4411 2 Lybrary BOROUGH OF ROMFORD ROM 33 Esser HEALTH DEPARTMENT ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1958 JAMES B. SAMSON, M.D.. D.P.H.. Medical Officer of Health R BOROUGH OF ROMFORD HEALTH DEPARTMENT ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1958 JAMES B. SAMSON, M.D., D.P.H., Medical Officer of Health 3 BOROUGH OF ROMFORD MEMBERS OF THE COUNCIL (As at 31st December, x958) His Worship the Mayor: Councillor F. G. Carrick, J.P. Deputy Mayor: Councillor W. S. Gardner Aldermen: Alderman F. C. Bell Alderman W. R. Pike Alderman T. W. Bradley Alderman P. D. Ridley, Aldermen Mrs. M. Clark-Lewis M.A., (Cantab.) Aldermen Mrs. L. A. Irons, Alderman G. Roberts, J.P. J.P., C.C. Alderman Mrs. O. M. J. Roberts, Alderman A. McGonagle J.P. Councillors: Councillor H. L. Barrett Councillor Mrs. O. N. Boultwood Councillor P. F. Broadhead, D.S.C. Councillor E. F. Castle, B.Com.A.C.A., C.C. Councillor E. T. Clough Councillor W. C. Coates Councillor E. W. Driscoll Councilor W. H. England Councillor F. A. Fisher Councillor A. Hawkesworth, B.E.M. Councillor W. J. Hawkins, B.A. (Com.) Councillor E. H. Jarvis Councillor A. C. Latham Councillor R. Lowley Councillor M. Monk Councillor J. Raeburn Councillor D. Raper Councillor V. Rowlands, A.M.I.E.E. Councillor W. G. Russell Councillor E. E. Stallard Councillor G. E. Waller Councillor M. J. Ward, B.A. (Admin.) Councillor W. A. White Councillor F. W. Wright Councillor H. F. Wright 4 BOROUGH OF ROMFORD PUBLIC BUILDINGS AND HEALTH COMMITTEE His Worship the Mayor: Councillor F. G. Carrick, J.P. (ex-officio member) Chairman: Councillor W. S. Gardner Vice-Chairman: Councillor D. Raper Councillor P. F. Broadhead, D.S.C.Councillor W. J. Hawkins, Councillor E. F. Castle, B.A.(Com.) B.Com., A.C.A., C.C. Councillor R. Lowley Councillor E. T. Clough Councillor M. J. Ward, B.A. (Admin.) 5 HEALTH DEPARTMENT Public Health Staff (As at 31st December, 1958) Medical Officer of Health J. B. Samson, M.D., Ch.B., D.P.H. Assistant Medical Officers (a) N. P. Bhandari, M.B., B.S., M.R.C.S., L.R.C.P., C.P.H. (b) J. J. Duffy, M.B., B.Ch., B.A.O., D.P.H. (c) Mrs. E. M. Haga, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. (d) Miss S. R. Ingold, M.B., B.S., M.R.C.S., L.R.C.P., M.(Obst.). R.C.O.G. Dental Officers (a) Mrs. F. Ell, Registered Dentist. (Part Time). (b) Miss M. L. Ell, L.D.S., R.C.S., (Eng.). (c) Mr. L. Morrissey, B.D.S. (Part-time). (Commenced duties 12th May). Public Health Inspectors (a) H. C. Boswell (A.B.) (Chief Public Health Inspector). (b) W. Hodson (A.B.). (Senior Assistant Public Health Inspector). (c) M. J. Dove (A.B.). (d) P. W. Edwards (A.B.). (e) G. D. John (A.B.). (f) T. E. R. Jones (A.B.). (g) G. F. Hobson (A.B.). (h) M. J. Lee (Pupil). A. Sanitary Inspector's Certificate of the Royal Sanitary Institute, and Sanitary Inspectors' Joint Examination Board. B. Certificate of the Royal Sanitary Institute for Inspectors of Meat and Other Foods. 6 Health Visitors Superintendent: Miss F. K. Wells (A.B.D.). (a) Miss A. D. Batt (A.B.D.G.). (b) Miss B. C. Blackley (A.B.D.E.G.). (c) Miss G. Brocklebank (A.C.D.G.). (d) Mrs. J. A. Child (A.B.D.G.). (e) Miss O. Clements (A.B.D.F.G.). (f) Mrs. F. Court (A.C.D.G.). (g) Miss P. F. Cullis (A.B.D.G.). (h) Miss D. I. A. Hall (A.B.D.G.). (i) Mrs. B. Kersey (A.C.D.G.). (j) Mrs. M. K. Pressey (A.B.D.G.). (k) Mrs. M. Rigby (A.B.D.G.). (Commenced duties 17th February). (1) Mrs. L. Thompson (A.B.D.G.). (m) Miss A. M. Tidd (A.C.D.F.G.). Tuberculosis Visitors (a) Miss E. G. Govan (A.B.E.). (b) Mrs. F. C. Marshall (A.E.F.). (c) Miss B. Mulligan (A.E.). Domiciliary Midwives (a) Miss I. A. Bassett (B). (b) Miss M. Dove (A.B.). (Commenced duties 21st July). (c) Miss E. E. Jeenes (A.B.). (d) Mrs. K. Jenkinson (B.). (Commenced duties 15th September). (e) Miss G. Jones (A.B.F.). (f) Miss C. M. Kerr (A.B.). (g) Miss D. D. Martin (A.B.). (h) Mrs. G. Merry (A.B.). (i) Mrs. M. Mylward (B.). (j) Mrs. E. Pougher (B.). (Commenced duties 4th June), (k) Mrs. E. A. Rooks (B.). (l) Mrs. G. E. Sexton (A.B.). Queen's Certificate of District Nursing. (m) Mrs. F. Smith (B.). (Commenced duties 20th October). 7 Home Nurses (a) Mrs. E. M. Andrews (A.). (b) Mrs. E. M. Broome (A.). (c) Mrs. E. D. Carrington (A.B.). Queen's Certificate of District Nursing. (d) Mrs. B. Casey (A.C.). (e) Mrs. C. Cook (A.). (f) Mrs. J. Jennings (A.B.). (g) Mrs. I. Norris (A.). Queen's Certificate of District Nursing. (h) Mrs. J. D. Silcock (A.B.). (i) Mrs. D. I. Towell (A.). (j) 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. Certificate of Tuberculosis Nursing. F. Registered Fever Nurse. G. Also holds the appointment of School Nurse. Domestic Help Organiser Miss N. Keay. (Commenced duties 5th May). Day Nurseries—Matrons "St. Moritz" Mrs. I. C. Bowyer, S.R.N. Collier Row Mrs. D. Stinson, S.R.N. Rush Green Mrs. R. M. O'Halloran, S.R.N., R.F.N. Domiciliary Occupational Therapist Miss Z. Mercer, Registered Occupational Therapist (Part-time). (Commenced duties 6th October). Dental Attendants (a) Mrs. L. Bond. (Commenced duties 3rd March). (b) Mrs. K. Goulding (Part-time). (c) Mrs. H. E. Lightfoot. (d) Mrs. M. Tisdall (Part-time). (Commenced duties 12th May). (e) Mrs, M. Warder. 8 Clerical Assistants (a) E. W. Gowers, Chief Administrative Assistant. (b) C. G. Humberston, Senior Administrative Assistant. (c) E. Lamb, Administrative Assistant. (d) A. V. Tibbitt, Administrative Assistant. (e) S. A. A. Bowers. (f) Miss M. E. Firmin. (g) Mrs. B. Mather. (h) Mrs. M. Barnard. (Part-time). (i) Mrs. F. Butt. (j) Mrs. D. E. Cast. (k) Mrs. S. Corner. (1) Miss R. Harvey. (m) Mrs. L. Holding (Part-time). (n) Miss P. Mann (Part-time). (Commenced duties 9th January). (o) Mrs. S. Moss. (p) Mrs. J. Nichols (Part-time). (q) Miss J. V. Saggers. (r) Miss G. Smith. (s) Miss A. Vale. (t) Miss V. C. Warren. Harold Hill Health Centre Nursing Staff Mrs. W. Clegg, S.R.N. Mrs. R. Reed, S.R.N. (Commenced duties 21st July). Clerical Assistants Miss M. O. Little. Miss R. Markram. Miss A. Wright. 9 BOROUGH OF ROMFORD To His Worship The Mayor, Aldermen, and Councillors of the Borough of Romford. Me. Mayor, Ladies and Gentlemen, I have the honour, herewith, to present to you, this, my Annual Report on the Health of the District for the year 1958. This is the Twenty-fifth 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, and with Circular No. 22/58 of the Ministry of Health, dated 9th December, 1958. As is known, the position I hold is a "mixed" one, being that of Medical Officer of Health for the Borough, and Area Medical Officer lor the Romford Area of the Essex County Council. For convenience the work of both appointments is comprised in this one Report. My best thanks, as usual, go to all members of the Borough Council, and the Health Area Sub-Committee; to the members of my staff; and to my fellow officials for their kind assistance throughout the year, and for their ever ready co-operation in all matters likely to further the interests, and well-being of the residents in this town. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, JAMES B. SAMSON, Medical Officer of Health. Public Health Department, Town Hall, Romford. (Tel.: Romford 46040). May, 1959. 