AC 4363 SHOR 62 REPORT on the HEALTH AND SANITARY CONDITION of the METROPOLITAN BOROUGH OF SHOREDITCH IN THE COUNTY OF LONDON FOR THE YEAR 1957 BY B. BROAD BENT, M. A. ,M. B. ,M. R. C. S. ,D. P. H. , Medical Officer of Health. S.S.5099 REPORT on the HEALTH AND SANITARY CONDITION of the METROPOLITAN BOROUGH OF SHOREDITCH IN THE COUNTY OF LONDON FOR THE YEAR 1957 BY B. BROADBENT, M. A. ,M. B. ,M. R. C. S. ,D. P. H. , Medical Officer of Health. Printed by WATERLOW & SONS LIMITED. S.S.5099 2. To the MAYOR, ALDERMEN and COUNCILLORS of the METROPOLITAN BOROUGH OF SHOREDITCH. Mr. Mayor, Ladies and Gentlemen, During 1957 there have been several misrepresentations of Shoreditch by outside bodies, the latest being the Registrar-General who states that the high death rate from bronchitis in the Borough is because "the smoke pall lies heavy". In point of fact this department at any rate has been delighted with the results shown by the measuring apparatus which is in constant operation on the Town Hall, which shows that Shoreditch is among the cleanest of the London Boroughs. Another authority has spoken of the large Communist element in Shoreditch, which I am sure the Borough Council would like vigorously contradicted, especially as regards its own constitution (similarly with the accusation of Fascism in another instance). In fact Shoreditch would appear to be among the most truly democratic and clean areas, although it did not quite live up to the exemplary standards of 1956 as regards the infant mortality rate (21.94 as against 16.53). The improvement in the death rate at all ages is more apparent than real, for this was the first year in which the deaths at our local Geriatric Hospital (St.Matthew's) were referred partly to the Boroughs from which the patients had been admitted to hospital. Total deaths from tuberculosis were the same as in 1956, but it is a point worthy of note that not one of these deaths had been in a patient under active treatment by our local Chest Physician, Dr.Cullen, who has proved himself to be outstanding in the tuberculosis world, and universally popular with all in the Borough. To return to the more usual diseases causing death,-while there has been an increase in deaths from cancer of the lung (from 29 to 37) and of the stomach (22 as against 15), it is pleasing to note that coronary disease took a smaller toll of 64 instead of last year's 100, although there were more than twice as many males as females this year, while in 1956, females suffered equally with the men. There has been no maternal death since 1951, and even that was the result of a self-induced abortion. While there were no deaths from any of the notifiable diseases (apart from tuberculosis) I regret to say that we had one case of diphtheria in a child aged 9 years, at a time when there had been no diphtheria near London for many ' months. I can only assume that her father (being a long-distance lorry driver) had carried the infection from the North on a toys however, there was fortunately no spread of the disease. It was a heavy year for measles, but light for polio, whooping cough and even for dysentery (although doubtful cases were all bacteriologically examined). The much-heralded "Asian flu" epidemic merely showed that this population has a high resistance, the main outbreak being mild and chiefly in schoolchildren. The Council's Social Welfare Services continued to expand (more detail on p.22 ) especially in the visiting of old age pensioners at their own homes, and in the numbers of guests at the Council's Holiday Home in Sussex, the other activities being at a more-or-less constant level. For the visiting we have been gratified by the City of London and East London Dispensary's help towards one visitor, and for the Holiday Home to King Edward's Hospital Fund for an unprecedented amount of assistance. 3. The Metropolitan Boroughs (Organisation & Methods) Committee's team have spent a considerable part of the year in an effort to render the services more efficient, and it is hoped to implement their suggestions during 1958. Fortunately they found little to criticise in the Health Department itself. The extreme shortage of Public Health Inspectors has made 1957 a very difficult year for those remaining, and has meant that the Chief (Mr.Grant) and the Deputy Chief(Mr.Marshall) have worked heavily on routine matters as well as doing their more normal duties. The Inspectorate have perforce been compelled to cease visiting measles and whooping cough patients' houses, but fortunately these diseases have been very mild this year. The number of 'complaints' received has also been smaller, but we cannot hope that this will continue. At the same time an increase in removals to new property, and of dumping on vacant sites, (not to mention the Rent Act'.) has entailed even more work than usual, so that more staff is really essential, the staff being at the moment scarcely more than one-third of establishment. With the passing of the Clean Air Act, the selecting and surveying of a proposed Smoke Control Area gave the Inspectorate additional work, but fortunately some of this could be done (and was quito well done) by our Trainee and Student Inspectors, so that the Council now awaits the Ministry's approval for an area of 9 acres to be a Smoke Control area (details and acknowledgments on p. 34 This smoke control area, together with the 2623 new flats erected by the Borough Council since the war (all of which comply with the Clean Air Act), together with the flats erected by the L.C.C., which comprise between them more than half the homes in the Borough, should enable Shoreditch to become still less polluted by smoke in future years. Single stack drainage in the Borough is reflecting great credit on the ingenuity of the Chief and Deputy Chief Public Health Inspectors (p.36 ). The erection of new flats has proceeded so rapidly in the Borough, that our 5 year programme was completed early, so that no representations for slum clearance remained to be made during 1957. The Rodent section continued the unique form of sewer treatment which was so successful last year, and results were even better (p. 42 ) as was the contract work with business firms. My final pleasant duty is to thank the whole staff for their unfailing support during the whole year, and to acknowledge with thanks the help and courtesy 3hown by members of the Council. Thanks are also due to my oolleagues serving both Shoreditch and many other authorities throughout the country. Yours faithfully, B. BROADBENT Medical Officer of Health. 4. PUBLIC HEALTH COMMITTEE (to May 1957) BOROUGH WELFARE COMMITTEE (to May 1957) Ex-officio: Alderman D. WRAY, J.P. (Mayer) Chairman: Coun. LINALE, R,G. Vice-Chairman: Coun. ROBERTSON, H.T.L. Alderman Rev.MEREDITH 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. RICHARDSON, 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. " WALKER, J.W. (Co-opted) Lady Cynthia COLVILLE, D.C.V.O., D.B.E., J.P. PUBLIC HEALTH COMITTEE (May 1957 to May 1958) BOROUGH WELFARE COMMITTEE (May 1957 to May 1958) Ex-officio: Councillor A.G. MAYHEW, J.P. (Mayor) Chairman: Coun. WICKS, A.E., L.C.C. Vice-Chairman: Coun.ROBERTSON, H.T.L. Alderman Rev. MEREDITH DAVIES, M.B.E. Councillor ALDRED, F.G. " DEACON, F.J. " HAYES, T. " KEEN, T. " LINALE, R.G. " McQUAIDE, J.J. " PAIN, Mrs. D.N. " ROBERTSON, W. " RUTMAN, P. " TEMPLE, J. Chairman: Coun. RICHARDSON, J. Vice-Chaiiman: Coun. PAIN, Mrs. D.N. Aldeiman Rev. MEREDITH DAVIES, M.B.E. Councillor ANDERSON, J. " DEACON, F.J. " GIRLING, Mrs. H.,O.B.E,,J.P. " HAYES, T. " McQUAIDE, J.J. " ROBERTSON, H.T.L. " SIIVMONDS, A.S. " SMITH, Mrs. E.E. " SWALES,R.T.J. " WAGNER, A.G. (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 Inspector Public Health Inspectors Clerks P.H.I. Trainees 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.,K.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) H.TAYLOR, (a)(b) (res. 31.8.57) G.C.E. GIBBS, M.A.P.H.I.(a)(b) N.J.BURTON, M.A.P.H.I.(a) (Comm. 11.2.57) A.G.WATMORE,M.A.P.H.I.(a) (Comm. 29.7.57) F. DUGGINS, M.A.P.H. I.