AC 4361 1/0/11/ 1949. ANNUAL REPORT ON THE HEALTH AND SANITARY CONDITIONS OF THE \ METROPOLITAN BOROUGH OF ISLINGTON. VICTOR FREEMAN, M.R.C.S., l.r.C.P., D.P.H., Medical Officer of Health. VAIL & Co., Ltd., Printers. 170 Farringdon Road, E.C.I 1 Public Health Department, Town Hall, N.l. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. I have the honour to present the Annual Report of the Metropolitan Borough of Islington for the year ended 31st December, 1949, in the abridged form required by the Ministry of Health. The vital statistics for this year continue to show many very satisfactory features. The post-war fall in the infant mortality rate, which was temporarily interrupted in 1948, was continued in 1949, and the remarkably low rate of 27 infant deaths per 1,000 live births was returned. This figure is lower than the average for the County of London and also below the rate for England and Wales. Although other areas, including some Metropolitan Boroughs, may show even more favourable results, nevertheless it must be recorded that the improvement in the chances of infant survival to this extent is a remarkable achievement in the light of unfavourable housing with all that this implies, and the working-class composition of the greater part of the population of Islington. The main causes of infant deaths are set out in more detail in the section on vital statistics. As mentioned in my last report, diphtheria is becoming rare, although there were two deaths in children who had not been immunised. Measles rose to epidemic proportions in 1949 with a very high incidence, although, fortunately, the severity of attack appears to be decreasing. The two principal unfavourable features of 1949, so far as infectious diseases are concerned, were Poliomyelitis and Pulmonary Tuberculosis. Poliomyelitis was more prevalent in Islington in 1949 than in the previous highest recorded outbreak in 1947, but the proportion of cases which ended fatally was, fortunately very small and there was a higher proportion of cases with either no paralysis at all or mild symptoms which cleared fairly rapidly. Pulmonary Tuberculosis continues to be a most difficult problem and there was a slight increase in the notification rate of new cases although the death rate is still falling. It is still not possible for a case of Pulmonary Tuberculosis to be admitted to hospital or sanatorium as speedily as is desirable. Reference is also made in the body of the report to some aspects of the care of elderly persons for whom the officers of the Public Health Department undertook much action on an unofficial basis in association with statutory bodies and voluntary organisations. With regard to food hygiene, special consideration was given to certain premises manufacturing ice cream where the products could not be considered altogether reliable. It is not always easy to detect the precise stage at which contamination may take place, and it may be necessary to sample at all stages of manufacture and to spend a good deal of time on one particular case. The free washing facilities which the Council have approved in particular, although not exclusively, for the benefit of street food traders, have been much appreciated and substantially used. 2 In respect of housing, Islington presents a formidable problem due to the high proportion of out-of-date housing in tenement occupation. The maintenance of houses free from nuisance under the Public Health (London) Act, 1936, is becoming increasingly difficult in a number of properties owing to the rising disparity between the cost of repairs and rents received. The necessity to take action under Section 11 of the Housing Act creates difficult problems of rehousing. I am again indebted to the loyalty and assistance of the senior officers and staff of the Public Health Department during the year and for the consideration extended by the Chairmen of the Public Health and Housing Committees, Councillor Mrs. F. H. Cantwell, J.P., and Councillor D. McArthur Jackson, J.P., respectively. V. FREEMAN, Medical Officer of Health. 3 MEMBERS OF THE PUBLIC HEALTH COMMITTEE (As at December 1949) Mayor : Alderman H. J. L. Lygoe, J.P., M.S.M. Aldermen : Mrs. Jessie Leonie Blythe, J.P. Frederick Thomas Herrington Councillors : Mrs. Emma Elizabeth Baker Charles Alfred Franks Mrs. Agnes Seeley Mrs. Jessie Maud Barnes John Robert Goodman Joseph James Shelley Mrs. Florence Hilda Cantwell, J.P. Charles Percy Hawkins Arthur Alfred Simpson Mrs. Gladys Dorothy Cantwell William George Keer Mrs. Edith Agnes Spriggs Mrs. Kate Elizabeth Fowler Herbert John Ranson Edward Albert Willis Chairman : Councillor Mrs. Florence Hilda Cantweli., J.P. Vice-Chairman : Councillor Mrs. Edith Agnes Spriggs Staff of the Public Health Department, Town Hall, Islington, N.l. (T = Staff on Temporary Establishment) Medical Officer of Health : V. Freeman, M.R.C.S., L.R.C.P., D.P.H. Public A nalyst : Senior Sanitary Inspector : D. F. H. Button, A.R.C.S., F.R.I.C (b), (c), (d) W. C. Bartlett Deputy Senior Sanitary Inspector : (b), (c), (e) B. J. Aslicroft Sanitary Inspectors : (b) J.W.Aiken (b) D. W. E. Jessett (b) J.N.Pitts (b) J.S. Ashworth (b) A.Jones (b), (c) Miss S. H. Prentice (b), (c) A. A. Aslamidis (b), (c), (d) N. Lightowlers (b) M. E. Rousell (b), (c) K. L. Garner (b) R. C. Lillis (b) A. K. D. Shuttleworth (b), (e) Miss V. M. Goddard (b), (e) G. W. Maidlow (b) F. J. B. Taylor (b) W. B. Goddard (a), (c) S. P. Marks (b) H. H. Uren (b), (c) A. W. Haydock (6) A. Moxon (b) A. Watson (b), (e) H. R. Homewood (b), (e) F. H. W. Pedrick (b) L. Weeks (b) C. G. Howell Chief Clerk : E. J. Sharp Clerical Staff: Miss D. A. Barr (T) Miss E. J. Harris P. L. Regan S. A. Bishop P. Hardwick Miss M. O'Grady Miss M. A. Blennerhassett L. Hummerstone (T) Mrs. A. Love (T) W. R. Causton* W. A. McAdam* Miss C. A. Smith C. J. Cridland* C. J. Moore* Miss W. Stittle Miss D. Francis Mrs. R. E. New (T) J. Thompson E. George S. C. Nottingham Mrs. F. Underwood W. H. Goody (T) D. Owen Mrs. Q. V. Weeks Staff at Public Health Department, Seven Sisters Road, N.7. Disinfecting and Bathing Stations. W. G. Jollie (Engineer-in-Charge) Mrs. H. W. M. Godkin (Nursc-in-Charge) 4 Home Visitors 1 Stoker Handyman 1 Assistant Driver 5 Bathing Attendants 2 Drivers 3 Disinfectors Rodent Control : C. Jackson (Rodent Officer) 3 Rodent Investigators 6 Rodent Operators (a) = Certificate Sanitary Inspectors' Examination Board. (b) = Certificate of the Royal Sanitary Institute and the Sanitary Inspectors' Examination Joint Board. (c) = Royal Sanitary Institute Meat Inspectors' Certificate. (d) = Royal Sanitary Institute Certificate in Sanitary Science. (e) = Royal Sanitary Institute Smoke Inspectors' Certificate. * = Senior Sectional Clerk. 4 SECTION A. GENERAL AND VITAL STATISTICS. Area of the Borough 3,092 acres. Population. Registrar General's estimate of civilian population, Mid-year 1949: 239,580 Live Births. Birth Rate per 1,000 Estimated Resident Population Totals. M. F. Islington London Admin. County. England and Wales. Legitimate 4,071 2,108 1,963 Illegitimate 318 160 158 4,389 2,268 2,121 18.32 18.5 16.7 Still Births. Legitimate 78 36 42 Rate per 1,000 Total (Live and Still) Births 19.87 Illegitimate 11 8 3 89 44 45 Deaths. Death Rate (Unadjusted) per 1,000 Population Totals M. F. Islington London Admin. County England and Wales 2,958 1,577 1,381 12.35 12.2 11.7 Death from Puerperal Causes. Deaths. Rate per 1,000 Total Births. Puerperal Sepsis — — Other Puerperal Causes 3 0.67 3 0.67 Death Rate of Infants Under One Year of Age. Islington London Admin. County England and Wales. All infants per 1,000 live births 27 29 32 Legitimate infants per 1,000 legitimate live births 27 Illegitimate infants per 1,000 illegitimate live births 35 Notification of Births. For year ending 31st December, 1949 4,479 (corrected figure from L.C.C.) Marriages (Provisional figures). Marriages solemnised in the Borough during the year 2,229 5 COMPARATIVE VITAL STATISTICS—1938 TO 1949. (Compiled from Registrar General's Returns) 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 Population 239,580 238,200 236,840 227,160 195,770 188,560 189,970 186,000 183,470 224,110 272,300 292,300 Live Births—(total) 4,389 4,608 5,577 5,284 3,708 3,826 3,592 3,368 2,986 3,850 4,168 4,487 (illegitimate) 318 331 431 442 438 335 264 251 214 272 245 278 Birth Rate per 1,000 population 18.32 19.34 23.55 23.26 18.94 20.29 18.91 18.10 16.27 17.18 14.47 15.35 Still Birth Rate per 1,000 births 19.87 18.94 18.99 22.20 22.41 25.72 24.97 33.29 26.72 32.17 30.24 27.52 Deaths 2,958 2,682 3,053 2,947 2,856 3,057 3,017 2 852 3,508 4,143 3,485 3,492 Death rate 12.35 11.26 12.89 12.97 14.59 16.21 15.88 15.33 19.12 18.48 12.79 11.94 Maternal Death rate per 1,000 births 0.67 0.85 0.70 1.48 0.26 2.03 2.71 2.29 3.02 1.59 1.47 2.17 Death-rate of infants under 1 year 27 35 32 39 46 48 46 54 59 47 50 65 Marriage rate per 1,000 population 18.61 19.67 19.54 20.21 25.00 18.36 18.59 25.30 28.07 32.92 23.89 19.57 T.B. Notifications per 1,000 population (all forms) 2.20 2.25 2.43 2.18 2.81 3.14 3.04 2.30 3.00 2.10 1.94 2.13 Death-rates per 1,000 population— Pulmonary T.B. 0.52 0.66 0.70 0.64 0.80 0.86 0.85 0.93 1.20 0.84 0.82 0.73 Diphtheria 0.008 Nil 0.004 Nil 0.01 0.01 0.05 0.01 0.06 0.09 0.04 0.08 Suicides 0.12 0.15 0.07 0.11 0.06 0.10 0.08 0.14 0.14 0.17 0.15 0.14 Road Traffic Accidents 0.06 0.08 0.11 0.10 0.07 0.16 0.10 0.16 0.14 0.14 * * Other violent causes 0.25 0.43 0.37 0.45 1.05 1.84 0.38 1.45 1.74 2.38 0.56 0.37 * Not given separately by Registrar General. 6 CLASSIFICATION OF DEATHS WITH AGE DISTRIBUTION. Cause of Death Ages—Both Sexes Totals Under 1 year 1 year and under 5 5 and under 15 15 and under 45 45 and under 65 65 and upwards All Ages M. F. All causes 119 17 16 215 649 1,942 2,958 1,577 1,381 Percentages 4.02 0.58 0.54 7.27 21.94 65.65 1. Typhoid and paratyphoid fevers — - — — - — — — — 2. Cerebrospinal fever — 2 — — 1 — 3 1 2 3. Scarlet Fever - - - - - - - - - 4. Whooping Cough 1 - - - - - 1 — 1 5. Diphtheria — 1 1 — - — 2 1 1 6. Tuberculosis of respiratory system — — 1 60 43 21 125 82 43 7. Other forms of tuberculosis — 4 2 2 2 1 11 9 2 8. Syphilitic disease 1 — — — 7 8 16 8 8 9. Influenza 1 1 — 1 13 21 37 19 18 10. Measles - - - - - - - - - 11. Acute poliomyelitis and polioencephalitis 1 2 3 1 2 12. Acute infectious encephalitis — — — — — - — — — 13. Cancer of buc. cav. and oesop (M) — — — 3 5 18 26 26 — Cancer of uterus (F) — 1 — 2 10 13 26 — 26 14. Cancer of stomach and duodenum — — — 5 26 41 72 30 42 15. Cancer of breast — — — 2 18 27 47 1 46 16. Cancer of all other sites 1 1 3 24 129 205 363 248 115 17. Diabetes — 1 — 3 1 16 21 7 14 18. Intra-cranial Vascular lesions — — — 4 43 198 245 113 132 19. Heart Disease — — — 22 127 616 765 344 421 20. Other diseases of the circulatory system 1 28 189 218 102 116 21. Bronchitis 3 — - 9 66 188 266 173 93 22. Pneumonia 16 — 1 6 24 143 190 96 94 23. Other respiratory diseases — — — 2 12 19 33 19 14 24. Ulceration of the stomach or duodenum - - - 3 15 20 38 27 11 25. Diarrhoea (under 2 years of age) 8 — — — - — 8 6 2 26. Appendicitis — — 1 2 5 5 13 5 8 27. Other digestive diseases — 2 1 4 7 36 50 24 26 28. Nephritis — — — 3 12 20 35 19 16 29. Puerperal and post-abortive sepsis — — — — - — — — — 30. Other maternal causes — — — 3 - — 3 — 3 31. Premature birth 27 — — — - - 27 13 14 32. Congenital malformations, birth injury, infantile disease 48 - 1 2 3 1 55 36 19 33. Suicide - — — 7 13 8 28 25 3 34. Road Traffic accidents — — 1 3 3 7 14 11 3 35. Other violent causes 5 1 2 13 10 29 60 36 24 36. All other causes 8 2 2 27 26 92 157 95 62 7 SUMMARY OF INFANT MORTALITY 1949. (Based on Registrar General's Returns) Primary Cause of Death Under 1 day Days Weeks Months 1949 (1948) 1-2 2—3 3-4 4—5 5—6 6—7 1—2 2—3 3-4 1—2 2—3 3—4 4—5 5—6 6—7 7—8 8—9 9—10 10—11 11—12 Totals Totals Measles - (1) Whooping Cough 1 1 (4) Cerebro Spinal Fever — (2) T uberculosis—Lungs — (1) Tuberculosis—Other forms — (2) Bronchitis 1 1 1 3 (7) Pneumonia 1 1 1 2 2 3 1 1 1 1 2 16 (31) Influenza 1 1 (—) Enteritis and Diarrhoea 2 2 1 1 2 8 (11) Premature Birth 11 4 2 2 1 2 2 2 1 27 (23) Congenital Malformation, Birth Injury, Atelectasis, Atrophy and Marasmus 20 4 3 2 2 1 5 2 1 2 2 1 2 1 48 (55) Syphilis 1 1 (-) Suffocation Overlying — (3) Violent Causes 1 1 1 1 1 5 (16) Road Traffic Accidents (1) All Other Cases 1 1 1 3 1 1 1 9 (4) Totals 33 10 5 4 3 2 4 8 4 2 4 9 8 6 4 4 3 2 - 1 3 119 (161) COMMENTS ON VITAL STATISTICS. Births. In accordance with the trend for the whole country, the birth-rate continues to fall from its post-war peak of 23.55 per 1,000 population in 1947, the corresponding 1949 figure being 18.32. The still-birth rate at 19.87 was fractionally higher than in 1948 (18.94). Illegitimate Births. 