AC4361 1954 • 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 E. G. Ellis & Sons, Willow Street, Chingford, E.4 achd 20/1/56 PB. 1 Public Health Department, Town Hall, N.l. To The Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. In presenting my Fourteenth Annual Report on the health of the Metropolitan Borough of Islington for the year ended 31st December, 1954, it is inevitable that I refer to certain fundamental features affecting the Public Health which are more or less constant and therefore have to be mentioned from year to year. In particular, reference was made in the Report for the year 1953 to the information published by the Registrar General in his County of London Report analysing the 1951 Census Returns. The overall congestion of the Borough, with an average of 76.2 persons per acre, has not materially altered and, in spite of the considerable volume of new housing in the Borough built by the London County Council and the Borough Council, the problem of out-of-date housing and the reduction of congestion still remains a most intractible one. The Housing Repairs and Rents Act, 1954, which came into effect during the year, requires Local Authorities to survey their areas and within one year submit proposals for dealing with slum clearance areas and individual unfit housing. It is indeed unfortunate that, with such important new projects as this in addition to the customary sanitary and environmental control which still has to be continued, the position in regard to the Sanitary Inspector establishment should have remained so unfavourable during the year. During the year the Department was substantially short to the extent of 25 to 33 per cent. of the number of Inspectors required to carry out work in the Borough. In spite of repeated advertisments, it was not possible to fill the vacancies and great difficulties were thereby experienced in dealing promptly, as they should be dealt with, with complaints of sanitary nuisances as well as the carrying out of routine housing inspections. It is common knowledge that there is a national deficiency of Sanitary Inspectors and it is regrettable that such deficiency should inevitably affect adversely the health interests of the people. In spite of certain adverse evironmental circumstances, there are, fortunately, many favourable features to be recorded for the year. The infant mortality rate reached the astonishing low figure of 17 deaths under the age of one year for every 1,000 live births. This is by far the lowest infantile mortality rate ever recorded in the history of the Borough ; the previous lowest rate was 22 in 1952. The general death-rate was also the lowest to be recorded, as can be seen from the table of Comparative Vital Statistics on page 5. This was due in the main to a decrease during the year in the number of deaths from the respiratory disorders, influenza, pneumonia and bronchitis. Whilst, in general, the incidence of infectious disease in 1954 was low, there was an exceptional increase in dysentery. This was very prevalent in the Borough during the year, with the highest number of cases which have occurred in any one 2 year. The illness was usually mild and more of a nuisance infection than a direct risk to life in the vast majority of cases. However, there may be a risk to the very young and the elderly and, although there was no direct evidence that the form of dysentery which occurred during the year was food-borne, the possibility of an explosive food-borne outbreak of dysentery had always to be borne in mind and enquiries made and precautions taken accordingly. During 1953 I recorded a Food Hygiene Exhibition being held, which was on show for three days. In 1954, approval was given for the holding of a major Health Exhibition at the Town Hall for a week in early October. A very considerable number of members of the public, as well as professional groups, saw the Exhibition, the basic objective being to inform the public and to bring more directly to their notice the preventive, and some of the curative services which are available to them, with more detailed information in regard to the nature of these services. This Exhibition required the Co-operation of a very considerable number of statutory organisations, both local and national, voluntary organisations and, of course, very much individual effort. Without this interest, which included the personal enthusiasm of many members of the Public Health Department's staff, it would not have been possible for so many exhibits of interest and educational value to be placed on view. I have from year to year had to record some increase in the services dealing with elderly persons. Minor, but useful additions during 1954 included the commencement of the Cleansing and Laundry Service for the personal clothing and bedding of elderly persons, where such bedding and clothing is liable to become soiled ; and also the development of the service for elderly persons who are so enfeebled that they are normally unable either to be cleansed at the Council's Cleansing Station or even to visit the Public Baths. Such persons may be cleansed in their own homes if they so desire by a staff visitor. I have again to thank the staff of the Department during the year, in particular Mr. E. J. Sharp, Chief Clerk, and his colleagues who gave so much of their own time and their personal interest to the arrangements and preparation of material for the Public Health Exhibition ; and Mr. W. C. Bartlett, Chief Sanitary Inspector, for his co-operation during the time when the work of the Sanitary Inspectors has been so greatly hampered by deficient establishment. I have also once again to thank the Members and Chairmen, Councillors A. J. Rogers and F. W. Byrne, of the Public Health and Housing Committees respectively, being the principal Committees of the Council dealing with the work of the Public Health Department. V. FREEMAN, Medical Officer of Health. 3 MEMBERS OF THE PUBLIC HEALTH COMMITTEE (As at 31st December, 1954) Mayor: Councillor Mrs. J. M. Barnes, J.P. Alderman: Herbert James Lowton Lygoe, J.P., M.S.M. Councillors: Ernest John William Bayliss Charles Henry Bowdler Miss Mary Eva Gertrude Bull Frank Ernest Field George Albert Gardner Ernest Charles Gough Charles John Hooper William Campbell Lillie Albert John Rogers Lewis Ross Mrs. Agnes Seeley Mrs. Emily Mary Simms Terence Patrick Spriggs Mrs. Bronwen Stradling Ernest David Ward Arthur Edward White Chairman : Councillor Albert John Rogers Vice-Chairman: Councillor Mrs. Emily Mary Simms 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. Deputy Medical Officer of Health: A. L. Thrower. M.B., B.S., M.R.C.S., L.R.C.P., D.P.H., (T. Part-Time.) Public Analyst: D. F. H. Button, A.R.C.S., F.R.I.C. Chief Sanitary Inspector: W. C. Bartlett (b) (c) (d) Deputy Chief Sanitary Inspector: H. Plinston (b) (c) Supervisory Sanitary Inspector: J. S. Ashworth (b) Sanitary Inspectors: (b) J. W. Aiken (b)(c) A. W. Haydock (b)(e) F. H. W. Pedrick (b)(c) A. A. Aslamidis (b)(c) H. R. Homewood (b)(c)(f)(g)(b) Miss S. H. Prentice (b) G. D. Couling (b) R. L. Hooper (b)(c) K. E. Sewell (b) D. T. Evans (b) A. R. Kempshall (b) A. K. D. Shuttleworth (b)(c) G.A.Faulkner (b)(c)(d) N. Lightowlers (b) U.P.Stanton (b)(c) K. L. Garner (b) A. Moxon (b) W. T. Stevenson (b)(c)(/)(g)(h) Miss V. M. Goddard Chief Clerk: E. J. Sharp Clerical Staff : R. J. Barker (T) S. A. Bishop W. R. Causton* E. Conner L. J. Cook † Mrs. V. E. Cox C. J. Cridland* Mrs. B. Y. Davies (T) Mrs. O. Easson Miss D. Francis W. H. Goody (T) P. Hardwick Miss M. E. Hudson L. Hummerstone Mrs. E. J. Johnson T. W. Johnson W. A. McAdam* Mrs. C. A. McCausland Mrs. E. M. Matthews (T) C. J. Moore* D. A. Owen P. L. Regan J. Thompson L. Turner Mrs. F. Underwood S. Wright Old People's Health Officer: Infectious Diseases Visitor: Mrs. B. I. Montaut (f) Mrs. C. M. Burton (f)(i) Disinfecting and Bathing Stations, Seven Sisters Road, N.7. W. G. Jollie (Engineer-in-Charge) Mrs. H. W. M. Godkin (Nurse'in-Charge) (f) 3 Home Visitors 1 Stoker/Handyman 1 Assistant Driver 2 Bathing Attendants 2 Drivers 3 Disinfectors (1 vacancy) 1 Driver/Handyman 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. (f) = State Registered Nurse. (g) = State Certified Midwife. * = Senior Sectional Clerk. †= On National Service. (h) = Health Visitors' Certificate. (i) = Registered Fever Nurse. 4 SECTION A. GENERAL AND VITAL STATISTICS. Area of the Borough 3,092 acres. Population. Registrar-General's estimate of civilian population, Mid-year 1954 : 230,500 Live Births. Birth Rate per 1,000 Estimated Resident Population Totals M. F. Islington England and Wales Legitimate 3,727 1,896 1,831 Illegitimate 336 160 176 4,063 2,056 2,007 17.6 15.2 Still Births. Rate per 1,000 Total (Live and Still) Births Islington England and Wales Legitimate 72 34 38 Illegitimate 8 4 4 80 38 42 19.31 24.0 Deaths. Death Rate (Unadjusted) per 1,000 Population Totals M. F. Islington England and Wales 2,425 1,200 1,225 10.52 11.3 Deaths from Puerperal Causes. Deaths. Rate per 1,000 Total Births Islington England and Wales 2 0.48 0.69 Death Rate of Infants under One Year of Age. Islington England and Wales All infants per 1,000 live births 17 25.5 Legitimate infants per 1,000 legitimate live births 16 Illegitimate infants per 1,000 illegitimate live births 30 Notification of Births. For year ending 31st December, 1954 3,958 (corrected figure from L.C.C). Marriages (Provisional figures). Marriages solemnised in the Borough during the year 2,230 5 COMPARATIVE VITAL STATISTICS—1943 TO 1954 (Compiled from Registrar-General's Returns) 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 Population 230,500 233,500 235,300 235,800 238,200 239,580 238,200 236,840 227,160 195,770 188,560 189,970 Live Births—(Total) 4,063 3,969 3,897 3,880 4,091 4,389 4,608 5,577 5,284 3,708 3,826 3,592 (Illegitimate) 336 296 282 285 302 318 331 431 442 438 335 264 Birth Rate per 1,000 population 17.6 17.0 16.56 16.45 17.17 18.32 19.34 23.55 23.26 18.94 20.29 18.91 Still Birth Rate per 1,000 births 19.31 22.66 17.89 20.94 17.48 19.87 18.94 18.99 22.20 22.41 25.72 24.97 Deaths 2,425 2,669 2,876 3,131 2,760 2,958 2,682 3,053 2,947 2,856 3,057 3,017 Death rate 10.52 11.43 12.22 13.28 11.59 12.35 11.26 12.89 12.97 14.59 16.21 15.88 Maternal Death rate per 1,000 births 0.48 0.99 1.01 0.50 0.72 0.67 0.85 0.70 1.48 0.26 2.03 2.71 Death rate of Infants under 1 year 17 24 22 28 29 27 35 32 39 46 48 46 Marriage rate per 1,000 population 19.35 19.08 17.85 19.17 18.37 18.61 19.67 19.54 20.21 25.00 18.36 18.59 T.B. Notifications per 1,000 population (all forms) 1.94 2.08 2.03 1.77 2.05 2.20 2.25 2.43 2.18 2.81 3.14 3.04 Death-rates per 1,000 population— Pulmonary T.B. 0.16 0.16 0.30 0.30 0.38 0.52 0.66 0.70 0.64 0.80 0.86 0.85 Diphtheria Nil Nil Nil 0.004 0.004 0.008 Nil 0.004 Nil 0.01 0.01 0.05 Suicides 0.13 0.14 0.076 0.15 0.09 0.12 0.15 0.07 0.11 0.06 0.10 0.08 Road Traffic Accidents 0.082 0.077 0.076 0.11 0.10 0.06 0.08 0.11 0.10 0.07 0.16 0.10 Other violent causes 0.17 0.20 0.22 0.26 0.26 0.25 0.43 0.37 0.45 1.05 1.84 0.38 6 CLASSIFICATION OF DEATHS WITH AGE DISTRIBUTION (REGISTRAR GENERAL'S RETURNS) Cause of Death Age Groups 0— 1- 5- 15— 25— 45— 65— 75— All Ages M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Total 1. Tuberculosis, Respiratory - — — — — - - - 1 6 12 1 5 6 6 - 24 13 37 1 2. Tuberculosis, Other 1 — — — — — — — — 1 — 1 1 - - - 2 2 4 2 3. Syphilitic diseases — — — — — — — — — — 2 1 2 2 — 1 4 4 8 3 4. Diphtheria — — — — — — — — — — — — — - - - - - - 4 5. Whooping Cough — — — — — — — — — — — — — — — — — — - 5 6. Meningococcal Infection — — 2 — — — — — — — — — — — — — 2 - 2 6 7. Acute Poliomyelitis — — — - - - - - 1 - - - - - - - 1 - 1 7 8. Measles 1 — — — — - - - — - - - — — - - 1 - 1 8 9. Other infective and parasitic diseases - - - - - - - - - 1 2 — 1 1 - - 3 2 5 9 10. Malignant neoplasm, stomach - - - - - - - - 2 1 17 11 10 10 12 11 41 33 74 10 11. Malignant neoplasm, lung, bronchus - - - - - - - - 2 1 62 5 23 9 11 10 98 25 123 11 12. Malignant neoplasm, breast — — — — — — — — — 5 — 26 — 9 — 12 — 52 52 12 13. Malignant neoplasm, uterus — — - — — — — — — 2 — 13 — 8 — 3 - 26 26 13 14. Other malignant neoplasms — — 2 — 1 — 2 — 12 6 36 48 42 32 38 41 133 127 260 14 15. A-and-Leukaemia — — 1 — — — — 1 2 1 3 1 5 7 — 1 11 11 22 15 16. Diabetes — — — — — — — — 1 — 1 - 1 3 1 3 4 6 10 16 17. Vascular lesions of the nervous system - - - - - - - - 1 - 23 32 32 45 46 78 102 155 257 17 18. Coronary disease, Angina - - - - - - - - 8 — 57 13 54 51 59 66 178 130 308 18 19. Hypertension with heart disease - - - - - - - - - - 6 4 12 8 14 11 32 23 55 19 20. Other heart disease - - - - - - 1 2 5 11 14 23 29 31 57 180 106 247 353 20 21. Other circulatory disease - - - - - - - - 2 — 8 8 26 14 17 51 53 73 126 21 22. Influenza — — — — — — — — 1 — — — - — 1 - 2 - 2 22 23. Pneumonia 4 3 — — 1 — — — — 3 14 6 14 9 28 40 61 61 122 23 24. Bronchitis 1 — 2 — — — — — 1 2 29 13 41 12 40 33 114 60 174 24 25. Other disease of the respiratory system - 1 - - - - - - 1 - 3 1 2 3 3 2 9 7 16 25 26. Ulcer of stomach and duodenum - - - - - - - - - 1 13 5 11 5 13 8 37 19 56 26 27. Gastritis, enteritis, diarrhoea 2 - - - - - - - 1 — 1 1 2 2 1 5 7 8 15 27 28. Nephritis and Nephrosis - - - - - - - 1 1 2 3 2 1 3 1 — 6 8 14 28 29. Hyperplasia of prostate — — — — — — — — — — — — 5 — 13 — 18 - 18 29 30. Pregnancy, Childbirth and Abortion - - - - - - - - - 2 - - - - - - - 2 2 30 31. Congenital Malformations 7 3 — — — — — 1 — — 1 1 — — - - 8 5 13 31 32. Other defined and ill-defined diseases 29 18 1 1 2 1 2 1 6 9 16 19 15 22 12 21 83 92 175 32 33. Motor vehicle accidents — — 1 1 1 — 2 1 3 1 — 1 — 2 4 2 11 8 19 33 34. All other accidents — — 1 — 2 — 1 - 2 2 4 2 5 3 9 9 24 16 40 34 35. Suicide — — — — — — 1 2 6 2 12 2 3 1 1 1 23 8 31 35 36. Homicide — — — — — 1 2 - — — — 1 — — — — 2 2 4 36 All Causes 45 26 10 2 7 2 11 9 59 59 339 241 342 298 387 589 1,200 1,225 2,425 Totals 70 12 9 20 118 580 640 976 2,425 Percentages 2.89 0.49 0.37 0.82 4.87 23.92 26.39 40.25 100 7 SUMMARY OF INFANT MORTALITY 1954 (Based on Registrar General's Returns) Primary Cause of Death Under 1 day | Days Weeks Months 1954 (1953) 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) Meningococcal Infection (1) Tuberculosis—Lungs (—) Tuberculosis—Other forms 1 1 (—) Bronchitis 1 1 (6) Pneumonia 1 1 1 1 1 1 1 7 (18) Influenza (-) Enteritis and Diarrhoea 1 1 2 (5) Premature Birth 6 4 1 1 12 (29) Congenital Malformation, Birth Injury, Atelectasis Atrophy and Marasmus (—) (—) 11 7 5 1 1 1 2 1 1 1 31 (32) Syphilis (-) Suffocation Overlying (1) Violent Causes (2) Road Traffic Accidents (—) All Other Causes 2 2 2 1 1 1 1 2 1 1 1 15 (1) Totals 20 14 8 2 — 2 2 2 2 1 3 3 4 2 1 2 1 — 1 — - 70 (96) 8 COMMENTS ON VITAL STATISTICS Births. Following the post-war increase in the birth-rate, which reached its peak of 23.55 per thousand population in 1947, there was a drop in each succeeding year until 1951, when the rate was 16.45. Since then each year has recorded a slight increase, and the rate for 1954 was 17.6 as against the previous year's rate of 17.0. The proportion of births classified as illegitimate remains fairly constant at 8.3 per cent, of all the 1954 births. Principal Causes of Death. The death-rate, at 10.52 per thousand population, is the lowest death-rate to be recorded in the Borough. Principal causes of death are discussed below. Infants under One Tear. The infant mortality rate of 17 per thousand live births is by a substantial margin the lowest ever recorded in the history of the Borough. The infant deaths have been analysed in the table on page 7 and the largest group of reductions have been in those deaths associated with premature birth. This is extremely gratifying, since the causes of premature birth can only be dealt with during pregnancy, and can only be dealt with by the better health of the expectant mother and her more detailed care by the doctor, midwife and health visitor. The premature infant, of course, also needs special care, but its best chance lies in the avoidance of prematurity as far as this can be done. Deaths from pneumonia in infants under one year also showed a considerable reduction, and the deaths from this cause were almost entirely confined to very young infants under the age of one month. The startling reduction in infant deaths emphasises my observation in the 1953 Report that even with the low rate for the latter year, there was still room for improvement. Although this observation still applies, it is difficult to apply preventive measures to what is now the largest single group of infant deaths, namely, those due to congenital malformation, birth injury, atelectasis, atrophy and marasmus. The other cause of infant wastage, viz. stillbirths, also showed a welcome reduction in the stillbirth-rates from 22.66 to 19.31, but the total number of stillbirths registered, 80, exceeded in 1954 the total infant deaths, 70, under the age of one year. Deaths from Other Causes. Respiratory Tuberculosis. The deaths from this cause, at 37, were the same as in the previous year, although that was the lowest recorded. Malignant Growths of Lung and Bronchus. Deaths Male Female Total 1950 115 14 129 1951 104 23 127 1952 107 20 127 1953 114 19 133 1954 98 25 123 As mentioned in my previous Report, the number of deaths from this cause now considerably exceeds those due to the previously mentioned cause, respiratory tuberculosis. There is increasing acceptance of the view that the chances of lung cancer are increased very materially by tobacco smoking, especially in the form of 9 cigarettes ; and also by atmospheric pollution in large built-up areas. Therefore, the problem of the prevention of a further increase in lung cancer deaths, if possible to be followed by an eventual reduction, is a social and educational problem as well as a medical one. The effects from smoke have to be applied over a long period, and the trend can be seen only over a period of many years. Any solution, therefore, will inevitably have to be on a long-term basis, but this is no reason why all forms of atmospheric pollution, whether personal or communal, should not be viewed as problems to be dealt with urgently. Diseases of the Respiratory System. There was a very substantial decrease in 1954 over the previous year, in deaths due to influenza, pneumonia and bronchitis. In particular, in respect of bronchitis, there was a decrease in all age groups. Accidents. The following table gives the deaths from accidents in Islington from 1949 onwards :— 1949 1950 1951 1952 1953 1954 Motor vehicle accidents 14 24 26 18 18 19 Other violent accidents 60 61 61 48 46 40 The Report of the Standing Interdepartmental Committee on Accidents in the Home, issued with Home Office Circular 106/1953, stated that the majority of accident victims are young children and old people, more than 25% being under 15 and more than 50% over 65. More children under 15 died from home accidents than from any single infectious disease ; between the ages of one and five years a fatal accident in the home is the third largest cause of death. In the following table there is an analysis of the causes of accidental deaths in 1954 in their respective age groups. Type 0- 1- 5- 15- 25- 45- 65- 75 + M F Total Moicor Vehicle Accidents - 2 1 3 3 1 3 6 11 8 19 Falls — — — — 1 2 4 12 8 11 19 Accidental Poisoning (Solid, Liquid Gases and Vapours) - 1 - - 1 2 1 3 4 4 8 Drowning — — 1 — — 1 1 — 3 — 3 Fire - - - - - - - 2 2 — 2 Inhalation of Stomach contents — — — 1 — 1 — — 2 — 2 Others (Non-motor Vehicle, Unknown, etc.) — — 1 — 3 1 — 1 4 2 6 Total — 3 3 4 8 8 9 24 34 25 59 It is to be regretted that Home Safety Committees have not been encouraged and have not been organised as have Road Safety Committees. Suicides. Suicide deaths, at 31, maintained the considerable increase recorded last year as compared with 18 in 1952. Again, there were only 8 females who committed suicide, but the number of males was 23, of whom over half were in the 45-65 age group. 