Ac 4411(3) Library 251/63 HORNC 30 Hornchurch Urban District Council ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH (James Gorman, M.B., Ch.B., D.P.H., F.R.S.H.) For the Year 1962 Hornchurch Urban District Council ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1962 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 31.12.62) 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 16 SECTION D—Housing 25 SECTION E—Inspection and Supervision of Food and Food Premises 27 SECTION F—Prevalence of, and control over, Infectious and Other Notifiable Diseases 37 SECTION G—Factories Acts, 1937 to 1959 44 Index 46 3 MEMBERS OF THE COUNCIL (as at 31.12.62.) Councillor A. C. Good, J.P., Chairman. (1) Councillor L. W. Carroll, J.P. Vice-Chairman. (1) Councillor Mrs. E. H. Dean. „ Mrs. M. W. Illingworth. (1) „ Mrs. J. L. C. Moore. (1) „ M. Ansell. „ E. W. Bull. „ A. G. C. Davis. „ J. S. C. Dix. „ F. W. H. Embleton. (1) „ A. R. Hall. „ L. B. Harris. „ K. T. Hay. „ S. G. Heath-Coleman. „ W. Hegarty. (1) „ E. A. Hillman, J.P. „ H. Holock. „ A. T. James. „ S. A. Legg. „ M. P. V. Leigh. „ A. A. Livingstone. (1) „ N. J. Miles. „ H. F. Moss. „ J. F. Moultrie, J.P. „ D. A. Poole. „ F. J. Powell. (1) and (2) „ N. E. Richards. (1) and (3) „ A. J. Twigger. (1) „ C. A. Welch. „ W. A. West. (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) Deputy Chief Health Inspector: E. Oliver, M.A.P.H.I., (1), (2) and (3). Public Health Inspectors: B. T. A. Cuthbert, (1) and (2) (Commenced 2.7.62). E. J. Day, M.A.P.H.I., (1) (2) and (3). W. R. M. Gray, (1) (2) and (3). A. V. J. Hutchings, M.A.P.H.I. (1) and (2). R. E. Ingleby, M.A.P.H.I. (1) (2) and (3). M. A. Jackson, M.A.P.H.I., (1) and (2). 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 (Resigned 6.9.62). Mrs. P. Martin (Commenced 21.5.62: Resigned 31.8.62). Miss L. Patterson (Commenced 16.8.62). Mrs. M. Behn (Commenced 24.9.62). Rodent Operative and General Assistant: W. T. Blanchard. Public Analysts: J. Hubert Hamence, M.Sc., Ph.D., F.R.I.C. P. S. Hall, B.Sc., 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. 20th Mav, 1963 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 1962. Population. The figure has risen from 131,070 (mid-year 1961) to 132,400 (midyear 1962) continuing the steady upward trend of recent years. Vital Statistics. The birth rate for the year showed a slight increase as against 1961, but at 17.15 was fractionally below the England and Wales average. The death rate—at 11.22—was slightly higher than last year, but is below the England and Wales average. The infant mortality rate at 20.05 shows a reduction on last year and is below the England and Wales average of 21.4 which itself is the lowest figure yet recorded. Infectious Diseases. The most notable feature of the year was a case of Smallpox which occurred at Rainham and which was subsequently the subject of a special detailed report. Fortunately the case proved to be an isolated one. One of the major side effects was a widespread demand for vaccination which manifested itself not only in this district but which—doubtless as a result of other cases occurring sporadically elsewhere—achieved farflung repercussions. Clean Air. Our Smoke Control Area plans proceeded reasonably and at the end of the year confirmation of No. 5 Area was awaited. Greater London. Although this reflects largely policy it should be noted that the joining of this district with Romford to form one of the new London 6 Boroughs appeared on the way towards reality. Should this finally transpire there is of course a tremendous amount of ground work to be done in the field of Public Health alone so that the eventual new Borough may commence its life in terms of smoothness and efficiency. Housing. The number of houses provided during the year showed a drop both from Local Authority and other sources. Inevitably as land becomes even scarcer, housing provision on a large scale will be more difficult to secure. The difficulties of the newly married couple in obtaining appropriate housing are, in my view very great still. Aeknowledgments. 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 1962) 132,400 Number of inhabited houses according to rate books (December 1962) 40,730 Rateable Value (December 1962) £1,925,231 Sum represented by a penny Rate (December 1962) £7,830 Extracts from Vital Statistics for the Year. Live Births: Number 2,443 (1241 males, 1202 females) Rate per 1,000 population 17.15 Illegitimate Live Births (per cent of total live births) 2.7 Stillbirths: Number 30 (15 males 15 females) Rate per 1,000 total live and stillbirths 12.13 Total Live and Stillbirths 2,473 Infant Deaths (deaths under 1 year) 49 (32 males, 17 females) Infant Mortality Rates: Total infant deaths per 1,000 total live births 20.05 Legitimate infant deaths per 1,000 legitimate live births 19.79 Illegitimate infant deaths per 1,000 illegitimate live births 29.41 Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 15.55 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 13.50 Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per 1,000 total live and still births) 25.47 Maternal Mortality (including abortion): Number of deaths 1 Rate per 1,000 total live and still births 0.40 Deaths: Number 1,220 (634 males, 586 females) Rate per 1,000 population 11.22 8 DEATH RATE—COMPARISON WITH PREVIOUS YEARS. 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 1952 10.4 1960 11.0 1953 13.1 1961 10.5 1954 12.1 1962 11.2 *Area Comparability Factor returned. The Area Comparability Factor for deaths this year altered from 1.25 to 1.22 and for births remained at 0.93. BIRTH RATE—COMPARISON WITH PREVIOUS YEARS 1947 20.7 1955 15.4 1948 17.2 1956 16.7 1949 16.0 1957 17.1 1950 13.6* 1958 18.5 1951 14.1 1959 18.1 1952 13.8 1960 18.3 1953 14.8 1961 17.0 1954 14.7 1962 17.1 * 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. 9 GENERAL MORTALITY—MAIN CAUSES 1952-1962 Causes of Death 1952 1953 1954 1955 1956 1957 1958 1959 960 1961 1962 Tuberculosis (all forms) 17 21 11 4 5 3 9 5 10 4 7 Cancer 184 211 234 210 253 248 236 247 235 206 223 Infectious diseases 1 3 1 2 0 2 0 2 0 1 1 Cardio-vascular disease 425 602 590 591 682 679 592 560 548 565 637 Influenza 2 14 1 2 7 8 6 12 0 5 10 Pneumonia 49 52 41 49 53 65 58 57 39 56 73 Bronchitis 52 85 54 65 95 79 76 61 65 76 88 Other respiratory diseases 9 10 8 10 7 9 13 14 8 10 3 Gastro intestinal diseases 12 28 13 10 14 10 15 13 13 13 8 Motor vehicle accidents 9 11 10 12 8 10 15 9 19 22 10 All other accidents 4 10 18 18 20 18 15 8 18 13 16 Suicide 10 7 11 11 9 14 8 12 9 10 3 The largest increase was in Cardio-vascular disease—from 565 to 637. This remained by far the largest cause of death. Cancer deaths rose from 206 to 223. 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 4 4 0 - - - - - - - - 1 - 2 - 1 - - - 2. Tuberculosis, other 3 2 1 - - - - - - - - 1 1 - - - - 1 - 3. Syphilitic disease 2 1 1 - - - - - - - - - - - - 1 - - 1 4. Diphtheria 0 0 0 - - - - - - - - - - - - - - - - 5.. Whooping cough 0 0 0 - - - - - - - - - - - - - - - - 6. Meningococcal infections 1 1 0 - - 1 - - - - - - - - - - - - - 7. Acute poliomyelitis 0 0 0 - - - - - - - - - - - - - - - - 8. Measles ... 