LIBRARY ROM 27 BOROUGH OF ROMFORD HEALTH DEPARTMENT ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1952 JAMES B. SAMSON, M.D., D.P.H. Medical Officer of Health BOROUGH OF ROMFORD HEALTH DEPARTMENT ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1952 JAMES B. SAMSON, m.d., d.p.h. Medical Officer of Health 3 BOROUGH OF ROMFORD MEMBERS OF THE COUNCIL (as at 31st December, 1952) His Worship The Mayor: Alderman G. Roberts, J.P. Deputy Mayor: Alderman A. McGonagle Aldermen: Alderman C. H. Barney, Alderman Mrs. L. A. Irons, A.S.A.A. J.P. Alderman T. W. Bradley Alderman L. S. Webb Alderman R. A. Forge, J.P. Alderman R. Yeal Councillors: Councillor P. J. Bartaby Councillor W. J. Hawkins, Councillor H. A. Beck B.A. (Com.) Councillor F. C. Bell Councillor A. C. Latham Councilor W. J. Martin Councillor I'. F. Broadliead, D.S.C. Councillor W. R, Pike Councillor S. C. Brown Councilor P. D. Ridley, Councillor F. G. Carrick B.A.(Cantab.) Councilor E. F. Castle, Councillor M. J. Riordan B.Com. ; A.S.A.A., C.C. Councillor Mrs. O. M. J. Councilor Mrs. M. Clark-Lewis Roberts Councilor G. Coulson Councillor M. Sharp Councillor L. F. P. Eley Councillor 8. E. C. Stevens Councillor S. V. Ellmore Councillor A. G. Western Councillor W. S. Gardner Councillor W. A. White Councillor O. J. Hammond 4 BOROUGH OF ROMFORD PUBLIC HEALTH COMMITTEE His Worship The Mayor: Alderman G. Roberts, J.P. (ex-officio member) Chairman: Alderman A. McGonagle Vice-Chairman: Councillor W. S. Gardner Alderman L. S. Webb Councilor O. J. Hammond Councillor P. J. Bartaby Councillor W. R. Pike Councillor F. C. Bell Councillor D. P. Ridley, Councillor P. F. Broadhead, B.A. (( antab.) D.S.C. Councillor M. J. Riordan Councillor S. C. Brown Councillor Mrs. O. M. J. Roberts C ouncillor -b . G. Carrick Councillor S. E. C. Stevens Councillor Mrs. M. Clark-Lewis 5 HEALTH DEPARTMENT Public Health Staff Medical Officer of Health J. B. Samson, M.D., Ch.B., D.P.H. Assistant Medical Officers (a) A. P. Draper, M.C., M.A., M.D., B.Ch., B.A.O. (b) Mrs. E. M. Haga, M.B., B.S., L.R.C.P., D.P.H. (c) Mrs. G. A. Kolibabka, M.A., M.B., Ch.B. Sanitary Inspectors (a) H. C. Boswell (A.B.) (Senior Sanitary Inspector). (b) M. J. Dove (A.B.). (c) T. E. R. Jones (A.). (d) W. Hodson (A.B.) (Commenced duties '22nd December, 1952). (e) H. H. Seddon (A.B.). A. Certificate of the Royal Sanitary Institute. B. Certificate of the Royal Sanitary Institute, Meat and Other Foods. Health Visitors. Superintendent: Miss F. K. Wells (A.B.D.). (a) Miss M. K. Bays (A.B.D.E.) (Resigned llth Jane, 1952). (b) Miss B. C. Blackley (A.B.D.E.F.) (Commenced duties 18th June, 1952). (c) Miss 0. Clements (A.B.D.). (d) Mrs. G. E. Engall (A.B.D.E.) (Commenced duties 28th July, 1952). .(e) Miss D. I. A. Hall (A.B.D.E.). (f) Miss M. Harrison (A.C.D.E.) (Commenced duties 1st May, 1952). (g) Miss M. Hill (A.B.D.E.). (h) Miss H. E. iS. Holmes (A.B.D.E.). (i) Miss M. A. Mander (A.C.D.E.) (Resigned 4tli August, 1952). (j) Mrs. S. Pratt (A.C.D.E.) (Resigned 31st August, 1952). (k) Mrs. Y. Stone (A.C.D.E.) (Commenced duties 24th July, 1952). (1) Mrs. G. Wallach (A.C.D.). Certificate of British Tuberculosis Association. Certificate of Brornpton Hospital. Tuberculosis Visitor. Mrs. B, Alder (A.B.), 6 Domiciliary Midwives. Non-Medical Supervisor of Midwives and Home Nurses: Miss M. B. Worby (A.B.). Midwifery Teaching Diploma. Queen's Certificate of District Nursing. (a) Miss I. A. Bassett (B.). (b) Miss C. M. Kerr (A.B.). (c) Miss M. Kitson (A.B.). (d) Miss F. L. Law (A.B.) (Commenced duties 4th February, 1952). (e) Mrs. M. Mylward (B.). (f) Mrs. E. A. Rooks (B.). (g) Mrs. G. E. Sexton (A.B.). (h) Mrs. J. Thompson (A-B.). (i) Miss M. R. Waddell (A.B.). (j) Mrs. M. B. Woodhouse (A.B.). Home Nurse/Midwives. (a) Miss R. E. May (B.). (b) Miss D. D. K. Martin (A.B.) (Commenced duties 4th November, 1952). Home Nurses. (a) Mrs. E. M. Broome (A.). (b) Mrs. B. Casey (A.C.) (Commenced duties 1st February, 1952). (c) Miss J. Macaulay (A.B.). Queen's Certificate of District Nursing. (d) Mrs. A. C. Silcock (A.B.). (e) Miss J. D. Silcock (A.B.). (f) Mrs. M. Slavin (A.). (g) Mrs. S. A. Wotherspoon (A.). A. State Registered Nurse. B. State Certified Midwife. C. Part 1 S.C.m. D. Health Visitor's Certificate. E. Also holds the appointment of School Nurse. F. Certificate of Tuberculosis Nursing. 7 Home Hf.lp Organiser. Mrs. L. Canham. Day Nurseries—Matrons. "St. Mortiz"— Mrs. I. C. Bowyer. Collier Bow— Mrs. D. Eveling. Rush Green— Mrs. R. M. O'Halloran. Clerical Assistants. (a) E. W. Gowers, Chief Administrative Assistant. (b) C. G. Humberston, Senior Administrative Assistant. (c) S. J. Adams, Administrative Assistant. (d) W. Norris, Administrative Assistant (Commenced duties 17th March, 1952). (e) Miss M. E. Firmin. (f) Miss B. Parker. (g) Mrs. M. Barnard. *(h) Mrs. S. Corner. (i) Mrs. I. M. Gray. (j) Miss R. Harvey (Commenced duties 3rd March, 1952). (k) Mrs. M. E. Riley (Commenced duties 1st July, 1952). (1) Miss J. V. Saggers (Commenced duties 3rd November, (1952). The Clerical Assistants also carry out duties in connection with the School Health Service of the Essex County Council with the exception of *. 