10 SECTION B. PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES. Notifiable Infectious Diseases and Deaths during the year 1954. Disease Number of Notifications Number of Deaths Removed to Hospital Number of Cases returned to RegistrarGeneral after correction of Diagnosis Cases "coming to knowledge" but not Notified Smallpox - (—) - - - - Scarlet Fever 201 (250) — 60 190 5 Diphtheria 6 (12) — 6 1 — Enteric Fever (including Paratyphoid) 1 (1) - - 2 - Typhus Fever — (-) — — — — Puerperal Pyrexia 311 (192) — 300 313 17 Ac. Primary & Influenzal Pneumonia 104 (322) 1 3 104 - Ophthalmia Neonatorum 17 (27) — 14 18 — Acute Encephalitis 1 (1) — 1 1 — Meningococcal Infection 9 (8) 2 9 3 3 Anthrax 1 (—) — — 1 — Dysentery 1,168 (372) — 150 1,127 149 Malaria 2 (5) — 1 2 — Erysipelas 37 (48) — 5 36 5 Measles 1,191 (2,541) 1 60 1,165 37 Whooping Cough 263 (1,188) — 48 250 17 Ac. Poliomyelitis 19 (34) 1 17 11 16 Food Poisoning 104 (243) — 29 102 55 Tuberculosis—Lungs 419 (450) 37 — 425 — Tuberculosis—Other Forms 28 (35) 4 — 31 — Scabies 59 (25) - 2 59 181 (Figures in brackets are notifications for 1953.) Domiciliary Visiting of Infectious Disease Cases and Contacts—No. of Visits. Smallpox 3 Erysipelas 37 Scarlet Fever 212 Measles 1,198 Diphtheria 9 Whooping Cough 251 Enteric Fever (including Paratyphoid) 5 Acute Poliomyelitis 44 Typhus — Food Poisoning 129 Meningococcal Infection 28 Scabies 233 Dysentery 1,528 Vermin 411 Malaria 3 Enteritis — Pneumonia — Ineffective Visits 610 Anthrax 1 Others 10 Total 4,712 Smallpox. No cases of smallpox were recorded. Three suspect cases were visited by the Medical Officer of Health on requests by medical practitioners. These were not confirmed, but follow-up visits were paid. In one of these cases, information was received from the practitioner during the course of the evening, the patient being retained at the doctor's surgery until seen by the Medical Officer of Health. The circumstances were rather unusual, in that the patient was a native of British Guiana 11 and resided in a boarding house containing a considerable number of residents from abroad. It was therefore considered that there was good ground for the doctor's anxiety and desire for confirmation. Pathological material was sent to the Virus Research Laboratory, Colindale, for confirmation regarding the diagnosis. As another example of precautionary measures taken in connection with suspected smallpox, information was received that a patient, not resident in Islington, was admitted to a hospital outside the Borough and was diagnosed as a probable case of smallpox. The ambulance which conveyed this patient was afterwards used to convey other patients to various hospitals, including an Islington resident who was transferred to a hospital in this Borough. This Islington resident, therefore, had to be regarded as a presumptive smallpox contact and all ward patients and various members of the hospital staff as possible secondary contacts. Full smallpox precautions were, therefore, taken and the ambulance contact at the hospital, ward patients and staff were vaccinated by the hospital medical staff. Fortunately, the original patient proved in the end not to be a case of smallpox, but the measures which had to be taken in this case are typical of the constant vigilance which has to be exercised. Successful vaccinations :— 1947 3,345 1st January—3rd July, 1948 1,124 5th July—31st December, 1948 702 1949 1,628 1950 2,307 1951 3,291 1952 2,450 1953 3,055 1954 4,052* (Figures from 1948 onwards kindly furnished by Divisional Medical Officer, London County Council.) * Including Re-vaccinations. The Vaccination Acts were rescinded under the National Health Service Act, 1946, as from 5th July, 1948. Certificates of Vaccination and Inoculation—Authentication—Ministry of Health Circular 60/48. The number of applications for authentication continued to increase rapidly, and during the year the Medical Officer of Health dealt with 394 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. Measles. I reported in 1953 that this was a high incidence year for measles, with 2,541 notifications. 1954 followed the normal course with a relatively low incidence, the number of measles cases notified being 1,191. 12 The following table shows the age-groups of the notified cases during 1954 :— Under 1 year 1—5 years 5 years and upwards No. of Notifications in 1954 46 634 511 Percentage of total notifications 3.9 53.2 42.9 No. of Deaths 1 — — It was only in the most exceptional circumstances that measles cases were removed to hospital. Whooping Cough. Whooping Cough in 1954 showed a substantial decrease, at 263 notifications, as compared with 1,188 for 1953. The distribution of whooping cough cases according to their ages was as follows :— Under 1 year 1—5 years 5 years and upwards No. of Notifications in 1954 35 142 86 Percentage of total notifications 13.3 54.0 32.7 No. of Deaths — — — The following chart shows the measles and whooping cough position since 1945 13 Fatality Rates per 1,000 notifications each age group Percentage of notifications (1945—1954) (1945—1954) Under 1 1—5 5 & upwards Under 1 1—5 5 & upwards Measles 6.19 0.38 — 5.0 59.2 35.8 Whooping Cough 24.1 2.26 — 12.7 58.9 28.4 Over the ten-year period 58.9 per cent, of all cases of whooping cough and 59.2 per cent, of all cases of measles were in children one to five years of age. Whooping Cough Prophylaxis. Whooping cough immunisation is carried out in the local Health Authority Clinics and by general practitioners. The Divisional Medical Officer has kindly made available the following information in regard to Islington children:— Whooping cough Prophylaxis Total attendances 7,863 Completed cases 2,596 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 No. of Ineffective Measles Whooping Cough Visits Re-visits 1,191 251 391 7 Acute Poliomyelitis There were less confirmed cases in 1954, but the total number was not large. One of the cases of poliomyelitis during the year had fatal results. The cases reported for each of eight years are set out as under:— No. Reported No. CONFIRMED 1954 35 12 1953 47 17 1952 30 15 1951 21 8 1950 54 31 1949 88 62 1948 11 9 1947 35 24 Onset dates Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 1954 - - - - - - 1 3 2 3 2 1 1953 1 - - - 2 2 6 2 3 1 - - 1952 - - - - 1 - 2 8 - 2 1 1 1951 1 - - 1 1 2 - 2 1 - - - 1950 1 - 1 - 2 2 10 10 1 2 2 - 1949 - - - - - - 9 6 17 18 8 4 1948 - 1 - 2 - 1 - 2 - 1 1 1 1947 - - 1 1 - 2 3 5 4 4 3 1 14  Age distribution : Under 1 yr. 1— 5— 15— 25 and over 1954 — 7 2 1 2 1953 — 6 5 3 3 1952 — 1 5 4 5 1951 — 2 2 2 2 1950 1 11 12 4 3 1947 1 7 6 7 3 Deaths—1954—1 (27 years). 1953—3 (4 years ; 15 years ; 24 years). 1952—Nil. 1951—Nil. 1950—2 (6 years ; 12 years). The onset of the disease of the 6-year-old was in 1949. 1949—2 (2 years ; 26 years). 1948—Nil. 1947—4. Diphtheria Cases and Deaths—1927—1954 Year Notified Cases Deaths Year Notified Cases Deaths Year Notified Cases Confirmed Cases Deaths 1927 720 25 1936 583 31 1945 86 45 3 1928 760 25 1937 623 20 1946 137 50 — 1929 1,008 34 1938 595 23 1947 72 19 1 1930 1,248 42 1939 254 10 1948 44 7 — 1931 714 15 1940 101 2 1949 55 17 2 1932 601 20 1941 174 11 1950 50 19 1 1933 551 33 1942 201 2 1951 43 17 1 1934 815 32 1943 188 9 1952 23 — — 1935 760 13 1944 94 2 1953 12 1 — 1954 6 1 - Corrected Notifications Year England and Wales London Islington 1944 23,199 758 38 1945 18,596 801 45 1946 11,986 747 50 1947 5,609 451 19 1948 3,575 335 7 1949 1,881 221 17 1950 962 81 19 1951 699 30 17 1952 101 5 — 1953 267 13 1 1954 176 8 1 It will be seen from the above tables that there was no confirmed case of diphtheria in the Borough in 1952, and the 1953 case included was, strictly speaking, not a clinical case but a contact who was a carrier and who remained in good health. The single confirmed case in 1954, however, was a true case of diphtheria. 15 Diphtheria Cases and Immunisation state 1947-1954 (inclusive) Year Immunised Non-Immunised Unknown Total Deaths Age Groups Age Groups 0—5 5—15 15 + 0—5 5—15 15 + 1954 - - - - - - 1 1 Nil 1953 - - - - - 1 — 1 Nil 1952 - - - - - - - - 1951 1 2 - 8 5 1 - 17 7 years—Not immunised 1950 - 5 - 3 7 4 - 19 7 years—Not immunised 1949 1 3 — 2 8 3 — 17 4 years Not immunised 6 year 1948 1 2 1 1 - 2 - 7 Nil 1947 — 5 1 2 4 5 2 19 16 years—Not immunised Totals 3 17 2 16 24 16 3 81 5 deaths (Noneimmunised) 22 56 No. of Islington Children Immunised against Diphtheria—1939—1953 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 525 89 3,261 5,734 6,321 3,165 3,688 3,425 4,563 5,387 3,185 2,604 3,073 3,019 2,654 Diphtheria Immunisation, 1954. Dr. B. E. A. Sharpe, Divisional Medical Officer, London County Council, has kindly supplied the following figures in respect of Islington children for the current year. As immunity tends to wane with the passage of time, the Immunity Index relates only to children who have been inoculated during the last 5 years. This is consonant with the Immunity Index given by the Ministry of Health. Age at 31.12.54 i.e. born in year Under 1 1954 1—4 1953-50 5—9 1949-45 10—14 1944-40 Under 15 Total Last complete course (whether primary or boost) 1950-54 445 8,744 5,683 1,489 16,361 Mid-year population 3,930 13,370 29,600 46,900 Immunity Index 11.3 65.4 24.2 34.9 Food Poisoning Number of notifications received 1947 7 1948 10 1949 55 1950 104 1951 148 1952 58 1953 243 1954 104 16 In accordance with Circular 2/50 of the Ministry of Health, the following table summarises the outbreaks of food poisoning and the character of each outbreak. Date No. of Notifications No. of persons served No. of cases reported No. of deaths Foods involved and Organisms responsible 1. 14.9.54 - 720 9 - Sausages, bacon and mock cream.— No organisms commonly associated with food poisoning were isolated. 2. 1.10.54 - 490 6 - Brown stew, cabbage, boiled potatoes and white beans. Jam sponge and custard.—No pathogenic organisms isolated. Further details of these outbreaks are as under :— 1. This outbreak occurred in connection with the nursery class of a school. The principal symptom was sickness which began approximately 12 hours after the suspected meal. The children were not severely ill and recovered fully within two days. 2. The second small outbreak also occurred in connection with a school and, again, the principal symptom was sickness, but commencing 3—4 hours after the suspected meal. The illness was mild, and those affected were in normal health within 48 hours. The campaign for safer food is dealt with in the Health Publicity section of this Report. Dysentery Dysentery notifications, at 1,168, showed approximately a threefold increase over the previous year. In fact, notifications exceeded those of 1951, when 995 notifications were received—the highest number to be recorded until 1954. All notified cases were visited by a Sanitary Inspector or Infectious Disease Visitor, and stool specimens were examined at the Public Health Laboratory Service Bacteriological Laboratory, County Hall, S.E.1. The increase in dysentery cases actually began in December, 1953, when 75 cases were notified. The numbers increased in the early part of the year and reached a maximum in March, with 242 notifications. The incidence continued high until July, then dropped substantially, but a smaller number of notifications continued steadily until the end of the year. A high proportion of the cases were bacteriologically confirmed, the great majority being due to Shigella Sonne which, in general, gives rise to the milder form of dysentery, but there were also a few cases due to other dysenteriform organisms which might cause relatively severer attacks, such as Flexner. There were groups of cases which occurred in association with day nurseries, schools, and a welfare home in the Borough, but there were also considerable numbers of individual and family cases. 17 In general, it is not considered that Sonne dysentery is a food'borne organism— that is to say, it is not normally a food poisoning organism. However, outbreaks of food poisoning due to Sonne dysentery have been recorded, and particular enquiries are made in every family visited as to whether a member of the family is engaged in any form of work as a food handler. Eight men and fourteen women employed as food handlers were actual cases of Sonne dysentery ; and 56 male and 54 female members of families where there was a case of Sonne dysentery were food handlers. In associated families there were 43 male and 40 female food handlers. Where considered advisable, such handlers were advised to discontinue work for reasonably safe periods. Amongst these cases, a notification of Sonne dysentery was received in respect of a person employed as a baker in this Borough. The diagnosis was bacteriologically confirmed and notice was served under the Public Health (Infectious Diseases) Regulations, 1953, requiring him to discontinue or refrain from engaging in the occupation of baker until further notice. Close liaison was maintained between this Department and Dr. Tomlinson of the Public Health Laboratory Service, as well as the practitioners, and the results of bacteriological examinations undertaken made it apparent in the early part of 1954 that a high proportion of the cases were becoming resistant to the sulphonamide group of drugs normally prescribed in the treatment of this type of dysentery. In order to deal with this problem and its implications, and other related problems, the Council approved the calling of a meeting in the Town Hall to discuss the matter. The meeting was called as a special meeting of the City Division of the British Medical Association, and those invited included all local practitioners, and medical staffs of local hospitals and the London County Council. The discussion was opened by Dr. W. Gunn, F.R.C.P., D.P.H., Physician, Royal Free Hospital Department of Infectious Diseases, Hampstead, Dr. A. J. H. Tomlinson, MB., B.Ch., Director, Medical Research Council Bacteriological Laboratory, County Hall, S.E.1, and the Medical Officer of Health. There was also considerable further discussion by others present. It was considered that the meeting was a most useful one and the recorded proceedings were available to all doctors for reference purposes. The following table summarises the progress of the outbreak and those affected :— 18 DYSENTERY OUTBREAK IN ISLINGTON—December, 1953—December, 1954 (inclusive) Month No. of Cases Sex Notified Coming to knowledge Confirmed Cases Age Groups Case employed as a food handler Food Handler Contacts Water Closet Accommodation 0- 1 - 5- 15- 25- 45- 65 + Same family Separate family Separate Shared December, 1953 80 M 34 5 62 6 16 15 1 - 1 - - 2 1 15 34 F 41 — 3 13 5 2 11 3 4 1 1 1 1954 January 143 M 60 10 90 8 29 23 3 4 2 1 — 6 4 28 100 F 67 6 4 23 12 8 16 4 6 — 9 4 February 143 M 55 5 75 4 19 23 2 7 3 2 1 8 5 56 84 F 69 14 4 23 25 7 20 3 1 2 9 9 March 269 M 115 13 146 6 52 47 4 17 2 — 1 6 4 99 141 F 127 14 9 42 38 15 25 5 7 1 10 3 April 185 M 80 10 109 13 27 23 6 12 8 1 1 10 12 57 114 F 81 14 7 25 22 9 22 7 3 3 4 6 May 206 M 89 12 121 2 33 42 3 17 2 2 1 7 5 87 103 F 91 14 2 36 36 6 21 2 2 2 9 5 June 123 M 56 5 47 2 21 29 4 3 2 — 1 2 3 50 58 F 55 7 6 15 25 4 5 4 3 1 1 3 July 42 M 24 2 17 3 13 5 2 — 2 1 1 2 — 15 25 F 16 — — 3 4 4 2 1 2 1 — — August 48 M 18 4 23 — 14 3 — 4 1 — — 3 3 16 26 F 23 3 3 11 3 4 2 3 — 1 4 4 September 43 M 21 1 26 1 8 5 1 5 2 — — 2 — 12 26 F 19 2 1 4 5 4 6 1 — 1 2 1 October 52 M 18 6 37 1 7 8 2 5 1 — 1 2 3 28 22 F 23 5 2 12 5 3 4 2 — — — 3 November 30 M 16 — 13 2 2 9 — 2 1 — 1 1 2 17 11 F 13 1 2 3 4 — 1 1 3 1 2 1 December 31 M 18 — 10 2 7 5 1 1 1 1 — 5 1 18 13 F 12 1 2 3 — 5 2 1 — — 3 — T otal 1,395 M 604 73 776 50 248 237 29 77 28 8 8 56 43 498 757 F 637 81 45 213 184 71 137 37 31 14 54 40 19 Anthrax A case of anthrax was notified, being the first notification received over a period of many years. The person concerned was employed in handling hides and skins at the Metropolitan Cattle Market. Liaison was immediately effected with the medical practitioner concerned, the Chief Inspector of Factories, Ministry of Labour and National Service, and also the Public Health Laboratory Service in regard to bacteriological confirmation of diagnosis. The Market Authorities were communicated with, as well as the London County Council in respect of the responsibility of the Public Control Department under the Diseases of Animals Order. Fortunately the diagnosis was not finally confirmed. Scabies and Vermin The number of cases of scabies treated continues to decrease. 