REPORT on the HEALTH AND SANITARY CONDITION of the METROPOLITAN BOROUGH OF SHOREDITCH IN THE COUNTY OF LONDON FOR THE YEAR 1956 BY B. BROADBENT, M. A. ,M. B. ,M.R. C. S. ,D. P. H. , Madical Officer of Health. REPORT on the HEALTH AND SANITARY CONDITION of the METROPOLITAN BOROUGH OF SHOREDITCH IN THE COUNTY OF LONDON FOR THE YEAR 1956 BY B. BROADBENT, M. A. ,M. B. ,M.R. C. S. ,D. P. H. , Medical Officer of Health. Printed by WATERLOW & SOWS LIMITED. S.S.4445 2. To the MAYOR, ALDERMEN and COUNCILLORS of the METROPOLITAN BOROUGH of SHOREDI TCH. Mr, Mayor, Ladies and Gentlemen, This report for the calendar year 1956 follows the lines adopted recently, with a few changes as suggested in the Ministry of Health Circular 19/56. I am glad to be able to report that the Borough's "health" figures fully maintained, and in places surpassed, the high level set in 1951, but, the health of seaside resorts having meantime improved, we are now displaced by several of them! Although there is a slight reduction in population and in the number of births, this is all to the good when the area of the Borough is considered, as overcrowding has in the past been a notorious feature here. The figure for the infant death rate (the numbers dying under the age of one year, out of every 1,000 born alive) at 16.5 is only fractionally above the best ever; the (adjusted) death rate in general is the best ever; tuberculosis exacted the lowest toll known in the history of the Borough (0.11 in all 'forms, as against 0.33 even last year); for the fifth year in succession, no death occurred in connection with childbirth, and even the deaths from cancer of the lung decreased from 35 to 29. (The Polio death was from 1955 outbreak, and the 7 notified were mild). Similar reductions occurred with most other causes of death, with one notable exception - the same one that I mentioned last year. It may be recalled that I was alarmed by the increase from 44 to 73 in the deaths from coronary thrombosis. This figure again rose sharply to exactly 100 deaths in the year, 50 in each sex, the greater part of them occurring so suddenly that they were subjected to post-mortem examination on the Coroner's instruction. This disposes of the theory put to me that the increased numbers were due to mere popularity of this diagnosis, for imagination plays a very small part in autopsies, especially when ordered by the Coroner, as these are performed by Home Office pathologists. The importance of this disease is emphasised by the fact that "World Health Day" this year was devoted to "Food and Health", following the assembly by the World Health Organisation of a study group on coronary thrombosis and allied diseases, All seem agreed that excess animal fats are a potent cause while vegetable and fish fats tend to reduce the risk of the disease. As they suggested individual research into the matter, I contacted the relatives of these proved cases in Shoreditch and am grateful for their co-operation, I came to the conclusion, even in these comparatively few cases, that there was one type in the "worrier" (admittedly not common in the Shoreditch cases to date) and that this kind seemed independent of the nature or amount of food eaten; but that most of the others affected seemed to be heavy eaters of fatty foods. There were no inherited cases of the type so frequent in the professions. The advice of the W.H.O.Gp is "moderation in everything", and this should strike home especially in Shoreditch where one of its favourite citizens sang "A little of what you fancy does you good" - but now the emphasis must be on the word ''little". The notifications of infectious disease were all fewer than in 1955, with the exception of Pneumonia in elderly people (which was scarcely surprising when the weather in 1956 is compared with the average). There was also a slight increase in TB notifications - 46 versus 44 - but these again were chiefly over 45 years of age (26 opposed to 12!)? Mass Radiography. 3. It is particularly gratifying to note the decrease in Dysentery notifications from 252 in 1955 to 92 in 1956 (Can we dare to hope that this is linked with the propaganda on the importance of handwashing before eating and after toilet?). The bulk of the Social Services (especially for old people) continues to be financed by the Borough Council itself, and is run by the Council's staff in this department. This is the only Borough even now, where this is the case on such a wide scale, so that we are particularly proud of the work being done, as shown in Section V (pag 22) of this report. Much help for the Council's Holiday and Rest Home at Copthorne in Sussex has come from King Edward's Hospital Fund since the liaison was made in 1950, and we are all grateful for that, not only from the financial angle, but also from the fact that this keeps the home fully occupied during almost the whole year as opposed to the normal holiday poak periods, as was the case when only Shoreditch people visited there. During 1956 the Fund paid half the cost of a new luxury coach for use to and from the Home, The disinfection work in the Borough received literally a new lease of life during the year, when the old steam disinfectors were replaced by a modern formalin plant which not only does the work cheaper and without atmospheric pollution, but does not damage any type of goods. The Sanitary Inspectors (Change of Designation) Act, 1956, has converted them into Public Health Inspectors, but has not yet filled the gaps in their ranks here, While two inspectors were lost to us, one fresh inspector came, and is working very efficiently as a Food & Drugs and Food Premises Inspector, Thus with two inspectors devoted to this cause during 1956, the implementing of the new Food Hygiene Regulations has been thorough, and the educational effect greater from direct personal contact than would have been possible by any other means such as guilds (other measures were of course adopted also (page 44), In addition to 3 student P.H.Is, the department began a paid pupillage scheme with 3 entrants during 1956, but without the excessively conscientious work of the Chief and Deputy Chief Public Health Inspectors all our work must have deteriorated. The Rodent work in the Borough was very successful, on the one hand by the use of a new method of sewer treatment (for the first time in any London Borough) and on the other hand by arranging contracts with business firms for the first time. It is a pleasure to have this public opportunity to thank the staff for their splendid work under difficult conditions, during the year, as well as to thank the Council members who have supported our efforts. Of people outside the Borough, special thanks are due to King Edward's Hospital Fund and to my colleagues in the various Health Authorities throughout the country. Yours faithfully, B. BRAODBENT, Medical Officer of Health, 4. PUBLIC HEALTH COMMI TTEE (to May 1956) Ex-officio: Councillor W. Chairman: Coun. IINALE, R.G. Vice-Chairman: Coun. WICKS, A.E., L. C. C. Alderman Rev, MEREDI TH DAVIES, M.B.E. Councillor EVERETT, A.J. " HI GGINS, Mrs. M.I., M.B.E. " KEEN, T. " RUM, P. " RICHARDSON, J. " ROBERTSON, H.T.L. " SMITH, Mrs. E.E. " TALLANTIRE, R.J. " VARNALS, Mrs. A.E., A.B.A.T.D. BOROUGH WELFARE COMMI TTEE (to May 1956) COYNE, J.P. (Mayor) Chairman: Coun. SMI TH, Mrs. E.E. Vice-Chairman: Coun. HEBDEN, W., J.P. Alderman WRAY, D. Councillor BRYANT, H.T. " DEACON, F.J. " GIRLING, Mrs. H., O. B.E., J.P. " HIGGENS, Mrs. M.I.,M.B.E. " HURLEY, J.J. " RICHARDSON, J. " ROBERTSON, H.T.L. " SIMMONDS, A.S. " SWALES, R.T.J. (Co-opted) Lady Cynthia COLVILLE, D.C.V.O,,D.B.E.,J.P. PUBLIC HEALTH COMMI TTEE (May 1956 to May 1957) BOROUGH WELFARE COMMITTEE (May 195 6 to May 1957) Ex-officio: Alderman D. WRAY, J.P. (Mayor) Chairman: Coun. IINALE, R.G, Vice-Chairman: Coun. ROBERTSON, H.T.L. Alderman Rev. MEREDI EI DAVIES, M.B.E, Councillor ALDRED, F.G. " DEACON, F.J. " HAYES, T. " KEEN, T. " PAIN, Mrs. D.N. " RUTMAN, P. " TEMPLE, J. " TURNER, C.H, " WICKS, A.E., L.C.C. " WILCOX, J.E. Chairman: Coun, SMITH, Mrs. E.E. Vice-Chairman: Coun. RICEARDSON, J. Alderman Rev. MEREDITH DAVIES, M.B.E. Councillor ANDERSON, J. " DEACON, F.J. " GIRLING, Mrs, H.,O. B.E., J.P. " HAYES, T. " PAIN , Mrs. D.N. " ROBERTSON, H.T.L. " SIMMONDS, A.S. " SWALES, R.T.J. " WAGNER, A,G. 11 WALKER, J.W. (Co-opted) Lady Cynthia COLVILLE, D.C.V.O., D.B.E.,J.P. 5. STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health Chief Public Health Inspector & Administrative Assistant Deputy Chief Public Health Inspector Food & Drugs and Food Premises Inspectors. Public Health Inspectors Clerks P.H.I. Trainee Rodent Foreman/Clerk and Disinfecting Supervisor. Welfare Officer and Organiser of Clubs. Assistant Welfare Officer Assistant Organiser of Clubs Shoreditch Holiday & Rest Home Visiting Medical Officer Matron Public Analyst (part-time) B. BROADBENT, M.A.,M.B.,B.Ch.,M.R.C.S., L.R.C.P.,D.P.H. DAVID GRANT, F.A.P.H.I. (a)(b) T.H. MARSHALL, F.A.P.H.I. (a)(b) J.A. HOARE, M.A.P.H.I,(a)(b) (comm. 1.9.56] H. TAYLOR, (a)(b) G.C.E. GI BBS, M.A.P.H.I .(a)( b) F. DU GGINS, M.A.P.H.I. (a)(b) V. CROFT, M.A.P.H.I. (a)(b) (res.4.1.56) J.B. MOLLOY, M.A.P.H.I. (a)(b) (ret.1.3.56) G.S. TOVEY, M.A.P.H.I, (a) (comm. 25.5.56, res.11.11.56) B.M.R. LEIGH E.A. CHRISTIAN G.A. POPE H.J. KEMP J.E. SCOTT Miss E. REEVES T. KEEN E. MERRILL M. DAVIS A. G. WA WORE H. BRYANT Mrs. J.E. ADAMS Mrs. I.E. PIKE W.A. FANSHAW, M.A., B.Sc.(Econ.) B.C. MORTON PALMER, B.A.,M.B.,B.Ch. L. M. S. S.A. Miss F.M. STACEY, S.R.N.,C.M.B. H. AMPHLETT WILLIAMS, Ph.D.,A. C. G.F. C., F.R.I.C, Notes:- (a) Public Health Inspectors' Certificate (b) Food Inspectors' Certificate. 6. I. - STA TIS STICS AND GENERAL INFORMATION. Area of Borough 662 acres Population, Census 1951 44,871 Population, Registrar-General's estimate, mid-1956 44,520 Number of houses, including separately rated flats (end of 1956) according to rate books 11,984 Rateable Value £1, 058,161 Sum represented by penny rate £4,100 A great variety of industries is carried on in the borough's 1,220 factories. Furniture-making is one of the most common of these, and one which is by tradition firmly established in the borough. The number of home workers notified under the Factories Act who are resident in the borough is approximately 300, EXTRACTS PROM VITAL STATISTICS FOR THE YEAR 1956. Male Female Total Live births - Legitimate 355 319 674 Illegitimate 25 27 52 Birth rate (crude rate) • • • 16.30 Birth rate (adjusted for Area Comparability Factor 0.89) • • • 14.51 Still births 7 6 13 Still births (rate per 1,000 total births) ... 17.59 Deaths- 351 337 688 Death rate (crude rate) • • • 15.45 Death rate (adjusted for Area Comparability Factor 0.73) • • • 11.28 Number of women dying in, or in consequence of childbirth • • • Nil Infant deaths - Legitimate ... 11 Illegitimate ... 1 Infant deaths (rate per 1,000 live births) ... 16.53 Neo-natal deaths (rate per 1,000 live births) • • • 9.64 Deaths from measles (all ages) .... Nil Deaths from whooping cough (all ages) ... Nil Deaths from diarrhoea (under 2 years of age)... • • • 1 Deaths from pulmonary tuberculosis • • • 4 Deaths from all forms tuberculosis • • • 5 Death rate from pulmonary tuberculosis • • • 0,09 Death rate from all forms of tuberculosis ... 0.11 7. Comparative vital statistics of the Borough during recent years are given in the following table :- Year Population estimated to middle of each year Births Total Deaths Registered in the District Transferable deaths Nett deaths belonging to the District Uncorrected Number Nett Number Rate of Nonresidents registered in the District Of residents not registered in the District Under lyeer of age At all ages Number Rate per 1,000 nett Births Number Rate Nunbor Rate 1945 36760 262 697 19.0 722 19.6 156 193 27 39 603 16.4 1946 42600 486 995 23. 