A C 4368 Pop63 Metropolitan Borough of Poplar ANNUAL REPORT OF The Medical Officer of Health FOR THE YEAR 1957 Metropolitan Borough of Poplar ANNUAL REPORT OF The Medical Officer of Health FOR THE YEAR 1957 INDEX Page Public Health Committee 4 Staff Statistics 5 Causes of Death 12 Sanitary Circumstances of the Area 14 Housing 31 Inspection and Supervision of Food 36 Infectious Diseases 48 General Provision of Health Services for the Area 55 3 4 METROPOLITAN BOROUGH OF POPLAR PUBLIC HEALTH BATHS COMMITTEE, 1957 - 1958 Councillor Mrs. M. M. Saunders, J. P. Mayor (ex-officio) CHAIRMAN: Councillor Mrs. M. Goodway VICE-CHAIRMAN: Councillor P.C. Philp Alderman Mrs. L.M. Sadler Councillor E.T. Block " A. Cummins " J.J. Docker " Miss M.C.R. Micklewright " C.J. Pidwell " M. Pollins " P. Sparks " J. T. Tucker W. T. Tuson " J.W. Vicat " H.A. Wilkins " Mrs. H. Wood Council's representatives on the London County Council (Division 5) Health Committee: Councillor Mrs. N.F. Cressall " Mrs. P. Sims STAFF OF THE PUBLIC HEALTH DEPARTMENT MEDICAL OFFICER OF HEALTH: W. C. TURNER, M.D., B.S., D.P.H., D.I.H. SENIOR P.H. INSPECTOR: C. A. Grabham (a) (d) (To 28.10.57) P.H. INSPECTORS: G. L. Belshaw (c) (d) (To 30.4.57) F. S. Jolliffe (c) (d) N. L. Brown (c) (d) H. W. Luke (c) (d) G. W. East (c) (d) J. E. G. Steeden (c) I.M.G. Farries (c) C. S. Westbrook (a) (d) (To 5.4.57) PUBLIC HEALTH INSPECTOR TRAINEES G.M.L. Wimbourne (From 4.11.57) D. C. Young (From 14.10.57) MEAT AND FOOD INSPECTOR'S ASSISTANT A. S. Collyer (To 16.6.57) J. P. Branagan (From 17.6.57) CHIEF CLERK: A. A. Hamilton (c) CLERKS: A. M. Cannon T. E. Oldfield W. J. Crone R. W. Scanes (From 7.10.57) G. R. Williamson DISINFECTION/DISINFESTATION R. Desmond (Chief Disinfector) and 5 Assistants J.W. Crawford (Rodent Officer) and 5 Rodent Operatives MORTUARY KEEPER: E. D. Davies (to 13.12.57) G. W. Hammond (From 13.12.57) PUBLIC ANALYSTS (Part time): Albert E. Parkes, F. I.C., F.C.S. (To 13.5.57). H. A. Parkes, B. Sc. , F.I.C. (a) Cert. S.I.E. Board. (b) Cert. R.S.I. (c) Cert. R.S.I. & S.I.E.J.B. (d) Cert. Meat & Food Inspector. 5 TO THE MAYOR, ALDERMAN AND COUNCILLORS OP 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 during the year 1957. The general standard of health of the inhabitants of the Borough has remained satisfactory but some distress is still being caused by the continuing shortage of satisfactory housing. Most of the worst slum property in the Borough has now been cleared and during the year the London County Council has made a start on site clearance in a number of areas in preparation for a further phase of housing development with the rebuilding scheduled to commence next year The nuisance arising from the uncontrolled trespass by dwellers in tents, vans and sheds on land cleared as a result of war and housing difficulties continues but some improvement in the situation has been effected through action by this department in co-operation with the London County Council, trespassers having been rehoused in some instances or evicted from several sites and the land fenced in, which now leaves the main concentration in one area scheduled to be an open space in the London development plan. Owing to the general shortage of Public Health Inspectors we have been unable to replace losses through retirement of the Senior Public Health Inspector, C.A. Grabham , and Mr, C. S. Westbrook and the resignation of Mr. G, L. Belshaw, this unfortunately has led to a restriction in the activity of the department. This has 6 been felt most in the postponement of new undertakings, particularly the preliminary surveys in connection with the "Smoke Control" areas under the Clean Air Act to which reference is made in the body of the report. Nuisance from the pollution of the river has been investigated during the year and I have formed the very definite opinion that the sulphur containing effluents from Power Stations employing flue gas washing are seriously implicated through slightly raising the temperature of the water and increasing the amount of sulphate to critical levels which favour the growth of a particular group of anaerobic bacteria which utilize the sulphates and reduce them to produce hydrogen sulphide which is the cause of the stinking black condition of the water and of the darkening of light colour paints on craft in the vicinity of the river. No serious outbreaks of food poisoning were reported during the year but there were several minor outbreaks of dysentery due to Shigella sonnei referred to in the body of the report, which were rapidly contained as a result of vigorous action as soon as the cause was apparent. Last year mention was made of the relationship between smoking habits and cancer of the lung. Further research all over the world has confirmed this relationship and also that the giving up of smoking or lessening the amount of tobacco taken, particularly in the form of cigarettes, gives a definite chance of delay in the onset of this condition and even the possibility of its avoidance if given up soon enough. I am happy to say that the deaths from cancer of the lung in the Borough were slightly below that of last year and I can only hope that this is 7 as the result of preventive measures. My thanks are due to the Chairman and Members of the Public Health and Baths Committee for their help and encouragement, to the Chief Officers of the Council and their staffs for their co-operation, finally to Mr.C.A. Grabham, Senior Public Health Inspector and Mr. H.W. Luke who took over his duties on his retirement, and Mr. A.A. Hamilton, Chief Clerk and all the other members of the staff of the Public Health Department for their assistance and loyal support at all times. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, W.C. TURNER. Medical Officer of Health. 8 SECTION A VITAL STATISTICS During the year births registered exceeded deaths registered by 424 but through rehousing and other reasons some 2,000 residents moved from the Borough to other areas and the home population estimated by the Registrar General to number 67,080 at the middle of the year shows a decrease of 1,540 compared with the estimate for the previous year. The birth rate was 16.6 per 1,000 of the population as compared with 17.5 for 1956. To enable a fair comparison to be made with other areas and the country as a whole, area comparability factors which take into consideration the age and sex distribution of the population are provided by the Registrar General. Factors are supplied both for births and deaths. Using the comparability factor the adjusted birth rate would be 15.4 as compared with 16.1 for England and Wales. The death rate in 1957 was 10.3 per 1,000 of the population as compared with 10.7 for 1956. Again using the comparability factor the adjusted death rate would be 11.9 as compared with 11.5 for England and Wales. Comparative