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. The Deputy Medical Officer of Health is available at the Public Health Department, Seven Sisters Road, for the examination of complicated cases of scabies or special cases referred by General Practitioners. Treatment for scabies and vermin was carried out at the Public Health Department, Seven Sisters Road (Cleansing Station), as under :— Children under 5 years Scabies Vermin Number treated 24 24 Number of baths given 52 — Number of treatments — 24 L.C.C. Children Number treated 63 344 Number of baths given 214* — Number of treatments — 346 Adults Number treated 88 74 Number of baths given 207* — Number of treatments — 76 *Baths were also given to 17 Scabies Contacts and 151 Special Cleansing Cases. Scabies Clinic: Number of Clinics held 7 Number of cases attended 10 Adults 4 Children under 5 years 1 School children 5 - 10 Diagnosis of cases— Scabies 9 Other conditions 1 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 169 1 140 310 Vermin 335 17 363 715 20 Tuberculosis. The rates per thousand population for new cases of pulmonary tuberculosis for the last six years have been:— 1949—2.39; 1950—2.07; 1951—1.87; 1952—2.16; 1953—2.34; 1954—2.22 512 new cases of pulmonary tuberculosis were added to the Register during the year, as against 546 in 1953. The 512 new cases are made up of 419 primary notifications, 251 male and 168 female, plus 93 transfers in and coming to knowledge from various other sources. The Registrar General's recorded number of deaths, 37, is the same as for 1953, but there has been a small decrease in the primary notifications ; although modern forms of treatment contribute very materially to the longer life of the patient suffering from tuberculosis, the volume of new cases is still very substantial. As I emphasised in each Annual Report, there is no basis for complacency in the problem of tuberculosis which still causes major social and economic, as well as medical difficulties. Of the 216 new cases of tuberculosis of the lungs in women, 150 were between the ages of 15 and 35, and it is obvious what this must mean in terms of personal and family upset. Of the 296 new cases of lung tuberculosis in men, 36 were aged 15 to 25, and 92 aged 25—35. Again, the serious consequences are obvious. New Cases and Mortality during 1954 Ages New Cases Deaths Respiratory Non'Respiratory Respiratory Non'Respiratory 0— M. F. M. F. M. F. M. F. 1 1 1 - - 1 - 1— 12 1 — 1 - — — — 5— 9 9 7 3 — — — — 15— 36 68 4 7 — — — — 25— 92 82 2 11} 1 6 — 1 35— 38 31 1 1} 45— 44 10 — - } 12 1 - 1 55— 33 4 - --} 65 and upwards 31 10 1 - 11 6 1 — Total for all ages 296 216 16 23 24 13 2 2 551 41 Rates per 1,000 population— New cases—pulmonary 2.22 non-pulmonary 0.17 Deaths— pulmonary 0.16 non-pulmonary 0.02 Public Health (Tuberculosis) Regulations, 1952 Although information in regard to the coming and going of tuberculous patients under these Regulations is not as complete as it was under the Tuberculosis Regulations, 1930, every effort is made to confirm the correctness of the Register still maintained in the Department. The total number of cases on the Register of the Department as at 31st December, 1954 was:— Pulmonary— Males 1,432 Females 1,165 Non-Pulmonary—Males 152 Females 173 2,922 21 The corresponding figures for previous years are :— 1948 2,401 1949 2,490 1950 2,368 1951 2,404 1952 2,575 1953 2,802 Chest Clinics The Chest Clinics of the Regional Hospital Board at the Royal Northern Hospital and the Royal Chest Hospital were, on 1st June, 1954, amalgamated and transferred to new premises at St. Mary's Wing, Whittington Hospital. Cases on Chest Clinic Registers Number of definite cases of tuberculosis on Chest Clinic Register as at 31st December, 1954 Pulmonary Non-Pulmonary Total Adults Children Adults Children Adults Children M. F. M. F. M. F. M. F. M. F. M. F. 1376 1075 116 83 70 96 16 19 1446 1171 132 102 -Grand Total 2,851- The corresponding figures for previous years are :— 1949 2,127 1950 2,238 1951 2,443 1952 2,575 1953 2,738 Tuberculosis Care Committee. The London County Council is responsible for care work under the National Health Service Act, 1946, but the Islington Tuberculosis Care Committee remains in being, working in conjunction with the Islington Chest Clinic, and Members of the Borough Council and the Medical Officer of Health serve on this Committee. Since the opening of the new Chest Clinic at Whittington Hospital the work of the Care Committee has also been centred there. Loans of bedding or medical appliances were made to 39 patients; others have been referred to various organisations for assistance. Tuberculosis—Mass X-Ray Unit of the North West Metropolitan Regional Hospital Board- the year. Over 17,000 Islington residents were passed through the Unit, and close liaison was maintained between the Unit and medical practitioners in the area. Dr. G.Z. Brett continued to act as Physician-in-charge of the Mass X-Ray Unit. Winter Epidemics Towards the end of 1954 a request was received from the Ministry of Health, acting through the Public Health Laboratory Service and the Medical Research Council, requesting the assistance of the Department in regard to an investigation of winter epidemics which might occur, with particular reference to influenza. It was desired that selected general practitioners should act as 'spotters' and furnish reports if and when occasion arose. The scheme included liaison between the 22 Medical Officer of Health, hospitals, medical officers of residential establishments, industrial organisations, etc.; and co-operation with the National Insurance offices of the Ministry of Pensions and National Insurance with a view to lcooping watch on rises in first claims to sickness benefit. Another aspect was to be liaison with the local Registrars of deaths in regard to increases in total deaths and deaths from pneumonia, bronchitis and influenza. Arrangements were also discussed for submission of pathological specimens to the Public Health Laboratory Service. The above suggested liaison arrangements were put into operation for the winter 1954-1955. Bacteriological Examinations All specimens for bacteriological examination dealt with through the Department are now submitted to the Public Health Laboratory Service, County Hall, S.E.1. Examinations carried out Swabs (Diphtheria) Total[###/] 202 Sputum (Tuberculosis) 23 Faeces (Typhoid) 9 Blood (Typhoid) — Faeces (Food poisoning) 173 Food (Food poisoning) 28 Faeces (Dysentery) 6,041 Swabs (Dysentery) (Lavatory appurtenances, etc.) 481 Swabs (Streptococci) 45 Swabs (Pertussis) 4 Smears (Variola) 2 Scrapings (Variola) 2 Other Specimens 5 Total 7,015 (I am indebted to Dr. B.E.A. Sharpe, Divisional Medical Officer, London County Council, for the 1954 figures in connection with vaccination, diphtheria and whooping cough inoculations, and chest clinics). SANITARY CIRCUMSTANCES OF THE AREA SECTION C (In conjunction with Mr. W. C. Bartlett, Chief Sanitary Inspector) The condition of the majority of houses in the borough continues to be very far from satisfactory. Although this Council and the London County Council have erected between them 763 flats during the year the remaining properties, in the main, are obsolescent and lack the essential amenities necessary to secure reasonable living accommodation for the occupants. A large number were built a century or more ago and are in a marked stage of disrepair. The repair of such being uneconomical, owners have in many cases either abandoned the property or requested the Council to take appropriate action under the Housing Act, 1936. The relative sections of 23 the Public Health (London) Act, 1936, were enforced where possible to secure the abatement of nuisances, but during the period between the complaint and compliance with the requirement of the Notice, further nuisances arose in many cases and, therefore, the work of the Inspector was considerably increased. Added to this difficulty is the fact that many owners cannot be traced. This situation is serious enough when the Sanitary Inspector establishment is up to full strength but with a depleted staff the difficulties are further accentuated. Indeed, the estalishment of 34 was at one period during the year 11 short, of which number nine were District or Housing Inspectors. The borough has seen many alterations since 1938 and areas damaged by enemy action are rapidly being re-developed. As fast as possible areas of obsolescent properties are being cleared and re-developed for housing purposes, although there still remains a lot to be done. With the exception of one or two open spaces the borough is mainly built up, factories being interspersed with dwellings. It is interesting to reflect upon the growth of Islington and in this connection the Council has, through its Librarian, collected books, prints, manuscripts and other data relative to the history of the borough. The resulting collection reveals an interesting picture of development of the borough during the last 250 years. In 1708 there were only 325 houses in Islington, the population being unknown. In 1800 there were 1,745 houses and a population of 10,212, whilst 100 years later the population reached its peak of 335,238. Whilst the living conditions of the borough's population are being improved as fast as possible, there is still found the odd case where conditions in which people live beggar description, as will be found in the section on Services for Elderly Persons. During the year the Housing Repairs and Rents Act, 1954, came into force, by virtue of which the London County Council By-Laws relating to tenement houses ceased to operate, being superseded by Sections 11 and 12 of this Statute. There has been a decrease in the number of prosecutions taken under the Public Health (London) Act, 1936; but in the number of cases taken for failure to comply with abatement orders substantial fines were imposed. Whilst it is necessary that such action be taken in default it would be a far more satisfactory position if owners complied with Notices within a reasonable period, and the money paid in respect of fines and costs were spent on the property at a much earlier stage. The work of the Department, as well as the Inspectors, would be considerably reduced and the tenants would live in reasonably nuisance-free accommodation. There is no truer proverb, as far as house property is concerned, than "A stitch in time save nine". Many a minor defect, if attended to at an early stage would prevent the occurrence of a nuisance of a major character. Summary of Work done by District Sanitary Inspectors. During the year 35,953 inspections or revisits were made by the District Sanitary Inspectors. In connection with visits to dwelling-houses, 41,747 inspections or re-inspections of separate lettings were made. 24 Routine Inspections, etc. Houses Inspected (on complaint, etc.) 8,620 do. Separate Lettings in above 14,456 Inspections re Schools 16 do. Licensed Premises 5 do. Child Life Protection 2 do. Stables, Manure Pits 6 do. Courts, Mews — 9 do. Food Salvage Containers 114 do. Bombed Sites 146 do. Derelict Buildings 24 do. A.R.P. Shelters, Static Water Tanks 19 do. Fairgrounds, Caravans 25 Nuisances dealt with by Notice 10,645 do. informally 1,207 Houses Reinspected 15,112 do. Separate Lettings in above 25,462 Other revisits 846 Notices Served—Intimation 3,861 do. Statutory 2,202 Notices Complied with—Intimation 1,575 do. Statutory 1,443 do. By Local Authority in default 18 Requisitioned Properties—Inspected 112 do. Separate Lettings in above 211 do. Reinspected 99 do. Separate Lettings in above 182 Land Charges Act, 1925. Enquires received 2,027 Properties involved 2,734 Investigations 6,165 Rational Assistance Act (Section 47).—Aged and Infirm Persons Cases Investigated 48 Cases Revisited 95 (See also Section on Services for Elderly Persons). Housing Acts. Sections 57/62, etc.—Inspections and Revisits 512 Survey of Areas—Preliminary Investigations 224 Sections 9, 11, 12, etc., Inspections and Revisits 991 do. Separate Lettings in above 1,018 Miscellaneous. Other Visits or Inspections not specified 2,693 Noneffective Visits 5,787 Total Nuisances and Contraventions Reported (all sources) 12,022 *Food &? Drugs Act, etc.—Wee^ End (Saturday—Sunday) Duty. Retail Shops and Food Purveyors Inspected 76 Street Markets Visited 155 Barrows, Stalls Inspected 217 * See also Section E. 25 Rent and Mortgage Interest Restrictions Acts, 1920 to 1939 (up to 30th August, 1954) Certificates of Disrepair. Applications brought forward from 1953 — Applications in 1954 17 Total 17 Certificates issued in 1954 11 Applications refused in 1954 1 Balance (Dealt with under Housing Repairs and Rents Act 1954) 5 Total 17 Clearance Certificates. Applications brought forward from 1953 2 Applications in 1954 15 Total 17 Certificates issued in 1954 11 Applications refused in 1954 6 Total 17 Housing Repairs and Rents Act, 1954 (from 30th August, 1954) Certificates of Disrepair. Section 26 Sections 26/27 Applications brought forward from Rent and Mortgage Interest Restrictions Acts, 1920 to 1939 - 5 Applications in 1954 134 10 Total 134 15 Certificates issued in 1954 79 8 Certificates refused in 1954 — — Balance to 1955 55 7 Total 134 15 Revocation Certificates. Applications in 1954 1 6 Total 1 6 Certificates issued in 1954 Certificates refused in 1954 — 3 Balance to 1955 1 3 Total 1 6 26 Improvements effected as a result of Service of Notices under the Public Health (London) Act. 1. Brickwork—walls repaired or rebuilt 5 2. Drains cleared, repaired, etc. 241 3. Dampness remedied 2,140 4. Fireplaces and ranges repaired/renewed 427 5. Floors repaired 312 6. Flues repaired 200 7. Internal walls repaired 1,074 8. Ceilings repaired 656 9. Rainwater pipes/gutters repaired 370 10. Roofs repaired 983 11. Rooms cleansed 130 12. Sinks provided 46 13. Soil pipes repaired and renewed 32 14. Staircases or passages cleansed 41 15. Staircases repaired 77 16. Waste pipes repaired 212 17. Water Closet Apartments cleansed 39 18. Water Closet Pans and Traps renewed 109 19. Water Closets—flushing apparatus repaired or renewed 167 20. Water Closets—general repairs 317 21. Water supply provided 44 22. Water service pipes repaired 111 23. Window cords renewed 1,336 24. Windows repaired or renewed 553 25. Miscellaneous improvements 702 Total 10,324 Total number of houses improved 2,998 Total number of separate lettings improved 3,506 Total number of nuisances abated 9,140 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 £1,125 9s. 6d. 27 Legal Proceedings. Public Health (London) Act, 1936. Failure to comply with Statutory Notices contrary to Section 82 (No. of Cases:95). Date Address Magistrate's Decision 14.1.54 123, Pembroke Street Defendant to pay £2 7s. costs. do. 28, Medina Road Ordered to abate within 14 days. Defendant to pay £1 14s. 6d. costs. do. 223, Junction Road Fined £3. Ordered to abate within 7 days. Defendant to pay £1 10s. 6d. costs. do. 34, Denmark Grove Ordered to abate within 21 days. Defendant to pay £l 14s. 6d. costs. do. 93, Calshot Street Fined £2. Defendant to pay £1 1s. costs. do. 15, Havelock Street Ordered to abate within 28 days. Defendant to pay £1 4s. costs. do. 71, Pembroke Street Fined £3. Ordered to abate within 28 days. Defendant to pay £1 10s. 6d. costs. do. 57, Gifford Street Ordered to abate within 28 days. Defendant to pay £1 4s. costs. 11.2.54 30, Ellington Street Defendant to pay £1 5s. costs. do. 5, Comus Road Adjourned sine die. do. 92, Gifford Street Adjourned sine die. do. 231, Junction Road Fined £2. Ordered to abate within 7 days. Defendant to pay 8s. 6d. costs. do. 178. Tufnell Park Road Fined £2. Defendant to pay £1 1s. costs. do. 8, Rickthorne Road Fined £3. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 9, Mackenzie Road Fined £3. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 521, Caledonian Road Adjourned sine die. do. 21, Wharfdale Road Fined £2. Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. do. 122, Northchurch Road Ordered to abate within 7 days. Defendant to pay £2 3s. 6d. costs. do. 57, Baxter Road Defendant to pay £1 5s. 0d. costs. do. 12, Ella Road Fined £3. do. 5, Chalfont Road Fined £3. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. 11.3.54 7, Pyrland Road Defendant to pay £1 6s. costs. do. 14, Crown Mansions Fined £5. Ordered to abate within 28 days. Defendant to pay £1 10s. 6d costs. do. 18. Ireton Road Fined £3. Ordered to abate within 28 days. Defendant to pay £1 10s. 6d. costs. do. 43, Girdlestone Road Fined £2. Ordered to abate within 15 days. Defendant to pay £1 9s. 6d. costs. do. 29, Arthur Road Fined £3. Ordered to abate within 56 days. Defendant to pay £1 9s. 6d. costs. do. 53, Roden Street Fined £5. Ordered to abate within 14 days. Defendant to pay £1 17s. 6d. costs. do. 36, Lowman Road Fined £5. Ordered to abate within 28 days. Defendant to pay £1 17s. 6d. costs. do. 25, Halton Road Fined £3. Ordered to abate within 14 days. Defendant to pay £1 10s. 6d. costs. 22.4.54 185, Offord Road Defendant to pay £1 6s. costs. do. 179, Offord Road Defendant to pay £1 6s. costs. do. 49, College Cross Defendant to pay £l 6s. costs. do. 72, Thornhill Road Defendant to pay £1 6s. costs. do. 35, Hampden Road Defendant to pay 10s. 0d. costs. do. 100, Bemerton Street Ordered to abate within 28 days. Defendant to pay £1 14s. 6d. costs. do. 5, Rydon Street (a) Defendant to pay £1 6s. costs. do. 5, Rydon Street (b) Defendant to pay £1 6s. costs. do. 111, Riversdale Road Defendant to pay £1 6s. costs. do. 37, Rhodes Street Fined £2. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 116, Lough Road Ordered to abate within 21 days. Defendant to pay 17/6d. costs. do. 4, Corporation Street (a) Ordered to abate within 28 days. Defendant to pay 13/6d. costs. do. 4, Corporation Street (b) Ordered to abate within 28 days. Defendant to pay 13/6d. costs. do. 22, Mayton Street Ordered to abate within 21 days. Defendant to pay 13/6d. costs. 28 Public Health (London) Act, 1936. Failure to comply with Statutory Notices contrary to Section 82 (N°. of Cases: 95).—contd. Date Address Magistrate's Decision 22.4.54 28, Ponder Street Fined £2. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 92, Blundell Street Fined £1. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. 20.5.54 13, Basire Street Fined £5. Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. do. 183, Barnsbury Road Defendant to pay £l 11s. costs. do. 349, Liverpool Road (a) Fined £2. Ordered to abate within 14 days. Defendant to pay £1 15s. 6d. costs. do. 349, Liverpool Road (b) Fined £2. Ordered to abate within 14 days. Defendant to pay £1 15s. 6d. costs. do. 230, Sussex Way Ordered to abate within 28 days. Defendant to pay £1 14s. 6d. costs. do. 20, Ireton Road Fined £2. Ordered to abate within 70 days. Defendant to pay £l 9s. 6d. costs. do. 163, Junction Road Ordered to abate within 28 days. Defendant to pay 13/6d. costs. do. 14, Berriman Road Fined £5. Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. do. 55, Berriman Road Fined £5. Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. do. 65, Roman Way Fined £1. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. do. 33, Westbourne Road Fined £2. Ordered to abate within 7 days. Defendant to pay £1 15s. 6d. costs. do. 22, Ellenborough Road Fined £5. Ordered to abate within 28 days. Defendant to pay £1 15s. 6d. costs. do. 5, Lesly Street Ordered to abate within 28 days. Defendant to pay £1 14s. 6d. costs. 24.6.54 25, Bedford Terrace Fined £2. Defendant to pay £1 1s. costs. do. 129, Huddleston Road Defendant to pay 5/- costs. do. 16, Arundel Square Defendant to pay £1 6s. costs. 22.7.54 9. Crown Mansions Defendant to pay £1 6s. costs. do. 27, North Road (a) Ordered to abate within 28 days. Defendant to pay 13/6d. costs. do. 27, North Road (b) Fined £2. Ordered to abate within 28 days. Defendant to pay 9/6d. costs. do. 9, North Road Fined £2. Ordered to abate within 28 days. Defendant to pay 9/6d. costs. do. 8, North Road Fined £2. Ordered to abate within 28 days. Defendant to pay 9/6d. costs. do. 7, North Road Fined £2. Ordered to abate within 28 days. Defendant to pay 9/6d. costs. do. 40, Copenhagen Street Ordered to abate with 28 days. Defendant to pay 13/6d. costs. do. 116, Barnsburv Road Ordered to abate within 14 days. Defendant to pay 13/6d. costs. do. 11, Stradbroke Road Ordered to abate within 28 days. Defendant to pay 13/6d. costs. do. 19, Barnsbury Grove Ordered to abate within 14 days. Defendant to pay £l 14s. 6d. costs. do. 3, Corporation Street Fined £2. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 84, Windsor Road Defendant to pay £1 11s. costs. 2.9.54 24, Offord Road Ordered to abate within 28 days. Defendant to pay 13/6d. costs. do. 89, Gillespie Road Fined £5. Defendant to pay £1 1s. costs. do. 40, Batt'edean Road Defendant to pay £1 6s. costs. do. 44, Arthur Road Fined £10. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 21, Roden Street Fined £5. Ordered to abate within 14 days. Defendant to pay £1 14s. 6d. costs. do. 61, Queensland Road Fined £5. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. do. 21, Roden Street Fined £5. Ordered to abate within 14 days. Defendant to pay £1 14s. 6d. costs. do. 179, Upper Street Ordered to abate within 28 days. Defendant to pay 13/6d. costs. do. 42, St. Judes Street Fined £5. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. 29 Public Health (London) Act, 1936. Failure to comply with Statutory Notices contrary to Section 82 (N". of Cases : 95).—contd. Date Address Magistrate's Decision 2.9.54 93, Queensland Road Fined £5. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. 7.10.54 2, Andover Street Fined £2. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. do. 48, Copenhagen Street Fined £1. Defendant to pay £1 1s. costs. do. 100, Bemerton Street Case withdrawn. (Action taken under Section 11 of Housing Act, 1936). do. 25, Marlborough Road (a) Fined £5. Defendant to pay £1 1s. costs. do. 25, Marlborough Road (b) Ordered to abate within 35 days. Defendant to pay £1 14s. 6d. costs. do. 85, Cornwallis Road Fined £2. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. do. 33, Westbourne Road Fined £1. Defendant to pay £1 1s. costs. do. 37, King Henry Street Fined £2. Defendant to pay £1 1s. costs. 4.11.54 24, Gainford Street Defendant to pay £1 11s. costs. 9.12.54 37, Florence Street Defendant to pay £1 6s. costs. do. 74, Pooles Park Fined £3. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 25, Mayton Street Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 31, St. Clements Street Fined £5. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. In addition, a Prohibition Order was made in relation to 160, Tufnell Park Road on 24.6.54, and Defendant was ordered to pay 13/6d. costs. Failure to comply with a Statutory Notice contrary to Secion 123. Date Address Magistrate's Decision 9.12.54 25, Mayton Street Fined £1 . Defendant to pay £1 1s. costs. 30 Public Health (London) Act, 1936. Failure to comply with Magistrate's Abatement Order (No. of Cases : 40). Date Address Magistrate's Decision 14.1.54 11, Huntingdon Street Not proceeded with. do. 8. Story Street Fined £3. Defendant to pay £1 1s. costs. 11.3.54 68, Lough Road Fined £15. Defendant to pay £l 1s. costs. do. 17, Ella Road Fined £15. Defendant to pay £1 1s. costs. do. 45, Sonning Street Fined £5. Defendant to pay £1 1s. costs. do. 230, Sussex Way Fined £15. Defendant to pay £1 1s. costs. 22.4.54 43, Oldershaw Road Fined £5. Defendant to pay £1 1s. costs. do. 31, Lyon Street Defendant to pay £1 6s. costs. do. 222, York Way Fined £2. Defendant to pay £1 1s. costs. do. 105, Georges Road Fined £5. Defendant to pay £1 1s. costs. do. 107, Georges Road Fined £3. Defendant to pay £1 1s. costs. 20.5.54 68, Lough Road Fined £25. Defendant to pay £1 1s. costs. Ho. 57, Gifford Street Fined £5. Defendant to pay £1 1s. costs. do. 71, Pembroke Street Fined £40. Defendant to pay £1 1s. costs. do. 8, Rickthorne Road Fined £25. Defendant to pay £1 1s. costs. do. 194, Liverpool Road Fined £20. Defendant to pay £1 1s. costs. 24.6.54 42, Arthur Road Fined £5. Defendant to pay £1 1s. costs. do. 21, Wharfdale Road Fined £2. Defendant to pay £1 1s. costs. 22.7.54 28, Medina Road Fined £2. Defendant to pay £1 1s. costs. do. 107, George Road Fined £5. Defendant to pay £1 1s. costs. do. 105, Georges Road Fined £10. Defendant to pay £1 1s. costs. do. 17, Ella Road Fined £3. Defendant to pay £1 1s. costs. 2.9.54 55, Berriman Road Fined £50. Defendant to pay £1 1s. costs. do. 92, Blundell Street Fined £30. Defendant to pay £1 1s. costs. do. 36, Lowman Road Fined £5. Defendant to pay £1 1s. costs. do. 22, Mayton Street Fined £50. Defendant to pay £1 1s. costs. 7.10.54 67, Regina Road Fined £10. Defendant to pay £1 1s. costs. do. 4, Corporation Street Fined £5. Defendant to pay £1 1s. costs. 4.11.54 4, Corporation Street Fined £10. Defendant to pay £1 1s. costs. do. 105, Georges Road Fined £50. Defendant to pay £1 1s. costs. do. 107, Georges Road Fined £50. Defendant to pay £1 1s. costs. do. 21, Wharfdale Road Fined £25. Defendant to pay £1 1s. costs. do. 22, Mayton Street Fined £63. Defendant to pay £1 1s. costs. do. 55, Berriman Road Fined £63. Defendant to pay £1 1s. costs. do. 28. Medina Road Fined £25. Defendant to pay £1 1s. costs. do. 42, Arthur Road Fined £10. Defendant to pay £1 1s. costs. 9.12.54 7, North Road Fined £25. Defendant to pay £1 1s. costs. do. 8, North Road Fined £25. Defendant to pay £1 1s. costs. do. 27, North Road (a) Fined £25. Defendant to pay £1 1s. costs. do. 27, North Road (b) Fined £5. Defendant to pay £1 1s. costs. 31 Disinfection and Disinfestation. The Council having decided to renew the boiler and disinfecting plant at the Disinfecting Station, the work normally carried out by this Council, including the treatment of scabies and other verminous conditions, was temporarily transferred to the Finsbury Health Centre during December. Thanks are due to the Finsbury Borough Council, through the good offices of its Medical Officer of Health, for its valuable assistance in permitting Islington cases to be treated and disinfection and disinfestation of articles to be carried out at Finsbury. 663 rooms were disinfected after cases of infectious or other disease. A total of 1,163 rooms were treated for vermin, of which 389 were disinfested free of charge. The majority of free cases were on behalf of elderly or infirm persons. The Council make a charge of 7/6d. for the first room and 5/-d. for every additional room treated for verminous conditions. The furniture and bedding of families moving to new Council dwellings were treated in situ with a preparation of D.D.T. before removal and again when families took up residence in the new accommodation. The effects of 443 families were so treated as a precautionary measure. In addition, six treatments for flies were carried out on static water tanks, bombed sites, etc. The Sanitary Inspector paid 134 visits to a factory to supervise the treatment of 720 bales of stockings or other materials for export to South Africa. Steam Disinfection. 56,174 articles of clothing or bedding were subjected to steam disinfection at the Disinfecting Station (42,130 for clothing contractors). Static water tanks, air-raid shelters, bombed sites, etc. The Department continued to receive complaints concerning the tipping of refuse, accumulation of water and other nuisances in respect of static water tanks on bombed or vacant sites. Organic and other refuse, such as bedding, etc., was removed by the Cleansing Superintendent upon requests forwarded by this Depart' ment. The co-operation of the London Fire Brigade continued to be available to pump out stagnant water from static water tanks. In accordance with arrangements made with the London County Council the Borough Engineer is authorised, on behalf of the Council, to proceed with the clearance of rubble from static water tanks, the cost being met by the London County Council who, in turn, claims grant thereon from the Home Office. The initiation of action for cleaning the tanks rests with the Borough Council. Details of the action taken are as follows :— Visits to bombed sites 146 Visits to air-raid shelters and static water tanks 19 Vacant land cleansed 6 Vacant land enclosed — Derelict buildings enclosed 2 Static water tanks cleansed 9 32 Blowfly Infestation. The treatment with D.D.T. of the sidings at Ashburton Grove Refuse Disposal Depot continued throughout the summer months. This treatment consisted of dusting with D.D.T. powder the large area of railway track, the broken bottle pit, the surrounding green areas and any other areas as circumstances required. • As and from April 1st this year the Council discontinued the separate collection of kitchen waste. Whilst the scheme was necessary, due to the economic situation of the country, numerous complaints were received by this Department and since its commencement constant supervision was necessary in order to prevent fly-breeding and smells from decomposing refuse. For some years arrangements were in operation for the bins to be subject to a periodic washing and cleansing by the Cleansing Department at the Depot and then to be treated on the site with D.D.T. powder. Whilst the scheme continued, however, it was always open to abuse and a potential source of nuisance. The borough has benefited from a public health point of view by its discontinuation. Atmospheric Pollution. Public Health (London) Act, 1936—Part V. Emission of Smoke. Smoke abatement continues to be a matter of major concern to the Department, the public, quite rightly, being smoke-conscious, particularly since the occurrence of the London "Smog" in December, 1952. The Inspectors, too, are fully aware of this fact, as is shown in the increased number of observations carried out and the number of notices served. Visits are paid and inspections made upon receipt of a complaint or as a routine measure and, where necessary, the Inspectors demonstrate to the stoker and other staff concerned, including factory owners and managers, how to stoke a furnace without giving rise to a smoke nuisance. Technical advice is given and any difficulties discussed at the time. Visits of this nature are of inestimable value to employers and employees, as well as the general public. Although the emission of smoke from factories is controlled by statute, the emission of domestic smoke is free from any such restriction. In November of this year the Report of the Committee on Air Pollution, under the Chairmanship of Sir Hugh Beaver, was published. The problem of air pollution is a difficult one and so many factors have to be considered. It is estimated that nearly half of all the smoke in the atmosphere is from domestic chimneys and in a densely built-up area, such as Islington and its contiguous boroughs, this is considerable. Much has been done by fitting grates suitable to burn smokeless fuels in new houses and flats and to convert existing ones but when this has been done there is no guarantee that smokeless fuel will be available in sufficient quantities and at an economical cost. In fact, it will be some considerable time before the consumer can be assured of a guaranteed supply. In addition, increased storage space will have to be provided. In certain areas smokeless zones have been created. It is, however, 33 difficult to foresee when it will be possible for similar action to be taken in this borough, having regard to the mixed industrial/domestic development in Islington. A considerable addition to domestic pollution locally is occasioned by the exhaust from diesel-engined lorries which pass through the borough to and from the North. The Report of the Committee on Air Pollution indicated that:— "Smoke from diesel engine exhaust can be a serious nuisance. It is discharged at a low level and may even at times endanger driving by reducing the field of vision. The dirt it deposits on windows, lamp-posts and other objects in the street is objectionable and difficult to remove. Diesel smoke is unnecessary. All the evidence agrees that diesel engines, if they are properly maintained, properly serviced and properly driven need not emit smoke except possibly for a short burst when starting." The Committee, however, would not agree that even at the starting such smoke should be tolerated, but to prevent it would require research into diesel engine design. It recommended that the present law for the control of pollution by motor vehicles should be more vigorously enforced. Before the year closed a "Clean Air Bill" was before Parliament which proposed to implement 8 of the 12 specific recommendations of the Report of the Committee on Air Pollution. When the Bill is placed on the Statute Book a considerable advance will be made in ensuring the maintenance of clean air. The public have been educated to demand clean pure water and food. It should also be able to be assured that the third essential to life, viz., air, is equally clean and pure. Not only would people enjoy better health by breathing clean fresh air but they would also benefit by the increased penetration of light. The Council, aware of the importance of this subject, agreed to the fixing of equipment for the daily recording of atmospheric pollution at the Town Hall and at the Disinfecting Station respectively. It is hoped that this apparatus will be installed early next year. The equipment is additional to the deposit and sulphur-dioxide gauges which are already in use, and from which results are obtained monthly. During the year the Council appointed two representatives, including the Medical Officer of Health, to serve on the London and Home Counties Smoke Abatement Advisory Council. Number of complaints received during year 41 Number of observations 315 Number of inspections and revisits 307 Number of notices served 10 Number of notices complied with 5 Recording of Atmospheric Pollution. A summary of the observations at the three stations in the Borough is as follows :— 34 Monthly Deposits recorded by the Deposit Gauges and Sulphur-Dioxide by the Lead-Peroxide Method. Month Site No. * Rainfall in Inches Insoluble Deposit Soluble Deposit Total Solids Mg.of SO3/day collected by 100 sq. cm. of Batch A Lead-Peroxide. (Louvered Box) (Tons per square mile) January 1 0.91 10.77 7.75 18.52 4.27 „ 2 1.02 14.98 30.46 45.44 4.31 „ 3 1.02 9.28 7.42 16.70 2.90 February 1 1.93 13.98 16.54 30.52 5.31 „ 2 2.13 21.11 50.44 71.55 4.90 „ 3 2.32 16.44 13.25 29.69 3.08 March 1 1.35 12.39 11.57 23.96 2 95 „ 2 2.09 21.08 27.90 48.98 3.35 „ 3 2.05 15.74 7.16 22.90 2.31 April 1 0.20 5.53 3.81 9.34 2.52 „ 2 0.32 8.45 3.98 12.43 2.36 „ 3 0.39 8.02 3.81 11.83 1.85 May 1 1.38 11.23 10.01 21.24 2.03 „ 2 1.69 17.30 24.09 41.39 2.14 „ 3 1.73 13.52 16.44 29.96 1.23 June 1 3.19 7.22 9.35 16.57 1 20 „ 2 3.07 12.76 18.29 31.05 1.04 „ 3 3.70 7.42 5.53 12.95 0.79 July 1 No Record „ 2 2.91 12.89 16.54 29.43 1.58 „ 3 2.99 7.95 5.63 13.58 0.63 August 1 2.60 6.46 9.15 15.61 1.58 „ 2 3.11 15.74 22.04 37.78 1.92 „ 3 3.55 7.79 9.14 16.93 0.83 September 1 1.69 8.82 9.74 18.56 2.09 „ 2 1.81 14.32 18.19 32.51 2 24 „ 3 1.77 9.94 6.93 16.87 1.07 October 1 2.40 7.36 7.79 15.15 2 99 „ 2 2.36 17.60 26.15 43.75 3.21 „ 3 2.25 8.15 5.53 13.68 1.47 November 1 2.88 10.17 12.10 22.27 5.02 „ 2 2.58 15.61 42.25 57.86 4.85 „ 3 3.51 9.84 14.55 24.39 3.07 December 1 1.58 11.43 9.74 21.17 4.89 „ 2 1.65 17.40 27.14 44.54 4.45 „ 3 1.85 10.01 5.96 15.97 3.18 * These sites are situated ait the following places in the Borough :— 1.—Town Hall roof. 2.—York Way Court (Caledonian Road area). 3.—Disinfecting Station at Seven Sisters Road. % Requisitioned Properties. The number of requisitioned properties on the 1st January, 1954, was 1297. 93 were de-requisitioned during the year. This department has drawn the attention of the Council's Housing Manager to any nuisances or major difficulties arising from the occupation of requisitioned properties in order to ensure the premises being reasonably nuisance free. 150 such references were made. 35 WORK OF SANITARY INSPECTORS ADMINISTERING FACTORIES ACT, 1937, FOOD AND DRUGS ACT, 1938, AND OTHER RELEVANT ACTS. Inspections and Re-Visits. 5,287 inspections and 3,703 re-visits were made by the Inspectors. These are summarised as follows:— Coffee and dining rooms, hotel and restaurant kitchens and refreshment rooms Inspections Revisits 892 409 Stalls (Refreshment and Food) 106 20 Factories (Mechanical) 1,305 1,333 Factories (Non-mechanical) 154 75 Factories (Public Health (London) Act, 1936) 1,269 1,239 Fish curers 66 7 Fishmongers 13 3 Fried Fish Shops 150 29 Noise Nuisances 49 39 Outworkers 73 40 Provision Shops 370 163 Special Inspections (Food licences) 14 — Bakehouses (Level) 133 72 Confectioners 188 72 Food Factories 2 — Fruiterers/Greengrocers 245 98 Preserved food premises 258 104 5,287 3,703 (See separate section for underground bakehouses and offensive trades.) Defects, nuisances or contraventions found. Nuisances and Notices. (a) Factories Act, 1937. Number of contraventions found 838 Number of contraventions remedied 857 Notices served 220 Notices complied with 189 (b) Food and Drugs Act, 1938. Number of contraventions found 1,738 Number of contraventions remedied 1,584 Notices served 160 Notices complied with 168 (c) Public Health (London) Act, 1936. Number of contraventions found 475 Number of contraventions remedied 418 Notices served 171 Notices complied with 134 (d) Shops Act, 1950. Number of inspections under this Act 447 Number of revisits 72 Number of exemption certificates applied for 4 Number of certificates granted 2 Complaints received. Number of complaints (General) 389 Number of complaints (Home Office) 19 36 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 Inspections Number of Written Notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 288 154 5 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,798 1,305 215 - (iii) Other Premises in which Section 7 is enforced by the Local Authority* (excluding out-workers' premises) — — — — Total 2,086 1,459 220 - 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) 9 32 4 3 Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) 1 2 — 2 — Inadequate ventilation (S.4) — 1 — 1 — Ineffective drainage of floors (S.6) 1 2 — — Sanitary Conveniences (S.7)— (a) Insufficient 8 15 — 1 — (b) Unsuitable or defective 489 522 — 18 — (c) Not separate for sexes 3 7 — — Other offences against the Act (not including offences relating to Outwork) 337 276 — — Total 848 857 4 25 — * i.e. Electrical Stations (Section 103 (1)), Institutions (Section 104) and sites of Building Operations and Works of Engineering Construction (Sections 107 and 108). 37 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 unwhole- some premises Notices served Prosecutions (1) (3) (4) (5) (6) (7) (8) {Making, etc. Wearing {Cleaning and apparel {washing }620 — — — — — Brass and brass articles 3 — — — — Furniture and upholstery 1 — — — — — Umbrellas, etc 2 — — — — — Artificial flowers 93 — — — — — Paper bags 10 — — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper 96 - - - - - Brush making 11 — — — — — Feather sorting 10 — — — — — Carding, etc., of buttons etc. 26 ___ Stuffed toys 49 - — — — — Cosaques,Christmas crackers,Christmas stockings, etc. 7 - - - - - Lampshades 17 - — — — — Chocolates and sweetmeats . . 