624 14.6 174 164 32 32 614 14.4 1947 44610 471 1044 23.2 610 13.7 169 220 43 41 661 14.8 1948 44960 385 853 19.0 511 11.4 158 177 21 25 530 11.8 1949 45200 351 864 19.1 552 12.2 171 212 33 38 593 13.1 1950 44800 285 791 17.7 565 12.6 178 168 24 30 555 12.4 1951 45010 278 830 18.4 586 13.0 179 195 13 16 602 13.4 1952 45800 246 829 18.1 517 11.3 172 214 23 28 559 12.2 1953 45770 213 815 15.7 500 10.9 78 193 18 22 615 13.9 1954 45960 212 765 14.6 472 10.3 81 169 17 23 560 12.7 1955 45480 184 761 14.7 528 11.6 110 167 15 20 585 13.4 1956 44520 200 726 14.5 609 9.8 101 180 12 16 688 11.3 GENERAL INFORMATION. Shoreditch is a district of irregular shape, of which the two longest diameters measure approximately one-and-a-half miles. Its boundaries are as follows:Hackney, N. and N.E.; Bethnal Green, E,; Stepney, S.E.; City, S.; Finsbury, W.; Islington, N. and N.W. The average height of the Borough above sea-level is 60 feet. The subsoil of the Borough is London clay with many pockets of gravel. Some areas aro covered to a depth of throe feet with a good quality sandy gravel on this subsoil. House Refuse. - The removal of house refuse is under the administrative control of the Cleansing and Transport Superintendent. Hospitals, - Within the Borough: St.Matthew's Hospital, Shepherdess Walk, N.1. St.Leonard's Hospital, Nuttall Street, N.l, Ambulance Facilities, - Ambulances are provided by the London County Council, Venereal Diseases. - Posters and notices are displayed at the conveniences in the Borough, drawing attention to the facilities available at local Hospitals. Public Mortuary - In view of the reorganisation of the work of County Coroners and Coroners' Districts which placed Bethnal Green and Shoreditch into the Northern District and Poplar into the Southern District, the joint mortuary service of these boroughs was discontinued from 1st April, 1956. As the Coroner for the Northern District proposed to move bodies from Shoreditch into Hackney mortuary, an arrangement was entered into with Hackney Borough Council for the use of their mortuary from 1st April, 1956, 8. CAUSES OP DEATH, WITH AGE DISTRI BUTION. CAUSES OF DEATH AGES SEX Total deaths duo to each cause Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 to 75 Over 75 Males Females 1. Tuberculosis, respiratory - - - - - 1 2 1 2 2 4 2. Tuberculosis, other forms - - - - - 1 - - 1 — 1 3. Syphilitic disease - - - - - 2 1 - 2 1 3 4, Diphtheria - - - - - - - - — - - 5, Whooping cough - - - - - - - - - - - 6, Meningococcal infections. - - - - - - - - - - - 7. Acute poliomyelitis - - 1 - - - - - 1 — 1 8. Measles - - - - - - - - - - - 9. Other infective and parasitic diseases - - - - - 1 - - - 1 1 10. Malignant neoplasm, stomach - - - - - 5 3 7 7 8 15 11. Malignant neoplasm, lung, bronchus - - - - - 18 6 5 26 3 29 12. Malignant neoplasm, breast - - - - 2 5 2 3 - 12 12 13. Malignant neoplasm, uterus - - - - - 3 - - - 3 3 14. Other malignant and lymphatio neoplasms - - - - 1 20 23 22 42 24 66 15. Leukaemia, aleukaomia - - - - - 1 - - 1 - 1 16. Diabetes - - - - - - 1 2 - 3 3 17. Vascular lesions of nervous system - - - - 1 16 22 49 39 49 88 18. Coronary disease, angina - - - - 4 20 24 52 50 50 100 19. Hypertension with heart disease - — - - - 2 5 9 6 10 16 20. Other heart disease ... — - 1 — 1 7 6 23 13 25 38 21. Other circulatory disease - - - - - 4 10 25 11 28 39 22. Influenza ... ... — — _ - - - 1 1 1 1 2 23. Pneumonia ... ... 2 - - - - 2 19 50 30 43 73 24. Bronchitis 1 - - - 1 14 26 53 61 34 95 25. Other diseases of respiratory system - - - - - - 4 2 5 1 6 26. Ulcer of stomach and duodenum - - - - - 9 4 4 14 3 17 27. Gastritis, enteritis and diarrhoea 1 - - - 1 - - 1 1 2 3 28. Nephritis and nephrosis - - - - 2 2 2 1 4 3 7 29. Hyperplasia of prostate - - - - — — 1 4 5 — 5 30. Pregnancy, childbirth, aborticn - - - - - - - - - - - 31. Congenital malformations. 4 - - - - - - - 3 1 4 32. Other defined and ill- defined diseases 3 - 1 - 1 8 9 15 15 22 37 33. Motor Vehicle accidents - - 3 - - 1 1 1 4 2 6 34. All other accidents 1 1 - - 1 1 1 1 3 3 6 35. Suicide - - - - 1 5 - 1 4 3 7 36. Homicide and operations of war - - - - - - - - - - - Total Deaths (all causes) 12 1 6 - 16 148 173 232 351 337 688 9. II. - POPULATION, BIRTHS, MARRIAGES AND DEATHS The Registrar-General's estimate for the mid-year 1956 population was 44,520, a decrease of 960 from the previous year. This figure is used for statistical purposes throughout this report. The density of the population is 67 persons per acre. The Area Comparability Factors for the borough are Births 0.89, and Deaths 0.73, and the rates shown in this report have been adjusted accordingly. BIRTHS, The numbers of registered live births allocated to the Borough during the calendar year 1956 were as follows:- Total live births - (legitimate and illegitimate) Males 380 Females 346 Total 726 Illegitimate live births- Males 25 Fomales 7 Total 52 The birth rate for the borough was 14.51. For England and Wales the rate was 15.6 and for London 15.9. The illegitimate births represented 7.04 per cent of all births in the borough. STILLBIRTHS. The number of registered stillbirths allocated to the borough was 13, or 1.76 per cent of all births. MARRIAGES. The number of marriages during the year was 444 and the marriage rate was 19.9 per 1,000 population. The marriage rate for the Metropolis was 20.7 and that for England and Wales 15.8. DEATHS. The number of deaths registered in the borough in 1956 - 609 Transferable deaths - Non-residents registered in Shoreditch - 101 Shoreditch residents registered elsewhere - 180 The number of deaths allocated to the borough is therefore - 688. This gives a death rate for the borough of 11.28 compared with 11.7 for England and Wales, and 11.7 for London. In connection with these deaths 17 10. inquests were held. 548 or 79.6 per cent of the people belonging to Shoreditch who died during the year, died in public institutions. The table on page 8 showing causes of deaths at all ages has been supplied by the Registrar-General. INFANTILE MORTALITY. The deaths of infants under one year numbered 12 of which 8 were males. These deaths amounted to 1.74 per cent of the total net Shoreditch deaths from all causes, as compared with 2.56 per cent in 1955. The infantile mortality rate (death rate of infants under one year per 1,000 live births) for Shoreditch was 16.53, the rate for England and Wales being 25.8 and that for London 21.4 One illegitimate infant died. The number of deaths of infants under 4 weeks of age was 7, which gives a neo-natal rate of 9.64. INFANTILE MORTALITY IN THE BOROUGH DURING 1956. CAUSE OF DEATH AGES SEX Under 1 day 1 day to 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 1 month 1-3 months 3-6 months 6-9 months 1 9-12 months Male Female Total deaths under 1 year Pneumonia - - - - - - - 1 - 1 1 1 2 Bronchitis - - - - - - - 1 - - 1 - 1 Gastritis, enteritis Congenital - - - - — - 1 - - - 1 1 malf ormati on - 1 1 - 1 3 - - 1 - 3 1 4 Other defined and ill-defined diseases. - 3 - - - 3 - - - - 2 1 3 Other accidents 1 - - - - 1 - - - - 1 - 1 Total 1 4 1 - 1 7 - 3 1 1 8 4 12 11. MATERNAL MORIALI TY, 1956. No maternal death was recorded during the year. The maternal mortality rates in England and Wales and in Shoreditch during the past seven years are given below Maternal Mortality Rate per 1,000 Live and Still Births 1956 1955 1954 1953 1952 1951 1950 England and Wales 0.56 0.64 0.69 0.76 0.72 0.79 0.86 Shoreditch Nil Nil Nil Nil Nil 1.18 Nil CANCER. The deaths from cancer in the Borough during the year numbered 125 as compared with 113 in 1955. BURIAL OF THE DEAD. Under Soction 50 of the National Assistance Act, 1948, the Borough Council is responsible for arranging for the burial or cremation of any person who has died or been found dead in their area, and where no other suitable arrangements for burial have been made or are being made. During the year 5 burials were carried out. The Council have not yet carried out any cremations, as although it may appear at the time of death that there are no surviving relatives, there is always the remote possibility that at some future date, one may come forward and start enquiries Which might result in the Council's action being disputed. III. INFECTIOUS AND OTHER DISEASES. During the year the number of notifications received was 592. Of those cases 3 were found not to be suffering from the disease stated on the certificate, which gives a corrected number of 589 cases for the year. SMALLPOX AND VACCINATION. Nc case of smallpox occurred in the Borough during the year and no vaccinations were performed by the Medical Officer of Health under the Public Health (Smallpox Prevention) Regulations, 1917. 12. CASES OP INFECTIOUS DISEASE NOTIFIED DURING 1956 (confirmed diagnoses) NOTIFIABLE DISEASE Total number of confirmed cases AGES Under 1 year 1-5 years 5-15 years 15 - 25 years 25 - 45 years 45 - 65 years 65 years + Deaths Diphtheria - - - - - - - - - Dysentery 92 4 33 32 8 11 1 3 - Acute encephalitis - post-infectious 2 - - 1 - - 1 - 1 Enteric (paratyphoid) 2 - 1 1 - - - - - Erysipelas 7 - - - - 1 4 2 - Measles 232 10 151 70 1 - — - — Meningococcal infection - - - - - - - - - Ophthalmia neonatorum 1 1 - - - - - - - Pneumonia 33 1 4 4 6 6 7 5 - Acute Poliomyelitis - - paralytic 2 - 1 1 - - - - - - non-paralytic 5 - 1 4 - - - - - Puerperal pyrexia - - - - - - - - - Scabies 13 - 3 2 3 3 2 - - Scarlet fever 32 - 11 19 - 2 - - - Whooping cough 107 15 54 38 - - - - - Tuberculos is - - pulmonary 40 - 2 - 7 6 15 10 4 - non-pulmonary 4 - - - - 3 1 - 1 Food Poisoning 8 - - - 2 4 2 - - Salmonella 9 1 2 3 - 2 1 - - Total 589 32 263 175 27 38 34 20 6 The following diseases are notifiable in this Borough: Disease Authority for notification Acute encephalitis Public Health Act, 1936 (Section 143) Reg.No.2259 made by Minister of Health, 1949 (1.1.50) Acute primary or Public Health Act, 1936 (Section 143) Reg.No.299 made influenzal pneumonia by Minister of Health, 1953 (1.4.53) Acute poliomyelitis Public Health Act, 1936 (Section 143) Reg.No.2259 made by Minister of Health, 1949 (1.1.50) Anthrax Public Health (London) Act, 1936 (Section 192 and 305) Cholera Public Health (London) Act, 1936 (Section 192 and 304) Continued fever Do. Diphtheria Do. Dysentery Public Health Act, 1936 (Section 143) Reg.No.299 made by Minister of Health, 1953 (1.4.53) 13. Disease Authority for Notification Enteric fever (including Public Health (London) Act, 1936 (Section 192 and 304) typhoid and para-typhoid) Reg.No.299 made by Minister of Health 1953 (1.4.53) Erysipelas Public Health (London) Act, 1936 (Section 192 and 304) Food Poisoning Food & Drugs Act, 1955 (Section 26) Glanders Public Health (London) Act, 1936 (Section 192 and 305) Hydrophobia Do. Leprosy Public Health Act, 1936 (Section 143) Reg.No.1036 made by Minister of Health, 1951 (22.6.51) Malaria Public Health Act, 1936 (Section 143) Reg.No.299 made by Minister of Health, 1953 (1.4.53) Measles Public Health Act, 1936 (Soction 143) Regs .Nos .1100 205 and 420 made by Minister of Health, 1938, 1940 and 1948. Membranous croup Public Health (London) Act, 1936 (Section 192 and 304) Meningococcal infection Public Health Act, 1936 (Section 143) Reg.No.2259 made by Minister of Health, 1949 (1.1.50) Ophthalmia neonatorum Public Health (London) Act, 1936 (Section 192 and 305) and Reg.No.971 made by Minister of Health, 1926 (1.10.26) amended by S.R.O.1928 No.419 and 1937, No .35 . Plague Public Health Act, 1936 (Section 143). Regulations of Local Government Board, 1900. Puerperal pyrexia Public Health Act, 1936 (Section 143), Regulations made by Minister of Health, 1951. No.1081 and 1954 No.1691. Relapsing fever Public Health (London) Act, 1936 (Section 192 and 304) Scabies (first case in Public Health Act, 1936 (Section 143). Reg.No.1016 house within 4 weeks) made by Minister of Health, 1943 (1.8.43). Scarlatina or scarlet fever Public Health (London) Act, 1936 (Section 192 and 304). Smallpox Do. Tuberculosis Public Health Act, 1936 (Section 1943). Reg.No.704 made by Minister of Health, 1952 (1.5.52) Typhus fever Public Health (London) Act, 1936 (Section 192 and 304) Whooping cough Public Health Act, 1936 (Section 143). Regs .Nos .1100, 205 and 420 made by Minister of Health, 1938, 1940 and 1948. 