(a)(b) (res.13.11.57). B.M.R. LEIGH E.A. CHRISTIAN G.A.POPE x H.J.KEMP x J.E.SCOTT Miss E. REEVES T. KEEN G. HARFIELD (Comm. 12.8.57) M. DAVIS (H.M.Forces) A.D. MELVIN (Comm.30.12.57). J.W. REAVLEY (Comm. 21.1.57) P. McCORMACK (Comm. 4.2.57) W.N. BRAZIL (Comm. 16.9.57) 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 x Student P.H.I. 6. I - STATISTICS AND GENERAL INFORMATION. Area of Borough 662 acres Population, Census 1951 44,871 Population, Registrar-General's estimate, mid-1957 43,870 Number of houses, including separately rated flats (end of 1957 according to rate books 11,377 Rateable Value £963,286 Sum represented by penny rate £3,850 A great variety of industries is carried on in the borough's 1,215 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 FROM VITAL STATISTICS FOR THE YEAR 1957. Male Female Total Live births - Legitimate 340 341 681 Illegitimate 32 16 48 Birth rate (crude rate) 16.61 Birth rate (adjusted for Area Comparability Factor 0.90) 14.95 Still births 5 3 8 Still births (rate per 1,000 total births) 10.86 Deaths 336 279 615 Death rate (crude rate) 14.01 Death rate (adjusted for Area Comparability Factor 0.75) 10.51 Number of women dying in, or in consequence of childbirth Nil Infant deaths - Legitimate 15 Illegitimate 1 Infant deaths (rate per 1,000 live births) 21.94 Neo-natal deaths (rate per 1,000 live births) 13.71 Deaths from measles (all ages) Nil Deaths from whooping cough (all ages) Nil Deaths from diarrhoea (under 2 years of age) Nil Deaths from pulmonary tuberculosis 5 Deaths from all forms tuberculosis 5 Death rate from pulmonary tuberculosis 0.11 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 N umber Nett Number Rate of Nonresidents registered in the District Of residaits not registered in the District Under 1 year of ace At all ages Number Rate per 1,000 nett Births Number Rate Number Rate 1946 42600 486 995 23.4 624 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 1957 43870 191 729 15.0 561 9.6 135 189 16 22 615 10.5 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 are covered to a depth of three 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 Super in tendent. Hospitals. - Within the Borough: St.Matthew's Hospital, Shepherdess Walk, N.l. St.Leonard's Hospital, Nattall 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 - The arrangement with Hackney Borough Council for the use of their mortuary for Shoreditch bodies was continued throughout the year. 8. CAUSES OF DEATH, WITH AGE DISTRIBUTION. CAUSES OF DEATH AGES SEX Total deaths due 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 1 4 1 5 2. Tuberculosis, other forms - - - - — - — — — — — 3. Syphilitic disease - - - — - 1 — — 1 — 1 4. Diphtheria - - - - - - - - - - - 5. Whooping cough - - - - - - - • - - - 6. Meningococcal infections. - - - - - - — - • - - 7. Acute poliomyelitis - - - - - - - - - - - 8. Measles - - - - - - • — — — — 9. Other infective and parasitic diseases — — — — — 1 — 1 — 1 10. Malignant neoplasm,stomach - - - - - 8 4 10 12 10 22 11. Malignant neoplasm, lung, bronchus. — — — — 1 10 17 9 29 8 37 12. Malignant neoplasm,breast - - - - - 4 1 2 - 7 7 13. Malignant neoplasm, uterus - - - - - — 1 1 • 2 2 14. Other malignant and lymphatio neoplasms — — — 1 2 25 9 14 25 26 51 15. Leukaemia, aleukaemia - 1 - - 2 - 1 4 — 4 16. Diabetes - - - - — 1 2 1 1 3 4 17. Vascular lesions of nervous system — — — — — 7 23 60 40 50 90 18. Coronary disease, angina. - - - - 3 14 26 21 43 21 64 19. Hypertension with heart disease — — — — — 2 3 5 6 4 10 20. Other heart disease - - - 1 6 11 12 32 23 39 62 21. Other circulatory disease - - - • — 1 7 26 13 21 34 22. Influenza - - - - 1 1 2 2 3 3 6 23. Pneumonia 3 1 - — 2 5 12 31 30 24 54 24. Bronchitis 2 — — — 1 10 12 34 40 19 59 25. Other diseases of respiratory system — — — — 1 1 1 2 3 2 5 26. Ulcer of stomach and duodenum — — — — — 1 1 3 3 2 5 27. Gastritis, enteritis and diarrhoea — — — — — 2 1 3 2 4 6 28. Nephritis and Nephrosis. — — - 1 - - - 2 3 - 3 29. Hyperplasia of prostate. - - - - - - - 5 5 - 5 30. Pregnancy, childbirth, abortion — — — — — — — — — — — 31. Congenital malformations. 2 1 - - - - - - 1 2 3 32. Other defined and ill- defined diseases 9 — — — 2 14 12 20 34 23 57 33. Motor Vehicle accidents. - - 1 1 1 1 — 1 5 — 5 34. All other — - 2 - • 1 3 3 2 7 9 35. Suicide - - - - - 2 — 1 2 1 3 36. Homicide and operations of war - - - - - 1 - - 1 - 1 Total Deaths (all causes) 16 3 3 4 21 128 150 290 336 279 615 9. II. POPULATION, BIRTHS, MARRIAGES AND DEATHS. The Registrar-General's estimate for the mid-year 1957 population was 43,870, a decrease of 650 from the previous year. This figure is used for statistical purposes throughout this report. The density of the population is 66 persons per acre. The Area Comparability Factors for the borough are Births 0.90 and Deaths 0.75, 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 1957 were as follows Total live births - (legitimate and illegitimate) Males 372 Female Total 357 729 Illegitimate live births - Males 32 Female 16 Total 48 The birth rate for the borough was 14.95. For England and Wales the rate was 16.1 and for London 16.2. The illegitimate births represented 6.58 per cent of all births in the borough. STILLBIRTHS. The number of registered stillbirths allocated to the borough was 8, or 1.08 per cent of all births. MARRIAGES. The number of marriages during the year was 405 and the marriage rate was 18.5 per 1,000 population. The marriage rate for the Metropolis was 20.5 and that for England and Wales 15.4 DEATHS. The number of deaths registered in the borough in 1957 - 561 Transferable deaths - Non-residents registered in Shoreditch - 135 Shoreditch residents registered elsewhere - 189 The number of deaths allocated to the borough is therefore - 615 This gives a death rate for the borough of 10.51 compared with 11.5 for England and Wales, and 11.2 for London. In connection with these deaths 17 inquests wore held. 491 or 79.8 per cent of the people belonging to Shoreditch who died during the year died in hospital. 10. The table on page 8 showing causes of death at all ages has been supplied by the Registrar-General. INFANTILE MORTALITY. The deaths of infants under one year numbered 16 of which 13 were males. These deaths amounted to 2.60 per cent of the total net Shoreditch deaths from all causes, as compared with 1.74 per cent in 1956. The infantile mortality rate (death rate of infants under one year per 1,000 live births) for Shoreditch was 21.94,the rate for England and Wales being 23.0 and thatifor London 21.0. One illegitimate infant died. The number of deaths of infants under 4 weeks of age was 10, which gives a neo-natal rate of 13.71. INFANTILE MORTALITY IN THE BOROUGH DURING 1957. A G E S S E X CAUSE OF DEATH 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 9-12 months Male Female Total deaths under 1 year. Pneumonia 1 — — - 1 2 - - 3 — 3 Bronchitis - - - - - - - 1 1 - 2 - 2 Prematurity 4 1 - - - 5 - - - - 4 1 5 Congenital malformation Atelectasis 1 2 - - - - 1 2 1 — - - 1 2 1 2 2 Other defined and illdefined diseases — - 1 - - 1 1 — — — 1 1 2 Total 7 2 1 - - 10 2 3 1 - 13 3 16 MATERNAL MORTALITY, 1957. 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. 1957 1956 1955 1954 1953 1952 1951 England and Wales 0.47 0.56 0.64 0.69 0.76 0.72 0.79 Shoreditch Nil Nil Nil Nil Nil Nil 1.18 11. CANCER. The deaths from cancer in the Borough during the year numbered 119 as compared with 125 in 1956. BURIAL OF THE DEAD. Under Section 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 984 notifications of infectious disease were received, and of these one case diagnosed as non-paralytic poliomyelitis was revised after examination of the patient in hospital. SMALLPOX AND VACCINATION. No 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. 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 influenzal pneumonia Public Health Act, 1936 (Section 143) Reg. No.299 made 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). CASES OF INFECTIOUS DISEASE NOTIFIED DURING 1957 (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 1 1 _ Dysentery 70 2 28 19 5 6 5 5 - Acute encephalitis - post-infectious - - - - — - - - - Enteric (paratyphoid) - - - - - - - - Erysipelas 4 - - - 2 - 1 1 - Measles 770 33 413 323 1 - - - - Meningococcal infection - - - - - - - - - Ophthalmia Neonatorum 1 1 - - - - - - - Pneumonia 19 - 4 4 - 3 6 2 - Acute Poliomyelitis - - paralytic 2 1 1 - - - - - - - non-paralytic 1 - 1 - - - - - - Puerperal pyrexia 1 - - - - 1 - - - Scabies 6 - 1 1 2 2 - - - Scarlet fever 33 _ 11 22 _ _ — — • Whooping cough 33 6 20 7 - - - - - Tuberculosis - - pulmonary 31 - 2 1 2 13 6 7 5 - non-pulmonary 3 - - 2 - 1 - - - Food Poisoning 8 2 1 - 1 2 1 1 - Total 983 45 482 380 13 28 19 16 5 13. Disease Authority for notification Enteric fever (including typhoid and para-typhoid) Erysipelas Public Health (London) Act, 1936 (Section 192 and 304) Reg.No.299 made by Minister of Health 1953 (1,4.53) Public Health (London) Act, 1936 (Section 192 and 304) Food Poisoning Food & Drug Act, 1955 (Section 26) Glanders Public Helath (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) Ma laria Public Health Act, 1936 (Section 143) Reg.No.299 made by Minister of Health, 1953 (1.4.53) Measles Public Health Act, 1936 (Section 143) Regs.Nos.1100 205 and 420 made by Minister of Health, 1938, 1940 and 1948. Membranous croup Meningococcal infection Public Health (London) Act,1936 (Section 192 and 304) 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 Rog.No.971 made by Minister of Health, 1926 (1.10.26) amended by S.R.0.1928 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 Scabics (first case in house within 4 weeks) Fublic Health (London) Act, 1936 (Section 192 and 304) Public Health Act, 1936 (Section 143). Reg.No.1016 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 Examination 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. Diphtheriaa metis isolated 2 Haemolytic Streptococci present 7 Negative results 49 58 Faeces Specimens: Shigella Sonnei isolated 99 Salmonella typhi-murium isolated 13 Salmonella Anaturn isolated 1 Salmonella Kentucky isolated 3 Negative results 342 458 Swimming bathwater examinations 20 Milk samples 63 Ice Cream samples 12 Cream Lolly samples 27 Foodstuff samples 3 IV. TUBERCULOSIS Notifications - Thirty one cases of pulmonary tuberculosis and three of nonpulmonary tuberculosis were notified during 1957 compared with 40 pulmonary and 4 non-pulmonary notifications in 1956. 