33 — — — — — Total 977 — — — — — Factories Act, 1937—Section 54. Underground Bakehouses. Certificates of Suitability, as required by Section 54 of the Factories Act, 1937, continued to be in force in respect of 21 underground bakehouses at the following addresses:— 52 Balls Pond Road, N.1 3 Cardwell Terrace, N. 76 Caledonian Road, N.1 144 Elthorne Road, N. 299 Caledonian Road, N.1 132 Holloway Road, N. 8 Danbury Street, N.1 27 Hornsey Rise, N. 68 Essex Road, N.1 7 Junction Road, N. 350 Essex Road, N.1 59 Junction Road, N. 121 Packington Street, N.1 239 Junction Road N. 52 Stanmore Street, N.1 77 Newington Green Road, N. 54 Archway Road, N. 123 Newington Green Road, N. 84, Ashbrook Road, N. 69, St. Peter's Street. 146, Blackstock Road, N. 38 Underground Bakehouses—continued. Certificates of Suitability in respect of the following premises ceased to have effect during the year, the basements being no longer used as bakehouses:— 128, Blackstock Road. 156, Blackstock Road. 398, Essex Road. 487, Hornsey Road483, Liverpool Road. 14, Upper Street. 102, Upper Street. Details of the work carried out under this section are as follows :— Number of routine inspections 145 Number of re-visits 215 Number of notices served 12 Number of notices complied with 14 Public Health (London) Act, 1936. London County Council (General Powers) Act, 1937. Noise Nuisances. Details of the action taken in respect of complaints received of alleged noise nuisances during the year are as follows :— Number of complaints of noise nuisances 28 Number of inspections 49 Number of revisits 39 Number of notices served 1 Number of notices complied with 1 One petition was received complaining of an alleged noise nuisance caused during the night at a certain factory in the borough. The Company, upon being approached, discontinued all night work and, therefore, no further action was necessary in this case. Public Health (London) Act, 1936 (Part IV). Offensive Trades. Details of the respective offensive trades in the Borough are as follows :— (a) 2 Tripe Boilers: 14/18, Market Road—Messrs. J. L. Henson (Wholesale) Ltd. 22/24, Vale Royal—Messrs. Edmund Martin Ltd. (b) 1 Knacker: 18/20, Vale Royal—Messrs. Harrison Barber & Co. Ltd. 39 (c) 1 Fur Skin Dresser : 24, Bracey Street—Messrs. J. & A. Fischer Ltd. (d) 7 Gut Scrapers : 3. Old Slaughterhouses—Casings Ltd. 4, Old Slaughterhouses—Home Killed Meat Association Ltd. 12, Old Slaughterhouses—Universal Casings Co. Ltd. 13, Old Slaughterhouses—Messrs. Morris & Co. (Meat Importers) Ltd. 15, Old Slaughterhouses—Messrs. Wm. Menzies Ltd. 5 Tileyard Road—Messrs. C. Edwards & Son Ltd. Tileyard Road—Messrs. Tracey & Co. Ltd. (e) 2 Fat Melters: 4, Old Slaughterhouses—Home Killed Meat Association Ltd. 16, Old Slaughterhouses—Messrs. Wm. Menzies Ltd. 43 inspections were made of the above premises and appropriate action taken where necessary. (f) 1 Slaughterer: 180, York Way—Messrs. Harrison Barber & Co. Ltd. This slaughterhouse was the subject of 115 inspections or visits. The Minister of Food, in Circular MF. 10/54, drew the attention of local authorities to the fact that the Ministry would cease to be responsible for the slaughter of animals and, therefore, private slaughtering could recommence on the 2nd July. Licences were current in respect of the following private slaughter-houses but the Council decided not to renew them after October this year. Accordingly slaughtering at these premises was not permissible after expiration of the licences :— 32, Islington High Street—Messrs. Chalk and Cox Ltd. 18, Brecknock Road—Mr. A. Guyer. 9, Junction Road—Messrs. Webber Bros. 498, Holloway Road—Mr. J. L. Williams. (g) The Council approved the issue of a licence under Section 145 in respect of the receiving of carcasses of dead horses for human consumption at :— 14/16, Vale Royal—Messrs. Harrison, Barber & Co. Ltd. (h) During the year the Ministry of Food issued Model Byelaws, Series 11, in respect of the sanitary conditions, management and keeping of records for knackers' yards. 40 The Minister of Food also issued the Knackers' Yard (Revocation) Order, 1954, thereby repealing the Knackers Yard Order, 1948, which required the occupier of a knacker's yard to hold a licence granted by the Ministry of Food and to keep certain records for the information of the Minister. The Slaughter of Animals (Amendment) Act, 1954, by virtue of which the Minister of Food is empowered to make regulations for securing humane conditions in slaughter houses, came into operation on 1st October. Shops Art, 1950—Applications for Exemption. There were four applications received for exemption from the provisions of Section 38 relative to the provision of suitable and sufficient sanitary conveniences. These were dealt with as follows :— Granted 2 Refused 1 Dealt with in 1955 1 Pharmacy and Poisons Acts, 1933/1941. Number of Listed sellers of Part II Poisons other than registered pharmacists 192 Number of initial registrations during the year 7 Number of visits and inspections 26 Amendments to the Poisons List and Poisons Rules were made during the year by virtue of the Poisons List Order, 1954, the Poisons List (No. 2) Order, 1954, the Poisons Rules 1954 and the Poisons (No. 2) Rules, 1954. Rag Flock and other Filling Materials Act, 1951. Number of premises on Register (Section 2 for Upholstery) 35 Number of Licences issued (under Section 7 for the storage of Rag Flock) 1 Diseases of Animals Acts. Foot and Mouth Disease. In February a notice was issued by the London County Council Public Control Department to the effect that an outbreak of foot and mouth disease had occurred at premises in proximity to London, resulting in Islington being in the restricted area. Pet Animals Act, 1951. Number of licences issued during year 27 Number of inspections and revisits 107 41 Prevention of Damage by Pests Act, 1949. The following is a summary of the work carried out during the year. Notices Served : 16 Intimations and 8 Statutory Notices. Type of Property Local Authority Premises Dwelling Houses Business Premises Total 1. Complaints received (including repeats) 24 1,230 177 1,431 2. Number of properties inspected as a result of : (a) Notification (initial complaint only) (a) 21 1,022 153 1,196 (b) Block Survey (b) 219 1,085 39 1,343 3. Number of properties found to be infested by rats (including 11 ship rats) 17 597 82 686 4. Number of properties found to be infested by mice 5 459 54 518 5. Re-visits by Investigators *1,104 3,611 92 4,807 6. Non-effective visits by Investigators 2 648 7 657 7. Number of infested properties treated (new jobs commenced) 620 1,065 129 1,814 8. Continuation or post-bait treatment *524 2,356 361 3,241 9. Visits by Operators *4015 12,259 999 17,273 10. Still being baited at end of year 1 19 11 31 11. Completed during the year 1,344 2,047 230 3,621 12. Number of Business Agreements dealt with : 107. 13. Members of the Rodent Staff assisted in the application of smoke tesits in respect of 149 drainage tests carried out by Sanitary Inspectors. * Includes the baiting of manholes for sewer maintenance treatments 19/20 and special sewer treatment No. 7. NOTE :—For the purpose of completing Sections 2, 3, 4 and 7, each property is entered once only in respect of inspections, infestations and treatments. Difficulties still continue to be met in this section of the work of the Department and it is only by patience and persistence that many of the cases are brought to a satisfactory conclusion. A number of infestations were traced to unsealed disused drains. Quite a lot of work can be done before a disused outlet is found and the premises cleared of rats. In one case where the premises were badly infested by rats an inspection of the sewer revealed six disused outlets. Upon these being sealed off the nuisance from rats was abated. In another case it was found that rats had gnawed a hole through a slate cap fitted to the clearing eye of the interceptor and, therefore, obtained access to the house. Had the slate cap been properly fitted the rats could not have found an edge on which to commence their gnawing operations. Another case which gave considerable trouble for a long period was one where a defect was eventually found in the drain of the adjoining premises at a point very near the sewer. Since this defect has been repaired no further rats have been seen at this address. 42 The Sanitary Inspector and the Rodent Officer made joint quarterly inspections of four hospitals in the borough and the Hospital Management Committee was informed of any matters which required attention. Representatives of the Public Health Department attended three meetings of the Workable Area Committee during the year. With the approval of the Committee, members of the Rodent Control staff were allowed to attend a one-day refresher course run by the Ministry of Agriculture and Fisheries during the year. The Council also agreed to the attendance of the Rodent Officer at a course in Pest Control. Sewer Treatments. Two routine sewer treatments were carried out during the year in connection with which the co-operation of the Borough Engineer and his staff was appreciated. Because of staff shortages difficulties was experienced by the Borough Engineer in supplying the necessary assistance during the year. Arrangements were made, however, with the Council's Contractors for the necessary labour to be provided. Details of the treatment are as follows :— T reatment No. Manholes Bodie® Seen Percentage of Poison Takes Baited Showing Complete Takes Showing pre-bait Takes Showing No Takes CT PT NT 19 798 203 426 372 6 6.57% 83.10% 10.33% 20 647 176 385 262 – (Poison takes not recorded) In addition a special treatment was arranged, upon the request of the Ministry of Agriculture and Fisheries, in which the poison 1,080 was used- Baits were laid at 34 manholes, 33 by this Council and 1 by the L.C.C. The results of the treatment of the 3 3 manholes by this Department are detailed below :— Treatment No. Manholes Bodies Seen Percentage of Poison Takes Baited Showing Complete Takes Showing pre-bait Takes Showing No Takes CT PT NT Special No. 7 33 nil 22 11 22 nil 66.67% 33.33% Water Supplies. The Metropolitan Water Board continues to be the responsible authority for the supply of water to this Borough. Public Health (London) Act, 1936—Section 95. (1) Water supplies to tenement houses. 40 notices were served under this section requiring the provision of water supplies to tenement houses. 43 44 water supplies were provided. One prosecution was taken for failure to comply with a statutory notice but the case was adjourned by the Court, in order that the proposal submitted by the owner could be considered by the Council. Upon the Public Health Committee considering this case the owner's proposals were agreed to and the case was with' drawn when it came up for reconsideration by the Court. (2). 58 applications were received for water certificates, and 58 certificates were issued in respect of 787 separate dwellings. Well Water. The annual examination of the twenty-eight bore holes and wells known to exist in the borough was carried out. Nineteen have been abandoned and effectively sealed, leaving nine capable of being used, three of which are temporarily out of commission. Samples of water for chemical and bacteriological examination have been taken from the six bore holes or wells at present in use and the results show that no exception can be taken to their continued use for domestic or washing purposes. In no case is the water used for dietetic purposes. Swimming Bath Water. The number of samples of swimming bath water taken during the year is as follows :— Satisfactory Unsatisfactory Chemical Bacteriological Chemical Bacteriological Chemical Bacteriological 10 10 10 10 — — In addition three samples of subsoil water were taken. SECTION D HOUSING (In conjunction with Mr. W. C. Bartlett, Chief Sanitary Inspector). The year under review is an important one in relation to housing, for it was on the 30th August that the Housing Repairs and Rents Act became operative, having received Royal assent a month previously. As indicated in circular 55/54 issued by the Ministry of Housing and Local Government this Act provides statutory powers needed to implement the proposals made in the White Paper—Houses—The Next Step—which was published in 1953. In particular the new Act facilitates the exercise of the Council's statutory resporv sibility for the clearance and replacement of slum houses, the enforcement of essential repairs and the encouragement of improvements and conversions. Part I of this statute deals with provisions as to clearance and redevelopment, the reconditioning of unfit houses and other amendments of the Housing Acts. It 44 places an obligation upon the Council to submit within the next 12 months for the Minister's approval proposals for dealing in one way or another with the houses in its area which appear to be unfit for human habitation and with any other houses within the district which are, or ought to be, included in clearance areas. The standard of fitness for human habitation has been revised and, in determining for any purposes of the principal Act whether a house is unfit for human habitation, regard shall be had to its condition in respect of certain specified matters. Consequent upon the passing of this Act the L.C.C. byelaws as to Lodging Houses for the Working Classes ceased to have effect, and as the appropriate section of the Public Health (London) Act, 1936, was also repealed, the proposed byelaws relating to hostels could not be proceeded with. Part II of this statute deals with the repairs increases in respect of controlled dwelling houses and makes certain amendments to the Rents Acts. Landlords can now in certain cases increase rents and this statute details the procedure which must be adopted. Tenants may, either under this Act or the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920, whichever is applicable, apply for Certificates of Disrepair from the Council and the number of such applications has considerably increased since the coming into operation of this Act, as will be seen by reference to the table given on Page 25 of this Report. Part III of this Act deals with miscellaneous and general provisions and includes modifications of procedure for obtaining Clearance Orders and certain Compulsory Purchase Orders. In order to carry out its obligations under this Act the Council approved an increase of three in the establishment of Sanitary Inspectors and the upgrading of all the positions of Inspectors engaged on duties under this statute. The implementation of this Act will cause a considerable increase in the work of Inspectors and the Department generally. The majority of the dwellings in the borough are reaching their centenary, are occupied by several families, and are falling into a state of disrepair and dilapidation. Owners in many cases find it difficult to comply with the requirements of the Council under the Public Health (London) Act, 1936, and upon finding the houses uneconomic, abandon them. In Circular 30/54 received from the Minister of Housing and Local Government in March the Council was asked to resume the full exercise of powers under Parts II and III of the Housing Act, 1936, and later Circular 55/54 explained the provisions of the Housing Repairs and Rents Act, 1954, to facilitate the enforcement of essential repairs and the clearance and replacement of slum houses. In view of the fact that the work under the Housing Act in connection with slum clearance, improvement areas and repair of houses is being recommenced— having been discontinued for 15 years—the Council agreed to those Inspectors whose duties were closely associated with this work attending a course of ten lectures at advanced level arranged by the London Centre of the Sanitary Inspectors'' Association, which commenced in December this year. These lectures, opened by the Parliamentary Secretary of the Ministry of Housing and Local Government, are of a high standard and both the Council and its Inspectors will benefit by the attendance of the Department's technical officers. There are approximately 14,000 underground rooms in the borough, the majority of which do not comply with the requirements of Section 12 of the Housing Act, 45 1936, and the Council's regulations made under this section. It is, therefore, pertinent to note that the Minister of Housing and Local Government issued Model Regulations, Series XXII, during the year. In certain cases it has been found that houses are being purchased and let in single furnished rooms at high rents. The accommodation, either as a single letting or totally, is found to be overcrowded and lacking amenities which should be provided to bring the property up to the required standard. During the year 278 notifications of intending immigrants were received from the Commissioner of Cyprus. 157 were acceptable on housing grounds in the first place but 75 applications could not be recommended. In a further 6 cases which could not be recommended in the first instance it was later found possible, by a re-arrangement or additional accommodation being found in the home, to approve these applications. No action could be taken in 25 cases, due to the wrong address being given or cancellation of the applications. At the end of the year 15 applications were still under consideration. The 278 applications refer to 471 persons comprising :— 177 male adults. 181 female adults. 113 children. Of the 163 cases accepted there were included 246 persons comprising :— 83 male adults. 102 female adults. 61 children. Notifications are also received from the Government of Malta where immigrants propose to take up residence in this Country. 7 applications were received during the year in respect of 9 persons comprising :— 3 male adults. 3 female adults. 3 children. Three applications were approved, 3 applications were withdrawn and in one application no action was possible due to the wrong address being given. The 3 approved applications included were in respect of :— 1 male adult. 1 female adult. 