0 0 0 - - - - - - - - - - - - - - - - 9. Other infective and parasitic diseases 2 0 2 - - - - - - - - - - - 1 - - - 1 10. Malignant neoplasm, stomach 24 11 13 - - - - - - - - - - 5 4 5 3 1 6 11. Malignant neoplasm, lung, bronchus 59 51 8 - - - - - - - - 2 - 28 4 14 2 7 2 12. Malignant neoplasm, breast 25 0 25 - - - - - - - - - 2 - 12 - 4 - 7 13. Malignant neoplasm, uterus 10 0 10 - - - - - - - 1 - 4 - 2 - 3 14. Other malignant and lymphatic neoplasms 105 55 50 - - - - 1 - - - 3 7 19 17 15 17 17 9 l5. Leukaemia, aleukaemia 7 3 4 - - - - - - - - - - 1 3 2 1 - - 16. Diabetes 11 2 9 - - - - - - - - 1 - 1 3 - 3 - 3 17. Vascular lesions of nervous system 177 71 106 - - - - - - 1 - - 2 16 14 24 25 29 65 18. Coronary disease, angina 235 156 79 - - - - - - - - 4 - 66 11 46 32 40 36 19. Hypertension with heart disease 40 19 21 - - - - - - - - - 1 5 1 4 4 10 15 20. Other heart disease 143 51 92 - - - - - 1 - - - 1 4 9 13 9 34 72 21. Other circulatory disease 42 19 23 - - - - - - - - - 1 5 5 4 7 10 10 22. Influenza 10 3 7 - - - - - - - - - - - - 1 - 2 7 23. Pneumonia 73 36 37 1 - 1 1 1 - - - 2 - 6 3 5 6 20 27 24. Bronchitis 88 64 24 3 - 1 2 - - - - - - 8 2 35 1 17 1 19 26. Other diseases of respiratory system 3 3 0 — - - - - - - - - - 1 - 1 - 26. Ulcer of stomach and duodenum 4 2 2 - - - - - - - - - - - - 1 1 1 1 j 27. Gastritis, enteritis and diarrhoea 4 3 1 1 - - - - - - - - 1 - - 1 - - 28. Nephritis and nephrosis 9 3 6 - - - - - - - - - 2 2 2 1 - - 2 29. Hyperplasia of prostate 5 5 0 - - - - - - - - - - - - - - 5 - 30. Pregnancy, childbirth, abortion 1 0 1 - - - - - - - - - - - - - - - - 31. Congenital malformations 12 7 5 6 3 - 1 1 - - - - 1 - - - - - - 32. Other defined and ill-defined diseases 92 43 49 19 13 1 1 - 2 - - 1 1 7 - 6 11 7 - 33. Motor vehicle accidents 10 8 2 - - - - - - 2 1 5 - 1 1 - - - - 34. All other accidents 16 11 5 2 1 1 - 2 - - - - 1 2 - - - - - 36. Suicide 3 0 3 - - - - - - - - - 1 2 - - - - - 36. Homicide and operations of war 0 0 0 — — — — — - - - — - - — — — — — TOTAL 1,220 634 586 32 17 5 5 6 3 4 1 21 23 179 103 180 128 207 306 11 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Staffing. An increase in the establishment of Public Health Inspectors was filled by the appointment of Mr. B. T. A. Cuthbert. Mrs. P. Martin, a Clerical Assistant, resigned during the year and her post was filled by the appointment of Miss L. Patterson. An additional post created during the year—mainly in connection with Smoke Control duties—was filled by Mrs. M. Behn. Mr. P. Cheese—seconded to the Department from the Pool of Juniors—also resigned during the year. Mcdical Examinations—Staff. Staff arrangements remain as last year. During the year arrangements were made for the examination of 280 (248) employees or prospective employees—85 (68) permanent and 195 (180) temporary. The 1961 figures are given in brackets. Public Relations. 1 have again to record my appreciation of the co-operation existing with Mr. Glyn Richards, J.P., our Public Relations Officer. Talks were given by members of the Department to 7 different local organisations during the year in some instances being accompanied by films or slides. Advantage was taken of an offer by the Hornchurch Carnival Committee to hold a Public Health exhibition during the period of the Carnival Fete Laboratory Facilities. Under the County Council arrangements certain work hitherto carried out at the Counties Public Health Laboratories will in future be dealt with at the Public Health Laboratory, Chelmsford. Dr. E. A. Atkinson, Oldchurch Hospital, Romford, kindly deals with a variety of other bacteriological and occasionally pathological material, whilst the laboratories at both Rush Green and Harold Wood Hospitals respond willingly to any calls made upon them. 12 Ambulance Service. The staff and vehicles of the Romford and Hornchurch Ambulance Stations were transferred to the new Ambulance Station in Oldchurch Road, Romford, on 27th May, 1962. Owing to the re-organisation of the County Ambulance Service certain changes became necessary in the procedures for requesting ambulance transport in the Metropolitan part of the County. As from thE 1st September the control of all ambulance vehicles in the area became vested in the Divisional Ambulance Control at Ilford and all requests for free ambulance transport under Section 27 of the National Health Service Act, 1946, relating to patients in this area are now made to the Divisional Ambulance Control, Aldborough Road, Ilford (telephone number Goodmayes 2311). There is no change in the procedure for calling an ambulance in emergency by use of the 999 system. 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) Avon Road, Upminster. (iv) Hornchurch Road, Hornchurch. (v) Nelmes Road, Hornchurch. (vi) St. Mary's Lane, Upminster. (vii) South End Road, South Hornchurch. (viii) Suttons Hostel, Suttons Lane, Hornchurch. (ix) Upminster Road, Rainham. (x) Westland Avenue, Hornchurch. Nursing Homes. The one registered Nursing Home in the district is supervised by the County Council. Midwives and Home Nurses. There are 12 midwives and 4 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 9 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. 13 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. It was not considered necessary during the year to take any action under Section 47 of the National Assistance Act, 1948. It may be informative to quote some notes on this Section of the Act also the National Assistance (Amendment) Act, 1951:— "The powers which a number of Local Authorities at present possess under local Acts to remove certain persons from insanitary conditions are now replaced by powers conferred by Section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendment) Act, 1951, on the Councils of all County Boroughs and County Districts and in London on all Sanitary Authorities. In the case of persons who: (a) are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions, and (b) are unable to devote to themselves and are not receiving from other persons, proper care and attention, the Authority may, on the written certificate of their Medical Officer of Health, apply to a Court of Summary Jurisdiction for an Order for a person's removal to and detention in a suitable hospital or other place (e.g. residential accommodation provided under the Act). The powers given to the Medical Officer of Health under the Amendment Act of 1951, enables him, with another registered medical practitioner, to act in an emergency, the duration of the enforced stay in an Institution being 3 weeks, after which any extension is required to be applied for by the Local Authority and not the Medical Officer of Health. It is a prerequisite of admission that the Institution concerned must have signified their willingness to admit the individual." May I again emphasise the importance of team work in the care of the aged. It is a problem of such wide variations that only the most comprehensive approach can go far towards securing anything like a satisfactory solution to it. Meals on Wheels. I am indebted to Mr. L. F. de Warr, Chairman of the Old People's Association for the following information:— 14 "The service commenced on 9th July, 1962, and during the period up to 31st December, 1962, a total of 2,588 meals was recorded. The cost of the meal supplied by St. George's Hospital kitchen is 2s. 3d. towards which the old person pays 1s. 0d. To date the balance of 1s. 3d. has been paid by the Local Authority who also supply the vehicle fully maintained for use. The service operates six days a week including Bank Holidays and Christmas and during the period under review only one day was missed (due to the December fog). We have divided the Urban District into three areas for distributing purposes. Those in Area 1 receive a meal on Monday and Thursday; Area 2 on Tuesday and Friday; Area 3 on Wednesday and Saturday. During December the average daily delivery was 20 (giving an overall total of 60 persons each receiving two hot meals in any one week). The daily round now involves 20/25 miles driving, taking approximately three hours to complete (say 11.30 a.m. to 2.30 p.m.). As we cannot expect our volunteers to work for longer than this each day nor the old person to wait until late afternoon for the meal, it is difficult to visualise any considerable increase in the service without using a second vehicle. If and when this development appears necessary, we may be able to consider the provision of three meals a week instead of the present two." Home Safety. As mentioned in my Report last year, from the 1st January all Home Safety matters were dealt with by a Sub-Committee of the Public Health Committee. This Sub-Committee included all the members of the original Home Safety Committee who have worked so harmoniously during the year with the Council members. The main function of such a Sub-Committee is to try to impress upon the public the need for care within their own homes with the everyday appliances, fixtures and fittings around them. This presents obvious difficulties as they have perhaps lived—accident free—with these appliances etc., for many years and—although agreeing that care should be taken—it is always "other people" who need so reminding. A more satisfying avenue for home safety propaganda is perhaps to schoolchildren (the great success of Road Safety propaganda is witness to this). It is most gratifying, therefore, to receive from Mr. D. H. Wilcockson, the Divisional Education Officer stout support in our endeavours. He has co-operated in full measure during the year. For example, special posters on firework dangers were displayed and headteachers gave verbal warnings to scholars just before the 5th November and perhaps this played some part in the resulting decline in the accident figures. In addition approximately 4,500 booklets entitled "Accidents in the Home" have been distributed to the more senior pupils. This booklet not only draws attention to the hazards within the home but gives practical advice should an accident occur. Produced by the Royal Society for the Prevention of Accidents, it 15 is proving a very good subsitute for the Home Safety brochure produced so successfully by the former Home Safety Committee. The present Sub-Committee gave careful consideration to the production of a further brochure but in view of the Rospa publication coupled with other factors, decided to defer the matter for a further 12 months. The Sub-Committee also arranged for a float to take part in the 1962 Carnival; participated in a public health exhibition on Clean Food and Clean Air; reviewed the hospital statistics of home accidents in the County; displayed posters throughout the district; supported the national Broken Glass and Water Safety Campaigns; distributed special cards to doctors and chemists drawing attention to the need for care in the storing of drugs. Visual education was not neglected and at one meeting a selection of home safety films was shown to members. It was decided to make further use of this medium when addressing organisations. Altogether a full and active year is reflected by our home safety activities. Laundry Service for the Incontinent— Section 84, Public Health Act, 1936. Advantage is taken of the above Section legally to provide this type of service. Increasing use is made of it (a fuller note was made in my 1960 report) and it is invaluable to the relatively few but deserving families who benefit by its operation. Since the service was commenced the number of cases partaking was 51. The number of garments treated during the year was 3,525. The cost of the service during the year was approximately £305. 16 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. Water Supplies. Main: 12 samples were taken by my Department during the year from the main supply. 5 were submitted for chemical and bacteriological examination and 7 for bacteriological examination only. In each case a satisfactory report was received. Well: Few now remain in the district. Mr. P. Gordon Spencer, Chief Engineer, South Essex Waterworks Company, has 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 4,020 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 last was 41,805 and the population as at the 30th June, 1962, as obtained from the Registrar-General was 132,400. We are unable to state the number of houses supplied by standpipes, but the total is quite insignificant." The Engineer and Surveyor has kindly informed me of the rainfall figures for the year and which relate to "Langtons." The 1961 figures are given in parenthesis. The total rainfall for the year 15.99 inches was materially down on the previous year's figure of 19.56, while 126 days produced rainfall as against a relative 134 for the previous year. Amount of rainfall in inches Number of days in which rain fell January 2.34 (0.46) 17 (15) February 0.46 (0.65) 7 (14) March 1.25 (0.09) 9 (4) April 1.53 (1.96) 14 (16) May 1.27 (1.36) 16 (6) June 0.17 (1.41) 3 (5) July 1.48 (1.40) 10 (7) 17 August 1.39 (2.37) 8 (12) September 1.89 (2.37) 12 (15) October 1.14 (2.91) 8 (16) November 1.23 (2.04) 15 (12) December 1.84 (2.54) 7 (12) 15.99 (19.56) 126 (134) Radioactivity. Whilst it cannot be said that the South West Essex Authorities have had occasion to consider any problem jointly, I should emphasise that although this subject of radioactivity rises and falls in popular appeal, I cannot see that in the foreseeable future it can fail to remain both in the civil and other spheres one of the vital preoccupations of the age. Clean Air. A synopsis of the position—albeit in considerable detail—was given last year and need not be repeated. May I, however, draw attention to certain important practical points affecting inhabitants of Areas which have already received publicity and should continue to do so:— (1) Whenever an Area is confirmed an application for grant should—where valid—be made without delay. Do not wait until the Area is on the verge of becoming legally smokeless, i,e. the operative date, but apply if at all possible—and normally it will be—not later than two months before. (2) It seems unlikely that the premium smokeless fuels, e.g. 'Coalite' and the like will be available on demand and the success or failure of a Smoke Control Area will not rest exclusively on such fuels. It is, therefore, no use complaining that Smoke Control cannot be made to work unless possibly the customary fuels are to hand. Other smokeless fuels will normally be available and are efficient. (3) Keep as much fuel as possible in stock. If hard weather finds you short of fuel there may well be others like you and your hopes for speedy delivery will be dashed. Likewise we can no longer, it is clear, rely upon our winters being in the main unlikely to produce sustained cold weather! (4) Adaptations are designed to make the heating arrangements comply readily with the Clean Air Act and at a minimum rate and cost to the taxpayer and ratepayer. A number of applications are framed on lines which show quite clearly that this point is not always appreciated. It is realised that the carrying out of adaptations may well entail considerable inconvenience but it will always be the policy of this Council—so far as lies within their power—to minimise such inconvenience. Smoke control policy is centrally determined and encouraged. In brief the securing of clean air is a matter upon which the Government has set its heart and upon which this Council is lending its full measure of support. 18 (5) The actual amount of grant given must depend upon the individual circumstances of each case and there may well and properly be a material variation between the amount approved for different applicants. That does not mean that any preferential treatment is being accorded. Smoke Control Areas: Number 4 Area duly came into operation on 5th November, 1962. Plans are drawn up to pursue a progressive policy of ensuring a smoke free District as soon as reasonably practicable. St. George's Hospital Chimney. It is pleasing to record that this is no longer regarded as a bete noir of the local inhabitants largely because of its flair for giving offence has to all intents and purposes disappeared. Special Processes. Liaison with the Alkali Inspector—Mr. G. Tiplady, M.Sc., F.R.I.C. —is excellent and of course common problems do from time to time arise. Atmospheric Pollution Investigation. Our present programme comprises smoke filters at:— (1) Public Health Department, Billet Lane, Hornchurch. (2) Scargill County Primary School, Mungo Park Road, South Hornchurch. (3) Ayloffs County Primary School, South End Road, Elm Park. (4) Whybridge County Primary School, Blacksmiths Lane, South Hornchurch. Volumetric SO 2 apparatus at the Public Health Department and Whybridge County Primary School. Clean Air Act, 1956, Section 21. The trial period allowed for a special apparatus dealing with the burning of sawdust waste and noted in last year's report was extended during the year. Clean Air Act, 1956, Section 3. Six notices of installation or applications for prior approval were submitted to the Council during the year. A total of 35 have now been registered. Clean Air Act, 1956, Section 12. Some 393 notices were served during the year. These were necessitated by the very great accumulation of claims for grant relating to No. 4 Smoke Control Area and received in such volume and in such close proximity to the operative date as to render—under all the circumstances —the securing of complete action before the operative date, impossible. 