14. BACTERIOLOGICAL EXAMINATIONS. Bacteriological examinations were undertaken by the Bacteriological Laboratory of the Medical Research Council which is accommodated at County Hall. Records of examinations carried out are as follows Nose and Throat Swabs; C. Diphtheriae mitis isolated - Negative results 23 23 Faeces Specimens: Shigella Sonnei isolated 180 Salmonella typhi-murium isolated 7 Paratyphoid B. isolated 2 Negative results 481 670 Swimming bath water examinations 13 Milk samples 23 Foodstuff samples 6 15. IV. - TUBER CULOSIS. Notifications - Forty new cases of pulmonary tuberculosis and four of nonpulmonary tuberculosis were notified during 1956 compared with 36 pulmonary and 6 non-pulmonary notifications in 1955. The following table gives the age grouping of new cases notified. FORMAL NOTIFICATIONS. Number of primary notifications of new cases. AGE PERIODS 0-1 1-2 2-5 5-10 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65-75 75 and upwards Total (all ages) Pulmonary, Males - - 1 - - 2 - 2 1 7 6 6 2 27 " Females - 1 - - - 2 3 1 2 2 - 2 - 13 Non-pulmonary, Males - - - - - - - - 1 - - - - - 1 Females - - - - - - - 1 1 - 1 - - 3 Total - 1 1 - - 4 3 4 5 9 7 8 2 44 The following table gives the number of cases which came to the notice of the Medical Officer of Health otherwise than by formal notification, and the source from which information was obtained. Source of information Pulmonary Non-pulmonary M F M F Death Returns - 1 - - Transfers from other areas 5 8 1 2 Other sources - - - - Total 5 9 1 2 16. Details of cases removed from Register during the year - Reason for removal Pulmonary Non-Pulmonary M F M F Withdrawal of notification - - - - Recovery from disease 15 12 2 2 Death 8 5 1 - Otherwise (e.g. removal from district) 24 15 5 5 Total 47 32 8 7 Revision of Notification Register - Pulmonary Non-pulmonary TOTAL M F M F No. of cases on Register at 31st December, 1955 377 336 111 84 908 No. added during year 32 22 2 5 61 No. removed during year 47 32 8 7 94 No. of cases on Register at 31st December, 1956 362 326 105 82 875 The following table shows the incidence of cases of tuberculosis and of deaths from that disease for the last twelve years:- Year Notification rate per 1,000 population Death rate per 1,000 population Pulmonary Non Pulmonary All Forms Pulmonary Non Pulmonary All Forms 1945 1.74 0.38 2.12 0.95 0.14 1.09 1946 1.83 0.24 2.07 0.92 0.09 1.01 1947 1.55 0.22 1.77 0.67 0.07 0.74 1948 1.62 0.18 1.80 0.77 0.07 0.84 1949 1.28 0.29 1.57 0.73 0.11 0.84 1950 1.36 0.18 1.54 0.38 0.07 0.45 1951 1.48 0.16 1.64 0.35 0.00 0.35 1952 1.22 0.13 1.35 . 0.28 0.02 0.30 1953 1.20 0.11 1.31 0.24 0.04 0.28 1954 0.94 0.11 1.05 0.24 0.02 0.26 1955 0.79 0.13 0.92 0.31 0.02 0.33. 1956 0.90 0.09 0.99 0.09 0.02 0.11 17. The following table gives the age grouping of deaths from tuberculosis:- Age periods 0-1 1-5 5-15 15-25 25-45 45-65 65-75 75 and upwards Total Pulmonary, Males - - - - - 1 1 - 2 " Females - - - - - - 1 1 2 Non-pulmonary, Males - - - - - 1 - - 1 " Females - - - - - - - - - luring the year Public Health Inspectors visited all new cases of tuberculosis notified, and also inspected the homes of all persons discharged from hospital or removing from another area into this borough. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS 1925. These regulations prohibit a person suffering from tuberculosis, and who is in an infectious condition, from following any employment or occupation in connection with a. dairy which would involve the milking of cows, the treatment of milk, or the handling of vessels used for containing milk. No formal action was necessary during the year. MASS MINIATURE RADIOGRAPHY. I am indebted to Dr. Thompson for the following report:- "Introduction During 1956 the Unit examined 37,264 males and 27,916 females making a total of 65,180, which shows an increase of about 3,400 on the 1955 figures. Sixty-two active cases of tuberculosis have been discovered, which gives a rate of almost one per thousand examined - with male examinees showing a slightly higher rate than females. All clinics have recorded their sputum findings, and twenty cases with a positive sputum have been reported, of which thirteen were male and seven female. 18. The Unit operated at the Mass Radiography Centre, 20, Golden Lane, London, E.C.I. from the 1st January to the 30th April and from the 8th August to the 31st December. The majority of examinees attending the Centre were employed in the City of London, although firms operating in the Metropolitan Boroughs of Finsbury and Shoreditch also sent their staffs, as well as Health and Teaching staffs of the London County Council. At the commencement of the year under review the new scheme, detailed in our previous Report, for the examination of school teachers, came into operation, and has worked quite smoothly even if the response has not been so great as was contemplated. Altogether the Unit X-rayed 535 teachers, representing ninety-three schools. A similar procedure has been adopted for Health Staffs in Divisions 3, 4 and 5. The normal Consent Form has been dispensed with; the examinee receiving the result of his (or her) examination. The upper portion of the form is sent to the Divisional Medical Officer, who will thus know who attended for examination. The Health Staffs' form is issued by the appropriate Health Division, and follows similar lines to the teachers' form. During the mobile period the Unit visited several firms in the City of London and carried out a special Survey in Finsbury, when the Unit operated in the Finsbury Health Centre, Pine Street, London, E.C.I, by kind permission of the Public Health Committee of the Borough of Finsbury. About 250 firms participated in this Survey, which took place from the 14th June to the 6th July. Particular emphasis was laid on firms operating in the northern sector of the Borough, as those in the southern area are conveniently situated to the Mass Radiography Centre at Golden Lane. Also in this Survey were included firms in the Ludgate Circus area, as there is direct transport facilities to the Health Centre. During the Finsbury Survey some Public Sessions were held at which no appointments were necessary. The usual publicity, e.g. posters, handbills, etc., was used, but the attendances at these Sessions were disappointing. At the request of the Medical Officer of Health for Finsbury (Dr. C.O.S. Blyth Brooke) special sessions were set aside for the examination of elderly folk. The attendance at the Public Sessions amounted to 542 with 4,299 at the Planned Sessions. Eight cases of active tuberculosis and 11 cases of inactive tuberculosis were discovered, as well as 2 cases of carcinoma of the lung. As this Unit does not have the usual X-ray van and trailer, it is necessary for our apparatus to be installed within a firm's premises, and so every endeavour is made during the mobile period to X-ray either firms in the vicinity of a particular site or firms associated with the Company in which the apparatus has been installed. One case in point during 1956 was the Union International Company when we X-rayed the staffs of 20 associated firms. Of the firms examined during 1956 a high proportion were small or new firms. Of the total number X-rayed about 42% had not been X-rayed before or been examined for three years or more. 19. 2/ No Public Sessions, that is sessions without appointment, were arranged while the Unit operated at the Mass Radiography Centre, but a large number of the general public have been X-rayed there, as well as doctors' cases. Zone of Unit. The zone of Unit 6D remains the same, viz., the City of London, and the Metropolitan Boroughs of Finsbury and Shoreditch, with the administrative offices at the Finsbury Health Centre, Pine Street, London, E.C.1. Owing to the intensive day population there is a great demand for the services of the Unit, not only from new firms which are constantly being discovered as a result of our circulations, but also old firms requiring repeat examinations which are carried out at approximately two yearly intervals. Method of Operation. The Unit has continued its normal procedure while operating at the Mass Radiography Centre of holding miniature sessions on Mondays, Wednesdays and Fridays, from 9.15 a.m. to 12.30 p.m. and 2.00 p.m. to 4.30 p.m. Separate sessions have been arranged for men and women and there has again been a predominance of men. Tuesdays and Thursdays have been allocated for reading miniature films, taking and reading large films and interviews by the Medical Director, and for the dispatch of results to examinees, who provide the stamped (2½d) addressed envelope. Examinees receive their results within a week. During the mobile period the sessions may have had to be slightly varied depending upon circumstances. Whenever possible, a firm's internal postal system is used for the circulation of examination results, as this provides a saving in time for recalls for large films. Also during the mobile period, miniature films are read almost daily, so that there is no unnecessary delay over the taking of large films. Except for large films, examinees are X-rayed over their clothes; ladies being advised what to avoid wearing on the day of examination. The Unit has emphasised the importance of newly appointed staff being X-rayed, and this is being adopted by a large number of City firms. The results of such examinations are, of course, sent direct to examinees. Propaganda. This item of expenditure continues to be very low for this Unit and is only incurred when circumstances warrant it, as, for example, when the Unit pays its periodical visits to Finsbury or Shoreditch. Staff. During the year under review, notwithstanding sundry changes in both technical and clerical staff, all members have provided an efficient and courteous service which has been fully appreciated by those attending the Unit. 20. Medical Procedure. Abnormal cases have an interview with the Medical Director and are referred through the examinee's own doctor to the appropriate Chest Clinic; the ultimate diagnosis being secured from the latter. We express our grateful thanks to the many Chest Clinics, to which we have referred cases, for their helpful co-operation. The Unit classifies its abnormal miniatures, and appropriate notification is passed to the examinee. Where an investigation is outside the purview of a Chest Clinic, the co-operation of St. Bartholomew's Hospital is secured. The help rendered by Dr. N.C. Oswald and his colleagues is herewith gratefully acknowledged. An examinee, age 24, attended this Unit for a routine film in October 1953, and nothing abnormal was found. In March 1956, an opaque mass was found in the right side of the chest. On April the 30th, 1956, he was operated upon by Mr. N.R. Barrett, and a large dermoid was removed. Histologically it was a benign cystic teratoma. The interesting feature of this case is the rapid growth of a presumably congenital tumour during two and a half years of adult life. This case was reported in "The Lancet", June 1957, by Dr. R.F. Guymer, Chief Medical Officer, Lloyds Bank, to whom I am indebted for the details. Conclusion. Since the Unit commenced operating in May 1950, it has examined (up to the end of 1956) 208,373 males and 152,274 females, making a grand total of 360,647. The friendliest relationship has existed between the Unit and Dr. J. Greenwood Wilson, Medical Officer of Health for the City of London, and with the Medical Officers of Health for the Boroughs of Finsbury and Shoreditch, all of whom have been most helpful. Our grateful thanks must also be accorded to the London County Council and the Divisional Medical Officers in Health Divisions 3, 4 and 5. To the Central Group Hospital Management Committee and to the Regional Hospital Board, we have much pleasure in recording our gratitude for the many services they have rendered to this Unit during 1956". SHOREDITCH TUBERCULOSIS CARE COMMITTEE. I am grateful to Miss Guest, the Secretary, for the following report of Care Work for the year ended 31st December, 1956. "During 1956 the Shoreditch Tuberculosis Care Committee continued its work of caring for the social needs of the tuberculous patients of Shoreditch and their families. In March 1956, however, the Committee, following the 21. raising of the matter by the National Association for the Prevention of Tuberculosis, and