10 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year 1958 Statistics and Social Conditions of the Area Area (in acres) 9,342 Population: Census (1951), 88,002; Mid. 1958 (Estd.) 113,700 Number of Inhabited Houses (end of 1958) 32,255 Rateable Value (end of 1958) £1,489,036 Product of Penny Rate (end of 1958) £5,880 Extracts from Vital Statistics for the Year Total M. F. Live Births: Legitimate 1,982 1,025 957 Illegitimate 71 31 40 Birth Rate: 15.2 per 1,000 of estimated resident population. Still Births: Legitimate 45 25 20 Illegitimate 3 2 1 Rate per 1,000 total (live and still births): 23.8 Deaths 810 435 375 Death Rate: 11.1 per 1,000 estimated resident population. Rate per 1,000 total (live and still) births Deaths from Puerperal causes 0.48 Death Rate of Infants under one year of age:— All Infants per 1,000 live births 19.5 Legitimate Infants per 1,000 legitimate live births 19.7 Illegitimate Infants per 1,000 illegitimate live births 14.1 Deaths from Cancer (all ages) 168 Deaths from Measles (all ages) — Deaths from Whooping Cough (all ages) — Deaths from Diarrhoea (under 2 years of age) — 11 TABLE 1 BIRTH-RATES, DEATH-RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY, and CASE-VRATES for certain Infectious Diseases in the year 1958. England and Wales, and Romford. (Provisional Figures based on Weekly and Quarterly Returns) RATE PER 1,000 POPULATION DEATH-RATE PER 1,000 POPULATION RATE PER 1,000 LIVE BIRTHS Live Births Still 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 England and Wales 16.4 0.36 11.7 0.00 0.00 0.00 0.10 0.06 0.00 0.00 0.64 0.4 22.5 ROMFORD 15.2 0.42 11.1 0.00 0.00 0.00 0.06 0.03 0.00 0.00 0.38 0.0 19.5 The Maternal Mortality Rate for Romford is as follows : Per 1,000 Total Live and Still Births — 0.48 The Maternal Mortality Rate for England & Wales is as follows : Per 1,000 Total Live and Still Births — 0.43 12 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 65-74 75 to upword 1. Tuberculosis, respiratory 3 4 7 .. .. .. .. .. .. 1 2 1 2 1 2. Tuberculosis, other .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Syphilitic disease 1 1 2 .. .. .. .. .. .. .. .. 1 1 .. 4. Diphtheria .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5. Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Meningococcal infections .. 2 2 .. .. .. .. .. .. 1 .. 1 .. .. 7. Acute poliomyelitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9. Other infective and parasitic diseases 3 .. 3 1 .. .. .. .. .. 1 1 .. .. .. 10. Malignant neoplasm, stomach 14 6 20 .. .. .. .. .. .. 2 2 .. 7 9 11. Malignant neoplasm, lung, bronchus 43 8 51 .. .. .. .. .. .. 1 4 20 17 9 12. Malignant neoplasm, breast .. 16 16 .. .. .. .. .. .. 1 5 3 3 1 13. Malignant neoplasm, uterus .. 4 4 .. .. .. .. .. .. 1 1 2 .. .. 14. Other malignant and lymphaticneoplasms 46 31 77 .. .. .. 1 4 2 3 12 22 22 11 15. Leukaemia, aleukaemia 6 6 12 .. .. 1 .. 2 .. 1 1 3 2 .. 16. Diabetes 3 3 6 .. .. .. .. .. .. .. .. 1 3 11 17. Vascular lesions of nervous system 28 57 85 1 .. .. .. .. .. 4 6 7 22 45 18. Coronary disease, angina 85 53 138 .. .. .. .. .. .. .. 20 24 53 41 19. Hypertension with heart disease 6 2 8 .. .. .. .. .. .. .. .. 3 2 3 20. Other heart disease 35 50 85 .. .. .. .. .. 1 4 5 10 16 .. 21. Other circulatory disease 13 19 32 .. .. .. .. 1 1 2 3 6 8 11 22. Influenza 2 1 3 .. .. .. 1 .. .. .. 1 .. .. 1 23. Pneumonia 18 25 43 4 1 1 .. .. .. .. 3 3 13 .. 24. Bronchitis 49 16 65 1 .. 1 .. .. .. 1 5 12 30 .. 25. Other diseases of respiratory system 3 3 6 .. .. .. 1 .. 1 .. .. 1 3 .. 26. Ulcer of stomach and duodenum 3 6 9 .. .. .. .. .. .. .. 1 .. 2 6 27. Gastritis, enteritis, and diarrhoea .. 1 1 .. .. .. .. .. .. .. .. 1 .. .. 28. Nephritis and nephrosis 3 9 12 .. .. .. .. .. .. .. 3 3 3 3 29. Hyperplasia of prostrate 3 .. 3 .. .. .. .. .. .. .. .. .. .. 3 30. Pregnancy, childbirth, abortion .. 1 1 .. .. .. .. .. 1 .. .. .. .. .. 31. Congenital malformations 13 4 17 13 .. .. 1 2 .. 1 .. .. .. .. 32. Other defined and ill-defined diseases 37 36 73 20 1 1 1 1 3 2 6 8 13 17 33. Motor vehicle accidents 4 .. 4 .. .. .. .. 1 .. 1 2 .. .. 2 34. All other accidents 8 3 11 .. .. 1 1 1 1 2 2 1 .. .. 35. Suicide 5 8 13 .. .. .. .. .. .. 4 3 5 .. .. 36. Homicide and operations of war 1 .. 1 .. .. 1 .. .. .. .. .. .. .. .. Total 435 375 810 40 2 6 6 12 10 33 88 138 223 252 13 This year the Registrar-General has given his estimate of the midyear population of Romford as 113,700, which compares with 111,800 for last year, an increase of 1,900. During 1958, the total number of live births registered was 2,053, and the total number of deaths registered was 810, the difference of 1,243 gives the natural increase in the population. As this number again falls short of the Registrar-General's estimated increase of 1,900, it again follows that the balance of 757 is made up of Immigration over Emigration. For 1958, we estimate the Birth Rate to be 15.2 per 1,000 of the estimated resident population. This figure is obtained by multiplying the Crude Birth Rate of 18.1 by the Comparability Factor of 0.84. For last year the Rate was 14.9. The Rate for England and Wales is given as 16.4. The Death Rate for Romford is estimated at 11.1 per 1,000 of the estimated resident population. This figure is obtained by multiplying the Crude Death Rate of 7.1 by the Comparability Factor of 1.57. For last year the Rate was 9.8. The comparable Rate for England and Wales is 11.7. 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. 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 0.48. The Infant Mortality Rate, or the Death Rate of Infants under one year of age per 1,000 live births is 19.5, an increase of 1.3 compared with 1957. The corresponding figure for England and Wales is 22.5. 14 1.—GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA (i) Staff The particulars of staff are set out at the beginning of this report. The Assistant Medical Officers, Dental Staff, Nursing Staff, Domestic Help Organiser, and also some of the Clerical Staff come under the jurisdiction of the Essex County Council, who are the Local Health Authority for the Part iii duties of the National Health Service Act, 1946, (ii) Laboratory Facilities The Laboratory facilities remain the same, and meet our requirements, and those of the General Practitioners. (iii) Nursing in the Home (a) General. At the end of the year 10 Home Nurses were serving the area. These were employed in general domiciliary nursing. Sick-room equipment has again been available for distribution on loan, free of charge, in accordance with Section 28 of the National Health Service Act. Table 3 sets out the work of the Home Nursing service during the year. TABLE 3 (1) Number of visits paid 23,981 (2) Number of cases attended 1,155 (b) Domiciliary Midwives. At the end of the year 12 Domiciliary Midwives were employed, and assistance was also obtained, throughout the year, from the Solvation Army Midwives. The following gives a summary of the cases attended by the Domiciliary Midwives, as Midwives, and as Maternity Nurses. TABLE 4 As Midwives 885 As Maternity Nurses 52 Table 5 gives a summary of the "Medical Aid" notices received during the year. TABLE 5 (1) Where the medical practitioner had arranged to provide the patient with maternity services, under the National Health Service 6 (2) Others 60 15 (iv) Ante-natal Clinics Three Ante-natal sessions are held each week. When required, use has again been made of the Consultative Clinic at Oldchurch Hospital. During the year 273 individual expectant mothers attended the Ante-natal Clinics, of which 155 sessions were held. The total number of attendances of the Ante-natal mothers was 1,544, giving an average of 5.7 attendances per patient. The average number attending at each session was 10.0 (v) Child Welfare Clinics Twelve Child Welfare sessions are held each week. Altogether, there were 612 sessions, and the following table gives a summary of the attendances. TABLE 6 Individual children attending 3,345 Children under one year attending for the first time 1,497 Medical consultations 6,188 Attendances of children under one year of age 18,349 Attendances of children between the ages of one and five years 5,187 Average attendance per session 38.5 (vi) Health Visitors At the end of the year, there were 13 Health Visitors. All of them also acted as School Nurses. Table 7 relates to Home Visits paid by the Health Visitors in connect on with their duties under Maternal and Child Welfare. TABLE 7 (a) To Expectant Mothers: — First Visits 142 Total Visits 216 (b) To Children under one year of age: — First Visits 2,041 Total Visits 5,794 (c) o Children between the ages of one and five years:— Total Visits 7,583 (vii) Inspection of Nursing Homes There are three Nursing Homes registered in the district. These were all inspected, on four occasions during the year, when the conditions were found to be satisfactory. 