 0 Cardio-vascular disease 441 418 425 002 590 591 682 079 592 500 548 Influenza 3 19 2 14 1 2 7 8 6 12 0 Pneumonia 20 30 49 52 41 49 53 65 58 57 39 Bronchitis 03 09 52 85 54 65 95 79 70 01 05 Other respiratory diseases 3 7 9 10 8 10 7 9 13 14 8 Gastro intestinal diseases 20 10 12 28 13 10 14 10 15 13 13 Motor vehicle accidents 9 14 9 11 10 12 8 10 15 9 19 All other accidents 12 12 4 10 18 18 20 18 15 8 18 Suicide 10 11 10 7 11 11 9 14 8 12 9 Cancer produced fewer deaths than last year as did Cardiovascular disease. No deaths were attributable to Influenza. Bronchitis showed a slight increase in mortality. Whilst the figures may not be relatively very high the fact remains that deaths from motor vehicle accidents more than doubled (19 as against 9) while all other accidents showed 18 deaths to have been caused during 1960 as against 8 the previous year. Cancer of the lung caused during 1960 51 deaths in males and 11 in females as against corresponding figures of 48 and 7 last year. As was the case last year no deaths fall to be recorded to Acute Poliomyelitis. 10 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 9 6 3 — — — — — — — — — 1 2 1 1 1 3 — 2. Tuberculosis, other 1 0 1 — — — — — — — — — — — — — — — — 3. Syphilitic disease 2 2 0 — — — — — — — — — — — — — — — — 4. Diphtheria 0 0 0 — — — — — — — — — — — — — — — — 5. Whooping cough 0 0 0 — — — — — — — — — — — — — — — — 6. Meningococcal infections 0 0 0 — — — — — — — — — — — — — — — — 7. Acute poliomyelitis 0 0 0 — — — — — — — — — — — — — — — — 8. Measles 0 0 0 — — — — — — — — — — — — — — — — 9. Other infective and parasitic diseases 3 1 2 — — — — — — — — — — — 2 1 — — — 10. Malignant neoplasm, stomach 19 9 10 — — — — — — — 1 — — 6 — — 1 1 8 11. Malignant neoplasm, lung, bronchus 62 51 11 — — — — — — — — 4 — 24 5 18 2 5 4 12. Malignant neoplasm, breast 29 0 29 — — — — — — — — — 4 — 11 — 4 — 10 13. Malignant neoplasm, uterus 11 0 11 — — — — — — — — — — — 5 — 4 — 2 14. Other malignant and lymphatic neoplasms 114 72 42 — — — — — — — — 7 2 26 12 22 11 17 17 15. Leukaemia, aleukaemia 9 4 5 — — — — 1 — — 1 — 1 1 2 2 — — 1 16. Diabetes 3 0 3 — — — — — — — — — — — — — 2 — 1 17. Vascular lesions of nervous system 162 58 104 — — — — — — — — — 1 12 12 15 28 31 63 18. Coronary disease, angina 196 139 57 — — — — — — — — 5 1 61 8 43 26 30 22 19. Hypertension with heart disease 14 4 10 — — — — — — — — — — — — 1 3 3 7 20. Other heart disease 148 43 105 — — — — — — — — — 1 5 7 4 18 34 79 21. Other circulatory disease 28 12 16 — — — — — — — — 1 1 5 3 4 6 2 6 22. Influenza 0 0 0 — — — — — — — — — — — — — — — — 23. Pneumonia 39 16 23 1 3 — — — — — — — 1 2 2 7 3 6 14 24. Bronchitis 65 45 20 1 — — — — — — — — — 12 2 15 4 17 14 25. Other diseases of respiratory system 8 5 3 — — — — — — — — — — 2 — 1 — 2 3 26. Ulcer of stomach and duodenum 9 7 2 — — — — — — — — — 1 2 — — — — — 27. Gastritis, enteritis and diarrhœa 4 1 3 — — — — — — — — — — — 1 I 1 — 1 28. Nephritis and nephrosis 9 7 2 — — — — — — 1 — 1 — 5 — — 1 — 1 29. Hyperplasia of prostate 7 7 0 — — — — — — — — — — 1 — — — — — 30. Pregnancy, childbirth, abortion 0 0 0 — — — — — — — — — — — — — — — 31. Congenital malformations 13 8 5 5 5 2 — — — — — — — — — 1 — — — 32. Other defined and ill-defined diseases 107 52 55 18 12 — — 2 — — — 5 3 10 6 5 13 12 21 33. Motor vehicle accidents 19 9 10 — — — — — 1 2 4 — 2 3 1 1 1 4 34. All other accidents 18 7 11 1 — — — 1 — — 1 — — 2 — — 2 3 8 35. Suicide 9 7 2 — — — — — — — 2 1 2 1 2 — 1 — 36. Homicide and operations of war 0 0 0 — — — — — — — — — — — — — — — — TOTAL 1,117 572 545 26 20 2 0 4 0 2 5 29 18 183 83 153 133 173 286 11 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Staffing. It is with much regret that the death has to be recorded during the year of Mr. George Taylor, O.B.E., F.R.I.C., one of the Analysts to the Council. Mr. Taylor had been an Analyst to this Council since 1st November, 1949, and by his sound approach and ready advice had been an unfailing source of strength to the Department. His place will be hard to fill, although continuity is happily secured through the medium of Dr. Hamence. Mr. Philip Sydney Hall, B.Sc., F.R.I.C., was appointed as his successor on 18th May, 1960. Towards the end of the year a comprehensive report was at the request of the Council presented to them by their Chief Officers embracing every Department of the Council. So far as concerns my Department it is clear that not only has the routine work increased very greatly with the years but in addition certain potential commitments, e.g. meat inspection, will add greatly to it whilst a progressive and accelerated smoke control programme brings staffing problems in its train. Bearing in mind these points it was felt that the number of District Public Health Inspectors should be increased and that—in view of the overall number of the Inspectors and the diversity of their work —the appointment of a Deputy Chief Public Health Inspector was a matter of prudence. This new establishment represents a notable advance and will secure not only that the present routine work of the Department is covered with suitable flexibility but also that, as noted earlier, our increased commitments will be dealt with in a satisfactory manner. Medical Examinations—Staff. Staff arrangements remain as last year. During the year arrangements were made for the examination of 258 (216) employees or prospective employees—84 (63) permanent and 174 (153) temporary. The 1959 figures are given in parentheses. Public Health Propaganda. Perhaps the greatest emphasis should be on smoke control. Not only did the subject attract a great deal of attention specifically, but was emphasised in the talks given from time to time to local organisations. 12 An important feature of the year was the attendance of the Chief Public Health Inspector at the Summer School of the Central Council for Health Education. Attendance at a Course of this kind not only increases one's personal appreciation of the subject with its many facets, but also secures close association with a number of co-workers in the same field. This inevitably elicits problems and points of view pertaining not only to this but to many other countries. 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, ice cream, water, shellfish, etc., the Essex County Council's scheme is utilised. 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) Nelmes Road, Hornchurch. (vi) St. Mary's Lane, Upminster. (vii) South End Road, Hornchurch. (viii) Suttons Hostel, Hornchurch. (ix) Upminster Road. Rainham. (x) 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 10 midwives and 3 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. 13 In addition to the home nurse/midwives there are eight home nurses working in the district. 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. Whilst this service is undoubtedly one of the highest importance instances do crop up which do not fall within its present scope. These relate, for example, to persons very often aged or living alone and in sanitary circumstances which, if not of the lowest order, are nevertheless sufficiently substandard as to ensure that any domestic help attending will speedily decide that other methods of dealing with the case should be sought. This is a point of view which one can of course understand, nevertheless this type of case demonstrates a gap in our social services. Care of the Aged. Once more I was fortunate in avoiding formal action under Section 47 of the National Assistance Act, 1948. A number of quite difficult cases were however brought to my notice and on more than one occasion it seemed very unlikely that any way out of the impasse would be found save that of formal action. In three instances at least only at the last moment did circumstances provide a solution to the problem. In two instances this was through hospitalisation and in one instance help from a variety of agencies enabled a satisfactory position to be secured. Although year by year a number of quite difficult cases arise the impression remains that were it not for a number of individuals and associations giving of their time to care for the aged, the problems with 14 which I am confronted would be increased very greatly both in number and in type. I must make special mention of the Annual Conference of the Old People's Welfare Association which I attended for the first time. Although of short duration I can say completely sincerely that the content of the Conference was of the most instructive and rewarding order. It provided a most valuable meeting ground for the amateur and the professional worker in this field and one could not but be very impressed by the enthusiasm and insight shown by the various voluntary organisations represented. This association of the voluntary and the professional based upon a deep appreciation of the problem involved and with each more conscious of his obligation than his rights operating freely, achieved that integration of effort which alone can produce the optimum results. I would again remark the most important but to some extent unostentatious tasks carricd out by the Public Health Inspectors