bearing in mind that the needs of the tuberculous should still be paramount, agreed that necessitous cases suffering from chest diseases other than tuberculosis should, subject to the approval of the Chest Physician, receive help from the fund. In practice, however, this has not yet been found necessary, as any such cases have received help from other appropriate sources. The net amount added to the fund through the Christmas Seal Sale was £220. Very strong competition was encountered from other voluntary associations wishing to add to their funds through Christmas Seals. £40 was received from the L.C.C. Sunday Cinema Entertainments Fund and £17.10.0 from the United Charities of St. Leonard. Domiciliary Occupational Therapy has continued and at the end of the year eight Shore ditch home bound patients were taking advantage of the scheme, which operates under the same Occupational Therapist, Mr. M.J. Sloman, in the districts coming under the supervision of the Metropolitan, Stepney and Shoreditch Chest Clinics. Mr. Sloman also instructs the patients from the Metropolitan and our own clinic who attend here on Wednesday afternoons. The amalgamation of the two clinics for the purpose of the handicraft class took place after Whitsun through lack of patients' support, but more patients are now taking advantage of the s Scheme . As it had been proposed that patients in certain parts of Hackney should be transferred to this clinic in the New Year, it followed that a proportion of the Hackney Fund should also be handed over to Shoreditch to enable the necessary care work to be carried on without a break, and it was decided that, if the transfer operated as from 1.1.1957, an amount of £45 should be handed over, or proportionately less if the transfer took place at a later date. It is very sad to have to report that on the 26th April, 1956, Sister M. Gilroy, who had been a Tuberculosis Health Visitor on this Borough for many years, died unexpectedly and the members of the Committee put on record their appreciation of her work for the tuberculous patients of Shoreditch. We thank all who have assisted the Committee in any way during the year, particularly the Soldiers', Sailors' and Airmen's Families Association and the Forces Help Society. 22. V. SOCIAL WELFiffiE SERVICES At last the Council's activities will be able officially to include the visiting of old age pensioners. This most necessary work has previously had to be done as a side issue by two of our existing staff appointed for other purposes, and has consequently been a heavy additional load. But now a regular income around £225 a year has been promised from the funds of the City of London and East London Dispensary which formerly gave free help to the sick-poor, and which was closed down as a result of the National Health Service Act of 1948. The trustees of this fund were so overwhelmingly in favour of a visitor being appointed, that the Council have agreed to supplement enough to pay the balance of her wages. As the actual appointment was in 1957 this will be referred to in next year's report, with further details of results. Meanwhile, the various old people's clubs continue at the same rate, and the enthusiasm of their handicraft work continues. Unfortunately the "Bell" Club's premises were sold over our heads, and this club has had to be accommodated in the Town Hall as a temporary expedient. However, at the time of going to press, there is great hope of their having the daytime use of a first-class community centre before next year's report is due. The Council's Holiday & Rest Home at Copthorne (on the borders of Sussex and Surrey) has become so popular with King Edward's Hospital Fund guests, that it is kept filled to capacity at most times of the year, especially as regards its six new ground floor bedrooms for which there is great competition'. However, with a total capacity for well over 40 adults apart from children, it is becoming well known all over the country, our latest enthusiasts being Exeter'. Shoreditch residents use it well between June and September and over Christmas, but K.E. patients Cases assisted by Shoreditch Tuberculosis Fund:- Cases referred for extra help to- Clothing 28 National Assistance Board Fares 53 (in addition to applications loans 6 for maintenance) 4 Rent Arrears 2 S.S.A.F.A. 4 Holidays 2 Forces Help Society 9 Money Grants 5 Shaftesbury Society 3 Wireless Expenses 4 L.C.C. (Clothing) 4 Other help 15 L.C.C. (Samaritan Fund) 2 W.V.S. 1 Glasspoole Trust 1 25. support it entirely for the rest of the year. Unfortunately 1956 saw us in some difficulty in getting an efficient replacement for our faithful old cook when she retired, but our difficulties in that direction seem now to have been solved. The coach in which guests have been taken to Copthorne for many years became useless during the year, and thanks to King Edward's Hospital Fund who covered half the cost, this was replaced by a luxurious vehicle of the same capacity which now gives not only greater comfort in the journeys between the Town Hall and Copthorne, but is in great demand for trips to the seaside from the Home. The old coach has been placed in the grounds and still gives great pleasure to the children as their most realistic toy. The extremely close liaison with St. Matthew's Hospital for the elderly sick, and with the L.C.C's "Hillside" Home for the elderly needing care and attention only, has been of very great help to the department. The Meals on Wheels service had a setback for the moment when the Red Cross were unable to find enough personnel to continue their share of deliveries. However, the local Salvation Army Goodwill Centre nobly stepped into the breach and now deliver even more meals each day (except Monday) than the W.V.S., as well assupplying their own vehicle. A further help to an increase in the number of meals delivered to the home bound each day has been by dividing the Borough so that one half is supplied entirely by the W.V.S. while the other half is dealt with by the Salvation Army only - thus reducing the mileage and time of each vehicle and avoiding duplication of journeys. During the year, new insulated containers of a smaller size have been supplied by the Council, as the previous ones were too heavy for women to lift. In addition the Council has agreed to provide a new van for the W.V.S. during 1957, a Council driver still working daily for them from 11 a.m. to 2 p.m. The meals continue to be cooked by a local caterer who was able for a month or two after his payments increased from ]/6d to 1/8d (following an increased grant from the L.C.C. of lOd instead of 8d), to give the old people a weekly treat such as steamed chicken for their lOd payment. This produced an increase in club members having lunch at that time, but now that the caterer's costs have further increased, these treats have unfortunately had to cease. The co-operation of District Nurses as well as L.C.C. Health Visitors and Hone Helps, has been of great assistance to our staff, and much appreciated by all concerned. We have given the L.C.C's Duly Authorised Officers some awkward problems and have forged closer links with Long Grove Hospital, Epsom, this year. Arrangements have been made with St. Matthew's Hospital for the laundering of bed linen etc., of the incontinent at the expense of the Borough Council. Altogether we feel that our Social Services for the aged are doing first class useful work. 24. The numbers of persons who attended the Shoreditch Holiday & Rest Home at Copthorne during 1956 were as follows:- Adults 238 10-18 years 21 5-10 years 66 9 months - 5 years 175 Under 9 months 60 Old Age Pensioners 231 Conference members - Total 791 The following table shows the average attendances at the Old People's Clubs during the year (1) (2) (3) Old People's Clubs Average number of attendances Av. weekly No. of Mon. Tues. Wed. Thu. Fri. Sat. Dinners Teas Hoxton Hall M. 4 — — — 6 — — 115 (2.30 - 4.30 p.m.) F. 21 — — — 82 — Bell M. 21 22 23 22 24 — 59 141 (10.30 a.m. - 4.30 p.m.) F. 4 9 8 8 16 — Haggerston M. — — 13 5 — - 92 (2 .30 - 4.30 p .m.) F. - - 35 38 - - Moorfields M. 2 2 2 2 2 — 34 61 (10.30 a.m. - 4.30 p.m.) F. 5 12 11 7 10 — Wenlock M. 12 12 10 16 10 — 85 532 (10.30 a.m. - 4.30 p.m.) F. 44 48 43 57 43 - 25. VI. - SANITARY CIRCUMSTANCES. The following tables summarize the visits of inspection and the work of the Public Health Inspectors during 1956. INSPECTIONS. Housing Act, 1956, Section 5 239 Housing Act, 1936 Section 9 - Housing Act, 1936, Section 12 382 Housing Repairs & Rents Act, 1954 95 Clearance Areas 471 Other Dwellings 3,626 Premises not specified below 1,096 Factories - mechanical 1,164 Factories - non-mechanical 69 Rag Flock Act, 1951 35 Pet Animals Act 1951 37 Outworkers 83 Hairdressers 193 Bakehouses 49 Milkshops 140 Cookshops 26 Fried Fish shops 23 Ice Cream shops 62 Butchers' shops, stalls, stores, etc. 94 Rag & Bone dealers 14 Food stalls 203 Registered Food shops or premises 1,207 Fish curers' premises 1 Fur skin dresser's premises 5 Stables 14 Shops Act, 1950 537 Smoke observations 594 Pharmacy & Poisons Act, 1933 45 Markets 90 Canteens 166 Vacant sites 168 Dangerous buildings 22 Infectious disease visits 447 Rodent Infestations 718 RE-INSPECTIONS. Housing Act 1956, Section 5 25 Housing Act, 1936, Section 9 - Housing Act, 1936, Section 12 50 Housing Repairs & Rents Act 1954 29 Clearance Areas 57 Other Dwellings 7,390 Factories 578 Rag Flock Act, 1951 1 26. RE-INSPECTIONS (Contd.) OutWOrkerS 4 Hairdressers 82 Bakehouses 49 Milkshops 60 Cookshops 186 Pried Fish Shops 23 Ice Crean Shops 8 Butchers shops, stores etc. 37 Rag & Bone dealers 1 Food stalls 45 Food shops and premises 304 Fish curers - Shops Act 1950 52 Smoke observations 14 Canteens 145 Vacant sites 69 Infectious disease visits 70 Rodent Infestations 450 Non-effective visits 3,237 SUMMARY OF DEFECTS FOUND. Premises requiring cleansing throughout 3 Premises requiring partial cleansing 78 Premises - total rooms 152 Verminous premises 17 Verminous rooms 27 Premises requiring general repair 277 Light & ventilation requiring remedying 14 Roofs, gutters, rainwater pipes defective 617 Premises damp 355 Windows requiring repair or adjustment 640 Premises overcrowded 21 Water reinstated 45 Water supply required to upper floors 6 Drains, new 131 Drains requiring reconstruction 20 Drains requiring improvement or repair 59 Drains requiring obstructions removed 113 Drains tested 271 Old drains sealed off from sewer 72 Soil vent pipes requiring repair or renewal 15 V.C's. new 23 W.C's. requiring improvement or repair 289 W.C's, requiring obstructions removed 34 Sinks new 46 Sinks requiring improvement 47 Sinks requiring traps to be provided 3 Waste pipes requiring repair or renewal 33 Other items not specified 892 27 SUMMARY OF DEFECTS FOUND (Contd.) Outdoor Premises Floors or paving requiring repair 25 Requiring cleansing or limewashing 2 Dustbins requiring renewal 47 Ashpits requiring abolition 3 Accumulations requiring removal 53 Urinals requiring cleansing or repair 8 Animals improperly kept 1 NOTICES SERVED Public Health (London) Act, 1936 - Intimation Notices 1,421 Nuisance Notices 320 Housing Act, 1936 - Factories Act, 1937 37 Shops Act, 1950 - Prevention of Damage by Pests Act, 1949 13 Food & Drugs Act, 1930 265 COMPLAINTS RECEIVED 2,394 VERMINOUS PREMISES. It was necessary to take measures on account of the presence of vermin in 17 houses, and in connection with these 27 rooms were dealt with, sanitary notices being served Where necessary. PERSONAL CLEANSING. The arrangement with the Fins bury Borough Council whereby residents of Shore ditch requiring treatment for Scabies or Vermin are sent to that Authority's Cleansing Station at Pine Street, was continued throughout the year. The numbers of treatments carried out are shown in the following tables:— VERMINOUS PERSONS. New Cases Total new cases Reattendances Total treatments 0 to 15 years Over 15 years - 4 4 - 4 SCABIES. New Cases Total new cases Reattendances Total treatments 0 to 15 years Over 15 years 5 8 13 8 21 (Until school-leaving age, the L.C.C. treat all affected Children at their own Centre). 