3 children. Re-housing. Number of dwellings erected by this Council during year 397 Number of dwellings in the course of erection at end of year by this Council 340 Number of new applications (L.C.C.) referred to this Department during year 1,360 46 Number of above families in respect of whom overcrowding forms have been issued 133 Number of above families not living in overcrowded conditions 129 ________________________ Number of overcrowded families re-housed by the Islington Borough Council during the year 465 Number of overcrowded families re-housed by the London County Council during the year 99 In addition, a number of families have been re-housed from sites acquired for re-development in connection with the Council's Housing Schemes. Further families have been re-housed from properties in respect of which Closing or Demolition Orders have been made. Number of applications referred to the Department from the Commissioner, Cyprus Government, for acceptance of immigrants from Cyprus 278 Number of letters sent concerning housing conditions during the year 2,589 Housing Act, 1936. Housing Consolidated Regulations 1925/32. During the year the following action was taken under the Housing Act, 1936 :— Number Section 9. Houses the defects in which were remedied in consequence of informal action nil „ Representations made with a view to the serving of notices requiring the execution of works nil „ Notices served requiring the execution of works nil „ Houses rendered fit after service of formal notices nil Section 11. Houses which on inspection were considered to be unfit for human habitation 33 „ Houses represented 33 „ Demolition Orders made 10 „ Closing Orders—Section 11 as amended by the Local Government (Miscellaneous Provisions) Act, 1953 8 47 Number Section 11. Houses in respect of which an Undertaking was accepted 9 „ Houses demolished 6 Section 12. Representations made with a view to the making of Closing Orders : (a) underground rooms 58 (b) parts of buildings 5 „ Closing Orders made : (a) underground rooms 53 (b) parts of buildings 7 „ Undertakings accepted 7 „ Closing Orders determined upon the completion of necessary work 6 „ Undertakings cancelled upon the completion of necessary work 1 Licences authorising temporary overcrowding. Four licences were granted under Section 61 of the Housing Act, 1936, authorising overcrowding ; 3 for a period of six months and 1 for a period of 3 months. In 3 cases these constituted renewals of licences which had expired. One application for a licence was not granted. The total number of dwellings affected was therefore 5. Town and Country Planning (Housing Accommodation) Direction 1952. In accordance with this Direction the Council is consulted by the London County Council before consideration is given to applications received for a change of user from a dwelling to another purpose. In this connection 34 investigations were carried out by this Department. SECTION E SUPERVISION OF FOOD The principal statute passed by the Government during the year was the Food and Drugs (Amendment) Act, 1954, which, with the exception of Section 28, will come into force on a date to be appointed by the Minister of Food. This Act will give increased control over food premises in due course and provide for the setting up of a Food Hygiene Advisory Council to consider and advise on questions relating to the Food and Drugs Acts, 1938/1954 as they apply in relation to food. The Minister of Food issued the Food Standards (Margarine) Order, 1954, which came into force on the 16th May and prescribed a standard for margarine as respects Vitamin A and Vitamin D to be contained therein. The Order applies to retail sales of home produced and imported margarine but does not include margarine used by a caterer in the preparation of made up foods or in cooking. It is very necessary that samples of margarine be taken in this borough as having regard to the high cost of butter it is possible that the consumption of margarine is proportionately high, and consumers, therefore, should be afforded the protection given by this Order. 48 The Report of the Food Standards Committee on colouring matters, giving recommendations relating to the use of colouring matters in foods, was published during the year. Circulars issued during the period under review include the following :— 1. The Public Health (Preservatives, fete, in Food) Regulations, 1925 to 1948— Thiourea. Circular MF. 2/54. This Circular, issued on the 25th January, 1954, drew the attention of Local Authorities to the possible use by certain orange growers of thiourea, and of fungi' cides containing thiourea as a rot and mould suppressant. The thiourea can penetrate the skins of citrus fruits and find its way into the juice. As it has been shown that this chemical is lethal to some animals in very low concentrations, its use is accordingly open to strong objections on grounds of toxicity. The Minister is advised, moreover, that thiourea falls within the definition of " Preservative " contained in the Preservatives in Food Regulations, and that the sale of any article of food containing thiourea would be a contravention of these Regulations, since no provision exists therein permitting its addition to food. 2. Cream Soup. Circular MF. 3/54. The Ministry of Food in a circular issued on 8th February, 1954, amended the Code of Practice for canned soup as respects the fat content of products known as " cream soups ". This was due to the fact that butter for manufacturing purposes had become more freely available, and it has therefore been agreed that the product described as cream soup shall contain not less than 2½% by weight of butter fat, with certain exceptions where the total fat content is not less than 3% or 3½% respectively. The food prepared, manufactured, stored and sold in the borough continues to be inspected and complaints received by the Department included the following :— Mince Pie containing a Nail. Cigarette-end in Loaf of Bread. Maggot in Cereal. Rodent Droppings in Loaf of Bread. Apple Turnover affected with mould. Dirty Bottles of Milk. Canned Soup containing excessive amount of tin. Piece of String in Cheese Roll. Nail in Loaf of Bread. Metal Caps in Bottle of T.T. milk. Packet of Oats containing Maggot. Cockroach in Jar of Extract of Malt. Nail in Cake. Black-currant Pie affected with mould. In the majority of cases the evidence was not sufficient to justify statutory action being taken. As a result of the conditions found at a cafe in the borough the owners and occupiers were prosecuted. Although these conditions had continued for some time 49 it was difficult to take action as the cafe changed hands frequently. The premises, although mainly structurally sound, were found to be in a filthy and deplorable condition. The cooking apparatus, walls, shelves and other fittings were covered with a layer of grease and dirt. The floor was dirty and littered and there was every appearance that clean sawdust had been put down on the top of existing dirt. Items mingled with the sawdust included bus tickets, egg shells, matchsticks, cigarette ends, banana peel, burnt paper, cigarette packets and remains of slices of bread. Behind and around the cookers there were empty match boxes, mouldy potato chips and a thick layer of grease. The floorboards inside the kitchen were broken and rotted. An open bucket used for the reception of kitchen waste was found to be coated with a thick layer of decomposing matter. An enamel bowl used for the storge of cooking fat and containing a small amount of dripping was found to contain spent matchsticks. No soap and clean towels were available for the use of the staff. There was also evidence that horseflesh was being sold for human consumption. Details of the action taken and results appear on pages 50/51 of this Report. It is very necessary for the Inspectors engaged on duties under the Food and Drugs Act, 1938, etc., to be kept informed of the latest developments in food hygiene and bacteriology. In this connection the Council approved the attendance of certain Inspectors at a course on the Bacteriology of Food and Food Poisoning given during the year by the Public Health Laboratory Service. Food and Drugs Act, 1938. Number of food premises in the area, and type of business. Bakehouses—level 33 —basement 21 Food factories 32 Fish friers 55 Fish curers 29 Fish depot 1 Cafes and restaurants 302 Public houses (catering) 218 Canteens and clubs 128 Coffee stalls 13 Off-licences selling food 43 Greengrocers 202 Grocers 293 Confectionery 199 Chemists 56 Fish shops 18 Continental Butchers 1 Food stalls (street traders) 83 Food storage premises for street traders 97 Bakers retail shops 37 Butchers 146 50 Preserved Food Premises Registered under Section 14(1 )(b) of the Food and Drugs Act, 1938. (Included in foregoing list.) Total No. of Preserved Food Premises 213 No. of Butchers 94 No. of Grocery and provisioij shops 84 No. of General shops 10 No. of Cafes 1 No. of Bakers, etc. (meat pies) 7 No. of Food Factories 13 No. of Cooked meat shops 4 Total No. of visits made by Inspectors to Preserved Food premises 362 Legal Proceedings. Details of the action taken by the Council under the Food and Drugs Act, 1938, are as follows :— (Number of Cases 20). Date Offence Magistrate's Decision 19.3.54 Selling food, namely bread which was not of the quality demanded contrary to Section 3 of the above Act at :— 49, Copenhagen Street Absolutely discharged. Defendant to pay £3 3s. costs. „ Selling food, namely bread which was not of the quality demanded contrary to Section 3 of the above Act at :— 53, Clephane Road Dismissed under Section 4(4) of above Act. „ Selling food, namely bread which was not fit for human consumption contrary to Section 9 of the above Aot at : 131, Stroud Green Road Dismissed. 18.6.54 Selling food, namely a mince tart, not fit for human consumption contrary to Section 9 of the above Act at :— 343, Upper Street Fined £5. Defendant to pay £5 5s. costs. „ Selling food, namely a loaf of bread, not fit for human consumption, contrary to Section 9 of the above Act at :— 114, Cloudesley Road Summons dismissed. 28.12.54 145/6, Upper Street. Failing to keep clean floor of room in which food is prepared for sale (Section 13(1)(g)) Each defendant (2) fined £2 and ordered to pay £3 3s. costs. „ Failing to keep in a proper state of repair the floor of a room in which food is prepared for sale contrary to Section 13(l)(c) Defendant discharged on payment of £1 1s. costs. „ Failing to keep clean the articles, utensils and apparatus of the said room (Section 13(l)(h)) Each Defendant fined £2. „ Failing to keep clean the walls of 'the said room (Section 13(1) (d)) Each Defendant fined £2. 51 Date Offence Magistrate s Decision 28.12.54 Failing to take steps to prevent contamination of food in the said room (Section 13(2)(b)) Each Defendant fined £2. „ Possessing for the purpose of sale horseflesh for human consumption without displaying the required notice (Section 38) Each Defendant fined £2. „ Failing to provide a sufficient supply of soap and clean towels for use of persons employed in the said room (Section 13 (1)(i)) Each Defendant fined £2. „ 66/68, Andover Road. Failing to keep in a proper state of repair the floor of a room in which food is prepared (Section 13(1) (c)) Fined £1. Defendant to pay £1 1s. costs. „ Failing to keep in a proper state of repair the window of the said room (Section 13(l)(c)) Dismissed. „ Failing to keep in a proper state of repair the walls of the said room (Section 13(l)(c)) Fined £1. Defendant to pay £1 1s. costs. „ Failing to keep in a proper state of repair the ceiling of the said room (Section 13(1)(c)) Fined £1. Defendant to pay £1 1s. costs. „ Failing to keep in a proper state of repair the doors of the said room (Section 13(1)(c)) Dismissed. • „ Failing to keep clean the walls of the said room (Section 13(l)(d)) Not separately dealt with. „ Failing to keep clean the ceiling of the said room (Section 13(l)(d)) Not separately dealt with. „ Failing to keep clean the apparatus and utensils of the said room (Section 13( 1) (h)) Fined £1. Defendant to pay £1 1s. costs. Details of the action taken by the Council under the By-Laws for the Protection of Food, 1952 are as follows :— Date Offence Magistrate's Decision 28.12.54 Failing to keep clean a receptacle used for the depost of refuse or filth at 145/6, Upper Street Each defendant (2) fined £2 Unsound Food. The total amount of food condemned during the year was :— 21 tons, 17 cwts., 2 qrs., 1 lb., 8 ozs. details of which are given in the following table :— 52 Description Tons Cwts. Qtrs. Lbs. OM. Tinned Goods 18 2 1 10 12 Fish — 4 7 12 4 Meat 2 3 — 25 12 Others 1 7 1 8 12 Total 21 17 2 1 8 Number of condemnation certificates issued was 1,450. Most of the above food was condemned upon request by the respective owners. Condemned food received from traders is taken to the Council's refuse disposal depot at Ashburton Grove awaiting conveyance, under supervision, to the refuse tip. Small quantities of food which may be subject of complaint by householders are surrendered to the Inspector, who ensures that there is no possibility of use for human consumption. Foods such as cereals are disposed of for animal feeding, under supervision, and if the food is conveyed to another borough, the Medical Officer of Health for that borough is informed accordingly in order that he may arrange for the supervision of its ultimate disposal. Where possible all other condemned food is dyed in order to make it impossible for it to be re-sold or used for human consumption. Condemned meat is used for animal feeding or industrial purposes. • Sampling. 334 samples (103 formal, 231 informal) were submitted to the Public Analyst for examination. Of these, 26 (or 7.78%) were adulterated as shown in the following summary :— Formal Informal Pork Sausages 1 Bread 7 *Likeur Bonbons 1 Pearl Barley 1 Concentrated Tomato Soup Canned 1 Chocolates 1 Sponge Mixture 1 *Chocolate Spread (Canned) 1 *Tomato Vitamin 1 Jam Sandwich 1 • Meat Pie 1 Milk 2 Almond & Butter Cracknells 1 Split Peas 1 Fruit Pie 1 Ammoniated Tincture of Quinine 1 Apple Puff 1 Apple Tart 1 Mince Pie 1 Total 3 Total 23 * Incorrectly labelled. 53 Meat and Other Foods. No visits by Officers of this Department were made during the year for the purpose of inspecting home killed or imported meat at the Metropolitan Cattle Market. In accordance with the requirements of the Public Health (Meat) Regulations, 1924/52, notices were received during the year in respect of the intended slaughter of animals for human consumption. Details of action taken are as follows :— Number of horses slaughtered 104 Number of carcasses inspected 104 Weight of horseflesh condemned nil None of the above carcasses were exported. Messrs. Harrison, Barber 6? Co. Ltd., who hitherto have used the slaughterhouse at 180, York Way, for the slaughter of horses, carried out considerable improvements to these premises during the year, and now slaughter both cattle and horses for human consumption. The number of animals slaughtered and post mortem inspections carried out are as follows :— Bulls or Bullocks Cows Calves 2 75 2 Conditions found and action taken :— No. of Cases Description of animal Nature of Disease Extent of Disease How disposed of 2 Oxen T.B. Whole carcass Used for knackers' meat or in the manufacture of fertiliser. 4 „ T.B. Lungs 3 „ T.B. Livers 1 „ T.B. Head & Tongue 1 „ T.B. Offal 2 „ Pleurisy Lungs 6 „ Parasitic Lungs 3 „ Parasitic Livers 2 „ Angiomatosis Livers 1 „ Actinomycosis Tongue 2 ,, Peritonitis Spleens 2 „ Abscesses Livers Slaughter of Animals Act, 1933. Slaughter of Animals (Amendment) Act, 1954. Slaughtermen's Licences. The Slaughter of Animals (Amendment) Act, 1954, having received Royal assent, came into operation on 1st October. This statute amends very considerably the Slaughter of Animals Act, 1933, particularly in relation to the issue of slaughtermen's licences, which will in future be issued annually instead of for a three-year period. This Act provides that a licence shall in future specify :— (a) the kinds of animals which may be slaughtered or stunned by the holder of the licence, and (b) the types of instrument which may be used by him for slaughtering or stunning any such animals. 54 The licence may, in such cases as may he prescribed by regulations under this Act, be granted subject to certain conditions. In addition a licence authorising the holder to slaughter or stun horses (whether or not it also authorises him to slaughter or stun other animals) shall be in force only within the district of the local authority granting the licence. Pursuant to this statute, the Minister of Food made the Slaughter of Animals (Prevention of Cruelty) (No. 2) Regulations, 1954, for securing humane conditions and practices in connection with the slaughter of animals at slaughter houses and knackers' yards and in this connection it is pertinent to note that model byelaws were issued during the year in respect of knackers' yards. The Corporation of the City of London continues to be the local authority for the purpose of enforcing the provisions of the Slaughter of Animals (Amendment) Act, 1954, in relation to the Metropolitan Cattle Market and for this purpose this market is taken to be within the area of the City Corporation. During the year 18 licences were renewed and two new licences were issued, making a total of 20 in force. Inspection of Refreshment and Coffee Stalls. 12 evening inspections of refreshment and coffee stalls were carried out by Sanitary Inspectors. No complaints relative to such stalls were received during the year, and the conditions found to exist at the time of the Inspectors' visits were generally satisfactory. Free Washing Facilities in Public Conveniences. The Council continued to provide free washing facilities in public conveniences in order to encourage cleanliness amongst food handlers and, particularly, street traders who have no convenient personal facilities. The following table given through the courtesy of the Cleansing Superintendent provides details of the weekly average number of persons who availed themselves of the Council's facilities. Convenience Jan. Feb. Mar. Apr. May Jun. July Aug. Sep. Oct. Nov. Dec. Approx. weekly average through -out year Archway— Men 28 25 27 32 39 28 40 36 26 35 28 27 31 Women 31 34 32 34 28 15 35 35 36 36 35 36 32 ParkhurstRd.— Men 38 43 42 50 56 55 57 52 46 46 49 41 48 Women 9 10 18 18 21 18 19 22 26 28 23 24 20 Finsbury Pk.— Men 65 68 71 69 67 71 81 90 80 79 74 74 74 Women 6 8 10 13 13 16 18 14 9 13 7 8 11 Highbury— Men 28 28 32 27 31 29 32 28 30 28 24 24 28 Women — — 6 5 4 14 6 7 13 5 14 17 8 Oftord Rd.— Men 11 10 10 10 12 11 14 12 12 11 10 10 11 Women 2 3 3 4 3 3 3 3 2 1 3 3 3 High St.— Men 48 42 46 46 31 32 42 35 36 34 28 32 38 Islington Gr.— Women 7 13 16 12 10 13 15 14 11 11 12 10 12 272 284 313 320 315 305 362 348 327 327 307 306 55 Ice-Cream. Ice-Cream (Heat Treatment, etc.) Regulations, 1947-51. Supervision of the Manufacture and Distribution of Ice-Cream. During the year 196 visits were paid to icecream premises and vehicles. Number of premises registered :— (a) for manufacture, sale and storage 91 (b) for sale and storage 188 (c) for sale only 253 (d) for storage only 8 540 Bacteriological Examinations. 35 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 23 Grade II 4 Grade III 7 Grade IV 1 35 The samples graded in I or II of the methylene blue test are considered satisfactory, and samples graded III or IV unsatisfactory. 