7.24 per cent, of the 1949 births were registered as illegitimate which is very slightly higher than last year's rate (7.18 per cent.). It will be of some interest to observe whether the post-war improvement in illegitimacy has only been temporarily halted, or whether the post-war social factors are tending to stabilise at this level. Principal Causes of Death. The death-rate for 1949 showed some increase (12.35) on the previous year (11.26). Islington's increase was part of a general increase in the County of London. The principal reasons will be mentioned in a later paragraph. Infants under one year. 1 mentioned in my report for 1948 that the moderate increase in infant mortality which took place in 1948 need not give rise to anxiety since it would probably turn out to be only a temporary phase. The constant fall in infant mortality has now been renewed, and again it has to be recorded with pleasure that the infant mortality rate for 1949 of 27 per 1,000 live births is the lowest in the history of the Borough. It also has to be noted that in spite of high population density, a large proportion of out-of-date multi-storey, tenement housing, a high proportion of underground and basement room occupation, and a paucity of 8 open spaces, adverse environmental factors which are probably as bad in Islington as anywhere in London, that the Islington infant mortality rate was lower than the figure for the whole County of London (29). This is indeed an excellent token of the care exercised by the individual mother during her pregnancy and her child's first year of life, as well as an index of medical advances. Even illegitimate infants, with an infant mortality rate of 35 per 1,000 live births, are only at slightly higher risk than other infants, and stand a very much better chance of survival at the age of 12 months than did all infants in Islington in pre-war days. There is reason to suppose that in the future an even greater proportion of all infants born will survive and grow to healthy adulthood. There is still an avoidable wastage of life which need not occur even within the limits of our present knowledge, if reasonable care is exercised, and the mother or mother-to-be takes advantage in good time of all the services, medical and socio-medical, which are provided for her. The principal improvements in infant survival (see Summary of Infant Mortality, 1949) are due to fewer deaths from the infectious diseases, bronchitis, pneumonia, and violent causes. There were no deaths ascribed to overlying in this year. Deaths from other causes. Pulmonary tuberculosis continues to be the greatest single cause of death in the age-group 15 to 45 years, with 00 out of 215 deaths due to all causes in this group. This represents 48 per cent, of all deaths due to pulmonary tuberculosis, and again of deaths due to this cause, 05.(5 per cent, were males and 34.4 per cent, females. The increase in the 1949 total deaths over 1948 was due to an increase in the age group 65 years and upwards, which comprised 65.65 per cent, of all deaths against 60.37 per cent, in 1948. The principal increases were ascribed to heart disease and other diseases of the circulatory system, bronchitis and pneumonia. There were decreases in deaths due to suicides, road traffic accidents and other violent causes. 9 SECTION B. PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES. Notifiable Infectious Diseases and Deaths during the year 1949. Disease Number of Notifications Number of Deaths Removed to Hospital Number of Cases returned to Registrar General after correction of Diagnosis Cases " coming to knowledge " but not Notified Smallpox - - - - - - Scarlet Fever 344 (328) — 156 337 16 Diphtheria 55 (44) 2 53 17 — Enteric Fever (including Paratyphoid) 3 (3) P.T. = 3 — 1 P.T. 4 — Typhus Fever — — — — — Puerperal Fever †- (7) — — — — Puerperal Pyrexia 55 (59)* 1 30 59 12 Ac. Primary & Influenzal Pneumonia 137 (68) 6 3 143 - Ophthalmia Neonatorum 16 (25) — 12 25 — Encephalitis Lethargica - (-) 1 — - — Cerebro-spinal Fever 11 (14) 2 8 6 — Anthrax — (—) — — — — Dysentery 48 (34) — 20 38 3 Malaria 1 (2) — 1 1 — Erysipelas 54 (49) — 16 53 7 Measles 2,771 (1,993) — 131 2,830 55 Whooping Cough 535 (944) 1 80 530 28 Ac. Poliomyelitis 69 (11) 2 66 52 4 Ac. Polioencephalitis 3 (-) — 3 6 — Food Poisoning 55 (10) — 11 54 — Tuberculosis—Lungs 488 (485) 130 - Not Returner 96 Tuberculosis—Other Forms 39 (52) 12 do. 18 Scabies 51 (88) — — 51 267 (Figures in brackets are notifications for 1948) * Including 2 Cases occurring in City of London Maternity Hospital, Liverpool Road. Home addresses outside London Area. † Puerperal Fever : L.C.C. (General Powers) Act, 1948, repealed Section 304 Public Health (London) Act, 1936, requiring Puerperal Fever as distinct from Puerperal Pyrexia to be notified (August, 1948). Investigations made in respect of infectious Diseases cases, contacts and etc., by the Sanitary Inspectors and Home Visitors during the year as under :— Smallpox 154 Erysipelas 64 Scarlet Fever 416 Measles 2,866 Diphtheria 92 Whooping Cough 564 Enteric Fever (including Paratyphoid) 22 Acute Poliomyelitis & Polioencephalitis 105 Typhus 5 Food poisoning 56 Cerebrospinal Fever 15 Scabies 383 Dysentery 213 Vermin 1,556 Malaria 1 Ineffective Visits 1,617 Total 8,129 Smallpox and Vaccination. The effects of the rescindment of the Vaccination Acts under the National Health Service Act, 1936, can be noted from the following table of successful vaccinations. 1947 3,345 1st January—3rd July, 1948 1,124 5th July—31st December, 1948 702 1949 1,628 10 Certificates of Vaccination and Inoculation—Authentication—Ministry of Health Circular 60/48. During the year the Medical Officer of Health dealt with 34 requests for authentication of International Certificates of Vaccination and Inoculation against smallpox, cholera, typhoid, etc. Measles and Whooping Cough. Measles and Whooping Cough became generally notifiable in London at the end of 1939. Prior to this there was only a limited notification. The following chart shows the measles and whooping cough notifications since 1942, and the table shows fatality rates per 1,000 notifications for each of the groups 0-1 ; 1-5 ; and 5 and upwards and the proportion of notifications in each of the age groups. 11 INCIDENCE OF MEASLES & WHOOPING COUGH, 1942—1949. Fatality Kates per 1,000 notifications each age group Percentage of notifications (1940-1949) (1940-1949) 0—1 1—5 5 & upwards 0—1 1—5 5 & upwards Measles 13.75 1.13 0.17 6.1 57.0 36.9 Whooping Cough 66.50 5.92 — 14.0 62.3 23.6 The highest fatality rates in both measles and whooping cough are in children under the age of one year. In children under one with whooping cough, approximately one case in 15 is fatal, which is nearly five times the corresponding rate for measles. 12 62.3 per cent, of all cases of whooping cough and 57.0 per cent, of all cases of measles occur in children 1-5 years. Although it is still the subject of medical enquiry, whooping cough vaccination is being increasingly requested by parents. London (Measles and Whooping Cough) Regulations, 1938. Home visiting of measles and whooping cough cases was carried out by the Home Visitors as under— No. of Investigations. Measles Whooping Cough No. of Ineffective Visits. Re-visits 2,855 562 408 13 Acute Poliomyelitis and Polioencephalitis. I reported in 1947 that the number of cases of Poliomyelitis and Polioencephalitis for that year were the highest recorded up to that time for any Islington outbreak. The number of cases in 1949, unfortunately, considerably exceeded those for 1947. The 1949 outbreak began in July and continued to December, and the summary of cases for each of the respective years is set out in the following table. No. of Cases reported 1949 80 1947 50 No. of CONFIRMED cases 1949 62 1947 20 (a) June July August September October November December 1949 ..— 9 6 1 718 8 4 1947 ..126443 - (b) Under 1 yr. 1—5 5—15 15—25 Over 25 1949 3 35 17 2 5 1947 1 5 5 7 2 (c) No. of Deaths—1949 2 (2 yrs. and 26 years). 1947 4 (10 months, 5, 22 and 24 years). It will be seen from the above table that there were approximately three times as many cases in 1949 as in 1947. The maximum number occurred in September and October, and 35 of 62 affected were between the ages of one and five years. Many of the cases were slight and diagnosable only with difficulty, sometimes only after special laboratory investigations were carried out whilst the patient was in hospital. In 11 of the cases there was no paralysis at all, and in many other cases it was anticipated that a complete recovery would eventually result. All General Practitioners in the Borough were aware of the importance of taking into account the possibility of Poliomyelitis, particularly in the sickness of a young child with indefinite symptoms. A film on Poliomyelitis, specially produced for doctors was, by arrangement with the Central Office of Information, shown in the Borough, and the Medical Officer of Health dealt with many enquiries from practitioners in regard to particular cases. Close touch was kept with the hospitals, Ministry of Health and the London County Council in regard to the technical aspects of the outbreak. It was not thought necessary to take drastic restrictive measures such as the enforcement of the closure of cinemas or swimming baths. So far as the Council's ACUTE POLIOMYELITIS, 1949. Key J July9 Cases. „ A August 6 „ „ S September 17 „ „ O October 18 „ „ N November 8 ,, „ D December 4 „ 13 swimming baths were concerned, the Baths Superintendent in consultation with the Medical Officer of Health, arranged for the greatest care to be taken that swimming bath water was chlorinated at all times to what was considered to give a reasonable margin of safety. In conjunction with the Cleansing Superintendent, particular attention was paid to reducing the fly incidence in connection with kitchen salvage bins by treatment with insecticides such as D.D.T. and Gammexane, although it is considered that such treatment cannot altogether obviate the fly nuisance with refuse of this character. All hospitals in the Borough were kept informed periodically of the incidence of Poliomyelitis and in view of the particular risks attached to operations for the removal of tonsils and adenoids these were, in general, suspended at the hospitals for the whole period of the outbreak. Although much research is being done on the nature of Poliomyelitis and possible means of prevention, there are at present no specific means of protection which can be offered to the public. It is therefore only possible at present to take such general precautions as have been mentioned above and to keep such careful account of cases as may throw some further light, in course of time, on the means of avoidance in the future of such outbreaks as have already occurred. The distribution of cases is shown in the accompanying " spot " map. 14 Diphtheria. A chart of the number of diphtheria cases and deaths, together with the number of children immunised, is shown as follows :— 15 No. OF ISLINGTON CHILDREN IMMUNISED AGAINST DIPHTHERIA, 1937-1949 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 281 1,078 525 89 3,261 5,734 6,321 3,165 3,688 3,425 4,563 5,387 3,185 TOTAL—40,702 No. OF CHILDREN WHO DIED FROM DIPHTHERIA OUT OF 40,702 IMMUNISED IN ISLINGTON—NIL. Diphtheria Immunisation. Under 5 yrs. 5—15 yrs. Estimated proportion of Children Immunised at 31.12.49 59.1% 83.08% Total Attendance at all Clinics 16,826 Sessions held 349 Average Attendance 48.3 Number of Children who received Full Course of Immunising— Injections :— Under 5 years 3,012 5-15 years 173 Number of children who were Primary Schick Tested with negative result and therefore did not require immunisation 34 Number of children re-tested with a negative result 455 Number of children Post Schick Tested with a negative result 3,027 Although there were 55 notifications of diphtheria in 1949, only 17 of these were confirmed subsequently. Although these figures are somewhat higher than the previous year, they are nevertheless only a fraction of the pre-war figures. The great protection which immunisation affords is now generally accepted by the public, as shown by the fact that approximately three-fifths of the under-fives and four-fifths of the over-fives are estimated to have been immunised against diphtheria. The two deaths from diphtheria which occurred were in children not immunised. Arrangements were continued in 1949 for the diphtheria immunisation mobile clinic to tour the Borough, and evidence of its attractiveness is shown in the following table of attendances. Total Sessions 21 Total Injections 1,555 1st Injections for diphtheria 357 Completed immunisations 58 1st Injections for Whooping Cough 852 Completed immunisations for Whooping Cough 122 Whooping Cough Prophylaxis. An increasing number of parents during the year requested prophylactic treatment to be given to their children against whooping cough. Although it is extremely difficult in the case of whooping cough to assess the results and to say, in any one case, partial or complete protection has been given for a period, it may well be that an inoculated child suffers from only a modified attack if complete protection is not afforded. The figures for the year—which are also included in the diphtheria immunisation table—are as follows ;— 16 Whooping Cough Prophylaxis. Total attendances 7,794 Completed cases 1,228 Combined Diphtheria and Whooping Cough Prophylaxis. Completed cases 249 Food Poisoning. During the year 55 cases of food poisoning were notified. As mentioned in my report last year, the sum total of illness due to the consumption of contaminated food is undoubtedly considerably greater than appears from the total of notified cases only. Fortunately, the majority of food poisoning cases are not severely ill and the attack is of short duration, so that medical attention is not always sought and therefore notification does not take place. In accordance with Circular 2/50 of the Ministry of Health, January, 1950, the following reports are included. Date No. of Notifications No. of persons served No. of cases reported No. of deaths Foods involved and Organisms responsible 29.3.49 Nil 153 8 Food and organisms not determined 28.6.49 Nil 609 36 — Food and organisms not determined 12.9.49 Nil 941 17 — Food and organisms not determined 22.9.49 Nil 442 123 — Food and organisms not determined *7.7.49 3 ? 