28. DISINFECTION AND DISINFESTATION. The number of disinfections of rooms after infectious disease and for other reasons was 74, The number of articles disinfected in this connection at the Council's disinfector was 543. During the year 501 rooms were sprayed for verminous conditions and the number of articles disinfected was 6390. In addition to the articles disinfected for infectious disease, etc., the Department carried out disinfection of articles for private firms in the Borough, and various goods were disinfected, for which charges amounting to £3.l0s. were made. During the year a new disinfecting apparatus was installed to replace the previous disinfecting apparatus Which was in a bad state of disrepair. The previous method of disinfecting by steam has been replaced by this new method of formaldehyde disinfection. Prom a Public Health point of view the new method of disinfection has been satisfactory but it is yet early to give a full comprehensive view on the question of cost. However, during the time the new apparatus has been working the cost of disinfection has been considerably reduced. In respect of one item alone - namely coal - in 1955 42 tons of coal were consumed at a cost of £221 and as the cost of the chemical fluid is considerably less the resultant saving in 12 months has been approximately £168 during the use of the new apparatus. The one big saving which cannot be estimated in £ s d is the fact that it takes less labour to manipulate as against the old steam boiler method, coupled with the fact that a contribution has been made towards reducing atmospheric pollution by the elimination of coal-consuming apparatus. During the year 288 families were removed to new housing accommodation on the Borough Council's housing estates. This work entails a considerable amount of additional work for the staff. All furniture is disinfected by the Hydrogen Cyanide method prior to removal to the new accommodation by a firm of contractors under the supervision of the officers of the Department. When informed by the Housing Department of the families to be removed, it is necessary for an officer of the Public Health Department to ascertain the amount of furniture per family and to make arrangements as to whether one or more families can be removed in the one furniture van. By this means there is a considerable reduction in the cost of removals. The vans are usually met at 8 a.m. at a rendezvous on the date of removal and it is our duty to see that all the furniture is placed in the van and the tenant given instructions with regard to food as well as seeing that arrangements are made for the reception of soft furniture after disinfestation has taken place. 29. When the furniture is loaded on the van it is taken to the Disinfecting Station; the van is then sealed and charged with HCN. The whole of the contents are disinfested for approximately four hours, the van is then opened, tested, and when clear of HCN the van moves to the new flat and the furniture is delivered. Soft goods, (that is, bedding, mattresses etc.) which are collected at the same time as the furniture by the Borough Council disinfecting van, are disinfected by the Council's disinfecting apparatus and returned at the same time as the furniture. The next morning the whole of the furniture is chemically tested to make sure that the whole of the HCN has been removed from the furniture and fittings. Much work has been done during the year in connection with the prevention of the breeding of cockroaches and beetles. Hot water ducts in new Council flats provide a favourable breeding ground for cockroaches and beetles but by arrangement with the Borough Architect's Department insecticide powder is placed in the hot water ducts when they are being constructed. This method of control has proved to be very successful. The depositing of insanitary and other putrescible matter on vacant sites and other places by unauthorized persons is a practice which is not easily controlled. During the year many sites have been sprayed to prevent the breeding of flies on putrescible matter, 113 articles being removed and 48 sites sprayed. HOUSING REPAIRS AND RENTS ACT, 1954. The work in connection with the above-named Act, which came into force in 1954, has considerably lessened in the last year, and in particular, applications made on behalf of tenants for Certificates of Disrepair have been considerably reduced. During the year 10 applications were made on behalf of tenants for Certificates of Disrepair where Notices of Increase of Rent had been served by the owners, as compared with 80 applications in 1955. Of the 10 applications made, 6 were granted. In this connection 38 applications for Certificates of Revocation in respect of Certificates of Disrepair previously served were received and in 36 cases these were granted. It is a requirement that owners shall provide certain particulars in the rent books and in all cases where the Public Health Inspectors have visited dwelling houses the rent books have been inspected, and where the provisions of the Act had not been complied with, letters were sent to the owners pointing out the contravention of the Act. In this connection 31 letters were sent to owners and in all cases the particulars were inserted in the rent books. 30. Whilst the period of four months from August 1954, and a full year's working during 1955 was too short a time to draw definite conclusions on the likely effect of the new provisions, a full working year during 1956 has proved in no uncertain manner that the fears expressed by Public Health officials everywhere that as a means of securing the repair of property, Part II of the Act was in reality of little value. REGISTRATION OF HAIRDRESSERS. The Chief Public Health Inspector and his Deputy made inspections of the 47 registered hairdressing establishments in the Borough. Advice wa given on the conditions and standards of hygiene required by the Byelaws, and in certain cases where deficiencies were observed intimation of the defects was given to theoccupiers. Generally speaking the standard of cleanliness observed in the hairdressing establishments in the Borough is good. WATER SUPPLY. The water supply of the Borough is controlled by the Metropolitan Water Board and is relayed from public mains direct to houses. No complaint regarding the quality of the water was received during the year SWIMMING BATH WATER. There are two Swimming baths in the Borough, one of which is open all the year round, the other during the summer months only. During the year thirteen samples of water from the baths were sent for bacteriological examination and thirteen for analytical examination, and all were found to be satisfactory. EXAMINATION OF WATER FROM WELLS . Three wells were in use in Shoreditch during the year, none being used for drinking or domestic purposes. OFFENSIVE TRADE PREMISES. An establishment order under Section 140, Public Health (London) Act, 1936, was renewed during the year in respect of the business of a Fur Skin Dresser. The number of visits made was 3. 31. SHOPS ACT, 1950. Sub-Section (2) of Section 38 of the Shops Act, 1950 requires that in every shop, not being a shop exempt from the provisions of this Sub-Section, there shall be provided and maintained suitable and sufficient sanitary conveniences available for the use of persons employed in or about the shop. Sub-Section (6) of Section 38 provides that a shop may be exempted from the provisions of Sub-Section (2) if there is in force a certificate exempting the shop therefrom granted by the authority whose duty it is to enforce those provisions. A certificate is granted if the authority are satisfied that by reason of restricted accommodation or other special circumstances it is not practicable to provide such accommodation on the premises and that alternative arrangements are conveniently available. 13 Certificates of exemption in respect of sanitary conveniences were issued during the year. The number of inspections and re-inspections made during the year was 589. COMPULSORY REMOVAL OF AGED AND INFIRM PERSONS. Under Section 47 of the National Assistance Act, 1948, the Council are empowered to apply to a Court for an Order for the removal to hospital or other institution of a person who is aged, infirm or physically incapacitated, and who is living in insanitary conditions and "unable to devote to himself, and is not receiving from other persons proper care and attention". In addition, during 1951, the National Assistance (Amendment) Act came into force. Under this Act, on certification by the Medical Officer of Health and another practitioner, emergency removals of such people for periods not exceeding three weeks may be enforced by the Courts. No action under this Section was necessary during the year. RAG EEALERS. There are 14 premises in the Borough in which the business of Rag Dealer is carried on. 14 Visits were paid during the year. ATMOSPHERIC POLLUTION. The passage of the Clean Air Bill through Parliament and the granting of Royal Assent on July 27th, 1956 with the prospect of the Act becoming operative towards the end of the year, was a signal for the collation of vital information and the formulation of measures whereby the Act could be properly implemented as soon as possible when required. 32. The Act became law on 31st December 1956 and by reason of its significance and by the fact that it greatly extends the functions of Public Health authorities, a summary of its purpose and measures required to implement it may prove to be both interesting and instructive. The main purposes of the Act are : (a) to prohibit the emission of dark smoke from chimneys, railway engines and vessels (b) to prohibit the installation of new industrial furnaces which are not capable, so far as is reasonably practicable, of being operated without emitting smoke (c) to minimise grit and dust from existing plant, and that new industrial furnaces burning pulverised fuel, or substantial quantities of other solid fuel, shall be provided with grit-arresting equipment and (d) to empower local authorities to determine "Smoke Control Areas". As from the first appointed day, viz. 31st December 1956, three sections of the Act became operative by Metropolitan Borough Councils, viz. Sec 3, requiring new furnaces to be, so far as is practicable, smokeless., Section 11, which gives a local authority power to determine areas to be 'Smoke Control Areas'., and Section 18 which deals with smoke nuisances from spoilbanks. It will also be the duty of local authorities to enforce Regulations made by the Minister concerning density meters and, under Section 24 of the Act, local authorities will be held responsible for making bye-laws to prevent the emission of smoke, so far as is practicable, from heating and cooking appliances in new buildings. Briefly this summary therefore portrays the objectives to be aimed for and also the parts of the Act operative as from 31st December this year. The introduction of the Act has already added to the duties of a depleted staff of Public Health Inspectors. To effectively implement the Act a full survey of all commercial and industrial undertakings and certain areas of private dwellings to obtain information regarding the types of appliances and fuels used was commenced in September At the end of the year about half of the 2000-odd business premises had been surveyed and during the year 394 smoke observations were made. This important work is continuing. In addition, the volumetric measurements of atmospheric pollution has been maintained throughout the year and reference to the chart appended indicates that Shoreditch compares very favourably with other Metropolitan Boroughs regarding the amount of atmospheric pollution. 