rates for the previous year were 12.6 and 11.7 respectively. The infant mortality rate, being the number of deaths of infants under one 9 year of age per 1,000 births, was 21.5 as compared with 24.9 for the previous year. The figures for England and Wales are 24.9 and 29.2 respectively. The causes of death are shown in Table 1 in accordance with the classification used by the Registrar General. Deaths from neoplasms of the lung, which have for the last decade shown a steady but progressive increase, during this year show a slight decrease but from the general trend throughout the country this would appear to be purely a local variation. Deaths from other diseases showed no significant change from the numbers recorded in 1956. STATISTICS OP THE AREA Area (excluding water) 2,136 acres Area (including water) 2,331 acres Population, estimated mid-year 67,080 Number of inhabited houses (according to Rate books) 17,205 Rateable Value £ 990,205 General Rate (1956-1957) 17/4 in £ Sum represented by a penny rate (1956-1957) £ 3,800 10 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Males Females TOTAL Live Births: Legitimate 522 540 1062 Illegitimate 29 23 52 Birth Rate per 1,000 estimated resident population 16.6 Stillbirths: Legitimate 14 12 26 Illegitimate — 1 1 Rate per 1000 total (live and still) births 23.7 Deaths 381 309 690 Death rate per 1000 estimated resident population: 10.3 Deaths of Infants under one year of age: Legitimate 14 10 24 Illegitimate — — — Death rate of Infants under one year of age: All infants per 1,000 live births: 21.5 Legitimate infants per 1,000 22.6 legitimate live births Illegitimate infants per 1.000 0.0 illegitimate live births 11 12 TABLE 1 DEATHS CAUSES OF DEATHS SEX ALL AGES AGE GROUPS 0 - 1 - 5 - 15 - 25 - 45 - 65 - 75 ALL CAUSES M 381 14 4 6 5 17 109 132 94 F 309 10 - - 1 15 66 88 129 1. Tuberculosis, respiratory M 7 - - - - - 5 2 - F 2 - - - - 1 - 1 - 2. Tuberculosis, other M - - - - - - - - - F - - - - - - - - - 3. Syphilitic disease M 3 - - - - - 1 2 - F _ - - - - - - - - 4. Diphtheria M - - - - - - - - - F - - - - - - • _ - 5. Whooping Cough M - - - - - - - - F - - - - - - - - - 6. Meningococcal infection M - - - - - - - - - F 1 1 - 1 - - - - - 7. Acute poliomyelitis M - - - - - - - - - F - - - - - - - - - 8. Measles M - - - - - - - - - F __ _ _ _ _ _ _ _ _ 9. Other infective and parasitic diseases M _ _ _ _ _ _ _ _ _ F 2 - - - - - - 2 - 10. Malignant neoplasm stomach M 13 - - - - 1 5 6 1 F 7 - - - - - 2 2 3 11. Malignant neoplasm, lung, bronchus M 32 - - - - 2 13 15 2 F 7 - - - - 1 2 1 3 12. Malignant neoplasm, breast M - - - - - - - - - F 12 - - - - 1 2 5 4 13. Malignant neoplasm, uterus F 7 - - - - 1 4 1 1 14. Other malignant and lymphatic neoplasms M 34 - 1 1 _ 4 9 13 6 F 37 - - - - 2 14 10 11 15. Leukaemia, Aleukaemia M 1 - - - - - - - 1 F - - - - - - - - - 16. Diabetes M 4 _ _ 1 _ _ 1 2 _ F 1 _ _ _ _ _ _ 1 3 17. Vascular lesions of nervous system M 23 _ _ _ 1 1 4 8 9 F 41 _ _ _ _ __ 7 19 15 18. Coronary disease, angina M 75 - _ _ _ 3 21 26 25 F 34 _ _ _ _ _ 5 8 21 19. Hypertension with heart disease M 4 _ _ _ _ _ 1 1 2 F 9 _ _ _ _ _ _ 3 6 20. Other heart disease M 15 _ _ _ _ _ 3 7 5 F 34 - _ _ __ 3 4 5 22 21. Other circulatory disease M 14 _ _ ____ ___-_______________ 1 2 4 7 F 14 _ _________-_______ ______- __- 1 3 4 6 22. Influenza M 3 _ _ _ _ _ 1 2 _ F 3 _ __ _ _ _ 1 1 1 23. Pneumonia M 20 1 1 1 - - 5 5 7 F 15 2 _ 1 - 3 3 6 24. Bronchitis 58 2 _ - - 22 22 12 F 24 _ _ _ - - 5 8 11 25. Other diseases of respiratory system M 6 - - - - - - 3 3 F - - - . - _ - - - 26. Ulcer of stomach and duodenum M 14 . _ _ _ _ 4 6 4 F 4 - - - _ 1 1 1 1 27. Gastritis, enteritis and diarrhœa M 1 - _ _ _ - 1 - - F 5 _ _ _ _ 1 1 1 2 28. Nephritis and nephrosis M 1 __- _ _ - - - 1 - F 3 _ - - - - 2 1 - 29. Hyperplasia of prostate M 7 _ _ - _ _ _- _ 2 5 30. Pregnancy, childbirth, abortion F 2 - - - - 2 - - - 31. Congenital malformations M 3 1 1 - - - 1 - - F 9 5 _ - - 1 3 - - 32. Other defined and ill defined diseases M 20 8 - 1 - 1 5 2 3 F 29 2 - _ _ 1 6 7 13 33. Motor vehicle accidents M 6 _ - 1 2 1 - 1 1 F 2 - - - - - - 1 1 34. All other accidents M 12 2 1 1 1 1 3 2 1 F 1 - - - - - - - 1 35. Suicide M 5 _ _ _ 1 2 2 - - F 3 - _ _ - - 1 2 - 36. Homicide and operations of war M _ _ _ _ - - - - - F 1 - . _ _ _ . 1 - 13 SECTION B SANITARY CIRCUMSTANCES OF THE AREA Water Supply. The domestic water supply for every dwelling in the Borough is taken from the Metropolitan Water Board. Samples of the water are subjected to regular routine chemical and bacteriological examination at the Board's laboratories and the results of these examinations are made available to the local authority. The results were uniformly satisfactory throughout the year. Water supply certificates were granted in accordance with Section 95 of the Public Health (London) Act, 1936 in 216 cases. There are 11 private wells in the Borough some of which are used for industrial purposes. In no case is the water used for drinking purposes but by arrangement with the owners of the wells, the Metropolitan Water Board takes samples periodically for examination so as to have some record of the probable suitability of the water for drinking should this become necessary in the unlikely event of a major breakdown in the normal supply or in case of war. Sanitary Inspection of the Area The District Public Health Inspectors are responsible for the investigation of all complaints in connection with premises within their areas whether these be used as dwellings or for commercial or industrial purposes. The greater portion of the work concerns dwellings as can be seen from the summary of work done which follows. 14 TABLE II INSPECTIONS, INSANITARY CONDITIONS THEN EXISTING AND RE-INSPECTIONS DURING THE YEAR 1917 Number of Complaints received 1,965 House-to-House — Dwelling Houses On complaint 1,929 After Infectious Disease 45 Number of Where power is used 40 ( Factories ( No power used 7 Inspections Others — Outworkers — Stables 4 Smoke Observations 45 Miscellaneous visits and inspections (including visits to infectious disease contacts, school inspections, etc.) 1737 Re-inspections 4854 (Dwelling Houses 1538 Premises requiring amendment (Others 4 Service of Intimations, etc Intimations served 1196 Intimations complied with 942 Notices served 461 Notices complied with 400 Final notices served 65 Final notices complied with 80 Summonses applied for 82 Work done (number of instances not included above): (a) After legal proceedings 29 (b) Voluntarily 140 Defects, etc., found in Dwelling Houses: Nuisances, etc., found Works completed Drainage: Drains defective 46 42 Drains obstructed 144 122 Waste pipes defective, etc. 104 59 Rainwater pipes not disconnected . 