in the field of the aged. I mentioned earlier the number of cases which might have come to my formal notice but which, owing to the wealth of outexisting services, did not do so. In this connection it must be remarked that the District Public Health Inspector does more than his share, both from a formal and a less formal angle, to secure that legal action under Section 47 never gets beyond being a last resort. Home Safety. Close contact continues to exist between the work of the local Committee and your Public Health Department. Laundry Service for the Incontinent—Section 84, Public Health Act. 1936. Advantage is taken of this Section legally to provide this type of service. The object of the service is to fill a gap which exists in a relatively few households unfortunately placed in that normal laundry facilities are not the most appropriate vehicle for dealing with the material accruing largely from the presence of the chronic sick within the family. Such instances are brought to my notice from a wide variety of sources such as doctors, district nurses, neighbours and the like. The laundry is collected and delivered by the Departmental van and washing arrangements have been satisfactorily concluded through the kind help of the local Hospital Management Committee. This is essentially a service the success of which can never be reflected in mere statistics, but in achieving a successful solution to a problem which would otherwise baffle the householders concerned. Since the service was commenced on 1st November, 1959, the number of cases availing themselves of it was 17. The number of garments treated was 2,866. The cost of the service during this period, i.e. from 1st November, 1959 to 31st December, 1960, was approximately £190. 15 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. Water Supplies. Main: It was a highly noteworthy feature of the year that my remarks—made in last year's report—concerning the dry weather which favoured this country in 1959 did not require repetition. In fact the second half of the year, even in this District, seemed determined to atone for its lapse of the previous year. This it did in full measure! Thirteen samples were taken by my Department during the year from the main supply. 6 were submitted for chemical and bacteriological examination and 7 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 4,400 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. 1960, was 40,769 and the population as at the 30th June, 1960, as obtained from the Registrar-General was 124,590. We are unable to state the number of houses supplied by standpipes, but the total is quite insignificant." The Engineer & Surveyor has kindly informed me of the rainfall figures for the year and which relate to "Langtons". The 1959 figures are given in parentheses. It is perhaps worth recording that in the months of July, August, September and October, rain fell on 72 days as compared with 28 in the previous year. The total rainfall for the 16 year of 26.76 inches was materially up on the previous year's figure of 17.01, while in 1960 185 days produced rainfall as against a relative 128 for the previous year. Amount of rainfall in inches Number of days in which rain fell January 1.49 (1.64) 18 (14) February 1.42 (0.06) 15 (2) March 0.84 (1.35) 12 (15) April 0.31 (1.96) 10 (15) May 1.93 (0.95) 8 (5) June 1.66 (0.77) 10 (11) July 2.48 (0.83) 20 (8) August 2.82 (1.22) 18 (7) September 3.92 (0.03) 11 (1) October 4.88 (2.50) 23 (12) November 2.93 (2.70) 22 (13) December 2.08 (3.10) 18 (25) 26.76 (17.01) 185 (128) Well: Three samples were taken from 2 supplies of this type and the results were uniformly unsatisfactory. Follow-up action was taken concerning these unsatisfactory supplies. Well supplies in this District are, of course, disappearing bit by bit and now present no material problem at all. Atmospheric Pollution. Smoke Control Areas: The first 15 months in operation of our No. 1 Area in Cranham signalised what appeared to be a satisfactory commencement to the wider programme which must necessarily eventuate. Our No. 2 Smoke Control Area at South Hornchurch came into force on 1st November, 1960. Following our programme of gradual extension our No. 3 Smoke Control Area was surveyed with the following results:— Privately owned houses 2,873 Houses—Council 717 Houses—Essex County Council 4 Houses—Dagenham B.C. 4 Houses—British Transport Commission 1 Houses—Romford and Hornchurch Joint Sewerage Committee 13 17 Shops 64 R.A.F. Aerodrome 1 Public Houses 3 Schools 2 Garages 9 Factories 40 Gravel Pits 2 Coal Yards 2 Car Sales Sites 2 Warehouses 1 Waterworks Pumping Station 1 Churches 4 Nurseries (horticulture) 2 Health Services Clinic 1 Sewage Works 2 Social Clubs 1 Community Centres 1 British Transport Commission (Keeper's Cabin) 1 Offices 6 Milk Depots 2 Scrap Yards 2 Breakers' Yards 3 TOTAL 3,764. This Area is bounded by (a) River Beam on its western side from River Thames up to the District Railway in vicinity of northern boundary of Bretons Sewage Works: (b) Rainham Road, Elm Park, from railway to junction with Ford Lane: (c) South side of Ford Lane to junction with South End Road, South Hornchurch: (d) East side of South End Road, South Hornchurch, from junction of Ford Lane to junction of Wood Lane: (e) Northern boundary of R.A.F. aerodrome to River Ingrebourne, and then (f) River Ingrebourne to Rainham Creek and to the River Thames. The acreage is 2,050 (including 180 acres R.A.F. aerodrome). 18 At the end of the year the Area had been submitted to the Minister for confirmation. A postal survey will initially be made of the next Area and an assessment made of how far this method of surveying might prove to be one of choice. The general implications of our smoke control programme were dealt with in the preamble of this report and need not be dwelt upon at much greater length. I ought, however, to repeat that the work associated with a smoke control area, i.e. the detailed survey of all the buildings in the area, the assessment of the results obtained, the full enquiry into difficulties and unusual circumstances emerging from the survey, the initial and continuing publicity given to our proposals, the assessment of and decision upon grant applications, the further visiting to ensure that the necessary work and only the necessary work approved has been duly carried out, the ironing out of such fuel supply difficulties as arise (it must be said that these so far have been few in number), the preparation of future phasing of our programme and, last but not least, general observation to ensure that due compliance is being made with the terms of Orders already operative- these points give some indication of the amount of work involved on the part of my staff. These tasks are, however, inseparable from any active smoke control programme and their weight will only be lightened when the District finally becomes smoke free. In the ultimate the speed with which an area comes into operation and hence the phasing of our complete programme is dependent upon Ministerial sanction so that whatever speed may be theoretically possible locally in practice the ultimate control will not rest with this Council. Discussion with Neighbouring Authorities: Our liaison continues with Romford and Dagenham but no specific lines of mutual progress emerged during the year. Specific Complaints: As noted last year various complaints of smoke fumes or dust from factory or hospital chimneys were received during the year. It should be emphasised that special processes do not fall within the control of your Public Health Department but come within the field of action of the Alkali Inspector. It is, therefore, essential that a close liaison should exist with that officer and this in fact is the case in Hornchurch. A local Association raised some particularly pertinent questions during the year and in fact arranged a meeting with the Alkali Inspector 19 at which your Public Health Department was represented. I think that in the event this was helpful as it not only elicited the complaints from residents but also the difficulties of dealing with every complaint in a manner calculated to give complete satisfaction to the complainant. Whilst it may be that on occasion dust and the like is in fact present in the atmosphere to a degree likely to attract attention the important thing is that it must be established initially whether the dust or other cause of complaint is in fact occurring in spite of every reasonable step having been taken to prevent its occurrence. It is our experience in Hornchurch that industry appears to be as anxious as we are that no cause for reasonable complaint should exist. Atmospheric pollution difficulties arising from industrial processes require more than willingness and the expenditure of substantial sums to secure their solution. The matter is necessarily governed also by the degree of scientific progress which can be brought to bear on the problem. In the case of a large undertaking the effects of even a very small percentage of what one might reasonably—in the light of present knowledge—term