33. An important additional responsibility to be borne by the Public Health Inspector is that whilst it is obligatory on the part of a person proposing to install a new industrial furnace and other large furnaces such as may be found in large hotels and blocks of flats, persons may submit plans and specifications of such plant for approval of the local authority before installation in order to place the onus on the local authority should the plant prove ineffective in preventing the emission of smoke in practice. The Public Health Inspector is well qualified to deal with the majority of such plants likely to be installed in Shoreditch, but it may be necessary, in the event of a major industrial type of furnace, to seek specialist advice when considering such plans and specifications. 'Smoke Control Areas' As from 51st December 1956, local authorities will be enabled to establish smoke control areas by means of Orders confirmed by the Ministry. Broadly speaking, the effect of a Smoke Control Order will be to prohibit either entirely or partly the emission of smoke from chimneys in the area. The local authority may exempt certain buildings in the area according to local circumstances. The establishment of Smoke Control Areas will be a gradual process, the governing factors being the availability of smokeless fuels, the rate at which appliances can be converted or replaced, the financial resources of the local authority and public support. Encouragement, in the form of grants, may be given by the local authority to owners and occupiers who adapt existing fireplaces in private dwellings in the form of 70% of the cost of adaptations (the local authority bearing and the Exchequer 40%). The local authority also has power to make grants at their discretion to Churches, Chapels and charitable institutions, but grants are not to be made with regard to any other type of property. There can be no doubt that close liaison between neighbouring authorities will be of the utmost importance in establishing Smoke Control Areas and every effort should be made in this direction to encourage these authorities whose boundaries adjoin Shoreditch to enter into discussion before submitting any recommendations for the establishment of smoke control areas. 34. The Prohibition of Dark Smoke One of the most important provisions of the Act to prevent atmospheric pollution is Section 1 when, after an appointed day early in 1958, it will be an offence for the occupier to emit dark smoke from the chimney of any building (subject to certain exemptions) under the following maximum penalties - £10 in the case of a private dwelling and £100 in the case of other properties, and emissions on separate days will constitute separate offences. No longer will the Public Health Inspector be subjected to the laborious procedure of proving a public health nuisance, and it is anticipated that this Section will be of immense value when operative, in minimising atmospheric pollution from all types of properties. ATMOSPHERIC POLLUTION 1955-56 HIGHEST & LOWEST DAILY RECORDS OF SMOKE IN LONDON BOROUGHS & IN SHOREDITCH LONDON BOROUGHS SHOREDITCH Highest Lowest 8.73 0.30 Highest 0.53 Lowest 0.35 MILLIGRAMS PER CUBIC METRE 35. CLEARANCE AREAS. During the year official representation was made under Part III of the Housing Act, 1936 in respect of the following areas:- Area No. of houses No. of persons Action taken Haggerston Road Area. 10 55 Represented and declared a Clearance Area on the 25th September, 1956, but not yet confirmed by Ministry of Housing & Local Government. Nicholas Street Area. 45 165 -do- HOUSING - OVERCROWDING AND PREFERENTIAL TREATMENT. At the end of 1955 the total number of overcrowded cases on the Public Health Department register was 174, and the number on the medical preferential treatment register was 63. During the year 21 new cases of overcrowding and 4 new cases recommended for preferential treatment on medical grounds were added to the register. 26 Overcrowded families and 2 preferential treatment cases were rehoused. The number of overcrowded cases remaining on the register at the end of the year was 169, and the number on the preferential treatment register was 65. Sixty-one visits of inspection were made during the year. 36. UNDERGROUND ROOMS. During the year 26 underground rooms were reported on, and Closing Orders were made or Undertakings accepted in respect of 25. In 4 cases Closing Orders were determined, the rooms being made to comply with the Underground Room Regulations. The number of underground rooms on the register at the end of the year was 882. FACTORIES ACT, 1937. The number of factories on the register at the end of 1956 was :- Power Factories 1,085 Non-Power Factories 135 Total 1,220 During the year 82 factories were added to the register and 127 were deleted, making a nett decrease in the number of factories in the Borough of 45. 37. The particulars of inspections made during the year are as follows:- Premises Number of Inspections Written Notices Occupiers Prosecuted Power Factories 1,724 32 — Non-Power Factories 87 5 — Other Premises under the Act (including works of building and engineering construction but not including out-workers' premises) — Total 1,811 37 — The defects found and dealt with were as follows:- Particulars Number of defects Number of cases in which prosecutions were instituted Found Reme die d Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (Section l) 4 5 - 2 - Overcrowding (Section 2) - - - - - Unreasonable temperature (Section 3) - - - - - Inadequate Ventilation (Section 4) - - - - - Ineffectual drainage of floors (Section 6) - - - - - Sanitary Conveniences: (l) Insufficient 5 7 - - - (2) Unsuitable or defective 39 70 - 3 - (3) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to outwork) 28 32 - - - Total 76 114 - 5 - 38. HOME WORK. During the year 59 lists of outworkers were received from employers in the Borough, 31 in the first half-year due in February, and 28 in the second half-year due in August. These lists contained the names of 1,354 outworkers, of whom 1,162 were not resident in Shoreditch. The addresses of those non-resident were forwarded to the Sanitary Authorities of the districts to which they belonged. Lists were also received from 16 other Local Authorities containing the names of 381 outworkers living in Shoreditch and employed by firms outside the Borough. The total number of out-workers reported was therefore 1,735. As has been pointed out in previous reports, in numerous instances names and addresses of outworkers are duplicated owing to lists being sent in twice a year, and in some cases out-workers are employed by more than one firm, so that the numbers given must not be taken as representing actual numbers of individual workers. The tables on pages 39 and 40 show the distribution of out-workers as regards trades. During the year 87 visits of inspection were made to places where home work was being carried on, but no defect necessitating the service of a sanitary notice was found. 39. HOME WORK. The following is a summary of the lists received from employers in the Borough NATURE OF WORK OUTWORKERS' LISTS, SECTION 110 Outwork in unwholesome premises Section III Outwork in infected premises Lists received from Employers Notices served on Occupiers as to keeping or sending Lists Prosecutions Instances Notices served Prosecutions Instances Orders made Prosecutions February Aureus t Failing to keep or permit inspections of Lists Failing to send Lists Lists Outworkers lists Outworkers Contrac tors Workmen Contrac tors Workmen (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Artificial Flowers 1 — 15 1 — 11 — — _ — — — — — — Boxes 4 — 141 5 — 66 — — — — — — — — — Brushes 1 — 5 1 — 6 — — — — — — — — — Button Mounting 2 — 56 2 — 44 — — — — — — — — — Paper Bags 2 — 11 1 — 6 — — — — — — — — — Stuffed Toy Making 2 — 117 2 — 128 — — — — — — — — — Wearing Apparel 18 77 305 15 68 291 — — — — — — — — — Upholstery 1 — 5 1 — 2 — — — — — — — — — Total 31 77 655 28 68 554 — — — — — — — — — 40. The following table shows the number of outworkers living in Shoreditch and employed by firms outside the Borough during 1956 as notified by the various sanitary authorities. DISTRICTS NUMBERS OF OUTWORKERS RECEIVED PROM OTHER DISTRICTS DURING 1956 Making Wearing Apparel Toys and Crackers Artificial Flowers Lamp Shades Umbrellas etc. Paper Bags and Boxes Sweet wrapping Furniture & Upholstery Card Mounting Brushes Feather mounting Totals Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb . Aug. Feb. Aug. Feb. Aug. Feb. Aug. Bethnal Green 23 25 2 — — — — — — — — — — — — — 1 — 1 1 — — 27 26 Finsbury 54 35 7 3 1 2 — — 2 2 2 3 — — — — 6 8 — — — 1 72 54 Hackney 20 14 — — 7 2 — — — — 3 3 4 — 1 1 — — — — — — 35 20 Holborn 1 2 — — — — — — — — 1 1 — — — — — — — — — — 2 3 Islington 1 19 — 2 — 6 — — — — — — — — — — — — — — — — 1 27 Kensington 1 1 — — — — — — — — — — — — — — — — — — — — 1 1 Lewisham 1 1 — — — — — — — — — — — — — — — — — — — — 1 1 S.t.Marylebone 3 3 — — — — — — — — — — — — — — 1 — — — — — 4 3 London, City of 5 5 — — — — — — — — — — — — — — — — — — — — 5 5 St. Pancras 3 2 — — — — — 1 — — — — — — — — — — — — — — 3 3 Southwark 1 1 — — — — — — — — 1 1 — — — — — — — — — — 2 2 Stepney 5 7 — — — — — — — — — — — — — — — — — 19 — — 5 26 Stoke Newington 5 7 — — — — — — — — — — — — — — — — — — — — 5 7 Westminster 35 — — — — — — — — — — — — — — — — — — — — — 35 — Woolwich 1 — — — — — — — — — — — — — — — — — — — — — 1 — Tottenham 2 2 — — — — — — — — — — — — — — — — — — — — 2 2 Totals 161 124 9 5 8 10 — 1 2 2 7 8 4 — 1 1 8 8 1 20 — 1 201 180 41. HEATING APPLIANCES (FIREGUARDS) ACT, 1952 General observation was kept on the sale of heating appliances to ensure that they complied with the Regulations made under the above—named Act. In several cases the sellers and users of heating appliances requested that their guards be tested. The Chief Public Health Inspector made several tests of appliances at the request of manufacturers and others in the Borough, PREVENTION OF DAMAGE BY PESTS ACT, 1949. The rodent staff employed for this particular work consists of one rodent supervisor — Mr. Bryant (part—time), one investigator and two rodent operators. The whole of the sewer system throughout the Borough was treated, and poison baiting was carried out twice during the year. The second maintenance treatment of 1956 was carried out in the Borough from the 26th November to 8th December inclusive, when for the first time a full scale Warfarin 5 treatment was carried out. This is the first time that this system of baiting has been carried out in the London area. The initial results are very satisfactory and the officers of the Ministry of Agriculture, Fisheries and Food are satisfied up to the present with the results of this new method of treatment. Further treatments are being carried out in a similar manner during 1957 and until these treatments have been carried out, complete results as to whether the experiment has been a success or not cannot be fully estimated. The number of complaints received in connection with the common rat increased during the year, probably owing to the amount of new building which has been done in the Borough and the consequent disturbance of old drains during demolition. It is customary, when buildings are demolished, for the Public Health Inspector to visit and ensure that the old drains are effectively sealed off from the sewer. In connection with the complaints received, 271 drains were tested and in 79 cases it was found that the drainage was defective. Notices were served to remedy the defects found. There has been a continued decrease in complaints regarding infestation by the black rat. During the year the system of arranging for contracts with business firms to assist them in rodent disinfestation was instituted. 26 Contracts were entered into. Infestations from mice appear to have been on the decrease this year. The following tables are an indication of the amount of work carried out in connection with the Prevention of Damage by Pests Act 1949- 42. REPORT FOR 12 MONTHS ENDING 31.3.57. Council Property Dwelling Houses Business Premises Total No. of properties in Borough 16 11,984 3,029 15,029 No. of properties inspected as a result of: (a) Notification 1 245 90 336 (b) Survey under the Act — 126 272 398 (c) Otherwise ~~ 905 444 1, 349 Total inspections carried out 81 3,645 1,867 5,593 No. of properties inspected which were found to be infested by: (a) Rats Major — — — — Minor 1 98 79 178 (b) Mice Major — — — — Minor — 139 25 164 No. of infested properties treated by Local Authority 1 235 75 311 No. of notices served under Section 4 of the Act: (a) Treatment (b) Structural works (i.e. Proofing ) — 8 5 13 No, of cases whore action was taken following service of notice — — — — Legal Proceedings. — — — — No. of "Block" control schemes carried out 46. 