Ac-4361 ISL 89 1960 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. 1 CAN on bury 3388 Public Health Department, Town Hall, Islington. N.1. TO THE MAYOR, ALDERMEN AND COUNCILLORS OP THE METROPOLITAN BOROUGH OP ISLINGTON I have the honour to present the Annual Report for 1960 on the health of the population of the Metropolitan Borough of Islington. The Report includes mention of a variety of changes in a direction favourable to the public health and indicates some of the fields where there is little or no cause for satisfaction in the existing state. The birth-rate continues to increase and it is now one of the highest local rates in London, having almost reached the level of the post-war peak year in 1947 the 1960 birth-rate represented a total of over 5,000 new arrivals during the year. The increase in the birth-rate over the last few years, which may well continue for some time, obviously raises important problems of production, housing, schooling, etc., for which planning is required for many years phead. Anotherrecord low figure for deaths from pulmonary tuberculosis (which was once a major 'killer' disease) was again recorded, but unfortunately there was little change in the notification of new cases of pulmonary tuberculosis which indicates that there must still be a good deal of residual infection in the population It therefore appears that pulmonary tuberculosis (of which there are some 2,700 cases in the health records of the Borough) is likely to remain a major medico-social problem for several years to come at least Malignant disease of the lung and bronchus, working in the contrary direction to tuberculosis, has continued to increase and deaths have established a new high record in the Borough With so much well-based evidence of the ill-effects of smoking upon health (and not only in relation to promoting lung cancer), it is difficult to understand why commercial publicity through the press, public hoardings and television is permitted the full liberty to encourage young people in particular to take up this habit which may produce ill-health of a dangerous character especially from middle-age onwards. Having regard to the adverse social conditions in which many people in Islington live, the low infant mortality rate must be regarded as a tribute to the efficiency of the medical and welfare services on the one hand and the good standard of mothercraft on the other. This is not to say, however, that there is not considerable room for further improvement in the prevention of the ill-health which still occurs in infants and young children. Accident prevention in the home and on the road is another field where much preventive work remains to be done to save human life and to avert injuries which may be long-term or even permanent. In regard to the incidence of the various infectious diseases there were no exceptional peaks in 1960. although there was a substantial rise in the number of whooping cough cases over the previous two years. After the unfortunate experience of Islington in the 1959 poliomyelitis outbreak, there was a small number of cases only in 1960 and not above the general average There was not a single confirmed case of diphtheria, which event has happened only once before, in 1952 There was a small increase in the dysentery cases, mainly in all children under 15 years; and there were two moderate-sized outbreaks of food poisoning which are dealt with in the body of the report. 2 Health & Hygiene Education In addition to the usual health education work which goes on continuously by distribution of handbills, poster exhibition various talks and the advice given by the officers of the Department when visiting homes shops, factories, etc., there were two publicity highlights in the year. These were the holding of two public exhibitions one on the subject matter of Clean Air, and the other having "Safety in the Home" as its theme. Exhibitions of this nature involve a good deal of work for everybody concerned and, as described in this report, it will be obvious that many individuals and organisations were actively concerned in the arrangements for these exhibitions as well as the Public Health Department itself. Exhibitions in these days must face the competition of many other attractions for the public both during the day and in the evening It is satisfactory to record, however, that both exhibitions were considered to have justified the work involved in their arrangements and the "Safety in the Home" Exhibition in particular proved attractive to the general public as well as to the special groups who visited, such as school children, A feature which aroused very considerable interest at this exhibition was the invitations to schools to send in children's paintings around the theme of home safety. This gave scope for a good deal of imagination and the standard of many of the paintings sent in, allowing for the ages of many of the children submitting pictures, was considered to be excellent The work of the Islington Home Safety Committee also received considerable publicity from the publication of the handbook "Sense About Safety" Legislation and Problems Minor legislation which may add up to quite a considerable number of improvements continued to be introduced during the year Tragedies due to the use, and sometimes mis-use, of oil heaters led to the passing of the Oil Burners (Standards) Act 1960 which should be of considerable help in reducing such risks in future. In matters of this kind however, it must be borne in mind that the most important factor in prevention is the intelligent co-operation of the public itself. The Noise Abatement Act, 1960, was another piece of legislation which should help with a continually increasing problem of modern life, that is, noise nuisance For the first time vibration as well as noise may be dealt with. The London County Council (General Powers) Act, 1960 also enlarged powers of dealing with dust nuisances, and the Caravan Sites and Control of Development Act, 1960, similarly extended the powers for dealing with caravans and caravan sites Fortunately, perhaps, one compensation of an area which is so completely built up as Islington is that very little space, if any is left for caravan sites Property improvements as mentioned in last year's Report are proceeding on a considerable scale but nevertheless there are still many instances where the Department has, unfortunately found it necessary to institute proceedings for public health nuisances which have not been dealt with in a reasonable time and the Report includes a summary of legal proceedings which had been taken in 36 nuisance cases Pollution of the Atmosphere It is hoped that as time goes on more areas in Islington will be declared Smoke Control Areas at an increasing rate. Two Smoke Control Orders came into operation during the year and it is gratifying that there has been the most excellent co-operation of the public and no objections at all were raised against the respective Orders. The Council during the year agreed to the appointment of two Technical Officers to be engaged whole-time on duties under the Clean Air Act working under the supervision of the Specialist Public Health Inspectors, and the benefits of these appointments will no doubt be felt in the very near future 3 Housing Housing has continued to be a major problem in the Borough, and no doubt this will be the position for many years to come. Greater attention is being given to bringing older type houses into some measure of conformity with modern standards and the provision of amenities which should reasonably be expected at the present time. The Report gives figures of the considerable number of new houses and flats which were erected in the Borough during the year through the respective agencies of the Borough Council, the London County Council and private enterprise and, as detailed in the Report, the local authority housing which now exists in the Borough is very considerable. Nevertheless, the greater part of the population of Islington must still continue to occupy older-type houses and therefore the problems of improvement and modernisation are very important. Food Hygieni The Report includes an account of two food poisoning outbreaks, neither, fortunately, on a very large scale but nevertheless examples of what should be prevented. New Regulations concerned with food hygiene came into force during the year and these Regulations amplified earlier controls. Codes of Practice dealing with hygiene in the fish trade were also issued by the Minister of Health and the Minister of Agriculture, Fisheries and Pood and, whilst the greatest measure of local trade publicity to these Codes of Practice was sought through their being personally distributed by the Public Health Inspectors to all fish businesses, it is presumed that such Codes may be a forerunner of further food hygiene regulations if found necessary. New aspects of food hygiene risks come to light and it is thought that an account of some interest is included in the Report in the mention of bacterial contamination of desiccated coconut products which may give rise to food poisoning, and which was not previously considered as being a possible food poisoning risk. Whilst the vast majority of food traders in the Borough provide conditions of a good or reasonable standard with no cause for statutory action, the Report does include a summary of a number of cases where offences occurred under the Pood and Drugs Act and the Pood Hygiene Regulations and legal proceedings had to be taken by the Council. Elderly Persons The services for elderly persons which the Borough is able to render through current legislation continued to provide substantial help during the year as detailed in the body of the Report. The Department" s arrangement for the treatment of soiled laundry was extended, and the arrangements for the cleansing of many elderly persons either in the home or in the Treatment Centre under qualified supervision by the Department* s staff, has continued to providi a most useful service of considerable assistance in helping many elderly persons to maintain their self-respect as well as improving their physical condition The ambulance which the Council purchased particularly for the transport of elderly persons in this connection has proved a very sound investment. Perhaps the usefulness of the Department" s work in connection with the elderly can best be seen from the details given in the Report of just a few cases illustrating the problems met with and the manner in which they were dealt with Staff and General It is becoming a regular feature of these reports that I have to mention the serious deficiency in the number of Public Health Inspectors on the establishment. This situation, unfortunately, continued during 1960 and there appears to be little possibility of worth-while improvements in the near future. The effect, of course, is to render it impossible to carry out as many inspections of houses, shops, food examinations, etc. as are considered desirable and delays in carrying out visits or responding to requests from the public inevitably arise and are very greatly regretted Nevertheless the Report records a very considerable amount of work done by the existing Inspectors, working frequently under circumstances which require the exercise of considerable tact. 4 I have mentioned in previous reports that the Public Health Department is a health team which depends upon the contributions of its various members to the total value of the services it is able to render I again have to express my personal thanks particularly to Dr. J.P.J. Burns, Deputy Medical Officer of Health Mr. W. C. Bartlett, Chief Public Health Inspector, Mr. H. Plinston, Deputy Chief Public Health Inspector and Mr E.J Sharp Chief Clerk, as the principal officers responsible for the work of the Department I again have pleasure in thanking Dr Wilfrid G. Harding Divisional Medical Officer Health Division 3, and his Divisional staff for their full and unstinted co-operation at all levels in the exchange of public health information and for their part in effecting co operation and liaison between the Borough's environmental health services and the County Council's personal health services which is so absolutely essential for the benefit of the public as a whole. Finally, I am happy to record my continuing thanks and appreciation to the respective Chairmen of the two Committees with which the Public Health Department is most intimately concerned, namely, Alderman A.J. Rogers of the Public Health Committee, and Councillor E J Bayliss of the Housing Committee. My thanks are also extended to all Members of their respective Committees for their courteous reception and consideration of the reports I have placed before them V FREEMAN Medical Officer of Health 5 MEMBERS OF THE PUBLIC HEALTH COMMITTER (As at 31st December 1960) MAYOR: Councillor MRS. AGNES SEELEY, 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 MRS. PRANCES MARJORIE COLE WILLIAM DRADEY HENRY WILLIAM FRANCIS FORD ALBERT GEORGE LANGDON HYDE MRS. MARY EVA GERTRUDE HYDE HENRY JAMES REID TERENCE CORNELIUS ROONEY 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 PALL, ISLINGTON, N.1. Medical Officer of Health: V. FREEMAN, M. R. C. S. , L.R. C. P. , D. PH. Deputy Medical Officer of Health: J P.J. Burns, M.C., M.B. , B Ch. , B. A 0. , D. P H. , (Part-time) Public Analyst: D. F.H. BUTTON, A. R. C S , F. R. I. C. Chief Public Health InsDector W. C. BARTLETT, M.A.P.H.I., M.R. S. H. (b) (c) (d) Deputy Chief Public Health Inspector: H. PLINSTON, (bj (c) Supervisory Public Health Inspector: J. S. ASHWORTH, (b) 6 Public Health Inspectors: H. Archibald (b)(c) A. Aslamidis (b)(c) G. D. Couling (b)(c) K.L. Garner (b)(c) Miss V M Goddard (b)(c)(f)(g)(h) R. T Govett (b)(c) H. P. Johnson (a) A. R. Kempshall (b) T. Lawson (h)(e) W. S. LeMaitre (a) N Lightowlers (b)(c)(d) S E. Muggeridge (b)(c)(e) J.H Newman (b)(c) P.H I, Pedrick (b)(c)(e) Miss S H Prentice (b)(c)(f)(g)(h) K. D Rattenbury (b)(c) G. A. Reid (b)(c) K E Sewell (b)(c)(d)(e) D. P. Stanton (b)(c) W. T. Stevenson (b)(c) R C Whittaker (b)(c) R D Williams (a) (9 vacancies) Technical Assistant-Clean Air Act 1956: R. A Drake Chief Clerk: E J Sharp Clerical Staff: S. A. Bishop P. Hardwick Mrs &R Moody Mrs, M Brain J Hough C.J Moore* W, R. Causton* Miss M E Hudson D A. Owen E. E. Conner L Hummerstone P. L. Regan Mrs V E Cook D Jefferys Mrs V. Skinner Mrs J M Crisp Mrs E Johnson J. Thompson P.E.J. Dymond W A McAdam* Mrs F Underwood Mrs 0. Easson Mrs C A McCausland S. Wright* Old People's Health Officer Infectious Diseases Visitor Mrs A E. Poster (h) Mrs C M Burton (h) Treatment Centre Seven Sisters Road N.7 W G Jollie (Qigineer in Charge) Mrs. H W Godkin (Nurse in Charge) (h) 4 Home Visitors 1 Stoker Handyman 1 Assistant Driver 4 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 the Public Health Inspectors Education Board (b) - Certificate of the Royal Sanitary Institute and the Sanitary Inspectors Examination Joint Board or other qualification as a Public Health Inspector approved by the Minister of Health (c) - Certificate of the Royal Society of Health or the Royal Sanitary Institute (or other approved qualification) in Meat and Other Pood inspection (d) Certificate of the Royal Society of Health or the Royal Sanitary Institute in Sanitary Science (e) - Certificate of the Royal Society of Health or the Royal Sanitary Institute in Smoke Inspection (f) - Health Visitor's Certificate (g) State Certified Midwife (h) - State Registered Nurse * 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 1960: 222,940 Live Births BIRTH RATE PER 1,000 ESTIMATED RESIDENT POPULATION Totals M. F. Islington England & Wales Area Unadjusted Comparability Adjusted Factor Legitimate 4,543 2,346 2, 197 Illegitimate 652 330 322 5,195 2,676 2,519 23.3 0.92 21.4 17.1 Illegitimate live births per cent of total live births 12.6 Still Births RATE PER 1,000 TOTAL (LIVE AND STILL) BIRTHS Totals M. F. Islington England & Wales Legitimate 85 49 36 Illegitimate 20 11 9 105 60 45 19.8 19.8 Total live and Still Births 5,300 Notifications of Births For the year ended 31st December, 1960 5, 187 (corrected figure from L.C.C.) Marriages (Provisional figures) Marriages solemnised in the Borough during the year 2,367 a Deaths Infant mortality (deaths under 1 year) Total deaths 109 RATE PER 1,000 LIVE BIRTHS England & Islington Wales 21.0 21.9 Legitimate 20.0 Illegitimate 27.6 Neonatal mortality rate (deaths under 4 weeks) 15.8 Early neonatal mortality rate (deaths under l week) 13.3 Perinatal mortality rate PER 1,000 TOTAL LIVE AND STILL BIRTHS (still births and deaths under 1 week combined) 32.8 Maternal deaths (Including abortion) Total deaths 1 RATE PER 1,000 LIVE AND STILL BIRTHS 0.19 0.39 All deaths RATE PER 1,000 POPULATION England & Total M. F. Islington Wales Area Comparability Unadjusted Factor Adjusted 2,466 1,283 1,183 11.1 0.96 10.6 11.5 9 CLASSIFICATION OF DEATHS WITH AGE DISTRIBUTION (REGISTRAR GENERAL'S RETURNS) CAUSE OP DEATH AGE GROUPS All Ages 0- 1- 5- 15- 25- 45- 65- 75- M. F. Total M. F. M F. M. F. M. F. M. F. M. F. M. F. M. F. 1. Tuberculosis, Respiratory 6 5 11 1 2 2 2 2 1 1 1. 2. Tuberculosis, Other 1 1 2 - _ _ _ _ - _ _ _ _ _ 1 1 _ _ 2. 3. Syphilitic diseases 5 1 6 - - - _ _ _ - _ _ _ 1 _ 1 _ 3 1 3. 4. Diphtheria - - - - - - - - _ - - _ - - _ - - _ _ 4. 5. Whooping Cough - - - - - - _ _ - _ _ _ _ _ _ _ _ _ 5. 6. Meningococcal Infection 1 1 1 - - _ . _ _ _ _ _ _ _ _ _ _ 6. 7. Acute Poliomyelitis - - - - - _ - _ - _ _ - _ _ - _ _ _ 7. 8. Measles - - _ - _ _ _ _ _ - _ _ _ _ _ _ _ _ _ 8. 9. Other infective and parasitic diseases 1 1 _ _ _ _ - - _ _ _ _ 1 _ _ _ 9. 10. Malignant neoplasm, stomach 47 32 79 _ _ - _ _ _ _ _ 1 _ 21 15 15 4 10 13 10. 11. Malignant neoplasm, lung bronchus 156 26 182 - _ _ _ - _ _ 11 1 82 8 43 6 20 11 11. 12. Malignant neoplasm, breast 1 36 37 - _ _ _ _ - _ _ 3 1 17 5 _ 11 12. 13. Malignant neoplasm, uterus - 19 19 _ _ _ _ _ - _ _ _ 2 _ 8 _ 7 _ 2 13. 14. Other malignant neoplasms 97 125 222 - 1 - - - 1 1 1 7 9 43 38 20 34 26 41 14. 15. A-and-Leukamia 9 5 14 _ 1 3 _ _ 1 _ 3 1 4 _ _ 1 _ _ 15. 16. Diabetes 6 9 15 _ . _ _ _ 1 _ 1 1 1 3 2 1 5 16. 17. Vascular lesions of the nervous system 88 151 239 - _ _ _ _ _ _ _ 2 2 25 24 26 33 35 92 17. 