19 General Information. Meetings of the National Society for Clean Air and its South East Division, the Conference of Co-operating Bodies for the Investigation of Atmospheric Pollution and the London and Home Counties Clean Air Advisory Council are attended as a routine. Sewerage and Sewage Disposal. Regional Scheme: The benefits of the proposed regional scheme have been noted in previous reports and it is clear from repeated analyses of the rivers Beam and Ingrebourne that some drastic measures are required to remedy the position. Fortunately it seems that progress is now being made. It seems likely that Brentwood will be permitted not to come within the proposed scheme in view of the improvement likely to be effected in the Nags Head works. How far the existence of a relatively dry watercourse such as the Ingrebourne without sewage effluent is prejudicial to the amenity of a district is problematical and the view has been expressed, and may well account for the present decision to exclude Brentwood, that such a watercourse when dry (if one may be excused that unusual expression) is more prejudicial to a district than a good effluent. Be that as it may the matter still remains relative and a good effluent is not a good natural river water. Unless, therefore, a good effluent can receive adequate dilution in the stream which it enters, one's joy at having it traverse the district of which one is Medical Officer of Health will not be wholly unalloyed. I am indebted to the Engineer and Surveyor for the following information: — Bury Farm Works: It was hoped that the final extensions to these works which would provide an installation up to modern standards and to a design capacity for a population of 20,000 at 40 gallons per person per day and discharging an effluent which would be to a higher standard than that required by the Royal Commission, would have been completed. Unfortunately, the digestion tanks were not able to be used until July and the last of the four filters did not come into operation until September. All structural works to provide the required standard of effluent have now, however, been completed and it is hoped shortly to discharge the final effluent over the irrigation area. It could be said that the works are now fully operational, but certain structural works still require to be done and these are in the hands of the Council's consultants. Soil sewers: Work has been completed on appoximately 600 yards of new sewers at: — Roneo Corner soil sewer improvement (21"diameter/18" diameter/ 15" diameter) which has been designed as an integral part of a projected improvement between Roneo Corner and Bretons Sewage Disposal Works. 20 Upminster Road, Hornchurch, soil sewer improvement (12" diameter/9" diameter) in conjunction with a surface water sewer improvement. Work has commenced on: — The construction of Parsonage Road Pumping Station which, pending implementation of the Regional Scheme, provides the last soil sewer outfall necessary for the making up of all the Rainham private streets and the elimination of cesspools in Parsonage Road, Glebe Road, Allen Road and Farm Road. Surface Water Sewers. The following works have been completed—a total length of approximately 800 yards: — Sycamore Avenue relief (21" dia. /15" dia. /12" dia.). Upminster Road, Hornchurch, improvement (30" dia./27" dia./21" dia.). Elgin Avenue relaying (15" dia.). The following works are under construction:— St. Mary's Lane, Upminster and Cranham, improvement comprising approximately 2½ miles of new sewers, of which about 50% has been completed by the Council's contractors. Development removed from public sewers: Wherever possible developers are persuaded of the advantages to be obtained from connection to a public sewer, even when such development is remote from the nearest sewer available. In one case of industrial development at Rainham, the developers have agreed to provide a rising main over half a mile long and the Sewerage Authority has agreed to the acceptance of the discharge. This has obviated the installation of a very large cesspool or septic tank, which could have given rise to difficulties and possible nuisance. Refuse Collection and Disposal. Over the last year collection has been undertaken from approximately 41,000 properties in the district and approximately 35,000 tons of material have been deposited in worked out gravel pits within the area. The Council have granted free tipping facilities at their Gerpins Lane Tip for all trade refuse and builders' rubbish transported there by local traders. There has also been a free collection of material from householders which could not be regarded as suitable for collection by the normal refuse service. To some extent this service has reduced the indiscriminate dumping of rubbish in ditches and on waste ground, although unfortunately some of this still continues. Streets Made Up and Taken Over. The Engineer and Surveyor has supplied the following list of streets made up and taken over during the year ended 31st December, 1962: — yards Private Streets: Penerley Road 470 Rothbury Avenue 558 Beechwood Gardens 191 Nelson Road 535 Trafalgar Road 126 21  yards Lichfield Terrace (part) 320 Peterborough Avenue (part) 270 Winchester Avenue (part) 187 Total Length 2,657 Estate Roads : Lakefields Close 236 Marlborough Gardens 143 Grey Towers Gardens 35 Rutland Drive 161 Manstead Gardens 39 Thorogood Way 285 South Hall Drive (part) 131 Eldred Gardens 165 Lincoln Close 71 Cheshire Close 54 Hubbards Chase (part) 42 Kerry Drive (part) 167 Kerry Chase 122 The Witherings 158 Denbigh Close 105 Pembroke Close 47 Total Length 1,961 Swimming Pool. 12 samples were taken and have been uniformly satisfactory. Paddling Pools. 13 samples were taken from the Council's four paddling pools during the months May/August. The samples were in general satisfactory. 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 357 visits to deal with infestations. 1,687 routine or re-visits were also made. The premises visited comprised 296 dwellings and 61 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. Farm Work. 76 visits were made to farms by the Public Health Inspectors or Rodent Operative. 4 infestations were found and cleared. Establishments for Massage or Special Treatment. The Essex County Council granted licences to 10 persons during the year authorising them to carry on establishments for massage or special treatment. 12 visits were made to these premises. 22 Heating Appliances (Fireguards) Act 1952 and Regulations 1953. During the year 3 visits were paid in this connection. 11 appliances were tested (involving 22 tests) and all were found to be satisfactory. Old Metal Dealers (Hornchurch) Order, 1956. At the end of the year 15 persons had registered as Dealers in Old Metal. Noise Abatement Act, 1960. One notice was served during the year in this connection. Pet Animals Act, 1951. 17 visits were paid to the 9 Pet Shops in the District. 3 notices were served during the year relevant to the display of the name and address of person having key of shop, provision of thermometers, provision of dustbins, removal of refuse and cleansing and tidying of yard. Rag Flock and Other Filling Materials Act, 1951. One address in the district is registered pursuant to the provisions of Section 2 of this Act. 2 samples were taken during the year and satisfactory reports were received. Riding Establishments Act, 1939. Mr. R. L. Wylie, M.R.C.V.S., and Mr. R. H. M. Coulton, M.R.C.V.S., are the officially appointed Veterinary Surgeons for the purposes of this Act. Quarterly reports are given on the 2 riding establishments 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 18 licences were in force at the end of the year. Agriculture (Safety, Health and Welfare Provisions) Act, 1956. Four visits were made to farms in connection with the provision, maintenance and cleanliness of sanitary conveniences. No formal action was required. Public Health Inspection of the District. SUMMARY OF PUBLIC HEALTH INSPECTORS' WORK DURING 1962. Inspection of Food and Premises (visits paid): Bakehouses 46 Butchers' shops 120 Cafes 85 Confectioners 65 23 Dairies 9 Fish shops 46 Food complaints 111 Greengrocers' shops 105 Grocers' shops 346 Ice cream vendors' and manufacturers' premises 