AC 4361 ??? PH ??? ISC 88 1959 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 METROPOLITAN BOROUGH OF ISLINGTON With the Compliments of the Medical Officer of Health TOWN HALL. UPPER STREET. ISLINGTON, N.I. 1 CANonbury 3388 Public Health Department, Town Hall, Islington, N. 1. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OP ISLINGTON The Annual Report for 1959, which I have the honour to present on the health of the population of the Metropolitan Borough of Islington includes as is customary accounts of progress made and advances in public health It also includes, unfortunately, information which demonstrates that our control over infectious disease, for example, and other major preventable causes of sickness and mortality is still far from complete. Contrary to the experience after the first world war there has been no continued fall in the birth-rate, following the post-war 'bulge' Over the past few years the Islington birth-rate has continued to increase in line with or even slightly in advance of the national tendency, so that the 1959 figure was the highest since 1947 It is difficult to resist the conclusion that the increase in births is linked with the present period of national prosperity just as the decrease in births of the nineteen- thirties was linked with the depressions of that time Deaths due to tuberculosis of the lungs were the lowest so far recorded but there are still considerable numbers of new cases every year and respiratory tuberculosis is likely to remain a major health social and economic problem for many years to come Islington shares the regular national increase year by year of deaths due to malignant growths of the lung and bronchus, and deaths due to this cause were the highest on record so far. These deaths can very largely be prevented by the avoidance of smoking cigarettes, but it is obvious that this is not a position which has so far been accepted by the general public, or if it is known to some, then the implications are being ignored. It would also appear to be obvious that the pro-cigarette smoking publicity through the mass advertising media overshadows the more reticent publicity on ill-effects based upon evidence accepted for some years by the Medical Research Council and the Ministry of Health, and which is almost daily receiving international as well as national confirmation In the field of infectious disease the principal feature in 1959 was a relatively short but nevertheless sharp outbreak of poliomyelitis, which is recorded in detail in the infectious diseases section of this Report The highest number of cases for ten years was recorded and the exceptional feature of this occurrence was that these Islington cases together with a few cases in neighbouring boroughs, did not form part of a widespread increase Such local outbreaks of poliomyelitis are, of course, unfortunate, but have occurred from time to time. Although the campaign of immunisation against poliomyelitis had not yet become fully comprehensive at the time, nevertheless the distribution of the cases showed that those who had had even an incomplete course of two inoculations were four to five times less likely to become sick with poliomyelitis than those who had not been immunised at all against this infection. Diphtheria was another infection during the year where there were rather more cases than for some years previously Fortunately the illness was mild in all those affected, but there is no guarantee that a severe attack of diphtheria might not occur under similar circumstances and immunisation against diphtheria must therefore continue to be strongly advised as a safeguard Pollution of the Atmosphere There was a short fog and 'smog' period early in 1959 There is an account in the Report of the effect of such weather conditions, even though of short duration in increasing the liability to bronchitis and pneumonia with all the risks that go with wuch infections, particularly for the elderly 2 Since pollution of the atmosphere is so much increased in the winter months from domestic smoke caused by the burning of raw coal, measures to render the air cleaner are important on health grounds. During the year, two Smoke Control Orders were made, one for part of the Canonbury area and the other for part of North Islington and these were confirmed by the Minister of Housing and Local Government. Although in each of these areas a considerable number of conversions will have to take place in order that smokeless fuel may be burnt, these areas can be regarded only as a beginning. A programme of Smoke Control Areas has been outlined which it is hoped will come into being within the next five years Every endeavour will be made, not only to implement this programme but to expedite and if possible extend it However the size of the problem is such that many years must elapse before the greater part of Islington will, as it is hoped, eventually become an area where the burning of raw coal in the traditional domestic grate is not permitted. Health & Hygiene Education Much of the work of the Public Health Department is inevitably associated with giving information to the public so that there will be as full an understanding as possible of the reasons for the action taken to ensure the willing co-operation and support of members of the public Health Education associated with practical work is therefore a continuous part of the activities of the Department. As a typical example of this work a special booklet was prepared and distributed personally to every householder in the areas to be covered by Smoke Control Orders In addition every householder in these areas numbering some twelve hundred were personally visited by the Public Health Inspectors responsible for this work Similarly, food hygiene Codes of Practice dealing with hygiene in the retail meat trade and the hygienic transport and handling of meat, and which were issued under the auspices of the Ministry of Health and the Ministry of Agriculture, Fisheries and Food were purchased for free distribution to every butcher in the Borough To emphasise the desirability of hygiene standards being brought up to the Codes of Practice, arrangements were made for the Inspectors to interview every butcher and personally hand him a copy of the Codes in order that his attention could be effectively drawn to what was expected of him and his staff Advantage, of course, is taken of such opportunities which are offered in the routine visiting of food premises, where advice bearing upon hygiene in the particular type of food premises visited is almost invariably dealt with. The increasingly cosmopolitan character of restaurants and other food premises undoubtedly adds interest and variety but may also raise certain problems of differing standards and introduce perhaps in a small number of cases some difficulties of language which have to be overcome This does not necessarily mean that co-operation is not almost invariably forthcoming as may be observed from the decorative but co-operative communication received from the proprietor of a Chinese restaurant and which is reproduced in the Report. Another sphere of health education where prevention and education are necessary and urgent is in relation to the prevention of accidents in the home. This work was done partly through the Islington Home Safety Committee and partly through the Public Health Department itself by the holding of meetings, talks to old people's clubs, widespread distribution of printed publicity matter as set out in this Report and which included also local co-operation with the London County Council during its annual Home Safety Week. Legislation and Problems Although caravans have not in the past raised problems in Islington as they have done in some other areas (probably because of the very limited possible caravan sites available), nevertheless new powers which will come into force in 1960 should be helpful in reducing the possibility of caravans becoming a nuisance by their being set up on unsuitable sites New legislation will also ensure the requirement of approved standards for refuse accommodation in connection with any new building Some of the refuse accommodation provided in the past has been unsatisfactory, particularly that provided in connection with some of the older blocks of flats, and has caused considerable physical difficulties in proper clearance by the refuse collectors 3 Another minor legislative improvement which will fill a hygiene gap will be the requirement to provide sanitary conveniences for persons using refreshment houses or places of public entertainment. The problem of nuisance from noise mentioned in last year s Report continues to crop up in various forms. Some cafes and refreshment houses which may be a source of enjoyment to some may also be a cause of nuisance to neighbours in the near vicinity if such places remain in use until late at night or even in the early hours of the morning if they are used without consideration. Noise may be caused by persons being unnecessarily noisy on leaving the premises, or from the playing of juke boxes etc Noise from a car breakers yard was another unfortunate example of industry side by side with residential accommodation. Although in the main property improvements are proceeding on a very considerable scale by voluntary action the Report includes a summary of 40 cases where it was necessary to take Court proceedings in order to deal with sanitary nuisances under the Public Health (London) Act and a summary of another 12 cases where there was even failure to comply with a Magistrate" s Abatement Order made under the same Act. Housing A considerable amount of work as set out in detail in the Report was done during the year under the Housing Acts 131 Closing and Demolition Orders were made in respect of whole unfit houses and 158 Closing Orders were made in respect of parts of houses unfit, mainly comprising basement room accommodation On the other hand an increasing number of premises which have been the subject of Closing Orders in the past have had works carried out to render them fit by Housing Act standards During the year Closing Orders previously made were determined because of works carried out for 26 whole houses and 42 basement rooms In spite of much new housing in the Borough provided principally by the London County Council and the Borough Council by far the greater part of the population are still housed in old-type houses in multiple occupation with common entrances and passages w cs water points and sometimes even kitchen facilities and with no bathroom in the house There is no doubt that such out-of-date arrangements make congestion inevitable and domestic friction likely even where overcrowding by statutory standards does not occur Because of insufficient large housing sites alternative rehousing accommodation which can be offered by the Council is extremely limited and rehousing on purely health grounds is made very difficult and from the point of view of many applicants, almost impracticable Elderly Persons The Borough continues to provide many helpful services to elderly persons both directly and indirectly Details will be found in the Report of the installation of up-to-date washing disinfecting and other laundry equipment at the Treatment Centre Seven Sisters Road to deal particularly with the problem of laundering personal clothing and other articles from persons who have incomplete control of their physical functions and who are in the main elderly This is proving a most useful service and care is taken to return the laundered articles within twenty four hours to obviate possible hardship from the possession of insufficient clean changes It will be obvious that persons who require such a service will also probably need a certain amount of personal care. This can also be arranged through the Department by the employment of nurses and bathing attendants who will visit homes to cleanse and bath elderly persons who desire this. For those who can leave their own beds or rooms and for whom a bath under supervision at the Treatment Centre would be preferable the Council have provided a special ambulance for transport and this is proving a most useful addition to the group of services for physically handicapped elderly persons Some details are given in the Report of elderly persons problems which are brought to the notice of the Department and of the help which it has been found possible to give in many different ways and which would have been difficult - perhaps even impossible to provide so far as one can see, in the absence of the means provided through the Department Useful elderly people's services provided indirectly by Borough Council assistance to voluntary organisations include supplementary feeding of elderly persons through the Meals-on Wheels Service and lunch clubs and also the chiropody service. 4 Staff and General The deficiency in the establishment of Public Health Inspectors which has been mentioned in the last few Annual Reports unfortunately continued during 1959. This shortage of key sanitary staff renders it impossible to effect as many inspections as is thought desirable and inevitably entails delays on many occasions to members of the public following complaints made, and which delays are greatly regretted. These circumstances naturally place an additional burden upon the existing Inspectors, but in spite of these difficulties the great volume of their work done (which is embodied in the Report in summary form) must be apparent. The Medical Officer of Health is the principal representative of a health team and the value of the team depends upon the contributions made by all its members and their active and efficient co-operation. Dr. J.P.J Burns, Deputy Medical Officer of Health had a particularly difficult year arising out of the exceptional incidence of some infectious disease mentioned in the Report. I am pleased to express my thanks to him I again have to express my personal appreciation to Mr. W.C Bartlett, Chief Public Health Inspector and Mr. H Plinston, Deputy Chief Public Health Inspector, who have had to bear the brunt of the Inspector establishment deficiency; on the administrative side, thanks are due to Mr E J Sharp, Chief Clerk, as well as to all Officers and members of the staff of the Department. My appreciation would not be complete without again expressing my thanks to Dr Wilfrid G. Harding, Divisional Medical Officer, Health Division 3, and to all members of his Divisional staff for co-operation and liaison so willingly offered to link the two aspects of the environmental and personal public health services to the common advantage of the people of the Borough. I also have the pleasure in referring again to the importance of the relationships between Heads of Departments and the Chairmen of the respective Committees and the thanks I must express to the two principal Chairmen dealing with Public Health Department matters namely, Alderman A.J, Rogers of the Public Health Committee and Councillor E J W Bayliss of the Housing Committee My thanks must also include the Members of these Committees for their kind and courteous consideration of the many reports I have placed before them during the year. V. FREEMAN Medical Officer of Health. 5 MEMBERS OF THE PUBLIC HEALTH COMMITTEE (As at 31st December 1959) MAYOR Alderman JOHN C BARNES, J P Aldermen. HERBERT JAMES LOWTON LYGOE, M. B. E., J. P., M. S. M., L C C ALBERT JOHN ROGERS Councillors GEORGE ARTHUR WILLIAM AINSWORTH MRS. ZARA BAGNARI WILLIAM DRADEY PRANK ERNEST FIELD HENRY WILLIAM FRANCIS FORD RICHARD DAVID HAWES MRS MARY EVA GERTRUDE HYDE ALBERT GEORGE LANGDON HYDE HENRY JAMES REID LEWIS ROSS MRS MARGARET MARY SHORT MRS EMILY MARY SIMMS WALTER SMITH MRS BRONWEN STRADLING 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. O., D.P.H., (Part-time) Public Analyst: D.F.H. Button, A.R.C.S., F.R.I.C. Chief Public Health Inspector 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) 6 Public Health Inspectors (l)(m) H. Archibald (b)(c) A. Aslamidis (b)(c) G.D. Couling (b)(c) L. Foxley (b)(c) K.L. Garner (b)(c)(f)(g)(h) Miss V.M. Goddard (b)(c) R. T. Govett (b)(c) A. W. Haydock (b) A. R. Kempshall (b)(e) T. Lawson (b)(c)(d) n. Lightowlers (b)(c)(e) s.E. Muggeridge (b)(c)(e) F. H. W. Pedrick (b)(c)(f)(g)(h) Miss S. H. Prentice (b)(c) G. A. Reid (b)(c)(d)(e)(j) K. E. Sewell (b)(c) U. P. Stanton (b)(k) W. T. Stevenson (b)(c) R. C. Whittaker (12 vacancies) Chief Clerk E. J. Sharp Clerical Staff: S.A Bishop P. Hardwick C. J. Moore* Mrs. M. Brain J. Hough D. A. Owen E.P. Brewer Miss M. E. Hudson Mrs. E. V. Pelosi W.R. Causton* L. Hummerstone P. L. Regan E.E. Conner Mrs. E. Johnson Mrs. V. Skinner Mrs. V. E. Cook T.W. Johnson J. Thompson P. Dymond W.A. McAdam* L. Turner Mrs. O. Easson Mrs. C. McCausland Mrs. F. W. Underwood Mrs. S. R. Moody 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) 4 Home Visitors 1 Stoker-Handyman 1 Assistant Driver 3 Bathing Attendants 1 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 Sanitary Institute and the Sanitary Inspectors Examination Joint Board (c) - Royal Sanitary Institute Meat Inspectors Certificate (d) - Royal Sanitary Institute Certificate in Sanitary Science (e) - Royal Sanitary Institute Smoke Inspectors Certificate (f) - State Registered Nurse (g) - State Certified Midwife (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 Pood Inspectors Certificate (l) - Certificate of the Royal Sanitary Association of Scotland (m) - Meat Meat Products and Pish Certificate of the Royal Sanitary Association of Scotland * - Senior Sectional Clerk. 7 SECTION A. GENERAL AND VITAL STATISTICS Area of the Borough 3,092 acres population Registrar-General's estimate of civilian population Mid-year 1959: 223,400 Live Births. BIRTH RATE PER 1,000 ESTIMATED RESIDENT POPULATION Totals M. F. Unadjusted Islington Area Comparability Factor Adjusted England & Wales Legitimate 4,415 2,210 2,205 Illegitimate 557 264 293 4,972 2,474 2,498 22.3 0.91 20.3 16.5 Illegitimate live births per cent of total live births 11.20 Still Births. RATE PER 1,000 TOTAL (LIVE AND STILL) BIRTHS Totals M. F. Islington England & Wales Legitimate 87 45 42 Illegitimate 12 7 5 99 52 47 19.52 20.7 Total live and Still Births 5,071. Notifications of Births For the year ended 2nd January, 1960 4,956 (corrected figure from L.C.C. ) Marriages. (Provisional figures) \ Marriages solemnised in the Borough during the year 2,403. 