Journal Rebind Co. Ltd unit 4, pier Wharf. Grays, Essex. 4361 ISL 87 1958 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 68624 1 CANonbury 3388 Public Health Department, Town Hall, Islington, N.1. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OP ISLINGTON. I have the honour of presenting the Annual Report on the health of the Metropolitan Borough of Islington for 1958. The Report for this year includes a considerable number of new health enactments which, whilst not initiating major changes, collectively constitute quite material advances which should be advantageous to the health and welfare of the people in the Borough. Those important indicators of health changes, the vital statistics, have on the whole not been quite so favourable as for 1957, although the variations are minor in themselves. The general death-rate, the maternal mortality rate, and the infant mortality rate were all somewhat higher than the previous year and are the subject of some comment in the Report. The fact that deaths from tuberculosis of the lungs and the number of new cases found were not lower than the previous year is an indication that - even though the mortality from this cause is very much less than a few years ago - in this part of London tuberculosis is still a major social and health problem; especially as a high proportion of the new cases are found in what should be the prime of adult life. In 1957 I had, unfortunately, to record the highest number of deaths, 152. due to malignant growths of the lung and bronchus, In 1958 this number was exceeded slightly, with 154 deaths. I mentioned in the Report last year that the mortality due to bronchitis and pneumonia was well above the national average. 1958, was not more favourable, and since there is evidence that pollution of the atmosphere is an important factor in sickness due to these respiratory diseases, corresponding importance must be attached to steps which will reduce irritant impurities which are inhaled. polution of the atmosphere The Ministry of Housing and Local Government gave approval during the year to two proposed Smoke Control Areas, so that the detailed survey could be undertaken. This, of course, can only constitute a beginning, and many years must elapse before major portions of the Borough or the Borough as a whole will be relieved of visible smoke contamination. A source of contamination which was not dealt with in the Clean Air Act, 1956, was that due to emissions from petrol and diesel engined road vehicles. Islington is perhaps unfortunate in that it carries a main trunk route through almost its entire extent, and there is dense traffic along this road, particularly of the very heavy diesel engined variety. The Beaver Report of 1954 on Air pollution expressed the opinion that diesel engined vehicles need not emit smoke if properly maintained, serviced and driven. Those who have occasion to travel 2 along this road do not need to be told that if this is the case there must be many vehicles using the road which fail in at least one of these three respects mentioned The section of the Report dealing with this matter mentions a practice which has been in operation now for some years viz: if a Public Health Inspector notices a vehicle emitting dense smoke he endeavours to obtain identification particulars in order that a communication can be sent to the owner of the vehicle Since Inspectors are not specifically on this duty and can only notice a relatively small part of all the traffic passing along the trunk road, it is significant that during the year nearly two hundred letters were sent out by the Department drawing attention to what was considered to be excessive emission. No statutory action can be taken by the Department since the legislation dealing with this matter is under the Road Traffic Act, enforceable by the Police and not the Local Authority The facts of the emission to which the attention of owners was drawn were not disputed in any single case. It must also be said that in all instances co operation was promised for the prevention of recurrence by engine check, or by calling the attention of the drivers to the matter It is hoped that it will be possible in the future to reduce emission from road vehicles both by stricter enforcement of existing legislation and, perhaps more important, by investigation of methods which will mechanically reduce exhaust emissions. Health Education The Medical Officer of Health and the public Health Department are dependent to a very considerable extent for the success of their work on the co-operation given them by members' of the public. This co operation will not be forthcoming without some understanding of the matters and problems involved and health publicity and education must, therefore constitute a very important part of the work of every Public Health Department. Education of the public is effected not only by such publicity as posters talks, etc., but perhaps most important of all through the Department's staff the Public-Health Inspectors and Infectious Disease Visitors in particular by personal visitation of homes, shops, and workplaces with the opportunity of discussing on the spot the particular and individual problems arising out of the reason for the visit. Basically, this is more important that the enforcement of legislation for shortcomings. Health Inspector staff Higher standards in all public health activities must depend upon the voluntary acceptance of standards much more than on statutory action, since apart from any other reason it is obviously quite impossible for Inspectors to be present at day by day or hour by hour activities, for example, in connection with food premises. It is therefore regrettable that the Department has been able to carry out much less visiting and inspection than is desirable because of the continued deficiency in the establishment of public Health Inspectors. Out of a total establishment of 34 there were never less than eight vacancies during the year The problem is a difficult one with many aspects but with a national shortage of inspectors it is perhaps natural that many of them should prefer to work in outer London or Home Counties areas close to their own homes rather than in densely populated, older areas. The problem of compensating factors has not yet been solved and the deficiency is therefore likely to continue 3 Legislation and problems In spite of the staff deficiency the statutory obligations placed upon the local authority continue to increase and mention is made of some of the new work in the body of the Report The work in some instances for example, due to applications for Certificates of Disrepair under the Rent Act, necessitating an Inspector's visit on each application increased substantially over 1957 Reference is made in the Report also to the increasing tendency of owners to carry out repair work and to keep their properties habitable under the public Health and Housing Acts A higher standard for the provision of water closets in houses was also adopted in place of the previous standard and a procedure introduced for carrying out drainage work more expeditiously where this was urgently necessary Under the Clean Air Act it became illegal for dark smoke to be emitted from chimneys except for certain limited and specified periods. There was an increase in complaints of noise nuisance and there is no doubt that this promises to be a problem of the future Some of the more important complaints of noise are set out in the Report together with the measures taken, but it is apparent that in many cases the technical problems involved in reducing noise nuisance will be quite considerable. One noise problem which was specifically investigated arose out of the use of power sewing machines in premises which are still used as residences The machine may be used commercially part of the time but not necessarily all the time, and although some recommendations were made which were mentioned in the Report and which reduced the nuisance to others such recommendations can only be advisory. Housing Act work will continue to be a major matter for many years to come in a Borough with a high proportion of out of date housing such as Islington and in 1957 there were many houses represented as unfit under section 4 of the Housing Act, 1957 and which were closed or demolished either as individual houses or parts of houses, or were included in slum clearance areas. There was much legislative activity during the year in connection with the supervision of food and the various aspects of food hygiene One problem dealt with which is particularly mentioned in the Report and which was also a noise problem was in connection with the deliveries of milk to distributors in the late night and early morning hours This distribution of milk is governed by the Milk and Dairies Regulations and if milk is left on or near the public highway for distributors, there may be complaints as indeed there have been, from near neighbours on account of the noise caused on delivery as well as from the aspect of the hygienic protection of the bottles so left. The problem was the subject of discussion with the trade representatives who were naturally concerned because this procedure was widespread and not confined to Islington alone Arising out of discussions with the trade associations it was possible for considerable improvements to be effected during the year through voluntary co-operation. In the majority of cafes and restaurants care is taken to maintain reasonable standards of hygiene and cleanliness but in a relatively small 4 proportion the standard may fall short, not only of what is desirable, but of what is statutorily required and mention is made in the Report where, unfortunately, statutory action, had to be taken on account of such deficiencies. Home Accidents A reference was made in the 1957 Report to Section 82 of the London County Council (General Powers) Act, 1957, which gave Metropolitan Borough Councils certain powers of publicity in relation to the prevention of accidents in the home. The Borough Council during the year decided that it would assist publicity work in this field by the formation of a Borough Home Safety Committee, The constitution of the Committee is set out in the Report and it began to function towards the end of the year. Elderly persons Many aspects of the welfare of elderly persons were either improved or plans made for improvement during the year. In the Report there is a description of a small-scale enquiry into the means and methods adopted by some elderly persons of keeping themselves warm during the winter. This enquiry arose because it was realised a Smoke Control Area might entail special problems for elderly persons if they were no longer able to use a coal fire and might have to depend on solid smokeless fuel which, weight for weight, would occupy approximately twice the storage space. The enquiry gave an opportunity of obtaining information, not only on the fuels being used by elderly people, but the degree of safety, or lack of safety in connection with the sources of heat and also the effectiveness of the heating arrangements. It was evident, even from the limited amount of information obtained that there was much room for improvement. There were too many fires which were insufficiently guarded and which could easily become dangerous. There were many appliances which needed far too much attention, much more than an elderly person was reasonably able to carry out, especially if not feeling well. Storage accommodation for fuel was frequently far too inconveniently sited and some heating appliances were of an improvised nature - especially some gas or paraffin sources of heat which were definitely thought to be unsafe. It would also appear from the enquiry that many old people must suffer considerably during inclement weather because the temperature in the living room, let alone the bedroom (if there is a separate one) is far too low for normal comfort and would certainly not be helpful if the elderly person were unwell. A scheme was also approved by the Council for the installation of modern machinery for disinfecting and laundering soiled bedlinen and other articles from persons who have incomplete physical control, and since the soiling of personal clothing and bedlinen must necessarily give rise to the cleansing requirement for the persons themselves, the Council also agreed during the year to assist the bathing services by the provision of a specially designed vehicle for conveyance to and from their homes of suitable cases for baths at the Treatment Centre. Considerable assistance in maintaining the nutrition of elderly persons was also rendered possible during the year by the provision of a second meals-on wheels van to be staffed through the good offices of volunteers under the auspices of the Islington Old People's Welfare Council. 5 Staff and General On the personal side, I am glad to report that after an interval of approximately eight months following the resignation of Dr. a.L. Thrower as Deputy Medical Officer of Health, in 1957, Dr. J.P.J. Burns was appointed to this post and commenced his duties in Islington in March of this year. The greater part of his work is with the Borough, but as with his predecessor, the appointment was made jointly with the London County Council, for which authority Dr. Burns also acts as an Assistant Medical Officer. This joint appointment serves a most useful liaison purpose on occasions, particularly when investigations into infectious disease outbreaks or occurrences have to be made which may affect the respective responsibilities both of the County Council and the Borough Council. Dr. Burns was appointed from his previous post as Deputy Medical Officer of Health, Willesden, and Senior Assistant Medical Officer, Middlesex County Council, and I am pleased to welcome him to the Department. The National Health Service Act administratively severed the personal health services from the environmental in the Borough, but there are so many points at which they have to be related in practice that the maximum measures of co-operation between the respective Authorities are necessary if the best is to be done for the welfare of the people living in the Borough, and I am therefore pleased to express again my thanks to Dr. Wilfrid G. Harding, Divisional Medical Officer, Health Division 3, and to all members of his Divisional staff for their continued cooperation, both formal and informal, during the year with this Department. With respect to the staff of the Public Health Department, I have again to express my personal appreciation both to Mr. W.C. Bartlett, Chief Public Health Inspector, and Mr. H. Plinston, Deputy Chief Public Health Inspector, who have had a particularly difficult year arising out of the shortcomings of the Inspector establishment; Mr. E.J. Sharp, Chief Clerk, and the Clerical staff under his charge, the Infectious Disease and Old People's visiting staff, and the other members of the Department. I have again to refer to the value to local government of good relationships between the departmental Chief and the respective Chairmen of Committees and I am pleased to have had the continued support of the sane two Chairmen with whom the Medical Officer of Health here is particularly concerned, namely, Alderman A.J. Rogers of the Public Health Committee and Councillor E.J.W. Bayliss of the Housing Committee, and their respective Committees, who have always given the most careful consideration to the various matters I have been privileged to place before them. V. FREEMAN Medical Officer of Health. 6 MEMBERS OF THE PUBLIC HEALTH COMMITTEE (As at 31st December, 1958) MAYOR: Councillor W B GOUGH, J P Aldermen: HERBERT JAMES LOWTON LYGOE, M B E , J P . M S M , L. C. C. ALBERT JOHN ROGERS Councillors: GEORGE ARTHUR AINSWORTH MRS FRANCES MARJORIE COLE WILLIAM DRADY FRANK ERNEST FIELD ERNEST CHARLES GOUGH ERNEST GEORGE HILLS MRS MARY EVA GERTRUDE HYDE WILLIAM CAMPBELL LILLIE ALEXANDER MACDONALD HENRY JAMES REID LEWIS ROSS MRS MARGARET MARY SHORT MRS EMILY MARY SIMMS MRS BRONWEN STRADL1NG VIVIAN STEWART STRADLING Chairman: Alderman ALBERT JOHN ROGERS Vice Chairman: Councillor MRS EMILY MARY SIMMS STAFF OF THE PUBLIC HEALTH DEPARTMENT. TOWN HALL. ISLINGTON, N 1 Medical Officer of Health: V FREEMAN M R. C. S. , L. R C P. , D„ P H„ Deputy Medical Officer of Health: J P J , Burns, M B. , B Ch. , B A. 0. , D P H \ Par t-Time) ( Commenced 24/3/1958) Public Analyst: Chief Public Health Inspector: D. F. H. Button, A R C. S. F.R.I C W C. Bartlett, M.A.P.H.I., M R S H. (b) (c) (d) Deputy Chief Public Health Inspector: H Plinston, (b) (c) Supervisory Public Health Inspector: J S Ashworth, b) 7 Public Health Inspectors; (l)(n) H. Archibald (b) T. Lawson (b)(c) A. Aslamidis (b)(c)(d) N. Lightowlers (b)(c) D.T. Evans (b)(c)(e) S E. Muggeridge (b)(c) G.D. Couling (b)(c)(e) F.H.W. Pedrick (b) A.V. Frisby (b)(c)(f)(g)(h) Miss S.H. Prentice (b)(c) L. Poxley (b)(c) G. A. Reid (b)(c) K.L. Garner (b). R. A. Royle (b)(c)(f)(g)(h) Miss V.M. Goddard (b) M.R. Ruocco (b)(c) R. T. Govett (b)(c)(d)(e)(j) K„E. Sewell (b)(c) A.W. Haydock (b) U.P. Stanton (b) A R. Kempshall (b)(k) W.T. Stevenson (b)(c) R. C. Whittaker (8 vacancies) Chief Clerk: E.J. Sharp Clerical Staff: S. A. Bishop E. P. Brewer Miss M. Brewer W. R. Causton* E. Conner Mrs. V. E. Cook P. Dymond Mrs. 0. Easson P. Hardwick J. H0ugh Miss ME Hudson L. Hummerstone Mrs. E. Johnson T. Johnson W A. McAdam* Mrs. C. McCausland Mrs. S.R Moody C.J. Moore* D A. Owen Mrs. E,V. Pelosi P L. Regan Mrs. M. Taylor J. Thompson L. Turner Mrs. P. Underwood S Wright* Old People's Health Officer: Mrs. A. E. Poster (f) Infectious Diseases Visitor: Mrs. C. M Burton (f) Treatment Centre, Seven Sisters Road, N. 7. W.G. Jollie (Engineer-in-Charge) Mrs. H.W Godkin (Nurse-in-Charge) (f) 3 Home Visitors 1 Stoker/Handyman 1 Assistant Driver 3 Bathing Attendants 1 Driver/Handyman 1 Ambulance Driver 2 Drivers 2 Disinfectors (1 vacancy) Rodent Control: C. Jackson (Rodent Officer) 3 Rodent Investigators 6 Rodent Operators (a) - Certificate of Sanitary Inspectors' Examination Board. (b) - Certificate of the Royal 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. (h) - Health Visitors Certificate. (i) - Health Visitors' Diploma. (j) - Royal Society of Health Certificate for Inspection of Water and Drainage Installations. (k) - Royal Society of Health, Meat and Other Food Inspectors' Certificate. (I) - Certificate of the Royal Sanitary Association of Scotland.. (m) - Meat, Meat Products and Fish Certificate of the Royal Sanitary Association of Scotland. * - Senior Sectional Clerk. 8 SECTION A. GENERAL AND VITAL STATISTICS Area of the Borough 3 092 acres Population. Registrar-General's estimate of civilian population. Mid-year 1958: 225,800 Live Births. BIRTH RATE PER 1 000 ESTIMATED RESIDENT POPULATION England & Totals M. F. Islington Wales Legitimate 4.098 2,045 2,053 Illegitimate 494 270 224 4,592 2,315 2,277 20.3 16.4 Illegitimate live births per cent of total live births 10.76 Still Births. RATE PER 1.000 TOTAL (LIVE AND STILL) BIRTHS England & Totals M. F. Islington Wales Legitimate 90 44 46 Illegitimate 13 7 6 103 51 52 21.94 21.6 Total live and still births 4,695 Deaths DEATH RATE (UNADJUSTED) PER 1,000 POPULATION England & Totals M. F. Islington Wales 2,594 1,273 1 321 11 49 11.7 Maternal deaths (including abortion) Total deaths 6 Islington England & Wales Maternal mortality rate per 1.000 live & still births 1.28 0.43 Infant mortality Total deaths 107 Islington England & Wales Infant mortality rate per 1,000 live births total 23 23 do. legitimate 21 do illegitimate 45 Neo natal mortality rate per 1,000 live births (first four weeks) 16.55 Notifications of Births For year ended 3rd January 1959 4,720 (corrected figure from L. C. C.) marriages (Provisional figures) Marriages solemnised in the Borough during the year 2 368 9 CLASSIFICATION OF DEATHS WITH AGE DISTRIBUTION (REGISTRAR GENERAL'S RETURNS) CAUSE OP 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 _ 2 3 8 3 10 3 1 - 22 9 31 1 2. Tuberculosis, Other _ - _ _ _ _ . - _ _ _ - 1 1 1 2 2 3 5 2 3. Syphilitic diseases - - - - - - - - - - 2 1 2 4 1 4 5 9 14 3 4 Diphtheria - - - - - - - - - - - - - - - - - - - 4 5. Whooping Cough - - - - - - - - . - - . - - _ - _ - _ 5 6. Meningococcal Infection - - - - - - - - _ - - _ - - . _ _ _ _ 6 7. Acute Polionyelitis - - - - - _ _ - . _ _ _ _ _ _ _ _ - _ 7 8. Measles - - _ . 1 _ _ _ . _ _ _ _ _ _ . 