16 (viii) Domestic Helps The requests for this service again remained fairly constant. During the year 112 Part-time, and Casual Helps were employed, and they attended 607 individual cases. Tuberculous patients have again, when required, been given domestic assistance, by specially recruited volunteers. (ix) Day Nurseries The three Day Nurseries continued on the same lines, as hitherto. The average daily attendances for the year at each Nursery is shown below : TABLE 8 "St. Moritz" Nursery 29 Collier Row Nursery 21 Rush Green Nursery 25 The "St. Moritz" and Collier Row Nurseries are scheduled to take 40 children each, and the Rush Green Nursery 50 children. (x) Dental Service At the end of the year, the number of Dental Officers had, unfortunately, diminished to one whole-time, and two part-time; the latter giving between them nine sessions per week, of which three were evening sessions. This problem of recruitment is a national one, and is not peculiar to Essex. The Consultant Anaesthetist has continued to attend on one session per week, for the purpose of administering general anaesthetics to the more difficult cases. The following' gives particulars of the work done during the year for expectant and nursing mothers, and children under school age. TABLE 9 (a) Numbers provided with Dental care:- Examined Needing Treatment Treated Made Dentally Fit Expectant and Nursing Mothers 41 28 26 16 Children under Five 283 198 182 188 (b) Forms of Dental Treatment provided:- Extractions Anaesthetics Fillings. Scalings or Scalings and Gum Treatment Silver Nitrate Treatment Dressings Radiographs Dentures provided Local General Complete Partial Expectant and Nursing Mothers 42 36 5 93 13 3 4 2 9 14 Children under five 186 23 143 509 4 34 20 - - - 17 (xi) Harold Hill Health Centre The work in the Local Authority section has proceeded on the same lines as last year, and has met with similar satisfaction. So far as this particular section is concerned, the services provide for Maternal and Child Welfare, and the care of the health of the School Child. This embraces Ante-natal, and Post-natal consultations, and examinations, Mothercraft lectures, Ante-natal exercises, Child Welfare Clinics, Minor Ailment Clinics, Speech Therapy, Dental Sessions, Immunisation Sessions, etc. The four suites in the General Practitioners' section have again been utilised by the same eight practitioners, or their partners or assistants and nursing staff and clerical assistants, provided by the Local Health Authority, are at their disposal. The necessary equipment is also provided by the same Authority. The Regional Hospital Board are responsible for the provision of the Ophthalmic and Orthopaedic services, and the Executive Council for the General Dentistry. 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 1958, other than those for supply to permanent housing sites. (b) Lengths of mains laid, in yards:— 3" 4" 6" 9" 12" 21" Romford Area 1,744 1,837 16 6 2 114 (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 4,080 Chemical, Bacteriological, and Biological examinations have been made. In addition, samples were examined for radoactivity. (e) The waters are not liable to plumbo-solvent action. (f) No contamination has arisen, therefore, no action has been necessary." 18 In addition to the analyses carried out by the Waterworks Company, samples have also been taken from consumers' taps by the Public Health Inspectors, and sent lor 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 Chief Public Health Inspector has given me the undermentioned report, as required by Article 27 (18) of the Sanitary Officers' (Outside London) Regulations, 1935, and also the particulars which follow:— During the year, 1,713 complaints were received, and investigated, and 6,097 visits were made for this purpose. TABLE 10 Nature and Number of Inspections During the Year Accumulations and Refuse Deposits 234 Atmospheric Pollution (Clean Air Act) 94 Bakehouses 42 Butchers' Shops and Stalls, etc. 301 Cesspools 86 Common Lodging Houses 8 Dairies and Milkshops 185 Drains, relaid and altered 386 Drainage—obstructed or defective 607 Drains Tested and inspected 882 Disinfections and Disinfestations 12 Diseases of Animals Act 60 Dustbins 38 Establishments for Massage and Special Treatment 10 Factories Act (Mechanical Power) 128 Factories Act (Non-mechanical) 24 Factories Act (Outworkers Premises) 397 Food Preparing Premises 322 Food Hawkers 87 Food Hygiene Observations 623 Food Inspections 513 Food Sampling—Formal 1 Food Sampling—Informal 349 Food Shops 580 Food Vehicles 65 Housing Acts—General 315 Housing—Rent Act, 1957 589 Heating Appliances (Fireguards) Act, 1952 245 Ice Cream Vendors 151 Infectious Disease 874 Insects and pests 54 Keeping of Animals 146 Milk Sampling 126 Miscellaneous 1,273 Markets 182 Nuisances, Public Health Act 2,510 19 Pet Animals Act 1951 49 Prevention of Damage by Pests Act, 1949 2,478 Public Baths 15 Public Conveniences 43 Rag Flock Act 6 Sale of Horseflesh 19 Schools and School Canteens 56 Shops Act—All Sections 4,555 Slaughterhouses 1,060 Smoke Observations 68 Streams, Ponds and Watercourses 196 Tents, Vans and Sheds 65 Verminous premises 34 Water Closets 22 Water Supplies 78 Informal Notices (number served) 544 Statutory Notices (number served) 108 As a result of the service of Notices, the necessary works were completed by the owners or occupiers in all cases except 113, the works for which were still in hand at the end of the year. Notices served under the Shops Act 44 Notices served under the Food and Drugs Act 43 (iii) Factories Acts 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 14 17 2 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 284 128 5 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding Outworkers premises) 92 27 - - Total 390 172 7 - 20 2. Cases in which Defects were Found Particulars No. of Cases in which defects were found No. of Cases in which prosecutions instituted Found Remedied Referred to H.M. Inspector by H.M. Inspector Want of Cleanliness 2 2 - - - Overcrowding — — — — — Unreasonable Temperature - - - - - Inadequate Ventilation - - - - - Ineffect. drain. of floors - - - - - Sanitary Conveniences— - - - - - (a) Insufficient 1 1 - 1 - (b) Unsuitable or defective 4 4 - 4 - (c) Not separate for Sexes - - - - - Other Offences - - - - - Total 7 7 - 5 - 3. Outwork. Nature of Work No. of OutWorkers in August List 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 Prosecutions Wearing Apparel— Making, etc. 22 - - - - - Box Making 7 - - - - - Total 29 - - - - - During the year 397 inspections were made of Outworkers' promises, (iv) Caravan Sites. There are in the area six licensed caravan sites; two of these now being controlled by the Council. Altogether, there are 299 caravans on these sites. In general, they are maintained in a satisfactory condition. In addition to the above, there are seven individual caravans licensed for residential purposes. Quite a number of gipsy caravans visit the district during the course of the year, and encamp on waste land in the north of the Borough. These nomads cause a considerable nuisance to householders in the neighbourhood, by their insistent demands for water, and by their very low standards of hygiene. The Public Health Inspectors have spent a considerable amount of time in securing their removal, and the police have been very co-operative in this respect. 