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 - - - - 6 3 - 6 6 - 22 “ Females - - 1 - 1 1 1 3 1 - - - 1 9 Non-pulmonary, Males — — — — 1 — — — — — — — — 1 “ Females - - - 1 - - - 1 - - - - - 2 Total - - 2 1 2 1 1 10 4 - 6 6 1 34 15. 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 - - • _ Transfers from other areas 9 9 - - Other sources - - - - Total 9 9 - - 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 22 14 5 6 Death 6 - - - Otherwise (e.g. removal from district) 17 13 2 3 Total 45 27 7 9 Revision of Notification Register - Pulmonary Non-pulmonary TOTAL M F M F No. of cases on Register at 31st December, 1956 362 326 105 82 875 No. added during year 31 18 1 2 52 No. removed during year 45 27 7 9 88 No. of cases on Register at 31st December, 1957 348 317 99 75 839 16. 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 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 1957 0.70 0.07 0.77 0.11 0.00 0.11 The following table gives the age grouping of deaths from tuberculosisj- Age periods 0-1 1-5 5-15 15 - 25 25 - 45 45 - 65 65 - 75 75 and upwards Total Pulmonary, Males - - - - 1 2 - 1 4 " Females - - - - - - 1 - 1 Non-pulmonary, Males - - - - - - - - - " Females - - - - - - - - - During 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 1525. 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, Medical Director of Unit 6D for the following report :- "Introduction During 1957 the Unit examined 40,097 males and 25,295 females, making a total of ,65,392 which is a slight increase on the previous year's figures. Eighty-four active cases of tuberculosis have been discovered, which is a 35% increase on last year's results, and gives a rate of 1.28 per 1,000 examined. Of these eighty-four cases it is interesting to note that seventynine were discovered from firms which have been previously examined by the Unit and only five from new firms, although the ratio of new to old firms was one to seven. This would appear to indicate that it is not a wasted effort re-examining firms after a suitable lapse of time. The Unit functioned at the Mass Radiography Centre, 20, Golden Lane, E.C.I from 1st January to 30th April and from 8th August to 31st December, during which period there was a continuous flow of examinees from the City of London, the Metropolitan Boroughs of Finsbury and Shoreditch, Health and Teaching Staffs of the London County Council, Doctor's referrals and the General Public. All volunteers attended as a result of prior appointments which has proved to be the most acceptable method to all concerned. During the mobile period the Unit visited several firms in the City who could either themselves or in collaboration with other firms in the vicinity, provide a sufficient number of "bodies" to render the Unit's visit economical. The Unit also spent several weeks in Shoreditch, operating from the Haggerston Library, 236, Kingsland Road, E.2, by kind permission of the Libraries Committee. Firms were circulated by the Public Health Department of Shoreditch and staffs attended the Unit in a series of appointments. Public Sessions were held but these were not so well attended as the plenned sessions, notwithstanding the display of posters, distribution of handbills and announcements in the local Press. We would take this opportunity of recording our grateful appreciation to the Medical Officer of Health for Shoreditch (Dr. B. Broadbent) and his staff for their helpful co-operation. Zone of Unit. The zone of Unit 6D covers 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.I. There is no dearth of volunteers for examination and the Unit is continuously adding new firms to its already extensive card index. 18. Method of Operation. While operating at the Mass Radiography Centre "miniature" sessions were held on Mondays, Wednesdays and Fridays with sessions from 9.15 a.m. to 12.30 p.m. and from 2.00 p.m. to 4.30 p.m. Throughout the year separate sessions were arranged for men and women, although early in 1958 the Unit discontinued this practice and now examines both sexes during the same sessions. Tuesdays and Thursdays were allocated for the reading of miniature films, taking and reading large films, interviews by the Medical Director, and the dispatch of results to examinees who provide a stamped addressed envelope for this purpose. During the mobile periods sessions were arranged to meet particular requirements. Whenever possible a firm's internal postal system was used for the dissemination of results and recalls for large films. Further time was saved by the daily reading of miniature films. Except for large films examinees are Xrayed over their clothes; ladies being advised what to avoid wearing on the day of examination. No expense has been incurred for hiring accommodation when the Unit was mobile, and it is only right and proper that we should record our appreciation of the services rendered by firms, etc. Many City firms insist on a Chest X-ray when new staff is undergoing a medical examination. The result of such an examination is, of course, sent to the examinee. Medical Procedure. Abnormal cases (after an interview with the Medical Director) are referred, through the examinee's own doctor, to the appropriate Chest Clinic. The ultimate diagnosis is secured from the latter through the medium of the form designed for this purpose. We express our grateful thanks to the many Chest Clinics, to which we have referred cases, for their helpful co-operation. All clinics have recorded their sputum findings, and thirty-one cases with a positive sputum have been reported, of which twenty-seven were male and four female. This denotes an increase of 50% on the 1956 returns. The Unit classifies its abnormal miniatures and appropriate notification is passed to the examinee. Thus when an examinee's film shows scars of old, and now healed, lesions he (or she) does not receive the normal notification card but a specially worded letter. Where an investigation is outside the purview of a Chest Clinic, the co-operation of St.Bartholomew's Hospital is secured, and with appreciation I acknowledge the help rendered by Dr.N.C.Oswald and his colleagues. Increasing use is made of the re-examination of previous miniatures for comparison purposes to clear up doubtful abnormalities. Such en investigation may go back eight years. Suspected malignant disease and most of the sarcoidosis cases have been brought to light by these reviews. The recall rate for large films is thereby lowered to the advantage of the examinee who is spared an unnecessary journey and anxiety, without impairment to the efficiency and accuracy of the Unit. There is a corresponding saving of time and materials. 