1 - 1 8 9. Other infective and parasitic diseases - - - 1 - - _ - - - 2 _ - _ - 1 2 2 4 9 10. Malignant neoplasm, stomach - - - - - - - - 1 3 15 7 13 4 14 15 43 29 72 10 11. Malignant neoplasm, lung bronchus - - - - . - - - - 7 2 63 6 42 11 18 5 130 24 154 11 12. Malignant neoplasm, breast - - - - - - - - - 7 1 14 - 11 - 8 1 40 41 12 13. Malignant neoplasm, uterus - - - - - - - - - 4 _ 9 - 9 - 6 - 28 28 13 14, Other malignant neoplasms _ - - 1 - - - 2 6 5 35 29 29 25 46 37 116 99 215 14 15. A-and-Leukamia - - - 2 1 - 1 1 2 1 3 1 2 2 - 2 9 9 18 15 16. Diabetes _ . _ . _ _ _ _ _ _ 1 1 4 6 3 1 8 8 16 16 17. Vascular lesions of the nervous system - - - - - - - 1 1 2 21 22 40 40 37 89 99 154 253 17 18. Coronary disease, Angina - - - - - - - _ 7 1 71 21 68 74 66 88 212 184 396 18 19. Hypertension with heart disease - - - - - - - - - - 6 7 3 13 13 22 22 42 64 19 20. Other heart disease - - - - _ - 1 1 5 5 15 14 17 36 56 159 94 215 309 20 21. Other circulatory disease - - - - - - - - - 2 7 8 9 15 22 55 38 80 118 21 22. Influenza - - - _ - _ 1 _ _ 1 2 - 5 3 2 1 10 5 15 22 23. Pneumoni a 8 11 3 2 - - - _ 1 1 9 10 15 16 37 50 73 90 163 23 24. Bronchitis 1 3 . _ - _ _ _ 3 1 29 11 51 24 57 48 141 87 228 24 25. Other disease of the respiratory system - 1 - - - 1 - - 1 - 10 - 4 2 6 3 21 7 28 25 26. Ulcer of stomach and duodenum - - - _ - _ . - 1 1 8 3 13 3 8 3 30 10 40 26 27, Gastritis, enteritis, diarrhoea 1 1 - - _ _ 1 _ 2 _ 1 1 _ 1 3 8 8 11 19 27 28. Nepth'ritis and Nephrosis - - - - - - - 1 2 2 4 1 _ 1 3 3 9 8 17 28 29. Hyperplasia of prostate - - - - - . _ _ _ - _ _ 5 _ 9 _ 16 _ 16 29 30. Pregnancy, Childbirth and Abortion - - - _ _ _ - 1 _ 5 _ . _ - _ _ . 6 6 30 31. Congenital Malformations 8 20 - - - 1 - 1 - _ 1 1 2 - - - 11 23 34 31 32. Otfyer defined and ill-defined diseases 26 26 1 1 - - 1 1 4 6 15 16 16 16 18 35 81 101 182 32 33. Motor vehicle accidents - - 1 - 3 _ 5 - 2 1 7 2 2 3 1 3 21 9 30 33 34. All other accidents _ _ 1 - 3 1 3 _ 6 _ 2 _ 6 3 4 11 25 15 40 34 35. Suicide - - - _ - . 1 1 8 3 7 8 4 _ 1 _ 21 12 33 35 36. Homicide 1 - - - - - 1 - - - 1 . - 1 - - 2 2 4 36 All Causes 45 62 6 7 8 3 16 10 61 56 347 197 363 327 427 659 1273 1321 2594 Totals 107 13 11 25 117 544 690 1086 2594 Percentages 4.13 0.50 0.42 1.00 4.51 20.97 26,60 41,87 1.00 10 COMPARATIVE VITAL STATISTICS - 1947 TO 1958 (Compiled from Registrar General's Returns) 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 Population 225,800 227,800 228,300 228,800 230,500 233,500 235,300 235,800 238,200 239.580 238,200 236,840 Live Births - (Total) 4,592 4,582 4,322 3,945 4,063 3,969 3,897 3.880 4,091 4,389 4,608 5,577 (Illegitimate) 494 467 402 340 336 296 282 285 302 318 331 431 Birth Rate per 1,000 population 20.3 20.1 18.9 17.2 17.6 17.0 16.56 16.45 17, 17 18.32 19.34 23.55 Still Birth Rate per 1,000 births 21.94 19.68 21.51 21.09 19.31 22.66 17.89 20.94 17 48 19.87 18.94 18.99 Deaths 2.594 2,457 2,566 2,591 2,425 2,669 2,876 3.131 2,760 2,958 2,682 3,053 Death rate 11.49 10.79 11.24 11.32 10.52 11.43 12.22 13.28 11,59 12.35 11.26 12,89 Maternal Death rate per 1,000 births 1.28 0.64 0.45 0.25 0,48 0.99 1.01 0.50 0.72 0.67 0.85 0.70 Death rate of Infants under 1 year 23 21 21 26 17 24 22 28 29 27 35 32 Marriage rate per 1,000 population 21.0 20.73 21.44 20.95 19.35 19,08 17,85 19.17 18. 37 18.61 19.67 19.54 T. B. Notifications per 1,000 population (all forms) 2.13 1.51 1.81 1.97 1.94 2 08 2 03 1.77 2.05 2.20 2.25 2.43 Death-rates per 1,000 population - Pulmonary T.B 0,14 0.12 0.15 0.20 0.16 0.16 0.30 0.30 0.38 0.52 0.66 0.70 Diphtheria Nil Nil Nil Nil Nil Nil Nil 0 004 0.004 0.008 Nil 0.004 Neoplasm of Lung, Bronchus & Trachea 0.68 0.67 0.62 0.52 0.53 0.57 0.54 0.54 0.54 Nil Nil Nil Suicides 0.15 0.11 0.15 0.13 0.13 0.14 0.076 0.15 0.09 0.12 0.15 0.07 Motor Vehicle Accidents 0.13 0 092 0.13 0.14 0.082 0.077 0.076 0.11 0.10 0.06 0.08 0.11 Other violent causes 0.18 0.23 0.22 0.22 0.17 0.20 0. 22 0.26 0.26 0.25 0.43 0.37 11 SUMMARY OF INFANT MORTALITY 1958 (Based on Registrar General's Returns) Primary Cause of Death Under 1 day Days Weeks Months 1958 (1957) 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 Whooping Cough Meningococcal Infection (2) Tuberculosis - Lungs Tuberculosis - Other form Bronchitis 2 1 1 4 (3) Pneumonia 1 4 2 2 2 2 1 2 1 1 1 19 (12) Influenza Enteritis and Diarrhoea 2 2 (1) Premature Birth 6 1 1 1 9 (12) Congenital Malformation, Birth Injury, Atelectasis Atrophy and Marasmus 29 3 4 3 2 1 2 1 2 2 4 2 1 1 57 (59) Syphilis Suffocation Overlying Violent Causes 1 1 Road Traffic Accidents All Other Causes 4 1 2 1 2 1 2 1 1 15 (5) TOTALS 41 5 11 4 4 1 3 3 4 2 4 9 5 2 4 1 3 1 107 (94) 12 COMMENTS ON VITAL STATISTICS Births. The trend to an increase in the birth-rate which has been commented upon during the past few years continued in 1958 The total number of births ascribed to the Borough, 4,592, was a slight increase over the previous year, but allowing also for the Registrar General's reduced estimate of population there was an increase in the birth-rate to 20.3 This is the highest rate since 1947 when the figure was 23 55 per thousand population 10.76 per cent. of all 1958 births were classified as illegitimate. population. In view of the interest in the post-war "bulge" the following table (extracted from the Registrar General's Returns) gives the estimated number of children under the age of 15 years in the County of London and in Islington:- Under 1 year 1-4 Total under 5 5 - 14 Total under 15 London Admin. County 52,100 179,300 231,400 417,500 648,900 Islington 4,400 13,900 18,300 30,100 48,400 Deaths. The death-rate of 11.49 per thousand population was a little higher than in 1957 (10 79) There were relatively small increases in a number of causes of death but the groups where the major increase in numbers of deaths occurred were due to some failure related to the blood circulatory system, comprising vascular lesions of the nervous system, coronary disease and angina, other heart and circulatory disease Deaths from respiratory trouble, i.e pneumonia and bronchitis being the principal groups, were almost the same as in the previous year. Seasonal influences on deaths doe to respiratory diseases It is a matter of common knowledge that coughs and colds bronchitis, etc. increase in the winter months. The effect of seasonal influences on deaths due to this group (i.e. influenza, pneumonia and bronchitis) at the. various age groups is shown in the following table:- 13  Under 1 year 1 -44 45-54 55-64 65-74 75† Total January 3 2 9 12 29 24 79 February 2 1 4 6 15 29 57 March 2 1 2 5 17 31 58 April 1 1 1 6 8 15 32 May 2 1 1 - 4 8 16 June 1 1 2 4 8 16 July 2 1 1 - 8 9 21 August 2 - - 1 3 5 11 September 1 1 1 - 3 4 10 October 1 - 1 2 3 16 23 November 4 1 1 4 11 13 34 December 1 5 6 8 18 26 64 Deaths of Infants under one year: The infant mortality rate, at 23 per thousand live and stillbirtha, although a little higher than in the past two years, was nevertheless comparable with that of the country as a whole From the summary of the total infant deaths given on page 11, it will be noted that of 107 deaths under the age of twelve months, no less than 41, or 38 3 per cent. occiftred within twenty-four hours of birth, and a total of 69, or 64.5 per cent took place within seven days of birth, 57 infant deaths, or 53.3 per cent of the total were ascribed to the group of causes, (congenital malformation, birth injury, atelectasis, etc.,) related directly to maternal causes, and almost all occurred within the first four weeks of life, and mostly much earlier The second largest single group of infant deaths, 19 in all, was ascribed to pneumonia, and this was responsible for more infant deaths after the age of one month than any other single cause. Respiratory Tuberculosis The continuous reduction in deaths due to respiratory tuberculosis over the past years was interrupted temporarily one hopes, with a total, of 31 from this cause as against 28 the previous year. The increase in itself would give no cause for anxiety since it is relatively small, but combined with some increase in the notification of new cases (commented upon elsewhere) there is no reason for complacency yet with regard to tuberculosis of the lungs in an area such as Islington. Malignant growths of Lung and Bronchus It is unfortunate that the steady increase which has been noted year by year in deaths due to malignant disease of the lung and bronchus since the figures were separately classified from 1950 onwards, has continued in 1958. The increase in the total numbers over the previous year is very slight but nevertheless the same tendency is there, and this is in accordance with the continued increase for the country as a whole. 14 Deaths Male Female Total 1950 115 14 129 1951 104 23 127 1952 107 20 127 1953 114 19 133 1954 98 25 123 1955 103 17 120 1956 119 22 141 1957 127 25 152 1958 130 24 154 No new evidence has been brought forward which in any way controverts the evidence accepted by the Ministry of Health that the principal factor in the increase in lung cancer over the past years is due to prolonged and heavy cigarette smoking by individuals. Many enquiries have shown that cigarette smoking in boys frequently starts quite early. Substantial numbers of schoolboys smoke in their early 'teens and a not inconsiderable number at even earlier ages. The problem is therefore being tackled by many school authorities but the work of these authorities cannot be made easier without active parental co-operation It is obvious that the attitude of parents towards their children smoking at an early age is most important in regard to the commencement of this habit. Accidents. The following table gives the deaths from accidents to Islington residents from 1952 onwards:- 1952 1953 1954 1955 1956 1957 1958 Motor vehicle accidents 18 18 19 33 29 21 30 Other violent accidents 48 46 40 50 51 52 40 In the following table causes of accidental deaths in 1958 are analysed, in their respective age groups. Type 0- 1- 5- 15 - 25- 45- 65- 75† M F. Total Motor Vehicle Accidents - 1 3 5 3 9 5 4 21 9 30 Falls - - 1 1 3 2 5 9 12 9 21 Accidental Poisoning (Solid, Liquid Gases and Vapours) - - - - - - 4 2 2 4 6 Drowning - - 1 1 - - - - 2 - 2 Fire - - - - 2 - 2 3 1 4 Inhalation of Stomach contents, ingestion of food, etc, - - - - - - - 2 1 1 2 Others (Railway Accidents, etc.) - 1 2 1 1 . . . 5 - 5 Total - 2 7 8 9 11 14 19 46 24 70 The total of fatal accidents was three less than last year, but 30 fatalities due to motor vehicle accidents were an increase of nine over the previous year. 15 SECTION B. PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES. Notifiable infections Diseases and Deaths during the year 1958- 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 272 (203) - 43 268 24 Diphtheria 6 (9) - 6 2 - Enteric Fever (including Paratyphoid) 3 (9) - 2 2 1 Typhus Fever - (-) - - - - Puerperal Pyrexia 329 (361) - 318 322 - Ac. Primary & Influenzal Pneumonia 112 (170) - 3 109 - Ophthalmia Neonatorum 29 (17) - 25 29 - Acute Encephalitis 3 (3) - 2 3 1 Meningococcal Infection 8 (4) _ 6 5 1 Anthrax - (1) - - - - Dysentery 831 (385) - 79 810 222 Malaria - (-) - - - - Erysipelas 31 (31) - 6 29 3 Measles 2965 (1766) 1 75 2940 196 Whooping Cough 116 (431) - 7 113 15 Ac. Poliomyelitis 28 (45) - 24 10 - Food Poisoning 183 (150) - 25 170 35 Tuberculosis -Lungs 457 '(316) 31 - 314 - Tuberculosis -Other Forms 23 (29) 5 - 21 _ Scabies 112 (70) - 3 110 131 (Figures in brackets are notifications for 1957). Domiciliary visiting of infections Disease cases and contacts - no of visits Smallpox 3 Scarlet Fever 278 Diphtheria 19 Enteric Fever (including Typhoid and Paratyphoid) 23 Meningococcal Infection 10 Dysentery 1,344 Malaria Acute Encephalitis 4 Erysipelas 39 Measles 3, 100 Whooping Cough 130 Acute Poliomyelitis 65 Food Poisoning 190 Scabies 184 Vermin 468 Influenza Ineffective Visits 1,239 Others 36 Total 7,132 16 Smallpox The Medical Officer of Health was called into consultation in respect of two patients who had rashes and where it was desired to rule out the possibility of smallpox The first case was a young married woman whose husband was a male nurse at a hospital, and the second was herself a nursing auxiliary at another hospital. Both cases, fortunately, were negative and the diagnosis was finally confirmed with negative results on examinations carried out by the Virus Reference Laboratory, Colindale, on pathological specimens taken from each patient. A third suspect case, a young woman residing in a hostel which included other residents who had recently come from abroad, was also seen by a hospital Consultant and again, smallpox was not confirmed. The following is the table of successful vaccinations performed over the past eleven years:- 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* 1955 5,942* 1956 2,590* # 1957 3,624* 1958 3,449* (Figures kindly furnished by Divisional Medical Officer., London County Council.) *Including Re-vaccinations #Group Sessions for Schoolchildren discontinued. The Vaccination Acts were rescinded under the National Health Service Act,1946 as from 5th July, 1948 Certificates of vaccination and Inoculation - Aatheatieation - Ministry of Health Circular 60/48 Applications for authentication to be dealt with by. the Medical Officer of Health numbered 743 as against 1,045 for the previous year The applications comprise requests for authentication of Internal Certificates of Vaccination and Inoculation against smallpox, cholera typhoid, etc. and constitute a substantial item of work. The certificates, of course, are required for travel abroad. 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. 17 Meaales. 1958 was a year of substantial increase in the incidence of measles There were 2,695 notifications, as against 1,766 the previous year, and this is the third largest total of cases in any post-war year, being exceeded only to a slight degree in 1955, and by a somewhat greater margin in 1951, as shown in the diagram on page 18 As is customary, over half of the children affected were under the age of five years, but fortunately only a small proportion were under the age of twelve months. There are no active measures of immunisation which can yet be adopted against measles. It will be apparent from the chart of the course of the outbreak during the year that the highest Incidence was in mid. summer. Measles began to increase in February and cases reached a peak in June, after which the incidence diminished rapidly to a low level by September The following table shows the age-groups of the notified cases during 1958:- Under 1 year 1 - 5 5 years and upwards No of Notifications in 1958 93 1,587 1,285 Percentage of total notifications 3.1 53.5 43.4 No. of Deaths 1 18 Whooping Cough: By contrast with measles, the number of cases of whooping cough in 1958 was the lowest in the Borough since whooping cough became notifiable. It is difficult not to believe that apart from natural variation which may occur in any infectious disease from year to year, the very substantial number of children in the Borough who have now received immunising injections against whooping cough is not having some considerable effect. In the absence of control enquiries, it is not possible to put the assessment of whooping cough diminution into precise form. If, however, whooping cough incidence eventually follows the course of diminution similar to that which has occurred with diphtheria, it will certainly support the view that active protection against whooping cough is having a major and mass effect. Nearly one-fifth of all the whooping cough notifications were Under the age of twelve months, at which period whooping cough is at its most dangerous. Early protection against whooping cough is therefore extremely desirable. Under 1 year 1 - 5 5 years and upwards No of Notifications in 1958 20 62 34 Percentage of total notifications 17.3 53.4 29.3 No. of Deaths _ - _ 19 Fatality Rates per 1,000 notifications each age group (1949-1958) Percentage of notifications (1949-1958) Under 1 1 - 5 5 & upwards Under 1 1 - 5 5 & upwards Measles 1.97 0.21 0.11 4.1 57 6 38 3 Whooping Cough 5. 16 1.41 - 11.9 54 8 33.3 Over the ten-year period 54.8 per cent of all cases of whooping cough and 57 6 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 7917 Completed cases 2667 London (Measles and Whooping cough) Regulations, 1938 Home visiting of measles and whooping cough cases was carried out by the Home Visitors as under:- No. of Investigations Measles Whooping Cough No. of Ineffective Visits Re visits 3,098 128 316 4 Acute Poliomyelitis. There were relatively few confirmed cases of poliomyelitis during the year. In fact, the number, as will be apparent in the table, was the lowest in any post-war year except 1951 None of the cases was fatal. Immunisation against poliomyelitis was carried on throughout the year through the Divisional Health Services of the London County Council. The cases reported for each of ten years are set out as under:- 20 No. Reported No. CONFIRMED 1958 37 10 1957 55 25 1956 34 13* 1955 97 56 1954 35 12 1953 47 17 1952 30 15 1951 21 8 1950 54 31 1949 88 62 Onset dates Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct . Nov. Dec. 1958 - - - 1 1 - 2 - 5 1 - 1957 2 - - 2 1 2 5 4 5 2 2 - 1956 1 - 1 1 1 - - - - 2 3 4* 1955 2 1 - - f 1 5 11 15 9 9 3 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 Age distribution: Under 1 year 1 - 5 - 15 - 25 and over 1958 1 4 4 - 1 1957 1 6 12 2 4 *1956 - 4 5 2 2 1955 5 19 15 5 12 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 1949 3 35 17 2 5 Deaths: 1958 Nil 1957 1 (7 years) 1956 Nil 1955 3 (17% years;- 30 years; and 5 years - the latter contracted outside the borough, and not included in above tables). 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 * Two cases, with onset in December, 1956, were notified in 1957, and are included in the above returns. 21 Diphtheria. Cases and Deaths - 1927 - 1958 Year Notified Cases Deaths Year Notified Cases Confirmed Cases Deaths Year Notified Cases Confirmed Cases Deaths 1927 720 25 1938 595 Not available 23 1949 55 17 2 1928 760 25 1939 254 10 1950 50 19 1 1929 1008 34 1940 101 2 1951 43 17 1 1930 1248 42 1941 174 11 1952 23 - - 1931 714 15 1942 201 2 1953 12 1 - 1932 601 20 1943 188 9 1954 6 1 - 1933 551 33 1944 94 38 2 1955 9 1 - 1934 815 32 1945 86 45 3 1956 8 2 - 1935 760 13 1946 137 50 - 1957 9 1 - 1936 583 31 1947 72 19 1 1958 6 2 - 1937 623 20 1948 44 7 - 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 1955 169 17 1 1956 63 11 2 1957 40 4 1 1958 79 38 2 Diphtheria. Diphtheria continues to be a rare infection. One case was a six-year-old boy who was found to have a diphtheria organism in the throat, following a routine throat swabbing at a school inspection, but he appeared to be without symptoms and there was no recent history of illness. He had been immunised in infancy and had a booster dose a few months before this incident. There were several school contacts but no members of the family were affected. The other case was similar in type, although it occurred in an adult, also without symptoms, and came to light as a result of a throat swab being taken. 22 Diphtheria cases and Immunisation state 1947-1958 (inclusive) Year IMMUNISED NON-IMMUNISED Unknown Total Deaths Age Groups 15+ Age Groups 15+ 0-5 5-15 0-5 5-15 1958 - 1 - - - - 1 2 Nil 1957 - 1 - - - - - 1 Nil 1956 - - 1 - - 1 - 2 Nil 1955 - - - - - - 1 1 Nil 1954 - - - - - - 1 1 Nil 1953 - - - - - 1 - 1 Nil 1952 - - - - - - - - - 1951 1 2 - 8 5 1 - 17 7 years - Not imm. 1950 - 5 - 3 7 4 - 19 7 years - Not imm. 1949 1 3 - 2 8 3 - 17 4 years Not imm. 16 years 1948 1 2 1 1 - 2 - 7 Nil 1947 - 5 1 2 4 5 2 19 16 years -Not imm. Totals 3 19 3 16 24 17 5 87 5 deaths (None immunised) 25 V 57 Diphtheria Immunisation, 1958 Dr. Wilfrid G. Harding, 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 31.12.58 i.e. born in year Under 1 1958 1-4 1957-54 5-9 1953-49 10-14 1948-44 Under 15 Total Last complete course (whether primary or boost) 1954-58 721 9408 8367 7287 25,781 Mid-year population 4400 13,900 30,100 48,400 Immunity Index 16.4 67.7 52.0 53.27 23 Food poisoning Number of notifications received 1947 7 1948 10 1949 55 1950 104 1951 148 1952 58 1953 243 1954 104 1955 294 1956 141 1957 150 1958 183 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 10.9 58 1 555 14 Nil Beef: Food samples examined showed no pathogenic organisms present. C1. Welchii isolated from some case3 and symptomless kitchen staff. 27.11.58 - 276 11 Nil Beef: No food samples available. Stool specimens examined from cases and kitchen staff showed no pathogenic organisms present. There was some increase in the number of food poisoning notifications received The first outbreak reported above occurred in connection with a school It will be apparent that only a relatively small proportion of those who consumed food which presumably might have given rise to food poisoning actually developed symptoms Enquiries were instituted by the Public Health Department when information was received, and particular attention was directed to the meal which included cold roast beef which had been cooked the previous day Stool specimens from some of those affected were sent to the Public Health Laboratory.County Hall, and the food poisoning organism Clostridium Welchii was found. This organism is heat resistant to a very considerable degree and may be present in meat which is perfectly sound in appearance. The second outbreak reported above was also in relation to a school and again it will be seen that only a small proportion of those who consumed the meal in question were affected Stool specimens submitted by some of those affected contained no food poisoning organisms and the causative organism responsible for this outbreak was not discovered. 