3 — Food—duck egg : Organism — Salmonella typhi murium. *15.9.49 11 ? 15 — Cockles. Organisms not determined * Islington residents affected in outbreaks occurring in other Boroughs. Scabies and Vermin. Benzyl benzoate continues to be the treatment of choice for Scabies and proprietory 2 per cent. D.D.T. emulsion for the treatment of verminous heads. Both of these preparations have given extremely satisfactory results for their respective purposes. Complicated cases of Scabies and special cases referred by the general practitioners continue to be seen by the Council's consulting dermatologist, Dr. Marre, at the Scabies Clinic, which is held weekly. Treatment for scabies and vermin was carried out at the Public Health Department, Seven Sisters Road (Cleansing Station), as under— Scabies Vermin Children under 5 years Number treated 61 47 Number of baths given 119 — Number of treatments — 52 L.C.C. Children Number treated 69* 1,250 Number of baths given 316 — Number of treatments — • 1, 53 Adults Number treated 172 193 Number of baths given 416 — Number of treatments — 251 * 27 Contacts were given baths 17 Scabies Clinic.—A consultant dermatologist is in attendance. Number of Clinics held 52 Number of cases attended 445 Adults 241 Children under 5 years 78 School children 126 Diagnosis of cases— 445 Scabies 338 Other conditions 107 Home Visiting. Follow-up home visiting for cases of scabies and vermin was carried out by the Home Visitors of the Cleansing Station, as under :— Families Visited Revisits Ineffective Visits Total Scabies 291 19 181 491 Vermin 1.259* 74 898 2,231 (* 10 cases were treated at home) Bacteriological Examinations. Total Swabs (Diphtheria) 503 Sputum (Tuberculosis) 84 Faeces (Typhoid) 8 Blood (Typhoid) — Faeces (Dysentery) 126 Faeces (Food poisoning) 25 Swabs (Streptococci) 23 Total 769 Tuberculosis. The notification rates per 1,000 population for new cases of pulmonary tuberculosis for the last three years have been—1947—2.18 ; 1948—2.34 ; 1949— 2.39. This is disquieting in spite of the fact that pulmonary tuberculosis death-rates are falling very slowly. Although such increase may in part be due to better ascertainment, there is certainly no evidence that the real incidence is falling. There is much concern over our failure to tackle this problem successfully. There is no single road to success and attacks must be made on many fronts. Thus there is the medical aspect with improvements in treatment, the hospital problem of how to increase the number of beds for the treatment of cases in hospitals and sanatoria and reduce the waiting period at home of the diagnosed infective case, the problem of special provision for the chronic infective case and linked with these, the rehousing problem for tuberculous families. 18 New Cases and Mortality during 1948. Ages New Cases Deaths Respiratory Non-Respiratory Respiratory Non- Respi ratory M. F. M. F. M. F. M. F 0— 1 2 — 1 — — — — 1— 10 8 5 1 — — 3 1 5— 13 16 7 5 — — 1 1 15— 58 80 5 9 5 8 1 — 25— 54 76 2 8 13 10 1 — 35— 57 33 1 4 15 11 — 1 45— 52 13 1 3 10 6 2 — 55— 47 14 1 — 20 8 1 — 65 and upwards 32 8 2 — 22 2 — Total for all ages ... 324 250 24 31 85 45 9 3 629 142 Rate per 1,000 population— New cases—pulmonary 2.39 non-pulmonary 0.23 Deaths— pulmonary 0.54 non-pulmonary 0.05 Public Health (Tuberculosis) Regulations 1930. The total number of cases of tuberculosis on the Register as at 31st December, 1949, was— Pulmonary— Males 1,213 Females 977 Non-Pulmonary—Males 152 Females 148 2,490 Tuberculosis Dispensaries. The Tuberculosis Dispensaries of the Regional Hospital Board continue to function at the Royal Northern and Royal Chest Hospitals, with Dr. J. Wallace Craig as Chest Physician-in-charge. Cases on Dispensary Registers. Pulmonary Non-Pulmonary Total Grand Total Adults Children Adults Children Adults Children Number of definite cases of tuberculosis on Dis pensary Registers N M. F. M. F. M. F. M. F. M. F. M. F. 566 517 53 35 45 55 12 I8 611 572 65 48 1,296 S 383 305 34 41 24 23 10 11 407 328 44 52 831 at 31st December 1949 949 822 87 76 69 78 22 24 1018 900 109 100 2,127 From the information supplied by the Divisional Health Office, the Care Committee, during the year, dealt with 393 interviews. 140 patients have been helped, some on several occasions with cash or in kind, and loans of bedding or medical appliances were made to another 52 patients ; others have been referred to various organisations for assistance. I am indebted to Dr. A. B. Stewart, Divisional Medical Officer, London County Council for the 1949 figures in connection with vaccination, diphtheria and whooping cough inoculations, and tuberculosis dispensaries. 19 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. In an increasing number of cases owners are finding house properties uneconomic and, although the statutory procedure for the abatement of nuisances is fully implemented—which fact is evidenced by the very considerable number of prosecutions taken—the problem still remains to be solved. Houses which would have been dealt with pre-war under Section 9 of the Housing Act, 1936, cannot now be considered as repairable at reasonable cost, and the provisions of the Public Health (London) Act, 1936, are fully implemented in an endeavour to maintain the houses free from nuisance. Appropriate action has been taken under the Housing Act, 1936, in respect of certain properties, details of which are given under that heading. Difficulty continued to be experienced in combating a persistent fly nuisance at the Council's Refuse Depot at Ashburton Grove and experiments were carried out with various insecticides over stated periods during the year. Owing to the very nature of house and trade refuse respectively, it was found that considerable numbers of larvae infested the loaded railway trucks, large numbers falling on to the sidings to proceed into the pupae and fly stages. Whilst the adult fly can be readily destroyed, it was considered that little, if any, effect was made on the flies in the larvae or pupae stages. Discussions between representatives of the Railway Executive, on whose land the depot is situated, and the Council were still proceeding at the end of the year. The position in respect of the Sanitary Inspectors engaged in the Department improved during the year with the result that, for the first time for many years, the number engaged was up to full establishment. In addition, the Ministry of Health approved an increase in the establishment of Inspectors by four, making a total of thirty including the Senior and Deputy Senior Sanitary Inspectors respectively. The fact that there was no deficiency in the establishment assisted greatly in bringing the work of the Inspectors up to date, and this coupled with the revised procedure relative to the service of Notices, outlined in my previous report proved to be invaluable to the work of the Department. The residential properties in the Borough have deteriorated as a result of war damage and the lack of repairs during and since the war, and this, coupled with the fact that much of the property is more than seventy years old, renders the maintenance of these houses in a reasonably habitable condition extremely difficult. Owing to the acute housing situation it is not possible to re-house families on a large scale and areas which would normally have been cleared still remain. Nuisances continue to arise from the existence of bombed sites, static water tanks and air-raid shelters, due to misuse. Where necessary, spraying with D.D.T. solution was carried out to minimise the breeding of flies, mosquitos, etc. Thanks are due to the London Fire Service for their co-operation and services in respect of static water tanks. An arrangement with the Cleansing Superintendent whereby putrescible and other obnoxious matter deposited on bombed and other sites is removed, upon a request from the Sanitary Inspector, has worked satisfactorily during the year. It may well be that the provisions of the War Damaged Sites Act, 1949, which received royal assent on 16th December, 1949, will, when implemented have the very desirable effect of " tidying up " these areas, 20 Numerous complaints have been received in respect of pig bins which encourage fly breeding. These were investigated and the bins subjected to cleansing and additional treatments, where necessary, with a D.D.T. preparation. During the year complaints were received in respect of the keeping of pigs in an area abutting on dwelling houses but, consequent upon the fact that Regulation 62 (b) of the Defence (General) Regulatiops, 1939, is still in force, permitting swine to be kept in any place provided they are not kept in such a place or in such a manner as to be prejudicial to health or a nuisance, no action could be taken under Section 119 of the Public Health (London) Act, 1936, except to ensure that no Public Health nuisance arose. A number of complaints were also received relative to effluvia nuisances caused by processes carried out in industrial premises, such as paint and lacquer spraying. In such cases informal action was taken with satisfactory results. With the passing and coming into operation of the Milk (Special Designations) Act, 1949, the respective Special Designation Regulations and the Milk and Dairies Regulations 1949, drastic changes were made. Licences which hitherto were supplied on the payment of a statutory fee are now issued free, and the numbers of licences issued has therefore increased. This Council remains a Food & Drugs Authority under this Act and respective Regulations, and have not lost any of their previous powers relative to the supervision of dairies, milk shops and the sampling of milk. Consequent upon the receipt of a complaint in respect of the distribution of meat, under the Public Health (Meat) Regulations, 1924, negotiations were commenced with the City Corporation, who own and control the Metropolitan Cattle Market situated in this Borough, with a view to tightening up the supervision of meat transport. It was found that the existing conditions left much to be desired and it was agreed that active steps for the more hygienic transport of meat should be taken as soon as possible. In response to a request from the Hospital Management Committee of the Archway Group, the Council agreed to make the following services available to them without charge :— 1. A periodical inspection and advice on control of rodent and insect pests. 2. Advice on refuse storing and removal and sanitary matters generally. 