8 Deaths. Infant mortality (deaths under 1 year) Total deaths 109 RATE PER 1,000 LIVE BIRTHS Islington 22. England & Wales 22. Legitimate 22. Illegitimate 20. Neonatal mortality rate (deaths under 4 weeks) 15.08 Early neonatal mortality rate (deaths under 1 week) 13.07 Perinatal mortality rate PER 1,000 TOTAL LIVE AND STILL BIRTHS (still births and deaths under 1 week combined) 32.34 Maternal deaths. (Including abortion) Total deaths 6 RATE PER 1,000 LIVE AND STILL BIRTHS 1.18 0.38 All deaths. RATE PER 1,000 POPULATION Total M. F. Islington England & Wales Unadjusted Area Comparability Factor Adjusted 2,580 1,313 1,267 11.55 0.97 11.20 11.6 9 CLASSIFICATION OF DEATHS WITH AGE DISTRIBUTION (REGISTRAR GENERAL® S RETURNS) CAUSE OF DEATH AGE GROUPS 0- 1- 5- 15- 25- 45- 65- 75- All Ages M. F. M. F. M. F. M F. M. F. M. F. M. F. M. F. M. F. Total 1. Tuberculosis, Respiratory - 1 - - - - - - 1 1 7 2 3 1 7 - 18 5 23 1 2 Tuberculosis, Other - - - - - - - - - - - 1 - - - 1 - 2 2 2 3 Syphilitic diseases - - - - - - - - - - - - 1 1 1 1 2 2 4 3 4 Diphtheria - - - - - - - - - - - - - - - - - - - 4 5 Whooping Cough - 1 - - - - - - - - - - - - - - - 1 1 5 6 Meningococcal Infection - 1 1 - - - - - - - - - - 1 - - 1 2 3 6 7 Acute Poliomyelitis - - - 1 2 1 2 - 1 - - - - - - - 5 2 7 7 8 Measles - - 1 - - - - - - - - - - - - - 1 - 1 8 9 Other infective and parasitic diseases - - 1 - - - - - - - 1 1 1 - - 1 3 2 - 9 10 Malignant neoplasm, stomach - - - - - - - - 1 1 14 2 10 10 10 13 35 26 61 10 11 Malignant neoplasm, lung bronchus - - - - - - - - 2 - 73 14 52 4 18 8 145 26 171 11 12 Malignant neoplasm breast - - - - - - - - - 7 - 14 - 6 - 9 - 36 36 12 13 Malignant neoplasm, uterus - - - - - - - - - 2 - 10 - 11 - 4 - 27 27 13 14 Other malignant neoplasms - - 1 - 2 2 - 1 9 1 28 33 29 34 32 41 101 112 213 14 15 A-and-Leukamia - - - 1 - - - - 1 - 1 2 1 2 - 2 3 7 10 15 16 Diabetes - - - - - - - - - - 2 2 - 2 1 3 3 7 10 16 17 Vascular lesions of the nervous system - 1 - - - - - - 2 4 29 20 27 29 45 96 103 150 253 17 18 Coronary disease Angina - - - - - - - - 9 - 97 22 74 62 57 89 237 173 410 18 19 Hypertension with heart disease - - - - - - - - - - 7 2 4 7 12 21 23 30 53 19 20 Other heart disease - - - - - - 1 - 4 4 16 12 18 28 40 106 79 150 229 20 31 Other circulatory disease - - - - - - 1 - 2 - 11 7 13 20 19 73 46 100 146 21 22 Influenza - - - - - - 1 1 - 1 5 4 6 5 6 10 18 21 39 22 23 Pneumonia 8 8 1 1 - 1 2 - 1 - 13 9 17 18 44 53 86 90 176 23 24 Bronchitis 2 - - - - - - - 1 1 52 15 51 19 67 49 173 84 257 24 25 Other disease of the respiratory system 1 - - - 1 - - - - 1 3 4 6 3 6 - 17 8 25 25 26 Ulcer of stomach and duodenum - - - - - - - - - 1 3 3 5 1 4 5 12 10 22 26 27 Gastritis enteritis diarrhœa 1 - - - - - - - - - 1 1 1 3 2 3 5 7 12 27 28 Nepthritis and Nephrosis 1 - - - - - 1 - 4 - 3 1 2 3 - 1 11 5 16 28 29 Hyperplasia of prostate - - - - - - - - - - - - 4 - 6 - 10 - 10 29 30 Pregnancy Childbirth and Abortion - - - - - - - 1 - 5 - - - - - - - 6 6 30 31 Congenital Malformations 13 5 1 2 - 1 2 1 - - 2 2 - - - 1 18 12 30 31 32 Other defined and ill-defined diseases 35 25 - - - - - 1 6 8 16 17 17 21 15 37 89 109 198 32 33 Motor vehicle accidents - - - - 2 - 3 - 4 2 4 5 2 3 3 2 18 12 30 33 34 All other accidents 3 2 1 2 1 - - 1 3 - 7 - 4 1 8 22 27 28 55 34 35 Suicide - - - - - - 2 3 4 1 11 6 1 2 1 1 19 13 32 35 36 Homicide 1 - - - - - 1 2 3 - - - - - - - 5 2 7 36 All Causes 65 44 7 7 8 5 16 11 58 40 406 211 349 297 404 652 1313 1267 2580 Totals 109 14 13 27 98 617 646 1056 2580 Percentages 4.23 0.54 0.50 1.05 3.80 23.91 25.04 40.93 100 10 COMPARATIVE VITAL STATISTICS - 1947 TO 1959 (Compiled from Registrar-General's Returns) 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 Population 223,400 225,800 227,800 228,300 228,800 230,500 233,500 235,300 235,800 238,200 239,580 238,200 236,840 Live Births - (Total) 4,972 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) 557 494 467 402 340 336 296 282 285 302 318 331 431 Birth Rate per 1,000 population 22.3 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 19.52 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 2,580 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 11.55 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 1.18 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 22 23 21 21 26 17 24 22 28 29 27 35 32 Marriage rate per 1,000 population 21.51 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) 1.67 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. 0.10 0.14 0.12 0.15 0.20 0.16 0.16 0.30 0.30 0.38 0.52 6.66 0.70 Diphtheria Nil Nil Nil Nil Nil Nil Nil Nil 0.004 0.004 0.008 Nil 0.004 Neoplasm of Lung, Bronchus & Trachea 0.77 0.68 0.67 0.62 0.52 0.53 0.57 0.54 0.54 0.54 Nil Nil Nil Suicides 0.14 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 0.13 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 0.25 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 19 59 (Based on Registrar General's Returns) Primary Cause of Death Under 1 day Days Weeks Months 1959 (1958) 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 1 1 Meningococcal Infection 1 1 Tuberculosis - Lungs 1 1 Tuberculosis - Other form Bronchitis 1 1 2 (4) Pneumonia 1 1 1 2 2 1 1 2 3 1 1 16 (19) Influenza Enteritis and Diarrhœa 1 1 (2) Premature Birth 13 2 1 16 (9) Congenital Malformation. Birth Injury, Atelectasis Atrophy and Marasmus 26 11 4 3 1 4 3 1 4 3 1 61 (57) Syphilis Suffocation Overlying 1 1 Violent Causes 1 1 1 l 1 5 (1) Road Traffic Accidents All Other Causes 1 1 1 1 4 (15) TOTALS 39 14 5 4 1 1 5 3 3 6 6 3 3 4 5 1 1 l 2 2 109 (107) 12 COMMENTS ON VITAL STATISTICS Births Since 1955 both the number of births and the birth rate have increased year by year The trend continued in 1959 and with 4 972 births and a birth rate of 22 3 both figures are the highest since 1947 - the year of the post war bulge Although the Islington rate is rather above the National the increase is in line with the tendency throughout the country. The increase in the number of births to this extent which may well continue so far as can be seen into the immediate future must have many important effects The larger population resulting from the post war bulge is not something for which temporary provision must be made for example in the schools but its effects may well be spread over a much longer period than was thought likely only a few years ago when the birth rate was falling after the post war rise 11 20 per cent of all 1959 births were classified as illegitimate Population 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 54,400 181,200 235,600 408,800 644,400 Islington 4,800 14,300 19,100 29,600 48,700 Deaths The death rate at 11 56 per thousand population was only very slightly above that of 1958 (11 49) The distribution of deaths by causes however was somewhat different from the previous year there being more deaths from respiratory causes including lung cancer than in the previous year This will be separately commented on The effect of seasonal influences is again shown in the following table of deaths due influenza pneumonia and bronchitis Under 1 year 1 - 44 45-54 55-64 65-74 75+ Total January 4 6 3 10 22 31 76 February 2 4 11 33 36 68 154 March - 1 6 9 22 39 77 April 1 - 3 2 10 8 24 May 1 1 1 1 3 6 13 June 3 - 1 1 7 7 19 July - - - 4 4 6 14 August - 1 - 1 3 9 14 September 2 1 - - 4 9 20 October 1 - - 2 - 7 10 November - - 1 2 5 13 21 December 1 1 1 6 7 20 36 13 Deaths of infants under one year The infant mortality is, at 22 per thousand live births fractionally lower than in 1958 when the rate was 23 per thousand 36 per cent of all infant deaths occurred within the first 24 hours following birth and 59 per cent within seven days of birth Prom one to twelve months the greatest risk to infants is due to respiratory disease particularly pneumonia Of a total of 34 infant deaths in the age group one to twelve months 11 were due to pneumonia Respiratory Tuberculosis The downward trend continued in 1959 The 23 deaths due to this cause during the year are the lowest on record The mortality return must of course be considered in conjunction with the incidence of new cases and this aspect gives no cause for excessive complacency Malignant growths of lung and bronchus Deaths due to malignant growths of lung and bronchus have continued to increase in 1959 quite contrary to the position with tuberculosis of the lungs The total of 171 deaths in the year as will be seen from the table following is the highest on record It will also be noted from the table that the increase is due almost entirely to the increase in male deaths Comments have been made in this Report every year for the past few years on the relationship between the increase in malignant disease of the lung and bronchus and prolonged and heavy smoking of cigarettes The evidence on this relationship has been accepted by the Ministry of Health for some years although it is still not universally accepted but it can be said that as time goes on the new evidence which comes to light gives more and more weight to the officially accepted relationship particularly is this the case with new enquiries which are being completed abroad It is unfortunate that there is at present no reason to think that teenagers including those at school have refrained on health grounds from smoking to any greater extent than previously It therefore seems most likely that the evidence on smoking and lung cancer will continue to accumulate for many years to come 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 1959 145 26 171 Accidents The following table gives the deaths from accidents to Islington residents from 1952 onwards 1952 1953 1954 1955 1956 1957 1958 1959 Motor vehicle accidents 18 18 19 33 29 21 30 30 Other violent accidents 48 46 40 50 51 52 40 55 14 In the following table causes of accidental deaths in 1959 are analysed, in their respective age groups. Type 0- 1- 5- 15- 25- 45- 65- 75+ M. F. Total Motor Vehicle Accidents - - 2 3 6 9 5 5 18 12 30 Falls 1 2 - - 1 3 2 17 12 14 26 Accidental Poisoning (Solid, Liquid Gases and Vapours) - - - 1 - 2 3 8 5 9 14 Drowning - - - - - 1 - - - 1 1 Fire - 1 - - - - - 3 1 3 4 Inhalation of Stomach contents, ingestion of food, etc. 1 - - - - - - - 1 - 1 Others (Railway Accidents, etc.) 3 - 1 - 2 1 - 2 8 1 9 Total 5 3 3 4 9 16 10 35 45 40 85 Fatalities due to motor vehicle accidents were the same as in 1958 Other fatal accidents however were increased by 15 the increases being due more particularly to falls (an increase of 5) and accidental poisoning (an increase of 8) 15 SECTION B. PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES Notifiable Infectious Diseases and Deaths during the year 1959. 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 244 (272) - 25 242 17 Diphtheria 48 (6) - 47 9 - Enteric Fever (including Paratyphoid) 17 (3) - 11 9 5 Typhus Fever - - - - - Puerperal Pyrexia 312 (329) - 307 308 - Ac. Primary & Influenzal Pneumonia 108 (112) 6 7 108 - Ophthalmia Neonatorum 58 (29) - 53 58 - Acute Encephalitis 3 (3) 1 3 3 - Meningococcal Infection 4 (8) 3 3 5 3 Anthrax - - - - - Dysentery 329 (831) - 22 316 72 Malaria - - - - - Erysipelas 29 (31) - 5 28 3 Measles 1,360 (2,965) 1 67 1,382 81 Whooping Cough 165 (116) 1 28 158 20 Ac. Poliomyelitis 96 (28) 7 96 59 1 Food Poisoning 164 (183) - 22 158 215 Tuberculosis - Lungs 355 (457) 23 - 252 - Tuberculosis - Other Forms 19 (23) 2 - 14 - Scabies 73 (112) - 5 74 181 (Figures in brackets are notifications for 1958). Domiciliary Visiting of Infectious Disease Cases and Contacts - No. of Visits Smallpox 22 Measles 1,469 Scarlet Fever 253 Whooping Cough 186 Diphtheria 715 Acute Poliomyelitis 387 Enteric Fever (including Typhoid and Paratyphoid) 23 Food Poisoning 250 Meningococcal Infection 5 Scabies 198 Dysentery 411 Vermin 532 Malaria - Influenza - Acute Encephalitis 4 Ineffective Visits 1,280 Erysipelas 32 Others 66 Total 5,833 16 Smallpox Information was received on 16th May of five crew members and two passengers of the S.S. Ivernia, contacts of a case of suspected smallpox, who were proceeding to addresses in Islington. Regular daily visiting of these contacts was made until further information was received that the diagnosis of the suspected case had been corrected to chicken pox 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* 1959 2,692* (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 - Authentication - Ministry of Health Circular 60/48 Applications for authentication to be dealt with by the Medical Officer of Health numbered 740 as against 743 for the previous year The applications comprise requests for authentication of International 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 Measles The number of measles cases in 1959 was the lowest for many years with the exception of 1954. As will be seen from the chart, most of the cases occurred in the winter and early spring, with a moderate secondary rise about mid-summer. There were very few cases in the second half of the year. The following table shows the age-groups of the notified cases during 1959:- Under 1 year 1 - 5 5 years and upwards No. of Notifications in 1959 72 841 447 Percentage of total Notifications 5.3 61.8 32.9 No. of Deaths - 1 _ 18 Whooping Cough In 1958 I reported that the Incidence of whooping cough was the lowest in the Borough since this infection became notifiable in 1939. Although there were rather more cases notified in 1959, the totals in each of the last two years are less than in any previous years. Very substantial numbers of children have now been immunised against whooping cough and since this is the only new factor which has been introduced within recent years it is reasonable to assume that mass protection of young children against whooping cough is now beginning to show definite effects. Under 1 year 1 - 5 5 years and upwards No. of Notifications in 1959 34 86 45 Percentage of total notifications 20.6 52.1 27.3 No. of Deaths 1 - - 19 Fatality Bates per 1,000 notifications each age group (1950-1959) Percentage of notifications (1950-1959) Under 1 1-5 5 & upwards Under 1 1-5 5 & upwards Measles 2.14 0.30 0.11 4.0 57.0 39.0 Whooping Cough 5.39 1.51 - 12.1 54.0 33.9 Over the ten-year period 54 per cent of all cases of whooping cough and 57 per cent of all cases of measles were in children one to five years of age (hooping 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 6,612 Completed cases 2,348 London (Measles and Whooping Cough) Regulations, 1938. Home visiting of measles and whooping cough cases was carried out by the Home Visitors as under:- Measles No. of Investigations Re visits Whooping Cough No. of Ineffective Visits 1,464 184 334 7 Acute Poliomyelitis In the spring of 1959 cases of poliomyelitis were reported which heralded the beginning of an outbreak which was extremely local in character particularly in the early stages which rose to a crescendo within a few weeks of the first reported cases and then gradually eased off so that the outbreak, as such, could be considered over by August The total number of cases was unfortunately, the highest experienced since 1949 which with 62 cases, is the highest on record for the Borough The increase in 1959 cases was exceptional in that it was neither part of a National nor even a general London increase as in other high incidence years and it was also exceptional in that the increase occurred earlier in the year as compared with any previous similar occasions The very localised nature of the distribution of cases and the order in which they arose can be seen by reference to the map facing this page which sets them out according to the week of the year when the illness first commenced. When it became apparent in the early stages that the number of poliomyelitis cases being reported was somewhat exceptional, arrangements were made to issue regular reports which could be used by the local and National Press. Before this routine became recognised by the Press representatives were inclined to telephone at any hour of the day and even during the evenings to obtain the latest on the polio situation sometimes making detailed and personal enquiries which could not always be answered and which were not always relevant to the poliomyelitis outbreak When the routine reports became recognised as an established practice however it was accepted by all, or practically all, and the Press accepted the weekly situation report on the total number of new cases, any exceptional points, etc., and this information was issued on the same day and at the same time each week These reports were issued under the joint signatures of the Borough Council's Medical Officer of Health and the Divisional Medical Officer of the London County Council 20 Family practitioners, local hospitals and neighbouring Medical Officers of Health were kept informed by a weekly bulletin, sometimes issued as a special supplement to the routine weekly infectious diseases bulletin which had been sent out for some years previously Domiciliary contacts found to be due for operative procedures within the possible incubation period and expectant mothers similarly placed were reported to practitioners hospitals and local health authority midwives, etc. as appropriate, and this included cases due for E N T operations and large-scale dental extractions No general public restrictions were put into effect but schools were advised to refrain from arranging swimming galas Advice was given to the Baths Departments of the local authorities to maintain the maximum tolerable chlorination although again no restrictions were imposed on school children's attendance by classes at swimming pools The only personal restriction imposed was the exclusion from employment of contacts (some found bacteriologically positive) working as food handlers or as school or day nursery staffs After the outbreak had been in progress for some weeks a meeting was arranged under the auspices of local Divisions of the B M A to which all practitioners in the area were invited and at which the main features of the outbreak were reported upon by hospital Consulting staff Public Health Laboratory Service and Medical Officers of the County Council and Borough Council Throughout the whole period of this outbreak there was the closest possible co-operation between the Department, London County Council Health Division 3 the Public Health Laboratory Service, family practitioners and the Hospitals Seven of the cases had had two polio inoculations at some time prior to onset and were therefore presumed to have some degree of immunity but not sufficient for complete protection Since it was estimated that approximately half of the children under 15 years at the period of the outbreak had been immunised (with two but not with three injections) it will be apparent that there were many more cases in those who had not been immunised than in those immunised and this gives some measure of the protection afforded even with two inoculations Of the fatal cases none had had any poliomyelitis vaccine inoculations Every home where cases occurred or where information of a contact was received was of course visited by the Department s staff and investigation was also undertaken in conjunction with the Public Health Laboratory Service of contacts who might be carriers of the virus In all. 238 contacts were examined of whom 66 were found to be temporary symptomless carriers of poliomyelitis virus Appropriate supervision and exclusion measures were put into effect dependent upon the particular circumstances of the carrier. No. Reported No. CONFIRMED 1959 109 60+ 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 + Includes a case notified posthumously and not included in Registrar General's Tables * Two cases, with onset in December, 1956, were notified in 1957, and are included in the above returns 21 Onset dates Jan. Feb. Mar. Apr. May. June. July. Aug. Sept. Oct. Nov. Dec. 1959 - - 1 3 23 18 10 1 1 2 1 - 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 - - - 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 12 - 2 1 1950 1 - 1 - 2 2 1 0 1 0 1 2 2 Age distribution: Under 1 year 1 - 5 - 15 - 25 and over 1959 2 27 24 2 5 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 Deaths: 1959 6 1958 Nil 1957 1 (7 years) 1956 Nil 1955 3 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. (1¾ years, 6 years, 2 of 11 years 24 years 28 years,22 years - the latter contracted outside the borough and not included in the above tables) (17½ years 30 years and 5 years the latter contracted outside the borough, and not included in the above tables.) * Two cases, with onset in December, 1956, were notified in 1957, and are included in the above returns Protection against Poliomyelitis Protection against poliomyelitis is given at all Welfare Centres in Islington under arrangements made by the L.C.C. "Open Sessions" are held and attendance at these is not restricted by place of residence, hence it is not possible to give the number of Islington residents who have attended. The following figures show the numbers of persons who have been protected at sessions in 1959 in the whole of the Division comprising the areas of the Boroughs of Finsbury, Holborn and Islington Age groups Second injections given Third injections given 0-4 8,977 8,257 5-15 8,909 12,903 16 - 25 20,996 11,025 Others 2,651 1,003 Totals 41,533 33,188 22 Diphtheria Cases and Deaths - 1927 - 1959 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 _ 1959 48 9 _ 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 1959 103 75 9 It will be seen from the above tables that both the County of London and also Islington had more confirmed cases of diphtheris than for many years past In fact, so far as Islington is concerned, the nine cases diagnosed in the year have not been exceeded since 1951 Fortunately the illness was relatively mild in all concerned and none of the cases had a fatal issue All nine patients were children of school age and between them attended five schools including one in the Borough of Finsbury. All the cases occurred in the autumn of 1959. Following the occurrence in the earlier part of the year of cases of diphtheria in other parts of London, a discussion was arranged at County Hall on the initiative of the Medical Officer of Health of the London County Council at which Medical Officers of Metropolitan Boroughs were also present and a procedure in detail was considered and set out for operation should there be a further occurrence of this infection. It was fortunate that this discussion and agreement took place before there were Islington cases since it was possible to put the procedure into practice immediately. The objective of this particular procedure was not only to detect cases of diphtheria and deal with them as soon as symptoms occurred but to eliminate all possible sources of infection and eradicate as far as possible the chances of others contracting the illness. 