8 BOROUGH OF ROMFORD To His Worship the Mayor, Aldermen, and Councillors of the Borough of Romford. Mr. Mayor, Ladies, and Gentlemen, I have the honour, herewith, to present to you, this, my Annual Report on the Health of the Borough for the year 1952. This is the Nineteenth Report in the series, since I was appointed your Medical Officer of Health, and it is drawn up in accordance with the requirements of Article 17(5) of the Sanitary Officers' (Outside London) Regulations, 1935, as modified by Circular No. 2/53 of the Ministry of Health, dated 22nd January, 1953. This circular states that the Report should be prepared on the lines of that for 1951. As in the case of the Reports for the last few years, it is convenient to deal also with the Health Services administered by the Essex County Council, as the Local Authority for those services, in accordance with the National Health Service Act, 1946. Under the Scheme of the County, Health Area No. 6 is coterminous with the Borough of Romford, and your Medical Officer of Health also holds the appointment of Acting Area Medical Officer. Furthermore, your Medical Officer holds the appointment of Borough School Medical Officer. Such an arrangement gives unification of the service as a whole, and there is the minimum of overlap. The district still continues to grow, but, with the completion of the London County Council Estate at Harold Hill, a degree of stability will be reached, and we shall be in a position to consider the extent of our administrative problems, and to deal with them on a more satisfactory basis. The statistics in the following pages, I humbly submit, are a credit to your district. My thanks, as usual, go to all the members of my staff, to my fellow officials, and to all the members of the Council, and Health Area Sub-Committee for the assistance invariably given, and for the interest invariably taken in the betterment of health conditions in the town. I am, Mr. Mayor, Ladies, and Gentlemen, Your obedient servant, JAMES B. SAMSON, Medical Officer of Health. Public Hf.ai.th Department, Town Hall, Romford. May, 1953. 9 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year 1952 Statistics and Social Conditions of the Area Area (in acres) 9,342 Population: Census (1951), 87,991; Mid. 1952 (Estd.) 99,360 Number of Inhabited Houses (end of 1952) 27,533 Rateable Value (end of 1952) £724,120 Product of Penny Rate (end of 1952) £2,721 Extracts from Vital Statistics for the Year Total M. F. Live Births: Legitimate 1,862 923 939 Illegitimate 76 46 30 Birth Rate : 17.9 per 1,000 of estimated resident population Still Births: Legitimate 38 23 15 Illegitimate 2 1 1 Rate per 1,000 total (live and still births): 20.2 Deaths 756 412 344 Death Rate: 9.1 per 1,000 estimated resident population. Rate per 1,000 total (live and still) births Deaths from Puerperal causes 0.5 Death Rate of Infants under one year of age:— All Infants per 1,000 live births 25.3 Legitimate Infants for 1,000 legitimate live births 24.7 Illegitimate Infants per 1,000 illegitimate live births 39.5 Deaths from Cancer (all ages) 131 Deaths from Measles (all ages) Deaths from Whooping Cough (all ages) — Deaths from Diarrhoea (under 2 years of age) 4 10 TABLE 1 BITRTH-RATES, DEATH-RATES, ANALYSIS OF MORTALITY, MATERNAL,and CASE-RATES for certain Infections Diseases in the year 1952.} England and wales, London, 160 County Borough and Great Town, and 160 Smaller Towns.\ (Provisional Figure based on Weekly and Quarterly Returns ) RATE PER 1,000 POPULATION DEATH-RATE PER 1,000 POPULATION RATE PER 1.000 LIVE BIRTHS All Causes Typhoid and Paratyphoid Fevers Whooping Cough Diphtheria Tuberculosis Influenza Small-pox Acute Poliomyelitis and Polioencephalitis Pneumonia Diarrhoea and Enteritis (under 2 years) Total Deaths under 1 year Live Births Still Births England and Wales 15.3 0.35 11.3 0.00 0.00 0.00 0.24 0.04 0.00 0.01 0.47 1.1 27.6 160 County Boroughs and Great Towns, including London 16.9 0.43 12.1 0.00 0.00 0.00 0.28 0.04 0.00 0.01 0.52 1.3 31.2 160 Smaller Towns (Resident Populations 25,000 to 50.000 at 1951 Census) 15.5 0.36 11.2 0.00 0.00 0.00 0.22 0.04 0.00 0.00 0.43 0.5 25.8 London 17.6 0.34 12.6 0.00 0.00 0.00 0.31 0.05 0.00 0.01 0.58 0.7 23.8 ROMFORD 17.9 0.40 9.1 0.00 0.00 0.00 0.17 0.01 0.00 0.00 0.31 2.1 25.3 The Maternal Mortality Rate for England and Wales is as follows: Per 1,000 Total Live Births — 0.72 The Maternal Mortality Rate for Romford is as follows: Per 1,000 Total Live Births — 0.50 11 TABLE 2. Causes of Death All Ages Deaths at the subjoined ages of Residents, after correction for Inward and Outward transfers M. F Total Under 1 1 2-4 5-14 1524 2534 3544 4554 5564 6574 75 & upwards 1. Tuberculosis, respiratory 7 7 14 ... ... ... ... ... 2 4 4 3 1 ... 2. Tuberculosis, other 3 ... 3 ... ... ... ... ... 1 ... 1 1 ... ... 3. Syphilitic disease i 1 2 ... ... ... ... ... ... ... ... 1 ... 1 4. Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6. Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6. Meningococcal infections 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ... 7. Acute poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8. Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9. Other infective and parasitic diseases 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... 10. Malignant neoplasm, stomach 12 11 23 ... ... ... ... ... ... ... 