43. Details of treatments carried out Business premises Dwellings Rats Rats Mice Pre—baits laid — 288 250 Poison baits laid — 140 115 Warfarin trays laid 1,310 294 868 Traps set — 116 13 Estimated kill * 63 * *No estimate can be given. Sewers. June Dec. No. of manholes baited 418 428 Complete takes—pre—bait 34 —poison bait — 110 Partial takes — pre—bait 265 — poison bait 276 156 No takes —pre—bait 119 —poison bait 142 162 Estimated kill 1,191 * *No estimate can be given. Charges for servicing of business premises under Contracts and by single treatments carried out from 1st April 1956 to 31st March, 1957 amounted to £748. 7. 6. PIGEONS. luring the last few years the nuisance from pigeons has increased, and permission was granted to a specialist pigeon trapper to trap pigeons causing a nuisance in the Borough. This work is carried out without any charge to the Council and the trapper works under the general direction of the Chief Public Health Inspector. 44. NUISANCES FROM NOISE. Several complaints regarding nuisances from noise were made during the year. In all cases a satisfactory arrangement was made in connection with the use of machinery after inspections had been made by the Public Health Inspector. FOOD— HYGIENE. The work in connection with food hygiene was continued throughout the year, and regular inspections of all premises in the Borough where food is handled were carried out. The total number of food—handling premises in the Borough at the end of 1956 was 916, as follows Cafes and Restaurants 116 Factory and Warehouse Canteens 65 Ice Cream Shops and Manufacturers 104 Milk Shops and Depots 87 Butchers Shops and stores 44 Fried Fish Shops 10 Wet Fish Shops 6 Fish curers 1 Bakehouses 12 Food Warehouses 7 Grocery and Provision shops 131 Confectioners shops 72 Greengrocers shops 37 Public Houses 131 Food stalls 92 Coffee stall 1 916 The Food and Drugs Act 1955 which consolidated and amended previous food legislation became operative on the 1st January 1956 and included the Food Hygiene Regulations 1955 made under this Act, 45. As from September 1956 the Public Health Committee decided to make two appointments of Public Health Inspectors with special duties for the inspection of all food premises including stalls, canteens and other catering premises. The initial inspections under the new Regulations took up much more time than previous inspections, as additional information was required to be provided in the majority of premises and much time was spent in discussing with owners and— occupiers concerning the necessary improvements. In this connection many re—visits had to be made during the progress of the work and again at the final completion of works. In order to assist owners of food premises to understand the requirements cf the Food Hygiene Regulations, a booklet entitled "Your Guide to the Food Hygiene Regulations 1955" was distributed at the time of the initial inspection. A large amount of equipment has been installed and repairs and redecorations carried out in consequence of the service of notices. The improvement in food hygiene at food premises has been very noticeable. Some 87—1 food premises were inspected and in connection with work requested 2.14 notices were served. 747 re—inspections of the premises were made whilst work was in progress. By the end of the year the primary inspections of all food premises in the Borough had been practically completed. With regard to the requirements of the Food Hygiene Regulations as thoy affect street traders in food, the co—operation of the Eoxton Street Traders' Association was sought and the Regulations explained to the Honorary Secretary, who passed on the information to the stall holders concerncd. With few exceptions the various food stalls in the Borough now comply with the Regulations. Regular weekly inspections are made of all food stalls and the standard has improved considerably. FOOD HYGIENE. During the year observations wore kept in connection with the Regulation which prohibits the use of tobacco, including snuff, while handling open food in any food room in which there is open food. In six cases contraventions were observed and warning letters were sent in tho first instance to the offenders. In one case, after two previous warnings, the offender was prosecuted and fined £1 and ordered to pay one guinea costs. As a result of notices served under the Food Hygiene Regulations 1955 during the year the following items of work and apparatus were completed and installed:— 46. WORK COMPLETED, AS REQUIRED BY NOTICES SERVED UNDER THE FOOD HYGIENE REGULATIONS 1955, DURING 1956 Wash hand basins provided 39 Sinks—not wash hand basins—provided 18 Provision of hot water over sinks and wash hand basins 51 Accommodation for clothing provided 7 Refrigerators provided 2 Wash your hands notices provided 65 Light and ventilation provided 4 General repairs completed 6 Dirty floors cleansed, repaired, covered etc. 12 Nail brushes provided 10 Ventilated spaces between sanitary accommodation and food rooms 3 Food cabinets provided 8 Food preparation tables covered with non—absorbent materials 19 Premises or parts of premises redecorated 22 Improvements to urinals 4 First aid materials provided 12 Additional dustbins provided 2 STALLS Name and address on stall 4 Facilities for washing equipment provided 2 Nail brushes provided 2 Water supply provided 2 Screening of stall provided 1 Refuse bins provided 1 ANTI—FLY CAMPAIGN. The campaign to combat the fly nuisance was continued. By arrttngement, and with the co—operation of the Transport & Cleansing Superintendent, all dustbins and dust chutes were dusted during the fly—breeding season with Gammexane after the receptacles had been emptied by the Council1 s refuse collectors. Owners of blocks of flats were again encouraged to take action against flies, by purchasing insecticide supplied by the Public Health Department at cost price. Fly sprays were also sold to occupiers of food premises. FREE WASHING FACILITIES. Free washing facilities are installed in every public sanitary convenience in the Borough. These facilities are being made use of by an increasing number of users of the conveniences and are a regular feature in the use of public conveniences. 47. CHEMICAL ANALYSIS OF FOOD. 302 samples were submitted to the Public Analyst during the year, giving a rate of 6.8 per 1,000 population. These were as follows Ale and Stout 5; Almonds, ground 1; Arrowroot 3; Baking powder and golden raising powder 4; Barley, pearl 3; Brandy l; Bread 5; Bread (rolls) and butter 11; Butter 3; Cake and pudding mixture l; Castor Oil 2; Chocolate Liqueurs 1; Coffee Extract, dry 1; Condiment (imitation vinegar) 1; Confectionery, flour 4; Confectionery, sugar 15; Cough Syrups 4; Cream 5; Curry Powder 2; Dessert Powders 2; Drinks, soft 13; Drinks, soft powder 3; Dripping 2; Fish, canned 2; Fish Paste 1; Flour, self raising 1; Fruit, dried 8; Fruit, canned 3; Fruit Curd 1; Fruit Juice 2; Goes Linctus 1; Gelatine 1; Gin 3; Ginger, crystallised 2; Ginger, ground 1; Glaubers Salt 1; Golden Raising Powder 1; Ham Rolls 1; Honey 2; Jam 6; Jelly crystals 1; Jelly tablet 2; Lard 4; Lentils 1; Margarine 3; Marmalade 1; Marzipan 1; Meat, minced 6; Meat Pastes 2; Meat Products 10; Meat Products, bottled 1; Meat Products, canned 3; Meat Products, pies 2; Milk 71; Milk, evaporated 1; Mincemeat 2; Mussels, bottled 1; Oil, cooking 1; Oil, frying 2; Olive Oil 1; Paraffin, medicinal 1; Pease Pudding, canned 1; Pepper 1; Pickles o; Potato Crisps 1; Pudding, canned 1; Rice, ground 3; Rum 1; Saccharin Tablets 2; Sauce 2; Sausages 5; Soda, Bicarbonate of 1; Soup Canned 1; Soup Preparation 1; Spice 4; Suet 2; Sugar 2; Tapioca 1; Tea 1; Tomatoes, canned 2; Vegetables, canned 4; Vinegar 4; Vitamen 'C' Tablets 2; Whisky 7; Wine alcoholic 4; A sample of broad submitted was found to contain a damaged carcase of a fly which had been baked in the bread. Legal proceedings were taken and the defendant was fined £6 and ordered to pay six guineas costs. Samples of bread slices submitted contained black deposits which were found to consist of charred bread and mineral oil. A Warning letter was sent to the baker. Samples of iced candies taken were found to be dusty and rancid. The remaining stock was seized, condemned by a Magistrate and destroyed. Warning letters were sent in respect of cakes sold as cream slices which contained only imitation cream, minced meat which contained sulphur dioxide preservative, and for minor adulterations in mineral water and ground nut oil. 48. UNSOUND POOD. During the year 212 certificates were issued in respect of food unfit for human consumption, which included the following:- Meat 446 tins; 7 cwt. 1 qtr, 10 lbs.; Meat Pies 12 cartons; Ham 45 tins, 6 lbs.; Bacon 19 tins; 40 lbs.; Choese 38 cwt, 2 qtrs. 25 lbs.; 531 pkts.; 4 tins; Fruit 1,263 tins; 24 pkts.; Fruit, dried 10 cwt. 1 qtr, 27 lbs.; Fruit, dried 2 boxes; Fruit, salad 46 lbs,; Fruit 1 cwt, 1 qtr, 20g— lbs,; Milk 6 tins; Milk Powder 2 cwt. 28 lbs.; Cream 3 tins; Buttermilk Powder 2 qtrs, 21 lbs.; Butter 6 lbs.; Horlicks 1 jar; Cocoa Powder 4 bags; Chocolatc Coverture 3 tins; Coffee 56 lbs.; Coffee Beans 1 cwt. 1 qtr.; Tea Sweepings 15 lbs.; Ovaltine 3 tins; Bovril 1 tin; Malt 1 cwt.; Marzipan 2 tins; Fondant 20 lbs,; 2 boxes; Sugar 4 cwt. 1 qtr. 10 lbs,; Mixed Sugar and Lentils 56 lbs.; Lard 15 lbs,; Margarine 7g— lbs.; Junket 72 lbs,; Jelly 4 cwt. 0 qtrs, 26 lbs,; Suet 84 pkts,; Coconut 52—g— lbs, ; Chinese Frozen Egg 11 lbs.; Chinese Egg Yoke 2 cwt,; Cashew Kernals 2 tins; Peas, dried 60 lbs,; Poas 27 tins; 2 bags; Onion Powder 15 lbs,; Sago and Onion Stuffing 720 pkts,; Lentils 1 cwt,; Beans 2 cwt, 1 qtr, 6 lbs,; Soup 28 tins; assorted Peas and Soups 14 tins. Salt 11 cwt,; Sauce 4 bottles; Salad Cream 5 bottles; Cereals 14 cwts. 2 qtrs, 5 lbs,; 323 pkts,; Fish 42 tins; Shell—fish 2 tins; Lemon Curd 3 tins; Honey 10 jars; Marmalade 6 tins; Rice 1 cwt, 11 lbs,; Oatmeal 1 cwt,; Flour 5 cwt. 1 qtr, 9 lbs,; Flour 5½ bags; Tapioca 56 lbs,; Cornflour 2 pkts.; Antelope Baking 10 lbs,; Bag Easy Mix 2 qtrs. 21 lbs,; Pastry 3 tins; Cake Powder 33 lbs,, Viota A.T. Mixture 27 pkts.; Viota Spongo 6½— ozs; Cake Mixture 1 lb; Breakfast Spread 2 cartons; Ryvita 1 carton; Beetroot 5 tins; Biscuits 19 lbs; Sundry Food Samples 1 case; Emulsifer 31 lbs.; Qualifil 1 tin; Nibbets 2 cartons; Kit—E—Kat 10 tins; In order to prevent waste where possible, most of the unsound food is allowed to be distributed to recognised dealers for the recovery of fat and other waste products. In all cases the local authority in whose aroa the dealers are situated is notified when unsound food is sent to the manufacturers, CHINESE DRIED EGG ALBUMEN AND CHINESE WHOLE FROZEN EGG During the year information was received from various authorities that it was proposed to release this commodity to local bakers, and in particular the Medical Officer of Health of the Corporation of London sent information that a consignment of a shipment which was suspected of having been responsible for an outbreak of paratyphoid fever was sold to a wholesaler in the London area and distributed to bakers in the Borough. Immediately on receipt of this information visits were paid to the premises mentioned but on the date of the visit it was found that the whole of the consignment had been used. 49. In one other case it was found that several parcels of Chinese Dried Egg Albumen had been distributed by a wholesale firm in the Borough. In all cases where this had been distributed, the local authority in the areas concerned were notified and samples were taken and tested bacteriologically. In connection with this consignment the wholesaler in the Borough concerned gave an undertaking that owing to the possibility of the Albumen which had been sold containing organisms of the Salmonella group the Albumen would be subjected to a heat process, and to this purpose a condition of sale was made at our request. In all cases the samples tested proved satisfactory and no adverse report was received from the bacteriologist. PRESERVATIVES IN FOOD REGULATIONS. Daring the year an informal sample of minced meat revealed the presence of Sulphur dioxide, 85 parts per million. A formal sample was taken, revealing the presence again of Sulphur Dioxide, 45 parts per million. Sulphur dioxide is an added preservative and is not permitted in minced meat. A warning letter was sent in this case. PHARMACY AND POISONS ACT, 1953. 