AC4368 Ak 4/9/53 POP 58 Metropolitan Borough of Poplar ANNUAL REPORT OF The Medical Officer of Health FOR THE YEAR 1952 65985 Metropolitan Borough of Poplar ANNUAL REPORT OF The Medical Officer of Health FOR THE YEAR 1952 INDEX Page Public Health Committee 4 Staff 5 Statistics 9 Causes of Deaths 12 Sanitary Circumstances of the Area 15 Housing 35 Inspection and Supervision of Food 43 Prevalence of and Control over Infectious Diseases 54 General Provision of Health Services for the Area 58 3. METROPOLITAN BOROUGH OF POPLAR. PUBLIC HEALTH COMMITTEE 1952-1953 Alderman W. I. Brinson, J.P., Mayor (ex-officio) Chairman: Councillor J. Gillender Vice-Chairman: Councillor E, G. Hart Alderman J. Smart Councillor A.E. Allen „ J.G. Biggs „ Jo Bond „ Go Ho Buckingham „ P. Connolly „ Mrs. M. Goodway „ J. J. McDonald „ T. Phillips „ Mrs. E. Sims „ W. T. Tuson „ J. W. Vicat „ Mrs. H. Wood Council's representatives on the London County Council (Division 5) Health Committee : Councillors Mrs. N. F. Cressall and J. W. Vicat. 4. STAFF OF THE PUBLIC HEALTH DEPARTMENT. MEDICAL OFFICER OF HEALTH: R. Duncan Dewar, B.Sc., M.B., Ch.B., D.P.H. Senior Sanitary Inspector: C. A. Grabham (a)(d) Sanitary Inspectors: R. A. Begley (c)(d) G. L. Belshaw (c)(d) N. L. Brown (c)(d) G. W. East (c) I. M. G. Farries (c) F.S. Jolliffe (c)(d) H. W. Luke (c) (d) C. H. Medland (c)(d) J. E. G. Steeden (c) C. S. Westbrook (a)(d) M. R. Williams (c) (to 8.6.52) Chief Clerk: A. A. Hamilton (c) Clerks: D. N. Wo Irvine (e) A. M. Cannon Miss S. E. Fells G. R. Williamson W. J. Crone Disinfectors: W.Hodge (Chief) (b) R. Desmond (assistant) Public Analysts (Part-time): Albert E. Parkes, F.I.C.,F.C.S. H.A.Parkes, B.Sc., F.I.C. (a) Cert. S.I.E.Board. (b) Cert. R.S.l. (c) Cert.R.S.I. & S.I.E.J.B. (d) Cert. Meat & Food Inspector. (e) D.P.A. (5) To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Poplar„ Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report on the health and sanitary circumstances of the Borough for 1952. The Borough of Poplar is long and narrow in shape and forms part of the eastern boundary of the County of London. From north to south it extends for about 4½ miles whilst its average width from east to west is less than one mile. The Borough was formed by the union of Poplar and Bow and even after more than half a century these two areas retain their individuality. Poplar in the south contains the East India, West India and Millwall Docks, and the population shows evidence of its long association with the sea and sea-borne trade. There is also in Poplar a community of Irish ancestry which is mainly derived from the Irish labourers who assisted in the construction of the Blackwall Tunnel towards the end of the nineteenth century. The inhabitants of Bow in the north are typical of the Londoner as he is known to the whole world and they are justly proud of being the real east-enders. There is a considerable amount of light industry in Bow and some heavy industry. The general standard of the older houses throughout the Borough is poor. The houses are mainly in terraces built in the second half of the 19th century, somewhat less crowded than in other areas of East London, but poorly arranged and with amenities far below the present day standards. In contrast with the older houses the houses and flats built by the Poplar Borough Council and the London County Council provide some thousands of excellent dwellings of which the well known Lansbury Estate built by the London County Council provides examples. Whilst the large docks provide a means of access for cases of smallpox and other diseases which are not endemic in this country, the improving standards in the control of infections throughout the world have reduced what was a very 6. real danger in the past. Some danger still undoubtedly exists but the major problems of public health in Poplar are more closely related to housing and the living and working conditions of the people. When allowance has been made for the age and sex composition of the population the death rate for Poplar is 7% higher than for London and 12% higher than the rate for England and WaleS. If figures for sickness or ill health were available it might well be that they would be equally unfavourable. In spite of this the figures do show some improvement on those for the previous year and it is satisfying to note that the combined deaths from tuberculosis, influenza, and all the other notifiable infectious diseases is 40% less than for these diseases during the previous year, there being no notable epidemics in either year. The infant mortality rate shows a reduction from 31.5 in 1951 to 23.8 in 1952. Whilst this rate is extremely variable and cannot be used as a reliable guide to the degree of child care, the figures do at least indicate that the standard of care is being maintained. The care of mothers and young children is now largely a function of the London County Council and whilst it is a matter of considerable interest to the Public Health Department of the Borough Council it is a matter for report by the County Council and is therefore not included in the following pages. I have however included some figures on the personal health services which have been kindly supplied by the Divisional Medical Officer Dr. G. O. Mitchell. In mentioning the services administered by the London County Council I would like to express my appreciation of the help given to the aged and the sick by the Home Help Service which has done a tremendous amount of work to make life more comfortable for these old or ill people and has in many cases made it possible for them to remain, where they wish, in their own homes. In the following pages of this Report a summary is given 7. of the work carried out by the Public Health Department and much of this is necessarily given as figures. It is not possible to indicate the many human problems which are met with each day and the extent to which the problems can be solved. Many problems are concerned with housing and there can be only a limited solution for some time to come but I think that it would be fair to say that the amount of good which has been done and the progress which was made during 1952 was somewhat greater than that which a mere perusal of these figures would indicate. I would like to express my thanks to the Chairman and to the Members of the Public Health Committee for their interest, encouragement and support during the year. I would like to thank the Officers of the Council for their help and advice and particularly my own staff for their loyal assistance I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, R. DUNCAN DEWAR Medical Officer of Health. June, 1953. 8. SECTION A. STATISTICS. The population as estimated by the Registrar General at the middle of 1952 was 590 less than in the previous year in spite of there being 350 more births than deaths during the year. The number of inhabited houses increased by 135 during the year to give a total of 17,463 at the end of 1952. A recent estimate gave the number of habitable rooms throughout the Borough as 102,550c This means that for every 100 houses there are 587 habitable rooms which are occupied by 416 persons. On mere figures therefore, with the existing accommodation, the population could be doubled without causing any statutory overcrowding. In fact, it is found that there are some cases of overcrowding but they are not very numerous and there are many cases where houses are not fully occupied or not used to the best advantage. The Registrar General supplies area comparability factors which take into account the age and sex distribution of the population so that more accurate comparisons can be made between the birth rate and death rate of the Borough with the rates in other parts of the country. Using these factors the adjusted birth rate for Poplar is 16.3 as compared with 17.6 for London and 15.3 for England and Wales. The adjusted death rate is 13.5 as compared with 12.6 for London and 11.3 for England and Wales, The infant mortality rate which is the number of deaths of children under the age of 1 year for every 1,000 live births is 23.8 which is exactly the same figure as for London, the figure for England and Wales being 27.6. Whilst this is satisfactory the rate fluctuates considerably in a comparatively small population and care should be taken in drawing any conclusions. 