18 Coronary disease, Angina 277 163 440 - _ _ - - _ 1 - 13 _ 106 27 91 47 66 89 18. 19. Hypertension with heart disease 21 42 63 _ _ _ _ _ _ _ _ 1 3 2 3 6 15 33 19. 20. Other heart disease 78 147 225 _ _ _ _ 1 _ _ - 1 6 17 11 18 24 41 106 20. 21. Other circulatory disease 52 95 147 _ _ _ _ _ _ _ _ 1 1 10 7 14 14 27 73 21. 22. Influenza - 4 4 _ _ _ _ _ _ _ _ _ 1 _ 1 _ 1 _ 1 22. 23. Pneumonia 77 81 158 13 6 - _ _ _ 1 1 _ 12 5 18 24 33 45 23. 24. Bronchitis 126 64 190 1 _ 1 _ _ - _ 1 3 37 8 32 10 54 43 24. 25. Other disease of the respiratory system 22 6 28 _ _ _ _ _ - - 1 2 6 1 6 2 8 2 25. 26. Ulcer of stomach and duodenum 19 13 32 - _ _ _ _ - - 1 _ 6 _ 7 6 5 7 26. 27. Gastritis, enteritis, diarrhoea 2 11 13 _ 1 _ _ _ _ - _ 1 1 2 1 5 _ 2 27. 28. Nepthritis and Nephrosis 6 6 12 _ - - - - _ 1 _ - 1 3 4 1 - 1 1 28. 29. Hyperplasia of prostate 10 - 10 - _ - _ _ _ _ - - - 1 _ 4 - 5 _ 29. 30. Pregnancy, Childbirth and Abortion _ 1 1 - - - - - _ _ 1 _ _ _ _ _ _ _ _ 30. 31. Congenital Malformations 12 15 27 8 11 2 _ 2 1 _ _ - 2 - 1 - _ _ - 31. 32. Other defined and ill-defined diseases 84 81 165 43 22 _ _ _ _ 1 - 5 1 11 19 9 13 15 26 32. 33. Motor vehicle accidents 22 12 34 _ _ _ . 2 1 6 1 4 4 5 2 4 1 1 3 33. 34. All other accidents 35 22 57 2 _ 2 1 1 5 - 7 _ 10 3 2 5 7 12 34. 35. Suicide 19 10 29 - _ _ _ - _ 4 _ 6 3 7 3 3 2 1 35. 36. Homicide 3 - 3 - - 1 - - - 1 - 1 - - - - - - - 36. All Causes 1283 1183 2466 68 41 7 4 5 4 22 5 68 45 416 207 321 256 376 621 Totals 2466 109 11 9 27 113 623 577 997 Percentages 100 4.2 0.45 0.36 1.10 4. 58 25.26 23.40 40.43 10 COMPARATIVE VITAL STATISTICS - 1947 TO 1960 (Compiled from Registrar-General's Returns) 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 Population 222,940 223,400 225,800 227,800 228,300 228,800 230,500 233,500 235,300 235,800 238, 200 239,580 238,200 236,840 Live Births - (Total) 5,195 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) 652 557 494 467 402 340 336 296 282 285 302 318 331 431 Birth Rate per 1,000 population (Unadjusted) 23.3 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 19.8 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, 466 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 - (Unadjusted) 11.1 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 0.19 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 21 22 23 21 21 26 17 24 22 28 29 27 35 32 Marriage rate per 1,000 population 21.24 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) 1.83 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. 0.05 0.10 0.14 0.12 0.15 0.20 0.16 0.16 0.30 0.30 0.38 0.52 0.66 0.70 Diphtheria Nil Nil Nil Nil Nil Nil Nil Nil Nil 0.004 0.004 0.008 Nil 0.004 Neoplasm of Lung Bronchus & Trachea 0.82 0.77 0.68 0.67 0.62 0.52 0.53 0.57 0.54 0.54 0.54 * * * Suicides 0.13 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 0.15 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 0.26 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 * Not separately recorded. 11 SUMMARY OF INFANT MORTALITY 1960 (Based on Registrar General's Returns) 12 COMMENTS ON VITAL STATISTICS Births The increases in the annual births and birth-rates, which began in 1955 continued into 1960. Both sets of figures have almost attained the same levels as in 1947 which of course was the peak year of the post- war "bulge". There is no evidence yet that this tendency will not continue for at least the immediate future and those who are concerned with planning for the future, whether of houses, schools, or goods and services must take this rapidly rising population into account 12.6 per cent. of all 1960 births were classified as illegitimate This rate is also rising and it would be desirable to have further information on the social significance of this increase. 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 54,100 186,600 240,700 403, 400 644 100 Islington 4,900 15,100 20,000 28,900 48,900 Deaths The death-rate was somewhat lower than in 1959 and 1958 the main reason for the reduction being a lesser number of deaths due to the respiratory causes of influenza pneumonia and bronchitis. Apart from the absence of influenzal outbreaks this may be related to the relatively mild cold seasons in the year. The following table is reproduced for the current year showing the seasonal influences affecting deaths due to respiratory causes Under 1 year 1-54 55 - 64 65 - 74 75 + Total January 3 2 10 9 20 44 February - 2 5 5 31 43 March 2 3 7 14 28 54 April - - 5 10 11 26 May 1 4 4 10 17 36 June 1 - 2 6 16 25 July - 2 3 5 5 15 August 2 2 4 3 8 19 September 2 1 5 3 13 24 October 1 - 2 9 13 25 November 2 2 5 8 8 25 December 2 4 6 12 20 44 13 Deaths of infants under one year The infant mortality is, at 21 per thousand live births fractionally lower than in 1959, when the rate was 22 per thousand. 42 per cent of all infant deaths occurred within the first 24 hours following birth and 63 per cent within seven days of birth From one to twelve months the greatest risk to infants is due to respiratory disease, particularly pneumonia. Of a total of 27 infant deaths in the age group one to twelve months. 14 were due to pneumonia. Maternal Mortality It is a very considerable tribute to the hospital and London County Council ante natal and maternity services as well as the family practitioners concerned that in over 5 000 confinements during the year, only one mother unfortunately lost her life Respiratory Tuberculosis The downward trend in deaths due to tuberculosis of the lungs noted in previous Reports has not only continued, but accelerated Eleven deaths only due to this cause, giving a rate of 0.5 per thousand population, were by far the lowest figures for this cause ever recorded in the Borough Unfortunately, new cases of tuberculosis have not yet diminished so rapidly as the mortality, and this is commented upon elsewhere in this Report malignant Growths of Lung and Bronchas Contrary to the last-mentioned cause of death it has again to be recorded that deaths due to malignant disease of the lung and bronchus have again reached a new high record As pointed out in the last Annual Report, the table below indicates that the increase is due entirely to the increase in the number of males contracting this illness It is particularly unfortunate that young persons especially continue to ignore the health risk of cigarette smoking No new evidence has been produced which affects the formal acceptance by the Ministry of Health of the fact that by far the greatest risk of contracting lung cancer is due to excessive and prolonged smoking of cigarettes 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 1960 156 26 182 The following information has been kindly furnished by Dr Brett, Medical Director Static X-Ray Unit, Drayton Park in respect of persons passing through the Unit and found to have primary lung cancer tumour The figures given include residents outside the Borough as well as Islington residents Male Female Number of persons X-rayed 11,424 11,190 Number of cases found 72 10 14 Accidents The following table gives the deaths from accidents to Islington residents from 1952 onwards:- 1952 1953 1954 1955 1956 1957 1958 1959 1960 Motor vehicle accidents 18 18 19 33 29 21 30 30 34 Other violent accidents 48 46 40 50 si 52 40 55 57 In the following table causes of accidental deaths in 1960 are analysed, in their respective age groups. Type 0- 1- 5- 15- 25- 45- 65- 75+ M. P. Total Motor Vehicle Accidents - - 3 7 8 7 5 4 22 12 34 Falls - - - - - 7 4 15 12 14 26 Accidental Poisoning (Solid, Liquid Gases and Vapours) . - - 2 1 1 2 2 5 3 8 Drowning - - - 1 - - - - 1 - 1 Fi re 1 3 - 1 2 1 - - 6 2 8 Inhalation of Stomach contents, ingestion of food, etc - - - - - 1 - - 1 - 1 Others (Railway Accidents, etc.). 1 - 1 1 4 3 1 2 10 3 13 Total 2 3 4 12 15 20 12 23 57 34 91 Fatalities due to motor vehicle accidents were higher than in 1959 Other fatal accidents were increased by 2. 15 SECTION B PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES Notifiable Infectious Diseases and Deaths during the year 1960 Disease Number of Notifications Number of Deaths Removed to Hospi tal Number of Cases returned to RegistrarGeneral after correction of Diagnosis Cases "coming to knowledge" but not Notified Smallpox 1 - - - - - Scarlet Fever 128 (244) - 18 130 11 Diphtheria 4 (48) - 3 - - Enteric Fever (including Paratyphoid) 6 (17) - 4 4 1 Typhus Fever - - - - - Puerperal Pyrexia 160 (312) - 160 163 - Ac. Primary & Influenzal Pneumonia 56 (108) - 9 59 - Ophthalmia Neonatorum 17 (58) - 17 17 - Acute Encephalitis 2 (3) - 2 3 - Meningococcal Infection 4 (4) 1 4 4 1 Anthrax - - - - - Dysentery 804 (329) - 45 797 230 Malaria 1 . - 1 1 - Erysipelas 15 (29) - 5 15 1 Measles 1,436 (1,360) - 54 1,431 74 Whooping Cough 565 (165) - 83 567 75 Ac. Poliomyelitis 27 (96) - 27 15 - Food Poisoning 131 (164) - 12 123 48 Tuberculosis - Lungs 370 (355) 11 - 242 - Tuberculosis - Other Forms 39 (19) 2 - 31 - Scabies 62 (73) - 2 63 185 (Figures in brackets are notifications for 1959) Domiciliary Visiting of Infectious Disease Cases and Contacts - No. of Visits Smallpox 69 Scarlet Fever 140 Diphtheria 80 Enteric Fever (including Typhoid and Paratyphoid) 11 Meningococcal Infection 3 Dysentery 1,144 Malaria 1 Acute Encephalitis 1 Erysipelas 16 Measles 1,443 .Whooping Cough 624 Acute Poliomyelitis 135 Food Poisoning 136 Scabies 186 Vermin 290 Influenza - Ineffective Visits 1,045 Others 128 Total 5,452 16 Smallpox Four persons were referred by family practitioners to the Medical Officer of Health or his Deputy as suffering from rashes of a type where it was desirable to exclude smallpox as a possible cause Three were confirmed as cases of chickenpox and the fourth was finally considered to be a staphylococcal eruption of the face One of those reported as a suspect was a young man of Pakistani origin and although he was definitely diagnosed as a case of chickenpox, he was admitted to hospital since he was living in lodgings and no satisfactory attendance could be arranged for him at home for his period of sickness Information was received in the latter part of the year of a visitor to this country who arrived at London Airport having travelled from Singapore Two days after his arrival he attended the Casualty Department of a London Teaching Hospital on account of a slight rash. He was diagnosed as a case of modified smallpox and removed to the special isolation hospital Although this person did not visit Islington he had been seen by a medical student resident in this Borough and six other Islington residents were found to have been attending the Casualty Department at or about the same time as the smallpox case All contacts were kept under observation for the period of quarantine, and fortunately there were no further cases arising. These contacts, however necessitated 65 domiciliary visits by various members of the staff, including the Deputy Medical Officer of Health Visits were also paid to another contact of a suspect case in another Borough who was subsequently diagnosed as chickenpox. Surveillance of contacts included arrangements for their vaccination and liaison with the Divisional Health Office of the London County Council family practitioners and Medical Officers of Health of other local authorities, where appropriate 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* 1960 2,753* (Figures kindly furnished by Divisional Medical Officer, London County Council.) * Including Be-vaccinations # Group Sessions for Schoolchildren discontinued The Vaccination Acts were rescinded under the National Health Service Act, 1946. as from 5th July, 1948. 17 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 802 as against 740 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. 18 Measles The number of measles cases notified in 1960 was somewhat higher than in the previous year, which had been considerably lower than the average. As will be seen, however, from the chart showing the monthly distribution, measles incidence was relatively low during the first nine months of the year, but began to show a steady rise in October. This rise continued to the end of the year and into the early part of 1961 to a high level. MEASLES - MONTHLY INCIDENCE, 1960 19 Whooping Cough Comments were made in my Annual Reports for 1958 and 1959 on the unusually low incidence of whooping cough. 1960, with 565 notifications, as against 165 for 1959, showed a substantial increase. Under 1 year 1 - 5 5 years and upwards No. of Notifications in 1960 78 300 187 Percentage of total notifications 13.8 53.1 33.1 No. of Deaths - - - The following chart shows the measles and whooping cough position since 1948 Fatality Rates per 1,000 notifications each age group (1951-1960) Percentage of notifications (1951-1960) Under 1 1 - 5 5 & upwards Under 1 1 - 5 5 & upwards Measles 2.25 0.24 0.11 4.0 56.7 39.3 Whooping Cough 4.01 0.95 - 12.6 53.5 33.9 Whooping Cough Prophylaxis Whooping cough immunisation is carried out in the Local Health Authority Clinics and by general practitioners. The Divisional Medical Officer has kindly made available the following information in regard to Islington children:- Whooping cough Prophylaxis Total attendances 12,944 n 4,235 )Primaries Completed cases 239 ) Boosts London (Measles and Whooping Cough) Regulations, 1938 Home visiting of measles and whooping cough cases was carried out by the Home Visitors as under:- No. of Investigations Measles Whooping Cough No. of Ineffective Visits Re-visits 1, 441 624 372 2 Acute Poliomyelitis It was fortunate that the sharp but localised outbreak of poliomyelitis from which Islington suffered in 1959, and which was recorded in my Annual Report for that year, was not repeated in 1960. The following totals of reported and confirmed cases indicate the return to the average low-level years, and the distribution of the cases to the normal months of high poliomyelitis incidence in the second half of the year, as against the exceptional 1959 outbreak in the early months. It was also fortunate that of the 15 confirmed cases none was severe enough to prove fatal. Of those contracting the illness, 2 had been immunised against poliomyelitis. No. Reported No. CONFIRMED 1960 34 15 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. 1960 - - - - - - 2 3 5 1 4 - 1959 1 3 2 3 1 8 10 1 1 2 1 - 1958 1 1 - 2 - - 5 1 - 1957 2 - - 2 1 2 54 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 - - - - i - 2 8 - 2 1 1 1951 1 - - 1 1 2 - 2 1 - - 1950 1 - 1 - 2 2 10 10 1 2 2 Age distribution: Under 1 year 1 - 5- 15- 25 and over 1960 2 10 2 - 1 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: 1960 Nil 1959 6 (1& 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) 1958 Nil 1957 1 (7 years) 1956 Nil 1955 3 (17½ years; 30 years; and 5 years - the latter contracted outside the borough, and not included in the above tables) 1954 1 (27 years) 1953 3 (4 years; 15 years; 24 years) 1952 Nil 1951 Nil 1950 2 (6 years; 12 years). The onset of the disease of the 6 year old was in 1949. * Two cases, with onset in December, 1956, were notified in 1957, and are included in the above returns. 22 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 1960 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 4,709 8, 098 5 -15 1, 547 7, 205 16 -25 3,691 12, 345 Others 9, 405 3, 200 Totals 19, 352 30,848 23 Diphtheria Cases and Deaths - 1927 - 1960 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 " 1960 4 - . " 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 1960 53 18 "" It will be seen from the tables that whilst four cases were notified as diphtheria, none was confirmed 1960 was therefore the second year (the other 1952), in which there was not a single confirmed case of diphtheria. This is certainly not an indication that immunisation against this infection can be relaxed Immunisation in early childhood is still considered necessary if diphtheria infection is to be minimised or, better still, eliminated. 24 Diphtheria Cases and Immunisation state 1947-1960 (Inclusive) Year 0 - 5 IMMUNISED Age Groups 5 - 15 15 + 0 - 5 NON-IMMUNISED Age Groups 5 - 15 15 + Unknown Total Deaths 1960 – – – – – – – – – 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 6 yrs–not lmm" Nil 1948 1 2 1 1 – 2 – 7 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, 1960 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 31.12.60 i . e. born in year Under 1 1960 1 - 4 1959 - 56 5 - 9 1955 - 51 10-14 1950 - 46 Under 15 Total Last complete course (whether primary or boost) 1956-60 1,625 10,456 11,124 8,691 31,896 Mid-year population 4,900 15,100 28,900 48,900 Immunity Index 33.2 69.2 25 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 1960 131 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. 10. 3. 60 – 35 22 – Meat Pie:– Clostridium Welchii 2. 6. 7. 60 – 565 13 – Ham:– Staphylococcus phage type 42E. 1. Occurrence 10.3.60 - This outbreak occurred among the staff of a warehouse who had taken a meal at the staff canteen. Of the 22 persons affected the great majority commenced symptoms of food poisoning, with diarrhoea and stomach pains, within a period of approximately 12 hours after the suspected mid-day meal. Most had recovered within about 24 hours, although some were severely ill during this time. Stool specimens from 9 of those affected gave growths of Clostridium welchii, and the same germ was also isolated from the remains of the meat pie which was consumed. The meat was stewed on the same afternoon following morning delivery, was then cooled in the pantry where it remained all night, the prepared meat was then added to the pie on the following day for final preparation. 