24 The above occurrences took place in spite of the fact that good kitchen hygiene and a good standard of kitchen practice were present. Other food poisoning cases were either isolated ones or small family outbreaks During the year the Ministry of Health issued a revision of Memo 188/Med dealing with food poisoning. The Memorandum mentioned that the reported instances of food poisoning in the country showed no signs of decreasing and there were 6, 898 outbreaks, including family outbreaks between 1950 and 1956; in a large proportion of these outbreaks neither the causal food was named, nor the responsible organism identified Thorough investigation at an early stage is necessary if the most complete information is to be obtained, but this necessitates early notification by the practitioner, or early information from others being passed to the Public Health Department. If there is delay before information is received by the Medical Officer of Health, investigation is made much more difficult, and it may even be impossible to make complete investigation if the suspected foods have been disposed of. The Revised Memorandum deals with the investigation of notified cases, the collection of data on food poisoning, and includes amended report forms for returns to the Ministry of Health; it also outlines lines of enquiry into food poisoning outbreaks The field of laboratory investigations is dealt with in some detail, and the Memorandum- should assist in the central collation of information on a more precise basis. Typhoid and Parataphoid Fever. A four months old baby was admitted to hospital with a fever Bacteriological investigations were carried out and salmonellae typhi were found. Investigations by the Department into household contacts showed that the mother herself was also a carrier, and treatment was arranged through her own medical practitioner. A woman engaged as a pie-maker at an establishment in the Borough suffered an attack of enteritis; as a result of stool examinations she was found, to be suffering from infection with salmonella typhi B She accepted the advice of the Department and agreed to change her occupation to one where she was not called upon to handle food. Dysentery 1958 was a year of relatively high dysentery incidence in the Borough as will be seen from the table The majority of the cases were in the first half of the year and approximately 40 per cent were under five years of age Although dysentery or infection with Shigella Sonnei does not normally give rise to severe illness it is still desirable that hygienic precautions be taken in connection with persons and families- Enquiries are made in all instances where information of cases is received in relation to employment in food handling occupations. It will be noted from the table that 27 cases were actually employed as food handlers, and over 160 were food handler contacts Appropriate personal advice was given in every case. 25 DYSENTERY IN ISLINGTON - 1958 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 1958 111 79 4 20 24 1 3 - 2 5 12 7 January M 46 8 33 67 F 52 5 2 23 11 7 13 1 - February 184 M 60 23 157 - 28 46 2 6 1 - F 78 23 2 20 47 2 17 5 8 2 12 14 90 90 March 89 M 46 7 65 2 18 25 3 3 1 1 F 32 4 3 9 12 3 6 - 3 1 9 4 42 45 April 145 M 43 26 117 2 42 15 - 10 - - F 54 22 - 33 13 6 20 3 1 9 32 6 47 97 May 63 M 26 1 34 2 11 8 2 3 1 1 F 35 1 1 8 8 4 9 4 1 3 2 - 25 36 June 59 M 31 4 43 3 13 15 - 3 - - F 14 10 - 6 12 1 5 - 1 - 1 - 29 30 July 115 M 33 22 90 2 20 26 1 2 3 1 F 46 14 4 16 24 3 9 4 - 2 17 7 52 57 August 56 M 18 5 44 1 11 5 2 4 - - F 20 13 1 15 6 - 8 3 - 2 3 4 30 19 September 48 M 24 - 20 1 6 6 3 4 4 - F 22 2 2 6 4 6 1 4 1 - 3 - 24 21 October 73 M 32 2 35 6 11 8 1 4 2 1 F 37 2 5 13 13 2 5 1 1 1 1 - 41 28 November 26 M 12 2 12 2 3 3 - 4 2 - F 12 - - 5 2 1 2 2 - 1 4 5 8 17 December 67 M 24 16 54 2 22 11 1 3 1 - F 17 10 17 6 3 - 1 - 1 18 6 34 32 Total 1036 M 395 116 750 47 376 350 54 144 43 22 27 114 53 455 539 F 419 106 26 It will be noted also in the table that the greater number of cases reported occurred in houses where the water closet was shared. This is a relevant factor, as bacteriological investigations have shown that the Sonne dysentery organism is frequently present within a w.C. compartment and w.C. hygiene is therefore very important. Tuberculosis. The figures for new cases and deaths due to pulmonary tuberculosis in 1958 give no cause for complacency, and it is very apparent that this infection is still a major medical and social problem in areas such as Islington. Both the number of new cases and the number of deaths were somewhat higher than in 1957. as will be apparent from the figures in the tables. The 28 deaths from this cause in 1957 were the lowest on record, and had reached this level from a declining death rate over a period of several years. Although there was an apparent set-back in 1958 it is unlikely that this will affect the downward long-term trend and it would be surprising if the same did not apply to the new cases, although the diminution is likely to be somewhat slower if the experience of the past few years continues to be a guide for the future. As in previous years, tuberculosis continues to affect males to a considerably greater degree than females, roughly in the proportion 2:1. The largest single group of new cases was in the age group from 25 to 35 with 90 men and 50 women. Among the older age groups the difference between male and female new cases is even more marked, a high proportion of the total number of new male cases being in those over 45. Elderly -persons with chronic infection of the lungs are the. most likely source of transmitting the infection to others and it would appear that in this respect the males are probably more guilty than the females. No person with longstanding cough should hesitate to seek medical advice both for his own benefit and the possible advantage of others. New cases arid Mortality da ft rig 1958 Ages NEW CASES DEATHS Respiratory Non-Respiratory Respiratory Non -Respiratory M. F. M. F. M. F. M. F. 0- 1 1 - - - - - - 1- 7 3 - - - - - - 5- 9 5 - 3 - - - - 15- 42 30 2 1 1 - - - 25- 90 50 4 5 2 2 - - 35- 36 20 3 3 - 1 - - 45- 58 24 1 3 2 - - - 55- 54 11 - 2 6 3 - 65 and upwards 48 11 1 3 11 3 2 3 Total for all ages 345 155 11 20 22 9 2 3 531 36 Rates per 1,000 population: New cases : pulmonary 2.21 non-pulmonary 0.14 Deaths : pulmonary 0.14 non-pulmonary 0.02 27 Public Health (Tubercluosis) 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, 1958, was:- Pulmonary Males 1,641 Females 1,227 Non-Pulmonary Males 137 Females 167 3,172 The corresponding figures for previous years are:- 1949 2,490 1950 2,368 1951 2,404 1952 2,575 1953 2,802 1954 2,922 1955- 2,945 1956 3,048 1957 3,108 Islington chest Clinic, whittlngtan Hospital. St. pancras Chest Clinic, Margaret Street, St.' Marylebone During the year the Regional Hospital Board, in order to equalise the distribution of Islington patients between the Chest Clinics covering the area, decided that patients from south-west Islington (covering approximately 40,000 Islington residents) should receive attention, if necessary, at the St.Pancras Chest Clinic. This would relieve the pressure on the Islington Chest Clinic and enable more work to be done at the St.Tancras Chest Clinic. There was some concern initially that there might be inconvenience to persons referred to the St. Pancras Clinic, but experience of the operation since the new arrangements have been in force have indicated that the public have accepted - and indeed appreciated - the change and that as far as is known no hardship has been caused. Cases on Chest Clinic Registers Pulmonary Non-Pulmonsry Adults Children Adu1ts. Children Adults ' Children Number of definite cases of tuberculosis on Chest Clinic Register as at 31st December, 1958. Islington C.C. M. F. M. F. M: F. M. F M. F. M F. 1254 892 62 65 48 86 6 6 1302 978 68 71 St. Pancras C. C. 174 103 11 9 4 5 5 5 178 108 16 14 1428 995 73 74 52 91 11 11 1480 1086 84 85 Grand Total 2735 28 The corresponding figures for previous years are:- 1949 2,127 1950 2,238 1951 2,443 1952 2,575 1953 2,738 1954 2,851 1955 2,751 1956 2,772 1957 2,818 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. The Tuberculosis Care Committee is able to assist patients in many ways, and the Care Organiser reports that an average of 107 cases per quarter were helped with extra nourishment during the year, while loans of beds and bedding and medical appliances were made to 16* patients; others were referred to various organisations for assistance. Tuberculosis - Mass X-Ray Unit of the North-West Metropolitan Regional Hospital Board, 32, Drayton Park, N.5- The Mass X-Ray Unit continues to carry out most useful service in the Borough Dr G.Z. Brett, Physician-in-Charge of the Unit, has kindly supplied the following information in respect of Islington residents examined during the year:- Men Women Total No. X-Rayed 5, 544 7,963 13,507 No. of cases of tuberculosis 67 25 92 Rate per 1,000 12.0 3.1 7.0 In addition, a large number of others who work in the Borough were seen, and arrangements were made for many organised groups of volunteers to attend for examination at the Unit. Scabies and vermin The number of cases of scabies dealt with, both schoolchildren and adults, was greater than in the previous year. The reason for this increase is not very apparent, but in view of the relationship of personal hygiene to scabies, any tendency to increase will be a matter for enquiry. 29 Scabies Vermin Children under 5 years Number treated 18 30 Number of baths given 28 - Number of treatments - 30 L. C. C. Children Number treated 72 341 Number of baths given 176 - Number of treatments - 345 Adults Number treated 115 38 Number of baths given 235* - Number of treatments - 39 *Baths were also given to 158 Special Cleansing Cases. 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 129 1 88 218 Vermin 318 14 240 572 Bacteriological Examinations All specimens for bacteriological examination dealt with through the Department are submitted to the Public Health Laboratory Service,County Hall,S.E.I Examinations carried out Total Swabs (Diphtheria) 170 Sputum (Tuberculosis) 40 Faeces (Enteric Fever) 93 Blood (Enteric Fever) - Faeces (Food poisoning) 377 Food (Food poisoning) 8 Faeces (Dysentery) 6374 Faeces (Poliomyelitis) 86 Swabs (Streptococci) 56 Swabs (Pertussis) - Swabs (Influenza) 2 Smears (Variola) 2 Scrapings (Variola) Other Specimens 13 Total 7221 (I am indebted to Dr. Wilfrid G. Harding, Divisional Medical Officer, London County Council, for the 1956 figures in connection with vaccination, diphtheria and whooping cough inoculations, and chest clinics). 30 SECTION C SANITARY CIRCUMSTANCES OF THE AREA (In conjunction with Mr. W.C. Bartlett, Chief Public Health Inspector) As mentioned in the report for 1957 the Rent Act was placed on the Statute Book during that year but its effect upon the situation in this Borough was not felt until the year under review. The hope that the Minister had when he stated that the essence of the Rent Act was to put on the Statute Book some practical means of stopping the deterioration of 'millions of houses throughout the country has materialised in some measure in Islington.,The number of Certificates of Disrepair issued and the number of Certificates of Cancellation has far exceeded the numbers in 1957 The repair and reconditioning of property by landlords is encouraged not only by the possible statutory increase in rent but also by the fact that financial aid has become possible under other legislation in the way of loans or grants from the local authority. Notwithstanding the encouragement extended to owners to repair property under their control there still remains the hard core of houses which require to be dealt with by means of demolition, slum clearance or closure. By virtue of the London County Council (General Powers) Act, 1958, certain functions under Section 38 of the Shops Act, 1950, which have hitherto been carried out by the London County Council will be transferred to the Borough Councils as from 1st January, 1959. This will result in all the provisions of Section 38 being enforced by the local Council. These provisions relate to ventilation, temperature and sanitary conveniences which the Borough Council has always enforced, and to lighting, personal washing facilities and facilities for the taking of meals, which functions will be transferred from the County Council at the beginning of next year. A very useful piece of legislation included in the above mentioned statute is the substitution for Section 44 of the Public Health (London) Act, 1936, by a section which empowers a Borough Council to execute drainage work by agreement with the owner or occupier. During the year the London County Council revoked Byelaw 7 of the Water Closet Byelaws. 1930 which laid down the number of water closets to be provided in a building. In its place the Borough Council adopted the following new standard agreed by the constituent Councils of the Metropolitan Boroughs' Standing Joint Committee, viz: - " One water closet for each household where practicable; and where premises are let in lodgings at least one water closet for every 8 persons or one water closet for every 4 rooms, whichever standard is the higher." Inspectors carrying out inspections under Section 36 of the Housing Act, 1957, or Section 105 of the Public Health (London) Act, 1936, have been instructed to have regard to the above mentioned standard. 31 In accordance with Section 54 of the Factories Act, 1937, the quinquennial inspection of basement bakehouses commenced on 1st July. The number of such bakehouses is gradually decreasing and details of existing basement bakehouses appear on page 48. Complaints were again received during the summer of heavy infestation of red clover mite on the Council's Housing Estates. These mites travel from the lawns and trees on the Estates to the interior of the lower flats and whilst apparently not injurious can be a real source of nuisance to the tenants. As the Pest Infestation Branch of D. s.I. R. , Slough, are interested in the subject, Dr. Parkin of this Branch attended personally and arranged for equipment to be sent from Slough to demonstrate the treatment necessary. Thanks are due to Dr. Parkin and to his assistant for the interest shown and advice given. It is considered that more control should be exercised over licensed and unlicensed clubs, some of which are poorly appointed or situated Of the 23 licensed clubs in the Borough, 19 were inspected. Without a survey of the Borough, however, it is not possible to ascertain the number of unlicensed clubs. Following an approach made by the Head of the Department of Technology, Tottenham-Technical College the Council approved two Inspectors giving lectures and demonstrations to students during the year. The first gave lectures on basement bakehouses and smoke abatement respectively, and the second gave demonstrations in meat inspection. The Council was represented at the Conference of the Association of Public Health Inspectors by Alderman A.J. Rogers and the Chief Public Health Inspector. The shortage of Public Health Inspectors continues and the work proceeds with difficulty. During the year, however four trainees qualified and were appointed on the Public Health Inspectors' establishment. Summary of work done by District public Health inspectors. During the year 24,554 inspections or revisits were made by the District Public Health Inspectors. In connection with visits to dwelling houses 29,051 inspections or re-inspections of separate lettings were made. Routine Inspections, etc. Houses Inspected (on complaint, etc.) 5,422 do. Separate Lettings in above 9,453 Inspections re Schools. 13 do Licensed Premises. 315 do Child Life Protection 5 do. Stables, Manure Pits 7 do. Courts, Mews 9 do. .Bombed Sites 220 do. Derelict Buildings 11 do. A.R.P. Shelters, Static Water Tanks 30 32 Nuisances dealt with by Notice 8,427 do. informally 537 Houses Reinspected 11,436 do. Separate Lettings in above 19,527 Others revisits 611 Notices Served - Intimation 3,076 do. Statutory 1,658 Notices Complied with - Intimation 1,606 do. Statutory 1,175 do. By Local Authority in default 58 Requisitioned. Properties - Inspected 27 do. Separate Lettings in above 31 do. Reinspected 26 do. Separate Lettings in above 40 Land Charges Act, 1925. Enquiries received 2,847 Properties involved 3,502 Investigations 3,502 National Assistance Act (Section 47). - Aged and Infirm Persons Cases investigated 19 Cases revisited 32 Cases removed compulsorily (See also Section on Services for Elderly Persons). Miscellaneous. Other Visits or Inspections not specified 6,084 Non-effective Visits 3,554 Total Nuisances and Contraventions Reported (all sources) 9,149 *Food and Drugs Act, etc. - Week End (Saturday - Sunday) Duty. Retail Shops and Food Puryeyors Inspected 145 Street Markets Visited 48 * See also Section E. 33 Rent Act, 1957. Applications for Certificates of Disrepair. (1) Number of applications for certificates during 1958 348 Number of applications brought forward from 1957 147 Number of applications carried forward to 1959 29 Total number of applications receiving attention 1958 466 (2) Number of decisions not to issue certificate 16 Number of Undertakings on Form ' K ' accepted 239 (3) Number of decisions to issue certificates 211 (a) in respect of some but not all defects 158 (b) in respect of all defects 53 (4) Number of Undertakings given by landlords under paragraph 5 of the First Schedule 243 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the Schedule (Including 1 refusal brought forward from 1957) 5 (6) Number of certificatesissued where undertakings not accepted 5 Applications for Cancellation of Certificates. (7) Applications by landlords to Local Authority for cancellation of certificates 123 Number of applications brought forward from 1957 7 Number of applications carried forward to 1959 6 Total number of applications receiving attention 1958 124 (8) Objections by tenants to cancellation of certificates 53 (9) Decisions by Local Authority to cancel in SDite of tenant's objection 19 (10) Certificates cancelled by Local Authority 90 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 327 3. Dampness remedied 2089 4 Fireplaces and ranges repaired/renewed 171 5. Floors repaired 465 6. Flues repaired 60 7. Internal walls repaired 1384 8. Ceilings repaired 923 9. Rainwater pipes/gutters repaired 409 Applications by Overseas Companies for Certificates of Repair. Applications received 4 Certificates issued 4 34 10. Roofs repaired 912 11. Rooms cleansed 25 12. Sinks provided 15 13. Soil pipes repaired and renewed 36 14. Staircases or passages cleansed 12 15. Staircases repaired 165 16. Waste pipes repaired 175 17. Water Closet Apartments cleansed 2 18. Water Closet Pans and Traps renewed 98 19. Water Closets - flushing apparatus repaired or renewed 47 20. Water Closets - general repairs 474 21. Water supply provided 14 22. Water service pipes repaired 43 23. Window cords renewed 1081 24. Windows repaired or renewed 801 25. Miscellaneous improvements 1155 TOTAL ... 10,888 Total number of houses improved 3016 Total number of separate lettings improved 3443 Total number of nuisances abated 9544 Public Health (London) Act, 1936 - Sections 40 and 109. London County Council (General Powers) Act, 1955, Sections 25 26 and 27 Consequent upon Notices served by the Public Health Inspectors, the Council, in pursuance of their powers under the above Acts carried out works in default to a total cost of £3187 0s lid during the period under review. This amount is apportioned as follows under the appropriate Ac.ts and Sections:- £ s. d. Public Health (London) Act, 1936, Section 40 2,019 0 5 Public Health (London) Act, 1936, Section 109 145 6 6 London County Council (General Powers) Act, 1955, Section 25 116 15 8 London County Council (General Powers) Act, 1955, Section 26 - - - London County Council (General Powers) Act, 1955, Section 27 905 18 4 3,187 0 11 35 Legal Proceedings Public Health (London) Act 1936 Failure to comply with Statutory Notices contrary to Section 82 (No.of cases 76) Date Address Magistrate's Decision 14. 1. 58 58 Rhodes Street Ordered to abate within 21 days. Defendant to pay £1 14s 6d costs. do 58 Rhodes Street Withdrawn 18 2. 58 31 Lowman Road Not separately dealt with. do. 31 Lowman Poad Fined £2. Ordered to abate within 21 days. Defendant to pay £1. 9s. 6d. costs. do. 32 Gainford Street Fined £2. Defendant to pay £1. 1s. 0d. costs. do. 4 Lennox Road Fined £5. Ordered to abate within 14 days. Defendant to pay £1. 9s. 6d. costs. do. 4 Lennox Road Not separately dealt with. do. 87 Benwell Road Fined £5 Defendant to pay £1. 1s. 0d costs. 4. 3 58 19 Alexander Road Defendant to pay £1. 