1 W. Cs. and flushing apparatus defective 246 169 15 TABLE II (continued) Nuisances, etc., found Works completed Dampness: (Not due to defects shown elsewhere) 650 400 Water: supply cut off 16 40 Dust receptacles: Insufficient or defective 66 67 Miscellaneous: Rooms, etc., dirty and/or verminous 201 208 Cases of overcrowding 2 — Yards, etc., not properly paved or drained 97 58 Roofs defective 844 563 Rainwater pipes and gutters defective 426 179 Public House urinals requiring cleansing — — Other nuisances or defects 4903 1902 Defects, etc., found in Factories: Sanitary defects 2 — W. C. accommodation insufficient or unsuitable — — Overcrowding — — Stables: Accumulations found 1 Manure receptacles defective 1 16 Drainage and Sewerage During the year 60 plans of drainage work to new and existing buildings were submitted and approved. River Pollution During the year several complaints concerning smells in the vicinity of the River were investigated and it was found in each case to be due to an emanation of hydrogen sulphide from the River itself. The River water carries a large volume of sulphate from estuarine sources as well as a natural load in the head waters, and in the middle reaches the amount of sulphate seems to be increased to a critical level by the discharge of heated flue-gas washing effluents containing calcium sulphite and sulphate from the Battersea and Bankside Power Stations. It would appear that this discharge superimposed on an already grossly polluted water so increases the Biological Oxygen Demand that the available oxygen is so depleted that anaerobic organisms are favoured, particularly a very important group of sulphate reducers which are capable of a complete reduction of sulphates to hydrogen sulphide, which not only produces the smell of which complaint is made but by reason of its chemical activity causes increased erosion of under-water non-ferrous parts of ship,s it combining with soluble metallic salts in the river produces black sulphides similarly causes the darkening of paints on craft and buildings in the vicinity of the river. The question of gross pollution of the Thames has been the subject of very 17 considerable research but in view of the particular nature of the nuisance in the middle reaches and its relationship to sulphates, the discharge of large amounts of effluents containing these substances should be excluded from the river. From the point of view of the Clean Air Act owing to the relatively inefficient removal of sulphur from flue gases by the methods and equipment at present installed at the two Power Stations on the river, this, for an experimental period could well be stopped, as the gases discharged contain an excess of water which on evaporation so cools the plumes that they are rapidly brought to ground level and in so doing bring down the residual sulphur in solution in a most deleterious form, which is a factor in the increased rates of corrosion noted, whereas discharge of hot gases containing sulphur dioxide retain sufficient buoyancy to permit the sulphur dioxide to remain gaseous and to be diluted in the upper atmosphere, thus lessening the concentration and hence the corrosion at ground level due to higher concentration of these oxides in solution in a washed plume. Common Lodging Houses There was one licensed Common Lodging House,with accommodation for 295 males, in the Borough. 14 inspections were made during the year. Seamen' s Lodging Houses. There were two licensed Seamen' s Lodging Houses, providing accommodation for 187 and 26 males respectively, in the Borough. Inspections made during the year totalled 14. 18 Personal Cleansing Owing to the very small number of cases requiring personal cleansing an arrangement was made with the Stepney Borough Council to carry out cleansing where necessary at the Stepney Cleansing Station at Branch Road. The Poplar Cleansing Station, which is in Yeo Street adjoining the Disinfecting Station, is maintained in proper order and can be re-opened at any time should this be necessary. The number of persons cleansed during 1957 was as follows:- Verminous Scabies Total Adults 41 14 55 Children 1 13 14 42 27 69 19 Disinfection and Disinfestation The Council maintains a disinfecting station at Yeo Street and a summary of the work carried out is given below:- (a) Disinfection: - Premises Disinfected Articles Disinfected Infectious Disease 219 2.105 Tubercolosis 70 769 Verminous - - Miscellaneous 306 4,926 Disinfection for manufacturing firms - 24,243 TOTALS 595 32,043 In addition, 936 tons, 10 cwts. of waste paper, 3 tons, 16 cwts. of clothing 1 ton, 2 cwts, of Sterilised Rags, and 12½ cwts. blankets were disinfected. (b) Disinfestation:- Inspections:- Number of visits 884 Premises requiring treatment 722 Furniture requiring treatment 246 Re-inspections after disinfestation 55 Miscellaneous visits and revisits 48 Disinfestation carried out:- Rooms (in 732 premises) 1,600 Beds, bedding, etc. articles 2,741 Furniture articles 2,607 20 21 Prevention of Damage by Pests Act, 1949. Rodent Control measures throughout the Borough have been carried out under the supervision of the Rodent Officer and a staff of five operatives. Work of the section may be divided into three main categories:- (a) Sewer Maintenance Treatment. (b) Business premises - routine inspection for rodent control (c) Dwelling houses - complaints from occupiers. Sewer Maintenance Treatments have been carried out at six-monthly intervals with the cooperation of the Borough Engineer & Surveyor's Department under the direction of the Ministry of Agriculture and Fisheries to synchronise with treatments in the neighbouring Authorities' Areas. Business Premises The Council's Contributory Scheme of Rodent Control in business premises has again continued to function well. The income derived from this Scheme is now £3,500 per annum and the charges made to individual contributors are calculated in units of £5 to £200 dependent on the size of the premises and the storage of rat and mice attractive materials. It must be appreciated that the Borough has extensive river and canal frontages and an immense volume of goods of all description is carried by ship and barge. The Rodent Control staff carry out considerable routine work of inspection and treatment of premises where goods are landed. It is extremely difficult entirely to eliminate the menace o rats, but 22 by constant supervision and treatment, rats and mice in these areas have been reduced and maintained at a minimum which emphasises the general benefits of the Council's Contributory Rodent Scheme. Dwelling Houses During the year under review 547 complaints have been received, many of mice infestation. Each complaint has been investigated and treatment or treatments are carried out as may be necessary. Where rat infestation of dwelling houses has been discovered it has usually been found to be due to defects in the drain or sewer and suitable repairs have been effected. This service is carried out by the Council's Staff and no charges are made to occupiers of dwelling houses. TYPE OF PROPERTY Local Authority Dwelling Houses including Council houses All Other (including Business Premises) TOTAL Number of properties in Borough 39 16857 3,042 19938 Number of properties inspected as a result of - (a) Notification - 457 133 590 (b) Survey under the Act. - 62 106 168 Total inspections carried out, including re-inspections 52 1593 7773 9418 Number of properties inspected which were found to be infested by:- (Major 6 32 45 83 (a) Rats Minor 7 90 141 238 Major 3 58 63 124 (b) Mice Minor 9 133 170 312 No. of infested properties treated 22 492 1440 1954 Total treatments carried out 54 1390 1545 2989 Number of Block control schemes carried out - - 161 161 23 FACTORIES ACT, 1937 (TABLES III, IV & V) TABLE III INSPECTIONS FOR THE PURPOSE OF PROVISIONS AS TO HEALTH Premises Number on Register Number of Inspections Written notices Occupiers prosecuted 1. Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 66 7 - - 2. Factories not included in (1) in which Section 7 is enforced by the Local Authority 650 40 - - 3. Other premises in which Section 7 is enforced by the Local Authority 24 - - - TOTAL 740 47 - - 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 - - - - - - - - - - Overcrowding - - - - - - - - - - Unreasonable temperature . - - - - - - - - Inadequate ventilation - - - - - - - - Ineffective drainage to floors - - - - - - - - - - Sanitary conveniences:- (a) Insufficient - - - 1 - - - 1 - - (b) Unsuitable or defective - - - 4 - - - 4 - - (c) Not separate for sexes - - - - - - - - - - Other offences against the Act (not including offences relating to Outwork) - - - 1 - - - 1 - - TOTAL - - - 6 - 6 - - 25 TABLE V OUTWORKERS SECTION 110 SECTION 111 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 1ists No. of instances of work in unwhole- some premises Notices served Prosecutions Wearing apparel (Making, etc. 145 - - — —% — — — — — — Cleaning and washing - - - - - - - - - - - Miscellaneous. 66 - - - - - - - - - - TOTAL 211 - - - - - - - - - 26 Offensive Trades. One Dresser of Furskins is established in the Borough. Smoke Abatement under the Clean Air Act. During the year 7 complaints of nuisance from smoke were received. 45 smoke observations were carried out. SMOKE CONTROL AREAS,' In view of the nature of the district a recommendation was made to the Council that the whole Borough should be declared a 'Shioke « Control' area, so that the widely dispersed industrial undertakings could be controlled, with the proposal that all premises likely to be dealt with by re-development within the next 10 - 15 years be excluded and the remainder of the property, most of which is new post-war development, having been built by this Council and the London County Council, should be dealt with in three zones - 'Central' , Lansbury Estate area, the 'South' , Island area and the 'North' of the Borough which would be the area last to be developed, as the third phase. This was accepted in principle by the Council on 28th October, 1957. Unfortunately, owing to the extreme shortage of staff it has not been possible to implement any of these recommendations owing to complete inability to carry out the surveys necessary. INDUSTRIAL UNDERTAKINGS. A very considerable degree of co-operation has been secured on the part of the various industrial undertakings in the area and where attention has been drawn to the unnecessary production of smoke in the 27 majority of cases, this has been virtually eliminated. Dock and River craft. Prom time to time nuisance is created by craft in the river or in the docks and these cases are referred to the appropriate Authority. Shops Act, 1950 Under the provisions of this Act 2 visits were made. No exemption certificates under the Act were issued during the year. Pharmacy & Poisons Act, 1933 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 the list at the end of 1957 was 86. Rag Flock and other Filling Materials Act, 1931 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 10. The Act also requires the licensing of premises for the storage of rag flock, and 2 licences have been issued. Pet Animals Act, 1951 Licences have been issued in respect of 4 premises within the Borough. 28 Hairdressers and Barbers The total on the register at the end of the year was 49 persons and 44 premises. National Assistance Act, 1948, Section 47 A number of cases of aged people 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 in their own homes but where necessary they were persuaded voluntarily to enter hospital or other suitable establishments. Care of the Aged Help, advice and assistance for old people through the statutory authorities and voluntary organisations associated in welfare work continued throughout the year and the old people have benefited greatly from the services provided. National Assistance Act, 1948, Section 50 Burials carried out under the provisions of this Act totalled 5 (adults). The total cost was £52-10-0d. of which £32-0-0d. was recovered. 29 Mortuary and Coroner's Court The Poplar Mortuary is situated in Poplar High Street adjoining the Coroner's Court. It is fitted with modern refrigerating plant which will hold fifteen bodies and it has a well equipped post-mortem room. In addition there is a viewing room, a waiting room and accommodation for the use of the pathologists and clerks. The total number of bodies received during 1957 was 449. (Residents 228, non-residents 221). Post-mortem examinations were made in 349 cases and inquests were held in 100 cases. Swimming Baths and Wash-houses The following bathing establishments are maintained by the Council under the supervision of the Chief Baths Superintendent:- Poplar Baths Vapour, Foajn and Slipper baths, Swimming Pools Bow Baths Slipper Baths and Laundry Island Baths Slipper Baths and Laundry Wick Lane Baths Slipper Baths Watts Grove Baths Slipper Baths Sophia Street Baths Laundry only 30 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 23,600 tons of house, trade, street, gully, market and kitchen refuse were collected and disposed of at the controlled tip. In addition 13,095 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 work in conjunction with the manual sweepers, and as required 2 watering machines are used for street watering. Gully Cleansing. Three gully emptying machines have carried out 5,812 cleansings of the gullies during the year. 31 HOUSING Details of new housing accommodation completed in the Borough during 1957 are as follows:- Poplar Borough Council 39 dwellings London County Council Devons Estate 177 dwellings The number of families living in property owned or managed by the Borough Council at 31st December, 1957, was as follows:- Type of dwelling No. of Lettings Pre-war Council houses and flats 1,058 Post-war Council houses and flats 1,457 Temporary bungalows 515 Old properties in Compulsory Purchase Areas 49 Requisitioned Properties 443 Temporary hutments 3 TOTAL PROPERTIES. 