5 6 6 6 11. Malignant neoplasm, lung, bronchus 22 2 24 ... ... ... ... ... 1 3 1 6 10 3 12. Malignant neoplasm, breast ... 11 11 ... ... ... ... ... ... ... 3 1 3 4 13. Malignant neoplasm, uterus ... 5 5 ... ... ... ... ... 1 ... ... 2 1 1 14. Other malignant and lymphatic neoplasms 35 33 68 ... ... 1 ... 1 4 2 6 18 17 19 15. Leukaemia, aleukaemia 3 1 1 ... ... ... 1 ... ... 1 1 ... 1 ... 16. Diabetes 1 3 4 ... ... ... 1 ... ... ... ... 1 1 1 17. Vascular lesions of nervous system 30 55 85 ... ... ... ... ... ... 2 6 17 25 35 18. Coronary disease, angina 65 32 97 ... ... ... ... ... ... 2 7 25 29 34 19. Hypertension with heart disease 14 9 23 ... ... ... ... ... ... ... 1 4 10 8 20. Other heart disease... 51 57 108 ... ... ... ... 2 ... 5 2 8 16 75 21. Other circulatory disease 16 24 40 ... ... ... ... 1 1 ... 3 7 8 20 22. Influenza 1 1 ... ... ... ... 1 ... ... ... ... ... ... 23. Pneumonia 13 18 31 ... 3 1 ... ... ... ... 3 4 4 13 '24. Bronchitis 36 10 46 ... 1 ... ... ... ... 1 3 10 14 17 25. Other diseases of respiratory system 7 ... 7 ... ... ... ... ... ... ... 3 2 1 1 26. Ulcer of Stomach and duodenum 7 2 9 ... ... ... ... ... ... 1 1 2 4 1 27. Gastritis, enteritis, and diarrhoea 2 3 5 3 1 ... ... ... ... 1 ... ... ... ... 28. Nephritis and nephrosis 3 6 9 ... ... ... 2 1 ... ... 2 1 3 29. Hyperplasia of prostrate 7 ... 7 ... ... ... ... ... ... ... ... 2 2 3 30. Pregnancy, childbirth, abortion ... 1 1 ... ... ... ... ... 1 ... ... ... ... ... 81. Congenital malformations 7 5 12 8 1 1 ... ... ... ... 1 1 ... ... 32. Other defined and illdefined diseases 42 38 80 29 ... 1 3 1 4 5 6 9 10 12 33. Motor vehicle accidents 10 1 11 ... 1 1 5 1 ... ... ... 9 1 34. All other accidents 13 7 20 6 2 1 ... 1 ... 1 ... 1 1 7 35. Suicide 2 1 3 ... ... ... ... ... ... 1 ... ... ... 2 36. Homicide and operations of war 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ... Total 412 344 756 49 8 8 6 14 17 29 57 133 168 267 12 This year, the Registrar-General has given his estimate of the mid-year population of Romford as 99,360, which compares with 89,340 for last year, an increase of 10,020. The District, for statistical purposes, is now designated as a "Great Town," and, in future, comparisons will be made with the other 159 County Boroughs and Great Towns in England and Wales. During 1952, the total number of live births registered was 1,938, and the total number of deaths registered was 756. The difference of 1,182 gives the natural increase in the population. As this number falls far short of the Registrar-General's estimated increase of 10,020, it follows that the balance of 8,838 is made up of excess of Immigration over Emigration, and this, again, is very largely accounted for by the development of the Harold Hill Estate, although this development was almost complete by the termination of the year. For 1952, we estimate the Birth Rate to be 17.9 per 1,000 of the estimated resident population. This figure is obtained by multiplying the Crude Birth Rate of 19.5 by the Comparability Factor of 0.92. For last year the Rate was 17.9. The Rate for England and Wales for 1952 is given as 15.3, and for the 160 Great Towns, with populations over 50,000 at the 1951 Census, the Rate is 16.9. The Death Rate is estimated as 9.1 per 1,000 of the estimated resident population. This figure is obtained by multiplying the Crude Death Rate of 7.6 by the Comparability Factor of i.2. For last year the Rate was 10.2. The comparable Rates for England and Wales, and for the 160 Great Towns, as referred to above are 11.3 and 12.1 respectively. The chief causes of death in order of frequency were:— (1) Diseases of the Heart and Circulation. (2) Cancer. (3) Bronchitis, Pneumonia, and other Respiratory Diseases. (4) All forms of Accident. (5) All forms of Tuberculosis. The order remains the same as last year. The Maternal Mortality Rate, which is the number of Maternal Deaths, due to conditions associated with pregnancy or confinement per 1,000 total (live and still) births is 0.5. The corresponding Rate for England and Wales is 0.7. The Infant Mortality Rate, or the Death Rate of Infants under 1 year of age per 1,000 live births is 25.3, an increase of 1.0. The corresponding figures for England and Wales, and the 160 Great Towns are 27.6 and 31.2 respectively. 13 1.—GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA (i) Staff. Particulars of the staff are set out at the beginning of the report. I would again mention that the Assistant Medical Officers, Nursing Staff, and Home Help Organiser come under the jurisdiction of the Essex County Council, in their capacity as Local Health Authority. Similarly, the majority of the Clerical staff also come under the Essex County Council, but, for convenience, 25% of the time of the Chief Administrative Assistant is given to Borough Council work. As I have already mentioned, your Medical Officer of Health is also Acting Area Medical Officer for the Part III duties of the National Health Service Act, 1946. (ii) Laboratory Facilities. The facilities remain as before, and meet the necessary requirements. (iii) Nursing in the Home. (a) General Nursing. There are at present 7 Home Nurses in this area and 2 Home Nurse Midwives. Under the provision of Section 28 of the National Health Service