3. Examinations and reports on milk supplied to hospitals, etc. Summary of Work done by District Sanitary Inspectors. During the year 37,863 inspections and re-inspections of dwelling houses were carried out by the District Sanitary Inspectors, involving 55,082 inspections and re-inspections of separate lettings. A summary of the work done and action taken is as follows :— Routine Inspections etc. Houses inspected—house-to-house 249 Separate lettings inspected resulting from house-to-house inspections 341 Houses inspected (on complaint, following I.D. etc.) 10,991 Separate lettings inspected (on complaint, following I.D. etc.) 15,059 Nuisances found (on complaint) 40,423 21 Nuisances found (on inspection of District) 2,477 Notices served—Intimation 8,909 Notices served—Statutory 9,394 Notices complied with—Intimation 5,776 Notices complied with—Statutory 6,340 Notices complied with—By Local Authority in default 103 Houses re-inspected 26,623 Separate lettings re-inspected 39,682 Visits to requisitioned houses 644 Visits relative to Child Life Protection 39 Visits in connection with Local Land Charge enquiries 1,556 National Assistance Act, 1948—Section 47.—Aged and Infirm Persons. Cases investigated and reports submitted 146 Other Visits. Rag and Bone Dealers 31 Licensed Premises 19 Schools 61 Demolition sites, etc. 51 Static Water tanks 83 Fair grounds 42 Nuisances reported (not dealt with by Notice) 118 Re-inspections in connection with above 126 Total number of Nuisances Reported (All Sources) 43,018 Rent and Mortgage Restrictions Acts, 1920, etc. Certificates applied for 183 Certificates issued 175 Certificates refused 8 Balance to 1950 — Clearance Certificates applied for 84 Clearance Certificates granted 44 Clearance certificates refused 23 Balance to 1950 17 Public Health (London) Act, 1936—Sections 40 and 109. Consequent upon Notices served by the Sanitary Inspectors under Sections 40 and 109 respectively, of the Public Health (London) Act, 1936, the Council, in pursuance of their powers under this Act to carry out urgent sanitary and drainage work in default, executed work amounting to a total of £1,147. Issue of Licences. The Licensing Officer has provided the following information in respect of the total number of licences issued for the years 1948/1949, together with details of the number of licences issued in respect of Statutory Notices served by this Department and the value if the licences issued. It will be seen that in 1949 the licences issued in respect of statutory notices were considerably less than in 1948. This is due to the fact that in 1948 the £10 limit was in force, which in 1949 was increased to £100:- 22 No. of Value of Licences No. of Licences Value of Licences Statutory issued against issued issued Notices issued Statutory Notices 1948 7,550 £738,690 2,276 £264,718 1040 3,430 £676,478 652 £137,493 Prosecutions. Public Health (London) Act, 1036 (216 Cases). Date of Hearing and Court Address Offence Result of Proceedings 5.1.49 North London 9, Freeling Street General dilapidations and dampness. Work done. £1 1s. costs. 12.1.49 Noth London 13, Instow Place Roof defective and leaking Work done. Summons withdrawn. 26.1.49 North London 2, Bingfield Street Addition roof leaking, etc. Work completed. £1 1s. costs. 26.1.49 North London 59, Queensland Road Roof leaking, etc. Abatement Order within 28 days. 26.1.49 North London. 61. Queensland Road General Defects Costs £1 1s. Abatement Order within 14 days. 26.1.49 North London 61, Queensland Road Rain water pipe defective, etc. Costs £1 1s. Work completed — summons withdrawn. 26.1.49 North London 13, Baxter Road Main roof leaking, etc. Abatement Order within 28 days. Costs £1 1s. 26.1.49 North London 23, Lyon Street Dampness, etc. Work completed. Costs £1 1s. 26.1.49 North London 28, Medina Road Main roof leaking, etc. Abatement Order within 28 days. Costs £1 1s. 1.2.49 North London 73, Pembroke Street (1) Dampness, etc (1) Notice dated 2.7.48 to be abated in 28 days (2) Main roof defective (2) Notice dated 14.5.48 to be abated in 14 days £1 1s. costs on each summons. 1.2.49 North London 59, Nicholay Road Defective main roof, etc. Abatement Order within 28 days. Costs £1 1s. 1.2.49 North London 29, King Henry's Walk Leaking main roof, etc. Fined £5. Costs £2 2s. 1.2.49 North London 57, Nicholay Road Defective main roof, etc. Abatement Order within 42 days. Costs £1 1s. 2.2.49 Old Street 58, Morton Road Main roof leaking and general dilapidations. Work completed. Costs £2 2s. 2.2.49 Old Street 13, Charlton Place General dilapidations Work completed, summons withdrawn. 2.2.49 Old Street 21, Oakley Road Leaking main roof, etc. Work completed. Summons withdrawn. £2 2s. Costs. 2.2.40 Old Street 33, Sudeley Street Leaky roof, dampness, etc. Work completed. Summons withdrawn. 3.2.49 Clerkenwell 59, Muriel Street Dampness, etc. Abatement Order within 28 days. Costs £2 2s. 3.2.49 Clerkenwell 57, Muriel Street Defective sink, wall plaster, etc. Abatement Order within 21 days. Costs £2 2s. 23 Public Health (London) Act, 1936 (216 Cases). Date of Hearing and Court Address Offence Result of Proceedings 8.2.49 North London 91, Mitchison Road Failure to comply with an Abatement Order dated 6th December, 1948. Work completed. Summons withdrawn. 16.2.49 North London 141, Bemerton Street Extensive dilapidations Abatement Order with 28 days. Costs £3 3s. 16.2.49 North London 11, Freeling Street General dilapidations and dampness. Abatement Order within 14 days. Costs £2 2s. 16.2.49 North London 43, Twyford Street General dilapidations and dampness. Abatement Order within 28 days. Costs £1 1s. 16.2.49 North London 35, Berriman Road Dampness, etc. Work completed. Costs £2 2s. 16.2.49 North London 30, Benwell Road Roof leaking, etc. Work completed. Costs £2 2s. 16.2.49 North London 31, Boleyn Road General defects Abatement Order within 28 days Costs £1 1s. 16.2.49 North London 47, Canning Road Main roof defective, etc. Abatement Order within 28 days. Costs £1 1s. 16.2.49 North London 28, Clarence Terrace Dampness and Main roof defective, etc. Abatement Order within 28 days. Costs £1 1s. 16.2.49 North London 17, Queensland Road Stairtreads defective, etc. Adjourned sine die. 16.2.49 North London 19, Queensland Road Floorboards broken, etc. Adjourned sine die. 16.2.49 North London 21, Queensland Road General defects Adjourned sine die. 16.2.49 North London 23, Queensland Road General defects Adjourned sine die. 16.2.49 North London 25, Queensland Road Roof defective, etc. Adjourned sine die. 16.2.49 North London 58, Bryant wood Road Main and back addition roofs leaking, etc. Abatement Order within 28 days. Costs £1 1s. 16.2.49 North London 61, Highgate Hill Front main roof leaking, etc. Firm no longer in existence. Summons withdrawn. 16.2.49 North London 33, Westbourne Road Main roof leaking, etc. Abatement Order within 42 days. Costs £1 1s. 16.2.49 North London 69, Bride Street Roof leaking, etc. Abatement Order within 42 days. Costs£1 1s. 18.2.49 Clerkenwell 152, Cloudesley Road General defects Abatement Order within 28 days. Costs £3 3s. 18.2.49 Clerkenwell 152, Cloudesley Road General defects Abatement Order within 28 days. Costs £3 3s. 25.2.49 Old Street 393, New North Road Roof leaking, etc. Abatement Order within 28 days. Costs £3 3s. 3.3.49 Clerkenwell 23, Tilloch Street General dilapidations in Basement. Abatement Order within 28 days. Costs £2 2s. 3.3.49 Clerkenwell 87, Caledonian Road Fire range broken, dampness, etc. Work completed. Costs £2 2s. 3.3.49 Clerkenwell 31, Wharfdale Road Main roof defective, etc. Work completed. Costs £2 2s. 9.3.49 North London 2, Northampton Grove Leaking roof, etc. Abatement Order within 28 days. Costs £1 1s. 9.3.49 North London 4, Northampton Grove Leaking main roof, etc. Abatement Order within 28 days. Costs £1 1s. 9.3.49 North London 24, Burder Road Leaking main roof, etc. Abatement Order within 21 days. Costs £1 1s. 9.3.49 North London 3, Northampton Grove Leaking main roof, etc. Abatement Order within 28 days. Costs £1 1s. 24 Public Health (London) Act, 1936 (216 Cases). Date of Hearing and Court Address Offence Result of Proceedings 9.3.49 North London 7, Witley Road Roofs leaking, etc. Abatement Order within 42 days' £1 1s. Costs. 9.3.49 North London 2, St. John's Way Broken and fallen wallplaster. Summons not served Case withdrawn. 9.3.49 North London 19, Havelock Street Dampness, etc. Work completed. Costs£1 1s. 9.3.49 North London 1, Fortnam Road Defective main roof Abatement Order within 28 days. Costs £1 1s. 9.3.49 North London 5, Dignum Street Main roof defective, etc. Abatement Order within 14 days. Costs £1 1s. 9.3.49 North London 24, Mitchison Road Leaking main and back addition roofs, etc. Work completed. Costs £1 1s. 9.3.49 North London 56, Mildmay Street Dampness, etc. Work completed. Costs £1 1s. 9.3.49 North London 146, St. Pauls Road Leaking main roof, etc. Abatement Order within 28 days. Costs £1 1s. 9.3.49 North London 75, Benwell Road Main roof defective, etc. Work completed. Summons withdrawn. 16.3.49 Clerkenwell 43, Balfe Street Dampness, etc. Abatement Order within 7 days. Costs £1 1s. 30.3.49 North London 60, Andover Road Main roof leaking, etc. Work completed. Summons withdrawn. 30.3.49 North London 47, Bride Street Dampness, etc. Adjourned sine die. 30.3.49 North London 23, Burder Road Roof leaking, etc. Abatement Order within 28 days. Costs £1 1s. 30.3.49 North London 12, Pemberton Terrace Dampness, etc. Abatement Order within 28 days. 31.3.49 Clerkenwell 53, Treaty Street Dampness, etc. Work completed. Costs £2 2s. 31.3.49 Clerkenwell 63, Killick Street (1) Dampness, etc. (1) Work completed. Costs £1 1s. (2) Defective firegrate, etc. (2) Work completed. Costs £1 1s. (3) Defective floorboards, etc. (3) Work completed. Summons withdrawn. 8.4.49 Old Street 6, Dagmar House Crumbling wallplaster Abatement Order within 28 days. Costs £2 2s. 11.4.49 North London 30, Storey Street Dampness, etc. Abatement Order within 14 days. Costs £2 2s. 11.4.49 North London 309, Hornsey Road Dog kept as to be a nuisance Abatement of nuisance ordered. Defendant instructed to keep the dog in question in her own premises. 9.5.49 North London 1, Camden Lane General dilapidations Work completed. Costs £1 1s. 9.5.49 North London 5, Cathcart Hill Main roof leaking and general dilapidations. Work completed. Costs £1 1s. 9.5.49 North London 133, J unction Road Dampness and general dilapidations. Abatement Order within 28 days. Costs £1 1s. 13.5.49 Old Street 24, Almeida Street General dilapidations Abatement Order within 28 days. Costs £1 1s. 23.5.49 North London 28, Clarence Terrace Failure to comply with an Abatement Order, dated 16th February, 1949. Fined £10. Costs £2 2s. 23.5.49 North London 141, Bemerton Street Failure to comply with an Abatement Order dated 16th February, 1949. Work completed. Costs £1 1s. 25 Public Health (London) Act, 1930 (216 Cases). Date of Hearing and Court Address Offence Result of Proceedings 8.6.49 North London 53, Hillmarton Road Defective wallplaster Abatement Order within 28 days. Costs £2 2s. 8.6.49 North London 53, Hillmarton Road Dampness, etc. Abatement Order within 28 days. Costs £2 2s. 8.6.49 North London 53, Hillmarton Road Defective window Abatement Order within 28 days. Costs £2 2s. 8.6.49 North London 19, Barnsbury Grove General defects Abatement Order within 28 days. Costs £2 2s. 10.6.49 North London 55, Calverley Grove General dilapidations Abatement Order within 28 days. 10.6.49 North London 189, Fairbridge Road General dilapidations Adjourned sine die. 10.6.49 North London 30, Medina Road Dampness, etc. Abatement Order within 28 days. Costs £1 1s. 10.6.49 North London 63, Huntingdon Street Defective wallplaster No Abatement Order to be made; property changed hands. Costs £1 1s. 10.6.49 North London 256, Sussex Way Defective wallplaster and dampness. Work completed. Costs £1 1s. 14.6.49 North London 50, Ireton Road Defective floorboards Work completed. Costs £1 1s. 1 4.0.4!) North London 23, Comus Road Defective wallplaster Abatement Order within 14 days. Costs £1 1s. 14.6.49 North London 32, Hargrave Road Leaking roof Abatement Order within 42 days. Costs £1 1s. 14.6.49 North London 134, Huddleston Road Dampness Abatement Order within 14 days. Costs £1 1s. 14.6.49 North London 50, Ireton Road Defective firerange Work completed. Costs £1 1s. 14.6.49 North London 18, Macdonald Road General defects Abatement Order within 28 days. Costs £1 1s. 14.6.49 North London 7, Witley Road Failure to comply with an Abatement Order dated 9th March, 1949. Fined £5. Costs £1 1s. 22.6.49 Clerkenwell 33, Wynford Road Dampness, etc. Abatement Order within 14 days. Costs £1 1s. 22.6.49 Clerkenwell 12, Fife Terrace Defective walls and ceilings Adjourned sine die. 27.6.49 Old Street 166, Liverpool Road Broken sashcords, etc. Abatement Order within 21 days. Costs £2 2s. 27.6.49 Old Street 172, Liverpool Road Leaking roof. Abatement Order within 21 days. Costs £2 2s. 27.6.49 Old Street 172, Liverpool Road Defective flooring Abatement Order within 28 days. Costs £2 2s. 27.6.49 Old Street 393, New North Road Failure to comply with an Abatement Order dated 25th February, 1949. Fined £30. Costs £5 5s. 4.7,49 North London 2, Brookside Place Dampness Work completed. Costs £1 1s. 4.7.49 North London 31, Hampden Road Wallplaster defective, etc. Work completed. Costs £1 1s. 4.7.49 North London 109, Pembroke Street Roof defective, dampness, etc. Abatement Order within 42 days. Costs 10s. 6d. 4.7.49 North London 56, Gifford Street General dilapidations Abatement Order within 42 days. 4.7.49 North London 40, Tilloch Street General defects Abatement Order within 28 days. Costs £1 1s. 26 Public Health (London) Act, 1930 (210 Cases). Date of Hearing and Court Address Offence Result of Proceedings 4.7.49 North London 54, Gifford Street General dilapidations Abatement Order within 42 days. 4.7.49 North London 175, Offord Road Dampness, etc. Abatement Order within 28 days. Costs 10s. 6d. 4.7.49 North London 6, Huntingdon Street General defects Case withdrawn. 