23 With this objective in view, children at school were examined and swabbed on a fairly large scale through the School Health Service and the same procedure was applied to contacts at home by the Borough Council staff. The department’s Infectious Disease Visitors paid over 600 visits to the homes of cases, carriers, school absentees etc. Arising out of all these examinations 36 carriers of the diphtheria bacillus were discovered and suitable measures taken, including reference of the majority to be dealt with more appropriately in hospitals It is considered that these measures, although they entailed much work since it was important that all examinations carried out should be done within the shortest possible time of a case with symptoms occurring, proved their value in that the isolated case or small groups did not give rise to secondary cases which might otherwise have occurred. Measures were also taken by the London County Council to improve the acceptance of immunisation against diphtheria None of the cases with an immunisation history had had recent protection and this would appear to emphasise the importance of a booster dose during school life or immediately prior to it where diphtheria immunisation has been carried out during infancy. Diphtheria Cases and Immunisation state 1947-1959 (inclusive) Year IMMUNISED NON-IMMUNISED Unknown Total Deaths Age Groups Age Groups 0 - 5 5-15 15† 0 - 5 5-15 15 † 1959 _ 6 _ _ 3 _ _ 9 Nil 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 yrs not imm 1950 _ 5 _ 3 7 4 _ 19 7 yrs not imm 1949 1 3 _ 2 8 3 _ 17 4 yrs not imm 6 yrs 1948 1 2 1 1 _ 2 _ 7 Nil 1947 _ 5 1 2 4 5 2 19 16 yrs - not imm 3 25 3 16 27 17 5 96 5 deaths (None immunised) 31 60 Diphtheria Immunisation, 1959 Dr Wilfrid G Harding. Divisional Medical Officer London County Council has kindly supplied the following figures in respect of Islington 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 by general practitioners and in L C C Welfare Centres and Schools. This is consonant with the Immunity Index given by the Ministry of Health Age at 31 12 59 i.e. born in year Under 1 1959 1 - 4 1958 55 5-9 1954 50 10 - 14 1949 45 Under 15 Total Last complete course (whether primary or boost) 1955-59 704 9,772 8,274 7,424 26,174 Mid-year population 4,800 14,300 29,600 48,700 Immunity Index 14.6 68.3 53.0 53.7 24 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 1959 164 In accordance with Circular 2/50 of the Ministry of Health the following table summarises the outbreaks of food poisoning and the character of each outbreak Date No of Notifications No of persons served No of cases reported No of deaths Foods involved and Organisms responsible 1. 24. 4. 59 12 250 92 Nil Fresh Egg Salad, Corned Beef Pilchards Luncheon Meat Salad, Apple Pie: Salmonella Typhi murium 2. 14. 6. 59 — 345 52 Nil Bacon Clostridium Welchii 3. 9. 7. 59 2 337 89 Nil Pressed Veal Clostridium Welchii 4. 25. 9. 59 2 53 8 Nil Omelette & Chips Chocolate Pudding with Blancmange dressing Staphylococcus Pyogenes 1. This was an occurrence at a school which mostly affected children in the Infants and Junior Departments. The duration of the illness was in general 2 3 days of moderate severity It was considered that in the circumstances of this outbreak the initial cases were probably due to consumption of food infected with salmonella typhi murium but subsequent cases were probably due to case to case contact. 2. This was a school occurrence which affected three teachers as well as children who reported sick. The duration of the illness was up to five days and of moderate severity Clostridium Welchii was recovered from stool specimens from children and staff but it was not possible to examine the suspect meat dish as this had all been consumed In any event in view of the nature of this organism the food would have appeared to be perfectly normal. 3. This was a school outbreak in which those taken ill included eight members of the teaching staff, four members of the kitchen staff and the remainder children The duration of the illness was 1-3 days of varying severity and since the food poisoning organism was Clostridium Welchii which was found in the stool specimens and also in the pressed veal there would have been nothing in the appearance or flavour of the meat to indicate the presence of this organism. 4. Occurrence at private school The onset of illness was rapid i e within three hours of the suspected meal and with moderate or severe symptoms although not lasting in any case more than approximately eight hours The meals for this school are prepared at a local restaurant and delivered in bulk in containers The organism as reported in the above summary was recovered from the food samples but not from any of the patients. 25 Typhoid and Paratyphoid Fever There was an unusual number of enteric fever notifications during the year One was a case of typhoid fever but the remainder, 13 confirmed cases were paratyphoid (infection with salmonella typhi B). A five-months-old infant admitted to hospital was found to be suffering from this infection and examination of contacts disclosed that the father was a carrier of the same germ He was engaged in the sale of confectionery and ice cream and was excluded from carrying out such work by notice served under the Public Health (Infectious Diseases) Regulations 1953 He continued to be excluded until negative stool specimens were obtained. Another four-months-old infant, also suffering from this infection was found to be associated with three adult carriers, including the child's mother. Two other adult cases were resident in the same house and the remainder were isolated cases occurring in adults. The original source of infection was not traceable in any of the reported cases or discovered carriers. The typhoid fever case was a ten year-old girl of Italian origin who had recently visited Italy and possibly contracted the infection there Pour of the contacts of this case were food handlers working in other areas and the respective Medical Officers of Health were informed for appropriate action to be taken. Dysentery The incidence of dysentery in 1959, with under 400 cases was considerably lower than in 1958, when there were over 1,000 cases. The majority of the dysentery cases during the year were isolated or comprised small family or domiciliary outbreaks with relatively small groups in day nurseries and a Welfare Home. It will be seen from the table on page 26 that approximately one-third of those affected were under the age of five years and another third of school age Ten cases were found to be employed as food handlers and another group of contacts were engaged as food handlers. Supervision and exclusion measures were instituted as necessary. 26 DYSENTERY IN ISLINGTON - 1959 Month 1959 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 January 40 M 16 6 36 3 5 11 - 3 - - 1 2 1 25 15 F 13 5 -- 4 9 1 3 - 1 February 43 M 15 2 27 - 5 8 1 1 1 1 - 3 - 21 22 F 25 1 1 7 9 2 5 - 2 March 50 M 28 5 40 - 5 9 1 3 2 13 1 4 - 14 21 F 15 2 1 4 8 1 2 1 - April 52 M 27 2 38 1 6 11 - 6 - 5 1 3 - 14 33 F 18 5 1 7 7 1 5 1 1 May 79 M 34 4 49 2 11 13 3 5 2 2 6 4 3 25 52 F 32 9 3 8 12 4 9 2 3 June 26 M 10 3 7 1 4 4 1 1 2 - - 2 - 21 4 F 13 - - 4 5 - 3 1 - July 25 M 7 3 12 2 4 1 1 1 - 1 1 - - 9 15 F 8 7 1 3 4 2 3 2 - August 15 M 9 - 8 2 3 2 1 1 - -_ - - - 4 9 F 6 - - 2 1 - 3 - - September 11 M 4 1 2 - 3 2 - - - - - - - 8 3 F 6 - - 2 1 - 3 - - October 16 M 9 1 7 - - 6 4 - - - -- 5 - 7 7 F 3 3 - 1 2 2 - 1 - November 19 M 7 2 6 - 4 2 - 3 - - - 2 - 8 10 F 10 - - 7 1 1 1 - - December 18 M 4 3 14 1 2 3 - 1 - - - 4 - 7 11 F 3 8 2 2 4 1 1 1 - Total 394 M 170 32 246 21 103 135 27 63 16 29 10 29 4 163 202 F 152 40 27 Tuberculosis The increase in the number of new cases of tuberculosis of the lungs which occurred in 1958 was fortunately not repeated in 1959. There was a substantial drop in the number of those found suffering from this infection, but nevertheless close on 400 new cases represents a very substantial volume of long-term sickness. Among men the proportion of new cases is fairly evenly distributed over all age groups from 15 years onwards In women, however, the greatest proportion of new cases are in young adult life, i.e. between the ages of 15 and 35. It is obvious that a breakdown in health of young women many of whom must be mothers of young children, is a most serious matter for the family. A similar consideration, of course, applies to men who may be breadwinners for the family and who because of the long period of treatment required, may have their earnings substantially reduced temporarily or even permanently. In the case of men there is also the added family risk of the elderly person with a chronic cough who has not sought medical advice as early as he should have done and who may have unwittingly exposed others to his infection during this time. New Cases and Mortality during 1959 Ages NEW CASES DEATHS Respiratory Non-Respiratory Respi ratory Non Respiratory M. F. M. F. M. F. M. F. 0 - 1 2 - 1 - 1 - - 1 - 4 8 1 - - - - - 5 - 5 8 1 - - - - - 15 - 30 37 - 1 - - - - 25 - 53 29 6 5 - - - 1 35 - 36 16 2 - 1 1 - - 45 - 37 7 - 1 2 - - - 55 - 41 10 - 1 5 2 - - 65 and upwards 36 11 1 2 11 3 - - Total for all ages 243 128 11 11 19 7 - 1 393 27 Bates per 1,000 population: New cases : pulmonary 1.66 non-pulmonary 0.10 Deaths : pulmonary 0.12 non-pulmonary 0.004 Public Health (Tuberculosis) Regulations, 1952. Although information in regard to the coming and going of tuberculous patients under these Regulations is not as complete as it was under the Tuberculosis Regulations 1930 every effort is made to confirm the correctness of the Register still maintained in the Department. The total number of cases on the Register of the Department as at 31st December 1959 was - Pulmonary Males 1,585 Females 1,201 Non-Pulmonary Males 132 Females 156 3,074 28 The corresponding figures for previous years are:- 1958 3,172 1957 3,108 1956 3,048 1955 2,945 1954 2,922 1953 2,802 1952 2,575 1951 2,404 1950 2,368 1949 2,490 Islington Chest Clinic, Whittington Hospital St Pancras Chest Clinic, Margaret Street St Marylebone Mass X-Ray Unit of the North-West Metropolitan Regional Hospital Board 32, Drayton Park,N.5. The Borough is well and conveniently served by the above centres to which patients may be referred or where persons may attend for examination. Cases on Chest Clinic Registers Pulmonary Non Pulmonary Total Adults Children Adults Children Adults Children M. F. M. F. M. F. M. F. M. F. M. F. Number of definite cases of tuberculosis on Chest Clinic Register as at 31st December, 1959 Islington C C 1225 857 48 61 41 72 4 8 1266 929 52 69 St Pancras C C 138 90 7 6 5 1 - 1 143 91 7 7 1363 947 55 67 46 73 4 9 1409 1020 59 76 Grand Total 2564 The corresponding figures for previous years are:- 1958 2,735 1957 2,818 1956 2,772 1955 2,751 1954 2,851 1953 2,738 1952 2,575 1951 2,443 1950 2,238 1949 2,127 The Static X-Ray Centre still continues to perform a valuable survey of persons who may or may not have any symptoms and the following information in respect of Islington residents has been kindly furnished by Dr Brett the Medical Director of the X Ray Unit:- Male Female Total No of persons X-rayed 5443 7061 12504 No. of cases 54 23 77 Rate per 1,000 10 3.2 6.1 29 Tuberculosis Care Committee The London County Council is responsible for care and after care work under Section 28 of 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 Tuberculosis Care Organiser reports that an average of 114 cases per quarter were helped with extra nourishment during the year, while loans of beds, bedding and medical appliances were made to 11 patients from the L.C.C. loan stock, others were referred to various organisations for assistance. The Care Committee administers an occupational therapy service with occupational therapists employed by the L.C.C. The following figures illustrate the extent of the service provided:- No. of weekly classes at end of year 1 No. of patients in class 9 No. of sessions of instructions in homes during last week of year 16 No. of patients receiving instruction at home 55 Respiratory Infections In February, 1959, information was received of a considerable prevalence of respiratory illness. In accordance with an extremely useful arrangement with the Ministry of Pensions and National Insurance, information from local offices is passed to the Medical Officer of Health whenever there may be an unusual increase in sickness certification Such information was first received for the week ended 12th February, when sickness claims had increased to 260 per cent. of the weekly average and were still tending to rise. In the following week the claims actually rose to 380 per cent. of the average and the majority of claims were made on account of various respiratory conditions, e.g. colds, influenza, bronchitis, etc. In the latter part of January there were several recurrent fogs and quite a severe smog"' episode on 29th January, although it was of relatively short duration The atmospheric pollution figures were several times above average. Other confirmatory information was also received through the notifications of acute influenzal and acute primary pneumonias Deaths due to influenza pneumonia and bronchitis also increased and the changes over the four-week period in January/February 1959 are set out in the following table:- Week ended Noti fications Acute Influenzal & Acute Primary Pneumonia DEATHS Influenza Pneumonia Bronchitis Other Respiratory Total 31. 1. 59 2 - 9 8 1 18 7. 2. 59 4 2 13 15 1 31 14. 2. 59 10 1 7 15 1 24 21 2. 59 18 7 19 24 2 52 30 The age groups of the notified cases and deaths are set out below:- Age Group Notifications Acute Influenzal & Acute Primary Pneumonia DEATHS Influenza Pneumonia Bronchitis Other Respi ratory Total 0 - _ _ 2 _ _ 2 1 - 2 _ 1 _ _ 1 2 - 4 _ 1 _ _ 1 5 - 5 _ _ _ _ _ 15 - 1 2 _ _ _ 2 25 - 3 _ 1 _ 1 2 35 - 4 _ _ 1 _ 1 45 - 5 1 3 4 _ 8 55 - 5 _ 7 16 1 24 65 - 4 1 9 17 2 29 75 † 1 6 24 24 1 55 Totals 34 10 48 62 5 125 It will be noted from these tables that the notifications were spread fairly evenly throughout all ages. The fatal cases of respiratory illness however were heavily weighted in the old age groups, particularly above the age of 55. Scabies and Vermin There is still a considerable number of cases of scabies or itch as will be seen from the number of children of all ages and adults treated at the Department s Treatment Centre Greater attention to personal hygiene would reduce the likelihood of this infestation It is evident that the standard of hygiene and personal cleanliness in some homes leaves something to be desired although it must be remembered that the greater number of houses in Islington are still without a bath, and a similar scarcity applies also to wash basins with hot and cold running water for personal washing apart from the use of the kitchen sink The majority of cases of vermin infestation are, of course infestation with head lice and again, a better standard of personal cleanliness would result in fewer cases. Scabies Vermin Children under 5 years Number treated 40 33 Number of baths given 65 - Number of treatments - 33 L C C. Children Number treated 62 423 Number of baths given 132 - Number of treatments - 423 Adults Number treated 143 79 Number of baths given 299 - Number of treatments - 85 31 Hone 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 132 - 174 306 Vermin 330 5 343 678 Bacteriological Examinations All specimens for bacteriological examination dealt with through the Department are submitted to the Public Health Laboratory Service, County Hall, S.E.1 Examinations carried out Total Swabs (Diphtheria) 1,651 Sputum (Tuberculosis) 36 Faeces (Enteric Fever) 222 Blood (Enteric Fever) 3 Faeces (Food Poisoning) 588 Food (Food poisoning) 12 Faeces (Dysentery) 2,126 Faeces (Poliomyelitis) 470 Swabs (Streptococci) 451 Swabs (Pertussis) Swabs (Influenza) Smears (Variola) Scrapings (Variola) Other Specimens 57 Total 5,616 (I am indebted to Dr. Wilfrid G. Harding, Divisional Medical Officer, London County Council, for the 1959 figures in connection with vaccination, diphtheria and whooping cough inoculations, and chest clinics). 32 SECTION C SANITARY CIRCUMSTANCES OF THE AREA (In conjunction with Mr W C Bartlett, Chief Public Health Inspector) Improvements to properties in the Borough continue and many private owners are availing themselves of the financial inducements which are offered to them in the respective legislation Added to the already existing discretionary grants which a local authority may pay the House Purchase and Housing Act, 1959, which came into force in June this year set up a new system of standard grants The distinctive features of the new system are that these grants are payable only in respect of the provision of specified standard amenities and on the expenditure actually incurred for the purpose and provided that certain conditions are satisfied the owner of the property can claim the grant as a right Many improvements are evident in the Borough consequential to the closing of individual unfit houses or parts of hpuses the clearance of certain unfit areas and the reconditioning of property Redevelopment has taken place in various parts of the Borough and both the County and Borough Councils have been active in this field This has been supplemented by the purchase of a number of properties by the Borough Council many of which have been taken over upon release from requisition A number of privately owned flats and other dwellings have been modernised or converted the owners having availed themselves of the improvement grant to which they are entitled. By virtue of the London County Council (General Powers) Act 1959 movable dwellings will be controlled after 31st September 1960 After that date no person shall use or knowingly cause to be used as a site for movable dwellings subject to certain exceptions any land occupied by him unless he holds in respect of the land so used a licence granted by the London County Council. The statute also provides that after 31st March 1960 every specified building shall be provided with refuse accommodation approved by the Borough Council and in considering as respects any such building where reasonable accommodation is or is not provided or proposed regard shall be had to the character and situation of such buildings. With the object of bringing the London area into conformity with the provinces Metropolitan Borough Councils are now empowered subject to certain exemptions to require by notice the owner or occupier of any inn refreshment house or place of public entertainment in the Borough to provide and maintain in a suitable position such numbers of sanitary conveniences for the use of persons frequenting the premises as may be reasonable. During the year the Minister of Education made The Standards for School Premises Regulations These replace the existing regulations and whilst no significant changes in the basic standards have been introduced some of the requirements have been made’more flexible to allow increased freedom and experiment in design and construction Whilst the regulations are not enforced by the Borough Council it is highly desirable that the standards laid down should be complied with. The shortage of Public Health Inspectors continues and therefore thanks are due to the existing staff who have co-operated to the full in order to ensure as much as possible that the service to the public is maintained. Summary of Work done by District Public Health Inspectors (i) Inspections Houses/flats inspected under Public Health (London) Act 1936 3,931 Separate lettings in (1) 7,247 Revisits - Houses/flats 10,818 Separate lettings in (3) 19,675 33 (ii) Other inspections and visits Miscellaneous 2,645 Prevention of Damage by Pests Act 145 Infectious Diseases 358 National Assistance Act (Aged & Infirm) 87 Factories Act 1937 - Outworkers 930 Shops Act 1950 2,249 London County Council (G.P.) Act Hairdressers and Barbers 340 Pet Animals Act 1951 75 Heating Appliances (Fireguards) Act and Regulations 84 Noise Nuisances 20 Food Premises 226 Non-effective visits 3,322 (iii) Nuisances and Notices Notices served (Public Health (London) Act) (a) Intimation 2,164 (b) Statutory 1,119 Notices complied with (Public Health (London) Act) (a) Intimation 1,612 (b) Statutory 1,137 Nuisances found 5,513 Nuisances abated 7,796 Number of houses improved 2,486 Separate lettings in above 2,741 Total number of improvements to dwelling houses 7,763 (iv) Legal Proceedings Informations laid 65 Abatement Orders made by Magistrate 17 Abatement Orders complied with 24 Further Proceedings for disobedience of Abatement Orders (includes second and third application) 16 (v) Drainage Plans examined 352 Examinations and Tests 480 (vi) Complaints Outstanding (at end of 1958) 195 Received during the year 3,901 plus 351 repeated complaints Dealt with during year 3,648 Outstanding (at end of 1959) 448 (vii) Land Charges Act, 1925 Enquiries received 2,994 Properties involved 4,051 Investigations 4,051 34 (viii) Rent Act, 1957. Applications for Certificates of Disrepair. (1) Number of applications for certificates during 1959 88 Number of applications brought forward from 1958 29 Number of applications carried forward to 1960 2 Total number of applications receiving attention 1959 115 (2) Number of decisions not to issue certificate 3 Number of Undertakings on Form 'K' accepted 53 (3) Number of decisions to issue certificates 57 (a) in respect of some but not all defects 34 (b) in respect of all defects 23 (4) Number of Undertakings given by landlords under paragraph 5 of the First Schedule 58 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the Schedule ( †1 C/F. to 1960) 4 (6) Number of certificates issued where undertakings not accepted 4 Applications for Cancellation of Certificates. (7) Applications by landlords to Local Authority for cancellation of certificates 61 Number of applications brought forward from 1958 6 Number of applications carried forward to 1960 1 Total number of applications receiving attention 1958. 