Act, arrangements continue for the issue of sick-room equipment on loan, and there is now no charge for this service. Table 3 sets out the work of the Home Nurses during the year, insofar as their general domiciliary duties are concerned. TABLE 3 (1) Number of Visits paid. 22,404 (2) Number of Cases attended 2,027 (b) Domiciliary Midwives. At the end of the year 9 Domiliciary Midwives were employed and, in addition, the 2 Homes Nurse/Midwives, already mentioned. The following gives a summary of the cases attended by the Domiciliary Midwives, as Midwives, and as Maternity Nurses. TABLE 4 As Midwives 668 As Maternity Nurses 222 Table 5 gives a summary of the "Medical Aid" notices received during the vear. TABLE 5 (1) Where the medical practitioner had arranged to provide the patient with maternity services under the National Health Service 14 (2) Others 141 14 (iv) Ante-natal, and Post-natal Clinics. There are now 6 Ante-natal sessions held each week. Two Post-natal sessions are held per month. Mothers continue to be referred as, and when, necessary to the Consultative Clinic at Oldchurch Hospital. During the year, 957 individual expectant mothers attended the ante-natal clinics. In addition, 44 mothers attended for postnatal advice. In all, '283 ante-natal sessions were held. The total number of attendances of the 957 ante-natal mothers, mentioned above, was 3,715, giving an average of 3.9 attendances per patient. The average number attending at each session was 13.1. Twenty-one post-natal sessions were held, and 32'2 attendances were recorded. The average number attending at each session was 15.3. (v) Child Welfare Clinics. There are now 12 child welfare sessions held each week, an additional session having been commenced during the month of June, to meet the needs of the residents on the Harold Hill Estate. Altogether 589 sessions were held, and the following table eives a summarv of the attendances:— TABLE 6 Individual children attending 4,749 Children attending for the first time 2,089 Medical consultations 6,225 Attendances of children under one year of age 22,801 Attendances of children between the ages of one and five years 9,926 Average attendance per session 55.6 (vi) Health Visitors. At the end of the year there were 9 Health Visitors on the staff. There is still a great scarcity of Health Visitors throughout the County and, in fact, throughout the Country, but the scheme of training in operation in the County does enable us, periodically, to obtain new members. Table 7 relates to Home Visits paid by the Health Visitors during the year. TABLE 7 (a) To Expectant Mothers— First visits 174 Total visits 254 (b) To Children under one year of age— First visits 2,347 Total visits 5,237 (c) To Children between the ages of one and five years— Total visits 7,580 15 (vii) The Care of Premature Infants. Two draught-proof cots are kept at one of the clinics for issue on loan, as, and when, necessary, but adequate facilities are also available for in-patient treatment at Oldchurch Hospital. (viii) Inspection of Nursing Homes. There are 4 private nursing homes in the district. Details of these were given in my report for last year. These were inspected quarterly, on behalf of the County Council, and, on each occasion, were found to be satisfactory. (ix) Domestic Helps. This service has continued as before, and has met with all demands. During the year 183 Part-time Helps were employed, and, these gave assistance in 637 individual cases. Tuberculosis patients have again been provided with Helps, as required, and a number of Helps have volunteered for this purpose. Those particular Helps have, however, to undergo a special medical examination before they are appointed for this type of work. They also receive detailed instructions on precautionary measures to be taken. (x) Day Nurseries. Throughout the year the three Day Nurseries have been maintained. Admissions are based on a scheme of priorities. The alterations at "St. Moritz" Nursery, mentioned in my last report, were completed, and these have helped considerably in the day-today administration. A recommendation for two additional Nurseries, one at Harold Hill, and one on the Gobions Estate was before the Ministry at the end of the year. The average attendance for the year at each Nursery was as follows:— table 8 "St. Moritz" Nursery 30 Collier Row Nursery 33 Rush Green Nursery 36 The "St. Moritz" Nursery and the Collier Row Nursery are scheduled to take forty children each, and the Rush Green Nursery, fifty. (xi) Dental Service. My remarks of last year still apply, as the position has not altered, 16 The following gives particulars of the service:— TABLE 9 (a) Numbers provided with Dental care:— Examined. Needing Treatment. Treated. Made Dentally Fit. Expectant and Nursing Mothers 30 28 50 25 Children under Five ... 69 66 66 57 (b) Forms of Dental Treatment Provided:— Extractions. Anaesthetics. Scallngs or Scaling and Gum ' Treatment. Silver Nitrate Treatment Dressings. Radiographs. Dentures provided. Fillings Local. General. Complete . Partial Expectant and Nursing Mothers 8 — 7 92 8 — — — 1 2 Children under five 100 — 59 9 — — — — — — 2.