9. The causes of death are shown in Table I in accordance with the classification used by the Registrar General. It will be noticed that out of the 11 deaths amongst children between the ages of 1 and 15 years,three of the deaths were due to accidents, the same number as in the previous year. Apart from the reduction in the number of deaths from infectious diseases which has already been noted,there is no other cause of death which shows any significant variation from previous years. STATISTICS OF THE AREA. Area (excluding water) 2,136 acres Population, estimated mid-year 72,670 Number of inhabited houses(according to Rate Boooks) 17,463 Rateable Value £573,217 General Rate (1951-1952) 19/8 in £ Sum represented by a penny rate (1951-1952) £2,236 10. EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. Males Females Total Live Births: Legitimate 600 559 1,159 Illegitimate 37 25 62 Birth Rate per 1,000 estimated resident population: 16.8 Stillbirths: Legitimate 15 10 25 Illegitimate 1 2 3 Rate per 1,000 total (live and still) births 22.4 Deaths 499 369 868 Death Rate per 1,000 estimated resident population: 12.0 Deaths of Infants under one year of age: Legitimate 16 12 28 Illegitimate 1 1 Death Rate of Infants under one year of age: All infants per 1,000 live births 23.8 Legitimate infants per 1,000 legitimate live births 24.2 Illegitimate infants per 1,000 illegitimate live births 16.1 ll. 12. TABLE I DEATHS CAUSES OF DEATHS SEX ALL AGES AGS GROUTS 0- 1- 5- 15- 25- 45- 65- 75- ALL CAUSES M 499 16 1 5 5 32 147 157 136 F 369 13 4 1 2 13 79 119 138 1. Tuberculosis, respiratory M 16 - - - - 4 6 4 2 F 1 — - — 1 — — — — 2. Tuberculosis, other M 1 — — 1 - - — — — F 2 1 - - - - 1 - — 3. Syphilitic disease M 3 - - - - - — 1 2 F - - - - - - - - - -4 .Diphtheria M - - - - - - - F - - - - - - - - — 5. Whooping cough M - - - - - - - - - F - - - - - - - - - -6. Meningococcal infection M - - - - - - - - - F 1 - - - - - - 1 7. Acute poliomyelitis M - - - - - - - - - F - - - - - - - - 8. Measles M - - — — - — — — - F - - - - - - - - - 9. Other infective and parasitic diseases M - - - - - - - - F 2 - — — 1 1 — — — 10. Malignant Neoplasm, stomach M 21 — - - - - 10 8 3 F 12 — - - - - 5 3 4 11. Malignant Neoplasm, lung, bronchus M 26 — - - — 3 13 6 4 F 8 — - - — — 5 2 1 12. Malignant Neoplasm, breast F 11 - - - - 1 7 2 1 13. Malignant Neoplasm, uterus F 1 - - - - - 1 - - •21 TABLE I - continued DEATHS CAUSES OF DEATHS SEX ALL AGES AGS GROUPS 0- 1- 5- 15- 25- 45- 65- 75- 14. Other Malignant and Lymphatic Neoplasms M 45 ^.. — 2 13 19 11 F 37 — — — — 2 9 14 12 15. Leukaemia, a leukaemia M 2 — — — — — 1 1 — F 1 — — — - 1 — — — 16. Diabetes M 5 — — — 2 — 1 2 F 6 — — — — 1 4 1 17. Vascular lesions of nervous system M 35 — — — — 2 5 12 16 F 45 — — — — 9 16 20 18. Coronary disease, angina M 67 — — — — 5 24 21 17 F 31 — — — — — 5 10 16 19. Hypertension with heart disease M 14 — — — — — 3 6 5 F 10 — — — — — — 3 7 20. Other heart disease M 46 — — — — 3 5 14 24 F 58 — — — — 3 11 17 27 21. Other circulatory disease M 21 — — — — — 5 4 12 F 27 — — — — — 2 11 14 22. Influenza M 3 — — — — — 2 — 1 F 2 — — — — — 1 1 — 23. Pneumonia M 27 2 — — — — 7 8 10 F 20 2 1 — — 1 2 8 6 24. Bronchitis M 67 4 — — — — 29 22 12 F 38 —— — — — — 7 16 15 25. Other diseases of respiratory system. M 9 — — — — — 5 3 1 F 3 — 1 — — — — 1 1 26. Ulcer of stomach and duodenum M 12 — — — 1 3 2 6 — F 3 """ — — — — 1 — 2 14 TABLE I - continued DEATHS CAUSES OF DEATHS SEX ALL AGES AGE GROUPS 0- 1- 5- 15- 25- 45- 65- 75- 27. Gastritis, enteritis and diarrhoea M 1 1 — — — — — — — F — 1 — _ mm — — 2 1 28» Nephritis and nephrosis M 1 — — — mm — — 1 — F — — — — — — 2 1 — 29. Hyperplasia of prostate M 11 —- - - - - 1 5 5 30. Pregnancy, childbirth, abortion F 1 — - - - 1 — — - 31. Congenital malformations M 7 4 —^ 1 — 1 1 — — F 2 2 — — — — — — — 32. Other defined and ill-defined diseases M 35 5 1 — 1 mm 8 14 6 F 33 6 2 1 mm 2 7 7 8 33. Motor -vehicle accidents M 4 — — — 2 1 1 — F 1 — — — mm mm 1 — — 34. All other accidents M 14 — — 3 — 4 4 1 2 F 4 1 — — — — 1 1 1 35. Suicide M 6 — — * 1 2 2 — 1 F 2 — — — — 1 1 — — 36. Homicide and operations of war M — — — — — — — — — F — — — — — — —— — — SECTION B SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The Borough is provided with a domestic water supply by the Metropolitan Water Board, and samples of the water are subjected to routine chemical and bacteriological examinations at the Board's laboratories. The condition of the water supplied was satisfactory. 337 water supply certificates were granted in accordance with Section 95 of the Public Health(London)Act 1936. Sanitary Inspection of the Area. The major portion of the work of the Public Health Department concerns insanitary conditions in dwelling houses. It has not been found practicable to institute house-to-house inspections, and normally inspections are carried out only on complaint, followed where necessary by re-inspections. The District Sanitary Inspectors are responsible for all premises and for the investigation of all complaints arising within their own areas. The complaints mostly concern housing defects but also include such matters as nuisances arising on bomb-sites, nuisances from animals and complaints concerning noise or annoyance from trade processes. The District Inspectors are also responsible for the regular routine inspections of factories, shops, etc., as opposed to inspection merely on complaint and they are responsible for duties under the Food & Drugs Acts and the Food By-laws. The difficulties which arise in obtaining abatement of sanitary defects in houses are mainly due to the very high cost of repairs. There is now very little difficulty over the shortage of materials, but costs remain as high as ever and whereas in previous years it was usual to find that a 15. large proportion of the cost was being met by the War Damage Commission,a very large number of war damage claims have now been settled and the whole cost of repairs must be met by the owner. In these circumstances even a moderate expenditure on repairs may be quite uneconomic for a rent-restricted house and this is particularly the case where the house is situated in an area scheduled for clearance and redevelopment. It has, nevertheless, been possible to get a considerable amount of work done on the maintenance of property, some particulars of which are set out in Table II. The figures given do not of course include all those repairs which are carried out without coming to the notice of the Department. Further particulars on housing are given in the next section. TABLE II. INSPECTIONS, INSANITARY CONDITIONS FOUND EXISTING, AND RE-INSPECTIONS DURING THE YEAR 1952. Number of Complaints received 2,941 (Dwelling Houses (House-to-House (On complaint 2,924 ( (After Infectious Disease 152 Number of Inspections ( (Factories ( (Where power is used 203 (No power used 34 (Others 1 (Outworkers 25 (Stables 21 Smoke observations 8 Miscellaneous visits and inspections(including visits to infectious disease contacts,school inspections, etc) . 3,352 Re-inspectors 11,779 Premises requiring amendment (Dwelling Houses 2,486 (Others 65 Service of Intimations,etc. Intimations served 2,216 Intimations complied with 1,396 Notices served 1,046 Notices complied with 874 16. Table II (continued) Final Notices served 211 Final Notices complied with 182 Summonses applied for 69 Work done(number of instances not included above): (a) After legal proceedings 25 (b) Voluntarily 255 Defects,etc., found in Dwelling Houses : Nuisances, etc.,found. WorKS completed Drainage: Drains defective 95 129 Drains obstructed 207 181 Waste pipes defective,etc„ 131 150 Rainwater pipes not disconnected 4 9 W.C's and flushing apparatus defective 316 350 Dampness: (Not due to defects shown elsewhere) 897 861 Water: supply cut off 43 51 Dust receptacles: Insufficient or defective 93 60 Miscellaneous: Rooms,etc.,dirty and/or verminous 886 1,070 Cases of overcrowding 14 - Yards,etc.,not properly paved or drained 105 101 Roofs defective 987 912 Rainwater pipes and gutters defective 336 335 Public House urinals requiring cleansing - - Other nuisances or defects 4,227 4,424 Defects,etc., found in Factories: Sanitary defects 11 12 W.C. accommodation insufficient or unsuitable 16 14 Overcrowding — — Stables: Accumulations found 3 3 17. Drainage and Sewerage. During the year 77 plans of drainage work to new and existing buildings were submitted and approved. Houses let in lodgings. No.of Houses on Register at end of year 144 Inspections 12 Common Lodging Houses. There are two licensed Common Lodging Houses, with accommodation for 295 and 40 males respectively, in the Borough. 41 inspections were made during the year. Seamen's Lodging Houses. There are three licensed Seamen's Lodging Houses, providing accommodation for 126, 45 and 26 males respectively in the Borough. Inspections made during the year totalled 31. Personal Cleansing. At the end of 1951, the London County Council made alternative arrangements for the cleansing of school children. The cleansing station was in an unsatisfactory condition and some improvements were carried out. A further review of the arrangements during 1952 showed that the maintenance and staffing of the cleansing station had become uneconomic in consequence of the greatly decreased numbers of persons cleansed and it was decided to approach the Stepney Borough Council with a view to the cleansing of persons from Poplar at the Stepney Cleansing Station. A scheme on these lines was arranged and came into effect early in 1953. 