66 (8) Objections by tenants to cancellation of certificates 34 (9) Decisions by Local Authority to cancel in spite of tenant’s objection 10 (10) Certificates cancelled by Local Authority 42 Applications by Overseas Companies for Certificates of Repair. Applications received Nil Certificates issued Nil (ix) Improvements effected as a result of Service of Notices under the Public Health (London) Act. 1. Brickwork - walls repaired or rebuilt 28 2. Drains cleared, repaired, etc. 350 3. Dampness remedied 1,603 4 Fireplaces and ranges repaired/renewed 147 5. Floors repaired 407 6. Flues repaired 60 7. Internal walls repaired 768 8. Ceilings repaired 551 9. Rainwater pipes/gutters repaired 302 10. Roofs repaired 645 11. Rooms cleansed 9 12. Sinks provided 10 35 13. Soil pipes repaired and renewed 87 14. Staircases or passages cleansed 6 15. Staircases repaired 124 16. Waste pipes repaired 161 17. Water Closet Apartments cleansed 9 18. Water Closet Pans and Traps renewed 73 19. Water Closets - flushing apparatus repaired or renewed 128 20. Water Closets - general repairs 244 21. Water supply provided 5 22. Water service pipes repaired 70 23. Window cords renewed 824 24. Windows repaired or renewed 529 25. Miscellaneous improvements 623 TOTAL 7,763 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 £2,756 0s. 5d. during the period under review. This amount is apportioned as follows under the appropriate Acts and Sections:- £ s d Public Health (London) Act, 1936, Section 40 1,755 18 2 Public Health (London) Act, 1936, Section 109 294 18 3 London County Council (General Powers) Act, 1955, Section 25 126 14 5 London County Council (General Powers) Act, 1955, Section 26 - - - London County Council (General Powers) Act, 1955, Section 27 578 9 7 12,756 0 5 An appeal to the Quarter Sessions against the decision of the Local Petty Sessions that the owner should pay £300 towards the cost incurred by the Borough Council in repairing drains at 41 Wray Crescent following the service of a Notice in accordance with the terms of Section 40 of the Public Health (London) Act, 1936, was heard on 17th December, 1959 The respective parties were represented by Counsel. The decision of the Court was to the effect that the owner should pay the Borough Council the sum of £250 plus 15 guineas costs. 36 Legal Proceedings Public Health (London) Act, 1936 Failure to comply with Statutory Notices contrary to Section 82 (No. of cases 40) Date Address Magistrate’s decision 6. 1. 59 23 Cross Street Fined £3 Defendant to pay £1 1s. 0d. costs. do. 10 Bishops Grove Fined £5 Ordered to abate within 14 days. Defendant to pay £1 15s. 6d. costs. do. 12 Bishops Grove Fined £5 Ordered to abate within 28 days. Defendant to pay £1 15s. 6d. costs. 3. 2. 59 22 Wheelwright Street Defendant to pay £1 11s. 0d. costs. do. 64 Goodinge Road Fined £5 Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. do. 47 Kingsdown Road Fined £5 Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. do. 47 Kingsdown Road Fined £5 Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. do. 39 Stanmore Street Summons withdrawn (premises empty). 3. 3 59 29 Mountgrove Road Fined £10 Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 36 Liverpool Road Fined £5 Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. do. 36 Liverpool Road Fined £5 Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. do. 36 Liverpool Road Not separately dealt with. do. 67 Havelock Street Fined £5 Defendant to pay £1 6s. 0d. costs. do. 25 Pulteney Street Fined £8 Defendant to pay £1 6s. 0d. costs. do. 27 Alexander Road Fined £5 Defendant to pay £1 6s. 0d. costs. 7. 4. 59 179 Barnsbury Road Fined £2 Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. do. 41 Mildmay Road Discharged absolutely. Defendant to pay £1 6s. 0d. costs. do. 20 Bishops Grove Fined £2 Ordered to abate within 28 days. Defendant to pay £2 1s. 6d. costs. 5. 5. 59 31 Wolsey Road Absolute discharge Defendant to pay £1 6s. 0d. costs. do. 32 Islington Green Fined £2 Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. 2. 6. 59 63 Leconfield Road Ordered to abate within 14 days. Defendant to pay £1 14s. 6d. costs. do. 16 Baxter Road Ordered to abate within 21 days. Defendant to pay £1 14s. 6d. costs. do. 418 Hornsey Road Fined £5 Defendant to pay £1 11s. 0d. costs. do. 67 Oakley Road Summons withdrawn Work to be done in default under London County Council (General Powers) Act, 1955, Section 27. do. 104 Pembroke Street Work done Defendant to pay 10s. 6d. costs. do. 21 Charlesworth Street Summons withdrawn. Work done. do. 17 Sparsholt Road Fined £2 Defendant to pay £1 6s. 0d. costs. do. 16 Richmond Avenue Case withdrawn. 7. 7. 59 44 Ferntower Road Fined £1 Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 15 Tollington Way Fined £1 Defendant to pay £1 11s. 0d. costs. 37 Date Address Magistrate's Decision 21. 7. 59 421 Hornsey Road Fined 12 Ordered to abate within 28 days. Defendant to pay £.1 15s. 6d. costs. do. 23 Cross Street Fined £1. Ordered to abate within 7 days. do. 23 Cross Street Not separately dealt with. do. 31 Sudeley Street Fined £1 Defendant to pay £1 1s. 0d. costs. 1. 9 59 71 Pembroke Street Fined £2 Defendant to pay 10s. 0d. costs. 3. 11. 59 20 Alsen Road Ordered to abate within 21 days. Defendant to pay £1 14s. 6d. costs. do. 15 Charlton Place Discharged absolutely. Defendant to pay £1 6s. 0d. costs. do 15 Charlton Place Not separately dealt with. do. 67 Cloudesley Road Fined £2 Defendant to pay £1 1s. 0d. costs. 1. 12. 59 9 Elia Street Summons withdrawn Works completed. Failure to comply with Magistrate's Abatement Order (No. of cases: 12) Date Address Magistrate’s Decision 6. 1. 59 31 King Henry Street Fined £10 Defendant to pay £1 1s. 0d. costs. 3. 2. 59 127 Pembroke Street Discharged absolutely. Defendant to pay £1 1s. 0d. costs. 3. 3. 59 14 Bishops Grove Fined £10 Defendant to pay £1 1s. 0d. costs. do 50 Barnsbury Road Fined £10 Defendant to pay £1 1s. 0d. costs. 5. 5. 59 12 Bishops Grove Fined £9 Defendant to pay £1 1s. 0d. costs. do 10 Bishops Grove Fined £9 10s Od Defendant to pay £1 1s. 0d. costs. do. 64 Goodinge Road Fined £5 Defendant to pay £1 1s. 0d. costs. 15. 9 59 36 Liverpool Road Fined £2 Defendant to pay £1 1s. 0d. costs. do 20 Bishops Grove Adjourned sine die. do 63 Leconfield Road Fined £2 Defendant to pay £1 1s. 0d. costs. 6. 10. 59 23 Cross Street Fined £5 Defendant to pay £1 1s. 0d. costs. 13. 10. 59 17 Wolsey Road Discharged absolutely Defendant to pay £1 1s. 0d. costs. Second failure to comply with Magistrate s Abatement Order (Mo. of cases 3) Date Address Magistrate’s Decision 5. 5 59 14 Bishops Grove Fined £20 Defendant to pay £1 1s. 0d. costs. 15. 9 59 10 Bishops Grove Adjourned sine die. do. 12 Bishops Grove Adjourned sine die. Third failure to comply with Magistrate s Abatement Order (No. of cases. 1) Date Address Magistrate’s Decision 15. 9. 59 14 Bishops Grove Adjourned sine die. 38 Disinfection and Disinfestation. (a) General The public are becoming more conscious of insect infestations other than those caused by bugs The advice of the Public Health Inspector is often sought not only in dwellings but in factories and other business premises Number of rooms disinfected after cases of infectious disease 1 242 Number of rooms treated for vermin 1 288 Number of rooms included in the above figure treated for vermin (free) 365 (The majority of free cases were carried out on behalf of the elderly or infirm persons or persons of limited means ) Number of families where effects were treated with D.D.T. as a precautionary measure 174 The department also undertook the disinfection of wards in a number of hospitals on request for co-operation in the control of hospital infection In addition the routine disinfection of pillows and woollen blankets from a hospital in the Borough continued for the purpose of reducing the likelihood of infection particularly for certain types of staphylococcal infection During the year tests were carried out by representatives of the Hospital Medical staff which confirmed the efficiency of the method adopted 2 842 bags containing blankets and pillows were disinfected in accordance with this procedure at an agreed charge Disinfection is basically the use of formalin and steam at atmospheric pressure which does not render woollen blankets unusable after treatment 39 visits were paid by the Public Health Inspector to a factory to supervise the treatment of 175 bales of stockings or other Materials for export The total weight of bales treated was 58 tons 0 cwts 2 qrts 25 lbs In order that the work of disinfection and disinfestation may be carried out with the least possible delay the disinfecting staff were provided with transport by means of scooters and box sidecars By this means work is facilitated the equipment can be conveyed easily the public receive better service and the staff concerned are appreciative of the facilities provided (b) Steam Disinfection 2726 articles of clothing or bedding were steam disinfected (c) Fly and Other Infestations Anti-fly treatment at Ashburton Grove Depot commenced on 4th May and continued during the summer months Disinfestation staff dealt with 16 cases where complaints of wasps nests had been received The Council’s Housing Estates continued to be treated for red clover mite in order to keep the infestation to a minimum 39 (d) Static Water Tanks, Air-raid shelters, Boab Damaged Sites, etc. Although vacant sites in the borough are being re-developed there are still some sites in respect of which complaints continue to be received The tipping of refuse and the accumulation of water in static water tanks still present a problem By arrangement with the Council’s Cleansing Superintendent putrescible matter was removed by his Department upon request from the Public Health Inspector. The co-operation of the London Fire Brigade in pumping out stagnant water is appreciated Warning Notices are 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 361 Visits to air-raid shelters and static water tanks 43 Inspections of derelict buildings 33 War Damaged Sites Act, 1948 Number of Notices displayed 10 (e) Legal proceedings. In accordance with the provisions of the Fifth Schedule of the Public Health (London) Act, 1936, the Court, upon application by the Council, made an Order against the Council to abate a nuisance on a site which had suffered bomb damage - viz 31 Salisbury Road N 19, and which, consequent upon refuse being deposited, was infested with maggots and fly lavae which said matters and the smells arising therefrom constituted a nuisance The Council took this action as no known owner could be traced Atmospheric Pollution. Clean Air Act, 1956. The Minister of Housing and Local Government issued Circular 5 in January in which he stated that he had reviewed the progress made in establishing smoke control areas Although the first response was encouraging he hoped that from now on it would be possible to make faster progress, especially in removing the smoke pall from the black areas where air pollution is worst. He, therefore, asks that Councils in such areas should now consider their domestic smoke problem as a whole (if they have not already done so), decide on the smoke control areas that are needed, in what order of priority they should be made how many years it is likely to take to finish the job; and that they should then prepare a phased programme for establishing smoke control areas for the next five years The Council has therefore approved a 5 year programme, details of which were submitted to the Minister and are shown on the map opposite this page Should the staffing position improve, progress in making smoke control areas will be expedited. Circular 13 was also issued by the Minister in February This dealt with - (i) a leaflet entitled Smoke is your Enemy an explanatory document about smoke and smoke control areas for the information of householders whose dwellings may shortly be included in smoke control areas; (ii) the appointment of Liaison Officers by the British Transport Commission who will be able to give information about plans for the introduction of diesel and electric locomotives and trains, and (iii) the insertion of a new paragraph in the Model Notice in Appendix (ii) to the memorandum on Smoke Control Areas. A survey of the two proposed smoke control areas in the borough being completed the Council made two Orders known as the Canonbury (No.1) Smoke Control Order and the North Islington (No.1) Smoke Control Orders, respectively, and submitted details of the same for confirmation by the Minister of Housing and Local Government. (The Orders have been confirmed by the Minister). 40 In July, the Ministry made the Smoke Control Areas (Exempted Fireplaces) Order and issued Circular 44 relating thereto. This Order exempts, subject to certain conditions, from the provisions of Section 11 of the Clean Air Act, 1956, the following fireplaces:- (i) Fireplaces other than a fireplace fired by pulverised fuel constructed on or after 31st December, 1956, and equipped with a mechanical stoker or adapted on or after that date for use with such stokers; (ii) the fireplace known as the solid fuel Ductair unit, manufactured by Radiation Ltd; (iii) the fireplace known as the Fulgora Slow Combustion Stove manufactured by Fulgora Stoves Ltd. Local Authorities are asked in this Circular to consider the exemption of stoves and furnaces used for burning wood waste, particularly where these are installed on premises used by furniture manufacturers and other users of wood on a large scale. Regular observation ensures that smoke nuisances are kept to a minimum and advice is given by the Inspectors to stokers and managements on the spot regarding efficient stoking and the necessity for adequate instrumentation. Nuisances found to occur when industrial waste is burnt in unsuitable plant are usually dealt with in co-operation with the persons concerned and the Inspectors thus secure the discontinuance of this practice. Complaints are received of nuisances arising from the burning of refuse and bonfires on vacant sites but action is rendered difficult because members of the public are reluctant to give supporting evidence in Court. A prosecution was taken against a Company under Section 16 of the Clean Air Act, 1956, for emitting smoke other than dark smoke, so as to be a nuisance to the inhabitants of the neighbourhood. The factory in question was situated quite close to a block of municipal flats. This case is possibly the first taken in the Metropolitan Area and the Bench made a Prohibition Order for three months and awarded 5 guineas costs. In addition to other work the Company fitted a smoke alarm to their furnace. One laundry where an oil-fired boiler was emitting heavy oily smuts was the subject of repeated complaints. With a view to preventing this nuisance the management carried out metal insulating cladding of the chimney stack As the work has been done only recently it is too early to assess the results. At one Government stores in the Borough complete instrumentation was secured following the conversion of the boilers to oil-firing. One factory in a proposed smoke control area has installed a chain grate stoker on a water tube boiler previously hand-fired. An application for prior approval was granted in relation to the installation of 5 boilers at St. Mary's Wing of the Whittington Hospital. The necessary instrumentation will be provided, including smoke density recorders, C02 recorders and a smoke alarm to each boiler The 5 boilers, all of which will be oilfired, will be contained in one unit and steam will be conveyed to the Archway and Highgate Wings, respectively, by means of steam ducts passing through tunnels, one of which will be under Highgate Hill and the other under Dartmouth Park Hill Observations were kept on goods trains and shunting engines operating between Kings Cross and Finsbury Park It was found that the situation as far as smoke emission was concerned had improved. The pollution of the atmosphere caused by the emission of fumes from diesel-engined lorries continues and this is to be regretted. If the engines are properly tuned and operated no nuisance need arise from this source but complaints continue to be received particularly in respect of traffic travelling up Archway Road Details are taken where possible and an appropriate letter sent to the owners, who in most cases co-operate and express regret that it has been found necessary to draw the matter to their attention. 41 Number of applications received for prior approval Section 3 (2) 2 Number of applications for prior approval granted 2 Number of applications for exemption (Section 2) 1 Number of applications for exemption granted 1 Inspections 1, 502 Revisits 479 Complaints received 60 Smoke observations 498 Contraventions found 14 Adaptations completed (domestic) - Notices served 3 Notices complied with - Prosecutions 1 42 Recording of Atmospheric Pollution A summary of the observations at the three stations in the Borough follows - 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 1.89 12.75 8.71 21.46 6.45 ” 2 2.09 17.26 9.50 26.76 5.91 ” 3 2.48 8.08 7.72 15.80 3.62 February 1 0.04 6.36 3.18 9.54 5.89 ” 2 0.08 7.59 4.50 12.09 5.72 ” 3 0.04 5.26 3.58 8.84 3.65 March 1 2.05 12.02 8.61 20.63 3.50 ” 2 1.93 17.55 8.74 26.29 3.28 ” 3 1.85 16.10 5.50 21.60 2.23 April 1 1.97 12.58 6.36 18.94 2.89 ” 2 1.89 8.18 5.53 13.71 2.77 ” 3 2.05 11.59 3.97 15.56 1.76 May 1 0.79 6.62 2.72 9.34 1.60 ” 2 0.83 10.66 6.33 16.99 1.69 ” 3. 1.02 8.84 2.39 11.23 0.98 June 1 1.22 5.43 5.96 11.39 1.44 ” 2 2.01 12.75 7.19 19.94 1.51 ” 3 1.34 13.35 12.05 25.40 0.72 July 1 1.02 6.29 2.85 9.14 1.10 ” 2. 1.34 15.20 8.45 23.65 1.42 ” 3 1.38 11.00 8.71 19.71 0.69 August 1 1.85 13.21 1.79 15.00 1.30 ” 2 2.28 17.85 7.45 25.30 1.48 ” 3 2.36 12.95 3.84 16.79 0.71 September 1 0.08 8.15 3.74 11.89 1.45 ” 2 0.04 9.44 2.95 12.39 1.43 ” 3 0.04 5.33 2.55 7.88 0.62 October 1 1.66 10.76 6.41 17.22 2.87 ” 2 1.93 17.72 6.39 24.11 2.73 ” 3 1.85 14.61 5.56 20.17 1.32 November 1 2.36 9.37 16.16 25.53 4.46 ” 2 2.56 16.13 16.73 32.86 4.20 ” 3 2.56 8.21 14.94 23.15 2.61 December 1 2.28 9.21 8.34 17.55 3.28 ” 2 3.15 12.55 8.15 20.70 3.35 ” 3 3.47 7.15 7.88 15.03 2.65 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, volumetric apparatus is installed 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. Concentration of Smoke and Sulphur Dioxide recorded by the Volumetric method at the two stations In the Borough Stat ion Jan. Feb. Mar Apl. May June July Aug. Sept. Oct. Nov. Dec. SMOKE. (Milligrams per 100 cubic metres) Public Health Office, Town Hall. Monthly average 49.0 33.0 16.0 14.0 8.0 6.0 7.0 4.0 6.0 14.0 45.0 27.0 Highest daily average 164.0 170.0 55.0 32.0 21.0 16.0 36.0 15.0 18.0 34.0 116.0 80.0 Shelter House, Treatment Centre Monthly average 49.0 40.0 16.0 17. 