26 2. Occurrence 6.7.60 - This outbreak occurred in a school and the 13 persons affected comprised five adults and eight children. Symptoms of abdominal pain, nausea and vomiting, with diarrhoea in a few, commenced within 4 to 6 hours, but the duration of the illness was quite short. The probable cause of the outbreak, staphylococcus phage type 42E was isolated from stool specimens of a member of the kitchen staff as well as from the nasal passages of another member of the staff. The same germ was also found in ham, corned beef and caramel sauce. It appears that the ham, after being supplied from the meat depot, was cooked on 1st July and placed in the refrigerator. It was reported that the refrigerator broke down on 5th July, when the meat was removed and placed in the cooling-off room where, presumably, the temperature was insufficiently low to inhibit some multiplication of food poisoning organisms. Typhoid and Paratyphoid Fever There were two cases of typhoid and three cases of paratyphoid fever during the year The first patient, a female aged 30 years, commenced to have symptoms two days after return from Iran where, presumably, she contracted the infection. The diagnosis was confirmed by blood culture, stool culture and widal agglutinations. She made a satisfactory recovery. The other case was a nineteen-months-old-infant, whose mother was found to be a chronic carrier. The father was employed as a cook, but discontinued work on the circumstances coming to light. This family, of course, will be kept under observation. Two of the paratyphoid cases were husband and wife found to be infected with salmonella paratyphi B, and the third was also paratyphi B in a 13-year-old child THe origin of infection was not traceable. Dysentery The incidence of dysentery in 1960, with 1,029 cases, was considerably higher than in 1959 when there were 394 cases. From the detailed analysis it will be noted that approximately one third of all dysentery cases were under the age of five years and another third of school age, which appears to be a fairly common distribution. There were groups of cases at two day nurseries in the Borough, otherwise the distribution was fairly general. Domiciliary enquiries elicited that 24 of the cases were employed as food handlers and their work, of course, was discontinued during their periods of infection. 27 DYSENTERY IN ISLINGTON - 1960 Month 1960 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 29 M 8 2 20 – 3 4 2 – 1 – 1 5 – 13 15 F 17 2 4 9 – 1 2 1 2 February 126 M 54 20 109 1 21 34 6 8 2 2 5 7 – 43 80 F 43 9 2 15 9 5 17 3 1 March 156 M 65 15 127 5 27 36 1 9 2 1 10 4 80 76 F 59 17 – 18 38 3 10 5 2 April 165 M 57 19 124 4 25 31 4 9 3 – 6 27 11 85 80 F 65 24 3 22 32 9 17 6 – May 226 M 80 25 165 5 37 42 3 9 6 3 6 30 1 119 107 F 87 34 3 34 50 10 16 6 2 June 125 M 53 18 88 6 23 26 2 9 2 3 1 11 2 80 44 F 46 8 1 10 22 5 11 4 1 July 69 M 28 6 47 1 16 8 1 5 1 2 3 5 – 39 29 F 31 4 2 10 10 1 7 3 2 August 22 M 8 4 13 3 2 2 4 – 1 1 – – 14 8 F 10 - 1 3 4 - 2 – – September 41 M 17 2 34 2 7 6 – 1 3 – – 1 – 18 23 F 15 7 2 7 6 1 4 2 – October 32 M 17 4 17 – 13 5 – 3 – – – – 2 13 19 F 9 2 1 2 1 2 3 1 1 November 19 M 6 2 11 2 2 2 – 2 – – – 1 – 11 7 F 8 3 – 3 6 2 – – – December 19 M 6 1 13 1 3 1 – 2 – – – 3 – 10 9 F 10 2 1 3 4 1 3 – – TOTAL 1029 M 399 118 768 47 316 379 61 153 51 22 24 100 20 525 497 F 400 112 28 Tuberculosis The number of deaths due to tuberculosis of the lungs was by a substantial margin the lowest ever recorded. However, the same cannot, unfortunately, be said in respect of the number of new cases of tuberculosis of the lungs reported which was slightly higher than for the previous year. The distribution of cases as in former years differs as between the sexes. In adult males the new cases, as will be seen from the table, are spread fairly evenly throughout the age groups. In females on the other hand the greatest proportion of new cases is in adolescents and young women under the age of 35, accounting for almost 50 per cent, of all new cases of tuberculosis in females at all ages. It is obvious that the problem of tuberculosis of the lungs is still with us to a major degree, although the risk of a relatively early fatal issue may be very much less. New Cases and Mortality during 1960 Ages NEW CASES DEATHS Respi ratory Non-Respiratory Respiratory Non-Respiratory M. F. M. F. M. F. M. F. 0– – 2 – – – – – – 1– 8 7 1 – – – – – 5– 2 7 – – – – – – 15– 25 29 2 4 – – – – 25– 25 22 6 2 – 1 – – 35– 26 12 6 5 1 1 – – 45– 26 11 2 1 1 – – – 55– 27 12 – 2 1 – – – 65 and upwards 12 8 2 2 3 3 1 1 Total for all ages 151 110 19 16 6 5 1 1 296 13 Rates per 1,000 population: New cases: pulmonary 1. 17 Deaths : pulmonary 0.05 non-pulmonary 0.16 non-pulmonary 0.009 Tuberculosis 1960 Primary notification of Pulmonary Cases 29 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, 1960, was:- Pulmonary Males 1,543 Females 1,184 Non-Pulmonary Males 138 Females 169 3,034 The corresponding figures for previous years are:- 1959 3,074 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 mas X-Ray Unit of the North-Vest 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 1960: Islington C. C. 1182 828 44 50 50 84 5 9 1232 912 49 59 St. Pancras C. C. 139 79 6 11 4 6 – – 143 85 6 11 1321 907 50 61 54 90 5 9 1375 997 55 70 Grand Total 2497 30 The corresponding figures for previous years are:– 1959 2,564 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 4,980 4,615 9,595 No. of cases 46 32 78 Rate per 1,000 9.2 6.9 8.1 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 99 cases per quarter were helped with extra nourishment during the year, while loans of beds, bedding and medical appliances were made to 1 (one) patient 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 show the service being provided in a typical week No. of classes held 1 No. of patients in class 4 No. of sessions of instructions in homes during last week of year 14 No. of patients receiving instruction at home 51 31 The Public Health (Infectious Diseases) Amendment Regulations, 1960 Copies of Circular 24/60 of the Ministry of Health and the Public Health (Infectious Diseases) Amendment Regulations 1960, were received, dealing with the notification of anthrax, their purport being to include anthrax with the diseases which were made notifiable by the Public Health (Infectious Diseases) Regulations, 1953, to the appropriate Medical Officer of Health. Anthrax has been notifiable in Islington for many years by virtue of an Order made in 1909 for the notification of glanders, anthrax and hydrophobia in man within the Administrative County of London. In accordance with the Ministry's request information was sent to all practitioners in the Borough reminding them that all cases of anthrax should be notified to the Medical Officer of Health under these Regulations and, in addition, should a case occur in a factory, notification must also be made to the Chief Inspector of Factories under Section 66 of the Factories Act, 1937. Scabies and Vermin As will be seen from the following table, there are still a considerable number of cases of scabies or itch,and also vermin infestation. It is realised that the attainment of a good standard of personal cleanliness and hygiene is not a straightforward matter in the majority of Islington homes which have no bath, separate washing facilities for each household, or hot water points. This means that more effort must be made by families living in homes where washing facilities are inadequate by modern standards but nevertheless, the situation is gradually improving even if more slowly than could be wished. Scabies Vermin Children under 5 years number treated 30 38 Number of baths given 55 – Number of treatments. – 38 L.C.C. Children Number treated 74 313 Number of baths given 135 – Number of treatments. – 316 Adults Number treated 128 58 Number of baths given 205 – Number of treatments. – 60 Home Visiting Follow-up home visiting for cases of scabies and vermin was carried out by the Home Visitors of the Treatment Centre as under Families Visited Revisits Ineffective Visits Total Scabies 111 1 111 223 Vermin 219 5 170 394 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) 315 Sputum (Tuberculosis) 16 Faeces (Enteric Fever) 132 Blood (Enteric Fever) – Faeces (Food Poisoning) 436 Food (Food poisoning) 17 Faeces (Dysentery) 5,196 Faeces (Poliomyelitis) 116 Swabs (Streptococci) 47 Swabs (Pertussis) – Swabs (Influenza) – Smears (Variola) 1 Scrapings (Variola) – Other Specimens 45 TOTAL 6,321 (I am indebted to Dr. Wilfrid G. Harding, Divisional Medical Officer, London County Council, for the 1960 figures in connection with vaccination, diphtheria and whooping cough inoculations, and chest clinics). 33 SECTION C SANITARY CIRCUMSTANCES OF THE AREA (In conjunction with Mr W, C Bartlett Chief Public Health Inspector) During the year under review the work of the Department has continued with difficulty consequent upon the shortage of experienced Public Health Inspectors Thanks are due, therefore, to all, who through their loyalty and co operation, ensured that the residents of the Borough received attention to their enquiries and complaints with a minimum of delay. The early redevelopment of vacant and derelict sites is important, for not only are nuisances caused from the tipping of refuse but the conditions frequently encourage rats besides being unsightly In various parts of the Borough development by private enterprise of certain sites has taken place, where possible by infilling'' but much remains to be done. The number of immigrants residing in the Borough has increased with a consequent increase in the multi-occupation of houses Standards of hygiene vary considerably and not only does congestion occur but amenities which may have been adequate for the number of families previously in occupation fall far short of what is required when the number of separate lettings has increased. The position is aggravated where the sanitary accommodation has to be shared and, whilst the rooms occupied by the respective tenants, are usually found to be satisfactory, the parts of the houses used in common including the staircases and yards are often sub standard, With a view to securing the best possible relation with Immigrants and their families and to obtain a better understanding of the problems which are bound to arise and can only be resolved by patience and goodwill, the London Council of Social Service holds meetings of Metropolitan Borough representatives from time to time, and Councillor Mrs D E.A Hayward and the Chief Public Health Inspector have attended on behalf of the Council Included in the legislation made during the year was the Oil Burners (Standards) Act, 1960, which comes into force on the 1st January next year This measure became necessary because of the number of fires which have been occurring due to the use of oil heaters and the Secretary of State will upon the implementation of the Act be empowered to make regulations requiring specified heaters to comply with such standards of safety as. in his opinion are appropriate to reduce the risk of fire and to bear by means of labels instructions as to the working of the oil heaters. The Offices Act, 1960 which received Royal Assent in July comes into force on the 1st January 1962 It is a Statute which will secure by regulations made thereunder the health, safety and welfare of persons employed in offices By virtue of the Noise Abatement Act, 1960, which comes into operation during the year, Section 66 of the London County Council (General Powers) Act 1937, which provides that excessive, unreasonable or unnecessary noise, which is injurious or dangerous to health shall be a noise nuisance which may be dealt with summarily under the Public Health (London) Act, 1936, has been extended to include any noise In addition the section shall apply to vibration as it applies to noise The Council in March made a by law under the London Government Act 1939 prohibiting any person from shouting or using any bell, gong or other instrument in any street or public place so as to cause a nuisance to the inhabitants of the neighbourhood whilst hawking, selling, distributing or advertising any article In order to enforce this by-law it will not only be necessary for the Council to be able to prove that the noise itself causes nuisance to the inhabitants of the neighbourhood but also the Council must be able to prove who actually made the noise and it is insufficient for the Council merely to be informed of the name displayed on 34 a vehicle or the registration number of a vehicle. Wherever possible members of the public who are annoyed should obtain the assistance of the Police and see they obtain the name and address of the person causing the noise nuisance. They should then report this information to the Council together with the name and addresses of any other persons able to give evidence and who are willing to attend a Court should the Council institute proceedings. The London County Council (General Powers) Act, 1960 extends Section 82 of the Public Health (London) Act 1936 by adding the following nuisance which may be dealt with summarily "Any dust or other airborne particles caused by any trade, business, process or manufacture and being a nuisance or injurious or dangerous to health" . It also adds two sub-sections which provides inter alia that nothing shall render a person punishable in respect of any dust or other airborne particles if the Court is satisfied that having regard to cost and to local conditions and circumstances, the best practicable means have been taken for preventing or for counteracting the effect of such dust or airborne particles. The Caravan Sites and Control of Development Act 1960 came into force in August this year The Act is in two parts, the first dealing with licences and the control of caravan sites and the second part dealing with general control and development under the Town and Country Planning Act 1947. The Council* s powers and duties under Part I which is confined to the administration of Section 24, whereby Councils are empowered to provide sites for caravans were delegated to the Public Health Committee. Summary of Work done by District Public Health Inspectors (i) Inspections Houses/flats inspected under Public Health (London) Act, 1936 4,038 Separate lettings in (1) 7,262 Revisits - Houses/flats 9,606 Separate lettings in (3) 16,236 (ii) Other inspections and visits Miscellaneous 3,077 Prevention of Damage by Pests Act 101 Infectious Diseases 261 National Assistance Act (Aged & Infirm) 25 Factories Act 1937 – Outworkers 358 Shops Act, 1950 2,459 London County Council (G. P. ) Act - Hairdressers and Barbers 259 Pet Animals Act, 1951 53 Heating Appliances (Fireguards) Act and Regulations 63 Noise Nuisances 19 Food Premises 252 Non-effective visits 2,943 (iii) Nuisances and Notices Notices served - Public Health (London) Act, 1936. (a) Intimation 2,440 (b) Statutory 1,301 Notices complied with - Public Health (London) Act, 1936. (a) Intimation 1,429 (b) Statutory 887 35 Nuisances found 5,480 Nuisances abated 6,058 Number of houses improved 2,522 Separate lettings in above 2,690 Total number of improvements to dwelling houses 6,069 (iv) Legal Proceedings Informations laid 58 Abatement Orders made by Magistrate 17 Abatement Orders complied with 8 Further Proceedings for disobedience of Abatement Orders 6 (v) Drainage Plans examined 339 Examinations and Tests 294 (vi) Complaints Outstanding (at end of 1959) 448 Received during the year 3,756 plus 429 repeated complaints. Dealt with during year 3,933 Outstanding (at end of 1960) 271 (vii) Land Charges Act, 1925 Enquiries received 3,172 Properties involved 4,158 Investigations 4,158 (viii) Rent Act, 1957 Applications for Certificates of Disrepair (1) Number of applications for certificates during 1960 37 Number of applications brought forward from 1959 5 Number of applications carried forward to 1961 1 Total number of applications receiving attention 1960 42 (2) Number of decisions not to issue certificates 20 Number of Undertakings on Form 'K' accepted 13 (3) Number of decisions to issue certificates 19 (a) in respect of some but not all defects 15 (b) in respect of all defects 4 (4) Number of Undertakings given by landlords under paragraph 5 of the First Schedule 16 (5) Number of Undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule 3 (6) Number of certificates issued where undertakings not accepted 3 36 Applications for Cancellation of Certificates (7) Applications by landlords to Local Authority for cancellation of certificates 37 Number of applications brought forward from 1959 1 Number of applications carried forward to 1961 4 Total number of applications receiving attention 1960 34 (8) Objections by tenants to cancellation of certificates 8 (9) Decisions by Local Authority to cancel in spite of tenant's objection 2 (10) Certificates cancelled by Local Authority 27 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, 1936 1. Brickwork - walls repaired or rebuilt 33 2. Drains cleared, repaired, etc. 369 3. Dampness remedied 911 4. Fireplaces and ranges repaired/renewed 98 5. Floors repaired 275 6. Flues repaired 54 7. Internal walls repaired 464 8. Ceilings repaired 489 9. Rainwater pipes/gutters rep aired/renewed 316 10. Roofs repaired 704 11. Rooms cleansed 24 12. Sinks provided/renewed 25 13. Soil pipes repaired and renewed 83 14. Staircases or passages cleansed 8 15. Staircases repaired 93 16. Waste pipes repaired/renewed 151 17. Water Closet Apartments cleansed 16 18. Water Closet Pans and Traps renewed 79 19. Water Closets - flushing apparatus repaired, or renewed 104 20. Water Closets - general repairs 194 21. Water supplies provided 18 22. Water service pipes repaired 74 23. Window sash cords renewed 572 24. Windows repaired or renewed 408 25. Miscellaneous improvements 507 Total 6,069 37 Public Health (London) Act, 1936 - Sections 40 and 109. London County Council (General Powers) Act, 1955, Sections 25, 26 and 27. Work required to be done for Drains, Sanitary Conveniences and Premises. (a) 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, 419 7s. lid. during the period under review. This amount is apporti???ied as follows under the respective Acts and Sections:– £ s d Public Health (London) Act, 1936, Section 40 2,008 13 4 Public Health (London) Act, 1936, Section 109 90 1 3 London County Council (General Powers) Act, 1955 Section 25 251 14 10 London County Council (General Powers) Act, 1955 Section 26 – – – London County Council (General Powers) Act, 1955 Section 27 68 18 6 £2,419 7 11 (b) An appeal was made under section 6 of the London County Council (General Powers) Act 1951 against the terms of a notice served requiring the repair of drains at 25 Camden Walk. At the hearing on 21st October at the Old Street Magistrate* s Court the case was adjourned sine die. These premises are in an area which later in the year was represented for clearance under Part III of the Housing Act, 1957. 