18. The number of persons cleansed during 1952 was as follows:- Verminous. Scabies. Total. Adults 99 26 125 Children 8 7 15 107 33 140 Disinfection and Disinfestation. It is becoming evident that where people maintain a good standard of cleanliness there is much less need for disinfection after infectious disease than was previouslysupposed. Disinfection is still, of course, absolutely essential in some diseases such as smallpox, but in the cases of other diseases the position is almost ludicrous. The outstanding example is scarlet fever and it not uncommonly occurs that two persons are infected with the same type and strain of organism, in one case a rash develops and the patient is correctly diagnosed and notified as suffering from scarlet fever; in the other case no rash develops and the patient is correctly diagnosed as a case of Tonsillitis. In the Scarlet Fever case disinfection of the premises and clothing, etc., is offered, mainly to satisfy public opinion and to avoid criticism of the Public Health Department and the offer is usually accepted. In the Tonsillitis case where the danger to others is exactly the same, the Public Health Department is almost certainly unaware of the case and even if the information was given, would almost equally certainly take no action. It is almost impossible for a single local authority to rationalise the position in its own area without the assistance, at least, of neighbouring authorities, and it is quite unreasonable to expect a general medical practitioner to alter the advice he gives to his patients according to the local authority's area in which they live. It would be helpful if the Ministry would made some authoritative statement as to the practice which is recommended so that useless expenditure of public money could be avoided without causing that public disquiet which could arise from conflicting medical advice. 19. Infestation of premises by bed-bugs is still common in the borough, but it is noticeable that the massive infestations which were met twenty years ago have disappeared and that in the majority of cases which now occur only few bugs are seen. The use of insecticides such as D.D.T. which are not only effective but have a persisting effect for some weeks after spraying has been carried out, is probably responsible for much of the improvement, but the improved standards of cleanliness amongst the population at large has also had a considerable effect. The efficiency of the persistent insecticides has, however, been exaggerated and there have been many cases where premises have required repeated treatments over a long period before the infestation could be said to have been completely eradicated. A summary of the work of disinfection and disinfestation carried out during the year is given below. (a) Disinfection: Premises Disinfected. Articles Disinfected. Infectious Disease 484 3,970 Tuberculosis 69 764 Verminous 69 £,387 Miscellaneous 207 5,171 Total 760 12,292 (b) Disinfestation: Inspections: Number of visits 1,154 Premises requiring treatment 784 Furniture requiring treatment ££8 Re-inspections after disinfestation 181 Miscellaneous visits and revisits. £14 Disinfestation carried out: Rooms (in 784 premises) 1,437 Beds, Bedding, etc., articles 1,536 Furniture, articles. 3.343 Miscellaneous 187 20. Prevention of Damage by Pests Act, 1949. Work of the Rodent Control Section may be divided into treatments of Contributory Scheme premises, work in dwelling houses and Sewer Maintenance treatments. Contributory Scheme for Rodent Control. This work was first started in June, 1943, by direction of the Ministry of Food (Infestation Division), in the waterside food storage and food manufacturing premises. As experience was gained and labour became available, its service was extended over all the Borough and catered for all types of premises. The methods and techniques approved by the Ministry of Agriculture and Fisheries, Infestation Division, are used and that Division's officers inspect premises treated at frequent intervals. No major criticisms of work carried out or of infestation levels were received during the year The officers of the Borough Council and those of the Ministry work in close co-operation at all times, and this, together with the skilled work of the operatives, has resulted in new low levels of infestation being constantly achieved. Since half the Borough boundary is riparian in character and in view of the immense volume of goods carried by river and canal, it is extremely doubtful if the rat menace will ever be completely eliminated in this and other similarly situated metropolitan boroughs. Conditions now however, are greatly improved; in 1945, 12 infestations each exceeding 100 rats were encountered; in 1952, the heaviest infestation was one of 12 rats. As in the previous 4 years, the emphasis in the year's work under review has been on the eradication of mice in all types of premises. By the use of blood anti-coagulent agents this type of infestation is at least being controlled, and the only reservoirs or major infestations of mice, as with rats, are in food storage premises where the size of the stacks and the nature of the foods make it possible for rodents to live their lives within the stacks. Throughout the year it has been observed that the storage life of goods 21. is being cut down considerably, and it is believed that it will be possible in the future to control mice infestations at least as effectively as has been done with rats. The Council approved an alteration in the Scale of Charges to the contributors which came into effect on the 1st April, 1952. Whilst this improved the financial aspect, it also caused some contributors to withdraw from the Scheme (a number of whom have since re-entered), and it is thought that in future the number of contributors will be maintained at the present level of 198 (December, 1952) compared with 214 at the beginning of the year. Treatments carried out: 1,789 treatments to 252 premises of 222 contributors, plus 29 treatments to five Poplar Borough Council premises. 71,920 prebaits and 7,725 poison baits were laid, 455 traps were set, and 73 rat-sticker boards were used. The Rodent Officer made 2,328 visits and inspections, and the rodent staff 9,945 visits to apply treatments. 204 inspections and re-visits, and 64 test baitings were carried out at premises not participating in the Scheme. Work in Dwelling Houses, As with industrial premises the nature of this work has gradually swung from rats to mice and of the 421 dwellings treated, 319 were on account of mice infestations. Use of the new blood anti-coagulent agents has made complete elimination possible, even without the co-operation of the tenants of the affected dwellings, whilst with their cooperation it is now possible to eliminate all mice in a reasonable length of time. 647 complaints of rats or mice relating to 462 premises 22. were investigated and 2,086 treatments were applied. 9 complaints relating to 8 premises were outstanding and receiving treatment at the end of the year. 749 inspections by the Rodent Officer and 5,127 visits by the staff were made to apply treatment. Sewer Treatments, During the year the 17th and 18th Maintenance treatments were carried out by the Rodent Officer and operatives on behalf of the Works Department in co-operation with neighbouring Local Authorities under the direction of the Infestation Division of the Ministry of Agriculture and Fisheries. 1,950 manholes and 1,880 manholes were baited in May and December respectively. These treatments restricted the sewer rat population to fairly satisfactory levels, i.e., approximately 20% of the known level of infestation before treatments were commenced in 1943. The constant uncertainties of all Rodent Control work are seen most clearly in sewer treatments. A lapse of two consecutive treatments will allow the rat population to rise to its own natural level, dependent upon food supply and breeding spaces available, whilst the continuance of the treatments does little to reduce still further the infestation levels. It is hoped that a more effective technique will emerge from the experiments with new poisons that are being conducted by the Ministry of Agriculture and Fisheries. Factories. Details of the work carried out in connection with the Factories Act, 1937, are given in the following tables 23. TABLE III INSPECTIONS FOR THE PURPOSE OF PROVISIONS AS TO HEALTH. Premises Number on Register Number of Insp ections Written notices. Occupiers prosecuted. 1. Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities. 53 35 2 - 2. Factories not included in (1) in which Section 7 is enforced by the Local Authority,. 629 241 19 - 3. Other premises in which Section 7 is enforced by the Local Authority. 