7s. 0d. costs. (Work done) do. 22 Hercules Street Case dismissed - work done. do. 47 Hornsey Rise Discharged absolutely on payment of 6s. 0d costs. (Work done) do. 5 Christie Street Fined £2 Ordered to abate within 28 days. Defendant to pay £1. 9s. 6d. costs. 25. 3. 58 11 Kinloch Street Fined £4 Defendant to pay £1. 3s. 0d. costs. do. 57 Baxter Poad Fined £5. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. 8. 4. 58 362 Camden Road Fined £5 Ordered to abate within 28 days. Defendant to pay £1 9s. 6d costs. do. 75 §enwell Road Fined £5 Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. do. 6 Lennox Road Summons withdrawn (Work done under London County Council (General Powers) Act. 1955) 22. 4. 58 6 Woodville Road Fined £5 Ordered to abate within 28 days. Defencant to pay £1. 15s. 6d. costs. do. 7 Enkel Street Ordered to abate within 21 days Defendant to pay 10s 6d. costs do. 5A Marriott Road Fined £3 Ordered to abate within 28 days. Defendant to pay £1 9s 6d costs. do. 3 Corinth Boad Ordered to abate within 28 days Defendant to pay 10s 6d costs do. 48 Wall Street Fined £l Ordered to abate within 14 days. Defenoant to pay £1. 15s. 6d. costs. do. 21 King Henry Street, Defendant to pay £1. 6s. 0d. costs (Work done) 29. 4. 58 33 Huntingdon Street Fined £2. Defendant to pay £1. 6s,. 0d. costs. do. 19 Bracey Street Fined £5. Ordered to abate within 28 days. Defendant to pay £1. 9s. 6d. costs. do. 84 Pembroke Street Fined £5. Defendant to pay £2 2s 0d. costs. do. 17 Elton Street Fined £5 Defendant to pay £2. 2s. 0d. costs. 36 Date Address Magistrate's Decision 6. 5. 58 119 Hungerford Road Adjourned sine die (Dealt with under the Hbusing Act 1957) 3. 6. 58 27 Benwell Mansions Fined £.5 Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. do. 29 King Henry Street Fined £2 Ordered to abate within 28 days Defendant to pay £1 9s. 6d. costs. do. 7 Rocliffe Street Fined £2 Defendant to pay £1. 1s. 0d costs 24. 6. 58 65 Westbourne Road Ordered to abate within 7 days. do. 65 Westbourne Road Ordered to abate within 28 days. Defendant to pay £1. 9s. 6d. costs. do. 5 Oldershaw Road Ordered to abate within 21 days re outstanding items. do. 13A Crown Mansions Fined £5. Ordered to abate within 14 days Defendant to pay £1. 9s. 6d. costs. 1. 7. 58 13 King Henry Street Fined £2. Ordered to abate within 21 days. Defendant to pay £1. 9s. 6d costs. do. 72 Ockendon Road Ordered to abate within 7 days. Defendant to pay £1 14s 6d. costs. do. 31 King Henry Street Fined £2 Ordered to abate within 21 days Defendant to pay £1. 9s. 6d. costs. do. 42 Queen Margaret's Grove Defendant to pay £1. 6s. 0d. costs (Work done) 15. 7. 58 11 Freeling Street Withdrawn. do. 11 Freeling Street Fined £5 Defendant to pay £1. 1s. 0d. costs. do. 40 Tilloch Street Fined £5. Defendant to pay 11. 1s. 0d. costs do. 23 King Henry Street Fined £5. Ordered to abate within 28 days. Defendant to pay 11 9s. 6d costs. 29. 7. 58 46 Beresford Road Absolute discharge. Defendant to pay 11. lls.0d costs (Work done) do. 28 Gainford Street Absolute discharge Defendant to pay 11. lls. 0d costs (Work done). do. 28 Gainford Street Withdrawn do. 9 Havelock Street Fined £.2 Ordered to abate within 14 days Defendant to pay £1. 15s. 6d. costs 2. 9. 58 127 Pembroke Street Ordered to abate within 21 days. Defendant to pay 11. 14s. 6d. costs. do. 127 Pembroke Street Not separately dealt with. 16 9. 58 14 Bishops Grove Fined £.5. Ordered to abate within 7 days. Defendant to pay £1. 15s. 6d. costs. do. 17 Wolsey Road Ordered to abate within 21 days. Defendant to pay £1 14s. 6d. costs. do. 72 Biryantwood Road Ordered to abate within 21 days. Defendant to pay 11. 14s. 6d costs. 7. 10. 58 13 Mildmay Park Fined £2. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. do. 32 Freeling Street Fined £1. Defendant to pay £1. 6s. 0d. costs. do. 118 Barnsbury Road Fined £3 Defendant to pay £1. 11s 0d. costs. 37 Date Address Magistrate's Decision 21 10. 58 8 Herrick Road Withdrawn (Viork done) do. 389 Caledonian Road Ordered to abate within 56 days Defendant to pay £1 14s 6d costs. do. 389 Caledonian Road Not separately dealt with do. 2 Remington Street Withdrawn Defendant to pay £1. 11s. 0d. agreed costs. (Work done) 4. 11. 58 29 Frome Street Fined £1. Defendant to pay £1. 1s. 0d. costs. do. 29 Grosvenor Avenue Fined £1 Defendant to pay £1. 6s. 0d. costs. do. 15 Baxter Road Fined £1. Defendant to pay £1. 6s. 0d. costs. do. 98 Frederica Street Bench was formally requested that the summons be withdrawn. Action subsequently taken under Housing Act, 1957. do. 2 Northampton Grove Fined £1. Ordered to abate within 7 days. Defendant to pay £1. 15s. 6d. costs. 25. 11. 58 23 Copenhagen Street Fined £10. Defendant to pay £1. 11s. 0d. costs. do. 93 Killick Street Fined £8. Defendant to pay £1. 6s. 0d. costs. do. 14 Mildmay Road Fined £10. Ordered to abate within 21 days. Defendant to pay £1. 9s. 6d. costs. do. 15 Elton Street Fined £5. Defendant to pay £1. 6s. 0d. costs. 9. 12. 58 50 Barnsbury Poad Ordered to abate within 14 days. Defendant to pay £1. 14s. 6d. costs. do. 50 Barnsbury Road Withdrawn 30. 12. 58 91 Bemerton Street Ordered to abate within 7 days. Defendant to pay £1. 14s. 6d. costs. do. 117 Hungerford Road Withdrawn (Premises empty). do. 94 Gifford Street Fined £2. Defendant to pay £1. 11s. 0d. costs. do. 94 Gifford Street Fined £2. Defendant to pay £1. 11s. 0d. costs. do. 22 Gainford Street Fined £2. Ordered to abate within 21 days. Defendant to pay £1. 15s. 6d. costs. do. 41 Pulteney Street Withdrawn (Work done). failure to comply with Statutory Not ice contrary to Section 105. (No of cases 1). Date Address Magistrate's Decision 29. 7. 58 46 Beresford Road Withdrawn by consent. Defendant to pay £1. ls.0d agreed costs. Failure to comply with Magistrate's Abatement Order (No. of cases 6). Date Address Magistrate's Decision 11. 2. 58 60 Grenville Road Fined £5. Defendant to pay £1. 1s. 0d. costs, 7. 10. 58 13A Crown Mansions Fined £5. Defendant to pay £1. 1s. 0d. costs. 21. 10. 58 31 King Henry Street Fined £5. Defendant to pay £1. 1s. 0d costs. do. 13 King Henry Street Fined £3. Defendant to pay £1. 1s. 0d. costs. 4. 11. 58 5 Oldershaw Road Fined £5. Defendant to pay £1. 1s. 0d. costs. 30. 12. 58 9, favelock Street Fined £1. Defendant to pay £1. 1s. 0d. costs. 38 Second Failure to comply with Magistrate's Abatement Order (No. of cases 3) Date Address Magistrate's Decision 18 2. 58 4 Lennox Road Fined £7. 10s. 0d. Defendant to pay £1. 1s 0d costs do. 12 Lennox Road Fined £7. 10s. 0d. Defendant to pay £1 1s 0d. costs. 30. 12. 58 13A Crown Mansions Fined £5. Defendant to pay £1. 1s. 0d costs Disinfection and Disinfestation. (a) General. As stated in the previous report the public are becoming more conscious of infestations by insects other than bugs and the advice of the Public Health Inspector is often sought by tenants, not only of houses but of factories and other business premises. The disinfection of wards in a number of hospitals continues The number of rooms disinfected after cases of infectious or other disease. 688 Number of rooms treated for vermin 968 Number of rooms included in the above figure treated for vermin (free) 328 (The majority of free cases were carried out on behalf of elderly or infirm persons or persons of limited means). • Number of families where effects were treated with D. D. T. as a precautionary measure 225 In addition, the Public Health Inspector paid 24 visits to a factory to supervise the treatment of 50 bales of stockings or other materials for export The total weight of bales treated was 12 tons 18 cwts 1 qtr. 26 lbs During the year a request was received from a hospital in the Borough for the assistance of the Department in routine disinfection of pillows and woollen blankets for the purpose of reducing the likelihood of infection within the hospital, particularly for certain types of staphylococcal infection Following some experimental work by the hospital pathology department staff in conjunction with the Public Health Department, a satisfactory disinfecting procedure was finally adopted depending on the principle of steam at atmospheric pressure plus the addition of formalin vapour which, while effectively disinfecting, did not spoil or shrink the blankets. From May to December, 913 bags containing approximately 12 blankets and 12 pillows each, were disinfected in accordance with this procedure at an agreed charge. (b) Steam Disinfection. 3378 articles of clothing or bedding were steam disinfected. 39 (c) Fly and other Infestations. Anti-fly treatment at Ashburton Grove Depot commenced on 24th April and continued during the summer months. Complaints continued to be received concerning wasps nests and the disinfestation staff dealt with 10 cases during the year. The infestation of the Council's Housing Estates by red clover mite increased during the year and appropriate action was taken to keep this to a minimum. (d) Static- Water Tanks, Air Raid Shelters Bomb-Damaged Sites etc. The tipping of refuse and the accumulation of water in static water tanks and on bomb-damaged or vacant sites continued to rresent a problem to the Council By arrangement with the Council's Cleansing Superintendent putrescible matter was removed by his Department upon request from the Public Health Inspector A petition was received in respect of two adjacent static water tanks and satisfactorily dealt with. In another case the tipping of refuse overflowed from a bomb-damaged site into an area of the adjoining property, causing nuisance to the tenant. This ,was removed at the expense of the Council. The co-operation of the London Fire Brigade in pumping out stagnant water is appreciated. In certain cases Warning Notices can be displayed under the War Damage Sites Act, 1949, drawing the attention of the public to the fact that the depositing of refuse'is an offence. 'Visits to bomb-damaged sites 220 Visits to air raid shelters and static water tanks 30 Inspections of derelict buildings 11 Vacant land cleansed 4 Static water tanks cleansed 2 War Damage Sites Act, 1949. Notices displayed 5 Atmosoheric Pollution Public Health (London) Act 1936(Part V). Clean Air Act, 1956. The Clean Air Act, 1956 (Appointed Day) Order, 1958, brought into operation on 1st June the remaining provisions of the Clean Air Act which so far had been excluded. These include provisions relating to the prohibition of dark smoke from chimneys, measures for dealing with grit and dust from furnaces, abatement of smoke nuisances and the application of the Act to railway engines, vessels and Crown premises. 40 The Minister of Housing and Local Government also made the Dark Smoke (Permitted Periods) Regulations, 1958, which came into force on the same day This Order specifies the permitted emission of dark and " black smoke respectively but does not apply to the emission of smoke from vessels, which is the subject of another Order. Works controlled by the Alkali Act are subject to the special provisions of Section 17 of the Clean Air Act, 1956, and by Order of the Minister the list of scheduled works was extended as and from 1st June. As far as this Borough is concerned the only scheduled premises are those owned by the Central Electricity Generating Board at 60, Eden Grove, N.7. With a view to' assisting Local Authorities in administering the provisions of the Clean Air Act which came into operation on 1st June, the Minister published the 'Memorandum on Industrial Provisions The Memorandum draws attention to the fact that Section 29 of the Clean Air Act makes it a duty of the Local Authority to enforce the provisions of the Act. This js something new In the past under the Public Health Acts Local Authorities have, as a rule had power to take action only where a nuisance occurred Now, under the Clean Air Act, specific requirements are laid upon the occupiers of buildings and a Local Authority will have the more positive task of seeing that these requirements are complied with throughout the district. The Council is aware of the importance of clean air in the Borough and continues to do all possible to allow the Inspectors to keep fully informed of current trends in practice In this connection three Inspectors were afforded facilities to enable them to attend a Smoke Inspectors' Course at Tottenham Technical College "and one Inspector engaged in duties under the Clean Air ,Act, 1956, attended a special course on diesel engines The Coal Utilisation Council held a three day course to assist Public Health Inspectors concerned with the selection of appliances and general problems connected with domestic heating and the installation and maintenance of the same One Inspector attended by approval of the Council. In addition the teputy Chief Public Health Inspector attended a day's course of instruction at the Coke Laboratory, Watson House, Fulham, where problems relating to the efficiency or utilisation of coke-burning appliances were discussed Representatives of the Council on the London and Home Counties Clean Air Advisory Council during the year were Councillor L. Ross and the Medical Officer of Health The Standing Conference of Co-operating Bodies for investigating atmospheric pollution met on 2 occasions during the year. In my previous report mention was made of two proposed Smoke Control Areas The Ministry of Housing and Local Government has now given provisional approval in principle to the making of these Orders and a detailed survey of each area is proceeding. A brochure giving details of the requirements under the Clean Air Act and outlining the respective areas has been prepared and given to the occupiers of dwellings when interviewed by the Inspector 41 A petition was received during the year relative to a nuisance caused by the emission of smoke arising from the burning of dressings etc. in a Cochrane Boiler at one of the hospitals in the Borough. As a temporary measure arrangements have been made to burn the dressings under the grate and this has proved satisfactory. The Hospital Board, however, is considering the installation of a central block of modern boilers, details of which may be submitted to the Council during the spring of next year. Complaints were also received concerning smoke from two bakehouses and the management in each case decided to convert from solid fuel to oil. An application for prior approval was received from the British Railway Executive and approval in respect of the installation of two water tube boilers with ratings of 4 million and 3 million B.T.U.'s per hour with refractory combustion chambers and oil-fired, at the new Diesel Maintenance Depot at Clarence Yard, Tollington Road. The installation includes fully automatic instrumentation, together with a smoke recorder. At " Hillside " a Welfare Home of the London County Council, which is situated in one of the proposed Smoke Control Areas, a new boilerhouse is under construction. This will house three oil-fired economic boilers with fully automatic control and will replace the existing battery of coal-fired Cornish boilers. The practice of sending a letter to the owner of a diesel-engined vehicle emitting dense smoke whilst passing through the Borough continued. A total of 195 letters were sent during the year; the owners promised co-operation and immediate action to remedy the cause. Number of applications received for prior approval. Section 3 (2) - 1 Number of applications for prior approval granted - 1 Number of applications for exemption (Section 2) - 1 Number of applications for exemption granted - 1 Number of complaints received during year 29 Number of observations 568 Number of inspections and re-visits 519 Number of notices served Nil Number of notices complied with Nil Recording of Atnosphertc Pollution. A summary of the observations at the three stations in the Borough is as follows:- 42 Monthly Deposits recorded by the Deposit Gauges and Sulphur-Dioxide by the Lead-Peroxide Method Month Site No. Rainfall in inches (Tons per square mile) Mg. of SO3/day collected by 100 sq. cm. of Batch A Lead Peroxide. (Louvered Box) Insoluble Deposit Soluble Deposit Total Solids January 1 2.01 11.10 7.15 18.25 5.38 „ 2 2.09 13.97 8.15 22.12 4.45 „ 3 2.36 10.76 9.21 19.97 3.64 February 1 2.36 12.32 10.96 23.28 4.46 „ 2 2.44 16.39 8.91 25.30 3.89 „ 3 2.36 12.65 7.85 20.50 2.93 March 1 1.02 11.56 8.44 20.00 4.25 „ 2 1.10 16.56 9.14 25. 10 3.74 „ 3 1.18 11.62 5.83 17.45 2.66 April 1 1.54 7.75 5.33 13 08 2.96 „ 2 1.69 12.59 7.68 20.27 2.66 „ 3 1.69 10.53 5.50 16.03 1.83 May 1 2.36 9.40 7.91 17.31 1.71 „ 2 2 21 14.14 9.11 23.25 2.20 „ 3 2.44 12.39 5.23 17.62 1.00 June 1 4.77 9.31 7.72 17.03 1.65 „ 2 4.81 12.32 11.00 23.32 1.78 „ 3 4.41 10.73 8.38 19.4 0.84 July 1 2.05 6.89 5.96 12.85 1.22 „ 2 1.77 16.36 10.23 26.59 1.59 „ 3 1.93 7.52 5.17 12.69 0.59 August 1 3.11 7.22 5.23 12.45 1.38 „ 2 3.70 26.33 13.58 39.91 1.82 „ 3 3.11 7.75 2.82 10.57 0.60 September 1 3.31 10.37 8.51 18.88 1.84 „ 2 3.03 41.17 17.78 58.95 2.04 „ 3 3.47 14.01 7.42 21.43 0.88 October 1 3.66 8.45 16.56 25.01 3.23 „ 2 3.90 18.21 20.24 38.45 3.20 „ 3 3.82 8.21 14.90 23.11 1.53 November 1 0.39 5.90 3.84 9.74 4.50 „ 2 0.47 4 94 5.00 9.94 4 05 „ 3 0.39 3.61 1.79 5.40 2.11 December 1 2.76 9.11 16.06 25.17 5.01 „ 2 3.03 19.21 16.63 38.84 5.02 „ 3 2.96 11.16 9.60 20.76 2.84 These sites are situated at the following places in the Borough:- 1. Town Hall roof. 2. York Way Court (Caledonian Road area). 3. Treatment Centre at Seven Sisters Road. 43 In addition to the deposit gauges and lead peroxide candles which are sited at three positions in the Borough, the results from which are recorded monthly as shown in the above table, the Council has installed volumetric apparatus at the Town Hall and the Treatment Centre, Seven Sisters Road, respectively. The concentration of smoke and sulphur-dioxide in the atmosphere is recorded daily and such information is not only advantageous locally, but the daily findings are forwarded to the Fuel Research Station for collation and comparison with other Metropolitan Boroughs, in order that an overall picture may be obtained for the whole of London. The measurement of smoke and sulphur-dioxide, respectively, is given in the following table. 44 Concentration of Smoke and Sulphur Dioxide recorded by the Volumetric Method at the two stations in the Borough Station Jan. Feb. Mar. Apl. May June July Aug. Sep. Oct. Nov. Dec. SMOKE. (Milligrams per 100 cubic metres.) Public Health Office, Tom Rail. Monthly average 37.3 26.8 24.6 9.0 6.5 5.4 4.2 5.9 6.8 23.4 44.7 48.0 Highest daily average 74.0 57.0 61.0 24.0 15.0 11.0 10.0 13.0 19.0 106.0 128.0 106.0 Shelter Hoase Treatment Centre Monthly average 38.0 29.6 31.0 16.0 7.5 6.2 5.9 5.9 5.9 24.0 45.0 43.0 Highest daily average 92.0 54.0 54.0 31.0 18.0 12.0 11.0 17.0 28.0 113.0 147.0 94.0 SWIPHUR DIOXIDE (Parts per 100 million parts of air) Public Health Office, Torn Hall. Month1y average 15.5 11.1 11.4 6.7 5.6 5.2 4.4 3.7 4.9 11.3 16.6 19.2 Highest daily average 31.0 19.1 24.5 12.3 13.9 10.3 8.1 7.3 9.1 41.2 40.3 48.0 Shelter Honse Treatment Centre Monthly average 13.0 9.4 9.0 6.7 4.6 4.9 3.8 3.3 4.3 8.3 11.6 13.6 Highest daily average 35.6 17.0 19.1 11.5 11.1 9.5 7.7 6.5 10.9 28.2 35.7 35.0 45 Requisitioned Properties The number of requisitioned properties on 1st January 1958 was 500. 230 (including parts of premises) were de-requisitioned during the year. This department has drawn the attention of the Council's Housing Estates Manager to any nuisances or major defects occurring in requisitioned properties, in order to ensure the premises being reasonably nuisance-free. 24 such references were made. WORK OF PUBLIC HEALTH INSPECTORS ADMINISTERING FACTORIES ACT, 1937, FOOD AND DRUGS ACT, 19 55, AND OTHER RELEVANT LEGISLATION. Inspections and Re-Visits 2280 inspections and 3955 re-visits were made by the Inspectors. These are summarised as follows:- Inspections Re-Visits Coffee and dining rooms, hotel and restaurant kitchens and refreshment rooms and canteens 137 404 Stalls (Refreshment and Food) 26 9 Factories (Mechanical) 812 1534 Factories (Non-Mechanical) 16 24 Factories (Public Health (London) Act, 1936). 639 1260 Fish curers 35 82 Fishmongers 3 14 Fried Fish Shops 49 82 Noise Nuisances 37 50 Provision Shops 79 95 Bakehouses (Level) 66 116 Confectioners 11 31 Fruiterers/Greengrocers 15 20 Preserved food premises 137 234 2280 3955 (See separate section for underground bakehouses and offensive trades.) Nuisances or contraventions foand and complaints received Nuisances and Notices (al Factories Act, 1937 Number of complaints received - all sources 92 Number of contraventions found 1390 Number of contraventions remedied 1526 Notices served 190 Notices complied with 187 46 (b) Food and Drugs Act, 1938 Number of complaints received 31 Number of contraventions found 1292 Number of contraventions remedied 709 Notices served 317 Notices complied with 296 (c) Public Health (London) Act, 1936, Number of complaints received 181 Number of nuisances or contraventions found. 