0 8.0 4.0 3.0 5.0 7.0 15.0 31.0 29.0 Highest daily average 140.0 173.0 58.0 38.0 18.0 8.0 8.0 10.0 16.0 33.0 102.0 68.0 SULPHUR DIOXIDE. (Parts per 100 million parts of air ) Public Health Office, Town Hall. Monthly average 20.1 20.1 10.0 9.7 5.3 4.3 3.9 4.3 4.4 7.9 16.1 11.8 Highest daily average. 64.3 98.9 27.8 24.4 14.6 9.1 13.7 8.2 13.2 13.1 31.9 36.6 Shelter House, Treatment Centre. Monthly average 17.8 17.8 7.3 8.3 4.7 4.5 3.4 4.4 4.5 7.4 12.2 10.6 Highest daily average 55.5 85.1 21.4 21.1 14.0 8.3 7.4 12.1 9.2 13.5 25.2 28.8 44 45 Requisitioned Properties. The number of requisitioned properties on 1st January, 1959 was 262. 156 (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 79 such references were made Work of Public Health Inspectors Administering Factories Act, 1937 and other legislation Factories Act, 1937. Number of inspections 864 Number of revisits 671 Notices served 104 Prosecutions instituted - Defects found 667 Defects remedied 667 Defects referred to H M Inspectors - Defects referred by H.M Inspectors 17 Complaints received 47 Notices complied with 63 Public Health (London) Act, 1936. Factories visited 513 Contraventions found 69 Contraventions remedied 41 Notices served 29 Notices complied with 26 PART I OF THE ACT 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 (1) (2) (3) (4) (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 229 228 18 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,824 531 86 - (iii) Other Premises in which Section 7' is enforced by the Local Authority* (excluding outworkers' premises) 32 5 - - TOTAL 2,085 764 104 - *i e. Electrical Stations (Section 103 (1)), Institutions (Section 104) and sites of Building Operations and Works of Engineering Construction (Sections 107 and 108) 46 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 (1) (2) (3) (4) (5) (6) Want of cleanliness (S.1) 15 18 - 2 - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - 1 - Inadequate ventilation (S.4) 1 - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 307 291 - 1 - (b) Unsuitable or defective 299 309 - 10 - (c) Not separate for sexes 44 2 - 3 - Other offences against the Act (not including offences relating to Outwork) 1 47 - - - TOTAL 667 667 - 17 - PART VIII OF THE ACT Outwork. (Sections 110 and 111). SECTION 110 SECTION HI Nature of Work No. of outworkers in August list required by Sec. 110(1)(c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No of instances of work in unwholesome premises Notices served Prosecutions (1) (3) (4) (5) (6) (7) (8) Wearing apparel Making, etc. 552 - - - - - Cleaning and washing Furniture and upholstery 8 - - - - - Umbrellas, etc. 21 - - - - - Artificial flowers 91 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 55 - - - - - Brush making 7 - - - - - Stuffed Toys 11 - - - - - Basket making 1 - - - - - Carding, etc. of buttons, etc. - - - - - -" Cosaques, Christmas crackers Christmas Stockings, etc. 155 - - - - - Textile weaving 4 - - - - - Lampshades 7 - - - - - TOTAL 912 - - - - - 47 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 14 basement bakehouses at the following addresses: - 52 Balls Pond Road, N.1. 54 Archway Road, N 76 Caledonian Road, N.1. 146 Blackstock Road, N 299 Caledonian Road, N.1. 3 Cardwell Terrace, N 8 Danbury Street, N.1. 7 Junction Road, N 68 Essex Road, N.1. 59 Junction Road, N 350 Essex Road, N.1. 77 Newington Green Road, N 52 Stanmore Street, N.1. 123 Newington Green Road, N Public Health (London) Act, 1936. London County Council (General Powers) Act, 1937. Noise Nuisances. As mentioned in my previous Report, the age of mechanisation brings with it noise nuisances and complaints are received by the Department from time to time These are usually solved by the Public Health Inspector visiting the premises in question and obtaining the cooperation of the Management in abating the nuisance Difficulty is experienced in controlling cafes and refreshment houses which are open if not all night until the early hours of the morning Complaints are received of noise caused by the playing of juke boxes and in one case where repeated complaints had been received the Committee authorised an all-night inspection Consequent upon the continued efforts of the Inspector the noise nuisance was abated and in a letter received from one of the complainants, appreciation was expressed on behalf of himself and his neighbours for the action taken which had resulted in giving them a good night s sleep A petition was received from a number of residents in the neighbourhood of Camden Lane complaining of fires and petrol tank explosions In addition to the petition a local medical practitioner reported that the noise caused by car breaking in Camden Lane was having an adverse affect upon one of his patients As this Lane is included in a London County Council Compulsory Purchase Order the Valuer of that Authority was informed and although car breaking activities did not cease during the year the nuisance was kept to a minimum The operation of machinery and the continued use of fans during the night were the source of two further complaints Appropriate action was taken in each case and the nuisances were abated The work required to minimise noise nuisance caused by the combustion and inflow of air to the burners in two oil furnaces in a building occupied by a Government Department was completed during the year. Consequent upon the erection of baffle walls in the boiler house the nuisance was abated and no further complaints have been received Fun Fair - Copenhagen Street During December a fun fair was erected on the vacant site bounded by Boadicea Street. Treaty Street and Copenhagen Street Certain complaints were immediately received alleging nuisance from noise Upon investigation it was found that the fair operated from 6 p.m. until 10 p.m. Monday to Friday and on Saturday from 2 30 p.m. until 10 p.m. There was no music and the fair did not operate on Sundays All the caravans were provided with portable Elsan closets and water was obtained from the nearby house and arrangements were being made with the Metropolitan Water Board for a water rate to be paid The refuse disposal was satisfactory there was no nuisance from atmospheric pollution and although observations were kept by Public Health Inspectors on a number of occasions it did not appear that the amount of noise created would justify legal action Details of action taken in respect of complaints received of alleged nuisances during the year are as follows:- Number of Inspections 158 Complaints received 42 48 Smell Nuisance Having regard to a complaint received to the effect that a fish lorry parked outside a house in the borough between the hours of 4 30 and 5.0 a.m. was causing a nuisance by water pouring from the lorry which smelled highly of fish, and which smell continued after the lorry had gone, resulting in the street swarming with flies, the Committee approved two Inspectors being engaged on night duty, in order that a personal investigation could be made into this complaint The inspection was carried out during a very warm night the minimum temperature being 59°F. It was observed that the lorry in question arrived from North Shields at 4.50 a.m. laden with fish boxes The driver was given a cup of tea by the occupier of the house and the lorry left at 5.12 a.m., heading towards the City Although melting ice from the lorry left a stream of water in the street gutter no nuisance was caused at the time of inspection There was a very slight fishy smell but this was in no way offensive. It would appear that the lorry driver made a normal stop for refreshment, as no doubt he does on the main trunk roads from North Shields There was no evidence that flies were attracted to this particular area Public Health (London) Act, 1936 - Section 121. Protection of Birds Act, 1934. 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 one school and five 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 (d) 6 Gut Scrapers 3 Old Slaughterhouses - Casings Ltd 12 Old Slaughterhouses - Universal Casings Co Ltd 13 Old Slaughterhouses - Messrs Armour & Co Ltd 15 Old Slaughterhouses - Messrs Wm Meniies Ltd 5 Tileyard Road Messrs C Edwards & Son. Ltd Tileyard Road - Messrs Tracey & Co Ltd ( e) 1 Fat Melter: 16 Old Slaughterhouses - Messrs Wm Meniies Ltd (f) 1 Slaughterer 180 York Way - Messrs Harrison Barber & Co Ltd This slaughterhouse was the subject of 313 inspections or visits including visits for the inspection of meat. (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. 49 The number of inspections, etc. of offensive trades premises were:- Inspections Revisits Total Tripe Boilers 22 29 51 Knacker 5 5 10 Fur Skin Dresser 1 - 1 Gut Scrapers 9 5 14 Fat Melters 21 26 47 Licensed Slaughterhouse 9 13 22 With reference to the premises occupied by J L Henson (Wholesale) Ltd at 14/18 Market Road, for tripe boiling, the Council agreed in principle to the proposed transfer of this business to premises in Vale Royal. The new premises would include the tripe boiling factory of Edmund Martin Ltd, together with the establishment of the businesses of fat melter or fat extractor In accordance with the provisions of the Slaughterhouses Act, 1958 and a communication received from the Ministry of Agriculture Fisheries and Pood in September Messrs Harrison Barber & Co. Ltd, at 180 York Way, which is used as a slaughterhouse received consideration particularly as the Slaughterhouse Hygiene Regulations 1958, and the Slaughter of Animals (Prevention of Cruelty) Regulations, 1958, both of which had been amended now apply to slaughterhouses in the Administrative County of London In agreement with the Company it was considered that a recommendation could be forwarded to the Minister giving the appointed day for the coming into force of the Regulations in Islington as 1st September 1960 Arising out of a complaint received of offensive smells emanating from the rear of a butcher' s shop in the Borough, the Public Health Inspector, upon investigation found that the business of a slaughterer of poultry was being carried on in the rear basement room The fowls were kept in a large shed and at the time of inspection approximately 1,300 live birds were housed. The proprietor, upon being interviewed, stated that he had recently found a market for broiler chickens and, therefore, had carried on the business of slaughtering poultry to meet the demand He was informed that the trade of a slaughterer of poultry had been declared by Order of the London County Council, to be an offensive trade which could not be established without the approval of the Local Authority and he was liable to heavy penalties upon conviction for carrying on the business at this address. The butcher co-operated with this Department inasmuch as the slaughtering of poultry was immediately discontinued arrangements being made with an approved slaughterer in another Borough. The keeping of poultry at this address which is situated in a densely built-up area, was still under consideration at the end of the year Diseases of Aninals Acts, 1935-1950. Anthrax Order, 1938. Early in the year information was received from another district that 11 mink skins had been despatched by registered post from a mink farm in that area to an address in this Borough for dressing, and it was suspected that Anthrax infection was present Upon receipt of this information the Chief Public Health Inspector notified the Northern District Post Office immediately and the parcel was intercepted The Public Control Department of the County Council, being the Authority responsible for the Diseases of Animals Acts 1935-1950 was also immediately informed. The parcel, after identification, was forwarded to the Ministry of Agriculture for examination at their Weybridge laboratories Anthrax organisms were confirmed in the skins and the pelts were thereupon destroyed The parcel was so secured that infecting organisms were considered unlikely to have been distributed from the external surface of the parcel during transit but as a precaution the mail bag in which it was contained was destroyed and the uniforms of the Post Office staff who handled the parcel were similarly dealt with The Post Office were also requested to inform the Medical Officer of Health of any unusual staff sickness in those who may have come into contact with the package during the incubation period Fortunately there were no further developments and thanks are due for the co operation of the Post Office Authorities and the Company concerned. 50 Pharnacy and Poisons Acts, 1933'1941. Number of Listed sellers of Part II Poisons other than registered pharmacists 169 Number of initial registrations during the year 14 Number of visits and inspections 76 Number of samples taken 1 Number of samples reported satisfactory 1 Rag Flock and other Filling 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 Number of inspections and visits 18 Pet Animals Act, 1951 Number of licences issued during year 20 Number of inspections and re-visits 75 Heating Appliances (Fireguards) Act, 1952 Number of inspections and re-visits 84 London County Council (General Powers) Act, 1954 Hairdressers and Barbers. Number of Gentlemen s Hairdressers 84 Number of Ladies' Hairdressers 81 Number of Ladies' and Gentlemens' Hairdressers 20 Number of premises where hairdressing ceased 1 Number of Establishments situated in basements 3 Number of Establishments situated in dwelling houses 2 Number of Establishments where no assistants are employed 54 51 Prevention of Damage by Pests Act, 1949. (a) General. The following is a summary of the work carried out during the year Notices Served: 2 Intimations 8 Statutory Type of Property Local Authority Premises Dwelling Houses Business Premises TOTAL 1. Complaints received (including repeats) 36 1,052 128 1,216 2. Number of properties inspected as a result of (a) Notification (initial complaint only) (a) 35 921 129 1,085 (b) Block survey (b)254 527 59 840 3 Number of properties found to be infested by rats (including nil ship rats) 22 556 75 653 4 Number of properties found to be infested by mice 2 329 41 372 5. Re-visits by Investigators *1,046 3,430 54 4,530 6. Non-effective visits by investigators Nil 754 3 757 7. Number of infested properties treated (new jobs commenced) *617 881 110 1,608 8 Continuation or post-bait treatment *874 3,144 261 4,279 9. Visits by Operators *4,126 10,787 626 15,539 10 Still being baited at end of year Nil 36 1 37 11 Completed during the year •1,687 1,573 135 3,412 12 Number of Business Agreements dealt with 52 13 Members of the Rodent Staff assisted in the application of smoke machine in respect of 160 drainage tests carried out by Public Health Inspectors * Includes Sewer Maintenance Treatment Nos. 29 and 30 (1,654 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 52 Again there has been a slight decrease in the number of complaints and the number of infestations found No infestation of ship rats was recorded 72 investigations were traced to defective drains 4 to unsealed fittings, 2 to defective sewers and 1 to a disused drain In a number of cases heavy infestations of rats were caused by defects in drains including an old brick barrel outlet drain. Infestations ceased when repair or renewal of the drains in question was carried out The Council approved the attendance of one of the Rodent Operators at a three day basic course in Rodent Control sponsored by the Ministry of Agriculture Fisheries and Pood Quarterly inspections were carried out at the Archway Group of Hospitals during the year The Chief Public Health Inspector and the Rodent Officer attended three meetings of the Workable Area Committee No. 1 held during the year (b) Sewer Treatments. Two sewer maintenance treatments were carried out in connection with which the cooperation of the Borough Engineer and his staff was appreciated Details of the treatments are as follows:- Treatment No and date Manholes In Borough Not baited Baited Showing complete Takes Showing Prebait Takes Showing No Takes 29 13/4/59 827 43 784 371 602 182 30 12/10/59 828 53 775 341 564 211 Poison takes were not inspected water Supplies (a) The Metropolitan Water Board continues to be the responsible authority for the supply of water to this Borough Two bacteriological samples of mains supply and four for chemical examination were taken by the Public Health Inspectors All were found to be satisfactory Public Health (London) Act, 1936 Section 95 1 36 applications were received for Water Certificates and 36 Certificates were issued in respect of 414 separate dwellings 2 Water supplies to tenement houses 49 Notices were served under this section requiring the provision of water supplies to tenement houses 24 water supplies were provided or informed during the year (b) Well water. Of the 28 bore-holes or wells known to exist in the Borough nineteen continue to be unused, being effectively sealed five of the remaining wells are still out of use Ten samples were taken, five for chemical and five for bacteriological examination The chemical samples indicated that the water could not be considered free from pollution but the water from these wells, is used only for industrial purposes All the bacteriological results were satisfactory. 53 During certain alterations at 2A, Junction Road the Public Health Inspector was called in. Upon inspection, a well was found situated behind a temporary kiosk It measured some 8 ft. in diameter and was about 25 ft. deep. The well was perfectly finished and to all appearance was rendered from the top to the bottom. There was an iron ladder extending from the top to well below the surface of the water. A sample of the water was reported to be satisfactory. The well has been properly sealed off, and it is proposed to construct a new floor over the same. (c) water Supplies - Miscellaneous. Eight samples of sub-soil water were taken (d) Swimming Bath later. The following samples were taken during the year - Chemical Bacteriological Satisfactory Chemical Bacteriological Unsatisfactory Chemical Bacteriological - 133 - 133 - - By courtesy of the Chief Superintendent & Engineer of Baths and Washhouses the following information is included in this year's Report - There are ten swimming baths under the control of the Council one of which is out of commission at present. The Metropolitan Water Board supply the water for these baths The method of treatment for purification is by chemical dosage alumina ferric is the coagulant used to fulfil the function of forming a film on sand soda ash is the alkaline salt to counteract acidity A pH value of between 7 4 and 7 6 has proved most satisfactory to the swimmers using these baths. Aeration is maintained by means of an air compressor Sterilization: Chlorine gas is used, a residual of 0 5 to 0 75 p.p.m. being strictly adhered to. In the summer months when heavy loads are to be expected it is kept at 05 p.p.m. The frequency of changing the baths water is governed by the flow through the filters which, in the case of these establishments is approximately once every four hours In the summer months when the baths are open for 12 to 14 hours daily a complete turnover of three times per day is necessary. During the last twelve months the bacteriological examination reports have been exceptionally good for all establishments, showing the water to be practically sterile Samples of the water at Highbury Fields Open Air Swimming Pool which is controlled by the London County Council, were also taken regularly during the summer season for bacteriological examination All reports were satisfactory and are included in the figure given at the head of this section The water in the paddling pool at Highbury Fields however received attention during the year Four samples were taken for bacteriological examination and information of results was forwarded in all cases to the County Council Every endeavour is being made to maintain the water at a satisfactory bacteriological standard 54 SECTION D HOUSING (In conjunction with Mr. W.C. Bartlett, Chief Public Health Inspector.) Once again this has been mainly a year of work under Part II of the Housing Act 1957 details of which appear on pages 55/56. Over 1,600 detailed surveys have been carried out by the Inspectors and whilst it is apparent that there are still many unfit properties in the Borough the problem arising from properties which fell into disrepair during the war years and subsequently suffered from lack of maintenance in the immediate post war period is now much diminished It is pleasing to note that at the end of the year the last of the 400 properties falling to be dealt with as individual unfit houses under the programme submitted to the Minister of Housing and Local Government under the provisions of the Housing Repairs and Rent Act 1954 were dealt with There is a decreasing number of houses falling short of the standard of fitness required under Section 4 of the Housing Act, 1957 which are not capable of being repaired at reasonable cost Accordingly consideration should be given to action which will result in the older type properties being brought up to present day standards Many of the large terraced dwelling houses in Islington comprise four storeys and were obviously not designed to accommodate the number of families now residing therein In particular attention must be focussed on securing 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 During the year under review, no clearance areas were submitted to the Ministry of Housing and Local Government for confirmation. The number of flats and houses erected during the year is Borough Council 302 London County Council Nil Private enterprise 85 The number of municipal flats and houses erected since the war is Borough Council. 