3,525 32 Certificates of Disrepair Housing Repairs and Rents Act, 1954 No. of applications for certificates Number granted Number refused No. of applications for revocation of certificates Number granted Number refused (a) Dwelling houses which have been the subject of a notice of repairs increase of rent under Part II of the 1954 Act 10 9 1 11 9 2 (b) Dwelling houses which have not been the subject of a notice of repairs increase of rent under the 1954 Act but in respect of which permitted increases of rent are recoverable under Section 2(1)(c) and (d) of the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920 3 2 1 1 1 - RENT ACT, 1957 454 152 - 6 4 2 33 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 9 Number of cases of overcrowding relieved during the year:Rehoused by London County Council Rehoused by Poplar Borough Council 9 Number of persons concerned in cases rehoused 49 Closing Orders (Public Health (London) Act, 1936) No Closing Orders were made under this Act during the year. Closing Orders (Housing Acts, 1936 and 1957) Closing Orders in respect of 8 underground rooms were made under these Acts during 1957. 34 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) 1,998 (b) Number of inspections made for the purpose 6,852 (2) (a) Number of dwelling houses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 32 (b) Number of inspections made for the purpose 37 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 10 (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 1,336 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 875 35 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 461 (2) Number of dwelling houses in which defects were remedied after service of formal notice:- (a) By owners 480 (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 repairs - (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 made 4 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 4 (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 14 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit (e) Proceedings under Section 42 of the Housing Act 1936:- (1) Number of dwelling houses included in Clearance Areas (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 277 36 SECTION D INSPECTION AND SUPERVISION OF FOOD Food Premises The number of food premises in the area by type of business is as follows:Manufacturing premises 37 (Confectionery 6; Flour millers 3; Edible oils l; Ice cream 2; Wine blenders 2; Nut roasters 3; Grocery 1; Pickles 1; Spice grinders 1; Milk pasteurising 1; Food Dehydration 2; Meat products 7; Mineral waters 1; Sugar refiners 2; Bakers 1; Essences 1; Sausage Rusk 1. Biscuit 1). This list does not include places where food is manufactured principally for retail sale on the premises Wharves 28. Cold stores 1. Wholesale premises 18. (Grocers 11; Banana Merchants 2; Confectioners 3. Fruiterers 2;). Retail premises 967. (Grocers 171; Confectioners 117; Restaurants 119; Industrial canteens 100; Non-industrial canteens 26; School meals centres 25; Public houses 166; Off-licences 25; Bakers 32; Fishmongers 34; Herbalists 1; Greengrocers 62; Butchers 59; Chemists 16; Miscellaneous 14). Street market stalls 119. 37 Registered premises. Food & Drugs Act, 1955. Section 16, (a) Ice cream; Manufacture and sale 13 Sale and storage 165 Storage only 2 (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 and preserved, etc., foods 53 Milk & Dairies Regulations 1949. Dairies 2 Milk Distributors: Inside the Borough 136 Outside the Borough 31 38 Inspection of Food Premises The following is a detailed summary showing the types of premises inspected during the year:- Number of Inspections Bakers 45 Dairies 57 Milk Distributors 48 Restaurants 140 Industrial catering establishments 54 Other catering establishments 88 Pish shops, fryers and curers 17 Stalls and itinerant vendors 44 Market inspections 53 Ice cream premises 149 Wharves 83 Butchers 109 Registered food manufacturers 61 Other food premises 403 TOTAL INSPECTIONS 1,351 Unsatisfactory conditions, warranting formal action, were found at 7 premises. 39 TABLE VI Sample No. ARTICLE RESULT OP ANALYSIS ACTION 49* Meat Paste, Chicken. 7, 6 per cent deficient in meat. Formal Sample taken No. 57. 57 * 8.4 per cent deficient in meat. Letter to Manufacturer. 163* Chocolate Cake Mixture Contained a rancid fat Formal Samples taken No's 169/70 169 „ „ „„ Letter to Manufacturer 170 n „ „„ „ „ 226* Bread and Butter The fat consisted of margarine Formal Sample taken No. 227. 253* Meat Paste, Chicken. 12,7 per cent deficient in meat Letter to Packer 369 Meat Paste, Chicken. 3.8 per cent deficient in meat. Letter to Manufacturer. 411* Pork Luncheon Meat. Incorrectly labelled in that the label did not show the name and address of the packer or alternatively a registered trade mark. Letter to Manufacturer. 413* Curry Powder, Contains 10 parts per million of lead in excess of the amount permitted. Letter to Wholesaler. 516* Pork Sausages. Deficient in total meat in that the meat content was only 46. 2% Letter to Manufacturer. 40 Food Sampling. A total of 691 samples of food were procured during the year by the Council's Food Inspector. Of these, 550 were submitted to the Public Analyst for chemical examination, the remaining 141 being sent to the Public Health Laboratory Service for biochemical or bacteriological report. Samples examined by the Public Analyst included a comprehensive variety of food. 31 samples were acquired formally and 519 informally. A total of 11 samples (2.0 per cent) were found to be adulterated. Details of the unsatisfactory samples and the action taken are shown in Table VI, on page 39. During the year Thirty Two samples of sausages were purchased mostly from different manufacturers, including local butchers. The meat content of pork sausages varied from 46.2 to 77.9 per cent., with an average of 64.2 per cent. Prices varied from 2/4d. to 3/4d. per lb. with an average of 2/9d. per lb. In the case of beef sausages the meat content varied from 47.5 to 80.6 per cent. with an average of 59.2 per cent. Prices were from l/6d. to 2/4d. per lb. with an average of 1/lld. per lb. One sample of Pork Sausages was unsatisfactory. Details of this sample and action taken are shown in Table VI, page 39. 