21 (v) Prevention of Damage by Pests Act, 1949. During the year the Public Health Inspectors and Rodent Operative carried out 2,478 inspections, or re-inspections, to premises suspected of being infested by rats or mice. Further maintenance treatment, in respect of rat disinfestation to sewers, was undertaken during the year. In addition to rats and mice, a number of complaints were received concerning grey squirrels, pigeons and moles, advice was given in all instances, and where special treatment was necessary the matters were referred to the County Pest Officer. Towards the latter end of the year a number of complaints were received from the Havering area concerning damage caused by badgers and foxes. The assistance of the County Pest Officer was obtained, and, in conjunction with the police, an organised shoot was arranged, but unfortunately no foxes were seen. (vi) Disinfestation. Advice is given on all cases of infestation. Where the infestation is slight the Council has agreed to the work of disinfestation being carried out by the Rodent Operative, under the supervision of a Public Health Inspector, the charge made being based on labour and material. When the infestation is found to be severe, the persons concerned are advised to employ the services of specialist firms. During the year assistance has been given to householders in ridding premises of wasps, carpet beetles and other troublesome insects. (vii) Pet Animals Act, 1951. Fiiteen persons are licensed to keep Pet Shops. Frequent inspections are carried out. 3.—INSPECTION AND SUPERVISION OF FOOD (i) Milk Supply. At the end of the year 47 firms were registered as Retailers, or Distributors. Of these, 18 were licensed to retail Tuberculin Tested Milk, 25 were licensed to retail Pasteurised Milk, and 41 were licensed to retail Sterilised Milk. Or e Pasteurising plant has been kept under surveillance by the department. During the year, 116 samples of milk were taken, and all passed 'he prescribed tests. 22 (ii) Ice Cream. There were at the end of the year one manufacturer, and 220 vendors on the register. During the year, 43 samples were taken for Bacteriological examination, and, of these, 31 were satisfactory, and 12 unsatisfactory. Twelve samples of ice-lollies were taken, and, of these, 10 were satisfactory, and 2 unsatisfactory. (iii) Meat. There are three licensed slaughterhouses in the Borough, one of these being licensed for the slaughter of horses, as well as livestock. The Inspectors attend regularly to ensure that 100% inspection is maintained. During the year under review, 1,060 such visits were made. During this period, a total of 22,628 animals were slaughtered, and a total of 20 tons, 9 cwts., 9 lbs. of meat was found to be unfit for human consumption. This was disposed of for animal feeding through the recognised channels. Table 12 sets out the particulars of the carcases inspected, and condemned. There are also four Wholesale Meat Depots, and 72 Butchers' Shops in the Borough, and, during the year, 301 inspections were made of these premises. (iv) Food Products in General. In addition to the premises used for Milk, Ice Cream, and Meat, referred to above, the following are registered under the Romford Urban District Council Act, 1931, and are subject to the Clean Food Byelaws. Bakers 31 Cafes 58 Confectioners 62 Fishmongers 31 Greengrocers 58 Grocers 143 Miscellaneous 14 Hawkers 49 There are also 45 food stalls situated in the Market Place on. three days of the week. All the above are regularly inspected. During the year, 1,835 such inspections were made, and 43 informal notices were served Many improvements were obtained, and the majority of the food shops now have constant hot water for washing purposes. (v) Unsound Food. During the year, 513 visits were made to food premises, mainly on request, for the purpose of dealing with unsound food, and a total of 15 tons, 1 cwt., 26 lbs. of food was surrendered, as unfit for human consumption. Where possible, all unsound food is disposed of for animal feeding, and the remainder is dealt with by the Cleansing Department. 23 TABLE 12 CARCASES INSPECTED AND CONDEMNED 1958 Cattle except Cows Cows Calves Sheep and Lambs Pigs Horses TOTAL Number killed (if known) 1,604 1,212 201 8,623 10,679 305 22,624 Number inspected 1,604 1,212 201 8,623 10,679 305 22,624 All diseases except Tuberculosis. Whole carcases condemned 3 18 4 29 20 1 75 Carcases of which some part or organ was condemned 296 542 — 229 433 19 1,519 Percentage of the number inspected affected with diseases other than tuberculosis 18.58% 46.20% 1.99% 2.76% 4.24% 6.89% 7.04% Tuberculosis only. Whole carases condemned 5 12 — — 6 — 23 Carcases of which some part or organ was condemned 46 155 — — 183 — 384 Percentage of the number inspected affected with tuberculosis 3.18% 13.78% — — 1.77% — 1.8% 24 (vi) The Food and Drugs Act, 1955. During 1958, 350 samples were submitted for analysis, comprising one Formal, and 349 Informal. Table 13 sets out the types of food examined. Of the 349 informal samples taken, 27 proved to be not genuine. Eleven of these did not call for any particular action. The Public Analyst reported as follows on the remaining 16 : Baked Fruit Pudding This sample was submitted as the result of a complaint that it had a "soapy taste," the examination showed that the objectionable taste was due to the use of rancid oil or fat. This information was forwarded to the school canteen where the pudding was made. Ice Lollies (2) i. This sample was found to be not genuine on two counts. In the first instance examination showed that it contained lead to the extent of 1.6 parts per million. The lead content should not exceed 1.0 parts per million. Secondly, the list of ingredients printed on the wrapper in which the lolly was sold stated:— "Sugar, saccharin, citric acids, milk solids, pectin, saccharin and colouring." Examination of this lolly showed that it contained no appreciable quantity of fruit pulp and the proportion of fruit juice was less than 2 per cent, and that the lolly was poor in respect of its content of milk solids. This information was forwarded to the authority in whose area the lolly was manufactured. ii. This sample was described on the wrapper as being a "Pure Fruit Lolly." On examination it was found that the fruit juice content did not exceed 1 per cent, which quantity, in the opinion of the Public Analyst, was insufficient to justify the description " Pure Fruit Lolly." Whilst it is not suggested that an article described as a pure fruit lolly should be prepared entirely from fruit juice, nevertheless it is not unreasonable to expect that the fruit juice content should net be less than that required to be present in a fruit drink prepared for direct consumption without dilution. The minimum quantity of fruit juice required by the Soft Drinks Order is 5 per cent. This information was forwarded to the authority in whose area the lolly was manufactured, and improvements were obtained. 