inevitable pollution can give rise to serious public concern. The degree of pollution caused by the household chimney is not yet fully recognised by householders who are naturally prone to accept that any industrial chimney they see emitting smoke is in fact almost solely the 'villain of the piece'. Although understandable this reflects the position in somewhat too simple a light. It is to be hoped that next year will see the solution to the problem of pollution from St. George's Hospital chimney as it is anticipated that chain grate stokers will then be introduced and should obviate cause for further complaint. It is true that the year under review has proved somewhat unsatisfactory from the point of view of the operation of this chimney. It is also true of course—and this is in no wise offered as an excuse—that the somewhat isolated position of this chimney renders the possibility of any pollution through its operation escaping attention a most unlikely happening. Routine Observations: Our programme continued its normal course. On the operation of No. 2 Smoke Control Area observation of the last 3 months of the year was continued through the smoke filter at Scargill School which during that period had become absorbed in the Smoke Control Area. It will be interesting to note the smoke filter results now that it is sited within such an area as compared with the results prior to its being so sited. 20 At a meeting of Co-operating Bodies, i.e. of authorities playing an active part through instrumentation of atmospheric pollution within their areas, the findings of a special committee which had engaged in considerable research into the present methods of instrumentation were considered. It seems clear that—although up to now our accepted routine methods of investigation have provided a most useful picture— the future must see a somewhat different approach. So far as Hornchurch is concerned it seems likely that our programme will be revised with the effect of:— (a) Deposit Gauges. These are now thought to reflect a very limited field of pollution and, whilst in any particular instance of pollution they might be found desirable as a general measure their continued use does not seem justifiable. (b) Lead Peroxide Candles. Although when these are sited—as they are in Hornchurch—at varied points throughout the District they do provide a certain measure of the pollution problem, again their continued use is not likely to provide results justifying the work involved in their continuance. (c) Smoke Filters. It is our intention to continue with our existing smoke filters and where necessary to increase them. This method of investigation should be particularly valuable in presenting a picture of the smoke in the atmosphere before an area comes into force and in due course after it has been in force. (d) Volumetric SO 2 Apparatus. It is my intention to continue with the volumetric SO 2 apparatus at the Public Health Department. There is always the danger in a matter of this kind where positive statistical results are so difficult to evaluate that in the end and as time goes on, statistics are accumulated merely as statistics without their intrinsic worth being realistically appraised. It is, therefore, to the credit of the special committee mentioned earlier that they should have seen fit to suggest certain definite lines of revised investigation which if adopted would prove more valuable to the picture as a whole. It may be that in due course further revisions will be made as only in this way can time and money spent in making these observations be utilised to the best advantage. Radioactivity. A meeting on this matter—sponsored by the Barking Borough Council—was attended by a number of Essex authorities. I do not propose to repeat the remarks which I made in last year's Report and which are as relevant now as then. The problem of radioactivity whether it be small or large will remain with us in the foreseeable future and as the accent on one form of activity may diminish, so may the accent on another form 21 be emphasised. It is a subject which brooks of no parochial outlook and it is therefore important that all the local authorities in a conurbation should band together with a view to considering this matter collectively rather than individually. A nucleus of trained Public Health staff should be present constantly in each local authority area. Sewerage and Sewage Disposal. Soil Sewers. Agreement between the various Local Authorities on a Regional Sewerage and Sewage Disposal Scheme has been sought unavailingly over a period of many years with the result that in this district at any rate (and it is with this aspect that I am clearly concerned) the general position is not nearly so satisfactory as it should be. The situation at Bretons Farm Works which serves not only this district but also Romford in a major capacity, is one which must give cause for serious disquiet. However skilfully it has been operated (and there is no question of this) it is being progressively overloaded until the situation is now with us when some long-term and statesmanlike solution is imperative. I am indebted to the Council's Engineer and Surveyor for the following notes on the effect of its implementation so far as this district is concerned:— (1) Ravensbourne Valley Trunk Sewer would be relieved by the elimination of Paynes Brook Pumping Station; (2) The high level sewer to Bretons Farm Disposal Works would be relieved by the elimination of Hacton Farm Pumping Station and the construction of a relief link. (3) The Bretons Farm Sewage Disposal Works would be relieved by the Bretons Farm branch sewer. (4) The sewers at Dovers Corner, Rainham, would be relieved by two gravity outfalls from Parsonage Farm Estate; (5) The Wennington sewer flow would be improved by the Regional Works at Riverside; (6) The effluent from the Nags Head Works of Brentwood Council would no longer traverse our district from end to end through the medium of the River Ingrebourne of which—in dry weather —it provides the major flow; (7) Eventually the disappearance of the Bretons Farm Works would provide a considerable addition to the amenity of particularly the houses which border its perimeter over a considerable length, 22 Although this conception of the Regional Sewerage Scheme would —due to the necessary phasing of the works—take some time, it would nevertheless provide a comprehensive answer—and so far as one can see at present the only comprehensive answer—to our present difficulties. The Corbets Tey area is also open to considerable improvement either by gravity sewer from Corbets Tey to the Ingrebourne Valley (so eliminating the Pumping Station) or, alternatively, the provision of a new Pumping Station and extensive improvements to the existing gravity sewers to which the station discharges. A relief soil sewer at Upminster Road, Rainham, is under construction and work has also commenced on the Hall Lane/Warley Road soil sewer extension. The Queens Park Road (Harold Wood) relief sewer is included in the current year's Estimates. The current programme of improvements embraces the following areas:— (a) Roneo Corner; (b) Central; (c) Upminster Road, Hornchurch, and Hacton Lane, Hornchurch. A shallow sewer in Wingletye Lane will also receive attention. Work on the relaying of certain other sewers—mainly by the substitution of 9ins. for 6ins. diameter pipes—will be considered at the appropriate times as will also the position of the Clay Tey area which has a number of cesspools. Cesspools. The provision above noted would enable the majority of cesspool owners to obtain the benefits of main disposal. Cesspool emptying is costly and recurrent. A certain element of nuisance is inseparable if not from the presence of a cesspool (and some would even suggest this) at any rate from its emptying. Cesspools may be necessary in rural and isolated spots (and even here a septic tank may well give less offence). They have no place in a modern urban community. Surface Water Sewers, The current programme of major schemes includes, (a) St. Mary's Lane; (b) River Ravensbourne (in stages); (c) Harold Wood (Queens Park Road); (d) Central area (in stages); (e) Squirrels Heath—following the Ravensbourne; (f) Roneo Corner area. A number of minor schemes are also contemplated. Marlborough Gardens relief sewer is under construction. 