81 Mobile shops (hawkers) 55 Public houses 21 Sampling 494 School Canteens 67 Slaughterhouses 1,216 Staff Canteens 31 Miscellaneous Visits 42 Housing (visits paid): Overcrowding, etc. enquiries 131 Improvement grants 109 Sanitation 32 Structural defects 257 Water supply and pipes 42 Miscellaneous housing visits 158 Re-inspections 684 General Sanitary Circumstances (visits paid): Atmospheric pollution 642 Camping and fairgrounds, vans, etc 123 Conveniences 10 Drainage and sewerage 546 Dustbins 37 Farms 4 Stables, piggeries, animals, birds, etc 28 Nuisances 269 Paddling pool samples 16 Refuse tips 133 Pest Control 168 Swimming Pool samples 12 Water samples (main supply) 18 Water samples (well) 7 Rivers, streams, ponds, etc 36 Miscellaneous visits 162 Re-inspections 807 Factories and Outworkers: Number of visits paid 249 Shops Act: Number of inspections 433 24 Smoke Control Areas: Number of visits paid 8,723 Miscellaneous (visits paid): Diseases of Animals (Waste Food) Order 19 Heating Appliances (Fireguards) Act 3 Pet Animals Act 17 Rag Flock and Other Filling Materials Act 4 Massage establishments 12 Infectious Disease: Number of visits paid (including contacts) 945 Number of notices served: Informal 380 Statutory 61 The main headings under which work was done may be noted as follows: Smoke Control Areas 8,723 General Sanitation 3,018 Inspection of Food and Premises 2,940 Housing 1,413 Infectious Diseases 945 Shops Act Inspections 433 Factories and Outworkers 249 Public Health Inspectors' Work. The overall figures are of the same order as last year. Analysis shows that smoke control area visits were up four times with the consequent all round reduction in the other classes of visit, save for infectious disease which rose to 945. (Largely brought about by the repercussions of our Smallpox case). Shops Act, 1950. The number of shops on the register at the end of the year was 1,166. 56 notices were served during the year regarding contraventions of the Act. No legal proceedings were instituted during the year in connection with this Act. 25 SECTION D. HOUSING Number of New Houses erected during the year: (i) By the Local Authority 100(113) (ii) By other Local Authorities Nil (Nil) (iii) By other bodies or persons 391 (554) The previous year's figures are given in brackets. Number of Houses voluntarily demolished 2 96 and 98 High Street. Number of Houses voluntarily closed 1 22 High Street. Number of Closing Orders made 2 60 High Street . 293 South Street. Number of Demolition Orders made 22 378, 380, 382, 384, 386, 388, 390, and 392, Brentwood Road. 46, 48, 50, 52, 54 and 56, High Street. 5, 6, 7, 8, 9, 10 and 11, The Avenue, Upminster. Hut at rear of "Doriston," Southend Arterial Road, Cranham. Rent Act, 1957—Certificates of Disrepair. The following is the Return under the Rent Act, 1957, made to the Ministry of Housing and Local Government covering the period 1st January to 31st December, 1962: — Part I—Applications for Certificates of Disrepair: (1) Number of applications for certificates 15 (9) (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 6 (6) (b) in respect of all defects 9 (3) (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 8 (2) (5) Number of undertakings refused 0 (0) (6) Number of certificates issued 5 (7) (2 outstanding at end of year) 26 Part II—Applications for Cancellation of Certificates: (7) Applications by landlords for cancellation of certificates 3 (4) (8) Objections by tenants to cancellation of certificates 1 (1) (9) Decision to cancel in spite of tenants objections 0 (0) (10) Certificates cancelled by Local Authority 2 (3) The previous year's figures are given in brackets. Improvement Grants. My advice has been submitted to the Council in 80 instances during the year. Re-Housing—Medical Aspects. My advice has been sought during the year on some 123 applications respecting which medical recommendations for priority had been submitted by hospitals or private practitioners. Overcrowding. Every opportunity is taken in the course of routine visiting to ascertain what the general state of overcrowding is and where any infringement is being committed the matter is given full consideration and the advice of the Committee is sought. Short of a comprehensive survey which would show the true position at one particular time, no better method seems to exist of keeping in touch with overcrowding. The overcrowding at one such case noted above was abated during the year. Caravans. This problem is still with us in limited measure. Land Charges Enquiries. During the year 3,777 land charges enquiries were referred to the Department regarding the question of outstanding sanitary notices and/or certificates of disrepair. Information is also given as to whether or not a particular property is in a smoke control area. This is one of the routine unpublicised but time-consuming occupations of the Department. Common Lodging House. There are no registered common lodging houses in the district. 27 SECTION E. INSPECTION AND SUPERVISION OF FOOD AND FOOD PREMISES. Food and Drugs Administration. In the following statistics the figures for the previous year are given in brackets. 309 (322) samples were taken during the year of which 304 (314) were found to be genuine (List A) and 5 (8) to be sub-standard (List B). 13 (17) food complaints were referred to the Public Analysts (List C) and 27 (17) 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 Sidney 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. 28 LIST A SAMPLES SUBMITTED TO PUBLIC ANALYSTS AND FOUND TO BE GENUINE Article No. Article No. All Bran 1 Coca Cola Almond essence 1 Coconut, desiccated 1 Almonds, Ground 1 Coffee 1 Almond Marzipan 1 Coffee Crisp 1 Anchovies 1 Coffee, instant 2 Apple Flakes 1 Condensed milk 1 Apple Fruit Pie 1 Condiment non-brewed 1 Apple Sauce 1 Corned beef 1 Apples 1 Corned beef Hash Bag containing sweets or novelty, etc 2 Cornish Pastie 1 Crab Meat 1 Baked Beans 1 Crab Spread with Butter 1 Batter Mix. 1 Cream 2 Beef Curry with rice 1 Custard Powder 1 Beef steak with gravy 1 Dates 1 Beef suet 1 Drug 1 Biscuits, various Dressed crab 1 Blackberries in syrup 1 Evaporated milk 2 Blanc Mange 1 Fish and Macaroni 1 Boiled beef with Carrots and Dumpling 1 Fizz Bar 1 Flavour, raspberry 1 Brandy Snaps 1 Flavouring, rum 1 Butter Fresh Fruit pudding 1 Buttered rolls 1 Fruit salad 1 Buttersnap 1 Grannies Cookies 1 Buttersnax 1 Gravy Mix 1 Carraway seeds 1 Green Beans sliced 1 Casserole Steak 1 Ground mixed spice 1 Cheddar Cheese 1 Groundnut oil 2 Cheese Flaps 1 Ham and Chicken roll 1 Cheese Spread Haricot beans 1 Cheese Spread with Ham and Onions 1 Herrings 1 Herrings in tomato sauce 1 Cheese Spread with Lobster 1 Honeycomb mould 1 Cheese Spread with Shrimp 1 Ice Cream 34 Cherries Ice Lollies 15 Cherry Pie Filling 1 Jam 1 Chicken Curry 1 Jellies 3 Chicken Fillets 1 Lamb Chops 1 Chicken Meat and Fat Cube 1 Lard 1 Chicken Stock Cube 1 Lemon Cheese 1 Choc Ice 1 Lemon Curd 2 Chow Mein 1 Lemon Glucose Drink 1 Cinnamon, ground 1 Limmits 1 Coasters 1 Lunch Tongue 1 29 Article No. Article No. Margarine 1 Tea 3 Marmalade 1 Tea Cake Mixture 1 Milk 23 Tomatoes 2 Milk, Channel Islands Tomatoes, peeled 2 Milk chocolate sultanas 1 Tomato puree, condensed 1 Mixed cereal 1 Twiglets 1 Mixed fruit Vinegar, malt 1 Mixed Herbs dried 1 Walnut Bliss 1 Mixed peel Welsh Rarebit 1 Mincemeat 1 White Pepper 1 Mustard (mild) 1 Cherry Wine 1 Niblets (sweet corn) 1 Gin 2 Orange Juice 1 Rum 1 Orange Squash 1 Spanish Burgundy 1 Paste 2 Whisky 3 Pasteurised processed cheese spread with pineapple 1 Antiseptic Lozenges 1 Anti-smoking Tablets 1 Pate de Foie 1 Bi-carbonate of soda 1 Peanuts, salted 1 Bisodol 1 Pease pudding 1 Bone and Nerve Liniment Bronchial Catarrh and 1 Pearl barley 1 Pickling spice 1 Chest Mixture 1 Pork luncheon meat Children's Cough Pastilles 1 Pork rissole 1 Cold Sore Lotion 1 Potatoes 1 Cough Lozenges 1 Prawns 1 Dijex Tablets (Indigestion) 1 Prunes in syrup 1 Diuromil 1 Pudding, rice 1 Dristan (decongestant Tablets) 1 Quick thick gravy 1 Ravioli 1 Ferro Vitae Tablets 1 Rice 1 Glycerine, lemon and honey 1 Rice, ready cooked 1 Glycerine, lemon and honey with Ipecac 1 Sage and Onion stuffing 1 Sago Creamola 1 Glycerine, pure 1 Sago, pudding 1 Honey cough syrup 1 Salmon 1 Indigestion Tablets 2 Sandwich spread 1 Linctus 1 Sardines 1 Lozenges of Linseed, 1 Sauce, Fruit 1 liquorice and chlorodyne 1 Sausages, beef Malt extract with Cod Liver oil B.P. 1 Sausages, pork Sausage rolls 1 Mendaco (cough relief) Scampi Savoury 1 Mil-Par (laxative) 1 Soup Mouth ulcers tablets 1 Steak and kidney pudding 1 Nasal drops 1 Stewed beef steak 1 Nemakol tablets 1 Stewed steak 2 Nervessa 1 Sweets 3 Paxedin tablets (pain relief) 1 Swiss Roll 1 Quinine 1 30 Article No. Article No. Red Rose gargle 1 Turns 1 Rinstead pastilles 1 Vito Cee tablets 1 T.C.P 1 Therex / Decongestion tablets 1 Zinc and Caster Oil cream 1 Throat tablets 1 304 Tyrocane (antiseptic lozenges) 1 LIST B SAMPLES SUBMITTED TO PUBLIC ANALYSTS AND FOUND TO BE ADULTERATED OR UNDER STANDARD, etc. Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action Taken F. 1420 Stewed Beef Steak. Contained exessive amount of gristle. Manufacturer warned. Inf.2628 Stewed Steak in Gravy. Low content of meat for an article described as "Stewed Steak" in gravy. No further action in view of absence of legal standard for this type of article. Inf.2683 Linctus. Contained less than the stated amount of Vitamin A. Formal follow up sample taken. F. 1439 Linctus. Contained only 55% of stated amount of Vitamin A. Manufacturer prosecuted and fined £5. Inf.2759 Butter Cherry Genoa Cake. Contained insufficient butter fat to justify description "Butter" Cherry Genoa Cake. Matter taken up with Manufacturer. LIST C FOOD COMPLAINTS REFERRED TO PUBLIC ANALYSTS Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action Taken Cpt.2516 Bread. Contained oily masses of dough and vegetable tissue. Warning to Bakery. Cpt.2541 Stewed Beef Steak. Included 7% offal of nature of pancreas. Formal follow up sample taken. 31 Cpt.2557 Part of large white loaf. Contained oily dough. Warning to Bakery. Cpt.2597 Milk Bottle. Contained a snail. Warning to Dairy. Cpt.2620 Fruit Cocktail. Contained a "paint skin." Matter taken up with Importers. Cpt.2633 Beef Chipolatas. Contained mould growth. Vendor prosecuted and fined £5. Cpt.2634 Beef Chipolatas. Contained mould growth. Vendor prosecuted and fined £5. Cpt.2661 Orange Drink Contained a moth ball. Warning letter to Manufacturers. Cpt.2700 Cream Soda. Contaminated with carbolic acid. Warning letter to Manufacturer. Cpt.2724 Milk Bottle. Contained growth of micro-organisms mainly algae. Warning letter to Dairy. Cpt.2725 Milk Bottle. Contained milk film. Matter taken up with Dairy concerned. Cpt.2726 Large Sliced White Loaf. Contained pellet of oily dough. Warning letter to Bakery. Cpt.2753 Piece of Sandwich. Contained fragments of a fly. Warning letter to Bakery. LIST D FOOD COMPLAINTS WHERE ANALYSIS WAS NOT REQUIRED Complaint Action Taken Part of white loaf with discoloured dough. White loaf containing piece of string. Discolouration due to " brown " dough. Bakery informed. Bakery warned. Joint of meat containing abscess. Vendor informed. Customer reimbursed. The position of the abscess was such that neither vendor or consumer would have noticed this before meat had been cut. Meat spot in egg. No further action required. Harmless foreign body. Stewed steak containing foreign matter. Foreign matter identified as part of a lip of a beast. Manufacturer was informed but complainant later withdrew complaint. Jelly alleged to contain live maggot. Manufacturer informed. Investigation showed insect to be a house moth larva. No conclusive evidence as to whether moth gained access at shop or elsewhere. 32 Complaint Action Taken Packet of dates containing a maggot. Identified as a larva of the dried current moth. Probably present when packed in dates in Iraq. Matter taken up with Importer. White loaf containing piece of string. Bakery warned. Bottle of cream containing specks of dirt. Dairy informed but evidence not conclusive enough to warrant further action. Two slices of white bread alleged to contain insect. No insect found but traces of discoloured dough. No further action. Two slices and crust of bread alleged to be moist. Bread not unfit. No further action. Bottle of milk with blackish particles. Dairy informed. No further action. No evidence that particles were in bottle at time of delivery. Portion of slab fruit cake containing a stone. Bakery warned. Chicken and veal pie affected with mould. Vendor prosecuted. Fined £5. Loaf of bread with peculiar taste also presence of wood louse. Bakery informed. Peculiar taste due to salt being inadvertently omitted from a batch of loaves. No evidence to show that wood louse was in bread at time of delivery. Sausages containing alleged fragment of glass. Manufacturers informed but no further action taken as evidence was inconclusive. Meat with alleged blue stain. Investigation showed this to be probably due to a meat marking stamp. No further action. Packet of toasties containing insects. Insects identified as "Australian Spider Beetle." Warning letter to Vendor. Brown loaf affected with mould. Bakery informed. No further action taken in view of time lag between purchase of loaf and receipt of complaint. Flaked rice contaminated with weevils. Vendor prosecuted. Case adjourned sine die. Pork pie affected with mould. Vendor prosecuted. Fined £10. Bread rolls alleged to be dirty. Bakery informed. Investigation showed that contamination probably vegetable oil. No further action. 33 In the above instance the facts were so clear as not to demand the collaboration of our Public Analysts. Where any reasonable doubt is considered to exist, the opinion of the Analysts is naturally sought. 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 Hast year in brackets) show:— Bakehouses 22 (17) Butchers 74 (76) Cafes 53 (53) Confectioners (bread, cakes, etc.) 38 (41) Confectioners (sweets, etc.) 125 (126) Fish Shops 26 (27) Grocers 171 (179) Greengrocers 102 (102) Ice Cream Vendors 312 (309) Ice Cream Manufacturers 4 (3) Food Hygiene Regulations, 1955. Some 100 notices were served as against 186 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. Complaint Action Taken Loaf containing a moth. Identified as a Mediterranean Mill Moth. Warning letter to Bakery. Packet of rusks containing bluebottles. Manufacturers informed but no further action taken. Evidence inconclusive as to where infestation occurred. Condensed milk alleged to have caused diarrhoea. Submitted to Oldchurch Pathological Laboratory. No pathogenic organisms isolated. No further action taken. Pork pie affected with mould. Manufacturer informed but no further action possible in view of time lag between purchase of pie and receipt of complaint. Veal and ham pie affected with fly maggot. Vendors informed but no further action taken in view of time lag between purchase of pie and receipt of complaint. 34 Unsound Food. During the year 3 tons, 4 cwts, 186 lbs of food was voluntarily surrendered to the Public Health Inspectors after being found unfit for human consumption. Lectures on Food Hygiene. A course of six lectures on elementary food hygiene was given by arrangement with the Ardleigh House Authorities and it was hoped that a further course of advanced lectures would follow next year. This was strictly speaking an Ardleigh House venture and one which it is hoped to repeat. My thanks are due to the Warden for his interest in what is after all largely a Public Health pre-occupation. Slaughterhouses Act, 1958. Two slaughterhouse licences were issued during the year. Meat Inspection. It will be readily apparent that a vast increase in the sheep and lambs dealt with has occurred and although the number of cattle and cows is down, this is counter balanced by an increase in the number of calves and pigs. The percentage of carcases with disease other than Tuberculosis remained—save for a 4% increase in sheep and lambs—roughly as last year. The meat inspection work is of a demanding and time consuming nature including regular week-end duties. This fact has, of course, been recognised by you. Carcases Inspected and Condemned. The following tabular statement regarding the post-mortem inspection of animals at the two slaughterhouses is drawn up in accordance with the Appendix to Ministry of Health Circular 17/55 (last year's figures in brackets): — Cattle (excluding cows) Cows