2 1 - - Total 684 277 21 - 24. TABLE IV CASES IN WHICH DEFECTS WERE FOUND Particulars, No. of cases in which defects were No,of cases in which prosecutions were instituted. Found Remedied. Referred to H.M. Inspector by H.M. Inspector Want of cleanliness 9 7 - 2 - Overcrowding — — - — - Unreasonable temperature — — - — - Inadequate ventilation — 3 - — — Ineffective drainage to floors, 2 2 - - - Sanitary conveniences : (a) Insufficient - - - - - (b) Unsuitable or defective 18 14 - 1 - (c) Not separate for sexes 1 - - 1 - Other offences against the Act(not including offences relating to - - - - - Total 30 26 - 4 - 25. TABLE V, 0UTW0RKERS SECTION 110 SECTION III NATURE OF WORK No. of outworkers in August list required by Sec. 110(1) (c)(3) 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. Wearing apparel Making, etc. 103 - - - - - Cleaning and washing - - - - - - Miscellaneous 77 - - - - - Total 180 - - - - - 86 o Offensive Trades One Dresser of Furskins and one Soap Boilers are established in the Borough. Smoke Abatements During the year one complaint of nuisance from smoke was received, 8 smoke observations were carried out. and as a result two Intimations were served. Shops Act, 1950. Under the provisions of this Act 130 visits were made, and in one instance a notice was served in respect of the W.C. accommodation. No exemption certificates under the Act were issued during the year. Pharmacy & Poisons Act, 1953. A list of persons who sell poisons included in Part II of the Poisons List is maintained under the provisions of the Pharmacy & Poisons Act, 1933. The number of persons on this list at the end of 1952 was 99. National Assistance Act, 1948, -Section 47. During 1952 it was necessary to take action to obtain the compulsory removal of aged persons in four cases, brief particulars of which are set out below:- Mrs. "A", a widow aged 74 years living alone, She was suffering from arthritis and able to walk only with difficulty, A very respectable old lady in very poor circumstances. On account of a septic heel she was admitted in the first instance to St. Andrew's Hospital, 27. Mrs. "B",a widow aged 78 years living alone, Her right leg was amputated some years ago; she suffered from diabetes, was almost completely blind and very deaf. She was removed to St. Clement's Hospital and was quite happy there. At the end of the three months specified in the Order she was fit to be transferred to an institution but steadfastly refused to go although she was quite incapable of cooking after herself, Under an extension Order she was transferred to Luxborough Lodge in the care of the London County Council. Mrs. "c". a widow aged 75 years living alone„ She was a small thin old woman, undernourished and dirty,, She was not co-operative, her mental condition was only fair, and her room was very dirty and verminous. She was removed to Hillside in the care of the London County Council. Mrs. "D", a widow aged 81 years. This old lady had been a barmaid; she had a taste for alcohol and was very voluble. She was independent and occasionally truculent, insisting on doing her own work which was beyond her canabilities. She was transferred to Luxborough Lodge under the care of the London County Council, A large number of other cases came to the notice of the Public Health Department, but with the co-operation of the Home Help Service of the London County Council and with the assistance of the District Nurses, the Voluntary Services and friends and neighbours it was possible to provide proper care at home for a large proportion and the remainder were persuaded voluntarily to enter a hospital or institution. The greatest single factor in providing proper care at home was the help given by the Home Help Service, but the time, trouble and care given by the general medical practitioners contributed very largely to the satisfactory results which were obtained. Care of the Aged. In addition to the medical care provided by general medical practitioners and hospitals and residential care in the institutions maintained by the London County Council the old 28 people of Poplar are assisted in many ways by or with the assistance of voluntary bodies and these services are summarised below:- Old People's Welfare Committee. This Committee, established in 1948 at the instigation of the Borough Council,has the support and co-operation" of the London County Council, Hospitals, National Assistance Board, Citizens' advice Bureau, Women's Voluntary Services, Social Settlements, British Red Cross Society, Nursing Societies, Churches of all denominations, and other agencies, whose facilities for help, advice and assistance can thus be made known and given to old people in need. These bodies are represented on the Committee. Meals Service. By financial grants made by the Borough Council and the London County Council, the Women's Voluntary Services are enabled to provide and maintain a mobile meals service to the homes of old people,, In addition, an average of 35 meals daily are supplied to the old people's club at Bromley Public Hallo During the past year, approximately 17,600 meals have been provided by the service. The London County Council contribute 8d. per meal out of a total of l/6d. Chiropody Service. Treatment is at present provided by the old people's welfare committee on one day weekly, the number of patients attending the clinic being 120, each paying l/6d per attendance. Maintenance of the service is made possible mainly through the co-operation of the Women's Voluntary Services, who provide the accommodation and incidental services for running the clinic, by amenities for social service furnished by the Borough Council and by financial aid hitherto given by the County Council from contributions received from Sunday cinematograph entertainments. A chiropody service is also provided to persons associated with a local church, but this service is not restricted to old people. Home Help Service. This is a service of the London County Council, operated under the supervision of the Divisional Medical Officer by an organiser who has a staff of one full-time and 90 part-time home helps. Up to the end of 1952 579 old people benefited,those on National Assistance 29. ing the service free of cost. In the great majority of other cases the service was provided also without charge. The Old People's Welfare Committee enjoys the close co-operation of the officers of this service. Residential Home for Old People. Lansbury Lodge, 1, Grundy Street, Poplar, E.14., was opened by the London County Council in December 1951, as a home for old people who can no longer manage to live an independent life but need care and attention not otherwise available to them. Home Nursing Societies. The local organisations are the East London Nursing Society, 7, Stainsby Road, E.14, and St. John's Nursing Society, The Mission House, Lodore Street, E.14. Clubs for old people. The provision of clubs for old people is one of the best ways of giving advice and ready help in a manner most acceptable to old folk. Regular attendance at the clubs shows that a need is being fulfilled,, Friendships made between the members bring fresh interest into the lives of those living alone and helps to cure boredom and loneliness, those twin evils of the aged. It is one of the aims of the old people's welfare committee to secure the provision of more clubs insofar as is practicable with statutory and voluntary help, There are about 25 voluntary organisations in Poplar Borough which provide recreational facilities for old people, of which the following are prominent:- Women's Voluntary Services Darby and Joan Club, Bromley Public Hall, Bow Road, E.3. Darby and Joan Club, Unity Hall, 56a East India Dock Road. All Saint3 Old People's Club, 212 Poplar High Street. Trinity Grandfathers' Club, Trinity Church, East India Dock Bow and Poplar Methodist Missions, (Road. Pilgrim House, 1 Dace Road, Old Ford, E.9, Kingsley Hall, Powis Road, Bow. E.3. Old Age Pensioners Associations. Useful contacts beneficial to old people are maintained through the old age pensioners associations in the Borough, viz:- 30. National Federation of Old Age Pensioners' Associations, (Bow Branch, Secretary - Mr. J. Sealey, 15 Edgar Road, Bow, E.3) Alpha Old age Pensioners Society, (Secretary-Mr.J.B.Welby, 18 Dunbar House, Glengall Grove, Millwall, E.14). Cubitt Town Old Age Pensioners Society, (Secretary-Councillor E.H.Davison, 23 East Ferry Road, E.14) General. In addition to the services already mentioned there are many occasions when the needs of individual old people have been met through the help given by voluntary bodies associated with the Old People's Velfare Committee. By their contribution in service for old people the voluntary organisations and their workers have brought material help, cheerfulness and the warmth of human friendliness into the lives of many old persons. Much still remains to be done, but it can be claimed that despite a period of financial stringency much service has been given to old people in need of help, advice and assistance through the statutory authorities and voluntary organisations associated in welfare work. National Assistance Act, 1948, Section 50. Burials carried out under the provisions of this Act totalled 13 (11 adults and 2 children). The total cost was £129. 9s, 6d., and the amount recovered was £63. 3s. 3d. Mortuary and Coroner's Court. The Poplar Mortuary is situated in Poplar High Street, adjoining the Coroner's Court, It has a modern refrigerating plant which will accommodate fifteen bodies and a further fifteen bodies can be accommodated elsewhere. The post mortem room is well equipped and in addition there is a viewing room, waiting room and the necessary rooms for the use of the pathologists and clerks. 