3,494 London County Council 2,630 The total number of dwellings in the Borough at the end of the war was 44 476 Applications made by tenants for Certificates of Disrepair under the Rent Act 1957 required the inspection of many lettings together with additional re visits when owners had carried out works in order to obtain the increased rents to which they are entitled under the Act The problem of houses in multiple occupation has caused the Department no little concern particularly where properties are let out in furnished rooms with little regard to overcrowding or congestion which might occur, or the greater inconvenience to the tenants caused by lack of amenities During the present year some 69 inspections were made of houses let in lodgings and whilst it has been possible to deal with many of these properties on an informal basis it was also necessary to report five such cases with a view to stronger action being taken The Department has found that where owners are reasonable it is possible to effect some improvement in the living conditions in this type of property but a Notice served under Section 36 of the Housing Act 1957 suffers from the grave defect that whilst the person in control can be required to do work he can also in default of the execution of the specified works secure a reduction in the number of individuals or householders in lieu thereof It is of course well known that many of the families living in this type of property are usually in desperate need of accommodation and a service of a Notice cannot be a satisfactory solution of the problem in every case One certificate to the effect that the several tenements were so constructed and arranged as to secure effective ventilation of habitable rooms in every tenement was issued during the year under Section 5 of the Housing Act 1957 in respect of four flats in Block I of the Peabody Estate Greenman Street 55 Legal Proceedings 1. 103, Georges Road an appeal against a Demolition Order heard at the Clerkenwell County Court on 19th June, was dismissed and the Demolition Order confirmed 2. 369, Liverpool Road an appeal, made in respect of premises which were the subject of a Closing Order, was withdrawn. 3 44, Ferntower Road a summons was issued against the owner of this property for permitting a basement room to be used in contravention of the terms of a Closing Order The owner could not be brought to Court as the Warrant Officer charged with serving the summons, reported that he had proceeded to Nigeria. 4. 41, Wray Crescent a summons issued concerning a contravention of a Closing Order in respect of a ground floor room was adjourned generally at the hearing on 21st July 5 8, Playford Road.in this case the owner proposed to carry out work in order that the Closing Order which was operative in respect of the whole house could be determined He endeavoured to obtain acceptance of a lesser standard than that provided in the Housing Act 1957 and offered the Inspector a gift of money The facts were reported to the police who instituted legal proceedings and at the hearing the owner pleaded guilty and was fined £50 and ordered to pay 20 guineas costs Housing Act, 1937 During the year the following actions were taken Section 9 (Repair of insanitary houses) Inspections 69 Revisits 150 Section 16 (Individual unfit houses) Inspections, Visits and Revisits 1,615 Houses represented 135 Undertakings accepted - Undertakings cancelled upon completion of work - Section 17 (Individual unfit houses) Closing Orders made 123 Demolition Orders made 8 Houses demolished 24 Section 18 (Parts of buildings including basement rooms) Inspections, Visits and Revisits (a) Basement rooms 1,039 (b) Other parts of buildings 106 Representations made (a) Basement rooms 113 (b) Other parts of buildings 24 Closing Orders made (a) Basement rooms 131 (b) Other parts of buildings 27 Undertakings accepted (other parts of buildings) Undertakings cancelled or part cancelled upon completion of work (basement rooms) 5 56 Section 27 Closing Orders determined or part-determined upon completion of work in respect of (a) Whole houses 26 (b) Basement rooms 42 (c) Other parts of buildings 1 Section 36 ( Houses let in lodgings - securing fitness for occupation by number of families accommodated). Inspections, Visits and Revisits 69 Report to Committee 5 Notices complied with 3 Section 90 (Houses let in lodgings - overcrowding). Inspections, Visits and Revisits 14 Reports to Committee - Overcrowding abated - Section 42 (Clearance Areas). Inspections 5 Visits & Revisits 687 Housing Consolidated Amendment Regulations, 1932. (House to House Inspections). Total number of inspections 342 Total number of Visits & Revisits 245 Rousing Subsidies Act, 1956, as amended by Housing (Financial Provisions) Act, 1958. Certificates of unfitness issued in respect of certain Municipal properties - Individual houses 3 Housing Act, 1949 Improvement Grants. Inspections, Visits and Revisits 100 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 18 investigations were carried out by this Department. Licences authorising temporary overcrowding. No licences were issued during the year 57 SECTION E SUPERVISION OF FOOD (In conjunction with Mr. W C. Bartlett, Chief Pnblic Health Inspector) During the year certain legislation affecting the work of the Department was made or came into operation, including the following:- The ice cream (Heat Treatment, etc.) Regulations, 1959, consolidated and amended the previous Regulations. Ingredients used in the manufacture of ice cream must be pasteurised by one or other of the specified methods or sterilised and thereafter kept at a low temperature until the freezing process is begun. It is an offence to sell or offer for sale ice cream which has not been so treated or which has been allowed to reach a temperature exceeding 28°F, without again being treated Certain types of water ices and ice lollies which are sufficiently acid to make pasteurisation or sterilisation unnecessary are exempted Advice on tests of the bacterial cleanliness of ice cream and the procedure for the taking of samples is included in Circular 8/59 issued by the Ministry of Health in April The Pood Standards (ice Creaa) Regulations. 1959 describe amended standards of composition for ice cream and "PAREV" (Kosher) ice and introduce separate standards of composition for dairy ice cream and/or milk ice Alternative standards are prescribed for certain other types of ice cream The Labelling of pood Amendment) Regulations 1959, amend the Labelling of Food Order 1953 by the insertion of a new provision relating to ice cream These provisions prohibit inter alia, the labelling making or advertising of ice cream in a manner suggestive of butter, cream milk or anything connected with the dairy interest unless it contains no fat other than milk fat The Milk and Dairies (General) Regulations 1959. re enact with some amendments the Regulations of 1949-54 The changes brought about by these Regulations include:- 1. The registration of Distributors is now required to be effected only with the local authority in whose area the premises from which the milk is distributed are situated 2 Provision is made for the local authority to pay compensation to a person who sustains damage or loss from being debarred from certain employment connected with cows or with milk because he is suffering or has been in contact with a person suffering from a disease liable to cause infection of milk 3 There are new provisions as to personal cleanliness precautions against contamination or infection of milk and the provision of first aid equipment Circulars fsh 8/59 and 16/59 issued by the Ministry of Agriculture Fisheries & Food gave information of the products approved by the Ministers for the cleansing of milk tankers vessels or appliances as an alternative to scalding with boiling water or steam The Slaughter of Animals (Prevention of Cruelty) (Amendment) Regulations 1959, and the Slaughterhouse (Hygiene) (Amendment) Regulations, 1959, respectively provide that the principal Regulations which came into force on first January this year shall apply in London in the same way as elsewhere in England and Wales. The Ministry of Health and the Ministry of Agriculture Fisheries and Food issued two Food Hygiene Codes of Practice the first one dealing with hygiene in the retail meat trade and the second with the hygienic transport and handling of meat The Council authorised the purchase of a quantity of these publications in order that each butcher in the Borough could be provided with a copy. Arrangements are being made for the Inspector to interview every butcher in the Borough and hand him a copy of each of the Codes of Practice drawing his attention at the same time to what is expected of him and his staff in order to ensure that his business is carried out satisfactorily both in regard to his premises and the hygienic display and handling of meat by those engaged in the business As the Minister of Health states in the foreword to both publications these Codes of Practice have two broad aims that the condition in which meat is handled should be as good as possible and those who have to handle it should never through familiarity treat it with less than the care they would expect to have been given to meat which they eat themselves. 58 The White Fish Authority have issued a list of recommended names for the sale of fresh or frozen fish by retail This list is the result of an approach to the Authority by the respective Ministries, and can be considered as a Code of Practie which would indicate to all concerned what constitutes good practice in the sale of fish at the retail stage under prescribed names. General The supervision of food undertakings continues although the maintenance of satisfactory hygienic conditions in certain cases has proved difficult Whilst the proprietors endeavour to comply with the Council" s requirements, the standard is often low and the question of language may be a difficulty. In the majority of cases however a standard higher than those required by the Food Hygiene Regulations is maintained It has become a question of education to a great extent and the Public Health Inspector endeavours by talks and demonstrations on the premises to point out that a higher standard can be obtained very often with little expense and also the reasons why such steps are necessary More people are being convinced that food hygiene pays and attracts better custom to the shop concerned If the public would assist more in this matter and refrain from patronising establishments with unsatisfactory displays or handling of food the duty of the Inspector would be eased considerably With the influx of immigrants from various countries the pattern of food displayed and sold in the Borough is changing Exotic food shops stocking foods from almost any part of the world are being opened in the district This fact places more onerous duties upon the Department consequent upon the variety of foods which may be sold on one and the same premises As mentioned above the question of language could present a real difficulty as the following case will demonstrate Arising out of an inspection of a restaurant in the Borough the Public Health Inspector advised the Occupier upon certain improvements which in his opinion would be beneficial The proprietor readily agreed and the Inspector requested him to let him know when the work was completed A short time afterwards the communication reproduced at the beginning of this Section of the Report was received The same morning the Chief Public Health Inspector obtained a translation by having a personal interview with the Secretary of the China Inland Mission The translation was as follows - "Dear Sirs, We would respectfully like to inform you that with reference to the repairs to this property the work has now been completed and we hope that you will come along at an early date to inspect it.'' An appropriate reply was sent and upon the Inspector visiting he found that the advice given had been acted upon The transport and handling of meat engaged the attention of the Inspectors and a survey of a number of meat transport vehicles operating in the Borough was undertaken In all some twenty vehicles were involved the majority of which were found to be satisfactory both in respect of the vehicle itself and the employees engaged in handling the meat Where necessary Notices were served and the attention of the owners drawn to any infringement of the Food Hygiene Regulations The co-operation of all concerned was forthcoming and whatever was necessary was carried out Later in the year two Inspectors observed two meat handlers delivering home killed meat from a van to a butcher" s shop It was noticed from the opposite side of the road that neither of these handlers wore any head covering and that one of them had a sore on his forehead On being approached, both handlers agreed that washable head coverings were required to comply with the Regulations, and one of them stated that the reason why he had no head covering was because of the sore on his forehead His attention was drawn to the fact that his condition made it all the more necessary for his head to be covered as it was also an offence to keep an open cut or abrasion on any exposed part of his person not covered with a suitable waterproof dressing The institution of legal proceedings was approved following a report to the Public Health Committee. The Ministry of Housing and Local Government circulated a Memorandum to local authorities on Radio-Activity. The Memorandum summarises the action which various Central Government agencies concerned with radio-activity have in hand on matters in which local authorities may have a direct or indirect interest, and indicates the broad division of responsibilities between the Government Departments in England and Wales The memorandum concludes 59 THE WHITE HOUSE RESTAURANT Telephone: ARChwmy 1848 3/5 STROUD GREEN ROAD, FINSBURY PARK, N.4 For translation, see page 58 ( reproduced with the agreement of the Restaurant Proprietor) 60 "The training of the officers of local authorities in radiation matters is in general the responsibility of the Department concerned with the particular service but the Ministry of Health are responsible for the training of Medical Officers of Health and Public Health Inspectors notwithstanding that some of the services with which these officers are concerned are within the sphere of responsibility of other Departments, The training requirements in the health and safety field are at present being examined by a Committee." The report of this Committee is expected later this year Meat inspection at the one private slaughterhouse in the Borough continues It is gratifying to note that the effects of the T B eradiction programme is being felt for the number of cases of T B in animals has decreased considerably A number of night inspections were carried out by the Inspector concerned with the supervision of refreshment houses, the delivery of milk to retailers and the transport of meat Complaints were received in respect of alleged:- Foreign matter in loaf of bread Foreign matter in bun Mould in margarine Mould in fruit pie Mould in steak and kidney pie Button in corned beef Metal caps in bottle of milk Insects in swiss roll Insects in loaf of bread Insects in bread Fly in loaf of bread Insects in pearl barley Foreign substance in grapefruit so.uash Foreign matter in cheese cakes Foreign substance in bottle of lemonade Mould in pork-pie Mould in cake Mould in apple flan Metal in bread roll Sausages affected by mould Insects in steak and kidney pie Insects in corned beef roll Insects in nut crunch Rancid butter Foreign substance in milk Taint in bottle of cream soda Details of the action taken under the Food & Drugs Act 1955 and the Food Hygiene Regulations 1955 appear on page 62. Food and Drugs Act, 1955. Number of food premises in the area, and type of business. Bakehouses - level 25 - basement 14 Bakers retail shops 63 Butchers 136 - Continental 1 Cafes and Restaurants 249 Canteens and Clubs 104 Chemists 56 Coffee stalls 3 Continental Food Shops 44 Fish shops 39 "curers 17 ''depot 1 ''friers 53 Food factories 39 Food stalls (street traders including 14 shop extensions) 90 Food storage premises for street traders 86 Greengrocers and Fruiterers 189 Grocers and Provision merchants retailers 489 „ „ „ „ wholesalers 19 Licensed "Clubs" 30 Off-licences 105 selling other food (included in above) 58 Public Houses 259 „ „ catering (included in above) 221 „ „ beerhouses 27 Sugar and chocolate confectionery 412 Milk machines 16 Food machine 1 61 Preserved Food Premises Registered under Section 16 (l)(b) of the Food and Drugs Act, 1955. (Included in foregoing list.) Total No. of Preserved Food premises 175 No. of Butchers 123 No. of Grocery and provision shops 37 No. of Food Factories 11 No. of Cooked meat shops 1 No. of Jellied Eels and Pie Shops 2 No. of Bakers (meat pies) 1 Total No. of inspections and visits made by Inspectors to Preserved Food Premises 387 Details of the inspections etc. by the Inspectors are given below Bakehouses - level 96 „ - basement 125 Bakers (bread and cake shops) 174 Butchers 317 Butter blender 2 Confectioners 219 Fried fish shops 178 Fish curers 140 Fishmongers 34 Greengrocers & Fruiterers 208 Grocery and Provisions 1,246 Wholesale Food Stores and Depots 139 Markets 47 Food Storage for Street traders 22 Other Food Premises 220 Vehicles 158 Stalls 26 Public Houses and Off Licenses 11 Restaurants, Eating Houses and Canteens 796 Meat inspections at Licensed Slaughterhouse 313 Food examinations (other) 543 Ice Cream premises 505 Preserved Food Premises 387 Dairies (milk distributor) 1,128 Contraventions found 793 Contraventions remedied 775 Notices served (Food and Drugs Act) 305 Notices complied with (Food and Drugs Act) 275 Infectious Diseases 46 Food poisoning enquiries 40 General. Legal proceedings - attendances at Court 14 Non-effective visits 341 Miscellaneous 1,050 62 Legal Proceedings. Details of the action taken by the Council under the Pood and Drugs Act, 1955. and the Food Hygiene Regulations made thereunder are as follows - Date Offence Magistrate's Decision 3.3.59 Food Hygiene Regulations, 1955. Regulation 22 (1) Allowed a food room at 63 Hornsey Road to be used as a sleeping place Fined 16 Defendant to pay £2 2s Od costs. -do- Regulation 16 (1) Failure to provide wash hand basins at 63 Hornsey Road Fined £6 -do- Regulation 16 (2) Failure to provide supply of hot water at 63 Hornsey Road Fined £6. -do- Regulation 23 (1) Failure to keep ceiling and walls of food room at 63 Hornsey Road in such good order, repair and condition so as to enable them to be effectively cleaned Fined £6 -do- Regulation 23 (1) Failure to keep clean the ceiling and walls of a food room at 63 Hornsey Road Fined £6 7.4.59 Food Hygiene Regulations, 1955. Regulation 5 Unsanitary food premises at 22 Brecknock Road. Fined £3. Defendant to pay £2 2s, Od costs. 