11 ice lollies were examined bacteriologically and with the exception of 1, in which faecal coli was found, were satisfactory. 4 milky lollies were submitted for bacteriological examination, one of which was found to contain faecal coli. The samples containing faecal coli were from the same factory. Appropriate action was taken and further samples submitted for examination were reported to be satisfactory. Chemical Examinations. 3 Ice lollies were sent for chemical analysis and the reports received were satisfactory. Tinned Cream. In the early part of the year, a warning was broadcast through the B.B.C., and the Press, regarding the results found upon examination of " Galtee " Cream, an Irish product sampled at Birmingham- In some of the tins an organism which might give rise to a serious type of food poisoning was found. Consequent upon this publicity, a number of tins of cream, not of this brand were presented at the Public Health Department for examination. One firm in the borough reported that they held a quantity of tins of " Galtee " cream and samples 56 were taken for bacteriological examination. Fortunately, none of the batches which were sampled in this borough contained harmful organisms, although about onethird of the tins were not sterile, but contained harmless bacteria, possibly indicating insufficient heat-treatment. However, in view of the publicity given, all batches of " Galtee " cream were returned to the marketing agents. Milk Samples. The total number of samples taken during 1954 was 181. Samples submitted for Chemical Analysis :— Genuine Adulterated Total Formal 82 — 82 Informal 25 2 27 Total 109 Samples submitted for Bacteriological Examination :— Class of Milk Results Phosphatase Methylene blue Turbidity Total No. of Samples Pasteurised Satisfactory Unsatisfactory 69 *67 — 69 Sterilised Satisfactory Unsatisfactory — — 1 1 Tuberculin Tested (Pasteurised) Satisfactory Unsatisfactory 2 2 — 2 Total 72 * In the case of two additional samples the shade temperature exceeded 65° F. Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953, and Milk (Special Designation) (R aw Milk) Regulations, 1949 to 1954. The number of dairies and milk shops inspected 343 The following licences were granted :— Pasteurised 228 Pasteurised (supplementary) 14 Tuberculin Tested 130 Tuberculin Tested (supplementary) 14 Sterilised 306 Sterilised (supplementary) 17 709 57 Milk and Dairies Regulations, 1949 to 1954. Number of Dairies Registered in the Borough 26 Number of Distributors registered in the Borough 293 Number of Registered Distributors dealing from registered premises outside the Borough 24 Summary of visits by Inspectors. Dairies—Routine Inspections 16 Miscellaneous visits 52 Mil\shops—(Milk sold in sealed containers only)— Routine Inspections 154 Miscellaneous visits 120 Total number of inspections and miscellaneous visits 342 Number of Notices served 4 SECTION F—MISCELLANEOUS SERVICES HEALTH PUBLICITY Exhibitions. The Department's main activity in this field during the year was the production of a major Health Exhibition, which was held in October. This Exhibition was formally opened by the Rt. Hon. James Griffiths, P.C., M.P., and remained open to the public during the whole of the week, October 4th-9th inclusive. It is estimated, according to an approximate count kept at the door, that the Exhibition was seen by not less than 5,000 visitors. This must be considered as a very favourable response on the part of the public, and it is interesting to note that the largest attendance of any single day was on Saturday, the last day of the Exhibition, when there were over a thousand visitors. There were many attractive and interesting exhibits on the stands, a high proportion of which had not previously been shewn anywhere and were specially collected, devised, or arranged for this Exhibition. Some important Exhibitors had never previously taken part in publicity work of this description ; these included the London Executive Council, responsible for the general medical and dental practitioner services, pharmaceutical and supplementary ophthalmic services within the County, the North West Metropolitan Regional Hospital Board, the Chemical Branch of the London County Council, and the Department of Scientific and Industrial Research. Nevertheless, the Exhibitors expressed their satisfaction with the public response, and considered the Exhibition worth-while from their respective points of view. The principal object of the Exhibition was to provide the public with information of all the various health and allied services which are available to them—and some conception of the scope of these different services. So far as is known this Exhibition was unique in character, and it is doubtful whether many other Health Authorities have attempted anything comparable in scope or comprehensiveness. 58 Those Exhibitors who were asked to take part in the Exhibition did so with considerable enthusiasm, and went to a great deal of trouble in producing or finding interesting material for display, whether educational, historic, or scientific. Some of the exceptional items which might be specially mentioned were the original Rowlandson print and doggerel poem relating to illness caused through pork pies made in the Lower Road, Islington, in 1811, loaned by the Chief Sanitary Inspector, Luton ; a model showing the hanging of a citizen for producing smoke by burning raw coal in 1370, loaned by the Medical Officer of Health, Southwark, as well as two excellent models showing fit and unfit underground rooms ; radio-active blowflies and Geiger counter from the Department of Scientific and Industrial Research ; Home Accident models loaned by the Medical Officer of Health, Birmingham ; a most interesting collection of scarce historical pharmacists' exhibits on the stand of the London Executive Council ; automatic smoke recording apparatus from the L.C.C. Chemical Branch ; and a model room showing typical conditions of neglected old persons, constructed by members of the Public Health Department staff. Special attention was directed to the subject of promoting health consciousness in School-children. Children in all Islington Schools were invited to send in original paintings on health subjects— such as going to bed early, cleaning teeth, drinking milk, etc., and over 140 entries were received. These entries were judged by Mr. Barclay-Russell, Art Inspector, L.C.C., County Hall, Mr. Hickman-Smith, Islington Art Circle, and the Medical Officer of Health in relation to subject matter. Entries were received from children of seven years and over, and the judges agreed that a very high standard was reached, especially by the young children- The 27 best pictures selected were displayed in the Exhibition Hall. Her Worship the Mayor kindly presented awards consisting of small monetary prizes in the form of Savings Certificates and stamps, and Certificates of Commendation. School parties were specially invited to be present on this occasion. Among the visitors, were Health Department staffs from other Local Authorities in the London area, Post-graduate students in Public Health, Hospital Nursing and District Nursing staffs, both from Islington and other Boroughs, Polytechnic students, and St. John Ambulance Brigade contingents. Favourable publicity was given in the local Press and also in professional journals. In addition to the exhibits on the stands, Health films, selected by the Department, as well as rodent infestation films, were shewn throughout the week in the cinema constructed by the Ministry of Agriculture and Fisheries in the centre of the Public Hall. Further health educational work was also arranged during the Exhibition week by means of evening talks, with or without films, given by various organisations, including the Public Health Department. The very considerable assistance given by the Ministry of Agriculture and Fisheries in connection with the provision of exhibition stands and publicity was much appreciated. The Health Exhibition proved a most worth-while effort on the part of all concerned, in spite of the vast amount of work involved, and served a most useful purpose in the education of the public in health and Health Service matters. The stands arranged and the responsible exhibitors were as follows :— Metropolitan Water Board. Environmental Hygiene—Public Health Department, Islington. Housing—Housing and Public Health Departments, Islington. 59 Local Insect Studies—Department of Scientific and Industrial Research, Pest Infestation Laboratory, Slough. London County Council, Chemical Branch. Maternity & Child Welfare, London County Council, Health Division 3. School Health Service, London County Council, Health Division 3. Foot Health—Central Council for Health Education. Services for Elderly Persons—Combined Exhibits. Physical Education—College of Physical Education, L.C.C. Your Health Visitor—London County Council, Health Division 3. Services in the Home—London County Council, Health Division 3. London Executive Council. Fight Against Tuberculosis—Islington Chest Clinic and Mass X-Ray Unit 5D. Hospital Nursing Technique—Whittington Hospital. Health Control and Records—Public Health Department, Islington. Nutrition—Public Health Department, Islington. " Rest and Read "—Reading material supplies by Central Council for Health Education. Dental Health Education-—Dental Board of the United Kingdom. Air Pollution—Public Health Department, Islington. Food Hygiene—Public Health Department, Islington. Pest Control—Ministry of Agriculture and Fisheries, Infestation Control Division, Tolworth. Safety in the Home—Public Health Department, Islington. Safety on the Roads—Works Department, Islington. London Ambulance Service—London County Council. Panels were also exhibited, for which the following Departments or Authorities were responsible :— Cleansing Department, Islington. Works Department, Islington. Children's Poster Competition, Public Health Department in conjunction with London County Council Education Department. Libraries Department, Islington. Finance Department, Islington. Civil Defence Department, Islington. Baths and Washhouses Department, Islington. British Empire Cancer Campaign. London Marriage Guidance Council. 60 Chamber of Commerce meeting—Food Hygiene. The Islington Chamber of Commerce arranged a lecture'demonstration on the subject of Hygiene in Food Handling in the Public Hall of the Town Hall on the evening of Monday, 22nd November. The Medical Officer of Health was invited to take part in the proceedings, together with Dr. Charles Hill, Parliamentary Secretary, Ministry of Food, and Mr. AH, Walters, a Bacteriologist and well-known lecturer on the bacteriology of food hygiene. The Chamber of Commerce invited food trading concerns in Islington, and also extended invitations to neighbouring Chambers of Commerce. The Secretary of the Islington Chamber of Commerce wrote expressing his thanks for the assistance given by the Medical Officer of Health, the Chief Sanitary Inspector, and from the Department in general, and mentioning that there were about 140 people present. Such an effort by the Chamber of Commerce to improve traders' hygiene standards is a step in the right direction. Film Shows. Programmes of health films for exhibition to the general public were once again a prominent feature of the Department's Health Publicity programme. Ten shows were given during the year, and the policy was continued of including a full-length feature film as a special attraction on each occasion. At each meeting the Chair was taken by a member of the Public Health Committee, and a short address given by the Medical Officer of Health or his Deputy. The health films exhibited were provided by :— Central Film Library Imperial Chemical Industries The Ice-Cream Alliance Gaumont-British Film Division Marmite Ltd Royal Society for the Prevention of Accidents Gas Council and were entitled :— " Why won't Tommy Eat " " Town Rats " " The Fight Against Disease " " Fly About the House " " The Modern Ice Age " " Tremendous Trifles " " The Good Housewife in her Kitchen " " Surprise Attack " " Mary's Birthday " " Simple Nutrition " " A modern Guide to Health " " Human Factor " " Another Case of Food Poisoning " " Guilty Chimneys " " Something to Chew on " " Creatures of Comfort " Pamphlets and Posters. The use of health posters and pamphlets was continued for publicising matters of current health interest as a routine function of the Department, and co-operation from other Departments of the Council in their display and distribution was of great value. " SAFETY IN THE HOME " ROOM MODEL—NEGLECTFUL OLD PERSON 61 Venereal Disease—Publicity Campaign. As in previous years, the Ministry of Health requested the assistance of Local Authorities in the distribution and display of posters in connection with the Venereal Disease Publicity Campaign, and in compliance, it was arranged for 1,000 copies of the posters to be supplied and overprinted by the L.C.C. with the addresses of the nearest clinics to Islington. The posters were then distributed for display, not only in the Council's public conveniences, but also to the Managers of all Public Houses in the Borough, with a request that they be displayed in the conveniences attached to their premises. SERVICES FOR ELDERLY PERSONS The Department's work in connection with elderly persons continued during the year. As mentioned in my Report for last year, there are approximately 26,000 persons over the age of 65 residing in the Borough, and several thousands of them are living alone. It is not surprising, therefore, that difficult circumstances arise from time to time when there is nO'One to care for these old folk, and in many cases the Old People's Health Officer, assisted on a part-time basis by other staff, has been able to help, either directly through Borough Council sponsored services, or by reference to the various Authorities and voluntary organisations concerned with the care of the aged. It was reported in the local Press that a man of 76 was the subject of an inquest, having died from shock and burns. This man's clothing had caught fire, but there was nothing to indicate the cause, although a slightly burned armchair was found about four feet from the fireplace. This man had been visited by the Department's Officers on several occasions, and a ' Home-help ' and ' Meals-on-Wheels' had been arranged for him. Although enfeebled, he was not entirely incapacitated and was living on his own. This unfortunate case is illustrative of the difficulites, and risks run by many solitary old persons who have increasing trouble in caring for themselves. The Health Officer and her assistant visited 384 new cases during the year, and re-visits totalled 2,889. Twelve cases were dealt with under the National Assistance Acts, 1948 and 1951, and these are described on pages 63-67. 1,501 references were made to other Authorities and to voluntary organisations in connection with the provision of ' Home-helps,' National Assistance, ' Meals-onWheels,' etc. The Health Officer maintains close touch with the London County Council Divisional Staff, especially in respect of Home-help assistance, with the National Assistance Board, with the Duly Authorised Officer of the London County Council, with the Welfare Officer at " Hillside," as may be appropriate. She also attends meetings of voluntary committees connected with the welfare of the old persons, old persons clubs, etc., and is steadily building up a valuable register of old persons dealt with through the Department. National Assistance Acts, 1948 and 1951—Section 47. Authority for proceedings under Section 47 of the National Assistance Act, 1948, was obtained during the year from the Public Health Committee in two cases, one of which had already been removed to Hospital under emergency proceedings for a period not exceeding three weeks, and the other was also the subject of the proceedings under Section 47(4) mentioned below. Orders were made following Court proceedings. 62 " The following provisions of this section shall have effect for the plirpose of 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, ai\d are not receiving from other persons, proper care and attention. .... the court may, if satisfied on oral evidence of the allegations in the certificate, and that it is expedient so to do, order the removal of the person to whom the application relates, by such officer of the appropriate authority as may be specified in the order, to a suitable hospital, or other place in or within convenient distance of, the area of the appropriate authority, and his detention and maintenance therein : Provided that the court shall not order the removal of a person to any premises, unless either the person managing the premises has been heard in the proceedings or seven clear days' notice has been given to him of the intended application and of the time and place at which it is proposed to be made." In 11 instances it was necessary to invoke the procedure for the removal of persons to suitable premises without delay, in accordance with the provisions of the National Assistance (Amendment) Act, 1951. "An order under subsection (3) of section forty-seven of the National Assistance Act, 1948, for the removal of any such person as is mentioned in subsection (1) of that section may be made without the notice required by sub-section (7) of that section if it is certified by the medical officer of health and another registered medical practitioner that in their opinion it is necessary in the interests of that person to remove him without delay." A Magistrate's Order made earlier in the year under the principal Act, was extended, under Section 47(4), for the further detention and maintenance of an aged person in a Welfare Home for a period not exceeding three months. " (4) An order under the last foregoing subsection may be made so as to authorise a person's detention for any period not exceeding three months, and the court may from time to time by order extend that period for such further period not exceeding three months, as the court may determine." Details of the statutory action taken under these Acts are given in the following statement which has been compiled in the form required by the Ministry of Health :— 63 Aged and Infirm—Action taken under Statutory Powers Name and Age (1) Reasons for Council's Action (2) Period Named in Order (3) Type of accommodation to which removed (4) Ultimate Result (5) (1) Miss W. (62 years) The above-named was found to be bedridden and lonely and without proper attention when visited by Officers of this Department, who reported that the home was very dirty. This visit followed a reference from the patient's doctor, who was of the opinion that hospital attention, although refused, was necessary. Miss W. was suffering from myocardial degeneration, corneal ulceration and eczema of the scalp and was confused concerning the whereabouts of any friends or relatives. A J.P. made an Order. Not exceeding three weeks General Hospital Settled down in Hospital after detention period, but died three months later. (2) Mr. S. (84 years) Mr. S. lived in the remains of a demolished house and shop property situated at a site acquired by the London County Council for development purposes. Alternative accommodation had been refused. This hovel consisted of a shop and a former back room made into one and could be entered only through a narrow aperture as the rubbish in the front part was up to a height of nearly six feet. The roof let in water and no normal household facilities could be seen except for a gas ring. A worried sister called in a priest, who went to a doctor. The latter was unable to get into the premises and therefore advised this Department. The Sanitary Inspector visited and reported that the premises were indescribable from any public health standard and it was impossible to believe that any person could live there. Mr. S. was lying in one corner and could not be seen properly owing to the lack of light and surrounding piles of rubbish. All offers of assistance were refused. The Deputy Medical Officer of Health then visited in company with a local General Practitioner, Not exceeding three weeks General Hospital It was found that Mr. S. was suffering mainly from the results of self-neglect. With proper care and nourishment his health improved to such an extent that after four months treatment he was able to leave and take up lodgings in this Borough with a friend. The dog went back to his master. 