25 Milk This was a one-third pint bottle of school milk submitted as the result of a complaint that it contained a brownish foreign matter. Examination showed that a small mass of foreign matter in suspension and a brownish stain on the inner surface of the bottle consisted of mould growths. This matter was taken up with the milk suppliers and afterwards reported to the Public Building's and Health Committee. After considering all the circumstances the Committee resolved to send a warning letter to the suppliers. Pork Sausages This sample on analysis was found to contain only 55 per cent of meat and was considered to be unsatisfactory. Although there is no official standard for the meat content of pork sausages, the Association of Public Analyst have arrived at a tentative standard and agree that pork sausages should contain not less than 65 per cent meat. Further samples from the same producer proved to be satisfactory. Salmon Paste and Sweets The reason for considering these two foodstuffs together is that they shared one common factor, namely that they both contained a non-permitted coal tar colour. On examination both these foods were found to contain Rhodamine B which is not one of the colouring agents which are permitted by the Colouring Matter in Foods Regulations 1957. These Regulations came into operation in June, 1957. Prior to the passing of these regulations a manufacturer could use almost any organic colouring matter in his food products with the exception of about six prohibited yellow dyes. The number of synthetic food colours which may now be used in the preparation of foodstuffs is restricted to some thirty which are defined in the Regulations. As is customary with new legislation, the Regulations allowed a period of time for the manufacturers to adjust their formulae to comply with the Regulations. On enquiries being made, it was found that the foods referred to above were manufactured before the Regulations became fully operative. Soups (Dehydrated) (7) During the year seven packets of soup powders submitted for analysis proved to be unsatisfactory, one of these was a vegetable soup and the remaining six were meat soups. The relevant portions of the reports on these soups is set out below:— (i) Sample No. B/191. Oxtail Soup. " . . . the proportion of oxtail is small. In my opinion therefore this soup powder would be more properly described as oxtail flavour soup." 26 (ii) Sample No. B/273. Cream of Leek Soup. "... after preparation the fat content of the resulting soup would not exceed 1.0% by weight. In my opinion the description "cream soup" should only be applied to a preparation which yields a final soup containing' not less than 3½% of edible oil or fat, or if the fat is butter, not less than 2½% of butter fat. In my opinion therefore this preparation contains insufficient fat to justify the description "Cream of Leek Soup." (iii) Sample No. B/278. Clear Chicken Soup. "... the constituents of the sample included the following substances in proportions as under:— Salt 43.1% Total fat 22.8% Monosodium Glutamate Meat extractives and chicken meat (stated as protein) 12.2% Soup prepared in this manner (as directed on the packet) would contain meat extractives and chicken meat equivalent to only 0.3% of protein. The greater part of the flavour of the soup would be due to to the salt and the monosodium glutamate (an artificial meat flavouring). In my opinion the total protein in the form of meat extractives and chicken meat is insufficient to justify the description " Chicken Soup. (iv) Sample No. B/279. Clear Beef Soup Mix. The report is substantially the same as the above, except that the final soup preparation would contain meat extracts equivalent to only 0.17%. The Analyist's opinion is the same. (v) Sample No. B/281. Chicken Noodle Soup. "... soup prepared according to the directions given on the lab .1 would contain only 0.7% of lean chicken meat. In my opinion the proportion of chicken in the final soup is poor tor an article described as " Chicken Noodle Soup." (vi) Sample No. B/299. Chicken Noodle Soup. The report is identical to the above except that the proportion ox chicken meat is 0.8%. (vii) Sample No. B/300. Oxtail Soup. " From the order of the ingredients the proportion of oxtail is small and in my opinion this soup would be more properly described as " Oxtail Flavour Soup." In reporting on these soup powders generally, the Public Analyst states that in his opinion the meat content of the soups is very poor and that they should not be described as meat soups but as meat flavoured soups, e.g., Oxtail Flavour. The Public Analyst reported that the flavour of these soups would be due to the salt and to the artificial meat flavouring agent, monosodium glutinate. The Code of Practice for soups laid down by the Ministry of Food refers to canned soups and there is some doubt as to whether this code can be applied to products obtained from soup powders. 27 The point at issue is whether these soups are to be sold merely as appetisers, with no nutritive value, or whether they would be comparable with canned soups in quality. In my opinion and that of Dr. Hamence, the Public Analyst, if these substances are to be described as "soup" they should have a reasonably high nutritive value, which at present they have not, if they are to continue being' sold in their present form the manufacturers should be compelled to describe them as, e.g., "Oxtail Flavour Soup." Any member of the public demanding "Oxtail Soup" or "Beef Soup "or" Chicken Soup" is entitled in my view, to expect to be supplied with a nutritious soup and not a preponderantly chemical appetiser. The more of these samples that are analysed the more convinced the Public Analyst and myself become of the urgent need for some rigid form of standardisation, not only as regards the composition of the soups but also as regards the labelling and advertising. Labelling is particularly emphasised in the case of sample No. B/299 Chicken Noodle Soup, the illustration on the packet depicts a very large chicken surrounded by a small quantity of noodles—this being completely out of proportion with the actual composition of the soup. Canned Soup Cream of Celery' Soup. "... the constituents of the sample included the following substances in proportions as under:— Fat 3.0%. In my opinion Cream Soup should contain at least 3½ per cent of fat, or, if the fat is wholly butter fat, at least 2½ per cent of fat. The sample therefore contained insufficient fat to justify the description Cream of Celery Soup. (vii) Food Hygiene Regulations, 1955 The Public Health Inspectors continue to devote a considerable amount of time to the inspection of food premises of all types to ensure that the requirements of the above Regulations are complied with. Provision is not made in these Regulations for the service of Statutory Notices in the case of contraventions and, legally, every contravention found by the inspectors could result in prosecution. However, in practice, it is rare that the contraventions observed are sufficiently serious as to warrant immediate legal action. When contraventions are noted, they are immediately drawn to the attention of the occupier, and the need for improvement explained. This verbal intimation is always followed by a letter, indicating the nature of the offence, and allowing the offender a period of grace in which to comply with the Regulations. This procedure has been adopted with a view to educating food traders, rather than to prosecute, and it appears to be paying dividends as the general standard of the food shops in the district has greatly improved during the past two years. In addition to the inspection of food shops and restaurants, frequent visits are made to factory and school canteens, and other food preparing premises The two main difficulties experienced with the enforcement of the Regulations are (a) the protection of open foodstuffs exposed for sale on stalls in the open market and (b) smoking by food handlers. 