38 Legal Proceedings Public Health (London) Act, 1936 Failure to comply with Statutory Notices contrary to Section 82 Date Address Magistrate's Decision (1) 5. 1. 60 17 Charlesworth Street Fined £5. Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. (2) do. 11 Charlesworth Street Fined £2. Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. (3) 2. 2. 60 86 Pembroke Street Ordered to abate within 7 days. Defendant to pay £1 9s. 6d. costs. (4) do. 15 Mulkern Road Discharged absolutely. Defendant to pay £1 6s. 0d. costs. (5) 1. 3. 60 61 Cross Street Fined £5. Ordered to abate within 7 days. Defendant to pay £1 9s. 6d. costs. (6) 8. 3. 60 49 Goodinge Road Ordered to abate within 28 days. Defendant to pay £1 14s. 6d. costs. (7) do. 15 Scholefield Road Case adjourned sine die (8) do. 445 Caledonian Road Fined £2. Defendant to pay £1 1s. 0d. costs. (9) 5. 4. 60 2 Caedmon Road Case adjourned sine die. (10) do. 18 Almington Street Fined £2. Ordered to abate within 7 days. Defendant to pay £1 15s. 6d. costs. (11) 3. 5. 60 61 Cross Street Fined £1. Ordered to abate within 7 days. Defendant to pay £1 9s. 6d. costs. (12) do. 20 Railway Street Fined £2. Defendant to pay £1 11s. 0d. costs. (13) do. 192 Essex Road Work done Summons withdrawn on payment to Council of £1 11s. 6d. costs. (14) 5. 7. 60 33 Wharfdale Road Fined £2 2s. 0d. Ordered to abate within 14 days. Defendant to pay £2 3s. 6d. costs. (15) do. 23 Duncan Terrace Work completed. Discharged absolutely. Defendant to pay £1 10s. 0d. costs. (16) do. 6 Charteris Road Fined £5. Ordered to abate within 14 days. Defendant to pay £2 5s. 6d. costs. (17) do. 136 Copenhagen Street Fined £2. Ordered to abate within 21 days. Defendant to pay £1 15s. 6d. costs. (18) do. 136 Copenhagen Street Summons Withdrawn. (19) do. 120 Caledonian Road Fined £2. Defendant to pay £1 1s. Od. costs. (20) do. 183 Isledon Road Ordered to abate within 21 days. Defendant to pay £1 15s. 6d. costs. 39 Date Address Magistrate's 'Decision (21) 5. 7. 60 61 Corbyn Street Ordered to abate within 21 days. Defendant to pay £1 15s. 6d, costs. (22) do. 34 Story Street Ordered to abate within 21 days. Defendant to pay £1 15s. 6d. costs. (23) do. 282 Sussex Way Su???s withdrawn. (24) do. 282 Sussex Way Fined £2. Ordered to abate within 21 days. Defendant to pay £1 l5s. 6d. costs. (25) 6. 9. 60 20 Alsen Road Fined £5. Ordered to abate within 14 days. Defendant to pay £1 19s. 6d. costs. (26) do. 20 Alsen Road Summons withdrawn. (27) do. 38 Outram Street Fined £2. Defendant to pay £2 3s. 0d. costs. (28) 4. 10. 60 66 Play fond. Road Case withdrawn. Defendant to pay £1 5s. 0d. costs. (29) 1. 11. 60 11 Benwell Mansions, Benwell Road. Fined £2. Ordered to abate within one day. Defendant to pay £1 9s. 6d. costs. (30) do. 55 St. Clement Street Fined £5. Defendant to pay £1 1s. 0d. costs. (31) do. 67 Havelock Street Discharged absolutely. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. (32) do. 67 Havelock Street Summons withdrawn. Failure to comply with Magistrate's Abatement Order Date Address Magistrate's Decision (1) 5. 7. 60 18 Almington Street Fined £11 5s. 0d. Defendant to pay £2 2s. 0d. costs (2) 5. 7. 60 86 Pembroke Street Fined £1. Defendant to pay £1 1s. 0d. costs. (3) 4. 10. 60 61 Cross Street Fined £5. Defendant to-pay- £1 1s. 0d. costs. (4) 1. 11. 60 18 Almington Street Fined £25. Defendant to pay £1 1s. 0d. costs. (5) 1. 11. 60 282 Sussex Way Fined £3. Defendant to pay £l. 1s. 0d. costs. (6) 6. 12. 60 11 Benwell Mansions, Benwell Road. Warrant issued for arrest of defendant. Council to undertake cleansing works in default (such works carried out). 40 Disinfection and Disinfestation (a) General Number of rooms disinfected after cases of infectious disease 775 Number of rooms treated for vermin 1,509 Number of rooms included in the above figure treated for vermin (free of charge) 324 (The majority of free cases were carried out on behalf of elderly or infirm persons or persons of limited means) Number of families where effects were treated with DDT as a precautionary measure prior to rehousing 421 The department also undertook the disinfection of wards in a number of hospitals upon 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 of staphylococcal infection 3070 bags containing blankets and pillows were disinfected in accordance with an agreed procedure. Twelve visits were paid by the Public Health Inspector to a factory to supervise the treatment of 74 bales of stockings or other material for export The total weight of bales treated was 24 tons, 13 cwt.. 0 qtrs., 3 lbs , The Council approved the attendance of the employee engaged in operating the disinfecting plant at a course for such operators arranged by the Central Council of Health Education in conjunction with the Medical Officer of Health for the Borough of Pinsbury. (b) Steam Disinfection 2585 articles of clothing or bedding were steam disinfected (c) Fly and Other Infestations Anti fly treatment at Ashburton Grove Depot commenced on 5th May and continued during the summer months Disinfestation staff dealt with 12 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. 41 (d) Static Water Tanks, Air Raid Shelters, Bomb Damaged Sites, etc. Vacant sites in the borough are being re developed where possible but 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 494 Visits to air-raid shelters and static water tanks 15 Inspections of derelict buildings 42 Atmospheric Pollution Clean Air Act, 1956 The Minister of Housing and Local Government in July issued Circular No. 28 in which he stated that he had had a number of enquiries about the use of sticks and paper for lighting fires in Smoke Control Areas There is no doubt that gas provides the most convenient smokeless method of lighting coke and other authorised solid fuels. There will, however, be houses which have no Town gas and cannot be supplied with it at reasonable cost. Some people too, may object to having gas in their houses at all and in the Minister's view it would be undesirable to insist that they should. It is probable that, in time, other means of lighting fires smokelessly will come into general use. The Minister considers that legal cover for the use of sticks and paper for lighting fires can best be given by use of the powers of exemption in Section 11 (3) of the Clean Air Act, 1956, and he asks Local Authorities to include provision for exempting such buildings when preparing smoke controlled areas. Exemption will, of course, be conditional that only authorised fuels and kindling sticks and paper shall be used in the fireplace. In an appendix to this circular is a copy of a document entitled ''Smoke Control Areas – Your Questions Answered." which has been prepared as a guide for local authorities who wish to produce explanatory booklets to householders in properties in smoke control areas. The L.C.C. earlier in the year made a By-law amending the London Building (Constructional) By-laws, 1952, as follows:– "Smoke Prevention - 10.17 (1) There shall be provided in a new building (except in so far as heating is provided by furnaces to which section 3 of the Clean Air Act, 1956. applies) only such appliances for heating or cooking as are suitably designed for burning any of the following fuels, namely: (a) gas (b) electricity (c) coke or anthracite or are appliances of a description exempted from the provisions of Section 11 of the Clean Air Act, 1956 (which relates to smoke control areas), by an order for the time being in force under Sub-section (4) of that Section. "(2) This by-law shall not apply in relation to a new building begun before the date on which this by-law comes into operation." The by-law is to be construed as one with the principal by-laws and came into operation on the 1st day of April. 42 Two smoke control orders came into operation in September, viz. the Canonbury and North Islington (No.1) Orders respectively. Good public relations are essential in all aspects of the Department's work and particularly is it necessary where smoke control areas are concerned It is gratifying to record that in connection with the implementation of the first two smoke control orders the utmost co operation of the public was received and this was substantiated by the fact that no objections were raised against the making of the respective orders This is due in the main to the work of the inspectors concerned and to the fact that a "clean air" exhibition was arranged and held in the Town Hall In addition, the Solid Smokeless Fuel Federation Mobile Unit exhibited throughout each area when representatives of the Federation were available to explain the various appliances and fuels and to assist the public in the choice of solid fuel appliances. In both the exhibition and the Mobile Unit, appliances under fire were demonstrated and the former was supplemented by suitable film showings and talks Contraventions of the respective orders occurred which, upon investigation, were found to be due to the persons concerned using existing stocks of coal. Informal action was taken and the nuisances ceased The Council is very conscious of its responsibilities under the Clean Air Act and in order that the programme can be accelerated it authorised the appointment of two technical officers to assist the Public Health inspectors engaged in this work Numerous complaints were received due to the use of vacant sites for the breaking up and burning of motor vehicles. Warning letters were sent where appropriate and no further action became necessary. Industrial installations were the cause of some concern where it was found upon investigation that small quantities of industrial waste were being burned The occupiers co operated and the practice ceased. It is pleasing to record that in the case referred to in the previous report and which was the subject of repeated complaints due to the emission of oily smuts from an oil-fired economic boiler no complaints have been received during the year under review This is due to the fact that in December, 1959 the metal stack was insulated with aluminium cladding which has resulted in an increase in the stack temperature Smoke from railway engines is on the decline but the discharge of diesel fumes from road vehicles continues to be heavy particularly in regard to those travelling up the Archway Road The practice of drawing the attention of those concerned by means of a letter continues and the co-operation of the owners is sought and usually obtained The Council is represented on the London and Home Counties Clean Air Advisory Council by Councillor L Ross and the Medical Officer of Health. Number of applications received for prior approval by local Authority as to plans and specifications for new furnaces (Section 3 (2)) 4 Number of applications for prior approval granted re above 4 Number of applications for temporary exemption as to alterations to furnaces (Section 2) Nil Number of applications for exemption granted re above Nil Inspections 501 Revisits 2,003 Complaints received 31 43 Smoke observations 457 Contraventions found 22 Adaptations completed (domestic) 425 Notices served 240 Notices complied with 14 Prosecutions – One of the technical assistants authorised by the Council commenced duties on 24th October 1960, and the following statement indicates the work carried out by this officer for the remaining period of the year. Inspections 220 Re-visits and other calls 76 Recording of Atmospheric Pollution In addition to the deposit gauges and lead-peroxide candles which are stationed at three sites in the Borough, results from which are recorded monthly, 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. A summary of all recordings is set out in the following tables:– 44 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 1.54 10.90 6.56 17.46 4.25 „ 2 1.65 9.90 7.79 17.49 3.79 „ 3 1 85 7.02 6.36 13.38 2.65 February 1 2.05 9.64 5.30 14.94 4.40 „ 2 2.17 12.68 8.35 21.03 3.78 „ 3 2.36 11.03 6.92 17.95 2.77 March 1 1.65 14.21 12.39 26.60 4.35 „ 2 1.65 16.03 11.66 27.69 4.05 „ 3 1.58 12.65 6.66 19.31 2.07 April 1 0.43 8.51 8.08 16.59 3.27 „ 2 (No records available) 2.33 „ 3 0.67 11.43 3.71 15.14 1.41 May 1 (No records available) 1.99 „ 2 1.97 12.82 5.10 17.92 *1.95 „ 3 1.85 10.96 3.01 13.97 1.22 June 1 1.54 10.76 6.96 17.72 1.77 „ 2 1.85 14.70 6.46 21.16 1.38 „ 3 1.35 18.08 8.94 27.02 0.70 July 1 3.07 7.72 4.97 12.69 1.20 „ 2 3.03 12.92 4.87 17.79 1.48 „ 3 3.11 10.27 2.91 13.18 0.52 August 1 3.27 7.88 11.66 19.54 0.99 „ 2 2.76 12.19 8.94 21.13 1.04 „ 3 2.44 7.85 7.15 15.00 0.54 September 1 4.73 7.52 13.71 21.23 1.25 „ 2 5.00 11.36 9.64 21.00 2.07 „ 3 5.28 7.55 22.26 29.81 0.69 October 1 5.16 11.23 7.78 19.01 4.72 „ 2 5.52 11.53 8.94 20.47 3.05 „ 3 5.67 7.52 12.88 20. 40 * 1.66 November 1 3.86 6.89 7.15 14.04 4.35 „ 2 4.06 12.52 10.47 22.99 4.13 „ 3 3.70 8.08 4.77 12.85 2.47 December 1 2.32 9.11 9.07 18.18 4.32 „ 2 2.60 10.96 5.07 16.03 4.01 „ 3 2.80 9.47 4.57 14.54 2.51 * Period of exposure 3 10 60 1.11.60 (29 days) 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 45 Concentration of Smoke and Sulphur Dioxide recorded by the Volumetric Method at the two stations in the Borough Station Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. SMOKE, (Milligrams per 100 cubic metres) Public Health Office, Town Hall Monthly average 29.0 25.0 17.0 12.0 7.0 4.0 3.0 6.0 7.0 14.0 18.0 28.0 Highest daily average 93.0 70.0 40.0 32.0 15 0 9.0 7.0 12.0 16 0 21.0 40.0 83.0 Shelter House, Treatment Centre. Monthly average 33.0 27.0 15.0 15.0 8.0 3.0 6.0 5.0 6.0 13.0 15.0 46.0 Highest daily average 102.0 65.0 30.0 42.0 18.0 8.0 18.0 12.0 14.0 29.0 43.0 181.0 SULPHUR DIOXIDE. (Parts per 100 million parts of air) Public Health Office, Town Hall. Monthly average 13.3 12.8 8.6 6.5 4.5 2.7 2.9 4.1 5.0 8.3 12.0 13.7 Highest daily average 35.6 23.2 20.1 15.3 14.3 9.5 10.8 7.3 9.7 14. 5 23.4 23.9 Shelter House, Treatment Centre. Monthly average 10.1 11.1 7.2 7.1 5.8 5.1 3.2 4.2 3.8 7.7 9.1 14.1 Highest daily average 34.9 25.4 15.1 15.7 14.4 12.4 9.5 10.8 6.8 14.2 17.9 31.7 46 Requisitioned Propertie THe number of requisitioned properties on 1st January I960 was 111 which included 265 lettings. Requisition ended on 31st March after which there were no outstanding cases to be dealt with. Work of Public Health Inspectors Administering Factories Act, 1937 and other legislation Factories Act, 1937. Number of inspections 621 Number of revisits 826 Notices served 13 Prosecutions instituted 3 Defects found 766 Defects remedied 969 Defects referred to H.M. Inspectors 54 Defects referred by H.M. Inspectors 71 Complaints received 55 Notices complied with 74 Public Health (London) Act, 1936. Factories visited 726 Contraventions found 58 Contraventions remedied 113 Notices served 36 Notices complied with 35 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 In spections 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 215 118 1 – (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,856 454 52 1 (iii) Other Premises in which Section 7 is enforced by the Local Authority * (excluding outworkers' premises) 24 56 13 – TOTAL 2,095 628 66 1 * i.e. Electrical Stations (Section 103 (1)), Institutions (Section 104) and sites of Building operations and Works of Engineering Construction (Sections 107 and 108). 47 2. Cases in which Defects were Pound. 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) 18 14 2 2 - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) 1 - - - - Inadequate ventilation (S. 4) 2 2 2 5 - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 134 148 - - 1 (b) Unsuitable or defective 477 517 - 5 1 (c) Not separate for sexes 4 23 - - - Other offences against the Act (not including offences relating to Outwork) 4 71 4 9 . TOTAL 640 775 8 21 2 PART VIII OF THE ACT Outwork (Sections 110 and 111). SECTION 110 SECTION 111 Nature of Work No. of outworkers in August list requi red 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) Making, etc. Wearing Cleaning and apparel washing 558 - - - - - Furniture and upholstery 11 _ _ _ - - Umbrellas, etc. 22 - - - - - Artificial flowers 96 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 71 - - - - - Brush making 6 _ - - - - Stuffed Toys 20 - - - - - Basket making - - - - - - Carding, etc. of buttons, etc. _ - - - - - Cosaques, Christmas crackers Christmas Stockings, etc. 94 - - - - - Textile weaving - - - - - Lampshades 9 - - * - - TOTAL 887 - - - - - 48 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 13 basement bakehouses at the following addresses: 76 Caledonian Road, N.l. *299 Caledonian Road, N.l. 8 Danbury Street, N. 1. *68 Essex Road, N. 1. *350 Essex Road, N.l. *52 Stanraore Street, N.1. 54 Archway Road, N. 146 Blackstock Road, N. 3 Cardwell Terrace, N. 7 Junction Road, N. 59 Junction Road, N. 77 Newington Green Road, N. 123 Newington Green Road, N. * These bakehouses ceased to be used during the year under review. Legal Proceedings Factories Act, 1937 Date Address Section of Act Magistrate's Decision 5. 4. 60 104A Shepperton Road 7 Fined £2. 5. 4. 60 -do- 7 Fined £2. Defendant to pay £2 2s. 0d. costs. 7. 6. 60 .do- 7 (Continuing offence) Fined £3. Defendant to pay £2 2s. 0d. costs. Public Health (London) Act, 1936. London County Council (General Powers) Act, 1937. Noise Abatement Act, 1960. Noise Nuisances. As mentioned previously in this Section, the Noise Abatement Act, 1960, came into operation in November and now noise or vibration amounting to a Common Law Nuisance is made a Statutory Nuisance which can be dealt with under the Abatement procedure contained in the Public Health (London) Act, 1936. In London, Section 66 of the London County Council (General Powers) Act of 1937, is amended to provide that "any noise which is a nuisance" shall be a noise nuisance which may be dealt with summarily under the Public Health (London) Act, 1936 Arising out of complaints received concerning an alleged noise nuisance due to the parking of vehicles in one of the Squares in the Borough, the Public Health Inspector, with the approval of the Public Health Committee, kept two early morning observations, each of which were at approximately 5.30 a.m. Although it was confirmed that parking took place, there was no nuisance on either occasion at the time of the inspection. Complaints of noise from machinery operating throughout the night in two plating works were received. The management in each case co-operated, in the first case by improving the ventilating system and fitting the same with a sound absorbing material, and in the second by re-siting the machinery and sound-proofing the room in question. Another complaint received was in respect of an alleged noise nuisance from injection moulding machinery operated at night, and in this case the Inspector was able to secure the sound-proofing of the complete works, as a result of which the nuisance ceased. Number of (a) complaints received-44 (b) inspections-112. 