—SANITARY CIRCUMSTANCES OF THE AREA (i) Water. Mr. H. G. Ramsay, Chief Engineer of the South Essex Waterworks Company, has kindly given me the following report with regard to the water supply to the district:— (a) There have been no new extensions of public water supply during the year 1952. (b) Lengths of mains laid, in yards:— 3" 4" 6" 9" L.C.C. Harold Hill Estate 233 3,358 479 Romford Area 759 1,863 *2,677 615 Totals 992 5,221 3,156 615 *This figure indues 1,278 yards of main, relaid in Noak Hill Road. (c) The water supply of the area, and of its several parts, has been satisfactory both as to quality and quantity. (d) Bacteriological and Chemical examinations are made of the raw water, of the water in its various stages of treatment, of the water supplied from the Company's wells, and of the water going into supply. Analyses are also made of samples obtained from consumers' taps in various parts of the Company's district; all proved to be satisfactory. A total of over 3,500 Chemical, Bacteriological, and Biological examinations have been made. 17 (e) The waters are not liable to have plumbo-solvent action. (f) No contamination has arisen, therefore no action has been necessary. In addition to the analyses carried out by the Waterworks Company samples have also been taken from consumers' taps by the sanitary inspectors, and sent for Bacteriological analyses once per month, and Chemical analyses once per six months, and the results have confirmed the findings of the Company. (ii) Sanitary Inspection of the Area. The Senior Sanitary Inspector has given me the undermentioned report, as required by Article 27 (18) of the Sanitary Officers' (Outside London) Regulations, 1935, and also the following particulars:— TABLE 10 (a) Nature and number of Inspections during the year:— Accumulations and Refuse Deposits 31 Bakehouses 16 Butchers' Shops and Stalls, etc. 81 Common Lodging Houses 19 Cowsheds, Dairies and Milkshops 53 Drainage 688 Diseases of Animals Act 6 Dustbins 170 Establishments for Massage and Special Treatment 14 Factories (Mechanical Power) 164 Factories (Non-Mechanical) 43 Food Preparing Premises 108 Food Inspection 509 Foodshops 204 Ice Cream 128 Infectious Disease including Food Poisoning 1,098 Keeping of Animals 44 Markets 79 Pet Animals Act, 1951 24 Prevention of Damage by Pests Act, 1949 2,524 Public Baths 22 Public Conveniences 105 Rag Flock Act 10 Sale of Horse-flesh 10 18 Shop Acts 54 Slaughterhouses 466 Smoke Observations 18 Stables 1 Streams and Ponds 56 Tents, Vans and Sheds 101 Verminous Premises 90 Water Supplies 28 (b) Informal Notices (number served) 876 Stautory Notices (number served) 113 (c) As a result of the service of Notices, the necessary works were completed by the owners or occupiers in all cases except 169, the works for which were still in hand at the end of the year. (iii) Factories Acts, 1937 and 1948. A summary of the statistics, as required by the Ministry of Labour and National Service, is given below:— TABLE 11 1. Inspections. Premises. Number on Register. Inspections. Written Notices. Occupiers Prosecuted. (i) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 17 43 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 214 164 16 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding OutWorkers premises) 13 16 - - Total 224 223 16 19 2. Oases in which Defects were Found. Particulars. No. of Cases in which . prosecu- cutions instituted No. of Cases in which defects were found Found. Remedied. Referred to H.M. Inspector. by H.M. Inspector. Want of Cleanliness 4 4 - - - Overcrowding — — — — — Unreasonable Temperature - - - - - Inadequate Ventilation 1 1 - - - Ineffect. drain of floors - - - - - Sanitary Conveniences:- - (b)Insufficient 2 1 — 3 - (b) Unsuitable or Defective 1 1 - 1 - (c)Not Separate for Sexes 1 1 - - - Other Offences 7 7 — 2 — Total 16 15 — 7 — 3. Outwork. Nature of Work. List of No. of Outworkers in August. No. of Cases of default in sending List. No. of Prosecutions for failure to supply Lists. No. of Instances of Work in Unwhole some Premises. Notices Served. Prose cutions. Wearing Apparel— Making, etc. 34 - - - - - Total 34 - - - - - (iv) Caravan Sites. In addition to the two sites mentioned in my previous report, a further site in Walton Road received Public Health, and Planning consent. This is permitted to accommodate 8 caravans. In my last report, I indicated that a Compulsory Purchase Order was under consideration for land in Oldchurch Road. This has now been completed. At present, there are caravans on this site, and, although the land has not been purchased for this purpose, the caravans will be permitted to remain there, until arrangements can be made for their disposal elsewhere. In the intervening period the Council will administer this site. 20 (v) Prevention of Damage by Pests Act, 1949. During the year the Sanitary Inspectors, and Rodent Operative paid 2,524 visits, or re-visits, to premises infested by rats and mice. Further maintenance treatment, in respect of rat disinfestation of sewers, was undertaken on two occasions during the year. (vi) Infestation. The same facilities exist for the disinfestation, or destruction of clothing and bedding. This refers to infestation with lice or bugs. (vii) Pet Animals Act, 1951. This Act came into operation on 1st April, 1952. During the year 13 persons were registered to keep Pet Shops. 