64 Name and Age (1) Reasons for Council's Action (2) Period Named in Order (3) Type of accommodation to which removed (4) Ultimate Result (5) and the appropriate certificates were completed in accordance with the National Assistance (Amendment) Act, 1951, to the effect that this aged person should be removed without delay. The sister was informed and gave her consent to any action proposed to be taken by the Council in her brother's interest. An Order made by a J.P. was enforced. Arrangements were made with the Royal Society for the Prevention of Cruelty to Animals for the care of his dog. When Mr. S. was asked why he had adopted such an unhelpful attitude he replied " just devilment." (3) Miss B. (69 years) This was a case referred to the Department by the patient's doctor after this patient had been seen in the Casualty Department of a local Hospital. She had refused all treatment . When removed to Hospital on a J.P.'s Order this patient was suffering from a skin infection, was incontinent, and was lying in soiled bedding. Not exceeding three weeks General Hospital Transferred to Mental Hospital following visit by the Duly Authorised Officer of the London Council Council. (4) Miss B. (76 years) Conditions here became very acute when a friend indicated she was unable to continue daily visits to Miss B., who lived alone in two top rooms in a house in which the remaining rooms were unoccupied. This aged person was suffering from chronic bronchitis, was deaf, incontinent, and required nursing attention. Offers of assistance other than from this friend were refused. A J.P. made an Order after the appropriate certification. Not exceeding three weeks General Hospital Agreed to settle permanently in hospital. (5) Miss B. (81 years) This was a further case of a reference from a General Practitioner concerning the use of statutory powers for the removal of a person to suitable premises without delay. Miss B. refused medical and other attention and lived alone. When visited Not exceeding three weeks General Hospital Patient deceased one month after admission. 65 Name and Age (1) Reasons for Council's Action (2) Period Named in Order (3) Type of accommodation to which removed (4) Ultimate Result (5) by the Deputy Medical Officer of Health this aged person was found to be suffering from severe anaemia and malnutrition, and the home was in a very insanitary state. A J.P. made an Order. (6) Miss D. (80 years) This case was brought to the Departments notice following an urgent 'telephone call from the local police as to the squalid conditions under which this aged person was living. Miss D. was found to be seriously ill and all offers of assistance were refused. A J.P. made an Order following a visit by the Deputy Medical Officer of Health and the patient's doctor. Not exceeding three weeks General Hospital Patient deceased within 24 hours of admission to hospital and case reported to Coroner. A postmortem was carried out—no inquest. (7) Miss B. (71 years) This aged person had been the subject of previous statutory action under the principal Act in 1953 and rehabilitation had taken place as far as possible as a result of care in a Welfare Home for a period of six weeks. Upon her return home all help was refused. Following a collapse in the street a further visit was made to her home and it was apparent again that she was unable to care for herself The one room occupied was insanitary. There was a serious fire risk from a small oil-stove used for cooking. A tenant also complained of nuisances from smells, etc. A Magistrate made an Order for her detention and maintenance in a Welfare Home for a period of not exceeding three months and this was further extended by a similar period, following action under Section 47(4) of the Act. See column (2) Welfare Home Transferred to mental hospital. (8) Mrs. N. (84 years) At the urgent request of the patient's doctor, following an ambulance being turned away at the house, a J.P. was asked to make an Order in this case. Not exceeding three weeks General Hospital Settled down in hospital after detention period expired. Deceased four and a half months after admission when arrangements in hand for transfer to hospital near to daughter's home. 66 Name and Age (1) Reasons for Council's Action (2) Period Named in Order (3) Type of accommodation to which removed (4) Ultimate Result (5) Mrs. N. was partially paralysed and was in a room which contained a bed only. The remaining furniture had been taken away by a daughter to a house in another Borough. This daughter was under the care of the London County Council Mental Welfare Department. (9) Mr. C. (70 years) Action here arose out of a complaint from a tenant in the house to the effect that milk and papers had not been collected. A doctor stated that his patient was very weak and emaciated and suffered from a condition requiring urgent hospital treatment. The home was neglected. A J.P. made an Order after this aged person refused to go to hospital in an ambulance. According to a relative he " went to pieces" following the death of his mother two months previously. Not exceeding three weeks General Hospital Deceased two days after admission. (10) Miss H. (82 years) Miss H. was visited by the Deputy Medical Officer of Health when it was confirmed that this aged person was suffering from a chronic condition of the bowel, malnutrition and deafness. She was unable 'to care for herself and was not receiving enough care from other persons. She refused the hospital treatment which was necessary and available. A J.P.'a Order was obtained. Not exceeding three weeks General Hospital At the request of the Hospital Authorities during this three weeks period, court proceedings were instituted in accordance with the provisions of Section 47 of the National Assistance Act, 1948. A Magistrate made an Order for her further detention in the Geriatric Unit of a Hospital Group for a period not exceeding three months. Treatment was continued and she later settled down as a voluntary patient of the Hospital. (11) Mrs. W. (80 years) A nephew had previously advised this Department of his concern for the welfare of his aged aunt, and an investigation and appropriate action had been carried out by the Health Officer for Old People. When, therefore, five months later the patient's own medical adviser telephoned the Medical Officer of Health to the effect that his patient Not exceeding three weeks General Hospital The patient died 12 days after admission. 67 Name and Age (1) Reasons for Council's Action (2) Named in Order (3) Type of accommodation to which removed (4) Ultimate Result (5) had refused to go to hospital, although suffering from auricular fibrillation and a discharge from the left leg, proceedings were possible with the minimum of delay. The Deputy Medical Officer of Health confirmed that Mrs. W. was suffering from a grave chronic disease and refused to have hospital treatment. After a J.P. made an Order, removal took place the same day under the direction of a Sanitary Inspector as in similar cases. (12) Mr. M. (86 years) Mr. M. was cared for by a married daughter when reference was made to the Town Hall by the patient's medical adviser who stated that his patient refused very necessary medical attention for conditions requiring urgent hospital treatment. This aged person was found by Officers of this Department to be very ill lying on rags in a dirty condition. Offers of help were refused. A J.P. made an Order. Not exceeding three weeks General Hospital Patient deceased one week after removal. Cleansing and Laundry Service for Incontinent Old Persons. In April, 1954, the Council approved the setting up of a Cleansing and Laundry Service for Incontinent Old Persons, whereby their personal attire and bed'dothing could be cleansed, free of charge, in cases recommended to the Medical Officer of Health and approved by him. Requests for the service would be made by the District Nursing Association, Hospitals, General Practitioners, etc., and investigated by the Old People's Health Officer. As provided in Section 122 of the Public Health (London) Act, 1936, these cases could be dealt with where it was considered that the soiled articles were filthy, dangerous or unwholesome, and that health was affected or endangered thereby. Arrangements were made with the Baths Superintendent for the establishment of a Laundry for this purpose at the Essex Road Baths ; suitable equipment was installed, and the Department's service commenced on 19th October, from which time until the end of the year 20 recipients were approved for the service. Collection from, and delivery of the articles to the patients' homes was also provided for in the service. 127 washings were carried out, and 1,223 articles were cleansed. In view of the fact that this was an entirely new venture, smooth-working arrangements were soon made and a satisfactory service established. 68 National Assistance Act, 1948, Section 31. This section of the Act permits local authorities to make contributions to the funds of any voluntary organisation whose activities include the provision of recreation or meals for old people. A grant was again approved for the purpose of the " Meals-on-Wheels " service operated by the Women's Voluntary Service. Demand for the meals supplied was well maintained, and priority was given in cases where old people were unable to leave their homes for shopping, etc., or to prepare meals for themselves. The number of meals supplied, etc., during the year, is given in the following table :— Total number of names brought to the notice of the Department 384 Number recommended to W.V.S. 89 Number of meals delivered during the year 6,173 Weekly average 118 Meals were also provided on Club premises for elderly persons, and the Council's grant was continued for this purpose. Holidays for Elderly Persons. By means of a scheme administered through the Old People's Welfare Council, 495 persons "were able to enjoy a holiday by the sea, or in the country, at greatly reduced cost, where their circumstances were such that it would not have been possible for them to take a holiday at their own expense. A substantial grant was provided by the Borough Council for this scheme. Cleansing of Elderly Persons. London County Council (General Powers) Act, 1953—Section 43. As recorded in my last Annual Report, arrangements were made in accordance with Section 43 of the above Act for domiciliary cleansing of aged persons where Ithey (were so enfeebled as to be unable to avail themselves of facilities at the Cleansing Station. Details of this service for the year are as follows :— No. of baths given at home 186 No. of persons concerned 27 The work was carried out under the supervision of the Nurse-in-Charge of the Council's Cleansing Station. PUBLIC MORTUARY 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 The Medical Referee or the Deputy Medical Referee certified a total of 374 applications for cremation at the Council's Crematorium, East Finchley. 69 MATERNITY AND CHILD WELFARE SERVICES The Maternity and Child Welfare services are, of course, the responsibility of the London County" Council as the Local Health Authority. Islington is included in Division 3 of the L.C.C. Services and I am indebted to Dr. B. E. A. Sharpe, Divisional Medical Officer, for the information given below in respect of these services :— Welfare Centres. WELFARE CENTRE Children's AntcNatal and Post'Natal Immunisation Dental Vaccination Mon. to Fri. 1.45 p.m. Mon. Thurs. 1.45 p.m. midwives Wed. 2.0 p.m. Tues. 9 a.m. and 2.45 p.m. Wed. 2.0 p.m. North Islington Voluntary Welfare Centre, ... Wed. 1.45 p.m. 6-9, Manor Gardens, N.7. Tues. Thurs. 9.30 a.m. North Branch Clinic Fri. 1.45 p.m. Mon. 1.45 p.m. Blythe Mansions, Hornsey Rise, N.19. North Branch Clinic Wed. 1.45 p.m. Newcourt Church Hall, Tollington Pk., N.4. Archway M. & C.W. Centre ... Thurs. 1.45 p.m. Congregational Church, Junction Road, N.19. West Islington Welfare Centre, Mon. 1.30 p.m. Tues. 1.30 p.m. Wed. 10.30 a.m. Wed. 42 & 44, Richmond Avenue, N.l. Wed. 1,30 p.m. Thurs. 9 45 a.m. 10.30 a.m. Fri. 9.30 a.m. & 1.30 p.m. & 1.30 p.m. West Branch Clinic Thurs. 9.30 a.m. & 1.30 p.m. St. Luke's Mission Hall, Goodinge Rd., N.7. South Islington Welfare Centre, Mon. 1.30 p.m. Mon. 9.30 a.m. Tues. 10 a.m. Wed. 2.0 p.m. 6 Clephane Road, Essex Road, N.l. Wed. 9.30 a.m. & 1.30 p.m. Fri. Tues. 9.30 a.m. 1.30 p.m. Fri. 2.0 p.m. Thurs. 9.30 a.m. & 1.30 p.m. South Branch Clinic Union Chapel, Compton Avenue, N.l. Tues. 9.30 a.m. & 1.30 p.m. East Islington Welfare Centre, Tues. 9.30 a.m. 6^ 1.30 p.m. Mon. 9.0 a.m. Mon. 2.0 p.m. Mon. 3.0 p.m. 32. Drayton Park, N.5. Wed. 1.30 p.m. Fri. 10.0 a.m. Wed. 9.30 a.m. (Toddlers) Thurs 1.30 p.m. Fri. 1.30 p.m. East Branch Clinic Thurs. 1.30 p.m. Congregational Church Hall, Highbury Quadrant, N.5. Total Attendances at Infant Welfare Centres. Infants North South East West Archway 0—1 years 14,830 10,091 8,070 9,192 1,853 1—2 years 2,647 1,535 950 1,173 290 2—5 years 2,290 821 493 704 352 Ante-Natal and Post-Natal combined 4,834 1,890 1,280 2,324 – Child Life Protection. The table of foster-mothers and foster-children being cared for is as follows : 31.12.54 Number of persons on register prepared to receive children 22 Number of foster-children being cared for 33 70 At present there are 5 Day Nurseries open in Islington :— Scholefield Road 65 places Plimsoll Road 46 „ Canonbury Place 70 „ Windsor Street 68 „ Mitford Road 68 „ 317 There are also 50 places for Islington children in Springdale Road Nursery (Stoke Newington). 71 INDEX Accidents 9 Acute Encephalitis 10 Acute Poliomyelitis 6, 10, 13-14 Aged and Infirm Persons 61-68 Ante-Natal Clinics 69 Anthrax 10, 19 Atmospheric Pollution 9, 32-34 Bacteriological Examinations 22, 55, 56 Births 4, 5, 8 Blow-Fly Infestation 32 Chemical Examinations 55, 56 Child Life Protection 24, 69 Child Welfare Centres 69 Cleansing Station 19 Cleansing, Elderly Persons 68 Crematorium 68 Day Nurseries 70 Deaths 4, 5, 6, 7, 8, 9, 10, 12, 13, 14, 15 Dental Clinics 69 Diphtheria 5, 6, 10, 14-15 Diphtheria Immunisation 15, 69 Diseases of Animals Acts 40 Disinfection 31 Disinfestation 31 Disinfestation of Sewers 41. 42 Dysentery 10, 16-18 Elderly Persons, Services for 61-68 Encephalitis, Acute 10 Enteric Fever 10 Erysipelas 10 Exhibitions 57-58 Export Certificates 31 Factories Act—Complaints 35, 36 Factories Act—Contraventions 35, 36 Factories Act—Inspections 35, 36 Factories Act—Notices served 35, 36 Film Publicity 58, 60 Fog and Smoke 9, 32-34 Food and Drugs Act 24, 35, 47. 49 Food—Inspection and Supervision 24, 35, 47-57 Food—New legislation 47 Food Poisoning 10, 15-16, 55 Food Sampling 52 Food Unsound 48, 50-52, 53, 55 Foster Mothers and Children 24 Health Publicity 57-61 Holidays for Elderly Persons 68 Home Visiting—Scabies and Vermin 19 Housing 22-23, 24, 43-47 Housing Repairs & Rents Act, 1954 23, 25, 43-44 Ice Cream 55 Illegitimate Births and Deaths 4, 8 Immigrants 45, 46 Infant Mortality 4, 5, 7, 8 Infectious Diseases 6, 10-22 Influenza, Pneumonia and Bronchitis 6, 7, 9, 10, 21-22 Inoculation, etc. Certificates 11 Laundry Services 67 Lectures 58, 60 Legal Proceedings 23, 27-30, 48-49, 50-51, 61-67 Licences 53-54 Live Births 4 Local Government (Miscellaneous Provisions) Act, 1953 46 L.C.C. (General Powers) Acts 38, 68 M. & C. W. Services 69-70 Malaria 10 Marriages 4, 5 Mass X-Ray 21 Maternal Mortality 4, 5 " Meals on Wheels " 68 Measles 6, 7, 10, 11-13 Meat 53-54 Meningococcal Infection 6, 7, 10 Metropolitan Cattle Market 19, 54 Milk and Cream 55-57 Milk and Dairies Regulations 57 Milk (Special Designations) 56 Miscellaneous Services 57-70 Mortuary 68 National Assistance Acts 24, 61-67, 68 Neoplasms, Malignant 6, 8 Noise Nuisance 35, 38 Nurseries—Day 70 Offensive Trades 38-40 Ophthalmia Neonatorum 10 Outworkers 35, 37 Overcrowding 46, 47 Pet Animals Act 40 Pharmacy and Poisons Acts. etc. 40 Pneumonia 6, 7, 8, 9, 10, 21-22 Poliomyelitis 6, 10, 13-14 Population 4, 5 Post-Natal Clinics 69 Premature Infants 7, 8 Prevention of Damage by Pests Act and Orders 41-42 Prosecutions 23, 27-30, 48-49, 50-51 Public Health Committee 3 Public Health (London) Act—Improvements effected 26, 35 Public Health (London) Act, Sections 40 and 109 26 Public Health Officers 3 Public Health (Tuberculosis) Regulations, 1952 20 Publicity 57-61 Puerperal Pyrexia 4, 10 Rag Flock and Other Filling Materials Act 40 Rats and Mice 41-42 Refreshment and Coffee Stall 35, 49, 54 Rent Restrictions Acts (Certificates) 25, 44 Requisitioned Property 24, 34 Sampling 52, 55, 56 Sanitary Circumstances 22-43 Sanitary Inspection—District Work 23-34 Sanitary Inspection—Special Work 35-43 Scabies 10, 19 Scarlet Fever 10 Sewer Treatments 41-42 Shops Act 35, 40 Slaughtermen's Licences 53-54 Slum Clearance 46 Smallpox 10, 10-11 Smoke 9, 32-34 Staff 3 Static Water Tanks 31 Statistics—General 4 Statistics—Vital 4-9 Still-Births 4, 5, 8 Swimming Baths 43 Town & Country Planning 47 Tuberculosis 5, 6, 7, 8, 10, 20-21 Tuberculosis—Beds and Bedding 21 Tuberculosis—Care Committee 21 Tuberculosis—Chest Clinics 21 Tuberculosis—Deaths 5, 6, 7, 8, 10, 20 Tuberculosis Notifications 5, 10, 70 Typhoid Fever 10 Underground Bakehouses 37-38, 49 Vaccination 11, 69 Vermin 10, 19, 31 Washing Facilities, Free 54 Water Supplies 42-4 3 Welfare Centres 69 Whooping Cough 6, 7, 10, 11, 12-13 Winter Epidemics 21-22