49 Public Health (London) Act, 1936 Section 121 Protection of Birds Act. 1954 Pigeon Nuisances 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 a school, a factory and blocks of municipal and other flats. Although complaints are received from time to time arising from the congregation of ownerless pigeons by the residents in the Borough, it is found that public opinion is very strong against ridding certain areas of these birds and in fact, in many cases they are encouraged by the practice of feeding them. On more than one occasion, reports have been received by the Department that pigeons have been caught and destroyed by what is considered to be inhumane methods Upon investigation, however it was found that the persons concerned had no authority to operate in the Borough and in fact, had no connection with the pigeon catcher employed by the Council 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 Menzies Ltd. 5, Tileyard Road - Messrs. C. Edwards & Son, Ltd. Tileyard Road - Messrs. Tracey & Co. Ltd. (e) 1 Fat Melter: 16, Old Slaughterhouses - Messrs Wm, Menzies Ltd. (f) 1 Slaughterer: 180, York Way Messrs. Harrison Barber & Co. Ltd. This slaughterhouse was the subject of 243 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. 50 The number of inspections, etc. of offensive trades premises were:- Inspections Revisits Total Tripe Boilers 10 8 18 Knacker 13 10 23 Fur Skin Dresser 4 - 4 Gut Scrapers 11 - 11 Fat Melter 18 9 27 Licensed Slaughterhouse 14 21 35 The Slaughterhouses (Hygiene) Regulations, 1958 and the Slaughter of Animals (Prevention of Cruelty) Regulations, 1958 respectively which otherwise came into operation on 1st January 1959 provided for the deferment of certain requirements relating to the construction lay out and equipment of existing Slaughterhouses until such later dates as the Minister might appoint The Minister by Order has now declared that the appointed date for Islington shall be the first day of October, 1960. The only Slaughterhouse affected by this Order is that of Messrs Harrison Barber & Co. Ltd., 180, York Way. In the report for 1959, mention was made of the business of a slaughterer of poultry which was found to be carried on in the rear basement room of a butcher's shop in the Borough The slaughtering discontinued immediately but the keeping of poultry at this address which is situated in a densely built-up area was still under consideration at the end of that year It has now ceased completely, the poultry having been transferred to a farm outside the London area Diseases of Animals Act, 1935-1950 There was no action required to be taken under this legislation during the year. Pharmacy and Poisons Act, 1933 Number of Listed Sellers of Part II Poisons other than registered pharmacists 165 Number of initial registrations during the year 10 Number of visits and inspections 79 Number of samples taken 2 Number of samples reported satisfactory 2 Rag Flock and other Filling Materials Act, 1951 Number of premises on Register (Section 2 for Upholstery) 47 Number of Licences issued (under Section 7 for the storage of Rag Flock) 1 Number of Inspections and visits 48 Pet Animals Act, 1951 Number of licences issued during the year 18 Number of inspections and re-visits 53 51 Heating Appliances (Fireguards) Act, 1952 Number of inspections and re-visits 63 London Connty Council (General Powers) Act, 1954. Hairdressers and Barbers Number of Gentlemen's Hairdressers 87 Number of Ladies' Hairdressers 87 Number of Ladies' and Gentlemen's Hairdressers 17 Number of premises where hairdressing ceased Number of Establishments situated in basements 4 Number of Establishments situated in dwelling houses 2 Number of Establishments where no assistants are employed 49 Prevention of Damage by Pests Act, 1949. Complaints of rodent infestation increased by 108 over the previous year. The reasons for this include (a) the age of some properties, (b) increase in the number of houses in multiple occupation, and (c) the very wet year which resulted in an increased flow in the sewers and drains and, in consequence, more rats coming to the surface. There is no record of any infestation of ship rats during the year under review. By reference to the number of inspections and visits made and the number of infestations found which are dealt with in the following table, it will be recognised that the Rodent Section of the Department has been kept fully occupied. Twenty-three infestations were traced to defective drains, 5 to unsealed fittings, 3 to defective sewers and 5 to disused drains. Quarterly inspections continued to be carried out at the Archway Group of Hospitals. The Chief Public Health Inspector attended the three meetings of the Workable Area Committee No. 1, and consequent upon the retirement of Mr. D. Grant, Chief Public Health Inspector, Shoreditch, Mr. W.C, Bartlett was elected Chairman of this Committee. Mr. Jackson, the Rodent Officer, attended this meeting on two occasions. The work of rodent control requires continuity and patience in order to bring every case to a satisfactory conclusion. A number of cases were only resolved after great difficulty had been experienced. In one case of a school, which was the subject of complaint, it was necessary to resort to block control, but it was found ultimately that rats were gaining access through one of the drains where the cap was missing from the rodding arm. Upon this being replaced, baiting continued until the infestation was cleared. In another school, the outlet drain was found to be defective. This has now been repaired, and it is anticipated that the infestation will cease. Another case which received press publicity was in regard to a vacant site in Liverpool Road. As a result of negotiations with another Authority who were the owners of this particular site, a disused drain which was ultimately found, was sealed. No further complaints have been received. 52 One property was the subject of complaint over a considerable period. Drain tests were carried out and minor defects remedied, but still the infestation persisted. The tenants moved from the basement of this address and it was then possible to expose a portion of the combined drain when it was found that an open branch drain existed which did not take any drainage from this or any other premises. A smoke test revealed that this was the obvious source of the infestation and upon this drain being disconnected, no evidence of rat infestation has since been observed Upon a spot inspection being made by the Chief Public Health Inspector in company with the Inspector for bakehouses of a basement bakehouse in the Borough, it was found that there was a heavy infestation of mice, and a considerable number of droppings were seen under the tables, on racks, on some of the trays and on quantities of food exposed in the flour store. Action was taken under Section 3 of the Prevention of Damage by Pests Act, 1949 for failure to give notice of the infestation. The result of this case is reported at the end of this Section. (a) General The following is a summary of the work carried out during the year - Notices Served: Intimations 8 Statutory Type of Property Local Authori ty Premises Dwelling Houses Business Premises TOTAL 1. Complaints received (including repeats) 27 1123 173 1323 2. Number of properties inspected as a result of (a) Notification (initial complaint only) (a) 27 956 161 1144 (b) Block survey *(b)279 474 62 815 3. Number of properties found to be infested by rats (including NIL ship rats) 16 473 65 554 4. Number of properties found to be infested by mice 5 404 40 449 5. Re-visits by Investigators *1176 3065 56 4297 6. Non-effective visits by Investigators Nil 864 3 867 7. Number of infested properties treated (new jobs commenced) *573 1016 89 1678 8. Continuation or post-bait treatment *1924 2662 349 4935 9. Visits by Operators *3776 10807 733 15316 10. Still being baited at end of year Nil 15 1 16 11. Completed during the year *1412 1402 129 2943 12. Number of Business Agreements dealt with 77 13. Members of the Rodent Staff assisted in the operation of the smoke machine in respect of 111 drainage tests carried out by Public Health Inspector. * Includes seven maintenance treatments Nos. 31 and 32 (1664 manholes) NOTE: For the purpose of completing Section 2, 3, 4 & 7, each property is entered once only in respect of inspections, infestations and treatments. 53 (b) Sewer Treatments Two Sewer maintenance treatments were carried out in connection with which the co-operation of the Borough Engineer and his Staff was appreciated. Details of the treatments are as follows:- Treatment No. and date MANHOLES In Borough Not Bai ted Bai ted Showing complete takes Showing partial takes Showing No takes 31 4. 4. 60 828 35 793 403 610 183 32 10. 10. 60 836 58 778 445 614 164 Poison takes were not inspected. Legal Proceedings Date Premises Magistrate's Decision 3. 5. 60 54 Archway Road Offence: failing to notify the local authority that mice were living or resorting on said land contrary to Section 3, Prevention of Damage by Pests Act, 1949. Fined £5. 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 one for chemical examination were taken by the Public Health Inspectors. All were found to be satisfactory. Public Health (London) Act, 1936 Section 95 1. 48 applications were received for Water Certificates and 48 Certificates were issued in respect of 355 separate dwellings. 2. Water supplies to tenement houses. 12 Notices were served under this section requiring the provision of water supplies to tenement houses, 18 water supplies were provided or improved 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, four of the remaining wells are still out of use. Sixteen samples were taken, seven for chemical and nine for bacteriological examination. The chemical samples indicated that the water could not be considered free from pollution, but the water from these is used only for industrial purposes. All the bacteriological results were satisfactory. 54 (C) Water Supplies - Miscellaneous Three samples of sub-soil water were taken, (d) Swimming Bath Water. The following samples were taken during the year Satisfactory Unsatisfactory Chemical Bacteriological Chemical Bacteriological Chemical Bacteriological 2 67 2 61 _ 6 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 mainatined 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 0.75 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 Field Open Air Swimming Pool, which is controlled by the London County Council, were also taken during the summer season for bacteriological examination The County Council were kept informed of the results all of which were satisfactory and are included in the figure given at the head of this section. 55 SECTION D HOUSING (In conjunction with Mr. W. C. Bartlett, Chief Public Health Inspector) This again has been a year of work under Part II of the Housing Act with increasing emphasis on the problems arising from houses in multiple occupation. There are still many houses falling short of the defined standard of fitness provided under Section 4 of the Housing Act, 1957, and it was found necessary to continue representing houses and parts of houses with a view to demolition or closure. There can be little doubt that a very substantial number of houses could be repaired and made fully fit at reasonable cost. The problem of bringing older type houses more in conformity with present-day standards both in respect of condition of repair and the provision of adequate amenities, will almost certainly receive greater prominence in the future. The fact that repair and modernisation is now becoming a much more practicable and doubtless worthwhile proposition is emphasised by the amount of work necessarily carried out in the premises included in the table on page 57 under Section 27 of the Housing Act, summarising the Closing Orders determined in respect of both whole houses and parts of houses, (particularly basement rooms ) which had previously been the subject of Closing Orders because the cost of repair work had been regarded as unreasonable at the time of the original representation. During the year no clearance areas were submitted to the Minister of Housing and Local Government for confirmation although the Camden Walk Clearance area comprising 23 houses was represented and declared to be a clearance area by the Council. The number of houses and flats erected in the Borough during the year was Borough Council 221 London County Council 124 Private Enterprise 110 The number of municipal flats and houses erected since the war is Borough Council 3715 London County Council 2716+ 29 rebuilds from war damage. The total number of dwellings (i.e. flats and houses separately assessed) in the Borough at the end of the year was 46,547. Again, the problem of houses let in lodgings has merited urgent attention. Many of these properties contain single room lettings, and are occupied by persons of different nationalities, habits and customs. The lack of adequate sanitary accommodation, water supplies and facilities for the storage, preparation and cooking of food is most difficult to remedy because of the alternative open to the person in control of the premises following service of a Notice Under Section 36 of the Housing Act 1957, viz. to decrowd the house by a reduction in the number of families or individuals. Such action usually results in families who are desperately in need of accommodation being evicted. Many cases therefore have been dealt with on an informal basis and a considerable number of improvements have been effected. It is interesting to note that in respect of two properties the Council prosecuted the person in control following the service of Notices under Section 36 of the Housing Act, 1957 and convictions were obtained in both cases. There is a need for legislation which would allow a local authority to serve a Notice requiring the provision of the basic amenities in houses let in lodgings without the possibility of the tenants losing their protection under the Rent Act, and the inclusion of powers permitting the local authority to carry out work in default would also be helpful. The rehousing of families in order to bring about material improvements in the living conditions of the remaining tenants is also a further problem to be faced. 56 On 23rd March the last licensee in occupation of requisitioned premises was rehoused. This meant that the first phase of the de requisitioning programme was completed well before the terminal date, under the Requisitioned Houses and Housing (Amendment) Act, 1955, viz. 31st March, 1960. Two certificates under Section 5 of the Housing Act 1957, were issued to the effect that several tenements were so constructed as to secure effective ventilation of all habitable rooms in every tenement. These were in relation to two flats in Block E and four flats in Block H, Peabody Estate, Greenman Street, where works of improvements and conversions have continued. One of the Inspectors appointed to carry out duties under the Housing Act left the services of the Council in January and it has not been possible to fill the vacancy during the year. Legal Proceedings Date Address Court Magistrate's Decision (1) 1. 3. 60 67, Hornsey Road New River Petty Sessional Court Proceedings under Section 36(4) of Act for non-compliance with Notice served under Section 36 (1) of Act. Fined 15. Defendant to pay £2 2s. 0d. costs. (2) 11. 3. 60 8, Camden Walk Clerkenwell County Court Appeal against Council making Closing Order. Appeal made under Section 20 of Act. Action withdrawn by Appellants. Closing Order therefore made by Council. (3) 28. 3. 60 55, Green Lanes Shoreditch County Court Appeal against Council under Section 27 (3) of Act upheld and that appellants be at liberty to use the front and back basement rooms of the premises for the storage of timber. Respondents to pay costs of Appeal. (4) 5. 4. 60 8, Gaskin Street New River Petty Sessional Court Proceedings under Section 36 4) of Act for non-compliance with Notice served under Section 36 (1) of Act. Fined 12. Defendant to pay 12 2s. 0d. costs. (5) 3. 5. 60 67, Hornsey Road ditto Further proceedings re.hearing of (1) above. Fined 12 2s. 0d. Defendant to pay 12 2s. 0d. costs. (6) 4. 10. 