35 Licences were granted during the year. 45 Inspections and visits were made, and general observation was kept of stalls and shops for unauthorised sellers, but no infringements were reported. PHARMACY AND MEDICINES ACT, 1941. Throughout the year a watch was kept for contraventions of the Act, but none was observed. MERCHANDISE MARKS ACT, 1926, ORDERS. General observation was kept of all stalls and shops in the Borough where foodstuffs scheduled under these Orders were exposed for sale. PET ANIMALS ACT, 1951. There were nine premises licensed under this Act during the year. In six cases a considerable business is carried on, mostly in birds and goldfish, but the other three deal on a very small scale only, one in dogs and the others in pigeons. During the year 37 inspections were made of these premises, and in no case were the conditions of the licence being contravened. 50. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951. At the end of 1956 the number of registered premises where filling materials were used was 111, and during the year 11 licences were issued in respect of premises where rag flock is manufactured or stored. 36 Inspections of the premises were made. 12 Samples of filling materials were taken and submitted to the Public Analyst. All were found to comply with the prescribed standards. PUBLIC HEALTH PROPAGANDA. During the year Public Health propaganda was continued. Health propaganda posters were posted and regularly changed from time to time on the Public Health notice boards which are fixed in positions on the Council's housing estates. There is also a large notice board situated at the Town Hall and also one at St. John's churchyard. In addition to this Public Health leaflefts have been distributed through the courtesy of the Borough Librarian at the Public Libraries. During the year food hygiene circulars have been distributed to all shopkeepers and stall holders and "Do Not Spit" notices have been distributed to owners of blocks of flats. Articles have been written and published in the "Newsletter" and in all cases of infectious disease food handlers' pamphlets are distributed. PAID PUPILLAGE. In accordance with the Working Party's recommendations, a system of paid pupillage for Public Health Inspectors has been extended by the appointment of three paid pupils. Those appointed are men who are exempt from National Service. One, who is in his final year, sits for his examination in July, 1957. Another, who has qualified as a Public Health Inspector in Southern Ireland, is now in his last two years of training and sits for the examination in 1958, whilst the third, who has commenced his theoretical training, will sit for the examination in 1959. These appointments are in addition to the student training scheme which was commenced in 1946 when students were appointed as clerks and were given the opportunity to train as Public Health Inspectors. In this connection the number of students was governed by the number of vacancies in the clerical establishment of the Public Health Department. At the end of 1956 three student Public Health Inspectors were being trained; one, in his first year, has been attending the National Building Certificate and the other two are in the last two years of their theoretical training and will sit for the examination in 1958. Since the beginning of the scheme in 1946 six students have been successfully trained and passed their qualifying examination. 51. FOOD & DRUGS (MILK & DAIRIES) ACT, 1944. MILK (SPECIAL DESIGNATIONS) ACT, 19497 The details of licences issued during the year under the various regulations are given in the following tables:— Milk (Special Designations) (Pasteurised & Sterilised Milk) Regulations, 1949. Pasteurised Sterilised Dealers Licences 66 92 Supplementary Licences 27 30 Totals 93 122 Milk (Special Designations) (Raw Milk) Regulations 1949 Tuberculin Tested Dealers' Licences 48 Supplementary Licences 27 Totals 75 EXAMINATION OF MILK SUPPLIED TO L.C.C. SCHOOL AND DAY NURSERIES. Samples of milk were taken from supplies delivered to local schools and day nurseries and submitted for chemical analysis, methylene blue and phosphatase tests. All were found to conform to the required standards. BACTERIOLOGICAL SAMPLING OF MILK. 23 Samples of pasteurised milk were submitted for phosphatase and methylene blue tests. All samples conformed to the prescribed standard. 52. HOUSING STATISTICS. 1. INSPECTION OF DWELLING—HOUSES DURING THE YEAR. (l) (a.) Total number of dwelling—houses inspected for housing defects (under Public Health or Housing Acts) 6,454 (b) Number of inspections made for the purpose. 14,079 (2) (a) Number of dwelling—houses (included under sub—head (l) above) which were inspected and recorded under Section 5, Housing Act, 1936. 239 (b) Number of inspections made for the purpose. 264 (3) Number of dwelling—houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 61 2. REMEDY OF DEFECTS DURING THE YEAR WITHOUT SERVICE OF NUISANCE NOTICES. Number of premises where it was found necessary to serve Intimation Notices under the Public Health (London) Act, 1936, to abate nuisances or remedy defects 1,421 3. ACTION UNDER STATUTORY POWERS DURING THE YEAR. A. Proceedings under Public Health Acts:- (l) Number of dwelling-houses in respect of which nuisance notices were served requiring defects to be remedied 320 (2) Number of dwelling-houses in which defects were remedied after service of nuisance notices (a) by owners 303 (b) by local authority in default of owners - 53. B. Proceedings under Sections 9, 10 and 16 Housing Act, 1936 (1) Number of dwelling—houses in respect of which notices were served requiring repairs (2) Number of dwelling—houses which were rendered fit after service of formal notices: (a) by owners (b) by local authority in default of owners C. Proceedings under Sections 11 and 13 of the Housing Act, 1936 . (1) Number of dwelling—houses in respect of which Demolition Orders were made or Undertaking accepted — (2) Number of dwelling—houses demolished in pursuance of Demolition Orders 2 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 or Undertaking accepted 58 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 4 E. Proceedings under Section 25 of the Housing Act, 1936. (1) Number of houses included in representations by Medical Officer of Health 55 (2) Number of houses demolished in pursuance of representations - F. Proceedings under Section 10 of Local Government (Miscellaneous Provisions) Act, 1953. (1) Number of Closing Orders made 2 (2) Number of Closing Orders determined - 54. 4. HOUSING ACT, Part IV-OVERCROWDING. (l) (a) Number of overcrowded families on register at beginning of year 174 (b) Number of new cases found during year 21 (c) Number of cases rehoused or found other accommodation during year 26 (d) Number of overcrowded families on register at end of year 169 LEGAL PROCEEDINGS. PUBLIC HEALTH (LONDON) ACT, 1936. Date Nature of Offence Fine Costs Result Jan. 13th Non compliance with Nuisance order—111 Shepherdess Walk. 5. 0. 0 3. 3. 0 Defendant fined £5 and ordered to pay £3.3.0 costs. Feb. 10th Non compliance with Nuisance notice—52 Regents Row. 3. 3. 0 Closing order made Defendant ordered to pay £3.3.0 costs. Feb. 10th Non compliance with Nuisance notice—15 Hoxton Market Res 3. 3. 0 Ordered to comply with notice within 14 days and to pay £3.3.0 costs. Feb. 10th Non compliance with Nuisance notice—113 Shepherdess Walk. 3. 3. 0 Ordered to comply with notice within 28 days and to pay £3.3.0 costs. Mar. 16th Non compliance with Nuisance notice—44 Nichols Square. 3. 3. 0 Ordered to comply with notice within 14 days and to pay £3.3.0 costs. July 27th Non compliance with Nuisance notice — 85 Gladstone Buildings. 3. 3. 0 Order for notice to be complied with, within 7 days and to pay £3.3.0 costs. 55. Date Nature of Offence Fine Costs Result Sep. 14th Non compliance with Nuisance notice—10a Moye Street. 3. 3. 0 Notice complied with. Defendant ordered to pay £3.3.0 costs. Oct. 19th Non compliance with Nuisance notice—54 Shrubland Road. 3. 3. 0 Order for notice to be complied with, within 14 days and to pay £3.3.0 costs. Oct. 19th Non compliance with Nuisance notice—62 Shrubland Road. 3. 3. 0 Order for notice to be complied with, in 14 days and to pay £3.3.0 costs. Oct. 19th Non compliance with Nuisance notice—25, Shaftesbury Avenue. 3. 3. 0 Order for notice to be complied with in 28 days and to pay £3.3.0 costs. Oct. 19th Non compliance with Nuisance notice—27 Westland Place. Order to Council for notice to be complied with in 14 days. Dec. 7th Non compliance with Dustbin notice—19 Haggerston Road. 3. 0. 0 3. 3. 0 Defendant fined £3 and ordered to pay £3.3.0 costs. Dec. 7th Non compliance with Nuisance notice—4 Willow Court. Notice complied with. Summons withdrawn. Dec. 7th and 21st Non compliance with Nuisance notices—51, Shepherdess Walk. 4. 4. 0 Notices complied with. Defendant ordered to pay £4. 4. 0 costs. Dec. 21st Non compliance with Nuisance notice—40 Albert Buildings. 3. 3. 0 Notice complied with. Summons withdrawn, £3.3.0 costs paid. 56. FOOD & DRUGS ACT, 1955. Date Nature of Offence Fine Costs Result July 6th Selling food (an orange drink) contrary to Section 2, Food and Drugs Act, 1955. 2. 0. 0 5. 5. 0 Defendant fined 40/— and ordered to pay £5 .5.0 costs. Nov. 9th Smoking while handling open food. 1. 0. 0 1. 1. 0 Defendant fined 20/— and ordered to pay £1.1.0 costs. Dec. 7th Selling loaf of bread containing a fly. 6. 0. 0 6. 6. 0 Defendant fined £6 and ordered to pay £6 .6 .0 costs. STATISTICAL REPORT OF HOUSING WORK DOME BY THE PUBLIC HEALTH INSPECTORS, 1956. Overcrowding. Number of new cases reported 21 Number of new cases referred to L.C.C. 21 Number of cases relieved 26 Number of Inspections and Visits by Inspectors 44 Preferential treatment on health grounds. Number of new cases investigated and reported on to L.C.C. 4 Number of cases known to have been found accommodation 2 Number of inspections and visits by Inspectors 17 Underground rooms. Number reported on 26 Number closed 23 Number where undertakings received Number made to comply with regulations 4 57. INDEX Analysis of food samples 47 National Assistance Act— 50 Anti—fly campaign 46 Section 47 31 Area of Borough 6 Section 50 11 Atmospheric pollution 31 Noise Nuisances 44 Bacteriological examinations 14 Offensive Trades 30 Birth rates 9 Old People's Clubs 22 Burials 11 Outworkers 40 Overcrowding 54 Cancer 11 Clearance Areas 35 Paid Pupillage 50 Committees— Personal Cleansing 27 Public Health 4 Pests Act 1949 41 Borough Welfare 4 Pet Animals Act 1951 49 Pharmacy & Poisons Act 49 Deaths, causes of 8 Pigeons 43 Death rates 9 Population 9 Disinfection 28 Preservatives in food regs 49 Disinfestation 28 Public Health Propaganda 50 Factories Act, 1937 36 Rag Dealers 31 Food Hygiene 44 Rag Flock Act 1951 50 Free washing facilities 45 Rodent Infestation 42 Free washing facilities 46 Sanitary circumstances 25 Hairdressers registration 30 Shops Act, 1950 31 Health propaganda 50 Social Welfare services 22 Heating Appliances Staff 5 (Fireguards) Act 41 stillbirths 9 Holiday Home 22 Student Public Health Inspectors 50 Housing Statistics 52 Swimming Baths 30 Infantile mortality 10 Tuberculosis 15 Infectious diseases 11 Tuberculosis Care Committee 20 Legal Proceedings 54 Underground rooms 36 Unsound food 48 Marriages 9 Mass Miniature Radiography 17 Verminous houses 27 Maternal mortality 11 Vital statistics 6 Milk (Special Designations) 51 Water supply 30 Milk Sampling 51 Water from wells 30