28 It has been extremely difficult to impress on stallholders the real need for protecting food from contamination in the open air, but, after much perseverance, there is evidence of improvement. As regards smoking, the main difficulty is that this habit is so widespread and ingrained and some food handlers, especially stallholders, do not appreciate that they should be subjected to this prohibition, whilst the customer is not. Few people appear to appreciate that the reason for prohibiting the use of tobacco including snuff, whilst handling open food is that the habit brings the fingers into close contact with the nose and mouth both possible reservoirs of food poisoning germs, the hands thus become contaminated, and the contamination is then transferred to the foodstuffs. During the past year it was necessary to prosecute twelve persons for smoking, whilst handling open food, nine of these being stallholders in the Market. Unfortunately, the Courts do not take a very serious view of this offence, as the fines imposed were purely nominal, varying from £\ to £5. Onion Peelers As from the 1st June, 1958, the giving out " for reward " of food for preparation for human consumption on domestic premises is prohibited. The peeling of prawns, shrimps and onions is permissible on domestic premises, provided those premises are registered with the local authority, and that the principal provisions of the Regulations are observed. In this district there are 121 premises registered for the peeling of onions. The onions are distributed and collected by a large firm of pickle manufacturers, whose premises are situate in Barking. It is the responsibility of the suppliers to inspect these premises to ensure that conditions are satisfactory before applying for registration; the premises are afterwards subjected to inspection by the Public Health Inspectors. Generally, these premises are quite satisfactory, and the work is carried out under cleanly conditions. It has only been necessary to refuse registration in a few instances. On being requested, the firm readily supplied washable linen bags for the onions to be packed in after peeling. It is not wholly desirable that this type of work should be permitted in domestic prem ses, and it is hoped that in the near future pickle manufacturers will be able to arrange for this work to be done in premises, specially constructed for the purpose. Educational Activities In addition to the routine duties of inspection and observations, the Public Health Inspectors continue to give talks and lectures to local organisations, and, wherever possible, great stress is laid on food hygiene. At least once during the year a lecture is given to the staffs employed in the school canteens. 29 TABLE 13 SUMMARY OF SAMPLES TAKEN FOR ANALYSIS DURING THE YEAR 1958 Article Number examined Result of Analysis Formal Informal Total Genuine Not Genuine Almond Icing - 1 1 1 - Aspirin Tablets - 2 2 2 - Aspirin Tablets, Childrens - 1 1 1 - Baked Beans & Pork Sausage - 1 1 1 - Biscottes — 1 1 — 1 Black Pudding — 2 2 2 — Bread — 3 3 — 3 Butter — 7 7 6 1 Cake Icing — 1 1 1 — Cake Mix (Fruit) — 1 1 1 — Capsules — 1 1 1 — Catarrh Syrup — 1 1 1 — Celery Salt — 1 1 1 — Cheese — 10 10 10 - Cherry Linctus - 1 1 1 - Chicken Broth - 1 1 1 - Chicken, chopped — 1 1 1 - Chicken, minced - 1 1 1 - Chocolate Drink - 1 1 1 - Cinnamon - 2 2 2 - Cloves, ground - 1 1 1 - Coconut - 1 1 1 - Coffee & Chicory Essence - 1 1 1 - Condensed Milk - 1 1 1 - Cooking Oil - 1 1 1 - Cornish Pasty - 1 1 1 - Cough Pastilles - 2 2 2 - Crab, dressed - 1 1 1 - Cream - 7 7 7 - Currants - 4 4 4 - Curry Powder - 2 2 2 - Dextrol - 1 1 1 - Flavourings various - 9 9 9 - Fruit dried - 3 3 3 - Fruit, drink powder - 1 1 1 - Fruit, mixed - 7 7 7 - Fruit, pudding baked - 1 1 - 1 Fruit, salad evaporated - 1 1 - 1 Gelatine - 1 1 1 - Ginger, ground - 5 5 5 - Glucose - 2 2 2 - Herbs (dried mixed sweet) - 2 2 2 - Ice Cream - 16 16 16 - Ice Lolly 1 15 16 14 2 Jam - 6 6 6 - Jelly - 4 4 4 - Kokozade - 2 2 2 - Lard - 1 1 1 - Lemon Curd - 2 2 2 - Lemon Squash 1 1 1 Linseed Liquorice and Chlorodine Tabs - 2 2 1 1 Margarine - 1 1 1 - Marmalade - 4 4 4 - Marzipan substitute - 3 3 2 1 Meat, luncheon - 1 1 1 - Meringue Powder - 1 1 1 - Corned forward 1 154 155 144 11 30 Table 13—continued Article Number examined Result of Analysis Formal Informal Total Genuine Not Genuine Brought forward 1 154 155 144 11 Milk — 23 23 22 1 Milo Food Drink — 1 1 1 - Mincemeat - 1 1 1 - Mint Sauce - 1 1 1 - Mint in Vinegar — 1 1 1 — Nutmeg — - - 6 — Olive Oil — 1 1 1 - Orange Curd — 1 1 1 — Pastes, Fish — - - 2 1 Pastes, Meat - - - 4 - Peanuts, Sugared — 1 1 1 — Peas, Processed — 1 1 1 — Pepper — - - 4 — Pickles — 1 1 1 — Pies, Meat — - - 6 — Potato Crisps — 1 1 — 1 Prunes — 1 1 1 — Raisins — 1 1 1 — Rasprene — 1 1 1 — Relaxa Tablets — 1 1 1 — Rice Pudding — 1 1 1 — Rock Cream — 1 1 1 — Salmon — 1 1 — 1 Salmon Spread — 1 1 1 — Sardines — 2 2 2 — Sauce — 2 2 2 — Sausages, Beef — 6 6 6 — Sausages, Pork — 16 16 14 2 Sausages, Vienna — 1 1 1 — Sausages in Brine, Frankfurter - 1 1 1 - Sausage, Liver — 1 1 1 — Sausage, Meat — 1 1 1 — Saveloys — 1 1 1 — Seaweed Tablets — 1 1 1 — Soup — 30 30 22 8 Soup Powder — 1 1 1 — Sugar — 2 2 2 — Sultanas — 1 1 1 — Sunny Spread — 1 1 1 — Sweetex Sweetening Pellets - 2 2 2 - Sweets — 42 42 40 2 Tablets, New P.R. — 1 1 1 — Tablets, Slimming — 1 1 1 — Tablets, Tonic — 2 2 2 — Tablets, Yeast — 1 1 1 — Tea — 1 1 1 — Tomato Ketchup — 3 3 3 — Tomato Puree — 1 1 1 — Turkey, Minced — 2 2 2 — Vinegar — 6 6 6 Yeast Extract — 1 1 1 - Totals 1 348 349 322 27 31 LEGAL PROCEEDINGS (i) The following cases were taken under the Food and Drags Act, 1955. Offence Section Result (1) Insect in a swiss roll 8 Fined £1 Costs 18/9 (2) Sale of pears unfit for human consumption 8 Fined £2 (3) Meat pies affected with mould 8 Fined £5 (ii) The following cases were taken under the Food Hygiene Regulations, 1955. (4) Failure to provide proper containers Reg. 29(1) (d) for the transport of offal Fined £2 (5) Smoking whilst handling open food Reg. 9(c) Fined £1 (6) Smoking whilst handling open food Reg. 9(c) Fined £1 (7) Smoking whilst handling open food Reg. 9(c) Fined £3 (8) Smoking whilst handling open food Reg. 9(c) Fined £l (9) Smoking whilst handling open food Reg. 9(c) Fined £l (10) Smoking whilst handling open food Reg. 9(c) Fined £l (11) Smoking whilst handling open food Reg. 9(c) Fined £5 (12) Smoking whilst handling open food Reg. 9(c) Fined £5 (13) Smoking whilst handling open food Reg. 9(c) Fined £\ (14) Smoking whilst handling open food Reg. 9(c) Fined £2 (15) Smoking whilst handling open food Reg. 9(c) Fined £2 (16) Smoking whilst handling open food Reg. 9(c) Fined £2 (17) Failure to exhibit name and address Reg. 26(1) (a) on stall Fined 10/- (viii) Shops Act, 1950. Inspections. 