60 66, Playford Road Clerkenwell County Court Appeal against Council making Closing Order Appeal made under Section 20 of Act. Case quashed. Closing Order therefore made by Council. Housing Act, 1957 During the year the following actions were taken Section 9 (Repair of insanitary houses) Inspections - Visits 8 57 Section 16 (Individual unfit houses) Inspections, Visits and Revisits 1,576 Houses represented 39 Undertakings accepted 3 Undertakings cancelled upon completion of work Section 17 (Individual unfit houses) Closing Orders made 152 Demolition Orders made 3 Houses demolished 18 Section 18 (Parts of buildings including basement rooms) Inspections, Visits and Revisits (a) Basement Rooms 777 (b) Other parts of buildings 93 Representations made (a) Basement Rooms 32 (b) Other parts of buildings 10 Closing Orders made (a) Basement rooms 41 (b) Other parts of buildings 10 Undertakings accepted (other parts of buildings) 1 Undertakings cancelled or part cancelled upon completion of work (basement rooms) 1 Section 27 Closing Orders determined or part-determined upon completion of work in respect of (a) Whole houses 29 (b) Basement rooms 27 (c) Other parts of buildings 7 Section 36 (Houses let in lodgings-securing fitness for occupation by number of families accommodated) Inspections, Visits and Revisits 73 Report to Committee 2 Notices complied with 2 Section 90 (Houses let in lodgings-overcrowding) Inspections and Revisits 21 Reports to Committee - Overcrowding abated - 58 Section 42 (Clearance Areas) Inspections 210 Revisits 450 Housing Consolidated Amendment Regulations, 1932 (House to House Inspections) Number of inspections 450 Number of Visits & Revisits 300 Housing Subsidies Act, 1956, as Amended by Housing (Financial Provisions) Act, 1958 Certificates of unfitness issued in respect of certain Municipal properties Individual houses 10 Housing Act, 1949 Improvement Grants Inspections, Visits and Revisits 214 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 20 investigations were carried out by this Department. Licences Authorising Temporary Overcrowding No licences were issued during the year. 59 SECTION E SUPERVISION OF FOOD (In conjunction with Mr. W. C Bartlett. Chief Public Health Inspector) Certain legislation affecting the work of the department was made or came into operation during the year under review including the following The Milk (Special Designation) Regulations 1960 consolidated with amendments previous regulations relating to raw, pasteurised and sterilised milk The principal changes include 1. Dealers' Licences with a few exceptions will be granted by the Pood and Drugs Authority for the area within which are situated the premises at or from which the milk is pasteurised, sterilised or sold as the case may be dealers licences will permit sales outside as well as inside the area of the licensing authority and supplementary licences will be discontinued 2. A dealer's (pre-packed milk) licence is introduced 3 Period of licence in respect of a dealer is extended from one year to five years 4. A licence holder will be no longer required to allow samples of milk to be taken free of charge. 5. The conditions of the methylene blue test are modified and a different phosphatase test for pasteurised milk has been prescribed The Skimmed Milk with Non Milk Fat Regulations 1960 impose requirements as to the labelling and advertising of certain specified foods which have the appearance of milk and non-milk fat. They also prohibit subject to certain savings the labelling or advertising of specified foods and beverages containing skimmed milk, in a manner suggestive of milk or anything connected with the dairy interest. Circular FSH3/60 issued by the Ministry of Agriculture, Fisheries and Food gave information of the products approved by the Minister for the cleansing of milk tankers, vessels or appliances as an alternative to scalding with boiling water or steam The Food Hygiene (General) Regulations 1960 consolidated the regulations of 1955 and 1957 and extended the regulations to include food businesses carried on from home-going ships and moored vessels. Other principal changes include:- 1 The extension of the definition of the handling of food to include the cleaning of food utensils and equipment 2. The person carrying on the food business is principally responsible for securing compliance with the regulations, but a manager or foreman is also required to take all reasonable steps to secure compliance by the food handlers under his control. The Food Hygiene (Docks Carriers etc ) Regulations 1960 prescribe requirements to secure the hygienic handling of food at docks, warehouses, cold stores, carriers' premises, etc., which were excluded from the Food Hygiene Regulations 1955 60 The Arsenic in Food (Amendment) Regulations 1960 increase the maximum amount of arsenic permitted in brewers' yeast intended to be used in the manufacture of yeast products. The Meat (Staining and Sterilization) Regulations, 1960 require with certain exceptions all butchers' meat and imported meat which is unfit for human consumption to be sterilized and all knacker meat to be stained or sterilized before entering the chain of distribution The Ministry of Agriculture, Fisheries and Food issued an advisory leaflet 483 entitled "Insects Pests in Food Stores". This is an instructive and helpful publication giving details of various infestations which may be found in food and although the identification of insects is a job for the expert the warehouseman and shop-keeper are made aware of a few of the insects which they may come across in the course of their work, and how to control them The Minister of Health and the Minister of Agriculture. Fisheries and Food issued two further food hygiene codes of practice, No. 3 dealing with hygiene in the retail fish trade and No. 4 with the hygienic transport and handling of fish. The importance of fish as food is recognised and the trader is naturally concerned to ensure that all fish reaches the customer as fresh as possible The same precautions that are necessary to achieve this are required also in the interests of hygiene The Minister of Health in a foreword hopes that these publications will prove to be a helpful and practical contribution to better handling The Council recognising the importance of these codes of practice purchased a sufficient number of each, and these were distributed personally by the Public Health Inspectors to the owners or managers of fish businesses At the same time the Inspectors were able to discuss with the trader any possible difficulties he may have as well as to explain the contents of these publications 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 Bottle of cream soda unfit to drink Colouring substance in minced beef Canned processed peas decomposing Dirty soft drink bottle Foreign substance in loaf of bread Foreign matter in loaf Foreign substance in tonic water Insect in baked beans Insect lavae in bottle of milk Mould in meat pies Maggot in bag of popcorn Oil in loaf Rancid coconut ice Unfit minced beef Beetle in bread roll Canned pears black and unpleasant Condition of chopped pork meat Foreign substance in meat pie Foreign substance in milk Foreign substance in bottle of milk Hair in butter Insect in jam tart Insect in minced meat Mould in pork pie Nail in loaf Pork sausages alleged to be sour Spider in loaf Wasp in tin of plums 61 Bacteriological Contamination of Desiccated Coconut Products Information was received during the year from the Port of London Authority and also the Public Health Laboratory Service that samples of desiccated coconut imported into this country, principally from Ceylon, had been shown to contain some forms of bacteria which might potentially cause food poisoning. It was understood that only a minority of the samples taken were found to be contaminated, and this proportion was not thought to exceed approximately 10 per cent. Coconut products which are subjected to baking are probably made safe by this form of heat treatment, even if they should have been originally infected However, not all coconut products are heat treated during the normal processing since coconut is used in a very considerable variety of food products, which may include the following, by no means exhaustive list:- Con fectionery Ice-cream Cakes Bi scui ts Coconut flour Made-up curries When this information was received, arrangements were made in the first place for the Pood Inspectors to contact as many bakers and other trade users as possible to check the position and to see how far those concerned had been informed of the risks of using unheated coconut, through trade channels. It was in fact found that the majority of coconut users had been informed through the laboratories of the Baking Trades and were taking appropriate action Food Inspectors and others who might be concerned in enquiries into outbreaks of food poisoning were informed and existing stocks and usages of coconut in the Borough checked from time to time So far, no food poisoning outbreak has occurred in Islington which might have originated in contaminated coconut but the possible risk must, of course, be guarded against. Since coconut products are nationally distributed and desiccated coconut exports are a valuable commercial product, it is understood that the problem has been taken up both through the trade and public health and hygiene control channels in Ceylon The processes of production are traditional and it is understood that the producers have expressed their willingness to co-operate in modernising their mills and processing methods generally with a view to improved hygiene standards in production and in obtaining desiccated coconut in which the relatively small risk of food poisoning is reduced still further. Details of the action taken under the Pood & Drugs Act, 1955, and the Food Hygiene Regulations, 1955, appear on pages 63-65. Food and Drugs Act, 1955 Number of food premises in the area, and type of business Bakehouses - level 24 ,, - basement 13 Bakers' retail shops 68 Butchers 150 ,, - Continental 1 Cafes and Restaurants 256 Canteens and Clubs 111 Chemists 56 Coffee stalls 2 62 Continental Food Shops 43 Fish shops 38 ,, curers 23 ,, depot 1 ,, friers 52 Food factories 29 Food stalls (street traders including 14 shop extensions) 91 Food storage premises for street traders 88 Greengrocers and Fruiterers 178 Grocers and Provision merchants retailers 508 ,, ,, ,, wholesalers 18 Licensed ,, Clubs ,, 36 Off-licences 102 ,, ,, selling other food (included in above) 50 Public Houses 268 ,, ,, catering (included in above) 178 ,, ,, beerhouses 12 Sugar and chocolate confectionery 406 Milk machines 21 Food machines 5 Preserved Food Premises Registered under Section 16 (1) (b) of the Food and Drugs Act 1955 (Included in foregoing list.) Total No. of Preserved Food premises 178 No. of Butchers 121 No. of Grocery and provision shops 41 No. of Food Factories 11 No. of Cooked meat shops 1 No. of Jellied Eels and Pie Shops 2 No. of Bakers (meat pies) 2 Total No of inspections and visits made by Inspectors to Preserved Food Premises 573 Details of the inspections etc. by the Inspectors are given below Bakehouses-level 123 ,, -basement 167 Bakers (bread and cake shops) 227 Butchers 478 Confectioners 182 Fried fish shops 167 Fish curers 102 Fishmongers 14 Greengrocers & Fruiterers 90 Grocery and Provisions 1,306 Wholesale Food Stores and Depots 156 Markets 71 Food Storage for Street traders 16 Other Food Premises 151 Vehicles 173 Stalls 61 63 Public Houses and Off Licences 12 Restaurants, Eating Houses and Canteens 1,108 Meat inspections at Licensed Slaughterhouse 289 Food examinations (other) 566 Ice Cream premises 487 Preserved Food Premises 595 Dairies (milk distributor) 955 Contraventions found 865 Contraventions remedied 968 Notices served (Food and Drugs Act) 159 Notices complied with (Food and Drugs Act) 312 Infectious Diseases 29 Food poisoning enquiries 47 General Legal proceedings-attendances at Court 16 Non-effective visits 238 Miscellaneous 1,120 Legal Proceedings Details of the action taken by the Council under the Food and Drugs Act, 1955, and Pood Hygiene Regulations made thereunder, are as follow:- Date Offence Magistrate's Decision (1) 5. 1. 60 Food Hygiene Regulations, 1955 Regulation 22(1) Allowing a food room to be used as a sleeping place at 198 New North Road, N.1 Fined £10. Defendant to pay £5 5s. Od. costs. (2) 5. 1. 60 Regulation 16 (2) Failing to provide and maintain for every wash-hand basin an adequate supply of either hot or cold water, or hot water at a suitably controlled temperature at 198 New North Road, N.1. Fined £10. (3) 5. 1.. 60 Regulation 6 (1) Failing to keep equipment with which food comes into contact in the course of a food business clean and in such condition as to prevent so far as is reasonably practicable any risk of contamination of food at 198 New North Road, N. 1. Fined £10. (4) 19. 1. 60 Regulation 9. Whilst engaged in the handling of food failing to keep an open cut or abrasion on an exposed part of person covered with a suitable water-proof dressing at 56, Essex Road, N.1. Fined £5. Defendant to pay £2 2s. 0d. costs. (5) 19. 1. 60 Regulation 30. Whilst in the course of a food business carried meat, being meat which was open food liable to come into contact with the neck or head, and failed to wear a clean or washable head covering. (Defendant was owner of business) at 56, Essex Road, N.l. Fined £2. 64 Date Offence Magistrate's Decision (6) 19. 1. 60 Regulation 30. Similar offence as to above at 56 Essex Road, N.l. (Defendant was employee of owner of business) Fined 12. Defendant to pay £2 2s. 0d. costs. (7) 2. 2. 60 Food and Drugs Act, 1955. Section 8(l)(a) Selling food, namely an apple flan, intended for, but unfit for human consumption at 25 Green Lanes, N.16. Fined £3. Defendant to pay £2 2s. 0d. costs. (8) 1. 3. 60 Food and Drugs Act, 1955, Section 2(1) Selling food, namely two bars of chocolate nut crunch, not of the quality demanded at 26, Rheidol Terrace, N.l. Fined £5. Defendant to pay £10 l0s.0d. costs (£6 6s 0d. to Council, £4 4s. 0d. to Manufacturer). (9) 1. 3. 60 Food Hygiene Regulations, 1955. Regulation 5. Carrying on a food business in unsanitary premises, the use of which, because of the condition thereof, exposed food to , the risk of contamination at 389 Caledonian Road, N.l. Fined £2. Defendant to pay £2 2s. 0d. costs. (10) 1. 3. 60 Regulation 16 (2) Failing to provide and maintain for every wash-hand basin an adequate supply of hot water at a suitably controlled temperature at 389 Caledonian Road, N.l. Fined £2. (11) 1. 3. 60 Regulation 5. Carrying on a food business in unsanitary premises the use of which, because of the condition thereof, exposed food to the risk of contamination at 89 Upper Street, N.l. Fined £5. Defendant to pay £2 2s. 0d. costs. (12) 1. 3. 60 Regulation 14. Failing to keep clean a sanitary convenience situated at 89 Upper Street, N. 1. Fined £3. (13) 3. 5. 60 Food and Drugs Act, 1955. Section 8(l)(a) Having in possession for the purpose of sale or preparation for sale, certain food, namely approximately 13 lbs. of cake cuttings and sponge for eccles cake filling. Approximately 18 ozs. of filling for eccles cakes, one sack (approximately 20 lbs.) of milk powder intended for, but not fit for human consumption at 54 Archway Road, N.19. (Please also reter to legal proceedings on page 53 in relation to these premises) Fined £20. (14) 3. 5. 60 Food Hygiene Regulations, 1955. Regulation 5. Carrying on a food business in unsanitary premises the use of which, because of the condition thereof, exposed food to the risk of contamination at 54 Archway Road, N.19. Fined £5. 65 Date Offence trate's Decision (15) 10. 5. 60 Food and Drugs Act, 1955. Section 2 (1). Selling food, namely a pound of minced meat, which was not of the quality demanded at 134, Blackstock Road, N.4. Fined £10. Defendant to pay £3 3s. 0d. costs. (16) 7. 6. 60 Food Hygiene Regulations, 1955. Regulation 24. Allowing filth (cat faeces) to accumulate in a food room at 60 Islington High Street, N.l. Discharged absolutely. Defendant to pay £1 is. 0d. costs. (17) 4. 10. 60 Food and Drugs Act 1955. Section 2(i) Selling food, namely a loaf of bread, which was not of the quality demanded at 132, Holloway Road, N.7. Discharged absolutely. Defendant to pay £5 5s. 0d. costs. Unsound Food. During the year 62 complaints of unsound food were received. The total amount of food condemned was:- Description Tons Cwts. Qtrs. Lbs. Tinned goods 9 19 2 18 Meat 14 18 2 23 Fish 10 14 1 24 Others - 18 2 7 TOTAL 36 11 1 16 1, 196 condemnation certificates were issued, and 477 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. Sampling, 1960. 625 samples (58 formal and 567 informal) were sent to the Public Analyst for examination. Forty-four of these samples, or 7.04%, were adulterated, as shown in the summary below. It should be noted that a number of adverse reports relate to samples not taken during routine sampling but which were subject of complaint. 66 Formal Olive Oil 3 Prok Sausages 1 TOTAL 4 Informal Beef steak pie 1 Bread 5 Bread Rolls 2 Butter 1 Canned Baked Beans 1 ,, Pears 1 ,, Plums 1 ,, Pork Luncheon Meat 1 ,, Processed Peas 1 Chopped Pork 1 Coconut Ice 1 Cream Soda 1 Food Colouring 2 *Ginger (in Syrup) 1 Jam Tarts 2 *Lasognette with egg 1 Milk 4 Minced Meat 1 Mixed Vegetables (Pickled) 2 Olive Oil 1 Orange Drink 1 Pickled Gherkins 1 Pork Pie 1 Pork Sausages 1 Pork Sausage Meat 1 Quinine Tonic Water 1 Steak and Kidney Pie 1 Sweet Corn 1 Wine Vinegar 1 40 *Not properly labelled. 67 Meat and Other Foods No visits by officers of this department were made during the year for the purpose of inspecting home killed or imported meat at the Metropolitan Cattle Market. In accordance with the requirements of the Public Health (Meat) Regulations, 1924/52, notices were received during the year in respect of the intended slaughter of animals for human consumption. Details of action taken are as follows:- Cattle Excluding Cows Cows Calves Sheep and Lambs Pigs Horses Number killed (if known) 195 724 43 98 7 774 Number inspected 195 724 43 98 7 774 All diseases except Tuberculosis & Cysticerci Whole carcases condemned 6 63 1 27 - - Carcases of which some part or organ was condemned 6 302 2 23 - 76 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 6.15 50.41 6.97 51.02 - 9.81 Tuberculosis only Whole carcases condemned - 1 - • - - Carcases of which some part or organ was condemned - 1 - - - - Percentage of the number inspected affected with tuberculosis - .27 - - - - 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 all animal feeding preparations. Of the 774 horses slaughtered for human consumption, 628 were intended for export. Slaughter of Animals Act, 1958. Slaughtemen's Licences During the year no new Licences were issued, but eleven Licences were renewed and were current at 31st December. Export Certificates-Food 14 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, U.S.A., Australia and Sweden and Switzerland respectively. 