19. Carcinoma of the Lung. Deaths from broncho - genic carcinoma are reported to have increased 500% since 1930. Figures for this Unit show the number of cases discovered 1951 - 2 1954 - 12 1952 - 6 1955 - 10 1953 - 7 1956 - 11 1957 - 13 Compared with other Units, the above figures are on the low side which may be explained by the fact that apart from some pollution of the atmosphere by the internal combuston engine and cigarettes smoking there are no added industrial hazards in the City of London. It should be noted that asymptomatic carcinoma will often show no abnormal radiological shadows. To illustrate this problem let me quote two recent cases. A man (age - 60) was referred on account of a small haemoptysis in October 1957 and thoroughly investigated at one of the teaching hospitals with a negative result; in December he developed cerebral metastases. Another man (age - 66) had a miniature film at the end of February which was clear; two months later he developed a growth in his right upper lobe. Most of the cancers picked up by Mass Radiography Units were cases referred by general practitioners on account of symptoms. Up to the end of 1957 general practitioners have not utilised the services of our Unit so fully as might have been expected, but a revised procedure introduced early in 1958 has produced a greater response. Propaganda. Propaganda in the form of posters and leaflets is only occasionally employed, as approach to firms, etc., is made either by personal contact or by special letters, of which the Unit now has a series. Staff. Several changes in the technical and clerical staff occurred during 1957. I would like to record my gratitude for the wholehearted support rendered by all mombers of the staff during the year. Conclusion. During 1958 the Unit received visits from several medical students from overseas who were in 'this country under the auspices of the National Association for the Prevention of Tuberculosis. Friendly relationships have 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. Helpful cooperation has been shown by the London County Council and the Divisional Medical Officers in Health Divisions 3, 4 and 5. Our gratitude must be accorded to the Central Group, Hospital Managanent Committee and to the Regional Hospital Board, for the many services rendered to the Unit during the year". 20. DETAILS OP SOME SURVEYS DURING 1957. CENTRE & PERIOD GROUPS EXAMINED No.of Persons Examined. MALE FEMALE TOTAL MASS RADIOGRAPHY CENTRE, 20,Golden Lane,London,E.C.l. 1st January - 30th April Office and Factory Staff in the City of London,Boroughs of Finsbury and Shoreditch. Health and Teaching Staffs in Divisions 3,4 and 5. Individuals. Doctors' Patients. 15,328 9,353 24,681 BOROUGH OF SHOREDITCH, Haggerston Library, 236, Kings land Road,E. 2. 21st May - 3rd June. Office and Factory staffs in the neighbourhood. Hospital staff. Individuals. 1,554 922 2,476 MASS RADIOGRAPHY CENTRE, 20,Golden Lane,London,E.C.1. 7th August - 31st December. As above. 16,557 11,627 28,184 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 1957. "On 1st April 1957, following a decision of the North East Metropolitan Hospital Board, patients living in a certain portion of the Borough of Hackney came under the supervision of Dr.Cullen at the Shoreditch Chest Clinic. Because of this, the financial and social needs of these patients necessarily also became the responsibility of the Shoreditch Tuberculosis Care Committee instead of the Hackney and Stoke Newington Tuberculosis Care Committee as heretofore. Roughly, 400 patients were so transferred to this clinic, comparatively few of them, of course, requiring financial help or having domestic worries of any kind. An amount of £31.10.0d. was transferred to our fund from the Hackney and Stoke Newington Tuberculosis Care Fund to cater for the needs of the transferred patients from 1-4-1957 to 31-10-1957 (in excess of help obtained through statutory means). After that date it was considered that results would be coming in from the 1957/1958 Christmas Seal Sale to cope with demands upon the fund. This Committee has, therefore, been coping with added problems during the year to 31st December 1957, and we hope the patients so transferred to us have received adequate help from the fund and also been enabled to obtain the requisite aid from the various statutory bodies which exist to provide necessities for patients off work through chest diseases. Councillor Mrs.L.Calfe (a member of the Hackney and Stoke Newington Tuberculosis Care Committee) was co-opted on to this Committee to help with the problems of patients living in the district taken over. 21. We regret to have to report the death of Mrs.K.I.Higgins,M.B.E., on the 8th December, 1957. Mrs.Higgins was one of the representatives on this Committee of the Shoreditch Borough Council, and had been Chairman of our Committee for many years until, on account of illhealth, she resigned from the Chairmanship in March, 1957. whilst still remaining a member of the Committee. Tributes were paid by members of the Committee to the memory of Mrs.Higgins, who had always been very actively concerned with the welfare of the people of Shoreditch and, in particular, with our patients and their families. Councillor Mr.F.G.Aldred was appointed the new Chairman and Miss R.Glennie (the local secretary of the Soldiers', Sailors' and Airmen's Families' Association) the Vice-Chairman. Councillor Mrs.A.Varnals resigned from the Committee during the year. The Committee now consists of the following members :- Councillor Mr.F.G.Aldred, Chairman (Shoreditch Borough Council) Miss R. Glennie (S.S.A.F.A.) Vice-Chairman. Mrs. H. Alsford. Dr. B. Broadbent, (Medical Officer of Health, Shoreditch). Mrs. W. G. Dibble (Women's Voluntary Service). Councillor Mrs, L.S.Calfe, (Hackney & Stoke Newington Tuberculosis Care Committee). Miss N. Duffy, (Almoner, St.Leonard's Hospital). Dr. S. King, (Divisional Medical Officer - London County Council). Miss M.W.Sweeney, (Superintendent - Shoreditch & Bethnal Green District Nursing Association) Councillor J.Temple (L.C.C. Divisional Health Committee and Shoreditch B.C.) Miss M. Turnbull, (invalid Children's Aid Association). Ex Officio Dr. C.K.Cullen, Chest Physician. Miss M. Nutt, Tuberculosis Health Visitor. Mrs. D.E.McLean, Tuberculosis Health Visitor. Miss E.B.Guest, Secretary, The net amount added to the fund through the Christmas Seal Sale (our largest source of income) was £203.7.5d. after £10.14.1d. had been given to the National Association for the Prevention of Tuberculosis (i.e. as usual - 5% of the net profit), As in previous years, £40 was received from the L.C.C. Sunday Cinema Entertainments Fund and £17.10.0. from the United Charities of St,Leonard. £29.was received from the Mayor of Shoreditch Charity Fund, given in varying amounts for individual patients, and the Rotary Club of Shoreditch made a grant of £5. Again this year, our heaviest expenditure was on Wireless licences and servicing through relay systems. Other expensive items were fares - for relatives to visit patients in Sanatoria, and help towards clothing in 22. necessitous cases. Furnishing materials (linoleum, curtains, etc.,) were also given - chiefly in those cases rehoused through the Borough or L.C.C.housing schemes. Patients are enabled to purchase extra nourishment in the form of malted milks, etc., at cost price and take great advantage of this scheme. Domiciliary Occupational Therapy and the Handicraft Class - combined under one instructor - continued throughout the year, until in December, 1957, the Occupational Therapist resigned to take up another position and it is anticipated that another Occupational Therapist will be appointed early in the New Year. 22 patients were enabled to go on Holiday through the L.C.C.Recuperative Holiday Scheme during the year and expressed great appreciation of the service. The Committee would like to thank various voluntary societies, particularly the Soldiers', Sailors' and Airmen's Families' Association and the Forces Help Society, who are always interested in our patients and do all they can to get grants for necessitous cases. Cases assisted by Shoreditch Tuberculosis Fund:- Clothing 13 Fares 54 Loans 3 Rent Arrears 3 Money Grants 8 Wireless Expenses (new cases) 2 Other help 12 V. SOCIAL WELFARE SERVICES. The statutory work of all these services has been run by the Borough Council and its officers, the remainder being run as before by the Joint Welfare Committee (50 % councillors and 50% voluntary Old People's Welfare Committee). Visiting of Old Age Pensioners. - As stated last year, this service has received a boost by the appointment of a full-time visitor, with the Cases referred to extra help to:- National Assistance Board (in addition to applications for maintenance) '11 S.S.A.F.A. 7 Forces Help Society 9 Shaftesbury Society 1 L.C.C. Clothing 4 Mayor's Fund 11 L.C.C. (Samaritan Fund) 5 W.V.S. 2 Glasspoole Trust 3 Friends of the Poor 1 National Assn.for the Paralysed 1 23. help of the City of London and East London Dispensary. Her first year has "been fully occupied in visiting every person known to us,and in searching out others previously unknown to the department. On finding that an individual pensioner required help, she has passed the patient over to the more experienced visitors who are able to adjust this work with their other duties. Old People's Clubs - The numbers attending the Council's full-time clubs have remained almost constant this year, Moorfields having improved somewhat, while the Bell has retrogressed slightly, pending the erection of its new premises. Wenlock has gone still further ahead, Haggerston slipped slightly and Hoxton Friday club for the enfeebled has further increased (weekly concerts being given by Miss Betty Bray and her friends). However all seem happy, especially with their handicraft work and the weekly concert. The Council's Holiday & Rest Home in Sussex has had even more guests than before, and has continued to do excellent work in rehabilitation not only for Shoreditch residents, but also for people recuperating from other areas as far apart as Newcastle and Exeter. King Edward's Hospital Fund has helped financially to a greater extent in 1957 than in any previous year, and the home is being completely redecorated. The Meals on Wheels Service for the housebound has been maintained for 5 days a v/eek by the W.V.S. (for whom the Council has provided a new van this year, as well as a new set of insulated containers to replace the heavier ones previously used). The Salvation Amy has also delivered meals for 4 days a week, using their own van and insulated containers provided by the Borough Council. The meals for club members, still kept at lOd each, have also been delivered by Council van service by the organiser and helper of each club. These totalled about 100 meals/day. The S.O.S. Cards, laundry service (with the help of St.Matthew's Hospital), library service in the old people's own homes, shoe repair service by the Lion Boys' Club, wireless for the bedridden, fireguards and blankets, etc.