3—INSPECTION AND SUPERVISION OF FOOD (i) Milk Supply. Samples of milk have been taken regularly as before. In particular, one sample has been taken, per supplier, per school term, for bacteriological examination, and one sample of Pasteurised Milk, per supplier, per school year, for biological examination. At the end of the year, 30 persons or firms were licensed to retail designated milk. Of these 9 were licensed to retail Tuberculin Tested Milk, 2 were licensed to retail Accredited Milk, 15 were licensed to retail Pasteurised Milk, and 26 were licensed to retail Sterilised Milk. (ii) Ice Cream. At the end of the year 12 manufacturers, and 176 vendors were on the register. Here, also, regular sampling has been carried out. (iii) Meat. The Sanitary Inspectors have again attended regularly at the Regional Slaughterhouse, and, in fact, it is estimated that the equivalent time of one whole-time Inspector has to be devoted to this work. In addition, visits have been paid to Meat Depots, Butchers' Shops, Stalls, etc. Altogether, 557 visits have been paid, and, at the Ministry of Food Slaughterhouse alone 22,443 carcases were examined. No Ante-Mortem inspections are carried out, but all animals slaughtered are examined. The carcases of 1,052 horses were also examined at a private slaughterhouse, which is used solely for the slaughter of horses. Table 12 sets out the particulars of the carcases inspected, and condemned. 21 TABLE 12. CARCASES INSPECTED AND CONDEMNED. Cattle except Cows. Cows. Calves. Sheep and Lambs. Pigs. Horses. Total. Number killed (if known) 4,804 1,179 2,610 7,873 4,979 1,052 23,497 Number inspected 4,804 1,179 2,610 7,873 4.979 1,052 23,497 All diseases except Tuberculosis. Whole Carcases condemned 2 9 10 34 29 4 88 Carcases of which some part or organ was condemned 1,403 508 16 664 651 173 3,415 Percentage of the number inspected affected with diseases other than tuberculosis 29.17 45.5 0.99 8.8 13.6 16.8 14.9 Tuberculosis only. Whole carcases condemned 26 38 — — 12 — 74 Carcases of which some part or organ was condemned 384 321 — — 174 — 879 Percentage of the number inspected affected with tuberculosis 8.5 30.28 — — 3.7 — 4.05 22 (iv) Food Products in General. Insofar as it has been possible with shortage of staff, the Sanitary Inspectors have carried out routine inspections of premises where food is prepared or sold. All these concerned have been issued with a copy of the Byelaws, and, generally speaking, conditions are satisfactory. If not, appropriate action is taken. During the year, the Chairman of the Highways and Health Committee made it known publically that he had received messages of appreciation from several of those engaged in the trade ,as to the helpful advice which we had been able to offer, and as to the co-operative spirit which prevailed. I feel it is appropriate in this section of the report to state that, during the year, the Council decided that free cold washes with the use of paper towels be made available in the men's and women's conveniences at the Market Place, and in the women's convenience at Eastern Road. Such facilities already existed at the men's conveniences at Eastern Road. This resolution is a highly commendable one in the interests of public health, and strengthens our hands in carrying out our clean food campaign amongst the stallholders in the Market Place. 4.—HOUSING STATISTICS FOR THE YEAR 1952 TABLE 13 Number of Houses erected during the year:— (1) By Local Authority 201 (2) By Private Enterprise 96 (3) By L.C.C. at Harold Hill Estate 1,757 1. Inspection of Dwelling-Houses during the Year:— (1)(a) Total number of Dwelling-Houses inspected for Housing Defects (under the Public Health or Housing Acts) 1,794 (b) Number of inspections made for the purpose 3,678 (2) (a) Number of Dwelling-Houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 Nil (b) Number of inspections made for the purpose Nil (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 fit for human habitation 876 2. Remedy of Defects during the year without service of Formal Notices:— Number of Dwelling-Houses rendered fit in consequence of Informal action by the Local Authority or their Officers 707 23 3. Action under Statutory Powers during the year:— (a) 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 Nil (2)Number of Dwelling-Houses which were rendered fit after service of Formal Notices:— (b) By Owners Nil (b) By Local Authority in default of owners Nil (b) Proceedings under the Public Health Acts— (1)Number of Dwelling-Houses in respect of which notices were served requiring defects to be remedied 113 (2) Number of Dwelling-Houses in which defects were remedied after service of Formal Notices:— (a) By Owners 89 (b) By Local Authority in default of owners Nil (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 5 (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 1 (2)Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been made fit Nil 4. Housing Act, 1936, Part IV—Overcrowding:— (a) 1. Number of Dwellings overcrowded at end of year 184 2. Number of Families dwelling therein 324 3. Number of Persons dwelling therein 1,285 (b) Number of New Cases of Overcrowding reported during the year 27 (c) 1. Number of New Cases of Overcrowding relieved during the year Nil 2. Number of Persons concerned in such cases Nil (d) Particulars of any cases in which Dwelling-Houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil 24 5.