4.7.49 North London 173, Offord Road Roof leaking Abatement Order within 28 days. Costs 10s. 6d. 12.7.49 North London 4, Grosvenor Avenue Roof defective, etc. Abatement Order within 42 days. Costs £1 1s. 12.7.49 North London 18b, Highbury New Park Dampness, etc. Work in 'progress. Summons withdrawn. 12.7.49 North London 16, Clarence Terrace Roof leaking, etc. Work completed. Summons withdrawn. 12.7.49 North London 68, Mackenzie Road Roof leaking, dampness, etc. Adjourned sine die. 12.7.49 North London 22, Story Street General defects Abatement Order within 28 days. Costs £1 1s. 12.7.49 North London 109, Durham Road Roof leaking, etc. Work completed. Summons withdrawn. 12.7.49 North London 29, Ponder Street General defects Abatement Order within 28 days. Costs £1 1s. 12.7.49 North London 30, Tollington Road General defects Work completed. Summons withdrawn. 12.7.49 North London 35, Roden Street Dampness, etc. Work completed. Summons withdrawn-. 12.7.49 North London 53, Pooles Park General defects Abatement Order within 42 days. Costs £1 1s. 12.7.49 North London 28, Brewery Road Defective ceiling plaster Work completed. Costs 10s. 6d. 12.7.49 North London 28, Brewery Road Defective ceiling plaster Work completed. Summons withdrawn. 12.7.49 North London 28, Brewery Road Rear addition roof leaking, etc. Abatement Order within 28 days. Costs 10s. 6d. 12.7.49 North London 58, Bryantwood Road Failure to comply with an Abatement Order dated 16th February, 1949. Adjourned sine die. 25.7.49 North London 55, Bride Street General defects Adjourned sine die. 8.8.49 North London 22, Richmond Crescent Leaking roof, etc. Abatement Order within 28 days. Costs £2 2s. 10.8.49 Clerkenwell 11, Half Moon Crescent Defective roof, etc. Abatement Order within 21 days. Costs 10s. 6d. 15.8.49 North London 31, Boleyn Road General defects Work completed. Summons withdrawn. 22.8.49 North London 26, Tilloch Street Leaking roof, dampness, etc. Defendant deceased. Summons not served. 22.8.49 North London 35, Beresford Road Dampness ceiling plaster defective, etc. Abatement Order within 14 days. 22.8.49 North London 556, Caledonian Road Walls wet, ceiling plaster broken and fallen, etc. Abatement Order within 21 days. Costs £1 1s. 13.9.49 Clerkenwell 35, Culpeper Street Dampness, etc. Abatement Order within 14 days. Costs £1 1s. 13.9.49 Clerkenwell 59, Wynford Road Defective flooring Summons withdrawn 27 Public Health (London) Act, 1930 (216 Cases). Date of Hearing and Court Address Offence Hesult of Proceedings 14.9.49 Old Street 4, Dagmar House Perished walls and ceiling plaster. Abatement Order within 14 days. Costs £1 1s. 14.9.49 Old Street 5, Carleton House Leaking roof and dampness Abatement Order within 21 days. 22.9.49 North London 88, Carleton Road Dampness, etc. Abatement Order within 14 days. Costs/1 1s. 22.9.49 North London 507, Caledonian Road Accumulations of miscellaneous articles, decomposing rationed lats, etc., and floor and walls dust covered, etc. Abatement Order within 7 days. Costs £1 1s. 22.9.49 North London 26, Brewery Road Roof leaking and walls damp Abatement Order within 28 days. Costs £1 1s. 22.9.49 North London 26, Hargrave Park Main roof leaking ... Abatement Order within 28 days. 22.9.49 North London 71, Roden Street Rising dmapness, walls and ceiling dirty, etc. Abatement Order within 21 days. Costs £1 1s. 22.9.49 North London 31, Medina Road Rising dampness, wallplaster perished, etc. Abatement Order within 28 days. 22.9.49 North London 26, Hargrave Park Basement wallplaster broken and fallen, etc. Abatement Order within 28 days. 22.9.49 North London 27, Pemberton Gardens Side annex roof defective, dampness, pointing perished, etc. Work completed. Summons withdrawn. Costs £1 1s. 22.9.49 North London 26, Brookside Road Top floor front room and Landing in filthy condition. Work completed, summons withdrawn. 22.9.49 North London 4, Coinus Road General defects Abatement Order within 28 days. Costs £1 1s. 26.9.49 North London 117, Bemerton Street Roof leaking, dampness, etc. Work completed. Summons withdrawn. Costs £2 2s. 26.9.49 North London 33, Anatola Road Defective guttering and dampness. Abatement Order within 14 days. Costs £1 1s. 26.9.49 North London 23, Barnsbury Grove General defects Abatement Order within 35 days. Costs £1 1s. 26.9.49 North London 41, Westbourne Road Leaking roof, dampness, etc. Abatement Order within 35 days. Costs £1 1s. 26.9.49 North London 17, Barnsbury Grove Dampness ... Abatement Order within 28 days. Costs £1 1s. 26.9.49 North London 529, Liverpool Road Main roof leaking and general defects. Summons dismissed. Statutory period of six months elapsed. 26.9.49 North London 531, Liverpool Road Roof leaking and general defects. Summons dismissed —statutory period of six months elapsed. 29.9.49 Old Street 3, Carmarthen Street Defective window frame ... Work completed. Summons withdrawn. Costs £1 1s. 6.10.49 North London 106, Bemerton Street Broken wallplaster, dampness and general defects. Adjourned sine die. 7.10.49 North London 41, Tilloch Street Leaking roof and dampness Abatement Order within 28 days. Costs £1 1s. 7.10.49 North London 3, Corporation Street Dampness and defective wallplaster. Abatement Order within 28 days. Costs £1 1s. 7.10.49 North London 42, Gilford Street General dilapidations Abatement Order within 28 days. Costs £1 1s. 28 Public Health (London) Act, 1036 (216 Cases). Date of Hearing and Court Address Offence Result of Proceedings 7.10.49 North London 24, Hartham Road Dampness and perished wallplaster. Abatement Order within 56 days. Costs £1 1s. 7.10.49 North London 42, Ponder Street Dampness and dirty conditions. Abatement Order within 21 days. Costs £1 1s. 7.10.49 North London 146, St. Pauls Road Failure to comply with an Abatement Order dated 9th March, 1949. Defendant fined £ 10. Costs £1 1s. 7.10.49 North London 40, Tilloch Street Failure to comply with an Abatement Order dated 4th July, 1949. Defendant fined £5. 10.10.49 North London 5, Luard Street Roof leaking, dampness, etc. Abatement Order within 42 days. 20.10.49 North London 105, Marlborough Road Defective roofs, dampness, etc. Abatement Order within 21 days. Costs£1 1s. 21.10.49 Old Street 1, Carleton Terrace Dampness, rotted and broken floorboards, etc. Abatement Order within 28 days. Costs£1 1s. 2.11.49 North London 19, Barnsbury Grove Failure to comply with an Abatement Order dated 8th June, 1949. Defendant fined £106. Penalty reduced to £53 on Appeal, and costs of £1 7s. imposed. 16.11.49 North London 20, Ward Road General defects Adjourned sine die. 16.11.49 North London 11, Oatlands Mansions, Bewdley Street. Open hopper head causing smell nuisance, and loose parting bead to window. Summons withdrawn 16.11.49 North London 20, Northampton Grove Main roof leaking, etc. Work completed. Costs £2 2s. 16.11.49 North London 20, King Henry's Walk Plaster damp and perished, broken floorboard, concrete floor broken, etc. Work completed. Costs £2 2s. 16.11.49 North London 30, Kingsdown Road Broken and fallen wallplaster. Summons withdrawn 18.11.49 Old Street 9, Bampton House, Pleasant Place. Main roof leaking ... Work completed. Summons withdrawn. 23.11.49 North London 4, Corporation Street Dampness, defective wallpiaster, firegrate, etc. Work completed. Costs 10s. 6d. 23.11.49 North London 9, Luard Street Main roof defective, dampness, etc. Abatement Order within 42 days. Costs £1 1s. 23.11.49 North London 42, Tilloch Street Roof leaking, dampness, etc. Abatement Order within 28 days. Costs £1 1s. 23.11.49 North London 14, Luard Street Roof leaking, dampness, absence of sink, etc. Abatement Order within 42 days. Costs £1 1s. 23.11.49 North London 17, Luard Street Roof leaking, dampness, floorboards loose, perished wallplaster, etc. Abatement Order within 42 days. Costs £1 1s. 28.11.49 North London 147, Southgate Road Defective floorboards, perished wallplaster, broken handrail and banisters, etc. Adjourned sine die. 28.11.49 North London 19, Bishops Grove Damp and crumbling wallplaster, damp walls. Work completed. Costs £1 1. 28.11.49 North London 29, Boleyn Road Defective firegrate and fireranges, plaster broken, etc. Abatement Order within 28 days. Costs 10s. 6d. 28.11.49 North London 33, Boleyn Road Dampness, plaster perished, etc. Work completed. Summons withdrawn. Costs 10s. 6d. 28.11.49 North London 35, Boleyn Road Defective guttering, dampness, etc. Abatement Order within 28 days. Costs 10s. 6d. 28.11.49 North London 35, Boleyn Road Dampness, perished wallplaster, broken sashcords, etc. Abatement Order within 28 days. Costs 10s. 6d. 29 Public Health (London) Act, 1936 (216 Cases). Date of Hearing and Court Address Offence Result of Proceedings 28.11.40 North London 37, Boleyn Road Leaking main and back addition roofs, dampness, defective window sills, waste pipe, etc. Abatement Order within 28 days. Costs 10s. 6d. 28.11.49 North London 39. Boleyn Road Leaking main roof, valley gutter, dampness, etc. Abatement Order within 28 days. Costs 10s. 6d. 30.11.49 Old Street 46, Arlington Avenue Defective flue and broken wallplaster. Work completed. Case not proceeded with. 30.11.49 Old Street 19, Brooksby Street General defects Work completed. Costs £3 3s. 30.11.49 Old Street 34, Brooksby Street Leaking gutter, broken sashcords, dirty walls and ceilings, etc. Work completed. Costs £3 3s. 30.11.49 Old Street 3, Dagmar House Perished and broken wallplaster. Abatement Order within 21 days. Costs £3 3s. 30.11.49 Old Street 15, Dagmar House Dampness due to leaking roof. Adjourned sine die. 30.11.49 Old Street 86, Morton Road Defective wallplaster, floorboards, etc. Abatement Order within 28 days. 30.11.49 Old Street 13, Oakley Road Main roof leaking, dampness, wallplaster perished, etc. Work in progress— Summons withdrawn. Costs £3 3s. 1.12.49 North London 32, Anson Road General defects Abatement Order within 28 days. Costs £1 1s. 1.12.49 North London 15, Cathcart Hill General defects Abatement Order within 28 days. Costs £1 1s. 1.12.49 North London 36, Tilloch Street General dilapidations Work completed. Costs £1 1s. 1.12.49 North London 85, Cornwallis Road Bulged and broken ceiling plaster. Abatement Order within 21 days. Costs £1 1s. 1.12.49 North London 9, Havelock Street General dilapidations Work in progress. Order obtained against Agent of premises — no further action (see below). 1.12.49 North London 9, Havelock Street General dilapidations Abatement Order within 42 days. Costs 10s. 6d. 1.12.49 North London 21, Havelock Street General dilapidations Work in progress. Order obtained against Agent of premises — no further action (see below). 1.12.49 North London 21, Havelock Street General dilapidations Abatement Order within 50 days. Costs 10s. 6d. 1.12.49 North London 47, Havelock Street Roof leaking, dampness, etc. Summons not served. Case not proceeded with. 1.12.49 North London 26, Parolles Road Defective eaves gutter Abatement Order within 28 days. Costs 10s. 6d. 1.12.49 North London 26, Parolles Road Defective main roof, dampness, etc. Abatement Order within 28 days. Costs 10s. 6d. 1.12.49 North London 28, Richmond Crescent Broken sashcords, accumulation of refuse matter on attic floor, etc. Work completed. Summons withdrawn. 5.12.49 North London 6, Highbury Hill Absence of water supply Summons withdrawn 5.12.49 North London 78, Englefield Road Main roof leaking, dampness and general defects. Summons withdrawn 5.12.49 North London 29, North Road Defective wallplaster, dampness, etc. Abatement Order within 28 days. Costs£1 1s, 30 Public Health (London) Act, 1930 (210 Cases). Date of Hearing and Court Address Offence Result of Proceedings 5.12.49 North London 13, Ockendon Road Main roof leaking, defective plaster, floorboards, etc. Summons withdrawn 5.12.49 North London 2, Stanmore Street Ropf .leaking, dampness, etc. Abatement Order within 28 days. Costs 10s. Od. 9.12.49 Clerkenwell 175, Copenhagen Street Roofs leaking, dampness, etc. Work completed. Summons withdrawn. 