1,070 shops have been inspected and recorded on the Register. Altoget er 4,555 inspections and observations have been made for various purposes under the Act during the year. Th following contraventions were noted:— Failure to exhibit prescribed notices 294 Failure to keep records 52 Conditions of employment 18 Arrangements for Health and Welfare 36 Other matters 5 (b) Legal Proceedings. Offence Section Result (i) Sunday trading Sections 47 & 50 Case dismissed No costs awarded (ii) Evening closing hours Section 2 Fined £2 32 (ix) The Heating Appliances (Fireguards) Act, 1952. 245 inspections were made of premises where heating appliances were exposed for sale, and, as a result of these visits, 10 appliances were found not to conform with the standards prescribed. These were withdrawn from sale. I have to report that the appliances found not to conform with the Act were passed by the manufacturers as complying with the Regulations. At my request modifications have now been made to the guards, giving greater strength, etc., and the manufacturers have given assurances that more attention will be given in their final inspection to ensure there will be no further breaches of the Act. However, breaches will continue to occur, until each appliance is separately tested before leaving the factory. Enquiries show that only sample tests are made. In connection with the "Guard that Fire" campaign held during the month of November, all dealers in heating appliances were visited, and asked to display posters in their shops, pointing out the dangers of unguarded fires. Legal Proceedings. The Council authorised the following case to be taken before a Magistrates' Court. Offence Section Result Heating appliances not fitted with a guard 1 Fined £2 (x) Clean Air Act, 1956. (a) Smoke Control Areas Preliminary surveys have been carried out in various parts of the district with a view to the establishment of " smoke control areas " at some future date. Joint meetings have also been held with neighbouring authorities to explore the possibilities of establishing joint areas. The Council have adopted the Building Byelaw, referred to in Section 24 of the Act, requiring the installation of approved heating and cooking appliances, capable of burning approved smokeless fuel, in all new buildings. (b) Atmospheric Pollution The Council has continued to co-operate in the scheme, conducted by the Fuel Research Station, for recording atmospheric pollution. A Rain Deposit Gauge is situate on the roof of the Town Hall. This instrument is used to measure the rainfall in inches per month, and to estimate the amount of suspended pollution in the air. in the form of soluble and insoluble matter. A Lead Peroxide instrument is situate at North Road, Havering. This records the amount of Sulphur Dioxide in milligrams deposited per day on 100 sq. c.m. These recordings are taken monthly, and the records for 1958 are set out. Although the rainfall during 1958 was approximately 8.71 inches higher than in 1957, the total amount of insoluble matter deposited was reduced by approximately 6 tons per square mile. 03 03 TABLE 14 ATMOSPHERIC POLUTION. READINGS FOR YEAR 1958 Rain Fall in inches Insoluble Matter in tons per sq. mile Soluble Matter in tons per sq. mile Total Solids in tons per sq. mile Mg. of SO 3/day per 100 sq. c.m. January 1.42 7.95 10.71 18.66 2.0 February 1.93 10.57 8.89 19.46 1.9 March 0.79 6.04 6.47 12.51 1.1 April 1.46 6.87 19.61 26.50 1.0 May 1.77 8.56 9.26 17.82 0.47 June 4.53 4.63 10.57 15.20 0.56 July 1.54 7.41 7.08 14.49 0.38 August 3.78 5.00 10.98 15.98 0.81 September 3.86 4.56 9.10 13.66 0.48 October 1.69 5.57 8.25 13.82 1.5 November 1.73 3.99 6.45 10.44 1.2 December 2.44 5.57 10.10 15.67 2.3 TOTAL 26.94 76.72 117.47 194.21 13.7 MEAN AVERAGE 2.24 6.39 9.78 16.18 1.14 34 4.—HOUSING STATISTICS FOR THE YEAR. 1958. TABLE 15 Number of houses erected during the year: — (1) By Local Authority 158 (2) By Private Enterprise 209 1. Inspection of Dwelling Houses during the Year. (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 3,648 (b) Number of inspections made for the purpose 5,514 (2) (a) Number of dwelling houses (included under subhead (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 19 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects fit for human habitation 652 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 524 3. Action under Statutory Powers during the Year. (a) Proceedings under Sections 9, 10 and 12 of the Housing Act, 1957:— (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:— (a) 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 108 (2) Number of dwelling houses in which defects were remedied after service of Formal Notices:— (a) By owners 93 (b) By local authority in default of owners 13 35 (c) Proceedings under Section 16 and 17 of the Housing Act, 1957:— (1) Number of dwelling houses in respect of which demolition orders were made 16 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 2 (3) Number of Demolition Orders Revoked Nil (4) Number of Closing Orders made Nil (d) Proceedings under Section 18 of the Housing Act, 1957: (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (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, 1957, PartIV—Overcrowding. (a) (1) Number of dwellings overcrowded at end of year 23 (2) Number of families dwelling therein 36 (3) Number of persons dwelling therein 173 (b) Number of new cases of overcrowding reported during the year 4 (c) (1) Number of cases of overcrowding abated during the year 10 (2) Number of new cases of overcrowding relieved during the year 2 (3) Number of persons concerned in such cases 67 (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 5. Rent Act, 1957. lis Act came into operation on the 6th July, 1957, and replaced the Housing Repairs and Rents Act, 1954. The object of that part of the Act, which imposes duties on the Health Department, is to permit owners of controlled properties to increase the rents to a sum equal to twice he gross rateable value, provided the house is kept in a satisfactory state of repair. During the year, the Public Health Inspectors made 589 inspections in connection with the requirements of the Act. These inspections dealt with applications for Certificates of Disrepair, checking Undertakings made by owners, and inspecting the works carried out to remedy the defects and disrepair. The following is a summary of the matters dealt with during the year:— Number of applications for Certificates 130 Number of Certificates issued 26 Number of Certificates cancelled 5 Number of Undertakings accepted 100 Number of applications for Certificates as to remedying of defects, " Form O" 57 Number of Certificates as to remedying of defects:— Granted "Form P" 48 Refused 9 36 5. PREVALENCE OF AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES (i) Notifiable Diseases As is usual I have not recorded those notifications where the diagnosis has been altered after a period of observation, or after investigation. Where, however, the amended diagnosis has proved to be another type of infection which is notifiable, the case has been appropriately recorded. These amendments are sent to the RegistrarGeneral at the end of each quarter. (a) Acute Anterior Poliomyelitis This year I have again to report a very low incidence in Romford. In