—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES (i) Notifiable Diseases. The great majority of Infectious Diseases are now notifiable. In this section, according to custom, I have not recorded the notifications where the diagnosis has been altered after a period of observation, unless the amended diagnosis proved the condition to be one of another type of infection which is notifiable, when the case has been appropriately recorded. Amendments to notifications are sent to the Registrar-General at the end of each quarter. (a) Acute Anterior Poliomyelitis. This is the condition popularly known as Infantile Paralysis, but this term is really a misnomer, as adults can also be affected, and several cases may show no evidence of paralysis. It is better then to use the technical term, cumbersome thought it may be. When paralysis is present, it is more easy to be sure of the diagnosis, especially during an epidemic period, but when there is no paralysis, the diagnosis, to a large extent, rests on the history available, and on the result of the examination of the cerebro-spinal fluid. In the latter, if there is no clinical evidence of meningeal irritation, it is customary to diagnose the condition as "abortive", but if there is evidence of meningeal irritation, the case is diagnosed as "non-paralytic". Altogether, there were 19 cases in the district. Two of these occurred in January, and the remainder from June onwards. Of the 19 cases, 11 had paralysis of varying degree, and 8 were diagnosed as abortive. All were removed to Hospital, as also several suspected cases, which, on further observation, were proved not to be suffering from this condition. One of the paralytic cases died in January, 1953. This year, the epidemic throughout England and Wales commenced about the middle of May, and, after an abrupt rise, reached its peak about the middle of August, when it diminished rather slowly, but steadily. Essex, however, had a relatively few number of cases until the end of July, and the peak, with slight variation, was maintained until the beginnnig of October, after which there was a slow drop. (b) Acute Infective Hepatitis. This condition continues to be notifiable throughout the Eastern Region, and there were 22 notifications received in this area. Particulars continued to be forwarded to the Regional Medical Officer at Cambridge for research purposes. (c) Diphtheria. This was another year during which no case of diphtheria was reported. 25 Routine Diphtheria Immunisation, and the giving of "booster" doses has continued, as in the past. An endeavour is being made to get children completely immunised before they reach the age of one year. The following statistics relate to the state of immunisation at the 31st December, 1952:— TABLE 14 Under 5 yrs. 5-15 yrs. Number of children who had completed a full course of Immunisation at any time up to 31st December, 1952, and who were born between 31st December, 1937, and 31st December, 1952 4,570 11,849 (d) Dysentery. Ten cases were notified as belonging to Romford. One was Amoebic in type, and this was contacted abroad. Six were due to Shigella Sonnei, and three were unclassified. (e) Food Poisoning. During the year 42 cases were notified, and proved to be suffering, or possibly suffering, from food poisoning. The following table sets out details as required by the Ministry of Health. TABLE 15 (a) Total Number of Outbreaks Nil (b) Number of Individual Cases 42 (c) Number of Deaths Nil (d) (i) Organisms or other Salmonella Salmonella Unknown Agent responsible Typhi-Murium Enteritidis (ii) Outbreaks attributable to above Nil Nil Nil (iii) Individual Cases 7 3 32 (e) Foods involved Unknown (f) Measles. Measles was in epidemic form during the year. Altogether, 1,364 cases were notified, but there were no deaths. Most of the cases were in the latter half of the year. (g) Scarlet Fever. 388 cases were notified. The type continued to be very slight. No deaths were recorded. (h) Smallpox. No cases occurred in the district, and no contact, so that there was no call for surveillance this year, 26 Table 16 gives the statistics relative to vaccination, as recorded by the general practitioners of the district. TABLE 16 Vaccinated: Under year of age 432 Between the ages of 1 and 2 years 49 Between the ages of 2 and 5 years 49 Between the ages of 5 and 15 years 71 Over 15 years 100 Re-Vaccinated: Under 1 year of age — Between the ages of 1 and 2 years — Between the ages of 2 and 5 years 5 Between the ages of 5 and 15 years 37 Over 15 years 198 (i) Tuberculosis. The work of the Medical Research Council in this area in the evaluation of immunisation by the vaccine B.G.C. continues, and, in the month of September, the unit concerned visited the district, in order to re-examine by X-rays and skin-test those children who partook of the scheme whilst at school, but who had subsequently left school. The Health Visitors have willingly co-operated with the unit, and given all assistance required. I think it is worthy of note that, during the year, there were only 14 deaths from Respiratory Tuberculosis, in spite of