5.5.59 Food and Drugs Act, 1955. Section 2 (1) Selling food, namely a bun, not of quality demanded at 54 Archway Road Discharged absolutely. Defendant to pay £2 2s. Od, costs 2.6.59 Food and Drugs Act, 1955. Section 2 (1) Selling food, namely cheese cake, hot of quality demanded at 59 Caledonian Road Fined £5 Defendant to pay £2 2s Od costs 1.12.59 Food and Drugs Act, 1955. Section 2 (1) Selling food, namely corned beef roll, not of quality demanded at 104 Tollington Way Fined £5 Defendant to pay £2 2s Od. costs -do- Food ana Drugs Act, 1955. Section 2 (1) Selling food, namely a load of bread, not of quality demanded at 54 Archway Road Fined £5 Defendant to pay £2 2s. Od costs 63 Unsound Food During the year 81 complaints of unsound food were received. The total amount of food condemned was:- Description Tons. Cwts. Qtrs. Lbs. Tinned goods 19 0 1 8 Meat* 16 5 0 8 Fish - 2 3 13 Others 4 17 0 26 TOTAL 40 5 1 27 * Includes 15 tons 15 cwts 3 qtrs. 9 lbs. Harrison Barber & Co. Ltd 1,350 condemnation certificates were issued, and 388 inspections were necessary in connection with this work. Condemned food received from traders is either taken to the Council's refuse disposal depot at Ashburton Grove, awaiting conveyance, under supervision, to the refuse tip or is dyed in order to make it impossible for it to be re-sold or used for human consumption. Condemned meat is used for animal feeding or industrial purposes. Sanpling, 1959 548 samples (9 formal and 539 informal) were sent to the Public Analyst for examination. Forty of these samples, or 7.3%, were adulterated, as shown in the summary below. It should be noted that a number of adverse reports relate to samples not taken from routine sampling but which were the subject of complaint. Formal Caster oil 1 1 Informal Apple Flan 1 Bread 8 Bun 1 Butter 2 Castor Oil 1 Cheese Cake 1 Chocolate Nut Crunch 1 Chopped Ham (Canned) 2 Corned Beef 1 Corned Beef Roll 1 Cream Soda 2 Cream Bottle (dirty) 1 Fruit Pie 1 Grape Fruit Squash 1 Ham 1 Ice Cream 1 Kup Cake 1 Margarine 1 Milk (dirty bottle & containing foreign substance) 2 Mortadella (canned) 2 Pearl Bariey 1 Pork Pie 1 Preserved Beef Sausage Meat 1 Sausages 1 Steak and Kidney Pie 2 Swiss Roll 1 TOTAL 39 64 Meat and Other Poods 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:- Cattle Excluding Cows Cows Calves Sheep and Lambs Pigs Horses Number killed (if known) 142 620 27 145 9 666 Number inspected 142 620 27 145 9 666 All diseases except Tuberculosis & Cysticerci Whole carcases condemned 6 100 3 41 1 2 Carcases of which some part or organ was condemned 32 272 - 14 - 35 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 26.76 60.00 11.11 37.93 11.11 5.55 Tuberculosis only Whole carcases condemned - 2 - - - Carcases of which some part or organ was condemned - 4 - - - - Percentage of the number inspected affected with tuberculosis - 0 97 - - - - Cysticercosis Carcases of which some part or organ was condemned - - - - - - Carcases submitted to treatment by refrigeration - - - - - - Generalised and totally condemned - 1 - - - - All diseased or unfit meat was disposed of for use as knacker s meat or in the manufacture of animal feeding preparations. Of the 666 horses slaughtered for human consumption, 562 were intended for export. Slaughter of Animals Act, 1958. Slaughtermen' s Licences. During the year two new Licences were issued and fourteen Licences renewed Fifteen slaughtermen held current Licences at 31st December Export Certificates - Food 21 export certificates were issued in respect of consignments of ox tongues tinned soups chicken products and ox tongue and ham spreads The goods were exported to Canada USA Australia and Sweden respectively. 65 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, details of which are as following.- Merchandise Marks Acts. Inspections 188 Contraventions found 3 Contraventions remedied 2 Agricultural Produce (Grading and Marking) Acts Inspections 7 Contraventions found - 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. Traders are becoming more aware of these facilities, the number of persons taking advantage of them being on the increase. Convenience Jan. Feb. Mar. Apr. May Jun Jul. Aug. Sept. Oct. Nov. Dec. Approx. weekly average throughout year Archway- Men 46 52 49 46 50 64 92 95 76 74 70 53 64 Women 58 56 58 56 61 63 54 58 65 45 52 57 57 Parkhuret Road- Men 61 64 77 89 83 112 114 103 125 100 94 92 93 Women 44 68 58 53 58 66 50 56 48 87 82 84 63 Finsbury Park- Men 66 89 73 74 91 70 78 78 76 65 60 56 73 Women 20 27 26 31 42 24 44 60 24 18 17 20 29 Highbury- Men 18 27 25 22 24 30 35 27 36 28 28 20 27 Women 16 15 22 12 18 14 22 20 23 22 11 14 17 Offord Road- Men 10 10 11 10 12 16 14 13 14 12 11 7 12 Women 5 5 6 10 10 9 11 13 5 6 7 6 8 Islington GreenWomen 14 18 16 16 26 15 14 16 14 16 16 14 16 High StreetMen 52 53 - - 57 60 65 60 61 55 64 28 46 410 484 421 419 532 543 593 599 567 528 512 451 66 Ice Cream Ice Cream (Heat Treatment, etc.) Regulations, 1959 Supervision of the Manufacture and Distribution of Ice Cream During the year 506 visits were paid to ice cream premises and vehicles The number of premises registered:- (a) for manufacture, sale and storage 7 (b) for sale and storage 328 (c) for sale only 192 (d) for storage only 1 528 1 Bacteriological Examination. (a) Ice Cream. Nineteen samples of ice cream were sent for bacteriological examination and following Methylene Blue tests were graded as follows - Grade I 14 Grade II 5 Grade III - Grade IV - 19 Samples falling within Grades I or II are considered satisfactory (b) Lollies. Number sampled Satisfactory Unsatisfactory Cream Lollies 23 22 1 Plain Lollies 26 24 2 2 Chemical Examination. Ice Cream 15 14 1 Ice Lollies 32 32 Details of 15 samples of ice cream examined for fat content are as under 6% 7% 8% 9% 10% 11% 12% 13% 14% 15% 16% 17% 1 1 - 2 - 2 3 4 1 - - - One sample was 4.3% fat content and was thus 14% deficient Milk Samples. 1 Bacteriological Examination Details of samples submitted 67 Class of Milk Results Phosphatase Methylene blue Turbidity Biological Total Number of Samples Pasteurised Satisfactory 47 47 - - 47 Unsatisfactory - - - - Sterilised Satisfactory - - 27 - 27 Unsatisfactory - - - - Tuberculin Tested (Pasteurised) Satisfactory 28 28 - - 28 Unsatisfactory - - - - Tuberculin Tested (Raw Milk) Satisfactory - - - 5 5 Unsatisfactory - - - - TOTAL 107 2 Chemical Examination. Details of samples submitted. Satisfactory Unsatisfactory Total Formal 3 - 3 Informal 185 2 187 190 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1933, and Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954 The following licences were granted.- Pasteurised 316 Pasteurised (supplementary) ... 23 Tuberculin Tested . 172 Tuberculin Tested (supplementary) 23 Sterilised 353 Sterilised (supplementary) 27 914 Milk and Dairies (General) Regulations, 1939. Number of Dairies Registered in the Borough 19 Number of Distributors registered in the Borough 323 68 SECTION F MISCELLANEOUS SERVICES HEALTH EDUCATION AND HEALTH PUBLICITY Home Safety Islington Home Safety Committee As mentioned in last year's Report, the Borough Home Safety Committee was formed in 1958 and the inaugural meeting was held on 30th October. At this meeting it was decided to convene a Public Meeting, which took place on 8th January 1959 The principal speaker was Mr John Watson F. R. C. S. E. , Consultant Plastic Surgeon The Queen Victoria Hospital who dealt mainly with accidents causing burns and scalds. He pointed out that the annual death rate in England and Wales from this cause was still some 700 while it was estimated that 50,000 others received burns in the home sufficiently severe to require treatment in hospital. Mr. Watson considered that there were three ways in which the problem might be approached, viz statistical analyses of the facts and figures, design and planning of homes and education of the public. In the latter connection he felt it was dificult to get across to people just what a serious burning accident meant in terms of economics and human suffering Treatment of a child victim might extend over a period of ten years and the cost might be in the region of £1,000. While legislation such as the Heating Appliances (Fireguards) Act had done much to improve the position, Mr. Watson said he felt that much more depended on education Perhaps the best time to educate was to arrange classes for upper forms in schools and those in direct contact with the public in their homes - nurses, health visitors people responsible for the care of the elderly and young children - were in the best position to carry out educational work where it was most needed. The Chair was taken by Alderman Rogers, the Chairman of the Public Health Committee who was also appointed Chairman of the Home Safety Committee The meeting was attended, amongst others, by general practitioners, health visitors and social workers Four ordinary meetings of the Home Safety Committee were held during the year and as well as the numerous home safety aspects which were reported or discussed the meetings were preceded by talks on specific accident prevention themes. In addition to Mr Watson's lecture, talks were given by Miss Barbara Naish of The Royal Society for the Prevention of Accidents Mr HEP. Heath of the North Thames Gas Board and Mr. L. C. Atkins of the London Electricity Board. References from the Home Safety Committee included the siting of electric socket outlets in municipal and private housing developments; the provision of fireguards of good standard to persons in need through the National Assistance Board, the supply of specially designed gas cookers for handicapped persons through the North Thames Gas Board. Individual problems were also dealt with, such as the practice of a laundry van-man in throwing bundles of linen from Estate balconies. A suggestion made by the Home Safety Committee that safety hints should be published weekly in the local newspapers was adopted by the Public Health Committee who also received various reports from the Home Safety Committee during the year " Check that Fall " Campaign The annual home safety campaign by The Royal Society for the Prevention of Accidents and Central Council for Health Education was designed this year to focus attention on the danger of falls in the home and during the period October/December, emphasis was placed on falls of the elderly. 69 In its annual Home Safety Week 2nd - 7th November, the London County Council also adopted the theme of prevention of falls in addition to a follow-up of last year's "Guard that Fire" campaign. The Public Health Department took part in the Campaign by special displays of posters. distribution of leaflets, and also requested suitable shops in the Borough to display posters which were distributed to them. Other Departments of the Council also co-operated by the display of posters in their establishments and on vehicle some 6,000 leaflets and 20,000 bookmarks being distributed through the Public Libraries. Old People's clubs: Talks to eleven clubs, by the Medical Officer of Health or Deputy Medical Officer of Health, were a special feature of the prevention of falls campaign The old people took a lively and intelligent interest in the lectures and subsequent discussion and, as by far the greater number of victims of accidental falls are elderly persons, it is felt that this is a particularly useful type of accident prevention publicity. Lead Poisoning in a Child An enquiry was received from the Divisional Medical Officer of the London County Council in regard to a ten-year-old school child admitted to the Hospital for Sick Children suffering from serious illness found to be due to the effects of lead poisoning. A detailed enquiry into the home circumstances was undertaken and it was found that among the toys with which this child played were some toy soldiers Some of the limbs and heads were missing from these toys and it appeared very probable that the child had been in the habit of sucking the soldiers for some years Although redecoration of the premises had taken place for which some lead paint had been used there was no evidence that the child had played with or taken any of the paint It would therefore seem that the only possible source of the intake of lead was due to the child's unfortunate habit of sucking his lead soldiers. Poliomyelitis Publicity The outbreak of poliomyelitis in Islington provided some incentive for young people within the specified age groups to seek protection against the disease However a large number did not attend any of the numerous clinic sessions held for poliomyelitis inoculation With a view to increasing the public response, the Divisional Medical Officer of the County Council organised an intensive publicity campaign including the display of posters and distribution of leaflets in shops, offices, factories, cinemas public buildings and other establishments The Public Health Department assisted this campaign by the distribution of a large amount of material which was displayed in the various Departments of the Council and through the Public Health Inspectors in food shops in the Borough Education on Smoking and Lung Cancer The Department also co operated in similar manner with the London County Council in publicity on smoking and lung cancer The Deputy Medical Officer of Health (who is also an Assistant Divisional Medical Officer of the L.C.C. ) gave a number of talks to senior classes in secondary schools on this subject. General By special request, a lecture on Public Health Services was given to the Men's Club at Cross Street Baptist Church, by the Deputy Medical Officer of Health Routine publicity by posters and leaflets continued throughout the year by means of the Council's poster sites and from the Public Health Department occasionally also through other Departments of the Council. The Chief Librarian co-operated with this Department in the distribution of the monthly journal Better Health " through the Public Libraries and in the provision of "Family Doctor" for reading by members of the public. 70 During the year it became necessary to obtain a cupboard for the large amount of publicity material becoming available, and the opportunity was taken to incorporate an illuminated display section on top of the cupboard. This cupboard display stand has been installed near the public counter in the Public Health Department and, as well as providing an effective means of displaying posters, it is a useful distribution stand for leaflets. Conferences and Courses The Royal Society of Health Congress from 27th April to 1st May was attended by Councillor Dradey and the Medical Officer of Health; and the Conference of the Association of Public Health Inspectors by Councillor Field and the Chief Public Health Inspector. Early in the year arrangements were made for the presentation at the Town Hall of an In-Service Training Course provided by the Central Council for Health Education. The two-day course, on Modern Methods of Presenting Health Education was intended for Public Health Inspectors and Medical Officers of Health of adjoining boroughs were also invited to nominate members of their staffs to attend As a result of this six Public Health Inspectors. from other boroughs participated in the course, as well as five Islington Inspectors In addition, the following courses were attended by members of the staff - Attended by Week-end school organised by Association of Public Health Inspectors Deputy Chief Public Health Inspector Rodent Control Course (Ministry of Agriculture, Fisheries and One Rodent Operator Food) SERVICES FOR ELDERLY PERSONS Health and welfare services for elderly persons are conducted not only by the Borough Council and the London County Council, who have certain statutory powers and obligations to provide certain services, but also a considerable group of voluntary organisations which add to the various amenities to be enjoyed by elderly persons. The principal voluntary co-ordinating organisation within the Borough is of course, the Islington Old People's Welfare Council, which is grant aided by the Borough The IV S also play an important part by the provision of a meals service as well as conducting clubs and visiting, etc. The Public Health Department itself carries out a good deal of liaison work linking official and unofficial organisations and persons. To be aware of elderly persons who have problems and to be able to keep in touch with them is an important first step towards providing help. The Department's two health officers for elderly persons, who are assisted if necessary by other members of the Department's visiting staff, pay many visits to the elderly brought to their notice and requiring attention A register of such persons is being built up and now comprises approximately 3,000 names out of an estimated total of 25,000 of pensionable age in the Borough The health officers visited 435 new cases during the year and revisits totalled 5,097. 2,777 references were made to other authorities and to voluntary organisations in connection with the provision of " Home-helps'", National Assistance. " Meals-on-Wheels etc Installation of Modern Laundry Unit for dealing with Soiled Laundry In 1954, the Council, on the recommendation of the Public Health Commmittee, agreed to set up a service for dealing with soiled laundry under powers provided in the Public Health (London) Act, 1936, permitting Local Authorities to make arrangements to cleanse or disinfect filthy articles. 71 Such a service was considered to be necessary more especially to provide for incontinent elderly persons who may, unfortunately, soil their laundry so that it is in a condition unacceptable to the ordinary commercial laundry. Arrangements for laundering were made in the first place with the Council's Baths Department for the work to be done at Essex Road Baths making use of old fashioned washing machines installed some years ago. In view of the demand, and the proved usefulness of such a service, the Council decided to install modern disinfecting and laundry equipment which would obviate handling of the articles by the staff to the maximum extent The installation at the Treatment Centre, Seven Sisters Road has now been completed and a comprehensive hygiene service for elderly persons was formally instituted on 10th January 1959 The procedure, in brief, is as follows - 1. On receipt of information from a family practitioner hospital County Council Health Visitor district nurse or through the Department's own visiting staff for elderly persons that bedding or clothing requires special treatment because of soiling a visitor will call (if the case is not already known to the Department) explain the scheme to the elderly person concerned and obtain consent for the cleansing of the articles 2. The recipient is advised that a special laundry bag will be delivered in which articles are to be placed after marking and entering on a list provided. The person or a relative is asked to mark the linen but if this cannot be arranged the Department's own staff undertake this at the laundry, checking carefully to ensure that all articles are returned and no complications ensue The contents of all bags are of course carefully checked at the laundry. 3. The bags are collected by the Department's specially constructed vehicle to contain soiled and dirty articles 4. Careful sorting and preliminary cleansing has to be done by the staff at the laundry, who wear protective clothing. 5. The washed and sterilised articles are returned in the bag which has been similarly treated, and the return is normally made within 24 hours A longer period before return might well cause difficulty to many elderly persons who have only the minimum belongings The average service for each person is once weekly, but in special cases the work may be done twice weekly. Personal Cleansing It will be understood that persons who require this type of laundry service will of necessity, also have difficulties in regard to personal cleansing The Public Health Department have for some time past made arrangements for nursing and bathing attendant staff to visit the homes of such persons and there cleanse them as effectively as possible by means of a bed bath. It will be appreciated that in the circumstances of some homes this may be a difficult and not altogether satisfactory arrangement If a person is confined to bed then of course. no other arrangement can be made. Some persons however who receive the laundry service are not entirely confined to bed but nevertheless it would be unsuitable for them to visit the Council's Public Baths if, as is usually the case there is no bath in their own homes For this group of elderly persons the Council have now provided a sitting-case ambulance which is used to convey them to the Treatment Centre for a bath, under supervision and with assistance 72 This combined personal, clothing and bedding hygiene service should prove a most useful and helpful addition to the amenities provided for the physically handicapped elderly persons in the Borough. Public Health (London) Act, 1936, Section 122 Cleansing and Laundry Service During the year, the Council agreed to extend the laundry service for incontinent elderly persons to articles sent by the Home for Confirmed Invalids and the Aged Pilgrims' Friend Society, in addition to appropriate cases referred by the Holborn Borough Council. 