Calves Sheep and Lambs Pigs Goats Number killed 3,014 1,837 3,313 21,777 11,392 83 Number inspected 3,014 1.837 3,313 21,777 11,392 83 (4,338) (455) (1,664) (8,856) (9,500) (11) All diseases except Tuberculosis and Cysticercosis: Whole carcases condemned 2 6 10 40 15 — Carcases of which some part or organ was condemned 588 721 46 3,364 2,379 - Percentage of number affected 19.6 39.6 1.7 15.6 20.0 - Tuberculosis only : Whole carcases condemned — 1 - — 1 — Carcases of which some part or organ was condemned 11 10 - - 279 - Percentage of number affected 0.4 0.6 - - 2.5 - 35 Cysticercosis only : Carcases of which some part or organ was condemned 29 1 - - - - Carcases submitted to treatment by refrigeration 4 - - - - - Generalised and totally condemned - - - - - - Slaughter of Animals Act, 1958. Nine slaughterman's licences were issued during the year. Ice Cream. During the year one application for registration as a manufacturer, 11 applications for registration as vendors, one application for registration of premises for the manufacture, storage and sale and seven applications for registration of premises for the storage and sale of ice cream were granted. At the end of the year four persons and premises were registered for manufacture and 312 for the storage and/or sale of ice cream. 72 samples were taken during the year. 71 proved satisfactory. In addition, 49 samples were taken under the Food and Drugs Act for examination by the Public Analysts. The quality of the ice cream sold locally remains in general of a highly satisfactory order. Preserved Food Manufacturers. Section 90 of the Hornchurch Urban District Council Act, 1936. requires registration of preserved food manufactures and premises. At the end of the year 71 persons and 93 premises were registered for the manufacture, preparation or storage of preserved meat. 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 under review 78 persons and 16 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. 61 shopkeepers are registered for the sale of bottled milk only. 36 Milk Sampling. The 60 samples of milk taken from dairies, shops and in the streets during the course of delivery to customers throughout the year were submitted to the Laboratories for testing. In all cases satisfactory reports were received. In addition, 29 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. School Canteens. Our liaison with the Divisional Education Committee is now of a most satisfactory order and my thanks are due to the Divisional Education Officer, Mr. D. H. Wilcockson. B.A., M.Ed., for doing so much to achieve this. Milk (Special Designation) Regulations, 1960. The number of dealers' (pre-packed milk) licences in force at the end of the year was as follows:— premises Pasteurised 78 Sterilised 90 Tuberculin Tested 63 37 SECTION F. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER NOTIFIABLE DISEASES. Infectious and Other Notifiable Diseases, 1962. Disease Total cases notified No. of Cases hospitalised Dysentery 7 1 Erysipelas 10 2 Food Poisoning 26 8 Infective Hepatitis 26 8 Malaria (contracted abroad) 1 1 Measles 825 7 Ophthalmia Neonatorum 1 0 Paratyphoid Fever 1 1 Pneumonia 23 6 Poliomyelitis (non-paralytic) 1 1 Puerperal Pyrexia 3 0 Scarlet Fever 82 0 Smallpox 1 1 Typhoid Fever 1 1 Whooping Cough 18 1 The infectious disease cases were fewer than in 1961. The smallpox case in Rainham—a man of 49—resulted in vaccinations reported to the Local Health Authority going up from 2,354 in 1961 to 52,438 in 1962. This did not represent by any means the total increase in vaccinations during the year. Some 3,756 International Certificates were authenticated as against 570 in 1961. The event of even a single case of smallpox produces a very considerable strain on a Public Health Department, and one which has to be experienced to be assessed. I must thank all my staff for the encouraging and generous help which they gave during what was clearly an anxious time. One outbreak of food poisoning was associated with a canteen outside the District—the causitive organism being Salmonella Typhi Murium and the origin possibly connected with frozen liquid egg. International Certificates of Vaccination or Inoculation. 3,756 certificates were stamped during the year. The number for the previous year was 570. 38 Immunisation and Vaccination Statistics. I am indebted to Dr. R. D. Pearce, Area Medical Officer, for the following information concerning immunisation and vaccination statistics applicable to the Urban District for the year 1962:— Diphtheria Immunisation: Completed primary immunisations 1,845 Boost injections 1,381 Whooping Cough Immunisation: Completed primary immunisations 1,535 Boost injections 368 Tetanus Immunisation: Completed primary immunisations 2,407 Boost injections 677 Poliomyelitis Vaccination (Salk): Completed 2 primary injections 1,614 Boost injections 4,628 Fourth injections 3,980 Poliomyelitis Vaccination (Oral): Completed three doses 1,662 Third boosting dose 1,838 Fourth boosting dose 3,980 Smallpox Vaccination: Primary vaccinations 27,193 Re-vaccinations 25,245 B.C.G. Vaccinations (School Children of 13 years): Number vaccinated 714 Infective Hepatitis 26 cases were notified during the year as against 91 last year. Tuberculosis Respiratory: The number of new notifications decreased from 45 to 39. Non-Respiratory: The notifications remained at 4. The site of infection and age of the non-respiratory cases were as under: — Cervical glands Female 83 59 ” ” ” 19 Genito-urinary (bladder) Male 24 Inwards Transfers: These totalled 20 as against 32 last year. Deaths: There were seven this year as compared with four last year. 39 Cases on Register: The number of cases of tuberculosis on the register at the end of the year was as follows:— Respiratory: Males 532 Females 441 Non-Respiratory: Males 40 Females 28 Romford Chest Clinic. Noted below are some notes from Dr. S. Thompson, the Consultant Chest Physician:— "During 1962 the Romford Chest Clinic has continued to serve the needs of the combined areas of Romford Borough and Hornchurch Urban District and, in addition to the general supervision of over 1,500 notified cases of tuberculosis, an increasing number of patients have been referred by General Practitioners for chest symptoms not caused by tuberculosis. This is a satisfactory tendency and every encouragement is given to the general public, through their family doctors, to avail themselves of the diagnostic facilities provided by the Chest Clinic. By this means it has been possible to diagnose an increasing number of cases of carcinoma of the lung, and when the death rate from this disease alone is over 20,000 per annum the importance of early diagnosis cannot be over-emphasised. The Mass Radiography Units were very active in the area and all cases with any abnormality in the miniature x-ray film are seen at the Chest Clinic and full investigation is carried out. Most of these cases are small, indolent tuberculous foci, which are followed up on the miniature x-ray unit installed in the Chest Clinic. All the school children with positive tuberculin skin tests are referred to the Chest Clinic by the School Medical Officers and investigation is carried out to ensure that no active tuberculous focus is present. Examination of contacts to notified cases is done at regular intervals and for this purpose the miniature x-ray unit in the Chest Clinic is most useful. All the child contacts are offered B.C.G. vaccination and these children are followed up to ensure that protection remains effective. As my contract with the Regional Hospital Board ends this year it is probable that, after 40 years' service, this will be the last report on the Chest Services in the area that I shall submit. As I have been associated with chest work most of my professional career 1 have seen remarkableeven dramatic—changes in the control of the "white scourge"—tuberculosis, and from the seclusion of my garden in Shenfield I shall follow with unabated interest the further progress of the treatment of thoracic disease to which I have devoted my professional life." 40 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. Six factory visits, three schools, two old people's homes and 12 general public sessions were