the fact that there has, within recent years, been an increase in the number of cases, due to patients getting a priority for rehousing on the Harold Hill Estate. For the years 1947 to 1951 inclusive, the number of deaths from Respiratory Tuberculosis were 29, 25, 28, 29, and 27 respectively. Too much reliance cannot, of course, be placed on figures for one particular year, but the reduction for 1952 is promising, and has, no doubt some relationship to the more modern methods of treatment. (j) Whooping Cough. Altogether 379 cases were notified. These were fairly evenly distributed throughout the year, and no deaths occurred. (ii) Non-Notifiable. The prevalence of these is set out below, and, as the figures are compiled from the school returns only, they are, of course, an underestimate:— TABLE 17 Mumps 73 Rubella 21 6.—SUPPLEMENTARY Section 47, National Assistance Act, 1948. It was not found necessary to take any action during the year under this section of the National Assistance Act, 1948, 27 TABLE 18 MONTHLY NOTIFICATIONS OF INFECTIOUS DISEASES Month Scarlet Fever | Diphtheria Enteric Fever Puerperal Pyrexia Pneumonia Dysentery Encephalitis Post- Infectious Erysipelas Malaria contracted abroad Measles Meningococcal Infection Ophthalmia Neonatorum Poliomyelitis Paralytic Poliomyelitis Non- Paralytic Whooping Cough Infective Hepatitis Food Poisoning Tuberculosis Total Resp. Non.Resp. January 12 — — - 1 1 — 2 - 3 — - 2 — 19 — 3 17 4 64 February 14 — — 1 3 — — 3 1 4 1 - - — 8 2 2 26 1 66 March 19 — — 1 4 - — 1 — 21 — - - — 23 1 5 20 2 97 April 12 — - 2 3 1 - 1 - 8 2 - — — 40 3 6 12 5 95 May 20 — - — 4 2 2 1 — 9 3 - — — 55 2 3 20 3 124 June 16 — — — 5 1 - - — 52 — - 1 — 40 4 6 12 1 138 July 29 - — — — 1 — — — 139 — — — 2 38 1 6 24 2 242 August 16 - - - - - - - - 186 — - 1 — 46 — 4 26 2 282 September 27 — — 1 3 2 — 3 — 69 — 1 1 2 36 — 2 19 1 167 October 77 — — 3 2 1 — 1 — 170 - — 1 — 18 1 3 25 1 303 November 86 — — — 3 1 — 2 — 208 — — 5 3 26 2 - 34 2 372 December 60 — — 1 12 — 1 3 — 495 1 — — 2 30 6 2 11 — 624 Total 388 — — 9 40 10 3 17 1 1,364 7 2 11 9 379 22 42 246 24 2,574 TABLE 19 DISEASES NOTIFIED DURING THE YEAR, DIVIDED INTO AGE GROUPS. Disease Under 1 1-2 2-3 3-4 4-5 5-10 10-15 15 20 20-35 35-45 45-65 Over 65 Total Scarlet Fever 1 12 21 33 42 235 33 6 3 2 — — 388 Diphtheria — — — — - — — — — — — — — Enteric Fever — — — — - — — — — — — - — Puerperal Pyrexia — — — — — — - 1 8 — — - 9 Pneumonia 7 3 2 1 — 7 2 — 4 4 4 6 40 Dysentery - - 1 1 — 2 2 — 2 1 1 — 10 Encephalitis—Post Infectious — — — - — — — — 1 1 1 — 3 Erysipelas — — — - — 1 — 1 — 1 8 6 17 Malaria contracted abroad — — — — — — — — 1 — — — 1 Measles 34 105 148 194 163 703 5 4 7 1 — — 1,364 Meningococcal Infection 1 2 — — — 2 1 — - 1 — — 7 Ophthalmia Neonatorum 2 — — — — — — — — — — - 2 Poliomyelitis Paralytic — 4 — 1 — 3 — - 2 1 — — 11 Poliomyelitis Non-Paralytic — — 1 — — 3 3 — 2 — — — 9 Whooping Cough 29 38 58 35 52 160 5 — 1 — — 1 379 Infective Hepatitis — — — — 1 5 4 3 4 3 2 — 22 Food Poisoning 1 5 1 2 3 5 2 3 5 7 4 4 42 Total 75 169 232 267 261 1,126 57 18 40 22 •20 17 2,304 28 29 TABLE 20 DISEASES NOTIFIED DURING THE YEAR. DIVIDED INTO WARDS. Disease Bedfords Ward. Central Ward. Collier Row Ward. Gidea Park Ward. Harold Hill Ward. Heath Park Ward. Mawney Ward. Oldchurch Ward. Total. Scarlet Fever 45 23 23 28 184 36 24 25 388 Diphtheria - - — — — — — — — Enteric Fever - - — — — - - - — Puerperal Pyrexia - — — — 3 1 2 3 9 Pneumonia 7 4 9 5 7 3 2 3 40 Dysentery - 1 4 — 2 1 1 1 10 Encephalitis—Post Infectious - — — 1 — — — 2 3 Erysipelas 3 1 3 — 2 1 7 — 17 Malaria contracted abroad - - - 1 — — — — 1 Measles 124 42 246 132 608 59 118 35 1,364 Meningococcal Infection 1 1 2 - 2 1 — — 7 Ophthalmia Neonatorum - — — 1 1 - — — 2 Poliomyelitis Paralytic — — 3 2 3 1 2 — 11 Poliomyelitis Non-Paralytic 1 — - — 4 3 — 1 9 Whooping Cough 52 1 41 38 164 28 36 19 379 Infective Hepatitis 2 — 5 2 10 1 — 2 22 Food Poisoning 2 2 32 1 1 1 3 — 42 Tuberculosis—Respiratory 8 9 17 11 174 5 12 10 246 Tuberculosis—Non-Respiratory — — 1 2 17 1 1 2 24 Total 245 84 386 224 1,182 142 208 103 2,574 TABLE 21 NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING YEAR 1952. and HOSPITAL ADMISSIONS Disease Cases Notified. Cases Admitted to Hospital Total Deaths Scarlet Fever 388 28 — Diphtheria — — — Enteric Fever — - — Puerperal Pyrexia 9 1 — Pneumonia 40 23 31 Dysentery 10 1 — Encephalitis—Post Infectious 3 1 - Erysipelas 17 1 — Malaria contracted abroad 1 - — Measles 1.364 7 — Meningococcal Infection 7 7 1 Ophthalmia Neonatorum 2 1 — Poliomyelitis Paralytic 11 11 — Poliomyelitis Non-Paralytic 9 8 — Whooping Cough 379 8 - Infective Hepatitis 22 4 - Food Poisoning 42 4 — Total 2,304 104 32 30 31 TABLE 22 TUBERCULOSIS: NEW CASES AND MORTALITY DURING 1952 AGE PERIODS. NEW CASES. DEATHS. Respiratory. Non-Respiratory. Respiratory. Non-Respiratory. M. F. M. F. M. F. M. F. 0 — — — — — — — — 1 9 3 2 - — — — — 5 8 6 5 3 — — — - 15 26 37 2 2 - — - — 25 42 47 3 3 — 2 1 — 35 22 15 3 1 2 2 — — 45 13 8 1 — 2 2 1 — 55 7 1 — - 2 1 1 — 65 and upwards 2 — - - 1 — — — Total 129 117 15 9 7 7 3 — TABLE 23. OPHTHALMIA NEONATORUM. CASES Vision Unimpaired Vision Impaired Total Blindness Deaths Notified. Treated At Home In Hospital 2 1 1 2 - — — 32 Wilson & Whitworth Ltd. Romford—'E16.53