(per National Assistance Board), distribution of furniture from this department (and wheelchairs where necessary),handicrafts in the clubs (with paid L.C.C. instructors), baths (on the premises of Moorfields Club), chiropody (at the Council's former clinics, St.Leonard's Hospital and at home), many free gifts such as coal, mattresses, etc. from various sources, and of course the annual holidays at the Council's own home (at 10/- to 15/- a week, plus 10/- in the Council's own coach for the journey)have all continued to expand. The invaluable co-operation of St.Matthew's Hospital whenever required, the L.C.C.'s. Home Help Service, the District Nursing Association and many other bodies has been much appreciated. 24. The numbers of persons who attended the Shoreditch Holiday & Rest Home at Copthorne during 1957 were as follows:- Adults 246 10-18 years 22 5-10 years 92 9 months - 5 years 199 Under 9 months 41 Old Age Pensioners 286 Conference members – Total 886 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 ... (2.30-4.30 p.m.) M. 3 — — — 6 — — 122 F. 22 — — — 91 — Bell (10,30 a.m.- 4.30 p.m.) M. 16 18 19 18 18 _ 64 108 F. 4 9 8 7 15 Haggerston (2.30-4.30 p.m.) M. — — 12 2 — — — 84 F. — — 38 32 — — Moorfields (10.30 a.m.-4.30 p.m.) K. 2 2 2 2 2 — 38 71 F. 5 14 12 7 12 — Wenlock (10.30 a.m.- 4.30 p.m.) M. 12 12 11 15 11 — 78 507 F. 45 51 46 68 33 — 25. VI. - SANITARY CIRCUMSTANCES. The following tables summarize the visits of inspection and the work of the Public Health Inspectors during 1957. INSPECTIONS. Housing Act, 1957, Section 3 470 Housing Act, 1957, Section 9 35 Housing Act, 1957, Section 18 94 Housing Repairs & Rents Act, 1954 10 Rent Act, 1957 138 Clearance Areas 215 Clean Air Act 49 Other Dwellings 3,803 Premises not specified below 2,824 Factories - mechanical 2,152 Factories - non-mechanical 215 Rag Flock Act, 1951 212 Pet Animals Act 1951 26 Outworkers 184 Hairdressors 108 Bakehouses 119 Milkshops 537 Cookshops 389 Fried Fish shops 47 Ice Cream shops 614 Butchers' shops, stalls, stores, etc. 263 Rag & Bone dealers 15 Food stalls 154 Registered Food shops or premises 2,083 Fish curers' premises 26 Fur skin dresser's premises 4 Stables 19 Shops Act, 1950 769 Smoke observations 579 Pharmacy & Poisons Act, 1933 66 Markets 148 Canteens 345 Vacent sites 268 Dangerous buildings 68 Infectious disease visits 255 Rodent Infestations 593 RE-INSPECTIONS. Housing Act 1957, Section 3 52 Housing Act, 1957, Section 9 14 Housing Act, 1957, Section 18 71 Housing Repairs & Rents Act 1954 7 Rent Act, 1957 76 Clearance Areas 49 26. RE-INSPECTIONS (Contd.) Other Dwellings 7,719 Factories 937 Rag Flock Act, 1951 77 Outworkers 49 Hairdressers 12 Bakehouses 92 Milkshops 137 Cookshops 268 Fried Fish Shops 34 Ice Cream Shops 53 Butchers' shops, stores etc. 169 Rag & Bone dealers 4 Food stall 81 Food shops and premises 806 Fish curers 22 Shops Act 1950 226 Smoke observations 41 Canteens 84 Vacant sites 148 Infectious disease visits 51 Rodent Infestations 584 Non-effective visits 3,985 SUMMARY OF DEFECTS FOUND. Premises requiring cleansing throughout - Premises requiring partial cleansing 86 Premises - total rooms 132 Verminous premises 23 Verminous rooms 87 Premises requiring general repair 230 Light & ventilation requiring remedying 13 Roofs, gutters, rainwater pipes defective 304 Premises damp 265 Windows requiring repair or adjustment 876 Premises overcrowded 9 Water reinstated 11 Water supply required to upper floors 1 Drains, new 578 Drains requiring reconstruction 28 Drains requiring improvement or repair 78 Drains requiring obstructions removed 124 Drains tested 596 Old drains sealed off from sewer 167 Soil vent pipes requiring repair or renewal 31 W.C's. new 13 W.C's. requiring improvement or repair 227 W.C's. requiring obstructions removed 30 Sinks new 22 Sinks requiring improvement 18 27. SUMMARY Ox' DEFECTS FOUND (Contd.) Sinks requiring traps to be provided 8 Sinks requiring obstructions removed 19 Waste pipes requiring repair or renewal 30 Waste pipes requiring obstructions removed 8 Other items not specified 901 Outdoor Premises. Floors or paving requiring repair 43 Requiring cleansing or limewashing 4 Dustbins requiring renewal 42 Ashpits requiring abolition 13 Accumulations requiring removel 96 Urinals requiring cleansing or repair 3 Animals improperly kept 6 NOTICE SERVED. Public Health (London) Act, 1936 - Intimation Notices 1,125 Nuisance Notices 188 Housing Act, 1957 – Factories Act, 1937 49 Shops Act, 1950 – Prevention of Damage by Pests Act, 1949 Food & Drugs Act, 1955 3 133 COMPLAINTS RECEIVED 1,720 PERSONAL CLEANSING The arrangement with the Finsbury Borough Council whereby residents of Shoreditch 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 - 2 2 - 2 SCABIES. New Cases Total new cases Reattendances Total treatments 0 to 15 years Over 15 years 6 12 18 11 29 (Until school-leaving age, the L.C.C.treat all affected children at their own Centre). 28. DISINFECTION AMD DISINFESTATION. The number of disinfections of rooms after infectious disease and for other reasons was 77. The number of articles disinfected in this connection at the Council's disinfector was 519. During the year 505 rooms were sprayed for verminous conditions and the number of articles disinfected was 7866. In this connection sanitary notices were served in respect of 23 houses (87 rooms). 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 £14 were made. It will be noticed that the number of rooms and articles disinfected was greater than in previous years. The new method of disinfection reported in 1956 has proved satisfactory and the economy in cost as compared with the previous methods was maintained. It is estimated that on a full year's working the saving was £180. During the year 322 families were removed to new housing accommodation on the Borough Council's housing estates, as compared with 288 families in 1956. This increase of 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 goods after disinfestation has taken place. 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 disinfocting 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. 29. 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 unauthorised persons is a practice which is not easily controlled and has been on the increase this year. This entails additional work for the Public Health Inspectorate. During the year the number of sites sprayed to prevent the breeding of flies on putrescible matter was 52. 120 articles of clothing, mattresses etc., were removed, again a considerable increase on the previous year. HOUSING REPAIRS AND RENTS ACT 1954. The above-named Act, which came into force in 1954 was repealed by the Rent Act 1957 on 6th July 1957. The work in connection with theHousing Repairs & Rents Act for that part of the year in which the Act was in force, consisted of one application being made on behalf of a tenant for a Certificate of Disrepair, a Notice of Increase of Rent having been served by the owner, as compared with ten applications in 1956. This application was granted. There were nine applications for Certificates of Revocation in rospect of Certificates of Disrepair previously served and in four cases these were granted. RENT ACT 1957. This Act which came into force on 6th July 1957 altered the procedure considerably as compared with the Housing Repairs and Rents Act 1954. In the new Act the onus was placed on the tenant who is required to set out his own schedule of items of disrepair (Form G), The following is a summary of the work done from 6th July 1957 to 31st December 1957 - Number of applications for certificates of Disrepair 57 Number of decisions not to issue certificates Nil Number of decisions to issue certificates (a) in respect of some but not all defects 42 (b) in respect of all defects 15 Number of undertakings given by landlords under paragraph 5 of the First Schedule 28 30. Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule Nil Number of Certificates issued 16 APPLICATIONS FOR CANCELLATION OF CERTIFICATES. Applications by landlord to Local Authority for cancellation of certificates Nil Objections by tenants to cancellation of certificates ... Nil Decision by Local Authority to cancel in spite of tenants' objection Nil. Certificates cancelled by Local Authority Nil The early experience of the workings of this Act gives the impression that one of the achievements as stated by the Government to bring houses into a reasonable state of repair does not seem to have been reached. It was particularly noticed on the applications received on Form G from tenants that many important and serious items of disrepair wore not included in the schedule of items. It would also appear from the first six months of the working of the Act that the work in connection with this Act is very complicated, but it would be unwise to comment on the working of the Act fully until we have had an opportunity of seeing it work for a longer period than six months. The work in connection with the Act places an additional burden on the department. The inspections of premises where Certificates of Disrepair are applied for have to be carefully done and every item checked. As a result of the shortage of experienced Inspectors the work in connection with the Rent Act has been carried out by the Chief Public Health Inspector end his Deputy, In all cases a complete inspection of the premises is made and where applicable action is also taken under the Public Health and Housing Acts. In addition, each Undertaking presented by owners has to be carefully checked with the tenant's G Form before reporting to the Public Health Committee, The additional work under the Rent Act means many additional visits of inspection as compared with other work in connection with the Public Health Act and Housing Act and it appears that the increase of work in this connection will continue. 31. REGISTRATION OF HAIRDRESSERS The number of Hairdressers registered in Shoreditch is 49. Regular inspections were made of all hairdressers and from the result of these inspections it was found that the standard of cleanliness observed in the hairdressing establishments in the Borough was reasonably high. WATER SUPPLY The water supply of the Borough is controlled by the Metropolitan Water Board and is relayed from public mains direct to houses. During the year one complaint was received regarding the quality of the water and this was dealt with by the Metropolitan Water Board who carried out works to clean out the pipe from the main supply. SWIMMING BATH WATER. 20 Samples of water from the Haggerston Bath were sent for bacteriological examination, and 20 for chemice.1 examination. Bacteriological examination in all cases proved satisfactory, but chemical examination, during the summer months, showed the proportion of dissolved solids to be abnormally high. After consultation with the Acting Baths Superintendent it was recommended that the filters be opened and examined. The stirring gear of the agitators in the two Boll filters was found to bo obsolete and defective. The filters were emptied and refilled with new Leighton Buzzard sand and fitted with new strainer nozzles. The agitation system was converted to operate by blowing compressed air through the filter from the bottom of the unit. Further chemical examinations of the swimming bath water were carried out following these conversions and were reported on by the Public Analyst as being safe. WELLS. There are two wells in use in the Borough. In one case the water is used for washing down and cooling purposes, and in the other case, which is c factory, the water from the well is used for all 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 4. 32. 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. 1 Certificate of exemption in respect of sanitary conveniences was issued during the year. The number of inspections and re-inspections made during the year was 995. COMPULSORY REMOVAL OF AGED AND INFIRM PERSONS. Under Section 47 of the National Assistance Act, 1948, the Council are empowered to apply to the 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 periodsnot exceeding three weeks may be enforced by the Courts. Powers under these Acts wore used during 1957 in the case of a man aged 73 years, who refused to be helped and who could not care for himself. He lived alone, suffered from bronchitis and congestion of the lungs, was very weak and could not sit up in bed without assistance. He refused dinners and was offensive to people who offered to help him. He refused to go to hospital although his doctor recommended he should bo removed. An Order of the Court was obtained under the Amendment Act and he was admitted to St.Leonard's Hospital. RAG DEALERS. There are 14 premises in the Borough in which the business of Rag Dealer is carried out. 19 visits of inspection were made during the year. 33. ATMOSPHERIC POLLUTION. The Clean Air Act 1956 became law on 31st December 1956, although only a limited number of important sections became operative on that date. Progress has been particularly significant concerning the application of:- (a) Section 3, which requires that all now furnaces shall be, as far as is practicable, smokeless, and (b) Section 11 whereby local authorities may establish smoke control areas. During the year 308 flats were completed by the Shoreditch Borough Council making a total of 2623 flats erected since World War II. In every instance provision has been made for the space heating of the living rooms and in some, for the heating of the domestic hot water supply, by means of approved typo of eppliances for burning smokeless fuel. All therefore comply with the provisions of the Clean Air Act. Twenty-two central boiler houses supply domestic hot water to the majority of these flats, the furnaces being fired as follows:- (a) Five oil-fired furnaces. (b) Throe underfeed stokers (c) Fourteen hand-fired furnaces. The oil-fired furnaces and underfeed stokers have operated very successfully and comply with the requirements of Section 3 of the Clean Air Act, resulting also in a substantial saving in fuel and man-power. The Council have also agreed to convert all the remaining hand-fired boilers in the 14 boiler houses to the Council flats to oil-burning appliances at an estimated cost of £28,000 and work on the conversion commenced during the year. With efficient operation end proper maintenance a big reduction in atmospheric pollution will be effected. An important advance was made during the year in the design for space heating to multi-storey blocks of flats (over 10 storeys). In future, open fireplaces are to be omitted in the design of multistorey flats. Electric floor heating is to be provided and domestic hot water will be supplied from a central boiler house equipped with oil burning furnaces. The absence of open fires will make a further contribution to clean air conditions. The prevention of atmospheric pollution in existing premises. During the year 579 smoke observations were made as against 394 in 1956. 13 Notices were served concerning smoke nuisance under the Public Health (London) Act 1936. Plants were inspected and advice given 34. by the Public Health Inspectors to both management and stokers and others in an effort to raise the efficiency of plants and prevent atmospheric pollution. A matter of concern to the Public Health Department has been the amount of atmospheric pollution created by smoke from the chimney stack of the central boiler house of the L.C.C. Cranston Estate. This boiler house consists of four furnaces with underfeed stokers. A very full investigation throughout the year has proved successful in diagnosing the loss of efficiency in the furnaces and the cause of the resultant atmospheric pollution, viz :- (a) Handymen employed as stokers with a very limited or no knowledge of the principles of efficient combustion, and (b) the failure of the automatic plant to provide the correct proportion of air and fuel during automatic shut-down and periods of clinkering. Proposals have been made to the Chief Engineer of the London County Council and it is hoped that the efficiency of this boiler house may be raised and prevent emissions of dark smoke. Improvement at Whiston Road Power Station. During the year a great deal of unnecessary atmospheric pollution has been emitted from the main chimney stack of the Whiston Road Power Station. Many visits