1068 Number of nuisances or contraventions remedied 1270 Notices served 133 Notices complied with 125 (d) Shops Act, 1950 Number of inspections and re-visits 3258 Number of exemption certificates applied for Nil Number of certificates granted Nil Factories Act 1937 Prescribed particulars on the administration of the Factories Act, 1937. 1. Inspections for the purposes of provisions as to health (including inspections made by Public Health Inspectors). Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 228 16 3 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1840 812 184 - (iii) Other Premises in which Section 7 is enforced by the Local Authority' (excluding outworkers' premises) 37 1 3 - TOTAL 2105 829 190 - *i.e. Electrical Stations (Section 103 (1)), Institutions (Section 104) and sites of Building Operations and Works of Enginerring Construction (Sections 107 and 108). 47 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.1) 14 11 1 1 Overcrowding - 1 - - - Unreasonable temperature (S.3) 1 - - - - Inadequate ventilation (S.4) 2 2 - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 21 33 - 1 1 fbf Unsuitable or defective. 1094 1424 - 19 - (c) Not separate for sexes 49 43 - - - Other offences against the Act (not including offences relating to Outwork) 209 11 1 - - TOTAL 1390 1525 2 21 1 Outwork (Sections 110 and 111). Nature of Work SECTION 110 SECTION 111 No. of outworkers in August list required by Sec. 110(l)(c) No. of cases of default in sending lists to the Council No. of prosecu tions for failure to supply lists No. of instances of work in unwholesome premi ses Notices served Prosecutions (1) (3) (4) (5) (6) (7) (8) Wearing apparel Making, etc. Cleaning and washing 499 - - - - - Making of files - - - - - Brass and brass articles. - - - - - - Fur pulling _ - - - - - Umbrellas, etc 30 - - - - - Artificial flowers 63 _ » - - - The making of boxes or other receptacles or part thereof made wholly or partially of paper 61 - - - - - Brush making 17 - - - - - Stuffed Toys 11 - - - - - Basket making 2 - - - - - Feather sorting - - - - - - Carding, etc. of buttons etc Cosaques, Christmas crackers Christmas Stockings, etc. 164 - - - - - Textile weaving 4 - - - - - Lampshades 8 - - - TOTAL. 859 - - - - * 48 Legal Proceedings Factories Act, 1937 (Part I) Date Address Magistrate's Decision 25.3.58 71A Poets Road Mews Fined £.10. Defendant to pay £5. 5s. Od. costs. Factories Act, 1937 - Section 54 Basement Bakehouses Certificates of Suitability, as required by Section 54 of the factories Act, 1937, continued to be in force in respect of 16 basement bakehouses at the following addresses:- 52 Balls Pond Road, N.1. *84 Ashbrook Road, N. 76 Caledonian Road, N.l. 146 Blackstock Road, N. 299 Caledonian Road, N.l. 3 Cardwell Terrace, N. 8 Danbury Street, N.l. *144 Elthorne Road, N. 68 Essex Road, N.1. 7 Junction Road, N. 350 Essex Road, N.l. 59 Junction Road, N. 52 Stanmore Street, N.1. 77 Newington Green Road, N. 54 Archway Road, N. 123 Newington Green Road, N. *The use of these bakehouses was discontinued during the year. Details of the work carried out under this Section are as follows:- Number of routine inspections 55 Number of re-visits 64 Number of Notices served 11 Number of Notices complied with 1 Public Health (London) Act, 1936 London County Council (General Powers) Act, 1937 Noise Nuisances It is inevitable that in an age of mechanisation complaints of noise nuisance will be received from time to time. These are usually solved by an investigation by the Public Health Inspector who obtains the co-operation of the management concerned, the nuisances being reduced to a minimum. A series of complaints were received during the year concerning noise from a bakery at night. Two Inspectors were detailed to carry out a night inspection on two occasions but no statutory nuisance was confirmed. No unreasonable or excessive noise was heard on either occasion. 49 Noise caused by the combustion and inflow of air to the burners in two oil furnaces in a building occupied by a Government Department was the subject of a further complaint. The co-operation of the Department concerned was readily forthcoming and in an effort to reduce the noise the burners were enclosed in steel covers insulated with fibreglass and silencing tubes were constructed to the secondary air inflow. Arrangements were made for the baffle walls which surround the boilers to be extended up to roof level in sound-absorbing material. The noise has, therefore, been reduced considerably. Another series of complaints were received from tenants of one of the Council's Housing Estates concerning noise from the dust and chip collecting plant at a nearby furniture factory. Arrangements were made for the plant to be renewed during the year and no further complaints have been received. In view of the fact that complaints still continue to be received from noise due to the use on domestic premises of power machines that are usually operated during the evening or weekends, causing nuisance to other occupiers of such premises as the result of noise and vibration, the Council referred the question to the Metropolitan Boroughs Standing Joint Committee. The Committee was asked to consider the matter with a view to promoting legislation to prohibit the installation and use of power machines above a certain capacity in houses in multiple occupation. The problem was given very careful study and the various premises were visited to see the main type of power machines involved and several leading manufacturers and distributors were consulted. A detailed report, much of which is of a technical nature, was produced from which the following facts are culled. The main origin of the complaints of nuisance appears to be the use of electrically driven sewing machines, normally installed singly in ordinary rooms in domestic premises. The premises inspected were old terraced houses, still used for residential purposes, and the machine operators in most cases were housewives who undertake part-time sewing work for garment manufacturers in addition to normal domestic duties. There is no doubt that nuisance due to noise and vibration is caused by sewing machines but it is difficult to assess how intense and widespread is the nuisance. It is very difficult to devise a method of measurement which would give an accurate and consistent basis for assessing noise nuisance. It was concluded that there is little prospect of obtaining new legislation to control the nuisance but in order that such nuisances can be reduced the following recommendations were made:- 1. Ensure that all machines are well maintained and, in particular, that all standard resilient mountings connecting motor and machine are as recommended by the manufacturers, and excessive wear on moving parts is avoided. 2. Site machines near an outside wall, and as far as possible from other residential rooms, particularly bedrooms (the rooms above and below the workroom will be the most affected). 50 3. Restrict the use of machines after 6 p.m. and before 8 a,m and at weekends as much as possible. 4. Ensure the use of standard hard rubber pads under all machine stands The question of noise nuisance caused by itinerant ice cream vendors who have machines on their vehicles that make the sound of bells or chimes received consideration and the matter received the attention of the Metropolitan Boroughs' Standing Joint Committee. This Council was one of those that considered special legislation should be promoted to enable Councils to exercise stricter control. The Standing Joint Committee, however, concluded that no action was called for at the present time additional to enforcement of existing Byelaws. Details of action taken in respect of complaints received of alleged noise nuisances during the year are as follows:- Number of complaints of noise nuisance 22 Number of inspections 37 Number of re-visits 50 Number of Notices served - Number of Notices complied with - Public Health (London) Act. 1936 - Section 121 Protection of Birds Act 1954 Pigeon Nuisances The congregating of ownerless pigeons continues to be the subject of complaints from residents in the vicinity of the areas concerned. The Council renewed the authority previously given to a pigeon catcher to operate in the Borough for the year under review and engaged him to treat a number of premises and areas, including two schools, Canonbury Tower, and the surrounding neighbourhood, and three residential areas. 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. (c) 1 Fur Skin Dresser: 24 Bracey Street - Messrs. J. & A. Fischer Ltd. 51 (d) 6 Gut Scrapers: 3 Old Slaughterhouses - Casings Ltd. 12 Old Slaughterhouses- Universal Casings Co. Ltd. 13 Old Salughterhouses- Messrs. Armour & Co. Ltd. 15 Old Slaughterhouses- Messrs. Win. Menzies Ltd. 5 Tileyard Road - Messrs. C. Edwards & Son, Ltd. Tileyard Road - Messrs. Tracey & Co. Ltd. (e) 1 Fat Melter: 16 Old Slaughterhouses - Messrs. Wm. Menzies Ltd. 61 inspections and 56 re visits were made at 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 267 inspections or visits. (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. Pharnacy and Poisons Acts, 1933/1941 The Poisons List and Rules were brought up to date by the issue of the Poisons List Order, 1958 and the Poisons Rules, 1958, which came into operation on 1st July. They were further amended, however, by Orders made later in the year but which do not come into operation until 1st January of next year. Number of Listed sellers of Part II Poisons other than registered pharmacists 180 Number of initial registrations during the year 13 Number of visits and inspections 39 Number of samples taken 3 Number of samples reported satisfactory 3 Rag Flock and other Fllllrtg Materials Act, 1951 Number of premises on Register (Section 2 for Upholstery)43 Number of Licences issued (under Section 7 for the storage of Rag Flock) 1 Pet Animals Act, 1951 Number of licences issued during year 21 Number of inspections and re-visits 34 Heating Appliances (Fireguards) Act, 1952 Number of inspections and re-visits 92 52 Prevention of Damage by Pests Act, 1949 (a) General. The following is a summary of the work carried out during the year. Notices Served: 19 Intimations 1 Statutory Type of Property Local Authori ty Premi ses Dwelling Houses Business Premises TOTAL I., Complaints received (including repeats) 20 1120 129 1269 2. Number of properties inspected as a result of (a) Notification (initial complaint only) (a) 19 969 122 1110 (b) Block survey (b) 219 520 52 791 3. Number of properties found to be infested by rats (including nil snip rats) 23 666 37 726 4. Number of properties found to be infested by mice 9 347 45 401 5. Re-visits by Investigators *1110 3934 87 5131 6. Non-effective visits by investigators Nil 521 6 527 7. Number of infested properties treated (new jobs commenced) *540 1022 78 1640 8. Continuation or post-bait treatment *606 3586 307 4499 9. Visits by Operators *3175 12365 577 16117 10. Still being baited at end of year Nil 19 1 20 11. Completed during the year. *1069 1158 85 3312 12. Number of Business Agreements dealt with 69. 13. Members of the Rodent Staff assisted in the application of smoke machine in respect of 150 drainage tests carried out by Public Health Inspectors. *Includes Sewer Maintenance Treatment Nos. 27 and 28 (1511 manholes). NOTE: For the purpose of completing Sections 2, 3, 4 & 7, each property is entered once only in respect of inspections, infestations and treatments. 53 There has been a slight decrease in the number of complaints. Again no infestations of ship rats have been recorded There were 67 infestations traced to defective house drains; two to unsealed fittings and seven to disused unsealed drains, four of which were situated in developed housing sites. The Ministry of Agriculture, Fisheries and Food issued a Circular in August authorising the use of sodium fluoracetate (1080) for sewer treatments. In addition to the recommended procedure for using this poison in direct treatments given in the Ministry's Handbook on Rat and Mouse Control the Ministry issued a publication entitled, ''Use of Sodium Fluoracetate as a Rodenticide Precautionary Measures''. It is however considered unnecessary for the Council to use this poison in this Borough. The Council authorised the attendance of the Investigators and Operators to a one day refresher course held by the Ministry during the year. Tracing the source of rodent infestation is not an easy task and requires much patience in order that a satisfactory conclusion may be reached. In one case considerable baiting treatments were carried out without success. A negative result was obtained when the drain was tested but eventually, upon applying smoke to the rat hole it was found that there was a defective drain on the adjoining premises. Upon repairs being executed no further trouble was experienced. Due to the demolition of buildings and the result of war damage it is not possible in every case to trace disused drains which should have been grubbed up or filled in at the time of redevelopment. In four cases infestations have occurred on housing sites after redevelopment. Upon appropriate action being taken no further complaints have been received. It is not often that appreciation of the work done by the Rodent Control staff is expressed but the following is an extract of a letter received during the year:- ''My grateful thanks for your help regarding my appeal to your Department. It is comforting to know that there is such a service available in the neighbourhood and one that will be given with such kindly and courteous consideration." The Public Health Inspector and the Rodent Officer continued to carry out the quarterly inspection of four hospitals in the Borough and the Hospital Management Committee was informed of any matter requiring attention. In addition, a comprehensive preliminary inspection was carried out at two other hospitals in the Borough. Representatives of the Department attended four meetings of the Workable Area Committee. 54 (b) Sewer Treatments Two sewer maintenance treatments were carried out in connection with which the co-operation of the Borough Engineer and his staff was appreciated. Details of the treatments are as follow:- Treatment No. and date Manholes Baited Showing Complete takes Showing Prebait takes Showing no takes 27 14/15/21st/22nd April, 1958. 656 317 473 183 28 6/7/13th/14th October, 1958. 654 336 507 147 Water Supplies (a) The Metropolitan Water Board continues to be the responsible authority for the supply of water to this Borough. Pour bacteriological samples of mains supply taken by the Public Health Inspectors were found to be satisfactory. Public Health (London) Act, 1936 Section 95 1. 32 applications were received for Water Certificates and 24 Certificates, which included some in respect of applications received last year, were issued in respect of 437 separate dwellings. 2. Water supplies to tenement houses 27 Notices were served under this section requiring the provision of water supplies to tenement houses. 14 water supplies were provided during the year. 3. Legal Proceedings Failure to comply with Statutory Notices contrary to Section 95. (No. of Cases: 4). Date Address Magistrate's Decision 1. 7. 58 13, King Henry Street Fined £1. Ordered to abate within 14 days. Defendant to pay £1. 9s. 6d. costs. 2. 9. 58 127, Pembroke Street Ordered to abate within 21 days. Defendant to pay £1. 14s. 6d. costs. 2. 9. 58 127, Pembroke Street Not separately dealt with. 25. 11. 58 93, Killick Street Fined £8. Defendant to pay £1. 6s. Od.costs 55 Failure to comply with Magistrates Abatement Order (Sec. 95). Date Address Magistrate's Decision 21. 10. 58 13, King Henry Street Fined £5. Defendant to pay 11. Is. Od.costs. (b) Well Water. Of the 28 bore holes or wells known to exist in the Borough, 19 continued to be unused and were effectively sealed, 5 of the remaining wells are still out of use. 14 samples were taken during the year, 7 for chemical and 7 for bacteriological examination. 6 of the chemical samples indicated that the water could not be considered free from pollution but the water from these walls, however, is used only for industrial purposes. All the bacteriological results were satisfactory. During excavations carried out by the London Electricity Board under the highway in Laycock Street a well was discovered just outside the factory wall before one comes to Lewis Buildings. It was approximately 18.6'' deep and 10' in diameter; was constructed in brick and had the remains of a pump which evidently was operated at the time when the well was in use. It would appear that the well in question existed on the site of the late Laycock Farm and might well be the source of the water supply when this farm was in existence. As the Metropolitan Water Board is not interested in shallow wells it was considered advisable to fill the well in and this was done in conjunction with the Borough Engineer. (c) Water Supplies - Miscellaneous 4 samples of sub-soil water were taken. (d) Swimming Bath Water The number of samples of swimming bath water taken during the year is as follows:- Chemical Bacteriological Satisfactory Chemical Bacteriological Unsatisfactory Chemical Bacteriological 1 159 1 150 - 9 56 SECTION D HOUSING (In conjunction with Mr. W.C. Bartlett, Chief Public Health Inspector.) The main emphasis during the current year has been work under Part II of the Housing Act, 1957, details of which appear on page 57/58. It will be appreciated that the number of detailed surveys required to be carried out by the Inspector is much higher than the numbers represented and while there are still many unfit properties in the Borough the problem arising from properties which fell into disrepair during the war years and have since suffered through lack of maintenance is not nearly so serious as hitherto. At the end of the year there still remain some 150 unfit properties to be dealt with to complete the programme submitted to the Minister of Housing and Local Government under the provisions of the Housing Repairs and Rents Act, 1954. There are of course a large number of houses which fall short of the Standard of Fitness under Section 4 of the Housing Act, 1957, and which are capable of being repaired at reasonable cost. Consideration should be given to programmed action which will result in these properties being brought up to present-day standards. Many of the large terraced dwelling houses in Islington comprise four storeys and were not designed to accommodate the number of families now occuping them. Attention must obviously be focused on securing in such properties the installation of amenities, such as additional sanitary accommodation, water supply, together with adequate facilities for the storage, preparation and cooking of food and the disposal of waste water. The Minister of Housing and Local Government confirmed Orders under Part II of the Housing Act, 1957, in relation to the undermentioned Clearance Areas:- 13, 15, 17, 19, 21, 23, 25, 27, 29, 31 and 33 Provence Street. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, and 20 Dillon Place. The number of flats and houses erected during the year is:- Borough Council 352 London County Council Private Enterprise 85 The number of municipal flats and houses erected since the war is: - Borough Council ... ... ... 3192 London County Council ... ... 2630 The total number of dwellings in the Borough at the end of the year was 44,314. The full effects of the Rent Act, 1957, have been felt by the Department during the year. Applications made by tenants for Certificates of Disrepair have required the inspection of the premises in each case, together with many additional re-visits when owners have been carrying out work in order to obtain increased rents. 57 The problem of houses in multiple occupation has caused the Department no little concern, particularly when properties are let out in furnished rooms with little regard to any overcrowding which may occur or the great inconvenience to the tenants caused by lack of amenities. Where possible the Department has sought to deal with this type of property on an informal basis because a Notice served under Section 36 of the Housing Act, 1956 whilst requiring work to be done, also allows, in default of executing the specified works, the person having control to secure a reduction in the number of individuals or households in lieu thereof. Many of such families are in desperate need of accommodation and the service of a Notice is not always a satisfactory solution to the problem. Two Certificates to the effect that the several tenements were so constructed and arranged as to secure effective ventilation of the habitable rooms in every tenement were issued during the year under Section 5 of the Housing Act, 1957, in respect of 15 flats in Block "A" and 15 flats in Block "D" of the Peabody Estate, Greenman Street. Prosecutions Housing Repairs and Rents Act, 1934 Section 11 (3). Continuing Offence. Date Address Magistrate's Decision 28. 1. 58. 216/218, York Way Fined 1196. Defendant to pay £10. 