23 The current year's Estimates include work relating to Sycamore Avenue, Rainham Road, Norfolk Road, Kinfauns Avenue, Upminster Road (Hornchurch) and North Street, as well as a Severn Drive relief. Future schemes involving Emerson Park, Rainham, Harold Wood, Front Lane, Upminster, Wood Lane, ctc., are also due for consideration. Work relating to ditches also forms part of the future proposals. It will thus be seen that the proposals of both soil and surface water sewers are still important and still with us in this district. It is essential that in our rapidly growing population steps should be taken to keep pace in respect of all sewerage and sewage disposal matters. This naturally means that not only must existing disposal works be aligned to modern demands and new sewers provided, but also that the old ones are brought up to a state adequately to cope with the demands now placed upon them. One must conclude where one started by emphasising that the first matter to be settled is the question of the Regional Sewerage Scheme. Until this is done our actions can only be regarded as palliative rather than curative. Extensions or Improvements to Sewage Works. Stages II and III of the Eastern Outfall Works (Berry Farm) are in progress, these consisting of predigestion tanks and further humus tanks and three more biological filters which will be electrically controlled in order to give constant rate of effluent discharge through the filters and further treatment beyond the humus tanks by land irrigation in order to provide a higher standard than that required by the River Board and above Royal Commission standard. The improvements mentioned will include the introduction of a Mono-rail system to lighten the task of sludge removal which is at present being carried out entirely by manual labour. Rivers. Comment has already been made on the unsatisfactory position attending the River Ingrebourne. 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. 24 Swimming Pool. The water is sampled regularly and the results have been uniformly satisfactory. It might be appropriate—if somewhat provocative—to refer to the question of verrucas or plantar warts in relation to swimming baths. It is human nature to demand that a precise cause should be assigned to every ailment. Since verrucas occur very often within the same age group as the attenders at swimming baths it is a commonplace that the two should be associated. It might, however, be interesting to consider how far this association can in fact be proved. So far as I am aware the actual cause of plantar warts has not yet been determined with any precision. It is. thought that a very long time may well elapse between a sufferer being exposed to the possibility of infection and the actual condition occurring. There is no reason to establish that circumstances conducive to the spread of this condition are peculiar to swimming baths—if in fact they exist in the latter at all. Demonstrably the standard of hygiene at baths (with the unlimited supply of chlorinated water) is very high. However tempting dogmatism may be it should be reserved for circumstances far less equivocal than those pertaining to plantar warts and swimming baths. I am indebted to the Bath Superintendent for the following contribution:— Set in the pleasant surroundings of Harrow Lodge Park this modern building houses a pool 110 feet in length and 42 feet wide. It varies in depth from 3 feet at the shallow end to 12 feet 6 inches at the deep end to accommodate diving facilities of 1 and 3 metres spring boards and 3 and 5 metres firm boards. There is capacious spectator accommodation and a popular modern buffet bar for service of refreshments to patrons. The source of the water supply is the South Essex Waterworks Company and it is treated in the building by the continuous circulation system with a plant comprising six vertical filters, chemical tanks, chlorinator and heating calorinator. The normal turnover period of the pool is 4 hours and regular wastage of water via the overflow channels and backwashing of the filters with the subsequent topping up ensures that an adequate supply of fresh water is added periodically. Despite the very poor weather experienced during 1960 the Swimming Pool has again proved a popular venue, well over 300,000 having taken advantage of the facility during the year. Following the exceptionally good weather in 1959 a drastic reduction in patronage was anticipated but only 10,500 fewer patrons were recorded. The advantage of a modern, well heated building is now becoming obvious as the winter patronage continues to rise, whereas summer admissions are mainly controlled by weather conditions. A good, deal of the upward trend of winter patronage can be attributed to the commencement in October of "Adult Learn to Swim" classes which not only taught many 25 adults to swim but proved to them that winter bathing is just as good, if not better, than the crowded conditions experienced during the summer months. Paddling Pools. Four samples were taken from each of the four Paddling Pools, i.e., in May, June, July and August. All the samples were satisfactory. 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, 1960:— yards Private Streets: Elmer Gardens 476 Brookway 449 Ashvale Gardens 284 Ingrebourne Gardens (part) 171 Windsor Road 187 Maylands Way (part) 108 Prospect Road (part) 348 Hartland Road (part) 54 Total Length 2,077 Estate Roads: Tyne Close 90 Longwood Close 112 Rutland Approach 129 Stanley Close 60 Eastwood Drive (part) 131 Rutland Drive (part) 241 Gleneagles Close 54 Newtons Close 216 Kenilworth Gardens (part) 49 Parkland Avenue (part) 57 Brierley Close (part) Footpath only Plough Rise 200 Chelsworth Drive 334 Chelsworth Close 51 Karen Close 76 Hunter Drive (part) 477 Bourne End 161 Esdaile Gardens 309 Lewis Road (part) 46 Kersey Gardens 320 The Glade 130 Huntsmans Drive 195 Total Length 3,488 26 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 351 visits to deal with new infestations. 1,568 routine or revisits were paid. The premises visited comprised 289 dwellings and 62 business premises or factories. 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. Twenty-nine 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. Three infestations were found and clcared. 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. Routine visits were made to these premises. Heating Appliances (Fireguards) Act 1952 and Regulations 1953. During the year 24 visits were paid in this connection. 16 appliances were tested (involving 43 tests) and one was found to be unsatisfactory. Two others failed one of the prescribed tests. These three fires were withdrawn from sale. A demonstration of the testing of fireguards was given to the Press during the year. Old Metal Dealers (Hornchurch) Order, 1956. At the end, of the year 13 persons had registered as Dealers in Old Metal. Pet Animals Act, 1951. Forty-three visits were paid to the 10 Pet Shops in the District. 27 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, Mr. R. H. M. Coulton, M.R.C.V.S., was officially appointed an additional Veterinary Surgeon for the purposes of this Act. It was further agreed that quarterly reports should be given on the Riding Establishments in the District. The number of such establishments is now 5. 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 18 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. One notice was served during the year. Public Health Inspection of the District. SUMMARY OF PUBLIC HEALTH INSPECTORS' WORK DURING 1960. Inspection of Food and Premises (visits paid): Bakehouses 94 Butchers' shops 173 Cafes 149 Confectioners 149 Dairies 14 Fish shops 78 Food complaints 152 Greengrocers' shops 175 Grocers' shops 465 Ice cream vendors' and manufacturers' premises 141 Mobile shops (hawkers) 55 Public houses 36 28 Sampling 608 School canteens 108 Slaughterhouse 473 Staff canteens 28 Miscellaneous visits 56 Housing (visits paid): Overcrowding, etc. enquiries 179 Improvement grants 109 Sanitation 46 Structural defects 590 Water supply and pipes 46 Miscellaneous housing visits 155 Re-inspections 1,502 General Sanitary Circumstances (visits paid): Atmospheric pollution 479 Camping and fairgrounds, vans, etc. 145 Conveniences 15 Drainage and sewerage 726 Dustbins 63 Farms 19 Stables, piggeries, animals, birds, etc. 88 Nuisances 256 Paddling pool samples 25 Refuse tips 82 Pest Control 244 Swimming Pool samples 15 Water samples (main supply) 14 Water samples (well) 11 Rivers, streams, ponds, etc. 79 Miscellaneous visits 163 Re-inspections 1,373 Factories and Outworkers: Number of visits paid 363 Shops Act: Number of inspections 607 Smoke Control Areas: Number of visits paid 4,910 Miscellaneous (visits paid): Diseases of Animals (Waste Food) Order 54 Heating Appliances (Fireguards) Act 24 Pet Animals Act 43 Rag Flock and Other Filling Materials Act 4 Old Metal Dealers 4 Massage establishments 20 29 Infectious Disease: Number of visits paid (including contacts) 921 Number of notices served: Informal 381 Statutory 125 The main headings under which work was done may be noted as follows: Smoke Control Areas 4,910 visits General Sanitation 3,878 Inspection of Food and Premises 2,954 Housing 2,627 Infectious Diseases 921 „ Shops Act Inspections 607 ,, Factories and Outworkers 363 ,, Public Health Inspectors' Work. A perusal of the visit headings gives a fairly accurate general impression of the emphasis devoted by the staff to various aspects of their work. It shows, for example, the routine work carried out year by year with but little divergence in the figures. It shows markedly the attention devoted to any new endeavour such as Smoke Control. It shows perhaps above all the remarkable diversity of endeavour which the Public Health Inspector is called upon to make within the scope of his duties. The change of name from 'Sanitary' to 