9.12.49 Clerkenwell 175, Copenhagen Street Roofs leaking, dampness, etc. Work completed. Summons withdrawn. 14.12.49 Old Street 17, St. Pauls Street Dampness, bulged wallpiaster, etc. Abatement Order within 28 days. Costs £2 2s. 14.12.49 Old Street 25, St. Pauls Street Leaking main roof, dampness, broken wall and ceiling plaster, etc. Work completed. Summons withdrawn. 14.12.49 Old Street 53, Oakley Road Dampness, etc. Work completed. Costs £2 2s. 14.12.49 Old Street 38, Linton Street Leaking roof, dampness and perished wallplaster. Work completed. Costs £2 2s. 19.12.49 North London 7, Witley Road Failure to comply with an Abatement Order dated 9th March, 1949. Defendant fined £1. 19.12.49 North London 54 Gilford Street Failure to comply with an Abatement Order dated 4th July, 1949. Defendant fined £5. 19.12.49 North London 50. Gifford Street Failure to comply with an Abatement Order dated 4th July, 1949. Defendant fined £!i. 19.12.49 North London 44, Frederick Street Dampness, etc. Abatement Order within 28 days. 19.12.49 North London 173, Offord Road Failure to comply with an Abatement Order dated 4th July, 1949. Defendant fined £!i. 19.12.49 North London 173, Offord Road Broken ceiling plaster Abatement Order within 28 days. Costs £1 1s. 19.12.49 North London 9,TillochStreet Roof leaking, dampness, etc. Work completed. Costs £l1s. 19.12.49 North London 222, York Way Defective wallplaster, roof leaking, etc. Work completed. Costs £1 1s. L.C.C. Bye-Laws. 22.8.49 North London 100, Bemerton Street Failure to comply with the provisions of L.C.C. ByeLaws 14 (a) and (c), 17 (a), (c) and (d), 18 (c), and 25, dated 20th October, 1938, relating to Lodging Houses. Summons withdrawn Disinfection and Disinfestation. Again during the year D.D.T. (dichlor-diphenyl-trichlorethane) as a powder (10 per cent. D.D.T. in Kaolin) or in solution (5 per cent. in Kerosene) was used for the purpose of disinfestation of rooms in respect of bugs and other insect pests. The results proved very satisfactory and no reinfestations were reported. In a few cases, however, where it was considered that early redecoration had diminished or destroyed the residual action of the D.D.T., the premises were re-treated. The free treatment of rooms and furniture in recommended cases continued and the number so treated was 215, most of these being on behalf of elderly and infirm persons. 31 A total of 1,393 rooms were disinfestecl for vermin. During the year 1,512 rooms were disinfected after cases of infectious or other diseases. The precautionary spraying of furniture and bedding of families removing to Council or other new dwellings was continued and the effects of 285 families were treated:— 257 in respect of tenants moving into Council property. 28 in respect of tenants moving into flats owned by private housing trusts. It is the practice to spray with D.D.T. solution the furniture and premises of families removing to new Council properties before removal. The new premises are also sprayed soon after occupation in order to ensure that both the furniture and rooms are free from infestation for at least a month. Steam disinfection. 126,232 articles of clothing of clothing or bedding were subjected to steam disinfection at the disinfecting station (117,018 for Clothing Contractors). In addition, 47 tons 1 cwt. of material, for Clothing Contractors, were disinfected prior to export, when a certificate of disinfection is required by the authorities concerned. Public Health (London) Act, 1936—Emission of Smoke. The Council appointed two representatives to serve on the London and Home Counties Smoke Abatement Advisory Council. Consequent upon the control of fuel, difficulty continued in the enforcement of Part V of the Public Health (London) Act, 1936. With the co-operation of the proprietors and staff of the factories concerned, smoke nuisances were kept to a minimum during the year. A complaint was received from residents in the vicinity of one factory, in respect of the emission of dust from a boiler chimney due to forced draught and coke fuel. Arrangements were made for the Sanitary Inspector to meet representatives of the Ministry concerned, and suitable facilities were afforded the Company to purchase an appropriate grade of coal. The nuisance was abated. In this connection thanks are due to the Ministry of Fuel and Power for its active co-operation. Whilst appreciating the difficulties of fuel control, the Ministry has always afforded every facility within its power to assist the Council in the problems of smoke abatement and, by personal attendance of its representatives and also by advice, the problems have been discussed and smoke emission kept to a minimum. Number of Complaints received during the year 54 Number of Observations made 102 Number of Inspections and re-visits 93 Number of Notices Served 4 Number of Notices complied with 3 32 WORK OF SANITARY INSPECTORS ADMINISTERING FACTORIES ACT, 1937, FOOD AND DRUGS ACT, 1938, AND OTHER RELEVANT ACTS. Inspections and Re-Visits. 6,021 inspections and 3,666 re-visits were made by the Inspectors. These are summarised as follows:— Inspections Revisits Dining rooms, hotel and restaurant kitchens and refreshment rooms 911 388 Stalls (Refreshment and Food) 34 18 Factories (Mechanical) 1,635 1,100 Factories (Non-mechanical) 548 284 Factories (Public Health (London) Act, 1936) 735 1,046 Fish curers 24 16 Fishmongers 58 18 Fried Fish Shops 125 109 Half Way Houses 3 2 Noise Nuisances 53 21 Outworkers 116 44 Provisions Shops 123 79 Special Inspections (Food licences) 260 — Bakehouses (Level) 171 147 Confectioners 106 92 Food Factories 56 — Fruiterers/Greengrocers 106 105 Markets 59 6 Preserved food premises 900 191 6,021 3,666 (Sec separate section for underground bakehouses and offensive trades.) Defects, nuisances or contraventions found. Nuisances and Notices. (a) Factories Act, 1937. Number of contraventions found 2,187 Number of contraventions remedied 1,661 Notices served 308 Notices complied with 258 (b) Food and Drugs Act, 1938. Number of contraventions found 2,813 Number of contraventions remedied 2,728 Notices served 511 Notices complied with 513 (c) Public Health (London) Act, 1936. Number of contraventions found 948 Number of contraventions remedied 921 Notices served 397 Notices complied with 420 (d) Rats and Mice Destruction Act, 1919. Notices served 2 Notices complied with 2 Complaints received. Number of complaints (General) 302 Number of complaints (Home Office) 41 33 Factories Act, 1937. Prescribed particulars on the administration of the Factories Act, 1937. 1.—Inspections for purposes of provisions as to health (including inspections made by Sanitary Inspectors). Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 403 548 83 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,669 1,635 234 (iii) Other Premises in which Section 7 is enforced by the Local Authority* (excluding out-workers' premises) Total 2,012 2,183 317 — 2.—Cases in which Defects were Found. Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) 141 98 1 8 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) 13 10 2 1 — Inadequate ventilation (S.4) 24 10 2 1 — Ineffective drainage of floors (S.6) 5 — — — — Sanitary Conveniences (S.7)— — (a) insufficient 32 39 — 3 — (b) Unsuitable or defective 1,142 1,064 — 18 — (c) Not separate for sexes 16 7 — — — Other offences against the Act (not including offences relating to Outwork) 820 464 43 1 — Total 2,193 1,692 48 32 — * i.e. Electrical Stations (Section 103(1)), Institutions. (Section 104) and sites of Building Operations and Works of Engineering Construction (Sections 107 and 108). 34 Outwork. (Sections 110 and 111) Nature of Work Section 110 Section 111 No. of outworkers in August list required by Sec. 110 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions (1) (3) (4) (5) (6) (7) (8) Wearing apparel Making, etc. 673 Cleaning and washing Lace, lace curtains and nets 1 Furniture and upholstery 32 Fur pulling 4 Umbrellas, etc. 15 Artificial flowers 100 Nets, other than wire nets 1 Paper bags 3 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 56 Brush making 12 Feather sorting 21 Carding, etc., of buttons, etc. 17 Stuffed toys 72 Basket making 3 Chocolates and sweetmeats 46 Cosaques, Christmas crackers, Christmas stockings, etc. 38 Lampshades 11 Total 1,105 1 Public Health (London) Act, 1936, L.C.C. (General Powers) Act, 1937, Noise Nuisance. During the year under review repeated complaints were received in respect of a noise nuisance from a Glass Factory. The complaints were found to be justified, particularly after normal working hours and at weekends. The factory was working to full capacity day and night without cessation, and the roar of the furnace burners, the dropping of the moulds on the metal benches, and the humming of the fans at nights and weekends were a real source of nuisance to residents within a few yards of the factory premises. Day and night inspections were made by the Inspectors, and the Council obtained the opinion of a Consultant Engineer, who was an expert in furnace construction, in order that steps could be taken to mitigate the noise nuisance. Negotiations were still in progress at the end of the year. Public Health (London) Act, 1936—Offensive Trades. During the year the Council approved the establishment anew of the trade of a fat melter in respect of one address. Another trade, namely that of a fur skin dresser, was discontinued. 35 The offensive trades operating in the Borough are, therefore, as follows:— (a) Three Tripe Boilers. (b) One Knacker. (c) One Fur Skin Dresser. (d) Six Gut Scrapers. (e) One Fat Melter. 148 inspections and visits were made and appropriate action taken where necessary. Pharmacy & Poisons Acts, 1933/41. During the year a large number of applications to sell poisons from food shops continued to be received and, owing to the storage space in all cases being limited, the Public Health Committee were perturbed at the danger of possible contamination of food. In the majority of cases it was desired to sell pre-packed disinfectants, ammonia, etc. The person listed actually becomes entitled to sell all Part II poisons, including arsenical substances, spirits of salts, zinc sulphide etc., and is permitted to break bulk and re-pack certain of them. In view of the concern felt regarding the sale of poisons in some premises where it appeared there might be some incompatibility with other trades, the question was referred by the Council for the consideration of the Metropolitan Boroughs Standing Joint Committee. A good deal of consideration was given to this matter but it was finally felt that all applications for registration under the Pharmacy & Poisons Act, 1933, would have to continue to be dealt with under existing powers. Number of visits and inspections 394 Number of sellers of Part II poisons other than registered pharmacists:— 1.1.49—30.4.49 198 1.5.49—31.12.49 201 Number of initial inspections during the year 28 Number of samples taken 20 Number of samples unsatisfactory NIL. Underground Bakehouses. The number of underground bakehouses in respect of which a certificate of suitability continued to be in force pursuant to Section 54 of the Factories Act, 1937, was 39. Having regard to the fact that in 1938 there were 121 such bakehouses it will be seen that the number has considerably decreased. This is all to the good, for many of the bakehouses were in a very poor condition and the occupiers found that it was more economic to close them. Details relevant to the existing bakehouses are as follows:— Number of routine inspections 145 Number of re-visits 285 Number of Notices served 31 Number of Notices complied with 22 36 Shops Act, 1934. Owing to certain re-organisation of the duties of the Sanitary Inspectors, visits paid under the Shops Act are made by the same officer and at the same time as visits necessary under the Food and Drugs Act, 1938, etc., Number of Inspections under this Act 169 Number of re-visits 97 Rats and Mice Destruction Act, 1919. Infestation Order, 1943. During the year under review the expenses incurred in respect of the work carried out by the Rodent Control Section continued to rank for the 50 per cent. grant from the Ministry of Agriculture and Fisheries. In July the Prevention of Damage by Pests Act, 1949, received royal assent, although this statute does not come into force until 31st March, 1950. Details of the work performed are given as follows:— 1. Number of complaints received 1,499 2. Number of investigations carried out 5,720 3. Number of infestations found 2,099 (comprising 189 Business premises and 1,910 Dwellings) 4. Number of smoke tests on drains 151 Treatments carried out were:— Dwellings 1,910 with 12,943 baits being laid Business Premises 67 with 603 baits being laid Post