10s. Od. costs. Defendant given 14 days in which to pay otherwise imprisonment for two months. Rehousing. Dwellings erected by this Council during year 352 Dwellings in course of erection by this Council 301 Enquiries from London County Council regarding Housing applications 46 Enquiries from other sources regarding Housing applications 164 Families rehoused by Islington Borough Council from Clearance Areas 8 Families rehoused by Islington Borough Council as a result of Closing Orders or Demolition Orders 212 Overcrowded families rehoused by Islington Borough Council 248 Overcrowded families rehoused by London County Council after certification by Medical Officer of Health 14 Families rehoused by Islington Borough Council from redevelopment sites 19 Families rehoused by London County Council from redevelopment sites 52 Families rehoused by London County Council from Slum Clearance Areas 162 Families rehoused by London County Council from open spaces 15 Housing Act, 1937 Housing Consolidated Regulations 1923/32 Section 9 (Repair of insanitary houses) Preliminary inspections of houses 110 Surveys of houses 31 Houses represented 1 Houses rendered fit after service of Notices - 58 Section 16 (Individual unfit houses) Preliminary inspections of houses 231 Surveys of houses 242 Houses represented 203 Undertakings accepted 2 Undertakings cancelled upon completion of work 1 Section 17 (Individual unfit houses) Closing Orders made 154 Demolition Orders made 38 Houses demolished 3 Section 18 (Parts of buildings including basement rooms) Surveys made of (a) Basement rooms 170 (b) Other parts of buildings 21 Representations made- (a) Basement rooms 86 (b) Other parts of buildings 27 Closing Orders made- (a) Basement rooms 74 (b) Other parts of buildings 20 Undertakings accepted (other parts of buildings) 1 Undertakings cancelled or part cancelled upon completion of work (basement rooms) 5 Section 27 Closing Orders determined or part-determined upon completion of work in respect of (a) Whole houses 4 (b) Basement rooms 37 (c) Other parts of buildings 5 Section 36. (Houses let in lodgings - securing fitness for occupation by number of families accommodated). Inspections made 8 Report to Committee 2 Notices complied with 1 Section 90. (Houses let in lodgings - overcrowding). Inspections made 6 Reports to Committee - Overcrowding abated - Section 42 (Clearance Areas). Preliminary inspections of houses 174 Surveys of houses 108 59 Housing Subsidies Act, 1956 Certificates of unfitness issued in respect of certain Municipal properties - (a) Individual houses 16 (b) Ba sement rooms 9 Housing Act, 1949. (as amended by Housing Repairs & Rents Act,1954). Inprovement Grants. Inspections made 8 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 21 investigations were carried out by this Department. Licences authorising temporary overcrowding No licences were issued during the year. 60 SECTION E SUPERVISION OF FOOD (In conjunction with Mr. W.C. Bartlett, Chief Public Health Inspector) The legislation which came into operation during this year included the following:- The Public Health ( Preservatives, etc in Food) (Amendment) Regulations, 1958, which amended the existing regulations in order to provide for the sale and importation of citrus fruit containing a limited quantity of certain preservatives. The Public Health (Preservatives, etc. In Food) (Amendment No.2) Regulations, 1958, which amended the regulations so as to provide for the sale and importation of certain fruits containing orthophenylphenol within prescribed limits. The Anti-Oxidant in Food Regulations, 1958. These regulations provide for the sale and importation of foods which contain certain anti-oxidants within prescribed limits. Circular FSH 8/58, in which the Minister of Agriculture, Fisheries and Food stated that it was no longer necessary to continue to include particulars of the meat content and price of sausage samples which have been examined in the quarterly reports made by the Public Analyst. Cit-culars FSH 7, 10 and 20, in which the Minister of Agriculture, Fisheries and Food approved certain products for the celansing of milk containers, vessels or appliances as an alternative to scalding with boiling water or steam. The Labelling of Food (Amendment) Regulations, 1958. which revoked the requirements that no liquor should be labelled as a cocktail or as a mixture containing spirits unless it contains not less than 40% proof spirits. Slaughterhouses Aet, 1958, and Circular FSH 11/58 relating thereto, issued by the Minister of Agriculture, Fisheries and Food. Only certain sections and paragraphs apply to London. By virtue of Section 7, the Factories Act, 1937, was amended and so brings within the scope of the Factories Act, 1937/1958, Slaughterhouses and Knackers' Yards, including their lairages, whether on the same premises or detached. The Slaughter of Animals (Prevention of Otuelty) Regulations. 1958 These regulations re-enact with certain modifications and conditions previous legislation. The principal new provisions are:- 1. The use of stunning pens is made compulsory for the slaughter of adult cattle. 2. Special precautions will have to be taken with horned cattle and fractious animals in lairages. 3. When weather conditions are severe animals must not be kept in fields awaiting slaughter. 4. Licences for new Slaughtermen may be made conditionally upon their slaughtering only under supervision by someone more experienced. 61 The Slaughter of Pigs (Anaesthesia) Regulations. 1958 which permits the use of a process of anaesthesia by carbon dioxide gas in connection with the slaughtering of pigs. The Slaughter of Aninals Acts - Electric Stunning Circular FSH/3/58, which requested Local Authorities to ensure that those concerned with the killing of animals at slaughterhouses did not overlook the fact that the stunning of sheep, and especially long wooled sheep, by electricity, unless practised with particular care might inflict unnecessary suffering on the animals. The Circular also draws attention to certain precautions which should always be observed. The Slaughterhouses (Hygiene) Regulations. 1958 These regulations will not come into force until 1st January, 1959, in relation to new slaughterhouses, and on a date to be fixed by the Minister in the case of existing slaughterhouses. Memo 188/Med and Circular F 58, both issued by the Ministry of Health. This publication is a revised Memorandum detailing the steps to be taken in the investigation of food poisoning and is dealt with on page 24. Food Hygiene Regulations On 1st June Regulation 7 of the Food Hygiene Regulations, 1955, came into operation in relation to the giving out of shrimps, prawns and onions for preparation or packing in domestic premises. The Inspection of food undertakings continued and the food prepared, manufactured, stored or sold was subject to routine inspection and sampling. The standard of hygiene, both in regard to the premises as well as the personnel engaged in food handling, is steadily being improved. It is not an easy matter to change the habits of those engaged in the food trade and it is only by education that one can hope to make any improvement. Much of the Inspectors' time is taken up in talking to.the food handler on the spot, where he not only explains what is required but the reason why such requirements are made. Most proprietors and assistants are co-operative but there remains the hard core of those whose practices and premises leave much to be desired and have to be under constant supervision. The transport and delivery of meat in the Borough was kept under observation. In the majority of cases the vehicles used and method of handling was found to be satisfactory. Where necessary the attention of the Companies concerned was drawn to any contraventions. In order to secure compliance with food legislation it is sometimes necessary for the Inspectors to be on duty during the night. In this connection visits were made on a number of occasions during which the transportation of meat from the Metropolitan Cattle Market was kept under observation and certain cafes and other food undertakings open after normal business hours, inspected. During the performance of night duties the Inspectors observed that in a considerable number of instances Regulation 30 (a) of the Milk and Dairies Regulations, 1949/54, was contravened in as much as deliveries of milk by suppliers to distributors 62 were being left on the public highway. The attention of both wholesalers and retailers was drawn to this practice. In many cases co-operation was forthcoming but real difficulty was experienced in some instances as there was no room readily available where the milk could be deposited within the premises. An informal discussion was held with trade representatives and other interested parties, including representatives from the Finsbury Public Health Department, who were also carrying out observations in that Borough. The co-operation and assistance given by the Trade Associations are much appreciated. By the end of the year considerable improvement had been effected but the matter is still being kept under observation. Associated with the delivery of milk is the question of noise, which was the subject of complaint from a resident in the neighbourhood of premises where milk is delivered during the night and early morning. Such complaints are usually solved informally and no statutory action has been necessary during the year. The delivery and display of fish for retail sale was also the subject of investigation. Particular attention was paid to possible contamination of fish or other food during delivery of fish by the supplier, storage of fish pending sale and from the sale of the fish itself. Details of one prosecution taken appear on page 67. Following an unsatisfactory report from the Public Analyst upon a sample of tea taken informally, a formal sample was taken, in which was found an excess amount of lead, together with a metal paper clip and a number of fragments of metallic foil. Details of the prosecution appear on page 67. Over a number of seasons adverse reports have been received concerning samples of ice cream and ice lollies manufactured at an address in the Borough. Upon unsatisfactory samples being taken again this year the Company agreed to engage a consultant from Messrs. Deosan Ltd., in an advisory capacity, in order to ensure that their products are satisfactory in future. The importation of meat, viz. sheep livers, unfit for human consumption, was the cause of some concern during the year, particularly when it was found, upon investigation, to be displayed in butchers' shops for sale labelled " animal feeding Action was taken to ensure that the meat was segregated at all stages from the meat for human consumption. The present position is, however, most unsatisfactory and the sale of such meat for animal feeding is undesirable. In the case of one cafe prosecutions were successfully taken against the owner, including one for allowing a food room to be used as a sleeping place. A fine of £6 upon each of six summonses was imposed, together with 2 guineas costs on the first summons only. In another case two Inspectors were authorised to make a night visit to a cafe after complaints had been received that persons were allowed to sleep in the passages and kitchen of the cafe. The complaint was not confirmed but as the result of the visit the general conditions improved and no statutory action was necessary. On three occasions the Public Health Inspector, in the course of his duties, seized unfit food and obtained an Order from a Justice of the Peace for its destruction. Prosecutions were successfully taken in two out of three cases and a warning letter was sent in respect of the third case. 63 Consideration was given by the Council regarding the testing of milk for radioactivity. The Council approved the attendance of one Inspector engaged on duties under the Pood and Drugs Act at a course of 5 lectures on food infections given at the Central Public Health Laboratory, Colindale. Complaints were received in respect of alleged:- Abscess in liver Metal in wrapped loaf of bread Brown paper in bread Metal pin in bread Cigarette end in cake Mice droppings in bread Dirty milk bottles Mouldy bread Dirty bottle of orange drink Mouldy french jam sandwich Dirty cups in a canteen Mouldy custard tart Fly in bacon slices Mouldy faggots Foreign matter in loaves of Piece of metal in bread bread and bread rolls Rice not genuine Foreign matter in iced bun "Ropey" bread Foreign matter in sausage Salmon unfit Foreign matter in doughnut Sherbet unfit Foreign matter in light ale String in bread roll Insects in loaves of bread Tinned salmon unfit Insects in chocolate Unfit custard powder Insects in matzo meal Unfit fried cod Insects in macaroni Unwholesome steak and kidney pie Liver sausage not genuine Maggots in chocolate Details of the action taken under the Food and Drugs Act, 1955 and the Food Hygiene Regulations, 1955 appear on pages 64-67. As provided for in Section 92 (3) of the Food and Drugs Act, 1955, samples may be submitted to the Public Analyst from a person not being an officer of a Food and Drugs Authority. In accordance with the decision of the Southwark Borough Council the Public Analyst, who is an Officer of that Council, and also the Public Analyst for Islington, charges for samples submitted by private individuals for analysis a minimum fee of £3. 3s. 0d. per sample. Food and Drugs Act, 1955 Number of food premises in the area, and type of business Bakehouses - level 26 ,,- basement 16 Bakers' retail shops 74 Butchers 148 " - Continental 1 Cafes and Restaurants 245 Canteens and Clubs 104 Chemists 59 Coffee stalls 3 Continental Food Shops 15 64 Fish shops 39 Fish curers 28 '' depot 1 " friers 54 Food factories 38 Food stalls (street traders including 26 shop extensions) 174 Food storage premises for street traders 82 Greengrocers and Fruiterers 187 Grocers and Provision merchants retailers 531 wholesalers 21 Licensed ''Clubs" 21 Off-licences 105 " selling other food (included in above) 58 Public houses 259 '' " catering (included in above) 221 '' " beerhouses 27 Sugar and chocolate confectionery 309 Milk machines 16 Preserved Food Premises Registered under Section 16(1)(b) of the Food and Drugs Act, 1955 (Included in foregoing list.) Total No. of Preserved Food Premises 174 No. of Butchers 125 No. of Grocery and provision shops 36 No. of Food Factories 11 No. of Cooked meat shops 1 No. of Jellied Eels and Pie Shops 2 Total No. of inspections and visits made by Inspectors to Preserved Food Premises 371 Legal Proceedings Details of the action taken by the Council under the Food and Drugs Act,1955, and Food Hygiene Regulations made thereunder, are as follows:- Date Offence Magistrate's Decision. 7. 1. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely a packet of sweetcorn, not of quality demanded at 383, New North Road, N.l. Fined 15. Defendant to pay 12. 2s. Od. costs. 7. 1. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely rice pudding not of quality demanded at 26, Liverpool Road,.N.l. Case dismissed. 14. 1. 58. Food & Drugs Act,1955. Sec. 2 (1) Selling food, namely a tin of plums, not of quality demanded at 242, Hornsey Road, N. 7. Fined £5. Defendant to pay £2. 2s. Od. costs. 65  Date Offence Magistrate's Decision 14. 1. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely a cream bun, not of quality demanded at 76, Caledonian Road, N.l. Fined £1. Defendant to pay £2. 2s. 0d. costs. 4. 2. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely cheese spread, not of quality demanded at 128, Essex Road, N.l. Fined £50. 4. 2. 58. Food & Drugs Act, 1955. Sec. 8 (1) (a) Having in possession for the purpose of sale or preparation for sale, food, namely three tins of plum peeled tomatoes, intended for, but unfit for human consumption at 31, Upper Street. Fined £50. Defendant to pay £2. 2s. 0d. costs. 18. 2. 58. Food & Drugs Act, 1955, Sec. 2 (1) Selling food, namely a loaf of bread, not of quality demanded at 3, Hillmarton Terrace, N.7. Fined £10. Defendant to pay £3. 3s. 0d. costs. 18. 2. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely a chocolate eclair, not of quality demanded at 7, Junction Road, N.19. Fined £25. Defendant to pay £3. 3s. 0d. costs. 18. 2. 58. Food Hygiene Regulations, 1955. Regulation 5. Unsanitary food premises at 7, Junction Road, N.19. Adjourned sine die. 25. 3. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely a cake, not of quality demanded at 679, Holloway Road, N.19. Fined £25. Defendant to pay £4. 4s. 0d. costs. 22. 4. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely a loaf of bread not of quality demanded at 123, Newir.gton Green Road, N.l. Fined £25. Defendant to pay £5. 5s. 0d. costs. 6. 5. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely a bottle of milk not of quality demanded at 472, Hornsey Road, N.19. Fined £5. Defendant to pay £5. 5s. 0d. costs. 15. 5. 58. Food Hygiene Regulations, 1955. Regulation 5. Unsanitary food premises at 287, Upper Street, N.l. Fined £50. Defendant to pay £2. 2s. 0d. costs. 66  Date Offence Magistrate's Decision 1. 7. 58. Food & Drugs Act, 1955. Sec. 8 (1) (a) Having in possession for the purpose of sale, or preparation for sale, food, namely a quantity of sausage (beef and luncheon roll), intended for, but unfit for human consumption at 89, Upper Street, N. 1. Adjourned sine die. 29. 7. 58. Food & Drugs Act, 1955. Sees. 2 (1) and 113 (3). Selling food, namely a sliced wrapped loaf of bread, not of quality demanded at, St. Peter's Street, N.1./ Noel Road, N 1. Fined £10. Defendant to pay £2. 0. 0d. costs. 2. 9. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely a bread roll, not of quality demanded at 68, Essex Road, N.l. Fined £2. 0s. 0d. Defendant to pay £2. 2s. Od. costs. 16. 9. 58. Food & Drugs Act, 1955. Sec. 8 (1) (a) Selling food, namely a steak and kidney pie, intended for but unfit for human consumption at 659, Holloway Road, N.19. Fined £10. Defendant to pay £2. 2s. 0d. costs. 18. 11. 58. Food & Drugs Act, 1955. Sec. 8 (1) (a) Having in possession for the purpose of sale or preparation for sale, food, namely 30 apple charlottes, intended for, but unfit for human consumption at 136, Essex Road. Each defendant (two) fined £2. 10s. 0d. and each ordered to pay £1. Is. 0d. costs. 18. 11. 58. Food & Drugs Act, 1955. Sec. 8 (1) (a) Having in possession for the purpose of sale of preparation for sale, food, namely boxes of glace cherries, intended for but unfit for human consumption at 68, Essex Road, N.l. Fined £10. Defendant to pay £2. 2s. 0d. costs. 25. 11. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely a loaf of bread, not of quality demanded at 155, Thorpdale Road, N.4. Fined £10. Defendant to pay £2. 2s. 0d. costs. 9. 12. 58. Food & Drugs Act, 1955. Sec. 8 (1) (a) Selling food, namely two faggots, intended for but unfit for human consumption at 365, New North Road, N.l. Fined £10. Defendant to pay £2. 2s. 0d. costs. 67  Cate Offence Magistrate's Decision 30. 12. 58. Food Hygiene Regulations, 1955. Regulation 27 (1). Exposing food, namely fish, to the risk of contamination at 92, Tollington Way, N.7. Fined £5. Defendant to pay £2. 2s. 0d. costs. 30. 12. 58. Food & Drugs Act, 1955. Sec. 2 (1) Selling food, namely tea, not of quality demanded at 128, Essex Road, Fined 15. Defendanto to pay £2. 2s. 0d. costs.' Unsound Food. The total amount of food condemned during the year was:29 tons, - cwts., 2 qrs., 4 lbs., - ozs. details of which are given in the following table:- Description Tons Cwts. Qtrs. Lbs. Ozs. Tinned Goods 14 - - 22 4 Fish - 1 3 - - *Meat 10 7 1 3 8 Others 4 11 1 6 4 TOTAL 29 _ 2 4 _ *Includes 9 tons 12 cwts. 1 qrs. 8% lbs.,Harrison,Barber & Co.Ltd. The number of condemnation certificates issued was 1413. Most of the above food was condemned upon renuest by the respective owners, but on certain occasions it was necessary for the Inspector to seize food and remove it in order to have it dealt with as provided for by Section 9 of the Pood and Drugs Act, 1955. Details of the result of subsequent legal action taken appear on pages 64-67. Sampling. 691 samples (179 formal and 512 informal) were submitted to the Public Analyst for examination. Of these 34 (or 4.92 per cent.) were adulterated, as shown in the summary given below. Iricluded in the number of informal samples were two samples of margarine taken for vitamin content and reported as satisfactory. A number of adverse reports relate to samples which were the subject of complaint and not taken from routine sampling. 