'Public Health' Inspector may have suggested a certain upgrading of status. However fashionable it may now be to provide a more attractive verbal clothing for a post it should not be lost sight of that—consistent with modern progress—the duties of the post basically remain the same. The erstwhile 'Sanitary Inspector' had no reason to be embarrassed either about his calling or of its title. He did a grand job of work in the field of preventive medicine the fruits of which are now evident in the improved environmental standards obtaining throughout the country. Preventive medicine is seldom likely to become as glamorous as curative medicine but the Public Health Inspector is a member of a team still essential to our present day well being and his contribution to that team requires no exaggeration to emphasise its worth. Shops Act, 1950. The number of shops on the register at the end of the year was 1,189. Forty-seven notices were served during the year regarding contraventions of the Act. 30 SECTION D. HOUSING Number of New Houses erected during the year: (i) By the Local Authority 62 (25) (ii) By other Local Authorities 16 (10) (iii) By other bodies or persons 675 (691) The previous year's figures are given in brackets. The number of new houses erected is roughly comparable with last year save only that a rise is evident in the number of houses erected by the Local Authority. The number of sub-standard houses dealt with has increased although it has not yet reached any material propertions. It is evident that there is in fact no serious slum problem in Hornchurch at all. Whatever the programme of getting rid of the relatively few sub-standard houses might be it is necessarily a continuing process. As one small aggregation is dealt with so does one find from time to time that other houses have in fact gradually deteriorated into a condition which renders demolition the only possible course. Number of Houses voluntarily demolished 8 111, 113, 115, 117, 119, 121, 123 and 125, High Street. Number of Demolition Orders made 7 3, 4, 5 and 6, Cabbage Corner, Ockendon Road. 1 and 2, Walnut Tree Cottages, Ockendon Road. 452, Wingletye Lane. Number of Houses demolished following representations 8 "Danny's Bungalow" Bird Lane. 70, 72, 74, 76, 78 and 80, High Street. 452, Wingletye Lane. 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, 1960:— Part I—A pplications for Certificates of Disrepair : (1) Number of applications for certificates 17 (32) (2) Number of decisions not to issue certificates 0 (0) (3) Number of decisions to issue certificates: (a) in respect of some but not all defects 13 (21) (b) in respect of all defects 4 (11) (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 12 (22) (5) Number of undertakings refused 0 (0) (6) Number of certificates issued 5 (10) Part II—A pplications for Cancellation of Certificates: (7) Applications by landlords for cancellation of certificates 7 (19) (8) Objections by tenants to cancellation of certificates 1 (9) 31 (9) Decisions to cancel in spite of tenants objections 0 (2) (10) Certificates cancelled by Local Authority 5 (21) As will be seen from the figures in parentheses the work has shown some decrease during the year. Improvement Grants. My advice has been submitted to the Council in 71 instances during the year. Re-Housing—Medical Aspects. My advice was sought during the year on some 122 housing applications respecting which medical recommendations for priority had been submitted by hospitals or private practitioners. The trend in priority in re-housing on medical grounds appears to be turning somewhat towards one type of accommodation being preferable rather than another. Notably is this the case where applicants are recommended for ground floor accommodation. Although it is clearly important on medical grounds that each applicant should enjoy the accommodation best suited for his particular circumstances the fact remains that initially it is even more important that the accommodation should be adequate rather than it should be practically perfect. Lack of basic space and amenities present a problem which for a time will, I consider, have to take precedence of lack of just that particular type of housing accommodation which an individual might naturally desire. Overcrowding. A very limited amount of overcrowding has been ascertained and dealt with. Although no special survey has been undertaken to determine exactly the extent of the overcrowding which exists in the District, no opportunity is lost of making use of routine visits to ascertain at least a sample of the general situation. It is necessary that a vigilant eye should be kept on the general position since apart from what might be termed natural and family overcrowding, there is clearly a danger that overcrowding of a more serious nature may arise. This is especially the case where multi-family occupancy of houses tends to arise. Caravans. The provisions of the new Act are being pursued with all vigour. One or two of our open spaces have now been fenced in with the result that this problem has now been obviated. It cannot, however, be said that the Lake Avenue site problem has yet so far as one can see been solved. Looking back on events one would not have believed it was possible for this site to have persisted for so long in spite of the efforts made to secure its removal. Land Charges Enquiries. During the year 3,933 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. 32 SECTION E. INSPECTION AND SUPERVISION OF FOOD AND FOOD PREMISES. Food and Drugs Administration. Reference has already been made to the unfortunate death of Mr. Taylor. In common with his partner he was a source of never failing strength to us in dealing with the problems which from time to time arise. His loss to us will be a real one. In the following statistics the figures for last year are given within brackets. 308 (290) samples were taken during the year of which 300 (277) were found to be genuine (List A) and 8 (12) to be sub-standard (List B). 21 (18) food complaints were referred to the Public Analysts (List C) and 22 (34) food complaints were dealt with informally (List D). The accompanying lists (A and B) indicate the wide variety of food and drugs actually sampled. I would express my indebtedness to the Public Analysts, Dr. J. Hubert Hamence, M.Sc., Ph.D., F.R.I.C. and Mr. Philip Sydney Hall, B.Sc., 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. It is astonishing how undefined appear to be the arrangements in some shops for keeping separate goods known to be unfit from those in normal condition. There can be no valid excuse for confusing known good with known bad food and the fact that some inexperienced assistant (as is sometimes stated) sells unfit food is merely a natural happening in a haphazard system. 33 LIST A SAMPLES SUBMITTED TO PUBLIC ANALYSTS AND FOUND TO BE GENUINE Article No. Article No. Almonds, ground 2 Hamburgers 1 Batter Mix 1 Hamburgers with Gravy 1 Beef Curry with Rice 1 Herrings with Vegetables 1 Beef with onions minced 1 Honey 2 Beef Loaf, Minced with Onion 1 Horseradish Sauce 1 Ice Cream 33 Beef, Minced with Onion and Gravy 1 Irish Stew 1 Jam 22 Beef, Potted with Butter 1 Jam, Mixed Fruit 1 Biscuits 1 Jelly 1 Blancmange Powder 1 Lamb's Kidney Turbigo 1 Brandy Flavour 1 Lard 1 Brisling 1 Lemon Curd 2 Butter 1 Lemon Juice 2 Butter Shorties 1 Lemon Squash 1 Buttermilk Loaf 1 Lollies 27 Cheese Crisps 1 Marmite 1 Cheese Royals 1 Marzipan 2 Cheese Spread 3 Marzipan Almond Icing 1 Cheese Spread with shrimps 1 Mazola Corn Oil 1 Cheese and Ham Spread 1 Meat Pasties 3 Cheese Whiz 1 Meat Pies 1 Chicken chopped in Chicken Jelly 1 Meat Spread 1 Milk 40 Chicken and Ham 1 Milk Chocolate 1 Chicken à la King 1 Milk Shake Syrup 1 Chicken and Rice with Vegetables 1 Milkie Loaf 1 Mint 1 Chocalatiney 1 Mint Sauce 1 Coconut, Desiccated 1 Mustard, French 1 Coffee 5 Onions 1 Coffee and Chicory 1 Onions, Dried 1 Coffee and Chicory essence 1 Orange Juice 1 Crab Paste 1 Pate-de-Foie 1 Cranberry Sauce 1 Peel, Mixed Cut 1 Cream 1 Pepper 1 Cumberland Brandy Butter 1 Peppermint Cordial 1 Flour 1 Pickle 1 Fruit Mixture, dried 1 Pork, Danish 1 Fruit Salad 1 Pork, Chipolatas 1 Grape and Blackcurrant iuice Health Drink 1 Pork, Luncheon Meat 1 Pork Pies 2 Green Lime Cordial 1 Pork, stuffed paprika 1 Ham and Chicken Luncheon 1 Potatoes 1 Potato Puffs 1 34 Article No. Article No. Pudding creamed rice 1 Abidec Drops 1 Pudding orange sponge 1 Akta Vite 1 Ralettes 1 Almond Oil 2 Rice Pudding 1 Bronchial Balsam 1 Ricory 1 Camphorated Oil 1 Royal Chiffon 1 Children's Asprin Tablets 1 Rum Butter 1 Children's Cherry Cough Syrup 1 Rum Flavour 1 Salad Cream 1 Children's Linctus 1 Salmon, Pate smoked 1 Children's Mixture 1 Sardines 1 Cinnamon Tablets 1 Sauce Melba 1 Cold Sore Lotion 1 Sausages, Cocktail 1 Cold and Catarrh Syrup 1 Sausages, Beef 3 Compound Syrup of Figs 1 Sausages, Pork 5 Cough Syrup 1 Self Raising Flour 1 Cream of Magnesia 1 Skels, sugarless pastilles 1 Cream of Tartar 1 Soups Dextrosal 1 Soup—Noodle 1 Eucalyptus Oil 1 Spaghetti with Tomato and Cheese Sauce 1 Glauber Salts 1 Glycerinz 1 Spice, Mixed 1 Glycerine