carried out and a note of the attendance is given below:— Male Female Total Deyong's 15 121 136 Lacrinoid Products 187 96 283 Roneo Limited 911 574 1,485 Murex Limited 1,205 275 1,480 Victor Engineering Company 195 41 236 Rainham Working Men's Club 157 227 384 Mungo Park Road 51 344 395 South Hornchurch Clinic 204 236 440 Church Road, Harold Wood 259 272 531 Harold Wood Social Centre 145 229 374 Hornchurch Grammer School 188 151 339 Abbs Cross Technical School 141 143 284 Plough Inn, Cranham 146 212 358 Cranhain Clinic 139 261 400 Bell Hotel, Upminster 558 951 1,509 Spencers Arms, Ardleigh Green 52 177 229 Crown Inn, Roneo Corner 197 243 440 Odeon Car Park, Hornchurch 419 578 997 Elm Park Hotel 377 654 1,031 Avenue Industrial Estate 173 262 435 Brentwood Training College, Harold Wood 31 67 98 Stears Lodge, Harold Wood 21 28 49 "Ravenscourt," Station Lane 10 38 48 A total of 11,961 persons attended comprising 5,781 males and 6,180 females. The figures for 1960 were 9,478; for 1958—8,518; for 1956— 8,831 and for 1954—5,687. It will thus be seen that the final figure of 11,961 examinations for this visit shows an increase of 2,483 compared with the 1960 visit. The clinical evaluation of the visit is given below. The Unit detected ten cases of active pulmonary tuberculosis and seven of carcinoma of the bronchus, as against seven and two last time. Tuberculous lesions: Males Females Total Calcified primary 45 39 84 Inactive tuberculosis 51 39 90 Active tuberculosis 6 4 10 41 Other Abnormalities revealed: Abnormalities of the bony thorax and soft tissues—congenital 6 8 14 Abnormalities of the bony thorax and soft tissues—acquired 102 61 163 Congenital malformations of the lungs 5 3 8 Bacterial and virus infections of the lungs 6 2 8 Bronchiectasis 2 4 6 Emphysema 3 1 4 Pulmonary fibrosis—non-tuberculous 22 6 28 Pneumoconiosis 1 — 1 Benign tumours of the lungs and mediastinum — 1 1 Carcinoma of the lung and mediastinum 5 2 7 Metastases in the lung and mediastinum — 1 1 Sarcoidosis and collagenous diseases — 3 3 Pleural thickening or calcification—nontuberculous 46 23 69 Abnormalities of the diaphragm and oesophagus—congenital and acquired 2 5 7 Congenital abnormalities of heart and vessels 3 1 4 Acquired abnormalities of heart and vessels 14 36 50 Miscellaneous 10 4 14 Cases who fail to attend for further film or clinical examination 1 2 3 Total 330 245 575 42 CASES OF AND DEATHS FROM TUBERCULOSIS, 1962 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 - 2 - - - - - - - 2 - - - - - - 5—14 years 1 3 - - 1 - - - 2 3 - - - - - - 15—24 ,, 4 2 1 1 - 2 - - 5 5 - - - - - - 25—44 ,, 6 2 - - 6 8 - - 12 10 1 - 1 1 2 1 45—64 ,, 9 4 - 1 2 1 - - 11 6 2 - - - 2 - 65 and over 6 - - 1 - - - - 6 1 1 - 1 1 2 - Totals 26 13 1 3 9 11 - - 36 27 4 - 2 1 6 1 INTERVAL BETWEEN NOTIFICATION AND DEATH OF FATAL CASES OF TUBERCULOSIS, 1952—1962 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—1 years From 4 years and upwards Not Notified TOTAL 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 1961 — — — 1 — 1 — 1 1 4 1962 — — — — — 1 — Q 4 7 43 44 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. 28 16 3 - (ii) Factories not included in (i) in which Sec. 7 is enforced by the L.A. 315 167 7 - (iii) Other premises in which Sec. 7 is enforced by the L.A. 15 27 3 — Total 358 210 13 — 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 — — — — Overcrowding (Sec. 2) — — — — — Unreasonable temperature (Section 3) - - - - - Inadequate ventilation (Section 4) - - - - - Ineffective drainage of floors (Section 6) - - - - - Sanitary Conveniences (Section 7) (a) Insufficient 3 2 - 1 - (b) Unsuitable or Defective 8 2 - 4 - (c) Not separate for sexes 1 - - - - Other offences against the Act — — 4 — - Total 13 4 4 5 - 45 PART VIII OF THE ACT. OUTWORK—Sections 110 and 111. Nature of No. of Outworkers Work in August list Wearing apparel— No instances of work in unwholeMaking, etc. 122 some premises 46 INDEX Page Acknowledgments 6 Acreage 7 Adoption of Private Streets 20, 21 Alkali Inspector 18 Aged, Care of 13 Agriculture (Safety, Health & Welfare Provisions) Act, 1956 22 Amalgamation 5 Ambulance Service 12 Atmospheric Pollution 18 B.C.G. Vaccination 38 Births 7 Birth Rates 7 —Area Comparability Factor 8 —Comparative 8 —Illegitimate 7 Bury Farm Sewage Works 19 Canteens, School 36 Caravans 26 Care of the Aged 13 Certificates of Disrepair 25 Cesspools 20 Child Welfare 12 Clean Air Act, 1956 5, 17, 18 Clinics, Child Welfare 12 Contents, Table of 2 Day Nursery 12 Deaths 7 —Age Groups 10 —Causes of 10 —Infantile 7 —Main Causes 9 —Maternal 7 Death Rates 7 —Area Comparability Factor 8 —Comparative 8 —Early Neonatal —Infant 7 —Neonatal 7 —Perinatal 7 Diphtheria Immunisation 38 Diseases of Animals (Waste Food) Order, 1957 22, 24 Disinfection 21 Disinfestation 21 Domestic Help Service 13 47 Page Drainage and Sewerage 19, 20 Dysentery 37 Essex County Council Act, 1952— Section 103 35 Section 105 33 Establishments for Massage or Special Treatment 21, 24 Extensions or Improvements to Sewage Works 19 Factories Acts, 1937 to 1959 44 —Defects 44 —Inspections 23 —Outwork 45 —Prescribed Particulars 44, 45 Fireguards 22, 24 Farms 22 Food Poisoning 37 Food— Complaints 30, 31, 32, 33 Hawkers 35 Hygiene 33, 34 Inspection of 22 Meat Inspection 34, 35 Premises 22, 23 Preserved 35 Unsound 34 Food and Drugs Act, 1955 27 —Administration 27 —Food Hygiene Regulations, 1955 33 —Public Analysts 4, 27 —Sampling 27, 28, 29, 30 General Mortality—Main Causes 9 General Sanitary Circumstances 23 Greater London 5 Heating Appliances (Fireguards) Act, 1952 and Regulations, 1953 22, 24 Home Nurses and Midwive 12 Home Safety 14, 15 Hornchurch Urban District Council Act, 1936, Section 90 35 Houses— Inspection of 23 Number erected 25 Number inhabited 7 Housing 6, 23 —Caravans 26 —Certificates of Disrepair 25 —Closure and Demolition 25 —Common Lodging Houses 26 48 Page —Improvement Grants 26 —Overcrowding 26 —Rehousing (medical aspects) 26 —Visits paid 23 Ice Cream 35 —Registration 35 —Sampling 35 Immunisation and Vaccination Statistics 38 Improvement Grants 26 Infectious and Other Notifiable Diseases 5, 37 —Hospitalisation 37 —Notifications 37 —Visits paid 24 Infective Hepatitis 38 Informal Notices Served 24 International Certificates of Inoculation/Vaccination 37 Laboratory Facilities 11 Land Charges Enquiries 26 Laundry Service 15 Maternity and Child Welfare 12 Meals on Wheels 13, 14 Measles 37 Meat Inspection 31 —Carcases Inspected and Condemned 31, 32 Medical Examinations 11 Members of the Council 3 Members of the Public Health Committee 3 Metal Dealers 22 Midwives and Home Nurses 12 Milk- Distributors 35 Sampling 36 Special Designations 36 National Assistance Act, 1948, Section 47 13 New Streets 20,21 Noise Abatement Act, 1960 22 Notices Served 24 Nursing Homes 12 Officers of the Public Health Department 4 Old Metal Dealers 22 Outworkers 23,45 Paddling Pools 21 Penny Rate Product 7 Pet Animals Act, 1951 22, 24 49 Page Poliomyelitis 37 —Vaccination 38 Population 5, 7 Preface 5 Preserved Food Manufacturers 35 Public Analysts 4, 27 Public Health— Inspection 22, 23, 24 Inspectors 4 Public Relations 11 Radioactivity 17 Rag Flock and Other Filling Materials Act, 1951 22, 24 Rainfall 16, 17 Rateable Value 7 Refuse Collection and Disposal 20 Regional Sewerage Scheme 19 Rent Act, 1957— Certificates of Disrepair 25 Riding Establishments Act, 1939 22 Rivers 19 Rodent Control 21 —Farm Work 21 Royal Commission on Local Government in Greater London 5 St. George's Hospital 18 Scarlet Fever 37 School Canteens 36 Sewage Works 19 Sewerage and Sewage Disposal 19 Shops Act, 1950 23 Slaughter of Animals Act, 1958 35 Slaughterhouses 34 Smallpox 5,37, 38 Smoke Control Areas 17, 18, 24 Soil Sewers 19 Staff 4 —Medical Examinations 11 Staffing 11 Statutory Notices Served 24 Stillbirths 7 —Rates 7 Streets Made Up and Taken Over 20, 21 Summary of Public Health Inspectors' Work 22, 23, 24 Surface Water Sewers 20 50 Page Swimming Pool 21 Table of Contents 2 Tetanus Immunisation 38 Tuberculosis 38 —B.C.G. Vaccination 38 —Incidence and Mortality 42 —Mass Radiography 40 —Notification/Mortality Interval 43 —Chest Clinic 39 Vaccination Statistics 38 Vital Statistics 5,7 Water— Sampling 16 Supplies 16 Well 16 Whooping Cough Immunisation 38