41 Unsound food The Council's Pood Inspector is called upon to pass judgment of fitness on great quantities of food. Frequently large and valuable stocks are involved. Among special lots of food examined during the year were the following:- Cheese (Stock at Shop) 10 cwts Condemned and destroyed. Flour (Stock at Wharf) 7 cwts Condemned and destroyed Ham (Stock at Shop) 51/2 cwts Condemned and destroyed. Frozen Egg (Stock at Firm) 51/2 cwts Condemned and destroyed. Tomato Puree (Stock at Wharf) 10 cwts Condemned and destroyed. Apricot Pulp (Stock at Wharf) 16 cwts Condemned and destroyed. Dutch Potatoes (Stock at Wharf) 24 tons Condemned and destroyed. Sugar (Stock at Firm) 27 cwts Condemned and destroyed. The following is a summary of foods condemned as being unfit for human consumption: - Fresh foods Canned foods Meat and offal 962 lbs. 134 lbs. Meat products — 922 lbs. Ham — 2,752 lbs. Poultry 182 lbs. — Cheese 1,145 lbs. — Fish 320 lbs. 37 lbs. Milk 784 lbs. 381 lbs. Fruit juice — 845 lbs. Sugar 3,046 lbs. — Vegetables 54,208 lbs. 3,377 lbs. Fruit 56 lbs. 8,220 lbs. Other foods 250 lbs. 290 lbs. Egg (frozen) — 594 lbs. This summary 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 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 may be made under suitable guarantees from the owners, for the foods to be utilised for animal feeding or non-edible industrial purposes such as soap, starch, or manure making. 42 Milk Supply All domestic supplies of milk are sold in sealed bottles or cartons 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 twenty of the registered distributors. The London fresh milk depot of one of the leading wholesale milk concerns is situated within the Borough. Here, over 9,000,000 gallons of milk are pasteurised annually and distributed over some thirty to forty districts in the Greater London area. The Council is responsible for licensing and supervising the pasteurising process. 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 105 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 37 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 135 62 20 Supplementary 29 25 24 Pasteurisers — 1 — 43 Milk sampling. A total of 20 samples of milk (19 formal, 1 informal) were submitted to the Public Analyst for chemical examination. All samples were satisfactory. For average solids in all samples, excluding Ch'annel Islands milk, the figures were: Fat 3.55. Non-fatty solids 8.66. The Milk and Dairies (Channel Islands and South Devon Milk) Regulations, 1956, introduced on 18th June, fixed a minimum standard of 4 per cent fat in connection with milk sold under the Description Channel Islands, Jersey, Guernsey and South Devon. 3 samples of Channel Islands milk were taken and reports showed fat figures from 4.1 to 4.4 with an average of 4.23. Average figure for non-fatty solids was 9.06. Of the 34 samples of designated milk (28 pasteurised: 3 tuberculin tested pasteurised; 1 tuberculin tested; and 2 sterilised) submitted to the Phosphatase, Methylene Blue and Turbidity tests as appropriate, all were sf.tisfactory. Milk delivered to Schools and other London County Council Establishments. Of the 8 samples of milk taken on delivery at London County Council Establishments, 4 were submitted for chemical and 4 for bacteriological examination. All samples were reported to be satisfactory. 44 Oxidising Agents. The Milk and 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. One sample was tested for the presence of chlorates and 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. Inspections are madeofthe vehicles used by itinerant vendors; vehicles have been stopped, stocks inspected, temperature of containers checked and samples taken. A total of 86 samples were taken during the year. Of these 64 were submitted to the Public Health Laboratory for examination by the Methylene Blue test. The samples were graded as follows:- Grade 1 26 Grade 2 24 Grade 3 9 Grade 4 5 Reports from neighbouring authorities continue to be received from time to time concerning unsatisfactory samples of ice cream manufactured in this area normally by one firm whose plant and equipment is capable of producing a satisfactory commodity. During the course of investigation of unsatisfactory samples which 45 were received sporadically attention was drawn to the number of bacteria in the air being discharged as aerosoles from the breaking of bubbles caused by walking with rubber footwear over a wet floor. Where floors are kept wet it would appear that unless the flow of water is sufficient constantly to flush the surface, the water on the floor should contain sufficient free chlorine effectively to render non-viable any organisms falling on the floor. The remaining 22 samples were examined by the Public Analyst under the Food Standards (Ice Cream) Order, 1931. All samples were reported to be satisfactory, the quality in general being much higher than the standards prescribed in the regulations. 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 Borough. No prohibited meat may be imported into the country for sale for human consumption and no meat or meat products may be imported without an official certificate of inspection issued by the Country of Origin, and approved by the British Government. Detention notices were served under the Public Health (Imported Food) Regulations on 2 occasions, one in respect of food found to be unfit for human consumption and one in connection with a meat product without official certificates. Foods for Export In order to satisfy the Authorities of importing countries overseas it is 46 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 shipped. During the period covered by this report1C inspections were made of foods exported from the district; 12 certificates of purity were issued. Food Poisoning Fifty-four casesoffood poisoning were notified during the year. No serious outbreaks of food poisoning occurred and the few isolated cases of family outbreaks which occurred were found to be related to infection of one of the members of the family in Works canteens and cafes outside the area. 47 SECTION E INFECTIOUS DISEASES The total number of corrected notifications of infectious disease during 1957 was 1,476 which was nearly double the figure, 882, for the previous year and mainly due to the increase in the number of cases of measles 1,010 and 392 respectively, which were notified. Diphtheria It is gratifying to report that no cases of diphtheria were notified during the year but it must be emphasised that this has been achieved by a vigorous policy of immunisation and if diphtheria is not to re-appear asakilling disease constant vigilance is required and there must be no apathy on the part of the public in availing themselves of immunisation facilities as this degree of freedom from this serious disease will only be maintained if at least 80 per cent of the susceptible population are immunised and an alarming feature is that owing to the virtual disappearance of this disease there is a tendency to disregard its seriousness and the percentage of immunisation is barely being maintained at a satisfactory level in spite of vigorous propaganda campaigns. Dysentery During the year there were several small, isolated, family outbreaks of sonnei dysentery apparently unconnected but three