and Borax 2 Sponge Mixture 1 Gripe Water 1 Steak and Kidney Pie Haliborage Tablets 1 Steak Pudding 1 Influenza Mixture 1 Steak, stewed 1 Iron and Yeast Tablets 1 Strawberries in Syrup 1 Medicated Cough Drops 1 Sugarless Fruits 1 Menthol and Eucalyptus Sweets 1 Sugarless Marmalade 1 Sweet Corn 1 Neovit 1 Tapioca Ketchup 1 Oil of Eucalyptus 1 Tea 2 Olive Oil 1 Tomato Juice Cocktail 1 Rheumatic Tablets 1 Turkey, Minced 1 Syrup Minadex 1 Vegetable, mixed 1 Syrup of Sal Volatile 1 Vinegar, Malt 3 Tebs 1 Vita Cup 1 Tincture of Iodine 1 Wincarnis Jelly 1 Wintergreen Rub 1 Cherry B l Zinc and Castor Oil 2 Gin 2 Total 300 Pink Lady 1 Stout 1 Whisky 4 35 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.1288 Cream Cheese. Contained insufficient fat to justify the description of "Cream Cheese." Matter taken up with Manufacturers and description on label altered to "Cream Cheese Spread." Inf.1916 Cooking Fat. No declaration of ingredients as required by the Labelling of Food Order. Matter taken up with Manufacturers and label amended. Inf.1999 Lactic Cheese. Description 'creamy' could be misleading. Matter taken up with Manufacturers and label amended. Inf.2019 Soda Bread Mix. No declaration of the amounts of vitamins and mineral given as required by Labelling of Food Order. Formal |follow-up sample sought but not obtainable. No longer on sale in this country. Inf.2134 Pork Luncheon Meat. Contents unsound. Legal proceedings instituted. Product no longer being imported. Inf.2160 Cider Lolly. Poor in respect of its content of cider Verbal warning to producer. Inf.2164 Chicken Noodle Soup. Poor in meat content. Forcign product. Matter taken up with Importer and further sample taken outside 1960 period. Inf.2193 Chicken Noodle Soup. Poor in meat content. No definite standard for this commodity but Manufacturers approached and should any such standard be set, they will conform to it. It will be noted that satisfactory alterations in labelling were secured in some instances. The difficulty about some soups is one of standard. Where no legal standard exists the matter becomes one of opinion only. It is difficult enough to secure a successful conviction when the facts seem reasonably clear. When the initial basis for complaint is ill-defined, any subsequent proceedings could become merely an exercise in legal argument with little obvious benefit to the person initially prejudiced. 36 LIST C FOOD COMPLAINTS REFERRED TO PUBLIC ANALYSTS Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action Taken Cpt.1943 Milk Bottle. Contained mould growth on the inner surface of the bottle. Matter taken up with Dairy firm concerned. Cpt,1968 Buttered Roll. Contained Rodent excreta. Legal proceedings instituted. Vendor fined £10 plus £2 10s. costs. Cpt.1969 Candy 'necklace.' Coated with blackish foreign matter in the form of atmospheric dust and dirt. Foreign product— local vendor warned. Cpt.2010 Milk Bottle. Contained foreign matter in the form of atmospheric dust. Matter taken up with Dairy firm concerned. Cpt.2053 Milk Bottle. Contained a discoloured dried milk film. Bottling firm warned. Cpt.2062 Milk Bottle. Contained a dried milk film with growth of mould and algae. Bottling firm warned. Cpt.2072A Milk Bottle. Contained miscellaneous dust and dirt. Dairy company warned. Cpt.2072B Milk Bottle. Contained a number of blackish specks consisting of mould growth. Dairy company warned. Cpt.2077 'Glass' in Bread. Consisted of a piece of transparent plastic. Matter brought to the attention of the Bakery firm concerned. Cpt.2078 Slices of Bread. Contained a mould growth. Matter brought to the attention of the Bakery firm concerned. Cpt.2079 Milk Bottle. Sight deposit of mould growth on inner surface of bottle. Dairy company warned. Cpt.2083 Milk Bottle. Contained foreign matter in the form of mould growth in suspension adhering to top of bottle. Dairy company warned. 37 Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action Taken Cpt.2106 White loaf. Contained foreign matter in the form of minute fragments of charred wood. Bakery warned. Cpt.2113 Part of loaf. In a mouldy condition. Bakery warned. Cpt.2120 Milk Bottle. Contained mould growth. Dairy company warned. Cpt.2121 Pork Luncheon Meat. Had an objectionable smell of decomposition. Contents not sterile. Informal sample to be taken. Cpt.2122 Part of White loaf. Contained traces of dirty dough. Bakery warned. Cpt.2163 Bread Roll. Contained foreign matter in the form of burnt dough associated with traces of iron and mineral oil. Bakery warned. Cpt.2172 Children's Mixture. Insect contamination. Full inquiry and no further action. Cpt.2189 Chocolate Flavoured Drink. Contained a piece of wood. Milk Producer warned. Cpt.2200 Piece of Bread. Contained small fragments of foreign matter in the form of small masses of discoloured gluten. Matter brought to the attention of the Bakery firm concerned. As usual milk bottle and bread formed the chief subject of complaint. The description of the complaint and perhaps even more the note of resultant action may well be misleading without the detail which is available when the complaint is considered but obviously cannot be reproduced here. Factors often emerge which at once establish not only that, for example, the article surrendered to my department is unfit or not of the quality or substance demanded, but also that it is impossible accurately to determine how it came to be in that condition. 38 LIST D FOOD COMPLAINTS WHERE ANALYSIS WAS NOT REQUIRED Complaint Action String in Bloomer Loaf. Foreign matter in Corned Beef. Bakery warned. Investigation showed foreign matter to be thick skin. Vendor informed. Glass alleged to have been in bread of sandwiches. Investigation could not prove glass to have been in the bread. Foreign matter in Cooked Cod's Roe. Vendors approached. Unshelled nut in block of Almond Nut Chocolate Manufacturers informed. Glass alleged to be in sandwiches. Impossible to prove glass was found in bread. Mouldy pork pie. Legal proceedings instituted— Vendor fined £5. Dirty milk churns at farm. Matter reported to appropriate authority. Mouldy skinless pork sausages. Legal proceedings instituted— Vendor fined £5. Dirty milk bottle. Insufficient evidence of dirt. Mouldy skinless beef sausages. Matter taken up with Vendor and Manufacturer but insufficient evidence to take further action. Two Mouldy apple turnovers Bakery warned. Third pint bottle of milk containing bottle cap. Dairy informed—not a matter requiring further action. Cooked liver alleged to be unsound. Matter taken up with butcher. One Pig's kidney with blemishes. Matter taken up with butcher. Pint bottle of milk with neck of bottle broken. Matter taken up with Dairy firm. Piece of metal in sliced loaf. Investigation showed metal came from defective slicing machinc. Bakery firm warned. Bread 'dirty' on delivery. Complaints could not be substantiated. Fly-struck bacon. Vendor warned. Third pint bottle of milk containing bottle cap. Dairy informed—not a matter requiring further action. Earwig in slice of bread forming part of sandwich. Investigation did not justify further action. Unsound pork luncheon meat. Informal sample taken. This list largely refers to articles concerning which the cause for complaint required no specialist investigation. Mould growth forms one of the chief causes for complaint and as moulds spread relatively easily and even grow well at ordinary temperatures this is quite understandable. 39 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 an entry is made in respect of each trade). The varying types remain remarkably constant as the figures (last year in brackets) show:— Bakehouses 14 (17) Butchers 77 (75) Cafes 53 (53) Confectioners (bread, cakes, etc.) 40 (40) Confectioners (sweets, etc.) 126(119) Fish Shops 27 (28) Grocers 179 (183) Greengrocers 103 (100) Ice Cream Dealers 306 (291) Ice Cream Manufacturers 3 (3) Food Hygiene Regulations. 195S. Some 123 notices were served as against 65 last year. 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 — — 104 8 Meat — 3 98 2 Fish — 1 38 13 Tinned Meat — 12 83 14 Tinned Fish — — 19 11 Tinned Milk — 1 66 14 Tinned Food — 17 100 1 Miscellaneous Groceries — 1 67 1 Total 2 0 19 0 40 Carcases Inspected and Condemned. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed 545 11 161 2,257 1,505 Number inspected 545 11 161 2,257 1,505 All diseases except Tuberculosis and Cysticercosis— Whole carcases condemned — —. 1 — — Carcases of which some part or organ was condemned 33 3 2 24 46 Percentage of number inspected affected with disease other than tuberculosis, etc. 6.1 27.3 1.9 1.0 3.0 Tuberculosis omy— Whole carcases condemned – – – – – Carcases of which some part or organ was condemned 2 2 – – 41 Percentage of number inspected affected with tuberculosis 0.4 18.2 — – 2.7 Cysticercosis only NIL. Slaughter of Animals Act, 1958. Five slaughterman's licences were issued during the year. Ice Cream. During the year 21 applications for registration as vendors and 12 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 306 for the storage and/or sale of ice cream. Ninety-three samples were taken during the year. 83 proved satisfactory. In addition, 61 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. It is difficult exactly to define what is meant by an unsatisfactory sample since this term might well and properly be applied merely to a sample which does not come up to the highest standards. In the particular instances noted here as unsatisfactory it may be taken that there was no serious divergence from quite a normal satisfactory standard. 