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 the above Section of the Act, 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 - Islington residents - No. of recipients approved ... . . 1ll No. of washings carried out. ... ... ... 2,073 No. of articles cleansed ... ... ... 21,573 Home for Confirmed Invalids, Highbury Terrace The Public Health Committee, on 1st June, 1959, approved service for the Home for Confirmed Invalids at a cost of 7&d. per lb. (subject to a minimum of 12 lbs. at 7s. 6d ) This commenced on 13th July, and up to the end of the year the weight of laundry dealt with was 19 cwts. 2 ptrs 17 lbs. Aged Pilgrims' Friend Society Home, Hazellville Road Recommendations are received from the Matron for inmates of the nursing home wing who are incontinent. Operation commenced on 19th October and up to the end of the year 3 cwts. 3 qtrs 21/2 lbs. of laundry were dealt with. 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 1955, and during the current year 445 washings, comprising 3758 articles were carried out on behalf of 33 recipients. London County Council (General Powers) Act, 1933, Section 43 Cleansing of Elderly Persons Elderly persons cleansed by the Department's nursing staff and bathing attendants numbered 1,846. Visits were made to the homes of recipients in 1,234 cases, and 612 baths were given at the Treatment Centre, almost nil of the persons concerned being conveyed in the Department's sitting-case ambulance. This work is under the supervision of the Nursein-Charge at the Treatment Centre. 73 National Assistance Acts, 1948 and 1951 In one instance only it was necessary to invoke the procedure for the removal of a person to suitable premises without delay, in accordance with the provisions of the National Assistance (Amendment) Act, 1951. An order under subsection (3) of section forty-seven of the National Assistance Act, 1948. for the removal of any such person as is mentioned in subsection (1) of that section may be made without the notice required by subsection (7) of that section if it is certified by the medical officer of health and another registered medical practitioner that in their opinion it is necessary in the interests of that person to remove him without delay." Details of the statutory action taken are given in the following statement which has been compiled in the form required by the Ministry of Health Aged and Infirm - Action taken under Statutory Powers Name Period Type of and Reasons for Council's Action Named in accommodation Ultimate Result Age Order to which removed (1) (2) (3) (4) (5) Mrs R Mrs R had been the subject Not Welfare Home Remained in Welfare Home 91 vears ? ?n?o » statutory action exceeding as voluntary patient for incn Action was taken in three further six weeks after 1959 as the home was in a very weeks expiration of period insanitary condition with specified in Order On offensive odours permeating to return home accepted the outside of the room services offered including occupied. There was a fire personal cleansing, meals hazard as Mrs. R a registered bn wheels, laundry, and blind person, had the habit of home help A fireguard was dozing near the fire. The owner/ refused occupier and the patient s prior return the home doctor were concerned about her was thoroughly cleansed well being Welfare Home treat- and partlyBre furnished ment considered necessary was the 5atter with the heip refused and a Justice of the of the National Assistance Peace made an Order following a Board and the Islington visit by the Deputy Medical 01d people's Welfare Council. Officer of Health Our officers themselves laid down new linoleum New clothing was provided by the Welfare Home and a National Assistance Board officer looked into the financial position Mrs R s cat, safe guarded by the Animal Rescue League during her absence, was welcomed back Conditions were found to vary from time to time when visited by the Health Officer In the cases set out below it was possible, with the aid of the various services available to elderly persons, to find happier solutions to the problems raised and they are typical of the case work undertaken by the Department's visitors on behalf of the more difficult type of elderly persons where the Department is requested to assist by relatives neighbours family practitioners, etc. 74 Mr. C. (88 years) Mr. C. was a feeble old man maintained at home reasonably well with the help of neighbours and a relative Unfortunately this help was suddenly withdrawn and it was felt at first that it would be impossible for Mr C to remain at his address However, daily home help from the London County Council was arranged the Invalid Meals Service given, and later, home bathing and the Council s Special Laundry Service operated Even with available services it is often difficult adequately to care for anyone as infirm as Mr C but this situation was helped by tne fact that he was known to a number of callers, who, in turn, would report on his needs As a result of information received a broken front door lock was satisfactorily dealt with mice infestation treated by the Council s rodent section the National Assistance Board approached for clothing replacement and domiciliary chiropody treatment given Mrs K (97 years) Mrs K was first brought to the notice of the Department by the National Assistance Board and when visited by the Old People s Health Officer was found to be occupying a first floor front room which was smelly and filthy The room was cluttered with furniture and occupied by four cats, which were not let out. The smell was aggravated by the condition of Mrs K s ulcerated legs The District Nurse (from the North London (Islington) District Nursing Association) was attending to dress Mrs K s legs but found her task increasingly difficult due to the presence of the cats and vermin The Home Help Service of the London County Council was also operating but this was not regular as the majority of home helps found the conditions intolerable Fumigation was carried out by an operative of this Department and the Animal Rescue League collected three of the cats This improved conditions slightly but no considerable difference was made until the Nurse-in-Charge of the Borough Council Treatment Centre called to give regular home bathing In this way it was possible to obtain a change of linen and clothing and to arrange for the provision of Council s Special Laundry Service Domiciliary chiropody treatment was also given The structural and decorative conditions of the whole house are extremely bad but little can be done to improve this as the premises are subject to a Closing Order made by the Council under the Housing Act, 1957 Fortunately, the elderly owner lives on the premises and has never complained about conditions or Mrs K herself, as he maintains that she had been very good to him in the past However, with the right type of home help operating and maintenance of other services, conditions have not deteriorated further At some time in the future when the Council are able to deal with the question of rehousing the occupants the well being of Mrs. K will require further consideration Mrs V. (82 years) For many years Mrs W. had taken in lodgers but with advanced age and senility had become increasingly dependent on the services of one of these lodgers a Mr D who had been with her for a considerable time In May 1959 Mr D. collapsed in the street and was taken to hospital A local shopkeeper telephoned the Public Health Department to this effect, as Mr D was very concerned as to what would happen his landlady during his absence Following a visit by the Old People s Health Officer Mrs W was found to spend most of the time in bed and to be senile and incontinent Her bed and bedding were filthy and the room verminous and insanitary There were also five cats and innumerable kittens on the premises Offers of help were at first refused and Mr D (on his return from hospital) was also reluctant to avail himself of any services Finding the task of caring for the old lady increasingly difficult, however he did eventually agree to accept limited help The first step was to take both by the Council s ambulance to our Treatment Centre for personal cleansing and during their absence, the rooms were sprayed by an operative of this Department for vermin and the People s Dispensary for Sick Animals collected some of the cats and kittens Next, the home help service was introduced Two home helps did yeoman work to clear and clean Mrs W s room and eventually bed and bedding replacements were made and accumulation of rubbish removed by the Council's Cleansing Department Bathing has continued regularly for this couple together with the Meals Service and Mrs W now has the Council s Special Laundry Service and has benefited from domiciliary chiropody treatment 75 Mrs. C. (67 years) Mrs. C. was always a most difficult case to deal with but this was mainly due to her very poor health and the fact that her condition was aggravated by the basement accommodation to which she returned from Hospital. As the premises were subject to a Closing Order no improvements could be made to her room and she was unwilling to return to Hospital for treatment or to consider entering a Home. She would tolerate services for a limited period only and then refuse to open the door to any callers However, with patience and persistence (together with a regard to Mrs C! s wishes as to what time calls should be made) domiciliary services i.e. home help, meals on wheels and home bathing were maintained The Council was eventually able to offer Mrs C. alternative accommodation in a self-contained Council flat This offer was at first refused but eventually accepted and the Public Health Department staff gave every assistance in helping her to change accommodation and to get her settled in her new home Although she still complains from time to time Mrs C appears reasonably happy in her flat and the services indicated above are being maintained 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. Grants were approved for "Meals-on-Wheels" services operated by the Women's Voluntary Service and the Islington Old People's Welfare Council Meals supplied during the year were as follows on-Wheels Women's Voluntary Service 7,186 j Islington Old Peoples Welfare Council g | 18,911 meals > cooked by Lunch Clubs { NALGO, Town Hall \ Canteen) Gifford Hall Mission Welcome Club 3,840 j Caxton House Settlement ... 1,394 > A lunch club at St. Giles Christian Mission, Bride Street. N 7 also produced 2 438 meals with the help of their own voluntary workers and Council grant aid It is obvious from the figures given above of the number of meals supplied to elderly persons who would otherwise have had either no meal or a very unsatisfactory one that the meals service is now quite extensive and useful Nevertheless, the operation of the "Meals-onWheels" vans is limited, since the number of voluntary helpers upon which the service depends to a considerable degree is also limited and a very great burden is thrown upon those who are prepared to give up some of their time around mid-day so that others may obtain a warm mid-day meal. The service is also restricted by reason of the fact that it is not possible at present to provide more than two meals per week to any one person, and new applicants can only be put on the list after a waiting period. The nutritional value of the service would be greatly improved by increasing the number of meals provided per person and it is hoped that this development may be possible in the future. Holidays for Elderly Persons By means of a scheme administered through the Old People's Welfare Council 532 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 76 Chi ropody The Council has continued to support voluntary organisations in the provision of a chriopody service for elderly persons. There has been found to be an extensive demand for treatment and nine clinic sessions were held weekly, three at the Islington Medical Centre, the Gifford Hall Mission and the Junction Road Congregational Church Hall respectively Clinic appointments were made by the Public Health Department and during the year 3 809 treatments were given to 945 old age pensioners A limited domiciliary service is in operation and all applicants are visited by the Old People's Health Officers before treatment is given. During 1959 217 housebound elderly persons received 355 treatments in their homes. In addition, sessions for members of an old people's club continue to be held three times a month at the Caxton House Settlement Fonthill Road N. 4. PUBLIC MORTUARY By agreement with the St. Pancras Borough Council the use of the Council's Mortuary was discontinued as and from 31st March, 1949 all bodies being received at the St, Pancras Mortuary, Camley Street, N.W.I., after that date ISLINGTON CREMATORIUM The Medical Referee or the Deputy Medical Referee certified a total of 587 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, the Home Help Service and a foot clinic service in the Borough, which, together with the Boroughs of Pinsbury 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 Maternity & Child Welfare Centres Infants North South East West Archway 0-1 years 13,937 10,371 8,378 10,717 2,522 1-2 years 2,018 1,345 805 1,365 395 2-5 years 932 502 211 1,309 154 Special Toddlers' Clinics. 994 316 420 598 • . « Ante-Natal and Post-Natal Combined 5,518 3,236 3,371 * 2,449 Foster Mothers The table of foster-mothers and foster-children registered under the Childrens Act, 1958 is as follows - 31 12 59 Number of persons fostering children 22 Number of foster-children being cared for 30 77 L.C. C. Day Nurseries and Child Minders 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). In addition there were at the end of the year 124 children being minded by 108 child minders registered voluntarily under the L.C.C. scheme. Nurseries and Child Minders Regulation Act, 1948 At the end of the year there were 51 children being minded by 15 child minders registered by the L.C.C. under the provisions of the Nurseries and Child Minders Regulation Act 1948 There was also one private day nursery registered under the Act providing 8 places Foot Clinics A foot clinic is provided at East Islington Welfare Centre at Drayton Park for priority cases" - the aged, expectant mothers and the physically handicapped During the year there were 2,597 attendances. Many Islington residents attend the main foot clinic at Pine Street in Finsbury where the total attendances were 18,823. Home Helps The home help area is administered from three area offices in the Division Each of the three areas covers part of Islington and together cover the whole Borough The total number of households in the Division receiving home helps on 31st December 1959 was 1,732 -a oo Vaternity and Child Welfare Centres - The days and times of sessions are as follows - CENTRE Ante-Natal & Post-Natal Childern's Toddlers Dental Diphtheria Immunisation Poliomyelitis Inoculation Smallpox Vaccination North Islington Infant Welfare Centre (Voluntary) 6-9 Manor Gardens, N.7. Mon. \ Thurs Tues.-> Wed. ThursJ Wed. 2 p.m. (midwives) 10 a.m. 2 p.m. Mon. Frid. to 2 p.m. Wed 2 p.m. (2nd week) Thurs. 10 a.m. (1st week) 2 p.m. (4th week) Frid. 2 p.m. Wed. 1.30 p.m. Thurs 9.30 a.m. Frid. &1.30 p.m. Wed. 2 p.m. Fri. Thurs 10 a.m. 5.30 6.30 p.m. Wed. 2 p.m. North Branch Clinic Blythe Mansions, Hornsey Rise, N. 19. Fri. 2 p.m. Mon. 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.1. Tues. Thurs. & 10 a.m 10 a.m. 2 pm. (midwives) Mon. Tues Wed Frid. 2 p.m. 10 a.m. Wed. 10 a.m Wed. 10 a.m. Mon. 10 a.m. Wed. 10 a.m. West Branch Clinic Tenants Clubroom, Hilldrop Estate, N.7. Mon Tues Wed 2 p.m. South Islington Welfare Centre 6, Clephane Road, Essex Road, N.1. Mon. 1 Tues 1 Frid ) 10 a.m. Mon. Wed Thurs 2pm 10 a.m. 2 p. m 2 p. m Frid 2 pm. Frid. 2 pm. Thurs Wed 10 a.m. 5.30 6 30 p m Frid. 2 p.m. South Branch Clinic Union Chapel, Compton Avenue, N 1. Tues. Thurs 2pm East Islington Welfare Centre Mon 10 a m Tues 2 p m Tues 10 a m. Mon. 2p.m. Frid. 2 p.m. Mon. 3 p.m. 32, Drayton Park, N.5. Wed & 5. Thurs. Frid * 2 p. m (mi dwives), 30 1-6.30 p 2 p.m. 10 a m. Wed Fri. m. Tues 10 am 2 p.m. INDEX Accidents 10,13-14 Acute Encephalitis 15 Acute Poliomyelitis 15,19-21 Aged and Infirm Persons 73-75 Ante-Natal Clinics 78 Anthrax 15,49 Atmospheric Pollution 39-44 Bacteriological Examination 31,52-53,66 Births 7,10,12 Blow-Fly Infestation 38 Cancer - Lung 9,10,13 Certificates of Disrepair 34,54 Chemical Examinations 53,66,67 Child Life Protection 76 Child Minders 77 Child Welfare Centres 76,78 Chiropody for Elderly Persons 76 Clean Air Act, 1956 39-41 Cleansing, Elderly Persons 70-72 Closing Orders 55-56 Crematorium 76 Day Nurseries 77 Deaths 8-9,10,12-14 Dental Clinics 78 Diphtheria 10,15,22-23 Diphtheria Immunisation 23 Disinfection 38 Disinfestation 38-39 Disinfestation of Sewers 52 Dysentery 15, 25-26 Elderly Persons, Services for 70-76 Encephalitis, Acute 15 Enteric Fever 15 Erysipelas 15 Export Certificates 38,64 Factories Act 45-47 Fly Infestation 38 Food and Drugs Act 60-62 Food Hygiene Regulations 60-62 Food - Inspection and Supervision 57-67 Food - New Legislation 57 Food Poisoning 15,24 Food Sampling 63 Food, Unsound 63 Foot Clinics 76,77 Foster Mothers and Children 76 Hairdressers & Barbers 50 Health Publicity and Health Education 68-70 Heating Appliances (Fireguards) Act 1952 50 Holidays for Elderly Persons 75 Home Helps 77 Home Safety Committee 68 Home Visiting 31 Housing 54-56 Ice Cream 57,66 Illegitimate Infants - Births and Deaths 7,10 Infant Mortality 8,10,11,13 Infectious Diseases 15-ii. Influenza, Pneumonia and Bronchitis 29-30 Inoculation, etc,, Certificates 16 Laundry Services 70-71,72 Legal Proceedings 33,36-37,39,41,55,62 Live Births 7 L.C.C. (General Powers) Act 32,35,47,72 M & C. W. Services, 76-78 Malaria 15 Marriages 7,10 Mass X-Ray 28 Maternal Mortality 8,10 Meals on Wheels 75 Measles 15,16,17,18,19 Meat 64 Meningococcal Infection 15 Merchandise Marks 65 Metropolitan Cattle Market 64 Milk lations 57,67 Milk (Special Designations) 67 Miscellaneous Services 68 78 Mortuary 76 National Assistance Acts 73,75 Neoplasms, Malignant 10, 13 Noise Nuisance 47 Nurseries-Day 77 Offensive Trades 48 49 Ophthalmia Neonatorum 15 .t Outworkers 46 Overcrowding 56 Pet Animals Act 50 Pharmacy and Poisons Acts, etc 50 Pigeon Nuisances 48 Pneumonia 15,29 30 Poliomyelitis 15,19-21 69 Poliomyelitis, Protection Against 21 Population 7,10.12 Post-Natal Clinics 78 Premature Infants H Preserved Food Premises 61 Prevention of Damage by Pests Act and Order 51-52 Public Health Committee 5 Public Health Inspectors - District Work 32 35 Public Health Inspectors - Special Work 45 50 Public Health (London) Act - Improvements effected 34 35 Public Health (London) Act, Sections 40 and 109 35 Public Health Officers 56 Public Health (Tuberculosis) Regulations 1952. 27 28 Publicity 68-70 Puerperal Pyrexia 15 Rag Flock and Other Filling Materials Act 50 Rats and Mice 51-52 Refreshment and Coffee Stalls 65 Rent Act, 1957 34 Requisitioned Property 45 Respiratory Infections 29-30 Sampling 52-53,63 Sanitary Circumstances 32 53 Scabies 15,30 31 Scarlet Fever 15 Sewer Treatments52 Smallpox 15 16 Smell Nuisance 48 Smoke 39 44 Staff 56 Static Water Tanks, etc 39 Statistics - General 7-14 Statistics - Vital 7-14 Still-Births 7 T10 Swimming Baths 53 Toddlers' Clinics 78 Town & Country Planning 56 Treatment Centre 30,70-71,72 Tuberculosis 27-29 Tuberculosis - Beds and Bedding 29 Tuberculosis - Care Committee 29 Tuberculosis - Chest Clinics 28 Tuberculosis - Deaths 13 Tuberculosis Notifications 10,15,27 Typhoid Fever ... ... 15,25 Underground Bakehouses 47 Vaccination 16 Vermin —. 31 Washing Facilities, Free 65 Water Supplies 52-53 Welfare Centres 78 Whooping Cough 15,16,18-19 Ass Ed Tav it Printed and Published by Islington Borough Council