68 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 117 Contraventions found 1 Contraventions remedied 1 Agricultural Produce (Grading and Marking) Acts Inspections 1 Contraventions found 8 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 64 71 56 64 68 64 67 63 63 64 66 54 64 Women 60 68 62 56 59 42 70 72 80 69 62 76 65 Parkhurst Road Men 88 89 91 69 93 83 106 91 105 100 111 109 95 Women 87 75 78 29 26 41 67 65 67 34 22 45 53 Finsbury Park Men 58 64 64 59 69 72 62 58 55 60 63 57 62 Women 22 20 20 26 31 30 44 58 56 44 34 31 35 Highbury- Men 20 29 26 31 27 26 29 35 36 30 26 30 29 Women 34 10 11 12 14 17 35 29 28 30 40 24 24 Offord Road- Men 9 9 10 11 12 12 13 15 16 12 11 11 12 Women 8 6 9 7 10 9 12 11 18 13 16 12 11 Islington Green - Women 18 25 18 24 33 38 16 20 18 20 16 14 22 High Street- Men 38 57 58 55 63 71 67 51 70 60 60 65 60 506 523 503 443 505 505 588 568 612 536 527 528 69 Ice Cream Ice Crean (Heat Treatment, etc.) Regulations, 1959 Supervision of the Manufacture and Distribution of Ice Cream. During the year 518 visits were paid to ice cream premises and vehicles. The number of premises registered:- (a) for manufacture, sale and storage 6 (b) for sale and storage 369 (c) for sale only 179 (d) for storage only 1 555 1. Bacteriological Examination. (a) Ice Cream Thirty-one samples of ice cream were sent for bacteriological examination and following Methylene Blue tests were graded as follows:- Grade I 11 Grade II 9 Grade III 4 Grade IV 7 31. Samples falling within Grades I or II are considered satisfactory. The 11 samples which were graded III and IV respectively were taken from a retail shop whose supply of ice cream comes from another area. The Authority concerned was informed and appropriate action taken An improvement in the bacteriological standard resulted and samples taken subsequently were graded I and II. It is proposed to continue sampling ice cream from this particular source next year. (b) Lollies Number sampled Satisfactory Unsatisfactory Cream Lollies Plain Lollies 8 12 8 12 - - 2. Chemical Examination Ice Cream Ice Lollies 19 18 19 18 - - Details of 19 samples of ice cream examined for fat content are as under:- 6% 7% 8% 9% 10% 11% 12% 13% 14% 15% 16% 17% - 2 - 4 4 2 3 1 3 - - - Milk Samples. 1. Bacteriological Examination. Details of samples submitted-next page. 70 Class of Milk Results Phosphatase Methylene blue Turbidity Biological Total Number of Samples Pasteurised Satisfactory 39 39 - - 39 Unsatisfactory - - - - Sterilised Satisfactory - - 11 - 11 Unsatisfactory - - - - Tuberculin Tested (Pasteurised) Satisfactory 14 14 - - 14 Unsatisfactory - - - - Tuberculin Tested (Raw Milk) Satisfactory - - - 3 3 Unsatisfactory - - - - TOTAL 67 2. Chemical Examination. Details of samples submitted: Satisfactory Unsatisfactory Total Formal 27 - 27 Informal 154 4 158 185 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953 and Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954 The following licences were granted:- Pasteurised 339 Pasteurised (supplementary) 20 Tuberculin Tested 180 Tuberculin Tested (supplementary) 20 Sterilised 374 Sterilised (supplementary) 23 956 Milk and Dairies (General) Regulations, 1999 Number of Dairies Registered in the Borough 13 Number of Distributors registered in the Borough 337 71 SECTION F MISCELLANEOUS SERVICES HEALTH PUBLICITY AND HEALTH EDUCATION The year was distinguished by the holding of two major exhibitions, the first on the subject of "Clean Air" and the second on "Safety in the Home". "Clean Air" Exhibition In view of the coming into operation of the first two Smoke Control Areas in Islington on 1st September, 1960 (see page 42 ), the Public Health Committee approved the holding of an Exhibition for the purpose of giving publicity to the requirements of the Clean Air Act, and to the alternative means of space heating which could be installed and the fuels approved for use. The Exhibition was formally opened on 25th May, and Her Worship the Mayor of Islington, Councillor Mrs. A.M. Seeley, presided for the occasion. Dr. Eric Fletcher, Member of Parliament for East Islington, kindly agreed to open the Exhibition formally. Among those invited were representatives of the County Council, Metropolitan Boroughs, the Borough of Hornsey, and others. Publicity matter in respect of the Exhibition was distributed to every householder in the Smoke Control Areas. Very ready co-operation in this project was obtained from the Solid Smokeless Fuels Federation, the London Electricity Board, the North Thames Gas Board, and Shell-Mex and BP. Ltd., each of whom provided and equipped a stand dealing with their own forms of heating, and the London County Council Architect's Department provided a stand on the subject of fire precautions and those aspects of adaptations which are affected by the London Building (Constructional) Byelaws, 1952. The Islington Public Health Department stand was fitted up to illustrate (1) The Problem i.e. the public health dangers of atmospheric pollution, and (2) The Solution as provided by the requirements of the Clean Air Act. In equipping this stand the Public Health Department, in addition to its own resources, obtained contributions also from:- Medical Research Council Group for Research on Atmospheric Pollution, St Bartholomews' s Hospital Meteorological Office, Air Ministry. Department of Scientific and Industrial Research. A cinema projection unit was also provided for the showing of appropriate films. "Safety in the Hone" Exhibition. This Exhibition, designed to draw public attention to the ever-growing need for accident prevention in the home, was held from the 5th to 15th October, and was opened by Dr. C. A. Boucher, O.B. E., a Principal Medical Officer of the Ministry of Health. The London County Council, London Electricity Board, and the North Thames Gas Board were again prominent exhibitors, and other stands were provided and equipped by the Royal Northern Hospital, the Whittington Hospital, and the Oil Appliance Manufacturers' Association; while most useful contributions were received from the North London Association of Ophthalmic Opticians on the subject of good lighting and good sight, Messrs. Proban Ltd., the Luton Home Safety Committee and the Northern Polytechnic in respect of non-flammable fabrics and garments, and St. Bartholomew' s Hospital on the subject of safety in regard to drugs and medicines. 72 Hie scope of the Exhibition and the subjects covered can be gauged from the following list of stands:- Arranged by ISLINGTON HOME SAFETY COMMITTEE THE LAW AND SAFETY - DRUGS AND POISONS - FIREGUARDS VISION AND LIGHTING FABRICS AND FIRE RISKS '' HOME - UNSAFE HOME '' ISLINGTON PUBLIC HEALTH DEPARTMENT HAZARDS TO CHILDREN (Public Health Department) ESCAPE FROM FIRE (Architect's Department) (Building Regulation Division) (London Fire Brigade) PLANNING FOR SAFETY IN THE HOME (Housing Management Department) LONDON COUNTY COUNCIL ROYAL NORTHERN HOSPITAL WHITTINGTON HOSPITAL OIL HEATERS Voice and Vision Ltd., for Oil Appliance Manufacturers Association THE USE OF ELECTRICITY LONDON ELECTRICITY BOARD GAS IN THE HOME NORTH THAMES GAS BOARD CINEMA Showing Home Safety films at frequent intervals In addition the London County Council provided a fully equipped accident ambulance, which was on show to the public outside the Exhibition entrance Another special feature was a display of paintings submitted by Islington school children in a competition for posters on the theme of Home Safety. The paintings were judged by Mr K Jameson, Art Inspector, London County Council, who considered that some exceptionally good work had been done, and at a ceremony attended by the children and many of their parents and teachers prizes in the form of National Savings Stamps were presented by Her Worship the Mayor It is of interest to note that the paintings have since been displayed at various welfare centres within Health Division 3 and in Islington Public Libraries. 73 Also produced in conjunction with the Exhibition was a handbook, 'Sense about Safety", consisting in the main of articles based on a series of talks given at meetings of the Islington Home Safety Committee by experts in the various subjects. The booklet was distributed through the ''Safety in the Home" Exhibition, and also to Welfare Centres, Health Visitors, District Nurses, Social and Welfare Visitors, etc., in the borough. The handbook has been registered at Stationers' Hall and a copy supplied to the British Museum. In addition to the many members of the general public who visited the Exhibition, numerous school parties were brought by their teachers, and a considerable number of student nurses attended as well as students from the University of London Institute of Education and London School of Hygiene. It may be said, from the wide degree of interest shown, that the Exhibition was a very successful one and the efforts of all those engaged in its production fully worthwhile. Islington Borough Home Safety Committee membership, as at 31st December, 1960 Honorary President : Her Worship the Mayor Chairman : Alderman A.J. Rogers Honorary Secretary : Dr. V. Freeman Councillor Mrs. Z. Bagnari Islington Borough Council - Estates Committee Councillor Mrs. B. Stradling " " " - Housing Committee Councillor Mrs. M.M. Short " " " - Public Health Committee Dr. Wilfrid G. Harding London County Council - Health Division 3 Mr. S.R. Butcher " " " - Housing Department Mr. A.J. Hayes " " " - Fire Brigade Dr. C.D. Coyle Archway Group Hospital Management Committee Councillor Mrs. E.E. Bull, L.C.C. Mr. J. Capsey Northern Group Hospital Management Committee Mr. A. F. Gray Dr. E. Colin-Russ Local Medical Committee for the County of London Miss D.E. Church Islington Old People's Welfare Council Mr. H.E.F. Heath North Thames Gas Board Mr. L.C. Atkins London Electricity Board Mr. D.J. Cooper London Master Builders' Association Mrs. A. Griffiths Islington Trades Council (1953) Miss B. Naish Royal Society for the Prevention of Accidents The Committee had four ordinary meetings during the year, and at three of these the practice was continued of inviting a specialist speaker to give a short talk on a particular aspect of home accident prevention. The salient points of these talks have been reproduced in the handbook mentioned above. The speakers were: - > Mr. J.S. Grant, Pharmaceutical Chemist - ''Safety in Regard to Medicines in the Home'* Mr. A.J. Hayes, ''The Fire Service and Home Safety'' Mr. S.R. Butcher, ''Planning Homes for Safety'1. 74 Among the many and comprehensive aspects of home safety dealt with by the Committee, mention may be made of the following practical issues which were taken up at the instigation of the Committee:- A suggestion was made for the production of lockable medicine cabinets or compartments. This was pr ' on to the Royal Society for the Prevention of Accidents and after consideration by the National Home Safety Committee a request was made for the production of a British Standard for Medicine Cabinets. ?iinuiries into window cleaning facilities for aged and handicapped persons brought confirmation from local offices of the National Assistance Board that tnis matter would be sympathetically considered by their officers. The London Master Builders' representative passed on the Home Safety Committee s recommendations of the siting of electric socket outlets to the Registered Housebuilders Committee, who expressed appreciation of the suggestions, and stated that they were approaching the Ministry of Forks as to the issue of an advisory leaflet. The principal points from Mr. Butcher's talk on Planning Homer- for Safety were passed, via the Public Health Committee, to the Housing Committee and to the Council's Architect for consideration in the planning of future housing schemes Dr. Harding reported that a leaflet, 'Look after your Oil Heater'' had been produced by the London County Council for distribution to tenants and those concerned with home welfare services, and assistance in further circulation was recue~ted On the recommendation of the Home Safety Committee, the Public Health Committee approved the circulation of this leaflet through the Puulic Health Department, and willing co-operation was forthcoming from the Housing and Libraries Departments of the Borough Council. On the recommendation of the Home Safety Committee posters drawing attention to the grave risks to children of drugs and other dangerous substances in the home were forwarded to all family doctors in the borough for display in their waiting rooms. At the request of the Islington Trades Council (1953) 100 copies of a home safety game for children, ''Watch Your Step ' were supplied for distribution through the Trades Council and their ierresentative on the Home Safety Committee Lor. ion Countj Council I'orcc Safety PeeU As has been the practice in recent years, the Public Health Department cooperated with the London County Council in the dissemination of publicity for this campaign. Some 4 500 leaflets were distributed and about 40 posters put up on various sites available to the Council and a further 100 posters were distributed for display in suitable shops for the particular subject In addition all old people's clubs in the borough were written to and over 1,000 leaflets sent for distribution to club members. London Cornty Council Poliomyelitis Campaign During the year the age limit for poliomyelitis vaccination was raised to 40 years and the London County Council Divisional Medical Officer asked for the co-operation of the Public Health Department in providing additional publicity. Arrangements were accordingly made by the Department for the disposal of 150 leaflets and 12 posters through the usu 1 sites and offices and the Chief Librarian arranged to distribute 3 000 bookmarks and 500 leaflets through the Public Libraries 75 Arrangements were also made with the Divisional Medical Officer for about 100 members of the Borough Council' s staff to receive poliomyelitis vaccination under this scheme at clinic sessions held at the Town Hall. Child binding (London County Council leaflet.) In order to draw attention to the law concerning the minding of children, the London County Council, through the local Health Divisions, issued a leaflet printed separately in English, Greek and Turkish. At the reo.uest of the Divisional Medical Officer, 750 of these leaflets in English and 250 each in Greek and Turkish were distributed through the Public Health Department staff and 200 leaflets through the Housing Department to Council tenants Cancer Education Another leaflet produced by the London County Council was on the subject of cancer education, and 1.200 copies were distributed through the Public Health Department and Public Libraries. Mental Health Week With the intention of publicising and stimulation activity in all matters relating to mental health, 1960 was designated Mental Health Year, and the Ministry of Health produced in connection with this a poster and leaflet showing the essential elements of a comprehensive Mental Health Service. In addition special activities during Mental Health Week, 9th to 16th July, were entered into by the London County Council, who also issued a leaflet for the occasion Through the Public Health Department, the Borough Council participated by the display or distribution of 30 copies of the above-mentioned poster and 2,000 copies of both leaflets. Regular health education and publicity by means of posters and leaflets continued throughout the year. Most of this publicity matter is obtained from the Central Council for Health Education and the Royal Society for the Prevention of Accidents, but use is also made of material issued by the Ministry of Health and occasionally by other organisations Conferences and Courses The Congress of the Royal Society of Health, 25th to 29th April, was attended by Councillor Hyde and the Medical Officer of Health, and the Annual Conference of the Association of Public Health Inspectors, 20th to 23rd September, by Alderman A.J. Rogers and the Chief Public Health Inspector. At a Central Council for Health Education Seminar on ' The Role of the Medical Officer of Health in Health Education'' , attendance was shared by the Medical Officer of Health and Deputy Medical Officer of Health, and a Central Council Conference on "Health Education as a part of Social Work'' was attended by the Deputy Medical Officer of Health. Members of the Public Health Department staff also attended the following courses General Refresher Course in Meat Inspection (College for the Distributive Trades) Six Public Health Inspectors week end School (Association of Public Health Inspectors) Supervisory Public Health Inspector and one Public Health Inspector Social Workers Course on Old People's Welfare (King George VI Social Service Scheme) Health Officer for Old People. 76 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 in 1960, was assisted by a Borough Council grant of £9,240. The W.V.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 3,300 names out of an estimated total of 25,000 of pensionable age in the Borough. The health officers visited 480 new cases during the year, and revisits totalled 3,645 Consequent upon this visiting, not only were the Department' s services arranged where appropriate i. e. laundry and home bathing, but approximately 3 000 references were made outside the Department. These references covered such requests as the provision of the meals and home help services welfare home and/or hospital admission grants from the National Assistance Board introduction to clubs, Work Centre and associations dealing with blind and handicapped persons registration with a medical practitioner and contacting relatives. The Gas and Electricity undertakings were notified of any defective appliances and, in this connection, in order to combat accidents in the home, thirty-six fireguards were provided by the London County Council, on request and, from the same source, thirty one items of home nursing equipment were supplied on recommendation Public Health (London) Act 1936 Section 122 Cleansing and Laundry Service The Annual Report for 1959 reported the installation of modern disinfecting and laundry equipment for the treatment of soiled linen, and described the arrangements for dealing with this problem so that washed and sterilised articles were returned normally within 24 hours The service is once weekly for most cases but where specially required, may be given twice weekly This service has continued to prove most valuable during the year and, in fact, has been extended as noted below at the request of the Stoke Newington Borough Council. In addition to the Islington residents who were individually assisted, the service is also used on behalf of the institutions and authorities as set out below Islington residents:- No of recipients approved 93 No. of washings carried out 2,814 No. of articles cleansed 26,315 Home for Confirmed Invalids, Highbury Terrace This commenced on 13th July, 1959. The weight of laundry dealt with was 52 cwts 1 qtr. 3 lbs. 77 Aged Pilgrims' Friend Society Home, Hazellville Road Recommendations are received from the Matron for inmates of the nursing home wing who are incontingent. Operation commenced on 19th October, 1959 The weight of laundry dealt with was 28 cwts. - qtrs 3½ lbs, 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 559 washings, comprising 5,510 articles were carried out on behalf of 35 recipients. Stoke Newington Borough Council A similar agreement was entered into, as with Holborn Borough Council, the scheme coming into effect on 31st October, 1960 During the remainder of the current year 32 washings, comprising 278 articles were carried out on behalf of 5 recipients London County Council (General Powers) Act, 1953 Section 43 Cleansing of Elderly Persons The service for the personal cleansing of elderly persons is closely linked, as might be anticipated, with the soiled linen service mentioned above Cleansing may be carried out either in the person s home, if unable to leave home or alternatively at the Treatment Centre, Seven Sisters Road, where cases may be taken in the Department" s special ambulance 128 persons were thus assisted by the Department's nursing and bathing staff, and this entailed 1,284 home visits and 559 baths given at the Treatment Centre. The work is carried out under the supervision of the Nurse-in-Charge at the Treatment Centre and, in view of the increase in the laundry and personal cleansing services, an additional bathing attendant was appointed in July last. National Assistance Acts, 1948 and 1951 It was necessary to invoke the procedure for the removal to suitable premises without delay in respect o f five elderly persons in accordance with the provisions of the National Assistance (Amendment) Act, 1951 An order under subsection (3) of section forty seven of the National Assistance Act, 1948 for the removal of any such person as is mentioned in subsection (1) of that section may be made without the notice required by sub section (7) of that section if it is certified by the medical officer of health and another registered medical practitioner that in their opinion it is necessary in the interests of that person to remove him without delay 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. 