68 Formal Backache & Kidney Pills (deficient in potassium nitrate) 1 Tea 1 TOTAL 2 Informal Apple Charlotte 1 Backache & Kidney & Bladder Pills (Incorrectly labelled) 1 Bread 12 Bread rolls 2 Bun 1 Butter 1 Cake 1 Chocolate 1 Doughnuts 1 Faggots 1 Margarine 1 Matzo Meal 1 Milk 2 Sausages 1 Saveloys 2 Steak & Kidney Pie 1 Stewed Steak (canned) 1 Tea 1 TOTAL 32 Heat 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:- 69  Cattle Excluding Cows Cows Calves Sheep and Lambs Pigs Horses Number killed (if known) 81 617 23 43 19 707 Number inspected 81 617 23 43 19 707 All diseases except Tuberculosis & Cysticerci Whole carcases condemned 2 84 2 6 4 Carcases of which some part or organ was condemned 12 262 - 12 - 5 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 17.28 56.08 8.7 4.51 - 1.27 Tuberculosis only Whole carcases condemned - -4 1 - - - Carcases of which some part or organ was condemned 1 27 - - - - Percentage of the number inspected affected with tuberculosis 1.23 5.02 4???5 - - - Cysticercosis Carcases of which some part or organ was condemned - 2 - _ - - Carcases submitted to treatment by refrigeration - - - - - - Generalised and totally condemned - - - - - - All diseased or unfit meat was disposed of for use as knacker* s meat or in the manufacture of animal feeding preparations. Of the 707 horses slaughtered for human consumption, 598 were intended for export. A case of generalised Xanthosis occurred in a cow aged between 6-7 years. Normally discolouration - brownish in character appears in the heart, tongue and muscles of mastication, but in this instance discolouration was generalised throughout. The condition is due to pathological changes in the adrenal body. Slaughter of Animals Act, 1933. Slaughter of Anlnals (Amendment) Act. 1934 Slaughtermen's Licences. During the year one new Licence was issued and twelve Licences renewed. Thirteen slaughtermen held current Licences at 31st December. 70 Merchandise Marks Acts, 1887/1953 Agricultural Produce (Grading and Marking) Acts, 1928/31 Routine inspections are carried out by Inspectors to ensure compliance with the requirements of these statutes. Number of inspections - 66. Inspection of Refreshment and Coffee Stalls Evening inspections of refreshment and coffee stalls were carried out by Public Health Inspectors as found necessary, 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. Sept. Oct. Nov. Dec. Approx. weekly average throughout year Archway - Men 61 32 38 47 44 45 50 46 65 43 42 44 46 Women 42 73 64 52 30 36 64 60 61 65 65 60 56 Parkhurst Rd,- Men 71 57 41 70 68 67 60 57 64 60 57 59 61 Women 67 67 53 53 56 44 44 57 66 44 57 57 55 Finsbury Park- Men 64 54 65 66 62 56 67 69 74 69 72 69 66 Women 7 13 14 22 17 18 20 30 25 11 11 15 17 Highbury- 13 12 13 15 16 16 22 23 22 23 23 17 18 Women 10 12 10 11 15 8 27 14 13 19 10 7 13 Offord Road- Men 9 10 9 10 12 11 10 13 10 9 10 28 12 Women 3 4 6 6 6 4 4 7 8 4 3 3 5 Islington Gr.Women 9 12 11 9 10 12 11 13 13 14 14 12 12 High StreetMen 61 57 67 46 65 55 67 56 60 50 55 33 56 417 403 391 407 401 372 446 445 481 411 419 404 Ice Cream Ice Cream (Heat Treatment, etc ) Regulations 1947/52 Supervision of the Manufacture and Distribution of Ice Cream During the year 364 visits were paid to ice cream premises and vehicles. 71 The number of premises registered: - (a) for manufacture, sale and storage 6 (b) for sale and storage 274 (c) for sale only 215 (d) for storage only 3 498 1. Bacteriological Examination. (a) Ice Cream. Thirty nine samples of ice cream were sent for bacteriological examination and following Methylene Blue tests were graded as follows:- Grade I 21 Grade II 14 Grade III 4 Grade IV - 39 Samples falling within Grades I or II are considered satisfactory. At the end of the ice cream season a sample was taken which was not subjected to the Methylene Blue test but was reported to contain faecal coli. The attention of the manufacturer concerned was drawn to this and arrangements made for further sampling to take place on the resumption of manufacture. (b) Lollies Number sampled Satisfactory Unsatisfactory Cream Lollies 35 29 6 Plain Lollies 27 26 1 2. Chemical Examination Ice Cream 30 30 Ice Lollies 27 27 Details of 29 samples of ice cream examined for fat content are as under: 6% 7% 8% 9% 10% 11% 12% 13% 14% 15% 16% 17% 1 - 2 1 2 6 11 14 1 - - 1 Milk Samples. 1. Bacteriological Examination Details of samples submitted. 72 Class of Milk Results Phosphatase Methylene blue Turbidity Biological Total Number of samples Pasteurised Satisfactory 84 84 84 Unsatisfactory - - - - Sterilised Satisfactory _ - 44 - 44 Unsatisfactory - - - - Tuberculin Tested (Pasteurised) Satisfactory 26 26 - - 26 Unsatisfactory - - - - Tuberculin Tested (Raw milk) Satisfactory - - - 5 5 Unsatisfactory - - - - TOTAL 159 2. Chemical Examination. Details of samples submitted: Satisfactory Unsatisfactory Total Formal 157 . 157 Informal 65 2 67 244 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953, and Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954 The following licences were granted:- Pasteurised 288 Pasteurised (supplementary) 26 Tuberculin Tested 158 Tuberculin Tested (supplementary) 26 Sterilised 343 Sterilised (supplementary) 28 869 Milk and Dairies Regulations, 1949 to 1954. Number of Dairies Registered in the Borough 19 Number of Distributors registered in the Borough 303 Number of Registered Distributors dealing from registered premises outside the Borough 31 Summary of visits by Inspectors Routine Inspections 611 Miscellaneous visits 128 Total number of inspections and miscellaneous visits 739 Number of Notices served 42 73 SECTION F MISCELLANEOUS SERVICES HEALTH PUBLICITY AND HEALTH EDUCATION Islington Borough Home Safety Committee At the beginning of the year the Ministry of Health issued Circular 6/58, with Memorandum on the subject of Accidents in the Home, expressing concern at the number of such accidents, and recommending action by local health authorities, including the establishment of home safety committees, for the purpose of keeping the public informed of the precautions which should be taken in the home. The circular was addressed to County and County Borough Councils, but by virtue of Section 82 of the London County Council (General Powers) Act 1957. the Metropoli tan Borough Councils have powers of publicity concurrent with those of the County Council. Islington Borough Council has for some few years past manifested interest In the prevention of home accidents, and in view of the Ministry of Health" s Circular and Memorandum, it was considered that more systematic and concerted educational work on safety in the home should be undertaken. The Council there fore decided to form an Islington Borough Home Safety Committee, the Constitution of which is as follows:- 1. Terns of Reference The objects of the Islington Borough Home Safety Committee (hereinafter called " the Committee ") are to promote safety in the home to encourage the taking of proper precautions for avoiding the occurrence of accidents therein, and making arrangements for the dissemination within the Borough of information and advice relating to such matters under the general direction of and subject in all matters, including the incurring of expenditure, to the approval of the Public Health Committee of the Islington Borough Council. 2. Appointments of Honorary President His Worship the Mayor shall be invited to be Honorary President. 3 Constitution The Committee shall comprise the following:- Body or Organisation Representation Islington Borough Council: (i) Public Health Committee 2 representatives (ii) Estates Committee 1 representative (iii) Housing Committee 1 representative (iv) The Medical Officer of Health and/or his Deputy. 74 Body or Organisation Representation London County Council: (i) Health Division 3 2 representatives (one of whom should be an officer). (ii) Housing Department 1 representative (iii) London Fire Brigade 1 representative Archway Group Hospital Management Commitee 2 representatives (one of whom should be an officer). Northern Group Hospital Management Committee 2 representatives (one of whom should be an officer). Local Medical Committee (City Division of the B.M.A.) 1 representative Islington Old People's Welfare Council 1 representative Royal Society for the Prevention of Accidents 1 representative North Thames Gas Board 1 representative London Electricity Board 1 representative London Master Builders' Association 1 representative Islington Trades Council (1953). 1 representative 4 Period of Membership Members of the Committee shall hold office until their successors are appointed by the organisations or bodies set out in paragraph 3 above. 3 Appointment of Honorary Secretary The Medical Officer of Health or his Deputy will be the Honorary Secretary and all administrative and executive action will be carried out through and in the Public Health Department assisted by an officer of the Public Health Department nominated by the Medical Officer of Health or his Deputy. 6, Meetings The Committee shall meet in the Town Hall as and when required and at the direction of the Chairman or Vice-Chairman and three days' notice of meetings shall be given to Members. The quorum shall be five members. The inaugural meeting of the Committee was held on the 30th October 1958. Home Safety - November Publicity Campaign During the year the Home Office issued its Circular 58/1958 in which it was proposed to launch a National Campaign on the theme of "Guard that Fire" to take place during the month of November, and asked for the co operation of local authorities, among others, in the organising of local campaigns. 75 The London County Council's annual Home Safety Campaign, in which this Council co-operates through the Public Health Department was again held during the first week of November, and in view of the campaign initiated by the Home Secretary the County Council placed emphasis on burning accidents resulting from unguarded fires. The Public Health Department took an active part in both the above-mentioned campaigns and obtained from the Home Office and London County Council a total of 36,150 leaflets and bookmarks and 800 posters and stickers. Much of this material was distributed and displayed in other Departments of the Council, notably the Public Libraries and in view of the coincidence of the campaign week with the 5th November the Cleansing Department arranged for the display of stickers on refuse vehicles giving a warning on improper handling of fireworks. The co operation of coal merchants electrical and hardware stores was also obtained in displaying posters and stickers. In view of the liability of elderly persons to accidents, a special effort was directed in Islington to old people's clubs. At many of these clubs a special talk was given by either the Medical Officer of Health or Deputy Medical Officer of Health and as they were very well attended and roused a lively interest in the audiences it is felt that these talks served a very useful purpose. Ministry of Health Coughs and Sneezes Campaign As in previous years the Ministry of Health asked for the co -operation of local authorities in the annual winter campaign against coughs and sneezes and supplied a series of four posters for this purpose Through the Public Health Department copies of the posters were distributed to medical practitioners in the borough for display in waiting rooms to old people's clubs and to the various departments of the Council. Posters Leaflets and Publications In my last Annual Report mention was made of the acquisition of seven poster sites for use by the Public Health Department These sites were maintained in regular use with a change of posters normally every month dealing with subjects according to season or topicality. During the year posters were displayed on various aspects of home accidents coughs and sneezes food hygiene infectious diseases and rodent control. Leaflets on similar subjects and the journal "Better Health continued to be distributed through the Public Health Department and some other Departments of the Council. The monthly journal "Family Doctor". published by the British Medical Association is also provided for reading by members of the public in the Public Health Department and Islington Public Libraries. Publicity for Smoke Control Areas In connection with the proposed Smoke Control Areas which were under consideration during the year it was considered that a great deal of publicity would require to be carried out. and the Public Health Committee therefore agreed to the production of a pamphlet containing a short explanation of the Clean Air Act and its requirements in connection with Smoke Control Areas. This pamphlet was distributed to householders in the areas which were under consideration. 76 Conferences and Courses The Royal Society of Health Congress from 28th April to 2nd May was attended by Councillor Dradey and the Medical Officer of Health, and the Conference of the Association of Public Health Inspectors by the Chief Public Health Inspector and the Chairman of the Public Health Committee. the Chairman of the Public Health Committee. In addition special Training and Refresher courses were attended by members of the staff and Public Health Committee as follows:- Course Attended by Clean Air Act: Discussion on problems relating to the efficiency or utilisation of coke burning appliances (North Thames Gas Board) Deputy Chief Public Health Inspector. One Public Health Inspector. One day course on selection of appliances and general problems of domestic heating. (Coal Utilisation Council). One Public Health Inspector. Two Student Inspectors. Course of Study on Food Infections: (Association of Public Health Inspectors) bne Public Health Inspector. Refresher Course for Rodent Operators: (Ministry of Agriculture Fisheries and Food). Three Bodent Investigators. Five Bodent Operators. Food Monitoring Course: (Ministry of Agriculture Fisheries and Food). Medical Officer of Health. Discussion on Inspection of Meat in Slaughterhouses Wholesale Markets and Shops, and at the Docks. (Association of Public Health Inspectors). One Member of Public Health Committee. Lectures on "Radioactivity and its Hazards" (Sir John Cass College). Three Public Health Inspectors. SERVICES FOR ELDERLY PERSONS The work done by the Public Health Department directly by the Council's own staff, and indirectly in liaison with the Old People's Welfare Council, the Women's Voluntary Services, and other voluntary organisations dealing with the health and welfare of elderly persons (and also in co-ordination with the London County Council), continues to increase. In connection with the last-mentioned authority, arrangements have been made for the Borough Council' s visitors to supply systematic appropriate information to the County Council to avoid duplication. The Health Officer and her assistants visited 691 new cases during the year, and re-visits totalled 4,224. 77 2,736 references were made to other Authorities and to voluntary organisa tions in connection with the provision of "Home helps", National Assistance "Meals-on Wheels" etc. Enquiry into means of Spacc Heating used In homes of Elderly Persons Arising out of consideration of Smoke Control Areas in the Borough and the particular difficulties which might arise in connection with conversion and storage of solid fuel in premises occupied by elderly persons (especially as a high proportion in this Borough tend to live either in the basement or on the top floor,) it was considered that it would be helpful to obtain further information as to the present means employed for space heating. The question of the use of solid fuels by old people was also linked with desirable alternative forms of heating which would reduce the physical effort required in lighting fires stoking clearing the grate and transporting fuel At the same time the alternative heating to be supplied should in itself be a more efficient source of warmth, and this is important from the health point of view as elderly persons are more liable to contract respiratory disease, such as bronchitis or pneumonia It was therefore decided to carry out a short-term sample survey and this was done during a cold spell in the early part of the year Observations were made by the Department's Old People's Health Officers when carrying out routine visits. A record was made of space heating and fuel storage arrangements in the homes visited together with temperatures in the living room (taken with an ordinary domestic thermometer). Recordings were made in 102 homes visited and the following circumstances were found: Coal Fire in use-90 homes. Open 79 Kitchen range 11 Fire suitably protected 55 Not suitably protected 35 In 4 cases there were 13 - 20 steps from the room to the fuel store and in 15 cases more than 20 steps In 21 cases coal fires were supplemented with paraffin gas or electrical appliances. Paraffin heaters were found in 16 homes 11 were of the blue flame floor type, 4 of the yellow flame floor type and one of the yellow flame table type- this latter was not thought to be very safe. It will be appreciated that all paraffin heaters need reasonable care and maintenance for safe burning Gas was used for space heating in 14 homes This included 3 gas fires 9 gas cookers with oven door usually open and 2 gas rings. The apparatus was considered to be suitably protected in 10 homes but inadequately protected in 4 The gas connection was by flex metal in 2 cases, rubber tubing in 1, and the remaining connections were by fixed pipe. 3 electric heaters were found and all were suitably protected. 78 With regard to the temperatures in the living rooms, the maximum out side temperatures during the first two weeks of the recordings were 43° and 46° but rose to 52° in the third week In 18 cases during the three weeks the temperature in the living room was below 55°F (It is of course common for elderly persons to wear a very considerable amount of clothing even including an overcoat when indoors). In 73 cases the temperature was found to be between 55 and 60° and in only 11 homes was it recorded between 61 and 65°F These recordings were taken for the most part during the late morning or the afternoon. It was apparent from this small scale survey that conversion to smokeless fuels would present special problems for elderly persons since it would be undesirable to increase storage difficulties and to increase the number of journeys which would have to be made to and from the fuel store The introduction of more gas connections for lighting solid smokeless fuel appliances might also have its own risks for a forgetful old person. On the other hand any installation of a form of space heating which would increase efficiency would be helpful to the health of elderly persons since many of them appear to have insufficient warmth in their homes The results of the survey also showed that in a substantial number of the homes visited the sources of heat were still insufficiently protected although every effort is made to impress upon elderly persons the necessity for guards where there is any danger Useful information was provided which will be taken into account when a recommendation is made for a suitable conversion to smokeless fuel appliances where there is occupation by elderly people Improvement In Laundry Service for Incontinent Elderly Persons During the year the Council approved a scheme for the installation of machinery at the Treatment Centre Seven Sisters Road to deal with soiled laundry from incon tinent persons Useful work in providing this service had been done at Essex Road Baths, but using old fashioned equipment of the Baths Department which entailed much handling of the soiled laundry by the staff concerned The Council therefore approved the purchase of equipment which would obviate handling as far as possible and cleanse and sterilize in one operation Authority was given for the purchase of the following main items of equipment, 2 washing machines 1 hydro extractor 1 drying tumbler 1 steam heated and electrically driven ironing ma hine 1 double compartment sorting bin 1 marking machine Installation work was commenced during the year and was almost completed by the end of the year The new service began early in 1959 and apart from the considerable 79 hygienic improvement effected there was also substantial saving of staff time, since the staff were able to carry out their other duties (e.g cleansing of persons) on the same premises, instead of having to travel to and fro between Seven Sisters Road, and the Essex Road Baths as hitherto, Transport of Elderly Persons The Public Health Committee considered during the year the problem of the cleansing of elderly persons including those whose soiled laundry is dealt with by the Department. It is obvious that those who soil their bedlinen etc. must themselves need frequent cleansing Arrangements for the cleansing of such persons in their own homes have been made by the Department under the London County Council (General Powers) Act 1953 Section 43:- (1) Where it appears to a sanitary authority upon a report from the medical officer of health or a sanitary inspector for their district that any aged person within their district. (a) is verminous or is for any other reason in need of cleansing in order to prevent injury or the danger of injury to health; and (b) is so enfeebled that he is unable to avail himself of any facilities for cleansing himself provided by the authority under any enactment or to cleanse himself properly; the authority may on the application or with the consent of that person (but not otherwise) cause him to be cleansed free of charge at the place where he resides or at any other suitable place. (2) A sanitary authority may make all such arrangements and provide all such apparatus and things as may be necessary for the convenient exercise of the powers conferred by the foregoing subsection. Visiting each home, however is not only a time-consuming process but there are often very limited facilities for obtaining hot water etc. in the houses concerned It was therefore considered that the personal cleansing service should be further assisted by having available the alternative of bathing at the Council's Treatment Centre for those persons who are willing to go and not physically unable to leave their homes. The Committee agreed that for those unable to use public transport the Council should provide a special vehicle for sitting cases The vehicle eventually selected was an ambulance conversion which included a raised fibreglass roof, giving an interior height of 5' 7'' and seating for at least seven persons The vehicle was also to be lined with fibreglass internally and fitted with rubber flooring to allow for complete washing. 