point of fact there were only three cases, and all were of the nonparalytic type. There were no deaths. One could be sensational, and say that the low number of cases is the direct result of the immunisation campaign against the disease, and, whilst this may indeed be true, yet other factors may be involved, and it is, therefore, better to await developments over the next few years before coming to conclusions, and, in the meantime, take every advantage to avail oneself of immunisation, which undoubtedly has beneficial results. In connection with the scheme for immunisation, towards the end of the year, this was extended to include a third, or "booster" injection, and, also to those born in the years 1933-1942. Altogether during the year 196 children received the first injection, 21,262 two injections, and 4,291 a "booster" injection. Eighty-six adolescents received the first injection, and 21 two injections. Furthermore 108 expectant mothers received one injection, and 613, two injections. (b) Acute Infective Hepatitis. This condition is still notifiable in the Eastern region. Altogether, there were 20 notifications. During the year, three cases of Weil's Disease (Leptospiral Jaundice) were brought to my notice. In the first case, which occurred in January, the patient, unfortunately, died. The other two developed the illness in August. Both these were mild, and made a quick, and uneventful recovery. In each instance, the patients, in the course of their work, were in an environment, which encouraged rodent infestation, and this condition is one which is transmitted via rats. Generally speaking, the disease is rare throughout the Country, and, although groups of cases may occur, it does not give rise to epidemics Transmission is commonly from the excreta of rodents, through abrasions of the skin, and preventive measures, therefore, lie in the eradication of rodents. 37 (c) Diphtheria. No cases of Diphtheria were reported, but several contacts of a case in a neighbouring district were kept under observation. The following statistics relate to the state of immunisation at 31st December, 1958. In addition to the initial series of injections, "booster" doses have been administered. TABLE 16 Under 5 years 5-15 years Number of children who had completed a full course of Immunisation at any time up to 31st December, 1958, and who were born between 31st December, 1943, and 31st December, 1958 5,217 16,872 (d) Dysentery. Seventeen cases of Dysentery were notified, as belonging to the area. Twelve of these were due to Shigella Sonnei, and five were unclassified. (e) Food Poisoning. During the year, eight cases were notified, which proved to be suffering from food poisoning. In addition 15 proved indefinite. The following table sets out details, as required by the Ministry of Health. TABLE 17 (a) Total number of outbreaks Nil (b) Total number of cases included in (a) Nil (c) Number of single cases 23 (d) Number of deaths Nil Sal. Enteritidis Sal. Heidelberg Sal. Typhi-Murium Sal. Unspecified Unknown (e) (i) Organisms responsible (ii) Outbreaks attributable to (i) Nil Nil Nil Nil Nil (iii) Single cases attributed to (i) 2 1 4 1 15 (!) Measles. Measles was in epidemic form during the latter part of the year, and, altogether, throughout the year 476 cases were notified. (g) Scarlet Fever. The notifications numbered 240, and the type was again mild. (h) Smallpox. No cases occurred, and no contacts required to be kept under surveillance. Table 18 gives the statistics, relative to Vaccination, as recorded by the General Practitioners. 38 TABLE 18 Vaccinated: Under 6 months 460 Between the ages of 6 months and 1 year of age 349 Between the ages of 1 and 2 years 116 Between the ages of 2 and 5 years 99 Between the ages of 2 and 5 years 99 Between the ages of 5 and 15 years 154 Over 15 years 99 Re-Vaccinated: Under 1 year of age — Between the ages of 1 and 2 years 3 Between the ages of 2 and 5 years 20 Between the ages of 5 and 15 years 90 Over 15 years 183 (i) Tuberculosis. The scheme whereby B.C.G. is offered, with parental consent, to children at the age of 13 years was continued with the following' results TABLE 19 Number of pupils tuberculin tested 870 Number found to be positive 91 Number found to be negative 779 Number who received B.C.G. 738 (j) Whooping Cough. Altogether, 33 cases were notified, and during 1958, 1,180 children received immunisation injections. (ii) Non-Notifiable The particulars of these are set out below, and the figures are compiled from the school returns. As they are not notifiable, however, the general prevalence is unknown. TABLE 20 Chickenpox 697 Mumps 442 German Measles 57 39 TABLE 21 MONTHLY NOTIFICATIONS OF INFECTIOUS DISEASES Month Scarlet Fever Diphtheria Enteric Fever Puerperal Pvrexia Pneumonia Dysentery Encephalitis Acute Infective Erysipelas Malaria contracted abroad Measles Meningococcal Infection Ophthalmia Neonatorum Poliomyelitis Paralytic Poliomyelitis Nonparalytic Whooping Cough Infective Hepatitis Food Poisoning Tuberculosis Total Resp. NonResp. January 35 — — — 12 1 — — — 2 1 — — — 8 3 3 5 — 70 February 20 — — — 9 3 — 2 — — — — — — 2 3 1 5 2 47 March 42 — — — 3 — — 1 — 3 — — — 1 6 5 1 1 — 63 April 21 — — — 1 1 — 1 — 5 1 — — — — — 4 1 — 35 May 27 — — 1 2 2 — — — 6 — — — — 2 1 2 4 1 48 June 17 — — — 1 — — — — 20 2 — — — 5 4 1 4 2 56 July 15 — — — 3 1 — — — 82 — — — — 4 1 — 3 — 109 August 5 — — — — 3 — 1 — 65 — — — — 2 2 — 6 1 85 September 10 — — — 1 — — 2 — 10 — — — — 2 — 3 4 1 33 October 11 — — — 2 6 — 2 1 73 — — — 1 1 — 1 8 — 106 November 19 - - - 3 - - - - 112 - - 1 — 1 5 8 — 149 December 18 — — 1 1 — — — — 98 — — — — 1 — 2 — — 121 Total 240 — — 2 38 17 — 9 1 476 4 — — 3 33 20 23 49 7 922 40 TABLE 22 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 3 3 10 19 26 139 31 5 2 2 — — 240 Diphtheria - - - - - - - - - - - - - Enteric Fever - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - - 1 1 — — 2 Pneumonia 8 4 1 2 - 9 - 1 4 3 5 1 38 Dysentery — — 2 - - 8 1 — 2 4 — — 17 Encephalitis—Acute Infective - - - - - - - - - - - - - Erysipelas — — — — — — — 1 1 1 3 3 9 Malaria contracted abroad — — — - — — — — 1 — — — 1 Measles 16 48 52 43 61 251 4 1 — — — j — 476 Meningococcal Infection 2 - - - - - - - - - 2 - 4 Ophthalmia Neonatorum - - - - - - 1 - - - - - - Poliomyelitis Paralytic - - - - - - - - - - - - - Poliomyelitis Non-Paralytic - - - - - 2 - - 1 - - - 3 Whooping Cough 2 6 8 4 4 8 1 — - — - - 33 Infective Hepatitis - - - - - 5 6 3 2 3 1 20 Food Poisoning 2 - 2 1 - 6 3 1 3 4 1 — 23 Total 33 61 75 69 91 428 46 12 15 17 14 5 866 41 TABLE 23. NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING YEAR 1958, and HOSPITAL ADMISSIONS Disease Cases Notified Cases Admitted to Hospital Total Deaths Scarlet Fever 240 7 — Diphtheria - - - Enteric Fever - - - Puerperal Pyrexia 2 1 - Pneumonia 38 23 43 Dysentery 17 5 - Encephalitis—Acute Infective - - - Erysipelas 9 1 - Malaria contracted abroad 1 1 — Measles 476 5 - Meningococcal Infection 4 3 2 Ophthalmia Neonatorum - - - Poliomyelitis Paralytic - - - Poliomyelitis Non-Paralytic 3 3 - Whooping Cough 33 3 - Infective Hepatitis 20 - - Food Poisoning 23 3 — Total 866 55 45 42 TABLE 24 TUBERCULOSIS : NEW CASES AND MORTALITY DURING 1958 AGE PERIODS NEW CASES DEATHS Respiratory N on-Respiratory Respiratory Non-Respiratory M. F. M. F. M. F. M. F. 0 — — — 1 — — — — 1 — — — — — — — — 5 — 2 — 3 — — — — 15 3 6 — — — — — — 25 3 4 1 1 25 8 4 1 — — 1 — — 45 6 3 — — 2 — — — 65 4 2 — — — 1 — — 65 and upwards 2 2 — — 1 2 — — Total 26 23 2 5 3 4 - -