and observations were me.de and with the co-operation of the Chief Engineer of the station and the London Electricity Board a very definite improvement has resulted during this year. Advice given by the Public Health Inspectors has been readily accepted concerning the operation, repair end improvement of the chain feed stokers. Unfortunately instrumentation has not yet been provided in this boiler house. It is, however, intended that every effort will be made to persuade the London Electricity Board to provide instrumentation without delay, which, if operated correctly would reduce stilj further atmospheric pollution. Proposed Smoke Control Areas. During the year the Council decided in principle to put forward proposals for a Smoke Control Area to the Ministry. It was decided that a pilot scheme be introduced incorporating the Colville Estate consisting of 308 flats, 13 commercial buildings, 2 factories and 3 private dwellings. This is an area of approximately 9 acres bounded on the north by the Grand Union Canal, on the east by Whitmore Road and on the South by Hyde Road. In accordance with the Clean Air Act the necessary preliminary survey of the area has been made and full information sent for the approval of the Minister. In connection with this work a severe handicap was (a) that sufficient supplies of approved type fuel would not be available and (b) the limited fuel storage space in the flats that prevented fuel 35. suppliers from maintaining a regular supply of small quantities of fuel. I am pleased to report that full co-operation was afforded to this department by the officers of the North Thames Gas Board and fuel merchants and these difficulties were successfully overcome. Approval in principle of this Smoke Control Area from the Minister is awaited and if confirmed it is the intention of the Council to make the Colville Estate Area a 'Smoke Control Area'. Measurement of atmospheric pollution in Shoreditch. Work has continued throughout the year in the measurement of atmospheric pollution employing the volumetric system of measurement, and reference to the appended diagram indicates that Shoreditch compares very favourably with other Boroughs in the London area. The officers of the Public Health Department are indebted to the Council for their continued interest in the Clean Air Campaign. The Council are represented on the National Society for Clean Air by Mr.Councillor Linale and the Chief Public Health Inspector, Mr.Grant,who is also an elected member of the Council of the South-East Division of the National Society for Clean Air. The Council are also represented on the Standing Conference of Co-operating Bodies on Atmospheric Pollution by Council representatives and the Deputy Chief Public Health Inspector. ATMOSPHERIC POLLUTION 1957-58 HIGHEST & LOWEST DAILY RECORDS OF SMOKE IN LONDON BOROUGHS AND IN SHOREDITCH. MILLIGRAMS PER CUBIC METRE SINGLE STACK DRAINAGE Early in 1956, in consultation with the Borough Architect's Department, experimental work was carried out on one block of Council flats by introducing what is known as the single stack system of plumbing and drainage. We have now had an opportunity of observing the effects of this and are satisfied that this method of construction of drainage is efficacious. There is a very considerable saving in cost, as by this method, the number of pipes required to receive soil, waste water and rainwater is considerably reduced. Where possible, all W.C's. sinks, baths and washbasins are connected to a single pipe which is also designed to receive rainwater from the roofs. By careful planning and grouping of fitments it has been possible to shorten the length of the soil and waste pipes, eliminate the need for anti-syphonage and reduce the number of drain connections to the main drainage system. This method also results in space which is taken up by ducts to house pipes, being considerably reduced, resulting in the addition of more available floor space to each flat. Considerable care has to be taken in the construction of this drainage method and in particular there is a danger that if the main drain is obstructed that the soil drainage may surge up through the lowest fitment which is usually the W.C. of the ground floor flat. Stoppages, of course, are usually caused by lack of care on the part of tenants. However, by experiment we have arranged for a large radius bend to be provided at the foot of each stack to reduce the risk of stoppages. In addition, we have arranged for the construction of a relief or "safety valve" gully at the foot of each stack so that if by mischance there is a stoppage the soil will come through the gully which is in the open air. So far as we are aware no other Borough in London has adopted the system of having a relief gully in the design, and from experience wo have found this is a very advantageous addition. It is probable that as a result of these experiments by the Chief and Deputy Public Health Inspectors that several architects have been prompted to apply these principles of design to factory and commercial buildings in the Borough. In addition the London County Council architects have also applied the single stack system with success in a number of blocks of flats, including one of eight stories on the Ivy Walk site. CLEARANCE AREAS. No official representation under Part III of the Housing Act was made during the year, but the Haggerston Road and Nicholas Street Clearance Areas represented in 1956, were confirmed without modification by the Minister of Housing and Local Government on 4th October, 1957. 36. 37. HOUSING-OVERCROWDING MP PREFERENTIAL TREATMENT. At the end of 1956 the total number of overcrowded cases on the Public Health Department register was 169, and the number on the medical preferential treatment register was 65. During the year 8 new cases of overcrowding and 1 new case recommended for preferential treatment on medical grounds were added to the register. A special survey of all premises on the register was made and it was found that 116 overcrowded families and 29 preferential treatment cases had been rehoused or had found other accommodation themselves. The number of overcrowded cases remaining on the register at the end of the year was 61, and the number on the preferential treatment register was 37. 224 visits of inspection were made during the year. UNDERGROUND ROOMS. During the year 14 underground rooms were reported on, and Closing Orders were made or Undertakings accepted in respect of 13. In two cases Closing Orders were determined, the rooms being made to comply with the Underground Rooms Regulations. The number of underground rooms on the register at the end of the year was 826. FACTORIES ACT, 1937. The number of factories on the register at the end of 1957 was:- Power Factories 1,081 Non-Power Factories 134 Total 1,215 During the year 44 factories were added to the register and 49 were deleted, making a nett decrease in the number of factories in the Borough of 5. 38. The particulars of inspections made during the year are as follows:- Premises. Number of Inspections Written Notices Occupiers Prosecuted Power Factories 2,152 45 – Non-Power Factories 215 4 – Other Premises under the Act (including works of building and engineering construction but not including out-workers' premises) – – – Total 2,367 49 – The defects found and dealt with were as follows:- Particulars Number of defects Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (Section 1) 4 3 1 _ Overcrowding (Seotion 2) _ _ _ _ _ Unreasonable temperature (Section 3) _ _ _ _ _ Inadequate Ventilation (Section 4) _ _ _ _ _ Ineffectual drainage of floors (Section 6) 1 1 1 _ _ Sanitary Conveniences; (1) Insufficient 6 3 _ _ _ (2) Unsuitable or defective 66 55 _ 3 _ (3) Not separate for sexes 2 2 _ 1 _ Other offences against the Act (not including offences relating to outwork) 6 5 _ _ _ Total 85 69 2 4 _ 39. HOME WORK. During the year 55 lists of outworkers were received from employers in the Borough, 27 in the first half-year due in February, and 28 in the second half-year due in August. These lists contained the names of 1,109 outworkers, of whom 1,055 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 15 other Local Authorities containing the names of 414 outworkers living in Shoreditch and employed by firms outside the Borough. The total number of out-workers reported was therefore 1,523. 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 40 and 41 show the distribution of out-workers as regards trades. During the year 233 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. 40. 