31. The mortuary as a whole is probably the best one in North-East London, The total number of bodies received during the year was 711 (residents 286; non-residents 425). All except one were for post-mortem examination, and inquests were held on 168. Rag Flock &, other Filling Materials Act, 1951. This Act requires the registration of premises upon which a business is carried on involving the use of filling materials. The number of premises registered is 9. The Act also requires the licensing of premises for the storage of rag flock, and 3 licences have been issued. Pet Animals Act, 1951. This Act to regulate the sale of pet animals came into force on the 1st April, 1952. Licences have been issued in respect of seven premises within the Borough. Electrolytic Fluid Station. The manufacture of Electrolytic Disinfecting Fluid was started by the Borough Council in 1906. The installation of the apparatus was largely due to the enthusiasm of the then Medical Officer of Health, Dr. F. W. Alexander, The purpose at that time was to produce a safe and reliable disinfectant in order to save the high cost of the carbolic disinfectants which were issued free to the public but at a cost to the Council of £460 during 1905, The fluid was essentially a hypochlorite made by electrolysis of brine and a good deal of difficulty was experienced in obtaining a stable preparation which would retain its disinfectant properties for a reasonable period. In 1908 the electrolytic fluid was used in the Council's 32. swimming bath for the purification of the water. At that time the usual method of maintaining clean water was merely to overflow the bath so as to remove dirt or foreign matter which floated and to empty the bath twice a week and re-fill with clean water. The use of the electrolytic fluid was a very advanced idea and was the forerunner of the type of chlorination which is the regular practice in all modern swimming baths. The fluid was distributed on a large scale and in 1924 was at the rate of 140,000 gallons per year. This rate remained fairly constant during the next 25 years. Hypochlorite solution is an excellent deodoriser and it is possible that this virtue tended to encourage the belief that its disinfectant properties are greater than is in fact the case. During 1952 the Council considered very carefully all the aspects of the production and distribution of electrolytic fluid. Whereas in 1906 a plentiful and safe disinfectant was of great importance in the preservation of the public health the improvements in sanitation and hygiene now demand different techniques and materials, Modern disinfectants are far more efficient and a great deal safer than the disinfectants v/hich were available at the beginning of the century. Because of the increase in wages and prices of materials, the cost of producing the electrolytic fluid had increased enormously since the war; free distribution had led to some abuses; the fluid, so far as could be ascertained, was being used far more on account of its value as a bleach for laundry than as a disinfectant and since the National Health Service Act, 1946, came into force disinfectants for medical purposes have been freely available when required. The manufacture of electrolytic fluid was discontinued on 31st December, 1952. Swimming. Baths and Wash-houses. The following bathing establishments are maintained by the Council under the supervision of the Chief Baths Superintendent:- 33. Poplar Baths - Vapour, Slipper Baths, Swimming Pools. Bow Baths - Slipper Baths and Laundry. Island Baths - Slipper Baths and Laundry. Wick Lane Baths - Slipper Baths and Laundry. Watts Grove Baths - Slipper Baths and Laundry. Sophia Street Baths - Laundry only. Public Cleansing. The arrangements for collection, removal and disposal of refuse are under the control of the Borough Engineer and Surveyor, who has supplied the following information: Refuse-During the year 23,963 tons of house, trade, street, gully, market and kitchen refuse were collected and disposed of at the controlled tip. In addition 17,325 tons of refuse from a neighbouring borough were also dealt with at the Council's Refuse Disposal Depot. Street Cleansing-Two mechanical sweeper-collector machines supplement the work of manual sweepers in the daily cleansing of the streets in the Borough, and when necessary three machines are employed for the purpose of washing and watering the main thoroughfares. Gully cleansing-Four gully emptying machines have carried out 11,888 cleansings of the gullies during the year, 34. SECTION C. HOUSING. General The aims of the housing authorities are to secure for everyone decent housing conditions, within reasonable reach of the place of employment and at a rent which the family can affordo These aims are to some extent contradictory. Apart from basic essentials some amenities should be provided so that every family irrespective of size or financial position should be able to develop and live a full and healthy life. The provision of these amenities is expensire and an economic rent might well be beyond the means of the ordinary working family, so that it is necessary for the rent to be subsidised both from central and local sources, As a result persons living in the older properties with a minimun. of amenity do in fact contribute largely to the rent of those who are fortunate enough to obtain the tenancy of a Council house or flat. In order to keep people reasonably close to their places of work in places where land available for building is scarce, it is necessary to build flats, which people generally do not want, rather than houses which they do want. In Poplar it has fortunately been possible to build some houses although the majority of post war housing has been provided as flats. All housing authorities endeavour to make the best use of accommodation available putting a large family into a large house or flat and a small family into a small one, and on that basis there is some justification for the idea that the rent should not depend on the number of rooms, or, indeed that the larger accommodation should be at a lower rent. It is admitted that family allowances do not adequately provide even for food and clothing for the children in respect of whom the allowance is payable and apart from the armed services a man's rate of pay does not vary according to the 35 size of his family. It would therefore not seem unreasonable that if a housing subsidy is to be paid it should be used to relieve the rent of those most in need, that is, the large family of small children. It has been suggested that the housing shortage is mainly due to the fact that accommodation is not used to the best advantage, that too many three or four bedroomed houses are tenanted by couples without children and that if only houses and families could be redistributed according to need, the shortage would disappear. Such a redistribution is impracticable but the present demand for small accommodation is not necessarily a true indication of the need. Since the war, housing priority has been given, very properly, to the families with most children and the small families now form the majority of the applicants. There is a tendency in planning housing programmes to increase the number of the smaller houses and flats and it could well be that in a few years time the lack of larger houses and flats would cause a good deal of difficulty by reason of overcrowding. The Council is not only concerned with the provision of new houses and flats but with the maintenance of existing houses. Nearly all the older dwelling houses in the Borough of Poplar are privately owned and in practically all cases the rents are controlled. Almost all the older houses in Poplar are built in terraces, most of them opening direct on to the footway, A fair proportion of the houses are substantially built and must have provided quite good accommodation according to the standards of the 19th century, but few of them have baths or an adequate hot water supply and many of them have no rear access so that the dustbin must be brought through the house in order to be emptied. In general the houses are badly arranged and the only practicable method of improvement is by demolition and redevelopment. This is necessarily a slow process and in the meantime the aim is to ensure that the dwellings are maintained up to a reasonable standard. In a number of cases the owners of the property finding that the cost of repairs is high in proportion to the value of the house, have applied 36. for and obtained Magistrate's Closing Orders on the grounds that the cost of repair would be unreasonable. In other cases the properties have been abandoned. So far as is practicable, where property is proposed to be included in a clearance area, the repairs are kept to a minimum,, Where the area is one to be developed by the London County Council and major works are required to maintain a reasonable standard,, the County Council has, in some instances been very helpful by acquiring the property in advance of requirements and rehousing the occupants In spite of the high cost of repairs and other difficulties, a considerable amount of maintenance has been done by private owners. The number of families living in property owned or managed by the Borough Council at 28th June, 1952, was as follows: Type of dwelling. No, of lettings. Pre-War Council Houses and Flats. 1,074 Post-War Council Houses and flats. 