78 Aged and Infirm - Action taVen under Statutory Powers Name and Age Reason for Council's Action Period Named in Order Type of accommodation to which removed Ultimate Result (1) (2) (3) (4) (5) Case Mrs. B No. 1 90 years. An emergency doctor summoned by the police in February, 1960, brought this case to the attention of the Public Health Department. Domiciliary services were supplied Later in the year, her medical practitioner advised ner to go into hospital for bladder trouble. She refused. He referred the case to the Department and, following a visit by the Deputy Medical Officer of Health, an application to the Justice of the Peace was made and an Order granted for her immediate removal to hospital. Not exceeding three weeks Geriatric Hospital Died in Hospital 15 days after admission. Case Miss B No. 2 65 years. Hie police found this case in a collapsed state near her own home. An ambulance was called but she-recovered sufficiently to return home and refused to go in the ambulance. An emergency doctor was called but she refused to admit him The Public Health Department were notified and the Old People's Visitor and the Deputy Medical Officer of Health managed to get in to see her. She was gravely ill with cellulitis and varicose ulcers of legs. She refused to go to hospital and an Order from a Justice of the Peace was obtained for her immediate removal. Not exceeding three weeks General Hospital Died in Hospital on the day of removal. Case Mrs. R. No.3 92 years. This elderly lady was removed by an Order in 1952 to a Welfare Home. [Xiring her absence her home was cleaned up with her consent. She agreed to keep it clean and receive domiciliary services. After a period she lapsed into her old ways and refused admission to the domiciliary services. A further Order was obtained in 1959 and she was removed again. During her absence the same procedure as before was adopted and again she promised to receive the services and keep the place clean In 1960 she was lapsing again into her old ways but she became ill and entered hospital. She got better but before she was discharged, the hospital consulted the Department as to her disposal. She was considered unfit to care for herself and as she was unwilling to go away of her own accord, she was removed By an Order to a Welfare Home. Not exceeding three weeks Wei fare Home Settled down happily and remained in Home until her death the following year. Case Mrs. J No. 4 88 years. She was known to the Department for several years. She required no services apart from visiting However in 1960 her health was affected by cancer. She refused all domiciliary services. Her doctor arranged for her admission to hospital but she refused to go. The doctor notified the Department and following a visit by the Deputy Medical Officer of Health, an Order was obtained for immediate removal. Not exceeding three weeks Geriatric Hospital Died in Hospital ten days after admission. Case Mrs. B No.5 88 years. This lady was in poor health following an attack of pneumonia Her doctor advised her to go into hospital. She refused. He notified the Department and, following a visit by the Deputy Medical Officer of Health, an Order was obtained for her immediate removal. Not exceeding thre weeks Geriatric Hospital Eventually transferred to the long-stay annexe of the hospital, where she still remains 79 The following two cases illustrate how it was possible, with the aid of the various services available to elderly persons to find happier solutions to the problems raised. 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' s assistance is requested by relatives, neighbours, family practitioners, etc. Mrs. G. (83 years) Mrs. G. was an independent old lady who was first brought to the notice of the Department by her family, who were growing increasingly concerned about her selfneglect as tney were only permitted to provide food ana remove waste. The Old People's Visitor made a number of calls but Mrs. G. refused offers of any further domiciliary services. Eventually the old lady refused to allow members of the family into her home. Following a combined visit by several of the Department's Officers, Mrs. G. was persuaded to allow her family to visit and also to accept the Council's home bathing service. The Council's nurse was not only able to bathe Mrs. G. , cut and wash her hair, but also to change clothing etc. which was laundered through the Council's Special Service. Mrs. C (85 years) Mrs. C. , a sitting tenant, was brought to the notice of the Department by the National Assistance Board, following complaints from the new owner-occupier. The Old People's Visitor called and, after some difficulty persuaded Mrs. C. to accept the home help service, but other offers of help were refused. Continued complaints were received and the old lady eventually agreed to have the home bathing and laundry services and her rooms were disinfested. Mrs. C. refused to have electricity installed in her room, and there was a danger of her gassing herself by turning on the gas but not being able to reach high enough to light the burner. This was remedied by getting the burner lowered. National Assistance Act, 1948, Section 31 ' INeals-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-Vlheels'' services operated by the Women's Voluntary Service and the Islington Old People's Welfare Council. Meals supplied during the year were as follows.- neals-on-Wheels Women's Voluntary Service 6,962 18,033 meals cooked by NALQO, Town Hall Canteen. Islington Old People's Welfare Council 5,766 Lunch Clubs Giffotd Hall Mission Welcome Club 3,877 Caxton House Settlement 1,428 A lunch club at St. Giles Christian Mission, Bride Street, N.7, also produced 2,384 meals with the help of their own voluntary workers and Council grant-aid. Another lunch club, situated in the Borough of Finsbury at the Claremont Central Mission, White Lion Street, has a number of elderly diners from Islington, and receives a £50 grant from this Council towards running expenses. 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-on-wheels" 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. 80 Holidays for Elderly Persons By means of a scheme administered through the Old People's Welfare Council, 536 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 grant of £2,750 was provided by the Borough Council for this scheme. Parcels for Elderly persons In October the Council authorised the expenditure of £50 for Christmas gifts of food parcels to about a hundred old folk and these were much appreciated. Selection was made by our Visitors and delivery carried out by the Islington Old People's Welfare Council. Islington Work Centre for the Elderly The Islington Work Centre is held in rented premises at the Elizabeth Whitelaw Reid Club Cloudesley Street, N.1., which commenced activities in October, 1958, and continues to give physical and moral stimulus and recreation to an increasing number of elderly persons approximately 60 attending at the end of the year. The Centre is run under the aegis of a sub committee of the Islington Old people's Welfare Council, the Chairman being Alderman A.J Rogers, and Miss K.D. Lane, Centre Organiser. A wide variety of jobs are done by the old folk such as assembly and packing of eye-drop bottles, carding cigarette holders, circularising for mailing houses and making up divisions for cardboard boxes. As the first venture in Islington of this kind, it appears to fulfil a need and it is anticipated that it will serve as a forerunner to Work Centres in other parts of the Borough The Council agreed to assist this work with an annual grant of £1,800. Chiropody The Council has continued to support voluntary organisations in the provision of a chiropody 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 through the Public Health Department until the end of September when these arrangements were transferred to the Islington °ld People* s Welfare Council following consultations between the London County Council and the Borough Council. A limited domiciliary service is in operation and all applicants are visited by the Old People' s Health Officers before treatment is given. 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. 1., after that date. ISLINGTON CREMATORIUM The Medical Referee or the Deputy Medical Referee certified a total of 583 applications for cremation at the Council's Crematorium, East Finchley. 81 MATFRNITY 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 North South East West Archway 0 - 1 years 12,732 9,262 8,107 12, 487 2, 589 1-2 years 1,693 1,352 792 1,883 394 2-5 years 1,084 602 338 2,038 152 Special Toddlers' Clinics 1, 104 282 323 722 Ante-Natal and Post-Natal Combined 5, 533 4,000 3,747 3,136 Foster Mothers The table of foster-mothers and foster-children registered under the Childrens Act, 1958 is as follows:- 31.12.60 Number of persons fostering children 19 Number of foster-children being cared for 23 L C.C. Day Nurseries and Child minders At present there are 3 Day Nurseries open in Islington Scholefield Road 60 places Canonbury Place 67 ,, Mitford Road 67 ,, 194 ,, There are also 50 places for Islington children in Springdale Day Nursery (Stoke Newington). In addition there were at the end of the year 180 children being minded by 139 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 59 children being minded by 23 child minders registered by the L. C.C. under the provisions of the Nurseries and Child Minders Regulation Act, 1948. There were also two private day nurseries registered under the Act providing 33 places. 82 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 3,937 attendances. An additional foot clinic was started at South Islington Welfare Centre on 17th September 1960, and total attendances there to the end of the year were 241. Many Islington residents attend the main foot clinic at Pine Street in Finsbury where the total attendances were 17,478 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 1960 was 1,828. 83 Maternity and Child Welfare Centres The days and times of sessions are as follows:- CENTRE Ante-Natal & Post-Natal Children's Toddlers Dental Diphtheria Immuni sation Poliomyelitis Inoculation Smallpox Vaccination North Islington Infant Welfare Centre (Voluntary) 6-9 Manor Gardens, N.7. Mon. Tues. Wed. Thurs. Wed. 2 p.m. 10 a m. 2 p.m. Mon. to Frid. 2 p.m. Wed. 2 p.m. (2nd in Mtn. ) Thurs. 10 a.m. (1st in Mth.) Frid. 2 p.m. Wed. Thurs Frid. 1.30 p.m. 9. 30 a.m. & 1.30 p.m. Wed. Frid. 2 p.m. 10 a.m. Wed. Frid. Thurs. 2 p.m. 10 a.m. 5.30 6.30 p. m. Wed. Frid. 2 p.m. 10 a.m. North Branch Clinic - Blythe Mansions, Hornsey Rise, N. 19 Frid. 10 a.m. 2 p.m. Mon. Tues. 2 p.m. 2 p.m. Tliurs. 2 p.m. (3rd in Mtn.) Mon. Tues. 2 p.m. 2 p.m. Mon. Tues. 2 p.m. 2 p.m. Mon. Tues. 2 p.m. 2 p.m. North Branch Clinic Co-operative Hall, 129, Seven Sisters Road. N.7 Wed. 2 p.m. Frid. 2 p.m. (1st in Mth. ) Wed. 2 p.m. Wed 2 p.m. Wed. 2 p.m. Archway M. & C.W. Centre - Congregational Church, Junction Road, N.19 Thurs. 10 a.m. & 2 p.m. Tues. 10 a.m. (Alt. Wks. ) Thurs. & 10 a.m. 2 p. m. Thurs. & 10 a.m. 2 p.m. Thurs. 10 a.m. & 2 p.m. West Islington Welfare Centre, 42 & 44, Richmond Avenue, N.l Tues. Thurs. 10 a.m. 10 a.m. & 2p.m. (midwi ve3) Mon. Tues. Wed. Frid. Frid. 2 p.m. 10 a.m. Wed. 10 a.m. Mon. Wed. 10 a.m. Mon. Wed. 10 a.m. Mon. Wed. 10 a.m. West Branch Clinic, Tenants'Clubroom, Hilldrop Estate, N.7 Frid. 10 a.m. 2 p.m (midwives) Mon 1 Tues. 1 Wed Thurs. > 2 p.m. Tues. 10 a.m Mon. " Tues. Wed. Thurs ^2 p.m. Mon. ~| Tues. | Wed. Thurs J > 2 p.m. Mon. " Tues. Wed. Thurs p. 2 p.m. South Islington Welfare Centre, 6, Clephane Road, Essex Road, N.l. Mon. Tues. Thurs. Frid. 10 a.m. 2 p.m 1 (midwi ves) 10 a.m. Mon. Tues. Wed. 2 p.m. 10 a.m. 10 a.m. & 2p.m. Frid. 2 p.m. Thurs. Frid. 10 a.m. 2 p.m. Thurs. Frid. 10 a.m. 2 p.m. Thurs Frid. 10 a.m. 2 p.m. South Bran h Clinic, Union Chapel Compton Avenue, N.l Tues. Thur3. 2p.m. Tues. Thurs 2 p.m. Tues. Thurs 1 2p.m. Tue3. Thurs 2 p.m. East Islington Welfare Centre 32, Drayton Park, N.5 Mon. Wed. 4 5,30- Ihurs. FHrf 10 am 2 p.m. (midwi /es) 6 30 p.m. 2 p.m. 10 am Tues, Wed. Frid. 2 p.m. 10 a.m. 2 p.m. Tues. 10 a.m. Mon Frid 1 p. m. 2 p.m. Mon Frid. 2 p.m. 2 p.m. Mon. Frid. 5 p.m. 2 p.m. East Branch Clinic, 6. Hurlook Street, N.5 Tues. Wed. Thur3. 2 p.m. Tues. Wed. Thurs. 2 p.m. Tues. Wed. Thurs. | 2p.m. Tues. Wed. Thurs 2 p.m. INHFX Accidents 9, 10, 14 Acute Encephalitis 15 Acute Poliomyelitis 9,15,20-22 Aged and Inform Persons 76-80 Ante-Natal Clinics 81,83 Anthrax 15, 31 Atmospheric Pollution 41-45 Bacteriological Examination. 32,53,54,69-70 Births 7,10,12 Blow-Fly Infestation, 40 Cancer-Lung 13 Certificates of Disrepair 35-36 Chemical Examinations53,54,69,70 Child Life Protection 81 Child Minders 75,81 Child Welfare Centres 81,83 Chiropody for Elderly Persons 80 Clean Air Act, 1956 41-45 Cleansing, Elderly Persons 76-77 Closing Orders 57 Crematorium 80 Day Nurseries 81 Deaths 8-9,10,12,20,21,23-24 Dental Clinics 83 Diphtheria 9,10,15,23-24 Diphtheria Immunisation 23,24,83 Disinfection 40 Disinfestation 40 Disinfestation of .Sewers 53 Dysentery 15,26-27 Elderly Persons, Services for 76-80 Encephalitis, Acute 15 Enteric Fever 15,26 Erysipelas 15 Export Certificates 67 Factories Act 46-48 Fly Infestation 40 Food and Drugs Act 61-65 Food Hygiene Regulations 63-65 Food - Inspection and Supervision. 59-70 Food - New Legislation 59-60 Food Poisoning 15,25-26 Food Sampling 65-66 Food, Unsound 60-65 Foot Clinic 82 Foster Mothers and Children 81 Hairdressers & Barbers 51 Health Publicity and Health Education. 71-75 Heating Appliances (Fireguards) Act, 1952 51 Holidays for Elderly Persons 80 Home Helps 82 Home Safety Committee 72,73-74 Home Visiting 15,16,31,76 Housing 55-58 Ice Cream 69 Illegitimate Infants - Births & Deaths 7,10,12 Infant Mortality 8,10,11,13 Infectious Diseases 15-32 Influenza, Pneumonia and Bronchitis 9,12,15 Inoculation, etc. Certificates 17 Laundry Services 76-77 Legal Proceedings 38-39, 48, 53, 56,63-65 Live Births 7-10 L.C.C. (General Powers) Acts 37,77 M & C.W. Services 81-83 Malaria 15 Marriages 7, 10 Mass X-Ray 13,29,30 Maternal Mortality 8,10,13 ''Meals on Wheels'' 76,79 Measles 15,17,18,19,20 Meat67 Meningococcal Infection 9,15 Merchandise Marks 68 Metropolitan Cattle Market 67 Milk 59,69-70 Milk and Dairies Regulations 59,70 Milk (Special Designations)59,70 Miscellaneous Services 71-83 Mortuary 80 National Assistance Acts 77-80 Neoplasms, Malignant 9,10,13 Noise Abatement Act, 1960 33 Noise Nuisance 33-34,48 Nurseries - Day 81 Offensive Trades 49-50 Ophthalmia Neonatorum 15 Outworkers 47 Overcrowding 55, 57, 58 Pet Animals Act 50 Pharmacy and Poisons Acts, etc 50 Pigeon Nuisances 49 Pneumonia 9,12,15 Poliomyelitis 9,15,20-22 Poliomyelitis, Protection Against 22,74-75,83 Population 7,10,12 Post-Natal Clinics 83 Premature Infants 11 Preserved Food Premises 62 Prevention of Damage by Pests Act and Order 51-53 Public Health Committee 5 Public Health Inspectors - District Work. 34-37 Public Health Inspectors - Special Work.46-51 Public Health (London) Act - Improvements effected 36 Public Health (London) Act, Sections 40 and 109 37 Public Health Officers 5-6 Public Health (Tuberculosis) Regulations, 1952 29 Publicity71-75 Puerperal Pyrexia 15 Rag Flock and Other Filling Materials Act. 50 Rats and Mice 51-53 Refreshment and Coffee Stalls 68 Rent Act, 1957 35-36 Requisitioned Property46,56 Respiratory Infections9,12,15 Sampling 53-54,65-66 Sanitary Circumstances 33-54 Scabies 15,31 Scarlet Fever 15 Sewer Treatments 53 Smallpox 15,16 Smoke 41-45 Smoke Control Areas42-43,71 Staff 5-6 Static Water Tanks, etc 41 Statistics - General. Vital 7-14 Still-Births 7-10 Swimming Baths 54 Toddlers' Clinics 81,83 Town & Country Planning 58 Treatment Centre 31 Tuberculosis 9,10,13,15,28-30 Tuberculosis - Beds and Bedding 30 Tuberculosis - Care Committee 30 Tuberculosis - Chest Clinics 29-30 Tuberculosis - Deaths9,10,15,28 Tuberculosis Notifications10,15.28 Typhoid Fever 15,26 Underground Bakehouses 48 Vaccination16,17,83 Vermin 15.31 Washing Facilities, Free 68 Water Supplies 53-54 Welfare Centres 81,83 Whooping Cough9,15,17,19,20 Printed and Published by Islington Borough Council