incidents require comment. A small outbreak occurred in a local hospital. On investigation, in consultation with the Ward Medical Officers, it appears that the infection was brought 48 into the hospital from outside in the case of one patient admitted with diarrhoea and other persons in the same Ward became infected within a few days and a spread occurred to another ward, apparently through a nurse on night duty relieving between the two. All cases were adequately treated, and "barrier" nursing as soon as the nature of the outbreak was known contained the outbreak. As a result of this, as far as is practicable, the hospital no longer admits cases likely to be of an infectious nature. Later in the year a further outbreak occurred in the same hospital in an old People's Ward, two cases in neighbouring beds and the third and fourth cases, shared a day room with the two previous cases. One case appeared to be a symptomless excreter and may have been the cause although it was known that a domestic working in the Ward had had a stool, positive for Shigella sonnei in the previous November and it was subsequently learned that she had had an attack of diarrhoea some ten days before the present outbreak but had failed to report the matter to the Ward Sister. An outbreak occurred at a large Secondary School in the area. On enquiry it appeared that there had been other cases affecting nine children during the two weeks previous to the notification. As none of the pupils were found to have symptoms and the school was due to break up on the following day, instructions were given as to the general need for hand hygiene after using the toilet and before meals. There were no recurrences in the term after the vacation. A further outbreak occurred in a "Homeless Families" Unit, particularly 49 affecting the younger children who, apparently, infected their parents and other members of the families. With the co-operation of the London County Council, some alteration in the arrangements and distribution of the communal W.C. accommodation available was affected. Daily supervision by the Health Visitor and Public Health Inspector and individual talks with the parents as to the importance of hand hygiene after using the toilet and before cooking and eating meals, and in view of the age of the young children involved the supreme importance of cleansing of door knobs, doors and toilet fittings, as it was found that these children were having to use adult fitments which occasioned considerable handling of the seat and pan, this outbreak was very successfully confined and as soon as the precaution -ary arrangements had been implemented the cases ceased. Some children were kept under surveillance for up to three months on one case owing to persistent positive stool, but there were no further cases and eventually all cleared. A particular difficulty in this establishment is the frequent changing of the families - many new entrants having come from homes where Shigella sonnei was present. With the co-operation of the Warden these were all checked on entry and treated immediately if positive. This incident did draw attention to a difficulty in the functioning of the General Practitioner service under the National Health Service, in that coming from other areas the families could not be put on the lists of local doctors immediately, being still on the lists of the doctors in the former areas being regarded up to three months as "temporary residents" and only entitled, locally, 50 to treatment if ill. -0 This matter was brought to the notice of the London Executive Committee - and with the willing co-operation of the local General Practitioners the difficulty was overcome. Measles The number of cases of measles notified during the year was 1.010 as compared with 392 in 1956 and 1,559 in 1955. This follows the normal pattern of measles epidemics which prior to the war showed a fairly clearly marked two-year cycle in which a high peak was reached in alternate years, the intervening years being marked by relative freedom from the disease. Poliomyelitis During the year 10 cases of poliomyelitis (6 paralytic: 4 non-paralytic) were notified but diagnosis was confirmed in only 8 cases (5 paralytic; 3 nonparalytic). There were no deaths from this disease. Tuberculosis Notifications show little change from last year but when it is realised that every case arises from a previous case which is in an active phase of the disease it is apparent that in spite of modern therapeutic aids and improved diagnostic facilities this disease is only being held in check and is a long way from eradication. The local Chest Physician has sought my co-operation on a number of instances where persons suffering from tuberculosis and with a positive sputum have refused to accept any form of treatment. In most cases a satisfactory outcome was achieved. 51 We have in the Borough at Garford Street a Salvation Army Hostel for men of 295 beds and at any time there are probably up to 20 cases of pulmonary tuberculosis intermittent excreters of the organism and this does represent a considerable hazard both to the other inmates and to members of the public with whom they come in contact. This aspect of tuberculosis control is, at the moment, being very carefully considered by the various authorities interested. The following table shows the age and sex incidence of the cases notified. TABLE VII TUBERCULOSIS - PRIMARY NOTIFICATIONS Respiratory males 0- yrs. 1. yrs. 2yrs. 5yrs. 10yrs. 15yrs. 20- yrs. 25- yrs. 35yrs. 45yrs. 55- yrs. 65- yrs. 75yrs. TOTAL — — — 3 — — 4 3 5 4 11 4 — 34 Respiratory females — — — 2 1 2 1 5 3 3 2 — — 19 Non-respiratory males — — — — 1 — _ — 1 — — —- — 2 Non-Respi ratory females — — — — 1 —- — 1 — —- — — — 2 In addition, 41 other cases were added to the register as a result of information received from the following sources:- Local death returns 4 Transfers from other areas 37 During the year 9 deaths were certified as being due to tuberculosis, as compared with 9 the previous year. 52 The number of cases remaining on the register at 31st December, 1957, after adjustment in respect of deaths and transfers, was as follows:- Pulmonary Non-pulmonary TOTAL Males 415 65 480 Females 284 61 345 699 126 825 Mass Radiography No Mass Radiography Survey was carried out during the year. Whooping Cough There were 120 cases of whooping cough notified during the yea as compared with 174 the previous year. 69% occurred in children below 5 years of age and 13% in children below 1 year. This disease shows little variation over the years and in view of the age group attacked, predominantly in children below 5 years, it must still be regarded as one of the most serious diseases of childhood because of the possibility of sequelae. 