394 Temporary Bungalows , 541 Old Properties in Compulsory Purchase Areas, 181 Requisitioned Properties 1,364 Temporary Hutments 185 Total Properties 3,739 Closing Orders, During the year legal proceedings instituted by the Department to secure the abatement of nuisances resulted in Closing Orders being made by the Magistrate on 12 premises in the Borough, Closing Orders in respect of two premises in the Borough were revoked by the Magistrate, on the application of the owners, on the grounds that the necessary works had been carried out. Underground Rooms, There are many rooms throughout the Borough which come 37. within the category of underground rooms and which are not in all respects fit for habitation. It is not practicable at the present time to make house to house inspections and close all those rooms which do not comply with the required standards because alternative accommodation is not available,, Action is therefore confined to those rooms which on inspection following complaint are found to be seriously below the necessary standards, and to those which are vacated, in which cases closing orders are made by the Councilo During the year only 13 Closing Orders were made by the Council in respect of underground rooms. Overcrowding. (Housing Act,1936) Particulars of overcrowding and abatement of cases of overcrowding in the Borough during the year are as follows Number of cases reported during the year 88 Number of cases of overcrowding relieved during the year (Rehoused: by L.C.C. 46) (Rehoused: by P.B.C. 4) 50 Number of persons concerned in such cases 206 Slum Clearance. Immediately after the war it was not possible to carry out any slum clearance owing to the acute housing shortage but by 1949 it was possible to envisage a limited scheme for London as a whole. A slum clearance programme was prepared and agreement was reached with the London County Council as to which areas should be dealt with during a five year period and which of these areas should be dealt with by the Borough Council or by the County Council. 38. In general the larger areas are to be cleared and redeveloped by the County Council whilst the smaller areas are the responsibility of the Borough Councilo During 1952 the Borough Council dealt with the Chipka Street area involving 11 houses. In two areas, namely Arrow Road-Devons Road, and Beachy Road, which were scheduled to be dealt with during 1952, the houses had been so improved by the carrying out of War Damage repairs that their condition no longer warranted the priority which they had been given when the programme was preparedo In the Mackrow Street-Woolmore Street area involving 43 houses the survey was carried out and representation made to the Borough Council in 1952, but the Order was not confirmed until 1953. Demolition Orders were also made or undertakings not to use for human habitation were accepted in respect of four individual unfit houses which could not properly be included in the clearance areas, or which on account of their unfit condition had to be dealt with in advance of the agreed programme 0 New Housinp.o Details of new housing accommodation completed in the Borough during the year are as follows Poplar Borough Council 90 dwellings London County Council: Coventry Cross Estater 104 dwellings Lansbury Estate 193 dwellings 39. Housing Statistics. 1. Inspection of dwelling houses during the year:- (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 3, 107 (b) Number of inspections made for the purpose. 15,143 (2) (a) Number of dwelling houses (included under subhead(l) above) which were inspected and recorded under the Housing Consolidated Regulations,1925. 183 (b) Number of inspections made for the purpose. 183 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation. 5 (4) Number of dwelling houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 2,471 2. Remedy of defects during the year without service of formal notice Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 1,425 40, 3. Action under Statutory Powers during the year:- (a) Proceedings under Public Health Acts : (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 1,046 (2) Number of dwelling houses in which defects were remedied after service of formal notice:- (a) By owners 874 (b) By Local Authority in default of owners - (b) Proceedings under Sections 9,10 and 16 of the Housing Act 1936:- (1) Number of dwelling houses in respect of which notices were served requiring repairso (2) Number of dwelling houses which were rendered fit after service of formal notices;- (a) By owners (b) By Local Authority in default of owners — (c) Proceedings under Sections 11 and 13 of the Housing Act 1936:- (1) Number of dwelling houses in respect of which Demolition Orders were made0 . o 1 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 6 (d) Proceedings under Section 12 of the Housing Act 1936 (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 13 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit. - 41. (e) Proceedings under Section 25 of the Housing Act 1936:- (1) Number of dwelling houses included in Clearance Areas 29 (2) Number of dwelling houses demolished as a result of Clearance Area procedure - 4. Miscellaneous visits and inspections (not included above) made by the Housing Inspector during the year 694 SECTION D INSPECTION AND SUPERVISION OF FOOD The inspection and supervision of food plays a conspicuous part in the activities of the Public Health Department. During the year 2,097 visits were made to food premises in connection with taking samples, the examination of food,and the inspection of premises in which it is manufactured, stored and sold. An important part is played by the food trade in the industry of the Borough; factories, wholesale premises, warehouses and cold stores are distributed throughout the districto Many such premises are under the proprietorship of well-known firms, some producing commodities which have long since become household words. Surrounding the East India, West India, and Millwall Docks a four and a half mile water front provides an almost unbroken chain of wharves, many of which provide storage accommodation for food0 It is estimated that food stored at these wharves exceeds 125,000 tons0 This is a considerable quantity having regard to the fact that the figure does not take into account the enormous quantities of imported food landed inside the area of the Port of London Authority. In addition to a large number of retail shops situated throughout the Borough, the public is served by 3 markets with 116 foodshops and over 130 food stalls, all well stocked with foodstuffs appealing to a variety of tastes. The new Lansbury Market Square, constructed by the London County Council and completed in 1951, is a praiseworthy adventure in Local Government planning. The market consists of 37 shops with flats above them, two public houses with restaurants, and a covered market containing 47 lock-up shops„ The buildings surround an open space with 136 pitches for traders to place their barrows. 43. Food Premises. The number of food premises in the area by type of business is as follows: Manufacturing premises 37. (Confectionery 5; Bakers confectionery 1; Flour millers 3; Edible oils 2; Ice cream 2; Wine blenders 2; Nut roasters 2; Grocery 3; Pickles 2; Spice grinders 1; Milk pasteurising 2; Food dehydration 2; Meat products 7; Mineral waters 1; Ice lollies 1; Bakers 1.) This list does not include places where food is manufactured principally for retail sale on the premises,, Wharves 22. Cold stores 2. Wholesale premises 21. (Grocers 12; Greengrocers 3; Confectioners 5; Biscuits 1.) Retail premises 1,004 (Grocers 195; Confectioners 106; Restaurants 129; Industrial canteens 98; Non-industrial canteens 33; School meals centres 23; Public houses 179; Off Licences 25; Continental butchers 1; Bakers 38; Fishmongers 43; Herbalists 1; Greengrocers 61; Butchers 58; Chemists 14.) Street Market Stalls 130. Coffee Stalls. 10 Slaughterhouses 3 (Note-none of these were used during the year) Registered premises. Food & Drugs Act 1938, Section 14. (a) Ice Cream. Manufacture and sale 31. Sale and storage 143. (Note - in addition to the premises referred to above ice cream is also sold from 37 premises exempt from registration, i.e., Restaurants,Cinemas, etc.) (b) Sausages & preserved, etc.,foods. 48. 44. Food & Drugs Act 1938. Section 34: Wholesale Dealers in Margarine 7 Butter factories 2 (Note- no butter blending took place at either of these premises during the year). Milk & Dairies Regulations 1949. Dairies 11 Milk Distributors: Inside the Borough 136 Outside the Borough 25 Inspection of Food Premises. The following is a detailed summary showing the types of premises inspected during the year : Number of inspections. Bakers 65 Dairies 133 Milk Distributors 112 Restaurants 207 Industrial catering establishments 27 Other catering establishments 24 Fish shops, fryers and curers 51 Stalls and itinerant vendors 43 Market inspections 95 Ice cream premises 156 Wharves 75 Butchers 243 Registered food manufacturers 66 Other food premises 800 Total inspections - 2,097 Unsatisfactory conditions,warranting formal action,were found at 34 premises. 