41 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 70 persons and 89 premises were registered for the manufacture of preserved meat, an increase of 3 persons and 3 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 67 persons and 13 premises had been registered. Milk Distributors. There are 8 milk distributors with 12 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, 55 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) 63 Supplementary Pasteurised 7 Dealer's Sterilised 86 Supplementary Sterilised 8 Dealer's Tuberculin Tested 46 Supplementary Tuberculin Tested 6 Milk Sampling. The 94 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, 40 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. 42 School Canteens. A certain amount of progress has been made in securing that defects are remedied but it is a branch of the work which appears to require unremitting attention. Shellfish. Samples of prawns, whelks, cockles and jellied eels were sent for examination during the year with the results as under-noted: — Satisfactory 2 Unsatisfactory 3 The results of the sampling are of the same order as last year. Shellfish could be said to represent an individual taste and the devotees to this article of food are doubtless well aware of its individual characteristics. Shellfish as a general class are demonstrably more open to pollution in some instances than the ordinary run of foods. To judge from their relative popularity, however, the charms of the crustacea confer compensatory benefits upon the consumers. Slaughterhouses Act, 1958. During the year the Slaughterhouses (Hygiene) Regulations, 1958, and the Slaughter of Animals (Prevention of Cruelty) Regulations, 1958, came into force by virtue of the Slaughterhouses (Hygiene) Regulations (Appointed Day No. 2) Order, 1960, as regards the one existing slaughterhouse in Hornchurch. These Regulations ensured from the Appointed Day—1st October, 1960—improved standards of hygiene and arrangements for the slaughter of animals. Such items as better lighting facilities, vermin prevention, new floors, the provision of sterilisation equipment, new receptacles for waste material and the provision of a special stunning pen for slaughtering purposes were obtained. Towards the end of the year progress was being made in the building of a large slaughterhouse at Cornslands Farm, Hall Lane, Upminster, complying with modern standards required by these regulations. 43 SECTION F. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER NOTIFIABLE DISEASES. Infectious and Other Notifiable Diseases, 1960. Disease Total cases notified No. of Cases hospitalised Dysentery 79 12 Encephalitis (post infectious) 2 2 Erysipelas 11 5 Food Poisoning 13 2 Infective Hepatitis 33 11 Measles 23 0 Meningococcal Infection 2 2 Paratyphoid Fever 1 1 Pneumonia 6 0 Poliomyelitis (paralytic) 1 1 Scarlet Fever 234 7 Whooping Cough 238 6 Reviewing the list as compared with last year one sees that the Dysentery cases have increased from 10 to 79. Food Poisoning shows some decrease. Infective Hepatitis has increased from 11 to 35 cases, Measles has decreased from 2,590 to 23 and one case of Paralytic Poliomyelitis occurred. It is also interesting to note that Scarlet Fever remained almost constant with a figure of 234 vice 246 in the previous year. Lastly, Whooping Cough increased from 63 to 238 cases. In a large populauon the number of Dysenterv cases notified is not of great importance in this instance. It is gratifying to see that Food Poisoning has decreased to half its previous figure. Infective Hepatitis —Catarrhal Jaundice—which is only notifiable in certain parts of the country shows a marked increase and has in fact trebled its incidence from 11 to 33. It is difficult to stress the importance of this disease and the effects it might have subsequently. Immediately, however, it does not seem that material or permanent damage does result from it. That Measles should fall from a very high number to an insignificant one is typical of the incidence of that disease which commonly comes every other year. Especially interesting is the occurrence of only one case of Poliomyelitis. What part any immunisation may have played in this relatively happy state of affairs must remain a subject for opinion rather than for emphasis. There can be little doubt, however, that the future prevention of Poliomyelitis does lie in the widespread acceptance of protective measures which are happily now available on an ever increasing scale. As I remarked last year I see little benefit in Scarlet Fever being continued as a notifiable disease. 44 Whooping Cough, which rose sharply from 63 to 238 cases, has also lost much of its history as a killer and in fact of the 238 cases only 6 were sent to hospital. I think that the time is ripe for a comprehensive re-appraisal of the whole question of notification of disease. Whether notification of some diseases is really important or not—however legally it may be demanded—the fact remains that any disease which is notified can only be enquired into adequately if it is notified at the earliest possible moment Food Poisoning. In 12 out of 13 cases notified 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. Psittacosis. Cases or often suspected cases of this disease are occasionally brought to our notice as having arisen outside this District and possibly having originated at any rate indirectly in this District. This is a disease the control of which is highly unsatisfactory. Partially this is due to factors which are at the moment uncontrollable and partially it is due to factors which might be legally controlled but at the moment are not. Two of the difficulties in tracing any particular outbreak are, (1) the difficulty of identifying any particular bird in the absence of appropriate markings, and (2) the fact that records in general are not really required to be kept. As so often happens the chief public safeguard lies in the fact that on approach the dealers in, for example, parrots (parrots are by no means the only spreaders of the disease which has a widespread incidence among the bird population) are normally very willing to co-operate with this department in avoiding trouble. It is very clear that the interests of any Pet Dealer are best served by stamping out any illness among his pets and in avoiding such illness arising. This in fact is what happens. Whether in view of its relatively low incidence Psittacosis is worth exploring as a medium for more detailed legislation is under all the circumstances doubtful. International Certificates of Vaccination or Inoculation. 398 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. 45 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 1960: — Diphtheria Immunisation : Completed primary immunisations 1,859 Boost injections 1,756 Whooping Cough Immunisation: Completed primary immunisations 1,546 Boost injections 239 Combined Diphtherial Pertussis Immunisation: Completed primary immunisations 799 Boost injections 194 Poliomyelitis Vaccination: Completed 2 primary injections 8,938 Boost injections . 12,312 Smallpox Vaccination: Primary vaccinations 1,773 Re-vaccinations 365 Tuberculosis. The number of new notifications concerned in respiratory and nonrespiratory remained largely as last year. Respiratory: The number of new notifications increased from 41 to 43. Non-Respiratory: The notifications decreased from 5 to 4. The site of infection and age of the non-respiratory cases were as under: — Endometrium Female 28 Lupus (nose and nostril) „ 52 Meninges „ 24 Peritoneum „ 24 Inward Transfers: These totalled 43 as against 35 last year. Deaths: There were 10 this year as compared with 5 last year. Cases on Register: The number of cases of tuberculosis on the register at the end of the year was as follows: — Respiratory: Males 581 Females 497 46 Non-Respiratory: Males 51 Females 33 I have given additional tables to show as a matter of interest the position in 1938, 1950 and the year now being reported upon. It will be seen how the accent has markedly changed to that of an older age group in fact a very much older group being notified and dying from this disease. As I mentioned in a previous report Tuberculosis may be on the run but it is to some extent still full of running. Romford Chest Clinic. Noted below are some notes from Dr. S. Thompson, the Consultant Chest Physician: — "During the year 1960 the trend towards lower incidence and lower death rate from tuberculosis continued, though in the combined Districts of Romford and Hornchurch served by the Romford Chest Clinic there was a slight rise in new respiratory cases and also in the death rate. More cases