53 54 TABLE VIII INFECTIOUS DISEASE DISEASE Corrected Notifications Removed to Hospital 0yrs. 1yrs. 3yrs. 5yrs. 15yrs. 25yrs. 45yrs. 65yrs. TOTAL Dysentery 7 13 10 8 1 1 4 9 53 36 Encephalitis Acute — — — — 1 — — — 1 1 Erysipelas — — — — — 1 — —- 1 - Measles 48 267 306 384 5 — — — 1010 22 Meningococcal Infection 1 1 — — — — — — 2 2 Pneimonia 4 4 2 9 1 9 15 10 54 10 Poliomyelitis, Ac. Paralytic — 1 3 1 — — — — 5 5 Poliomyelitis, Ac. Non Paralytic — — 1 2 — — — — 3 3 Puerperal Pyrexia — — — — 5 8 — — 13 13 Scabies — 2 2 5 4 3 1 — 17 3 Scarlet Fever — 4 19 36 — — — — 59 3 Whooping Cough 15 25 41 35 1 — — — 117 11 Zymotic Ehteritis 9 15 6 2 — — — — 32 13 Tuberculosis, pulmonary — — 2 3 7 16 20 5 53 — Tuberculosis, Meninges & C.N.S _ _ _ — _ 1 _ _ 1 _ Tuberculosis, other forms — — 1 2 — — — — 3 — TOTALS 84 332 393 487 25 39 40 24 1424 122 SECTION F GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA Laboratory facilities During the year all bacteriological examinations for the Public Health Department were carried out by the Public Health Laboratory Service at the Laboratories at the County Hall, S.E.I. The service is also utilised by the general practitioners in the borough. Hospitals There are three hospitals in the Borough - St. Andrew's, St. Clement's and Poplar Hospital. 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, Bow Group Hospital Management Committee. Ambulance Facilities The provision of ambulance transport within the administrative County of London is the responsibility of the London County Council and is available, free of charge, in the following circumstances:- 55 (a) Accidents (wherever occurring) and sudden ) illness (in the streets, public places or places of employment) (b) Very urgent illness at home For the conveyance of sick persons from their homes to hospital, provided a doctor certifie that the case is one of life or death and that arrangements have been made with a hospital for the patient's admission. Dial '999' and ask for 'Ambulance' or follow instructions given on telephone instrument. WATerloo 6000 NEW Cross 2645 Telephone RELiance 3622 CENtral 6301 REGent 4000 (c) Maternity cases Normally, if the expectant mother has booked a bed at a hospital or nursing home, she is in possession of a white card (Form L.A. S. 23) confirming the booking arrangements and giving full instructions for summoning the ambulance. Where no previous arrangements have been made, however, the London Ambulance Service cannot accept direct applications for removal to hospital except in the case of emergencies occurring in the street or other public place, when the procedure as in (a) above should be made by a doctor or midwife to the Emergency Bed Service. Telephone HOP 7181 (d) Other illness Fbr the removal to and from hospitals, etc., of sick persons, provided the ambulance is ordered by the hospital authority, by the Emergency Bed Service or, in certain circumstances by a private doctor, application should be made in writing or by telephoning. Telephone WAT 3311 Further particulars may be had on application to the Officer-in-Charge, London Ambulance Service, County Hall, S.E.I. Telephone enquiries relating to the ordering of ambulances to WATerloo 3311; general enquiries to WATerloo 5000, Ext.6950. 56 Legislation The undermentioned new legislation affecting the Public Health Department came into operation during the year:- Acts and Statutory Instruments Colouring Matter in Pood Regulations, 1957. Housing Act, 1957. London County Council (General Powers) Act, 1957. Motor Cycles (Protective Helmets) Regulations, 1957. Public Analyst Regulations, 1957„ Rent Act, 1957. Rent Restrictions Regulations, 1957. Rent Restrictions Rules, 1957. Smoke Control Areas (Exempted Fireplaces) Order, 1957. The Clean Air Council Order, 1957. Pood Hygiene (Amendment) Regulations, 1957. The Poisons Rules, 1957. Circulars Ministry of Health Diphtheria Immunisation Publicity Campaign, Local Authority Services for the Chronic Sick and Infirm, Revised Manuals of International Statistical Classification of Diseases, Injuries and Causes of Death, Food Hygiene (Amendment) Regulations. 57 Ministry of Agriculture, Fisheries and Food Exchequer grants towards the cost of Meat Inspection, Amendments to Memo 3/Meat, Milk and Dairies Regulations Approved Oxidising or Preservative Agents, Colouring matter in Food, Slaughterhouses Recommended Minimum Standards, Public Health (Imported Food) Regulations- Official Certificates Hungary and Sind, Public Analysts Regulations. Ministry of Housing and Local Government Clean Air Act, Temporary Houses, Accidents in the home - fireguards, Rent Act, 1957, Housing Accommodation for Old People. 58 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.0. Mitchell), Division 5, London County Council, 273, Bancroft Road, E. 1. Treatment Centres and Clinics Ruston Street, E. 3. 54, West Perry Road, E. 14. Wellington Way, E. 3. 69, East India Dock Road, E. 14. Will Crook's Centre, 1-3, Wigram House, Poplar High Street, E.14. Newmill House, Coventry Cross, E.3. Statistics Infant Welfare Centres Total number of children who first attended during the year and who on the date of their first attendance were:- Under 1 year of age 1,202 1-5 years of age 247 Total number of children who attended during the year and who were born in: 1957 936 1956 1,049 1955—52 1,761 Total attendances by children:- Under 1 year of age 16,163 1-5 years of age 8,001 59 Ante Natal and Post Natal Clinics Ante Natal consultations: Number of women who attended during the year 468 Number of new cases included above 368 Total attendances 2,657 Post Natal consultations: Number of women who attended 131 Health Visitors Number of children visited during the year 5.672 Number of infants under 1 year of age visited for first time 1,196 Total visits to infants under 1 year of age 6, 884 Total visits to children aged 1 year but under 2 years 4,886 Total visits to children aged 2 years but under 5 years 12,304 Number of expectant mothers visited 631 Total visits to expectant mothers 1,565 Infant Life Protection Number on register at 1st January, 1957: Foster mothers 15 Poster children 8 Number on register at 31st December, 1957: Foster mothers 14 Foster children 13 Child Minders (Daily Guardians) Number of Daily Guardians: Statutory — Voluntary 70 Number of children minded: Statutory. — Voluntary 57 Care of premature infants Number of premature live births during the year 90 Number of deaths under 1 month 15 60 Diphtheria Immunisation Number of children who completed a full course of primary immunisation, and who at the date of the final injection were: Under 5 years of age 980 5-14 years of age 256 Number of children who were given a secondary or re-inforcing injection 1,731 Vaccination Number of children successfully vaccinated or revaccinated 777 Domestic Help Service Domestic Help was provided as follows: Maternity cases 20 T.B. cases 16 Aged and chornic sick cases 889 Other 16 61