bait treatments in respect of dwellings and business premises 462 with 4,313 baits being laid 2,439 17.859 Bombed sites. Test baited only. The number of agreements sent out 84 The number of agreements returned 70 Percentage of Ship Rats : 1½ per cent. of complaints received. It will be noted that many business firms did not avail themselves of the Council's facilities but, in these cases, their own staff, or a specialist firm, was engaged to carry out disinfestation. In such instances the treatments were followed up in order to ensure that they were satisfactory. Whilst many cases of rat infestation present no difficulty and, after treatment being carried out, the premises are cleared of rats, others require considerable carc and attention. This is particularly so where disused drains exist in respect of which no records can be traced. One such case is still under observation. In another instance it was necessary for 41 visits to be paid, where it was eventually found that the source of the trouble was an old brick barrel drain, reconstruction of which resulted in the premises being rat free. One of the hospitals in the Borough was successfully treated in respect of a heavy infestation of mice. An infestation of rats occurred in one portion of the Council's Cemetery at East Finchley. This was successfully dealt with conjointly with the Officials of the Finchley Borough Council and eventually cleared, 37 Sewer Treatments. Treatments of sewers were carried out on two occasions. The co-operation of the Borough Engineer's staff in relation to these treatments was appreciated. Details of the treatments are as follows:— 13th June to 23rd June, 1949. Manholes Baited Complete takes Partial takes No takes Bodies seen Percentage of poison takes Estimated kill 756 313 542 214 14 CT PT NT 4,005 5.1% 84.7% 10.2% 5th to 15th December, 1949. Manholes baited Complete takes Partial takes No takes Bodies seen Percentage of poison takes Estimated kill 758 399 580 178 15 CT PT NT 5,310 13% 83.5% 35% Water Supplies. The Metropolitan Water Board is responsible for all main water supplies in the Borough and samples of water, as supplied by the Board, were taken during the year and found to be satisfactory. Thanks are due to the Metropolitan Water Board for its co-operation and whole-hearted assistance during the year. Upon a complaint being received in respect of numerous organisms infesting a storage tank in one of the Council's prefabricated bungalows, the case was referred to the Metropolitan Water Board who, after the receipt of a report from the Board's representative, reported that the organisms had been identified as "spring tails" (Isotoma Palustris). The cistern in question was situated above the hot water system. The particular feature in this case was the fact that partially submerged in the water was a heavily gummed label, which was covered with "spring tails," and it appeared from the results of the Board's investigations that the label provided most of the nutritional needs for their multiplication. The cistern was cleaned out, disinfected and properly covered, and no further trouble has arisen. The number of bore holes, including wells known to exist in the Borough is 28, 18 of which have been abandoned, leaving 10 bore holes capable of being used. One of these was out of commission during the year, and samples from the remaining 9 were taken for chemical and bacteriological examination. From the reports received, and as none of the water from these bore holes is used for dietetic purposes, the position in regard to underground water in the Borough is satisfactory. In accordance with the requirements of Section 95 of the Public Health (London) Act, 1936, 30 applications for Water Certificates were received and 30 Certificates were issued in respect of 019 premises. 38 The following samples were taken:— Mains Supply. Chemical Bacteriological Satisfactory Unsatisfactory Chemical Bacteriological Chemical Bacteriological 3 3 3 3 Well Water. Chemical Bacteriological Satisfactory Unsatisfactory Chemical Bacteriological Chemical Bacteriological 9 9 9 9 — — Swimming Bath Water. Chemical Bacteriological Satisfactory Unsatisfactory Chemical Bacteriological Chemical Bacteriological 20 20 14 16 *6 *4 * The appropriate Authorities were informed and the necessary action taken. Requisitioned Property. Repairs, reconstruction or replacement of drainage and sanitary fitments have continued to be supervised in properties which have been requisitioned by the Council, to ensure, wherever practicable, compliance withe Statutory requirements. SECTION D. HOUSING. To a large extent, the houses in the Borough, due to their age and condition, present a major problem as emphasised in previous reports. Owners are reluctant to incur any expense in the repair of property which has proved to be uneconomic, and the relative provisions of the Public Health (London) Act, 1936, have been enforced to keep the houses free from serious nuisance. Overcrowding and the occupation of unfit underground rooms were the cause of much concern to the Council. It is still not practicable to assess the amount of overcrowding existing in the Borough, owing to the movement of the population and the absence of precise information. There is no doubt, however, that in common with other Metropolitan Boroughs, the attraction of employment within the London area is a contributary factor towards the creation of such conditions. Negotiations were in progress with the London County Council, in respect of a street of houses which were considered by the Council to be in such a condition as not to be repairable at a reasonable cost, as a result of which 16 houses in the street were surveyed and specifications relative to the same were priced. The question was still under discussion with the London County Council at the end of the year. The Housing Act, 1949, came into operation on the 30th July, the most important change, as far as this Department is concerned, being the deletion of the words " working classes " from the relative Sections of the Housing Act, 1936. Number of new applications (L.C.C.) referred to this Department 2,776 Number of applications recommended on the grounds of serious ill-health 12 Number of above families living in overcrowded conditions 877 Number of families re-housed by the L.C.C. 344 Number of above families not living in overcrowded conditions 690 Total number of letters sent concerning housing conditions 3,256 39 During the year the following action was taken under the Housing Act, 1936. Section Number of Dwellings represented 9 NIL. 11 (unfit houses) 21 12 (parts of buildings) 27 12 (underground rooms) 18 Total 66 Resulting from these representations and like proceedings during the year, the following action was taken:— Section Action Number of Dwellings 11 Demolition Orders 8 11 & 12 Undertakings accepted... 2 12 Closing Orders made ... 18 (33 underground rooms) 12 Closing Orders made ... 31 (flats) 12 Undertakings accepted in respect of 4 basement rooms 2 12 Closing Orders made (Parts of dwellings) 2 Total. 63 Undertakings cancelled upon completion of the necessary work 2 Number of dwellings erected by the Council during the year (In addition the Council had the right of nomination to 55 flats erected by Housing Associations financially assisted by the Council) 252 Prosecutions. One prosecution was taken out during the year under Section 14 of the Housing Act, 1936, This was withdrawn owing to the premises being vacated. SECTION E—SUPERVISION OF FOOD. It was reported in the Annual Report for 1948 that the Council had agreed, in principle, to provide free of charge washing facilities in public conveniences. The primary object of this scheme was to encourage greater cleanliness among food handlers, particularly street traders, who have no convenient personal facilities. The Council were of the opinion, however, that it would be difficult in practice to confine such an offer to street food traders, and free washing facilities were therefore extended to include all members of the public who desired to avail themselves of this service. This scheme was implemented in April, 1949. The following table, provided by the courtesy of the Cleansing Superintendent, gives details of the number of persons who availed themselves of the Council's facilities. 40 Lavatory 1949 April May June July Aug. Sept. Oct. Nov. Dec. Total Archway Rd. (Men) 61 66 84 100 76 70 46 52 60 615 do. (Women) 20 12 12 14 12 20 20 13 20 143 Finsbury Pk. (Men) 17 26 17 10 20 18 11 18 15 152 do. (Women) 14 13 6 22 14 15 9 7 11 111 Parkhurst Rd. (Men) 71 41 22 55 51 43 26 19 16 344 do. (Women) 52 44 81 44 56 37 31 16 12 373 Highbury (Men) 9 5 15 15 14 15 14 13 14 114 do. (Women) 9 10 16 2 27 15 11 6 5 101 Offord Road (Men) 9 10 7 12 15 11 9 7 2 82 do. (Women) 8 4 4 2 5 5 Nil 1 4 33 High Street (Men) 16 7 24 18 17 12 11 9 11 125 Islington Gr. (Women) 8 Nil 4 6 20 10 11 7 7 73 294 238 292 300 327 271 199 168 177 2,266 Inspection of Refreshment and Coffee Stalls. Such refreshment and coffee stalls which open after normal working hours were subject to a periodical evening inspection. The Inspectors found the general conditions of these stalls to be satisfactory. Food and Drugs Act, 1938—Milk and Dairies Regulations, 1926/43. Sampling of Food, including Milk. Prosecutions. Details of the action taken by the Council under the Food and Drugs Act, 1938, and the Milk and Dairies Regulations, 1926/43, are as follows:— Food and Drugs Act, 1938. Date of hearing Offence Result of Proceedings Court 16.2.49 Providing bread not of the nature, substance and quality demanded. (Foreign matter, possibly lubricating grease from machinery, in bread). Fined £5 and costs £3 3s. North London 11.4.49 Exposing for sale a goose intended for, but unfit for human consumption. Fined £15 and costs £1 7s. North London 10.6.49 Selling fruit pie not of the nature, substance and quality demanded. (Beetle in pie). Dismissed under the P. of O. Act. Costs £5 5s. North London 26.9.49 Selling bread not of the nature, substance and quality demanded. (Nail in bread). Fined £2 and costs £2 2s. North London 21.10.49 Selling bread not of the nature, substance and quality demanded. (Foreign matter possibly lubricating grease from machinery, in bread). Discharged under Criminal Justice Act, 1948. Costs £& 3s. Old Street Food and Drugs Act. 1938. Milk and Dairies Regulations. 1926/43. 8.8.49 Failure to cause a vessel containing milk to be kept in a state of proper cleanliness. (M. & D. Regs., 1926/ 43, and Food and Drugs Act, 1938) Case dismissed North London It will be seen that five cases were taken under the Food and Drugs Act, 1938, and one case under the Food and Drugs Act, 1938, and the Milk and Dairies Regulations, 1926/43. 41 Unsound Food. The total weight of food condemned during the year was:— 54 tons, 5 cwt. 3 qrs. 12 lbs. 11½ ozs. details of which are given in the following table:— Tons Cwts. Otrs. Stones Lbs. Ozs. Tinned Goods 13 6 3 0 1 7½ Fish 2 5 2 1 5 — Fruit 8 2 - 1 4 — Meat 5 19 - 1 6 12 Others 24 12 — — 9 8 Total 54 5 3 0 12 11½ The number of condemnation certificates issued was 942. All the above food was condemned upon request by the owner. Sampling. 1,099 samples (434 formal, 665 informal) were submitted to the Public Analyst for examination. Of these 18 (or 1.64 per cent.) were adulterated as shown in the following summary:— Formal Informal Milk 2 Milk 3 Wheatflakes 1 Bread 2 Spaghetti 1 Wheatflakes 1 Spaghetti 1 Cherries (canned) 1 Sweets 1 Potted Meat 1 Chewing Gum 4 4 14 Of the formal samples taken, two milk samples were found to contain an addition of 2 per cent. and 1 per cent. of water, respectively, the wheatflakes were infested with small insects and the spaghetti contained rodent (probably mouse) excreta. Meat and Other Foods. The owners of five private slaughterhouses renewed their licences. None, however, was used during the year owing to the Government Scheme of centralised slaughtering. The Metropolitan Cattle Market, which is controlled by the Ministry of Food, was visited on 56 occasions by the Meat and Food Inspector for the purpose of inspecting imported and other meat. One slaughterhouse for horses was licensed. Slaughtermen's Licences. 