80 National Assistance Acts, 1948 and 1951 Section 47 of the National Assistance Act, 1948:- (1) The following provisions of this section shall have effect for the purposes 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 themsel.es, and are not receiving from other persons, proper care and attention. It was necessary, during the year, to invoke this procedure for the removal of an elderly person to suitable premises once only (Case No 3 page 81). Fortunately, it proved unnecessary to enforce the Court Order in this instance, In cases 1, 2 and 4 of which details follow it was possible with the aid of the various services available to elderly persons to find happier solutions to the problems raised, but they are typical of the case work undertaken by the Department s visitors on behalf of the more difficult type of elderly person where the Department is requested to assist by relatives neighbours family practitioners etc. Case No. 1. Mrs. M. (86 years) Relatives reported that Mrs M was running wild and impossible tc cope with This was found to be all too true as she was a convicted vagrant All possible avenues were explored by her own doctor and the Deputy Medical Officer of Health to find a way of dealing with this case but Mrs M was not certifiable and far too active and healthy to be considered suitable for compulsory removal on a Magistrate s Order The Nurse-in-Charge of the Treatment Centre went in from time to time to give Mrs M home bathing. When found at home Mrs M was usually lying in bed fully clothed and covered with faeces as she showed a strong disinclination to use the toilet. However by the exercise of boundless patience and determination the home bathing service of this Council has continued to operate The Council's Special Laundry Service was also provided and at first difficulties arose as the Linen was sent down in such a foul condition This was partially remedied by a twice weekly service Mrs M was supplied with a rubber sheet and new bed and bed linen by the National Assistance Board but as these quickly rotted she has been supplied at regular intervals with replacements whenever secondhand mattresses or linen have been available. She also has to have a constant supply of personal clothing. By constant surveillance therefore this case is being kept under reasonable control. Case No. 2. Mrs K (74 years) Following a reference from this patient s doctor as to the filthy condition of rooms etc Mrs. K. was visited but she refused all offers of help Fumigation by this Department was carried out for vermin and the landlady arranged for the kitchen to be redecorated. Conditions did not improve however and after further visits by the Public Health Inspector and the Officer for Old People Mrs. K. was 81 eventually persuaded to accept the Home Help Service of the London County Council. This service could not operate successfully until an accumulation of bottles and other rubbish had been removed, but with the co-operation of the Cleansing Department Inspector and this Department's Visitor, this difficulty was overcome. Mrs. K. had badly ulcerated legs, and again difficulties arose as she refused to consult her doctor. At length the Visitor persuaded her to let her doctor call, which he did, prescribing appropriately and arranging for the service daily of a district nurse. The National Assistance Board was approached in regard to the provision of a new mattress and a grant was made to the landlady, who purchased a replacement. No further complaints have been received and Mrs. K. appears to be co-operating with the appropriate services in a satisfactory manner. Case No. 3. Mr. P. (74 years). Upon reference from the patient's doctor, Mr. P. was found to be living alone in filthy conditions. He was unkempt in person and appeared incapable of caring for himself or his home. Mr. P., who had lost a limb through a war injury refused all offers of help. Attempts were made to get him into hospital for medical attention, or into a Home for permanent care, but he refused to co-operate. Members of his family were consulted but he was violent when they attempted to intervene. After careful consideration it was eventually decided to apply to Court for a removal order. An Order was made but not enforced as Mr. P. agreed to accept services. Home bathing commenced, and has continued, not, however, without many setbacks as the service has often been refused and only resumed after further visits by the Deputy Medical Officer of Health and the Health Officer for Old People.The Council's Laundry Service has operated when Mr. P. could be persuaded to change his clothes. Following the redecoration of his premises, an excellent home help has carried on her duties under considerable difficulties. These difficulties, however, are aggravated by Mr. P.'s predeliction for hoarding and his habit of spitting on the floor. Case No. 4. Mr. C. (81 years) and Mrs. C. (79 years). Unlike the other cases mentioned, this elderly couple were prepared to accept services but, when brought to the notice of the Department, had reached the stage of complete lethargy and an inability to care for themselves. Mr. C. was found to be fairly active, but Mrs. C. had had a recent fall and required the attention of a doctor. She was not registered but, with the help of the London Executive Council, this omission was remedied. After the rooms had been disinfested, and a quantity of rubbish removed, a bed and mattress were supplied and the Assistance Board made a grant for personal clothing. The Home Bathing and Special Laundry Services were introduced and Mrs. C. was supplied with a commode, through the London County Council. She was also given domiciliary chiropody treatment. The couple have not yet accepted the Home Help Service, but it is hoped that they may eventually be persuaded to change their minds about this. 82 National Assistance Act, 1948. Section 31. "Meals on Wheels" and Lunch Clubs. 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 approved for the '' Meals on Wheels '' service operated by the Women's Voluntary Service and during the year a grant for a similar purpose was made to the Islington old People's Welfare Council. The number of meals supplied during the year, is given in the following table- Meals on Wheels Women's Voluntary Service 6,468 15,555 meals (cooked by N A.L.G.O. Town Hall Canteen) Islington Old People's Welfare Council twith effect from 24.2.58) 4,488 Lunch Clubs Gifford Hall Mission Welcome Club 3,694 Caxton House Settlement (with effect from 6.6.58) 905 The need for extension of Meals on Wheels service was recognised by the Borough Council, who subsequently made a grant for the purpose of purchasing a vehicle and equipment, together with the employment of a driver, to the Islington Old People's Welfare Council. The extended service commenced in February, 1958 with the assistance of voluntary workers. All prospective recipients are visited by this Department's Elderly Persons Visitors in order to confirm the need. The new vehicle was quickly operating to capacity, and in consequence was of benefit to elderly persons in the Borough. A brief inauguration ceremony, performed by His Worship the Mayor, took place on 24th February. 1958, in the forecourt of the Town Hall in the presence of representatives of the Islington Old People's Welfare Council and Women's Voluntary Service This was subsequently broadcast in the B B.C. Locals News Service and a film was televised. The figures quoted above do not include during the year under review records relating to lunch clubs which are subject to direct grants for meals supplied by private means with a view to recipients getting a hot 2-course meal at a reduced price. Such a club has already existed for a number of years at the Claremont Central Mission which, although situated in the Borough of Finsbury, receives a good proportion of elderly Islingtonians at its lunch club held on Tuesday Wednesday and Thursday. A newly-formed lunch club commenced at St. Giles Christian Mission Bride Street, N 7. on 22nd January, 1958, and the Council, on 21st February 1958 approved the payment of a grant towards the running of this club which operates on Wednesday On these premises a club room is available every week-day from 11 a.m. 83 Another newly-formed lunch club for the elderly received for the first time the benefit of a Council grant during the year. This was the Caxton House lunch club, Andover Road, N 7, where meals are served at a reduced price each Friday. These are supplied by the N A L G 0 Town Hall Canteen, and are delivered in bulk by the Islington Old People's Welfare Council Meals on Wheels Van which also conveys (again in bulk) meals from the Canteen to the Gifford Hall Mission Welcome Club. The lunch club here is also grant-aided by the Council and operates on Tuesday and Friday each week. Thanks are due to the voluntary workers at all Centres who assist in serving meals and washing up etc. and an appreciation is also recorded of the work undertaken by the numerous unpaid workers who regularly help in the delivery of meals on wheels. More volunteers for this task would be welcomed. Holidays for Elderly Persons By means of a scheme administered through the Old People's Welfare Council 516 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 Chi ropody The Council has continued to support voluntary organisations in the provision of a chiropody service for elderly persons There has been found to be a very wide demand for treatment and at the end of the year the following clinics were held Address Days and Times Clinic Held Date commenced Islington Medical Centre, 303, Upper Street, N.l. (near St. Mary's Church). Monday, 2 p.m. to 5 p.m. 31. 10. 55 Thursday, 9.30 a.m. to 12.30 p.m. Friday, 1.30 p.m. to 4 30 p.m. 25. 7. 57 Gifford Hall Mission, Gifford Street, Caledonian Road, N.l. (near Railway Bridge). Tuesday 9.30 a.m. to 12.30 p.m. 24. 1. 56 Friday Thursday 2pm to 5 p.m. 4. 4. 57 Junction Road Congregational Church Hall, Junction Road, N.19 (near Odeon Cinema). Wednesday 9.30 a.m to 12.30 p.m. 1. 8. 56 Friday Appointments at these clinics are made by the Public Health Department and during 1958, 3,586 treatments were given to 825 Old Age Pensioners A limited domiciliary service was commenced on 20 6.59 and all applicants are visited by the Old People's Health Officers before treatment is given. At the end of the year 105 housebound elderly persons had received 136 treatments at home. In addition a session for members of an old people"s club continues to be held 3 times a month at the Caxton House Settlement, Fonthill Road N 4 84 Public Health (London) Act, 1936 - Section 122 Cleansing and Laundry Service 1. Incontinent Elderly Persons in the Borough. This free service has proved to be of great benefit to those recommended for it. Bed clothing and bed linen were collected, and delivered to Essex Road Baths by this Department's vehicle and there cleansed by the Department's bathing attendants in plant on hire from the Baths and Washhouses Department. The scheme for modernisation of the laundry service at the Treatment Centre has been referred to on page 78. Requests for assistance come from the North London District Nursing Association, general practitioners hospitals, etc., and are investigated by the Old People's Health Officers. As provided in Section 122 of the Public Health (London) Act, 1936. cases dealt with are those where it is considered that the soiled articles are filthy, dangerous or unwholesome, and that health might be affected or endangered thereby. Relevant statistics for the year are as follows:- No. of recipients approved 105 No. of washings carried out 1846 No. of articles cleansed 13000 2. Holborn Borough Council. The agreement whereby clothing and bedclothes of incontinent elderly persons in Holborn Borough can be dealt with at the Islington laundry has continued. This scheme commenced in December 1955. and during 1958 460 washings comprising 3412 articles were carried out on behalf of 24 reci pients. 3. Islington Chest Clinic An extension of the service of cleansing the clothing and bedding of elderly persons in the Borough to include cases recommended by the Chest Physician for Islington was approved by the Council in 1955 Relevant statistics for 1958 are as follows No. of references by Chest Physician for Islington 1 No. of washings carried out 34 No. of articles cleansed 321 Articles are disinfected prior to washing. London County Council (General Powers) Act, 1933 Section 43 Cleansing of Elderly Persons 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 they were so enfeebled as to be unable to avail themselves of facilities at the Treatment Centre. Details of this service for the year are as follows:- 85 No. of baths given at home 1174 No. of persons concerned 113 The work was carried out under the supervision of the Nurse-in-Charge of the Council's Treatment Centre. 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.1 after that date. ISLINGTON CREMATORIUM The Medical Referee or the Deputy Medical Referee certified a total of 538 applications for cremation at the Council s Crematorium East Finchley. MATERNITY AND CHILD WELFARE SERVICES The London County Council, as the Local Health Authority is responsible for the Maternity and Child Welfare Services in the Borough which together with the Boroughs of Finsbury and Holborn. constitute Division 3. I am indebted to Dr. Wilfrid G. Harding Divisional Medical Officer for the information given below in respect of these services: Total Attendances at Infant Welfare Centres Infants North South East West Archway 9-1 years 14118 10451 8011 10678 2679 1-2 years 2239 1371 840 1461 388 2-5 years 1011 653 258 1331 212 Special Toddlers' Clinics 765 328 557 647 - Ante Natal and Post-Natal Combined 5907 3366 2980 3131 - Child Life Protection The table of foster-mothers and foster children being cared for is as follows 31.12.58 Number of persons fostering children 22 Number of foster-children being cared for 32 At present there are 3 Day Nurseries open in Islington Scholefield Road 60 places Canonbury Place 64 Mitford Road 67 191 There are also 50 places for Islington children in Springdale Day Nursery (Stoke Newington). 86 Welfare Centres. WELFARE CENTRE Children's Ante-Natal and Post-Natal Immunisation Dental Vaccination Toddlers North Islington Infant Welfare Centre (Voluntary) 6-9, Manor Gardens, N.7. Mon. to Frid. 2 p.m. Mon. Thurs 2 p.m. (midwives Wed. 2 p.m. Tues. 9 a.m. and 2. 45 p.m. Wed. 2 p.m. Tues. Wed. Thurs. Wed. 10 a.m. 2 p.m. Wed. 2 p.m. (2nd wk.) Thurs 10 a.m. (1st wk.) 2 p.m. (4th wk.) Frid. 2 p.m. North Branch Clinic Blythe Mansions Hornsey Rise N. 19 Mon. 2 p.m. Frid. 2 p.m. North Branch Clinic Co-operative Hall, 129, Seven Sisters Road, N.4. Wed. 2 p.m. Archway M. & C.W. Centre Congregational Church, Junction Road, N. 19 Thurs.10 a.m. 2 p.m. Thurs. 10 a.m. 2 p.m. Thurs.10 a.m. 2 p.m. West Islington Welfare Centre 42 & 44. Richmond Avenue N.l. Mon. 2 p.m. Tues, 10 a.m. Wed. 10 a.m. Wed. 10 a.m. Wed. 10 a.m. Tues. Thurs. 10 a.m. and 2 p.m. (midwives) Wed. Frid. 10 a.m. West Branch Clinic Tenants Clubroom Hildrop Estate, N.7. Mon. 2 p. m. Tues. Wed. South Islington Welfare Centre 6, Clephane Road Essex Road N. 1. Mon. 2 p.m. Mon. 10. a. m. Frid. 2 p.m. Frid. 2 p,m Frid. 2 p.m. Wed. 10 a.m. Tues. 2 p.m. Frid. Thurs. 2 p.m. South Branch Clinic Union Chapel. Compton Av.,N. 1. Tues. 2 p.m. Thurs East Islington Welfare Centre 32, Drayton Park, N.5. Tues. 2 p.m. Mon 10 a.m. Mon 2 p. m Mon. 3 p.m. Tues. 10 a.m. Wed. 10 a.m. Wed. ,2 p.m. (midwives) Frid. 10 a.m. Frid. 2 p.m. Thurs. 2 p.m. Frid. 10 a.m. East Branch Clinic 6, Hurlock Street, N.5. Thurs. 2 p.m. INDEX Accidents 9, 10, 11, 14 Acute Encephalitis 15 Acute Poliomyelitis 9, 15, 19-20 Aged and Infirm Persons 32, 76-85 Ante-Natal Clinics 85, 86 Anthrax 15 Atmospheric Pollution 39-44 Bacteriological Examinations 29, 55, 71 Births 8, 10, 12 Blow-Fly Infestation 39 Cancer - Lung 9, 10, 13-14 Certificates of Disrepair 30, 33, 56 Chemical Examinations 55, 71, 72 Child Life Protection 31, 85 Child Welfare Centres 85-86 Chiropody for Elderly Persons 83 Clean Air Act, 1956 39-44 Cleansing, Elderly Persons 79, 84-85 Closing Orders 58 Crematorium 85 Day Nurseries 85 Deaths 8, 9, 10, 12-14, 19, 20,21,22,26 Dental Clinics 86 Diphtheria 9, 10, 15 ,21 -22 Diphtheria Immunisation 22, 86 Disinfection 38-39 Disinfestation 38-39 Disinfestation of Sewers 52, 54 Dysentery 15, 24-26 Elderly Persons, Services for 76-85 Encephalitis, Acute 15 Enteric Fever 15 Erysipelas 15 Export Certificates 38 Factories Act 45, 46 - 48 Fly Infestation 39 Food and Drugs Act 32, 46, 63 - 68 Food Hygiene Regulations 61, 65, 67 Food - Inspection and Supervision 45 , 46 , 60-72 Food New Legislation 60-61 Food Poisoning 15, 23-24 Food Sampling 61, 62 , 67 - 68, 71 - 72 Food, Unsound 62, 63, 67 Foster Mothers and Children 31, 85 Health Publicity and Health Education 73-76 Heating Appliances (Fireguards) Act, 51 1952 Holidays for Elderly Persons 83 Home Safety Committee 73-74 Home Visiting 29, 76 Housing 56-59 Housing Repairs and Rents Act, 1954. 56, 57 Ice Cream 62, 70-71 Illegitimate Infants - Births and Deaths.. 8,10 Infant Mortality 8, 10, 11, 13 Infectious Diseases 15-29 Influenza, Pneumonia and Bronchitis 9, 11, 12 -13, 15 Inoculation, etc., Certificates 16 Laundry Services 76-79, 84 Legal Proceedings 35-38, 48,54- 55, 57, 62 64-67 Live Births 8, 10, 12 L.C.C.(General Powers) Act 30, 34, 48-50 84-85 M & C.W. Services 85-86 Malaria 15 Marriages 8, 10 Mass X-Ray 28 Maternal Mortality 8, 9, 10 "Meals on Wheels" 82-83 Measles 9,11,15,16 -19 Meat 61,62,68 -69 Meningococcal Infection 9,11, 15 Merchandise Marks 70 Metropolitan Cattle Market 61, 68 Milk 61-62, 63, 71 -72 Milk and Dairies Regulations 61, 72 Milk (Special Designations) 72 Miscellaneous Services 73-86 Mortuary 85 National Assistance Acts 32, 80 -83 Neoplasms, Malignant 9, 10, 13-14 Noise Nuisance 48 -50, 62 Nurseries-Day 85 Offensive Trades. 50-51 Ophthalmia Neonatorum 15 Outworkers 47 Overcrowding 58, 59 Pet Animals Act 51 Pharmacy and Poison Acts, etc 51 Pigeon Nuisances 50 Pneumonia 9, 11,12-13, 15 Poliomyelitis 9,15,19 -20 Population 8,10, 12 Poot†Natal Clinics 85, 86 Premature Infants 11 Preserved Food Premises 64 Prevention of Damage by Pests Act and Order 52-54 Prosecutions 35-38,48,54-55, 57,62,64-67 Public Health Committee 6 Public Health Inspectors-District Work 31-39 Public Health Inspectors-Special Work 45-55 Public Health (London) Act-Improvements effected 33-34, 46 Public Health (London) Act, Sections 40 and 109 34 Public Health Officers 6-7 Public Health (Tuberculosis) Regulations, 1952 27 Publicity 73-75 Puerperal Pyrexia 15 Rag Flock and Other Filling Materials Act Rats and Mice 52-54 Refreshment and Coffee Stalls 70 Rent Act, 1957 30,33,56 Requisitioned Property 32,45 Sampling 55,61,62,67-68,71-72 Sanitary Circumstances 30-55 Scabies 15,28-29 Scarlet Fever 15 Sewer Treatments 52,54 Shops Act 30,46 Slaughtermen's Licences 69 Slum Clearance56,57,58 Smallpox 15,16 Smoke 39-44 Staff 6-7 Static Water Tanks, etc. 31, 39 Statistics-General 8-14 Statistics -Vital 8-14 Still-Births 8, 10 Swimming Baths 55 Toddlers' Clinics 85,86 Town & Country Planning 59 Treatment Centre 28-29,79 Tuberculosis 9,10,11,13,15, 26-28 Tuberculosis - Beds and Bedding 28 Tuberculosis - Care Committee 28 Tuberculosis - Chest Clinics 27-28 Tuberculosis - Deaths 9,10,11,13,26 Tuberculosis Notifications 10,13, 26 Typhoid Fever 15, 24 Underground Bakehouses 31,48,63 Vaccination 16,86 Vermin 28-29 Washing Facilities, Free 70 Water Supplies 4-55 Welfare Centres 85-86 Whooping Cough 9,11,15,16,18-19 Printed and Published by Islington Borough Council