of tuberculosis were transferred into the area than were transferred out, so that the total notified cases remaining on the register at the end of the year showed a rise and there were over 1,500 notified cases at the end of the year. It is gratifying to note that the incidence in children is very small and the more serious forms of miliary tuberculosis of the lungs and tuberculous meningitis are becoming extremely rare. This is no doubt attributable to the great reduction in infectious cases in the population due to the widespread use of chemotherapy and anti-tuberculous drugs. In addition, the extension of the use of B.C.G. vaccination is giving the child population increased protection against infection. The Regional Hospital Board decided to close the smaller chest units in the Region and unfortunately the chest unit at Rush Green Hospital, which had served a most useful purpose for the local population for the past ten years, was one of the units to be closed and the beds used for other purposes. The bulk of the local cases of tuberculosis are now treated in Broomfield Hospital and Dagenham Hospital, together with a small chest unit at High Wood Hospital, Brentwood. The seeking out of contacts and the follow-up of cases referred from the Mass Radiography Units continues to increase and the miniature X-ray unit is most useful in catering for these cases, of which the total has now reached almost 3,000. In addition to dealing with cases of tuberculosis, large numbers of non-tuberculous chest conditions are referred for diagnosis by the General Practitioners and assistance is given to them in the treatment and management of these cases." 47 Mass Radiography Unit. This survey was arranged through Dr. Lawless, the Medical Director of Mass Radiography Unit No. 6b of the North East Metropolitan Regional Hospital Board. Five factory visits, 3 schools and 8 general public sessions were carried out and a note of the attendance at the latter is given below: — Male Female Total Harold Wood Hospital 101 178 279 Plough Inn, Cranham 155 213 368 Golden Crane, Cranham 151 298 449 Rainham Working Men's Club 168 160 328 Cherry Tree, South Hornchurch 157 244 401 Gaumont Cinema, Upminster 355 503 858 Odeon Cinema, Hornchurch Elm Park Hotel. Elm Park 513 438 675 748 1,188 1,186 A total of 9,478 persons attended comprising 4,684 males and 4,794 females. The figures for 1958 were 8,518, for 1956—8,831 and for 1954—5,687. It will thus be seen that the final figure of 9,478 examinations for this visit shows an increase of 960 compared with the 1958 visit. The clinical evaluation of the visit is not yet to hand. 48 CASES OF AND DEATHS FROM TUBERCULOSIS, 1960 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 — — — — — — — 5—14 years — — — — — — 1 — 1 — — — — — — — 15—24 3 4 — 2 4 0 — — 7 12 — — — — — — 25—44 ,, 12 7 — 1 9 16 1 — 22 24 — 1 — — — 1 45—04 ,, 12 1 — 1 4 2 — — 16 4 2 1 — — 2 1 65 and over 2 1 — — — — — — 2 1 4 1 — 1 4 2 Totals 30 13 — 4 17 24 2 — 49 41 6 3 — 1 6 4 49 COMPARATIVE TABLE OF NEW CASES OF TUBERCULOSIS, 1938, 1950 and 1960 AGE GROUPS RESPIRATORY NON-RESPIRATORY MAXES FEMALES MALES FEMALES 1938 1950 1960 1938 1950 1960 1938 1950 1960 1938 1950 1960 Under 5 years 1 1 1 0 2 0 3 2 0 1 1 0 5—14 years 0 3 0 2 0 0 17 3 0 15 1 0 15—24 ,, 12 9 3 10 21 4 2 1 0 3 4 2 25—44 ,, 22 20 12 26 20 7 4 0 0 7 3 1 45—04 ,, 12 10 12 6 4 1 0 0 0 2 1 1 65 and over 0 0 2 0 1 1 0 0 0 0 0 0 Totals 47 43 30 44 48 13 26 6 0 28 10 4 50 COMPARATIVE TABLE OF DEATHS FROM TUBERCULOSIS, 1938, 1950, and 1960 AGE GROUPS RESPIRATORY NON-RESPIRATORY MALES FEMALES MALES FEMALES 1938 1950 1960 1938 1950 1960 1938 1950 1960 1938 1950 1960 Under 5 years 0 0 0 0 0 0 2 1 0 3 1 0 5—14 years 0 0 0 0 0 0 2 0 0 0 0 0 15—24 „ .3 1 0 2 1 0 0 0 0 0 0 0 25—41 „ 11 3 0 8 3 1 1 0 0 2 2 0 45—64 ,, 9 12 2 1 1 1 0 1 0 0 0 0 65 and over 0 1 4 2 0 1 0 1 0 0 1 1 Totals 23 17 6 13 5 3 5 3 0 5 4 1 51 INTERVAL BETWEEN NOTIFICATION AND DEATH OF FATAL CASES OF TUBERCULOSIS, 1950—1960 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 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 1960 2 — — — — — — 5 3 10 52 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 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 13 3 — (ii) Factories not included in (i) in which Sec. 7 is enforced by the L.A. 288 240 17 — (iii) Other premises in which Sec. 7 is enforced by the L.A 34 45 2 — Total 351 298 22 — 2. Cases in which Defects were Found. Referred Particulars Found Remedied To H.M. Inspector By H.M. Inspector Prosecutions Want of cleanliness (Sec. 1) — — — — — Overcrowding (Sec. 2) — — — — — Unreasonable temperature (Section 3) — — — — — Inadequate ventilation (Section 4) — — 1 — — Ineffective drainage of floors (Section 6) — — — — — Sanitary Conveniences (Section 7) (a) Insufficient 3 2 — — — (b) Unsuitable or Defective 19 15 — 2 — (c) Not separate for sexes — — — 1 — Other offences against the Act — — 12 — — Total 22 17 13 3 — 53 PART VIII OF THE ACT. OUTWORK—Sections 110 and 111. Nature of Work. No of Outworkers in August list Wearing Apparel— Making, etc 127 No instances of work in unwholesome premises. 55 INDEX Page Acknowledgments 6 Acreage 7 Adoption of Private Streets 25 Alkali Inspector 18 Aged, Care of 13 Agriculture (Sfety, Health & Welfare Provisions) Act, 1956 27 Ambulance Service 12 Atmospheric Pollution 16 Births 7 Birth Rates 7,8 —Area Comparability Factor 8 —Comparative 8 —Illegitimate 7 Canteens, School 42 Caravans 31 Care of the Aged 13 Certificates of Disrepair 30, 31 Cesspools 21 Child Welfare 12 Clean Air Act, 1956 5, 16 Clinics, Child Welfare 12 Contents, Table of 2 Day Nursery 13 Deaths 7, 8, 9, 10 —Age Groups 10 —Causes of 10 —Infantile 7 —Main Causes 9 —Maternal 7 Death Rates 7,8 —Area Comparability Factor 8 —Comparative 8 —Early Neonatal 7 —Infant 7 —Neonatal 7 —Perinatal 7 Diphtheria Immunisation 45 Diseases of Animals (Waste Food) Order, 1957 27 Disinfection 26 Disinfestation 26 Ditches 23 Domestic Help Service 13 Drainage and Sewerage 21,22,23 Dysentery 43 56 Page Essex County Council Act, 1952— Section 103 41 Section 105 Establishments for Massage or Special Treatment 26 Extensions or Improvements to Sewage Works 23 Factories Acts, 1937 to 1959 28,52 —Defects 52 —Inspections 28,52 —Outwork 53 —Prescribed Particulars 52 Fireguards 26 Farms 26,27 Food Poisoning 44 Food— Complaints 36,38 Hawkers 41 Inspection of 27 Meat Inspection 40 Premises 27,39 Preserved 41 Unsound 39 Food and Drugs Act, 1955 5,32 —Administration 32 —Food Hygiene Regulations 39 —Public Analysts 4, 11, 32 —Sampling 32, 33 General Mortality—Main Causes 9 General Sanitary Circumstances 28 Heating Appliances (Fireguards) Act, 1952 and Regulations, 1953 26 Home Nurses and Midwives 12 Home Safety 14 Hornchurch Urban District Council Act, 1936, Section 90 41 Houses- Inspection of 28 Number erected 30 Number inhabited 7 Housing 30 —Caravans 31 —Certificates of Disrepair 30, 31 —Closure and Demolition 30 —Improvement Grants 31 —Overcrowding 31 —Rehousing (medical aspects) 31 —Sub-standard Accommodation 30 —Visits paid 28 57 Page Ice Cream 40 —Registration 40 —Sampling 40 Immunisation and Vaccination Statistics 45 Improvement GrantsB 31 Infectious and Other Notifiable Diseases 5, 43 —Hospitalisation 43 —Notifications 43 —Visits paid 29 Informal Notices Served 29 International Certificates of Inoculation/Vaccination 44 Laboratory Facilities 12 Land Charges Enquiries 31 Laundry Service for Incontinents 14 Maternity and Child Welfare 12 Maternity Homes 12 Measles 43 Meat Inspection 40 —Carcases Inspected and Condemned 40 Medical Examinations 11 Members of the Council 3 Members of the Public Health Committee 3 Metal Dealers 26 Midwives and Home Nurses 12 Milk- Distributors 41 Sampling 41 Special Designations 41 National Assistance Act, 1948, Section 47 13, 14 New Streets 25 Notices Served 29 Nursing and Maternity Homes 12 Officers of the Public Health Department 4 Old Metal Dealers 26 Outworkers 53 Paddling Pools 25 Penny Rate Product 7 Pet Animals Act, 1951 26 Poliomyelitis 43 —Vaccination 45 Population 6,7 Preface 5 Psittacosis 44 Public Analysts 4,11,32 58 Page Public Health— Inspection 27,28,29 Inspectors 4,11 Propaganda 11 Radioactivity 20 Rag Flock and Other Filling Materials Act, 1951 27 Rainfall 15, 16 Rateable Value 7 Regional Sewerage Scheme 21 Rent Act, 1957— Certificates of Disrepair 30, 31 Riding Establishments Act, 1939 27 Rivers 23 Rodent Control 26 Royal Commission on Local Government in Greater London 6 Scarlet Fever 43 School Canteens 42 Sewage Works 21,23 Sewerage 6,21,22 Shellfish 42 Shops Act, 1950 28,29 Slaughter of Animals Act, 1958 40 Slaughterhouses Act, 1958 42 Smoke Control Areas 16, 28 Staff 4,11 —Medical Examinations 11 Staffing 11 Statutory Notices Served 29 Stillbirths 7 —Rates 7 Streets Made Up and Taken Over 25 Summary of Public Health Inspectors' Work 27,28,29 Swimming Pool 24 Table of Contents 2 Tuberculosis 45 —Incidence and Mortality 28, 49, 50 —Mass Radiography 47 —Notification/Mortality Interval 51 —Chest Clinic 46 Vaccination Statistics 45 Vital Statistics 7 Water- Sampling 15, 28 Supplies 15 Well 16 Whooping Cough Immunisation 45