45. Food Hygiene. Cleanliness in the handling, storage and distribution of food has once again received the constant attention of the Department. Water supply, washing facilities, light, ventilation and the cleanliness and sterilisation of plant and utensils are matters upon which the inspectors concentrate. There can be no doubt that education of the food handlæ plays a paramount part in securing improvements to existing standards. When visiting food premises the Council^ officers have given advice and encouragement to both management and staffo In general, suggestions are received with understanding and enthusiasm. Byelaws for the protection of food have now been made by the London County Council and came into force on the 3rd November, 1952. A letter containing a summary of the provisions of the byelaws, together with an offer of advice and a request for co-operation, was sent to every food trader in the Borough. In the interests of hygiene notices have been printed suitable for display in retail premises, requesting shoppers not to bring dogs into places where food is stored. The notice, offered to every shop keeper in the district, was welcomed and displayed by a number of traders. It is to be regretted, however, that many complained that by far the greater nuisance arose from dogs which are allowed to roam the streets free from the attentions of their owners. Food sampling. A total of 726 samples of food were procured during the year by the Council's Food Inspector. Of these, 549 were submitted to the Public Analyst for chemical examination,the remaining 177 being sent to the Public Health Laboratory Service at Camberwell for biochemical or bacteriological report. Samples examined by the Public Analyst included 174 46. different varieties of food. Of these,130 samples were acquired formally and 419 informally. A total of 20 samples (3.6 per cent) were found to be adulterated. Details of the unsatisfactory samples and the action taken are shown in Table VI. The greatest care is given to the selection and analyses of food samples, each being selected with a definite examination objective in mind. Whenever possible,generally depending upon the suitability of an individual sample, a check is made upon a variety of matters. Particular attention has been paid to those foods for which legal standards are fixed; foods containing fats and oils were examined for the presence of mineral oil, and in canned food,particularly old stock,calculations were made of metallic absorbtion; special observations were kept for foreign matter and insect infestation; prepacked foods were checked against the statements of ingredients printed on the labels; preservatives and colourings were also checked. Constant vigilance has had the effect of reducing deliberate adulteration, so common in the past, to a rare occurrence. Nevertheless, the possibility of the addition of foreign matter is not overlooked, and every effort is made to ensure that food is of the nature,substance and quality expected. Among the samples submitted to the Public Analyst were 38 drugs, mainly proprietary articles used for medicinal purposes; these were checked against the statements of ingredients printed on the labels and the purity standards set out in the British Pharmacopoeia. Included in the specimens sent to the Public Health Laboratory were 14 samples,consisting of 9 varieties of food, specially examined in connection with complaints of illness0 In no cases were pathogenic organisms found. 47. 48. TABLE VI Saasple No. Article Result of Analysis Action 49 x Baking powder 25% deficient in available carbon dioxide. , Formal sample taken(No.65) 65 Bating powder 6% deficient in available carbon dioxide. latter to manufacturer. 137 Pork sausages 8.4% deficient in meat. Letter to Manufacturer. 157 x Chelsea Bum? Contained 0.8% mineral oil. Formal sample taken (No.210) 156 x Doughnuts Contained 0.4% mineral oil. Formal sample taken (genuine) 179 x toe Cream 14% deficient in fat. Formal sample taken (genuine) 209 x Ice Cream 40% deficient in fatt. Formal sample taken (No.275) 210 Chelsea Buns Contained 0.7% mineral oil. Letter to Manufacturer. 288 x Dripping Contained 9% water, 2% non-fatty matter, 3.4% free fatty acids. Producer discontinued manufacture of dripping. 252 x Butter Contained 16.2% waterc Formal sample taken (No.265) 261 x Pork Sausagaa 17% deficient in meat. Formal sample taken (No.273) 265 Butter Contained 16.2$ water. Letter to wholesaler. 273 Pork Sausages 18% deficient in meat. Letter to Manufacturer. 2^5 Ice Cream 30% deficient in fat. Letter to Manufacturer. Further formal sample taken. (genuine) 429 X Margarine Contained 16.2% water. 2 formal samples taken. (genuine) 483 X French processed peas (vanned) Contained tin 0.4 grains per pound iron 0.9 grains per pound Remainder of stock destroyed. 488 X Shredded beef suet 2.3% deficient in fat. Formal sample taken (geiuine) 497 Butter Contained 16.2% water. Letter to blender. 515 X Butter mint ova is Contained no butter fat. Referred to Battersea Borough Council. 525 X Embxolyn White Oils Deficient in acetic acid. (x — informal sample) Letter to Manufacturer. Unsound Food. The Council's Food Inspector is called upon to pass judgment of fitness on great quantities of food0 FrequentlyLarge and valuable stocks are involved. During the year examinations of special lots included: Ham 650 tins (4,550 lb) (1,218 lb.condemned) Mutton 51 carcasses (2,295 lb) (1,149 lbcmeat condemned) Mutton 34 carcasses (1,530 lb) ( 523 lb.meat condemned) The whole of each of the following special lots was condemned: Jellied Pork 465 tins ( 1,724 lb) Onions 1,288 lb. Ha res 35 bags ( 3,360 lb) Sweetened cake mixture 298 bags (16,688 lb) Dried peaches 8 cases ( 400 lb) Prunes 31 boxes ( 517 lb) Boned rabbits 185 cases (11,100 lb) Canned plums 35 cartons ( 1,050 lb) Canned peas 61 cartons ( 2,562 lb) Smoked bacon 303 lb. Ox heads 271 lb. Sheep's heads 244 lb. The following is a summary of foods condemned as being unfit for human consumption: Fresh foods. Canned foods. Meat 3,601 lb. 2,414 lb. Meat products 244 lb. 1,943 lb. Ham — 4,599 lb. Bacon 352 lb. — Poultry 546 lb. — Rabbits and Hares 14,460 lb. — Fish 237 lb. 46 lb. Milk — 1,099 lb. Cereals 16,843 lb. — Bread and cakes 192 lb. — Vegetables 1,308 lb. 3,329 lb. 49. (Foods condemned - continued) Fresh foods. Canned foods. Fruit 984 lb. 7,605 lb. £3weet fat 168 lb. - Other foods 133 lb. 87 lb. This table differentiates only between canned food and others; foods preserved by salt, sugar, dehydration, etc., being included under the heading "fresh foods". Disposal of Unsound Food. The bulk of the food condemned as being unfit for human consumption is removed from the premises concerned by the Borough Engineer's refuse disposal service. When suitable for animal feeding the food is collected and included with kitchen waste. Unsuitably packed and totally unfit foods are removed as trade refuse and the cost of removal is charged to the owners in accordance with the Council's fixed scale of charges. In special cases, where large quantities of food are condemned, arrangements are made, under suitable guarantees from the owners,for the foods to be utilised for animal feeding or non-edible industrial purposes such as 3oap, starch, or manure making. Milk Supply. All domestic supplies of milk are now sold in sealed bottles bearing a designation. Except for very small quantities of raw Tuberculin Tested milk from Attested Herds, all milk is heat treated. Although a large number of shop keepers are registered to sell milk, the greater proportion of milk supplied to domestic consumers is delivered to the door through eighteen of the registered distributors. Two dairies in the Borough pasteurise ovor 189,000 gallons of milk per week; in the same period over three-quarters of a million bottles are filled. Milk produced from these 50. dairies is distributed over some thirty to forty districts in the Greater London Area. The Council is responsible for licensing and supervising the pasteurising process, and it 3s pleasing to be able to say that its officers have received the greatest degree of co-operation from the managements concerned. Samples of milk have been taken from dairies, shops and deliverymen for the purpose of checking quality, purity and bacteriological cleanliness. Samples were also taken on delivery from supplies to schools. During the year 245 inspections were made of dairies and other premises from which milk is distributed. Conditions on the whole were found to be satisfactory. Registration and Licensing. For details of registration of dairies and distributors see page 45. Licences issued under the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, and Milk (Special Designation)(Raw Milk) Regulations, 1949 :- Sterilised. Pasteurised. Tuberculin tested. Dealers 126 61 19 Supplementary 25 21 19 Pasteurisers — 2 - Milk sampling. A total of 113 samples of milk ( 107 formal, 6 informal) were submitted to the Public Analyst for chemical examination. All were satisfactory. Satisfactory reports were received on 125 samples of designated milk (103 Pasteurised; 10 Tuberculin Tested Pasteurised; 2 Tuberculin Tested, and 10 Sterilised) submitted to the Phosphatase, Methylene Blue and Turbidity Tests as appropriate. Milk delivered to Schools. Of the 102 samples of milk 51. taken on delivery at London County Council Schools,half were submitted for chemical and half for bacteriological examination. All samples were reported to be satisfactory. Oxidising Agents. The Milk & Dairies Regulations, 1949, provide for the use of certain cleansing agents for milk containers and plant. All these products are required to contain a small percentage of sodium chlorate to act as a detector of the efficiency of subsequent rinsing. Four samples of milk were specially tested for the presence of chlorates and all were found to be free. Ice Cream. Close supervision is exercised in connection with the manufacture, sale and storage of ice cream. Premises, plant and refrigerators were kept under constant observation. Full and free consultation has taken place between manufacturers and the Council's Food Inspector on problems of production Itinerant vendors have not escaped attention; vehicles have been stopped, stocks inspected, temperature of containers checked and samples taken. A total of 79 samples were taken during the year„ Of these 37 were submitted to the Public Health Laboratory for examination by the Methylene Blue Test. The samples were graded as follows: Grade 1. Grade 2. Grade 3. Grade 4. 