21 Licences were granted, 1 new licence having been issued during the year. 42 Bye-Laws for the Protection of Food. No prosecutions were taken during the period under review. Registered Artificial Cream Premises. (At present dealing in Synthetic Cream). Number of visits—5. Ice Cream. Difficulty was experienced during the year in question in maintaining a satisfactory standard of ice cream at certain manufacturing premises and one in particular was the subject of a special investigation. It is very necessary that premises where ice cream is manufactured, stored or sold are kept under continued supervision, for it is evident that the personnel engaged in the manufacture and distribution of this commodity must, in addition to cleaning and sterilising the equipment used, maintain a high standard of personal hygiene. The manufacture and sale of ice lollies appears to be increasing. After some consideration it was decided to regard such ice lollies as coming within the definition of water ices, and premises for their manufacture and sale are required to be registered accordingly. During the year 1,021 visits were paid to ice cream premises. The number of premises registered:— (a) For manufacture/sale/storage 104 (b) For sale and storage 133 (c) For sale only 216 (d) For storage only 4 Total 457 Bacteriological Examination. 219 samples of ice-cream were sent for bacteriological examination. The gradings of those submitted to the Methylene Blue Test were reported to be as follows:— Grade I 60 Grade II 55 Grade III 54 Grade IV 47 Total 216 (Methylene blue test gradings in Grades I, and II are considered satisfactory products, Grades III and IV unsatisfactory.) Of the remaining 3 samples, one was found to be unsatisfactory. In addition 20 samples of Ice Lollies examined bacteriologically were reported to be satisfactory. Chemical Examination. 81 samples of ice cream were submitted for chemical analysis and none was found to be unsatisfactory. 80 of these samples were taken solely for the purpose of ascertaining fat content, as requested by the Ministry of Food (Circular MF.3/49 of 1st April, 1949), to whom returns of analyses were made. 43 The results were as under:— Fat Content Less Than— 3% 4% 5% 6% 7% 8% 9% 10% 11% 12% 13% 14% 15% 16% 6 6 4 7 10 5 11 15 13 1 — 1 1 — 11 Ice Lollie samples were also submitted for chemical analysis and no objection could be taken to results obtained. Milk Samples. The total number of samples taken during 1949 was 760. Samples submitted for Chemical Analysis:— Genuine Adulterated. Total Formal 422 2 424 Informal 118 3 121 Grand Total 545 8 samples of milk in transit were taken at a railway station in the Borough during the early hours of the morning. The samples gave satisfactory results and there was no evidence in respect of these samples of tampering in transit. Samples submitted for Bacteriological Examination:— Class of Milk Results Plate Count B. Coli Phosphatase Methylene Blue Turbidity Total No. of Samples Pasteurised Satisfactory 4 79 172 156 — 177 Unsatisfactory — — 5 21 — Heat treated Satisfactory — 3 7 7 — 7 Unsatisfactory — — — — — Sterilised Satisfactory — — 5 5 4 8 Unsatisfactory — — — — 1 Tuberculin Tested (Pasteurised) Satisfactory 1 2 5 5 — 5 Unsatisfactory — — — — — Tuberculin Tested (Raw) Satisfactory 12 9 13 18 Unsatisfactory 2 9 — 5 — Total 215 During the year 11 animal inoculations were carried out for tuberculosis tests. All were negative. The milks tested were:— Tuberculin Tested Raw 4 Pasteurised Milk 6 Heat treated milk 1 44 Milk (Special Designations) Regulations, 1936/48. Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, and The Milk (Special Designation) (Raw Milk) Regulations, 1949. The number of dairies and milk shops inspected 247 The following licences were granted:— Pasteurising Establishment 1 Pasteurised 146 Pasteurised (supplementary) 15 Tuberculin Tested 83 Tuberculin (supplementary) 8 Sterilised 201 Sterilised (supplementary) 8 Total 462 Milk and Dairies Regulations, 1949. Number of Dairies Registered in the Borough 131 Number of Distributors registered in the Borough 277 Number of Registered Distributors dealing from registered premises outside the Borough 24 Number of Pasteurisers 1 Summary of visits by Inspectors. Dairies—Routine Inspections 365 Miscellaneous visits 97 Milkshops (Milk sold in sealed containers only)— Routine Inspections 214 Miscellaneous visits 175 Vehicles Inspected. 101 Dairies and Milkshops—Inspections re special designated milk 247 Total number of inspections and miscellaneous visits 1,199 Number of Notices served 42 Diseases of Animals Acts. During the year no outbreak of foot and mouth disease occurred in the proximity of London which brought this Borough within the infected area, but the provision of the Swine Fever Order was brought into operation by the Ministry of Agriculture and Fisheries for a short period during the year. SECTION F—MISCELLANEOUS SERVICES. Aged & Infirm Persons. Since the National Health Service Act came into operation on 5th July, 1948, an increasing number of elderly infirm or sick persons have been referred to the Public Health Department for assistance in dealing with the various problems which have arisen. Section 47 of the National Assistance Act, 1948, provides for securing the necessary care and attention for 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 Medical Officer of Health may apply to a Court of Summary Jurisdiction for the removal of any such person on the grounds that it is in such person's interest or necessary for preventing injury to the health or serious nuisance to other persons. 45 Although this power is useful it was not found necessary to enforce the removal of a person under a Court Order in 1949. The main problems of elderly persons arise under other headings. The elderly chronic sick may, owing to shortage of hospital beds, have to wait many weeks or even longer before being admitted to a chronic sick bed after being placed on the waiting list. Many of these elderly persons must therefore remain at home under unsuitable circumstances even though willing to enter hospital, and suffer further physical and mental deterioration due to the fact that sufficient care and attention cannot be provided at home. The services of a Home Help and the District Nurse are useful, but obviously can only be part-time, and elderly persons frequently have no relative at all or no physically capable relatives to assist in their care. Many of them depend entirely upon the attentions and favours of good-hearted neighbours. In many cases there is some malnourishment as the persons are not able to prepare meals for themselves and assistance by others is only intermittent. Useful assistance for invalids (including elderly invalids) is given by the mobile meals service of the Invalid Kitchens of London, who provide a special dietary service for sick persons on medical recommendation. Another difficulty encountered is that there have been many instances of absence of medical attention for these elderly persons. Although they are of course entitled to medical attention under the National Health Service Act, a number of them have been found, when needing medical attention, not to have registered with any doctor. They are not aware of the minor formalities which have to be carried out in this connection and there may not be any person to act on their behalf. In such cases the officers of the Public Health Department have informally assisted by passing on the appropriate particulars of the person, such as the National Registration Number, etc., to the London Executive Council, but even there the difficulty does not necessarily end, since reliance must be placed upon a neighbour or other person to make the actual call for the doctor to attend. It is clear that there is a need for visitors such as those from an old people's welfare association to keep in constant touch with elderly persons who fluctuate so rapidly between a state of relative normal health and ill health. Public Mortuary. No bodies were received pending burial during the first quarter. By agreement with the St. Pancras Borough Council the use of the Council's Mortuary was discontinued as and from 31st March, 1949, all bodies being received at the St. Pancras Mortuary, Camley Street, N.W.I, after that date. Islington Crematorium. There were 211 cremations during the year at the Council's Crematorium, East Finchley, all of which were certified by the Medical Referee or Deputy Medical Referee. 46 Maternity & Child Welfare. Welfare Centres. WELFARE CENTRE Children's Ante-Natal and Post-Natal Immunisation Dental Vaccinatio North Islington Voluntary Welfare Centre, 6-9, Manor Gardens, N.7. Mon. to Fri. 1.45 p.m. Mon. Wed. 1.45 p.m. Tues. 9 a.m. & 2.45 p.m. Tues. 11.15 Tues. Thurs. 9.30 a.m. North Branch Clinic, Blythe Mansions, Hornsey Rise, N.19. Fri. 1.45 p.m. Mon. 1.45 p.m. North Branch Clinic, 112, Fonthill Road, N.4. Wed. 1.45 p.m. West Islington Welfare Centre, 42 & 44, Richmond Avenue, N.l. Mon., Wed. & 0Fri. 1.30 p.m. Tues. 9.45 a.m. Tues. 1.30 p.m. Thurs. 9.45 a.m. Wed. 10.30 a.m. Fri. ??? West Branch Clinic, St. juke's Mission Hall, Goodinge Road, N.7. Thurs. 11 a.m. & 1.30 p.m. South Islington Welfare Centre, Tibberton Square, Essex Road, N.l. Mon. Wed. Thurs. & 1.30 p.m. 1.30 p.m. 9.30 a.m. 1.30 p.m. Mon. 9.30 a.m. Pri. 9.30 a.m. & 1.30 p.m. Tues. 9.30 a.m. and 2 p.m. South Branch Clinic, Union Chapel, Canonbury Avenue, N.l. Mon. Tues. 1.30 p.m. 9.30 a.m. Tues. ??? South Branch Clinic, Mildmay Sunray Clinic, Mildmay Memorial Hospital, Newington Green, N.l. Tues. & Thurs. 9.30 a.m. 1.30 p.m. 1.30 p.m. East Islington Welfare Centre, ... 32, Drayton Park, N.5. Tues. & Fri. 9.30 a.m. 1.30 p.m. 1.30 p.m. Mon. 9 a.m. Wed. 9.30 a.m. & 1.30 p.m. Mon. Fri. 2 p.m. 10 a.m. Mon. ??? East Branch Clinic, Highbury Vale Mission Hall, Hurlock Street, N.5. Thurs. & 9.30 a.m. 1.30 p.m. Child Life Protection. The table of foster-mothers and foster-children being cared for is as follows:— 31.12.49 Number of persons on register prepared to receive children 38 Number of foster-children being cared for 57 Day Nurseries. At the beginning of 1949 there were 8 Day Nurseries in operation. The number of child places was 480. At the date of transfer there were 8 Day Nurseries open: Scholefield Road 65 places Camden Road 66 „ (closed 22/12/49) Clephane Road 60 „ Plimsoll Road 33 „ Pembroke Street 50 „ Canonbury Place 70 „ Windsor Street 68 Mitford Road 68 „ 480 „ I am indebted to Dr. A. B. Stewart, Divisional Medical Officer, London County Council, for the above information on maternity and child welfare services provided by that Authority. 47 INDEX. page Acute Polioencephalitis 6, 9, 12-13 Acute Poliomyelitis 6, 9, 12-13 Aged and Infirm Persons 44-45 Ante-Natal Clinics 46 Artificial Cream 42 Bacteriological Examinations 17, 37-38, 42, 43 Births 4, 5, 7 Bombed Sites 19 Cerebro-Spinal Fever 6, 7, 9 Child Life Protection 21, 46 Child Welfare Centres 46 Crematorium 45 Day Nurseries 46 Deaths 4, 5. 6, 7. 8. 9-18 Dental Clinics 46 Diphtheria 5, 6, 9, 14-15 Diphtheria Immunisation 15, 16, 46 Diseases of Animals Act 44 Disinfection 30-31 Disinfestation 13, 19-20, 30-31 Disinfestation of Sewers 37 Dysentery 9 Encephalitis Lethargica 6, 9 Enteric Fever 6, 9, 10 Erysipelas 9 Factories Act—Complaints 32 Factories Act—Contraventions 32-33 Factories Act—Inspections 32-33, 35 Factories Act—Notices served 32-33,35 Flies, Mosquitoes 13, 19-20 Food and Drugs Act 32, 40-43 Food- -Inspection & Supervision 32, 39-44 Food Poisoning 9, 16 Food Salvage Bins 13, 20 Food Sampling 41-43 Food, Unsound 41 Foster Mothers and Children 46 Home Helps 45 Home Nursing 45 Home Visiting—Scabies and Vermin 9. 17 Housing 19, 38-39 Ice Cream 42-43 Illegitimate Births 4, 5, 7 Illegitimate Children 7, 8 Infant Mortality 4, 5, 6, 7, 8 Infectious Diseases 9, 18 Infestation Order, 1943, etc 36-37 Live Births 4, 5, 7 M. & C. W. Services 46 Malaria 9 Marriages 4-5 Maternal Mortality 4, 5, 6 Measles 6, 7, 9, 10-12 PAGE Meat 41 Milk and Dairies Regulations 20, 40, 44 Milk (Special Designations) 20, 43-44 Mortuary 45 Noise Nuisance 34 Nurseries—Day 46 Offensive Trades 34-35 Ophthalmia Neonatorum 9 Outworkers 32, 34 Pharmacy & Poisons Acts 35 Pneumonia 6, 7, 8, 9 Polioencephalitis 6, 9, 12-13 Poliomyelitis 6, 9, 12-13 Population 4, 5 Post-Natal Clinics 46 Premature Infants 6,7 Prosecutions 22-30, 34, 40 Public Health Committee 3 Public Health Officers 3 Puerperal Fever 4, 6, 9 Puerperal Pyrexia 4, 6, 9 Rats & Mice Destruc tion Acts 32, 36 Rent Restriction Acts (Certificates) 21 Requisitioned Property 38 Sampling 37-38, 41-43 Sanitary Circumstances 19-38 Sanitary Inspection—District Work 20-30 Sanitary Inspection—Special Work 38-44 Scabies 9, 16, 17 Scarlet Fever 6, 9 Shops Acts 36 Slaughtermen's Licences 41 Smallpox 9, 10 Smoke 31 Staff 3 Statistics—General 4 Statistics—Vital 4-8 Still-Births 4, 5 Swimming Baths 12, 38 Tuberculosis—Beds and Bedding 18 Tuberculosis—Care Committee 18 Tuberculosis—Deaths 5, 6, 7, 8, 9, 18 Tuberculosis—Dispensaries 18 Tuberculosis—Notifications 5, 9, 17-18 Typhoid Fever 6, 9, 10 Underground Bakehouses 35 Vaccination 9, 10, 46 Vermin 9, 16-17, 30-31 Washing Facilities, Free 39-40 Water Supplies 37-38 Welfare Centres 46 Whooping Cough 6, 7, 9, 10-12, 16-16