29 5 1 2 Samples falling into the lower grades were in each case isolated. The remaining 42 samples were examined by the Public Analyst under the Food Standards(Ice Cream)Order,1951. Three samples all made by manufacturers in the Borough were found to be deficient in fat. In each case the advice of the Council's Food Inspector was sought and investigation revealed 52. faults in processing. The manufacturers followed the advice of the Inspector and subsequent samples were found to be satisfactory. Imported Food. The Council is a specially appointed Authority under the Public Health(Imported Food}Regulations,1937. Inspections are made of direct landings of imported foodstuffs at the Sufferance Wharves in the Borougho No prohibited meat shall be imported into the country for sale for human consumption and no meat or meat products shall be imported without an official certificate of inspection issued by the Country of Origin, and approved by the British Government. Except for 11 cwt of Onions damaged aboard ship all foods imported were found to be satisfactory„ Meat and meat products were all accompanied by satisfactory official certificates. Foods for Export. In order to satisfy the Authorities of importing countries overseas it is necessary for the exporter to obtain a certificate of purity signed by the Medical Officer of Health for the district from which the food is shippedo During the period covered by this report 47 inspections were made of foods exported from the district; 110 certificates of purity were issued. Food Poisoning. Thirteen cases of food poisoning were notified during the yearD Investigations failed to establish a specific cause in any of these cases. 53. SECTION E. PREVALENCE OF, AND CONTRGL OVER, INFECTIOUS DISEASES. The total number of corrected notifications of infectious disease during 1952 was 1,551 as compared with 2,523 during the previous year. This reduction was almost entirely due to the decrease in the number of cases of measles and whooping cough which occurred only about half as frequently as in 1951„ Diphtheria. No cases of Diphtheria were confirmed during the year. This very satisfactory position is due to the immunisation campaign which has proved so successful throughout the whole country during the past 10 years. Immunisation in London is mainly carried out by officers of the London County Council. although a number of cases have been immunised by general medical practitioners. The total number of children immunised for the first time, together with those given reinforcing doses was about 20% greater than in the previous year. Smallpox. No cases of Smallpox occurred in the Borough during 19520 Less than one-third of the children born during the year were vaccinated against smallpox. As vaccination is necessary for persons travelling in many parts of the world and for persons joining the armed forces, and as complications following vaccination are much more frequent in persons who are vaccinated for the first time in adult life, the present position is far from satisfactory quite apart from the added danger within the Borough should a case of Smallpox occur. 54. Poliomyelitis. Only two confirmed cases of poliomyelitis occurred during 1952 and in both cases the patient recovered. Measles. The number of cases of measles notified was 808 as compared with 1,761 during the previous year. There were no deaths from this disease. Whooping Cough. Of the 181 cases of whooping cough 18 occurred in children under the age of one year and more than one-third of the total cases were in children below the age of three years. Whooping cough is most fatal in the very young, but fortunately none of the patients died from the disease. Scarlet Fever. The number of cases notified was 208 as compared with 130 during 1951. The disease is now of a much less serious nature than was the case at the beginning of the century and treatment is much more effective„ There were no deaths from scarlet fever and no indication that any of the cases were of a serious nature. Dysentery. During the year 56 cases of dysentery were notified and it was necessary to remove the patient to hospital in 16 cases. There were no deaths from this disease. Tuberculosis. The following table shows age and sex incidence of the cases notified. 55. TABLE 711 TUBERCULOSIS - PRIMARY NOTIFICATIONS 0- yrs 1yrs 2yrs 5yrs 10yrs 15yrs 20- yrs 25- yrs 35yrs 45yrs 55— yrs 65yrs 75yrs  Respiratory males. — — 1 8 — 7 5 7 8 9 7 6 1 53 Respiratory females 1 — 1 2 2 5 10 11 4 1 1 — — 38 Non-respiratory males — — — 1 — 1 1 1 — — — — — 4 Non-re 3pi rato ry females — — — 1 — — — 2 — - — — — 3 In addition to the above 52 other cases were added to the register as a result of information received from the following sources Registrar-General's Death Returns (transferable deaths) Local Death Returns 4 Transfers from other areas 46 Other sources 2 During the year 20 deaths were certified as being due to Tuberculosis. The number of cases remaining on the Register at 31st December,1952, after adjustment in respect of deaths and transfers, was as follows:- Pulmonary. Non-pulmonary. Total. Males 373 65 438 Females 252 46 298 Total 625 111 736 56. 57. TABLE VIII. INFECTIOUS DISEASE. Disease Corrected Noti fi cat ions, Total Removed to Hospital 0- yrs 1yrs 3yrs 5- yrs 15- yrs 25yrs 45yrs 65yrs Diphtheria - - - - - - - - - - Dysentery 4 17 5 12 6 2 4 6 56 16 Erysipelas - - - - - 2 3 1 6 3 Measles 39 188 246 333 1 1 - - 808 20 Meningococcal Infection 1 - - - 1 - - - 2 2 Ophthalmia Neonatorum 4 - - - - - - - 4 4 Paratyphoid Fever - - - - - - 1 - 1 1 Pneumonia 6 5 6 11 - 18 22 17 85 - Poliomyelitis (paralytic) - - - - - 1 - - 1 1 Poliomyelitis (non-paralytic) - - - - - 1 - - 1 1 Puerperal Pyrexia. - - - - 18 21 - - 39 36 Scabies — 2 - 3 2 5 - - 12 - Scarlet Fever 1 13 48 145 1 - - - 208 13 Whooping Cough 18 45 50 65 - 2 1 - 181 12 Zymotic Enteritis 18 21 10 - - - - - 49 14 Tuberculosis, pulmonary 1 1 1 6 27 30 18 7 91 - Tuberculosis, other forms - - - 2 2 3 - - 7 - Totals 92 292 366 577 58 86 49 31 1,551 123 SECTION Fo GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA Laboratory Facilities. During the year all bacteriological examinations for the Public Health Department were again undertaken, a a part of the National Schemes by the Public Health Laboratory Service (directed by the Medical Research Council for the Ministry of Health) at the Laboratories, 134 Denmark Hill, SoEo5, Ambulance Facilities. The provision of ambulance transport within the administrative County of London is the responsibility of the London County Council. Hospitals. There are three Hospitals in the Borough - St. Andrew' St. Clement's, and Poplar., These Hospitals, together with the Poplar Chest Clinic, Wellington Way, E.3., which continued to operate during the year, are under the control of the North East Metropolitan Regional Hospital Board. Personal Health Services. The following information and statistics relating to the operation of the Personal Health Services in this Borough during the year have been kindly furnished by the Divisional Medical Officer (Dr.G. O. Mitchell), Division 5, London County Council, 273, Bancroft Road, E.l. 58. Treatment Centres and Clinics. Ruston Street, Eo3o Wellington Way, Bow, E.3. 154, Poplar High Street, Eol4. 54, West Ferry Road, Eol4. 69, East India Dock Road, E.14. All Hallows Hall, Devons Road, E.3. St0 Michael's Hall9 Ullin Street, E.14. Statistics. Infant Welfare Centres. Total No. of children who first attended during the year and who on the date of their first attendance were Under 1 year of age 1,122 1-5 years of age 419 Total No. of children who attended and who at the end of the year were Under 1 year of age 940 1-5 years of age 2,536 Total attendances by children Under 1 year of age 16,334 1-5 years of age 10,682 Ante-natal and Post-natal Clinics. Ante-natal consultations:- No.of women who attended for the first time 322 No. of women who attended 483 Total attendances 2,815 Post-natal consultations No. of women who attended 160 59. Health Visitors. NOo of infants under one year of age visited for first time 1 ,220 Total visits to infants under 1 year of age 10,371 Total visits to children 1 to 5 years of age 20,426 NOo of expectant mothers visited 715 Total visits to expectant mothers 1,362 Infant Life Protection. No. on Register, 1st January, 1952:- Foster mothers 15 Foster children 11 No0 on Register, 31st December, 1952:- Foster mothers 16 Foster children 10 Child Minders (Daily Guardians). NOo of Daily Guardians Statutory - Voluntary 57 « No0 of Children minded:- - Statutory - Voluntary 44 Care of Premature Infants. No. of premature births during the year 79 NO. of deaths under one month 9 60. Diphtheria Immunisation. NOo of children who completed a full course of primary immunisation:- Under 5 years of age 972 5-14 years of age 275 NOo of children who were given a secondary or re-inforcing injection 1,164 Vaccination. NOo of children successfully vaccinated 357 Domestic Help Service. No, of cases in which help was provided Maternity (including expectant mothers) 39 Tuberculosis 26 Other 714 61.