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 Ordora Made i-Tosecutions February August 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 - 14 - - - - - - - - - Boxes 4 - 55 6 — 56 - - - - - - - - - Brushes 1 — 6 — - — - - - - - - - - - Button Mounting 2 - 47 2 - 35 - - - - - - - - - Paper Bags - - - - - - - - - - - - - - - Stuffed Toys 2 - 129 1 - 135 - - - - - - - - - Wearing Apparel 16 63 252 17 86 213 - - - - - - - - - Upholstery 1 - 2 1 - 1 - - - - - - - - - Totals 27 63 506 28 86 454 - - - - - - - - - 41. The following table shows the number of outworkers living in Shoreditch and employed by firms outside the Borough during 1957 as notified by the various sanitary authorities. NUMBERS OF OUTWORKERS RECEIVED FROM OTHER DISTRICTS DURING 1957. Totals DISTRICTS Making Wearing Apparel Toys find Crackers Artificial F lower s Jewellery Hand Bags Umbrellas etc. Paper Bags abd Boxes Sweet wrapping Furniture & Upholstery Card Mounting Brushes Feather mounting ?eb. Aug. Feb. A.ug. Feb. Aug. Feb, Aug. Feb. Aug. Fob. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Fob, Aug. Bethnal Gr oen 23 23 - - - - - - - - - - - - - - - - - 1 - - 23 24 Finsbury 30 30 3 3 5 43 1 1 2 2 1 1 3 2 1 - 7 8 - - 1 - 54 90 Hecknoy 20 20 - - 10 9 - - 7 - 4 4 - - - 7 - - - - - - 41 40 Holborn 2 2 1 1 - - - - - - - - - - - - - - - - - - 3 3 Islington 7 12 - 2 2 6 - - 1 - - - - - - - - - - - - - 10 20 Kensington 1 1 - - - - - - - - - - - - - - - - - - - - 1 1 Lambeth - 1 - - - - - - - - - - - - - - - - - - - - - 1 Lewisham - 1 - - - - - - - - - - - - - - - - - - - - - 1 S.Karylebone 6 3 - - - - - - - - - - - - - - - - - - - - 6 3 London City 6 4 - - - - - - - - - - - - - - - - - - - - 6 4 St.Pancras 2 2 - - - - - - - - - - - - - - - - - - - - 2 2 Southwark 1 1 - - - - - - - - 1 1 - - - - - - - - - - 2 2 Stepney 9 8 - - - - - - - - - - - - - - - - 10 - - - 19 8 Stoke Newington 4 7 4 3 - - - - - - 1 - - - - - 1 1 2 2 - - 12 13 Westminster 16 7 - - - - - - - - - - - - - - - - - - - - 16 7 Totals 127 122 8 9 17 58 1 1 10 2 7 6 3 2 1 7 8 9 12 3 1 - 195 219 42. 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 sewer maintenance treatment as reported last year was carried out with a full scale Warfarin 5 treatment and as reported this was the first time that this method of baiting had been carried out in the sewage system in the London area. The results being satisfactory, this method was again used during the sewer treatments in 1957 and has proved so satisfactory from many points of view that it will be continued. The number of complaints arising in connection with the common rat increased during the year, probably owing to the amount of new building being 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 and drain outlets are effectively sealed off from the sewer. In connection with rodent complaints received, 596 drains were tested as against 271 last year and in 167 cases it was found that the drainage was defective, as against 70 cases last year, and there has been a considerable increase in this work during the year which takes up a considerable amount of time for the whole of the staff. In all cases where defects were found Notices were served to remedy the defects. There has been a continued decrease of complaints regarding infestation by the ship rat. The system of arranging for contracts with business firms to assist them in rodent disinfestation was continued. During the year 23 new contracts were entered into and with existing contracts were to the value of £809.16.8d. Charges for servicing business firms by single treatments carried out from 1st April 1957 to 31st March 1958 amounted to £204.15s, a considerable increase over the previous year. 43. REPORT FOR 12 MONTHS ENDING 31.3.58 Council Property Dwelling Houses Business Premises Total No. of properties in Borough 16 11,377 3,503 14,896 No. of properties inspected as a result of : (a) Notification 1 125 53 179 (b) Survey under the Act _ 134 751 885 (c) Otherwise 1 383 314 698 Total inspections carried out 174 3,062 3,241 6,477 No.of properties inspected which were found to be infested by : (a) Rats - (Major - - - - (Minor 2 54 27 83 (b) Mice - (Major — - - - (Minor 2 110 32 144 No.of infested properties treated by Local Authority 4 164 58 226 No.of notices served under Section 4 of the Act. (a) Treatment ) (b) structural works ) (i.e. Proofing) ) - 1 2 3 No.of cases where action was taken following service of notioe - - - - Legal Proceedings - - - - No.of "Block" control schemes carried out 65. 44. Details of treatments carried out. Business premises Dwellings Rats Rats Mice Warfarin trays laid 989 301 762 Traps set 156 128 54 Sewers. June Dec. No.of manholes baited 422 418 Complete takes - poison bait - 1 Partial takes - poison bait 111 119 No takes - poison bait 311 298 PIGEONS. During 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 trcpper works under the general direction of the Chief Public Health Inspector. NUISANCES FROM NOISE. Several complaints regarding nuisances from noise were male 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. Work in connection with Food Hygiene was continued throughout the year and routine inspections at all food handling premises were carried out. The number of food handling premises in the Borough at the 45. end of 1957 was 907 as follows ;- Cafes and R staurants 115 Factory and Warehouse Canteens 53 Ice Cream Shops and Manufacturers 104 Milk Shops and Depots 87 Butchers'Shops and Stores 44 Fried Fish Shops 10 ''Yet Fish Shops 6 Fish Curers 4 Bakehouses 12 Food Warehouses 7 Grocery and Provision Shops 130 Confectioners' Shops 72 Greengrocers' Shops 35 Public Houses 130 Food Stalls 97 Coffee Stall 1 907 The Public Health Committee, in considering the work in connection with the Food Hygiene Regulations, decided in September 1956 to make two appointments of Public Health Inspectors with special duties for the inspection of all food premises including stalls, canteens etc. In August 1957 one of the two special Inspectors left the service of the Borough Council and responsibility for this work has been carried out by the other Inspector. Advertisements for the replacement of this Inspector have proved unsuccessful, there being no applicants for the position. During the year some 2,692 visits of inspection were made to food premises and Intimation Notices of defects found were served in 133 instances, and 1746 reinspections of the premises were made. Stalls selling shellfish, wet fish, meat and poultry were given particular attention during the regular atreet market inspections and particular attention was given to the screening of the stalls. The cooperation of the Hoxton Street Traders' Association continued and this co-operation has again proved to be very valuable. Much of the Inspector's time is spent in discussing with owners and occupiers the work required at the premises to secure compliance with the Food Hygiene Regulations. Particular attention was! given to the availability at all times of hand towels, soap and nail brushes to washbasins ani advice given on the use of a combined detergent-steriliser in connection with the washing-up of utensils, particularly in cafes, restaurants and canteens. The continued distribution of the booklet "Your Guide to the Food Regulations 1955" has been much appreciated by many of the food traders who have made special efforts to carry out the advice given, not only 46. by the Inspectors, but by that published in this very useful handbook. In two instances tho proprietors of restaurants were persuaded to transfer their kitchens from basement level to more suitable positions on the ground floor and wherever possible to obtain, this policy will be oontinued. Samples of milk were taken from 18 schools, 2 hospitals and 2 day nurseries in the Borough and submitted for chemical analysis and for bacteriological examination. In all cases the reports of the analyst and the bacteriologist were satisfactory. There were 12 bakehouses in the Borough, all of which were visited regularly every month. All are above ground with one exception which is situated underground and will be subject to special inspection with a view to continuance of the Certificate of Suitability which is now in operation, in 1958. Observations were kept in connection with the Food Hygiene Regulation which prohibits the use of tobacco, including snuff, while handling open food in any food room in which there is open food. In two cases warning letters were sent to the offenders. As a result of Intimation Notices served under the Food Hygiene Regulations 1955 during the year, the following items of work and apparatus were completed and installed :- Wash hand basins provided 7 Sinks - not wash hand basins - provided 8 Provision of hot water over sinks and wash hand basins 18 Accommodation for clothing provided 3 Refrigerators provided 2 Wash your hands'notices provided 20 Light and ventilation provided 5 General repairs completed 33 Dirty floors cleaned, repaired, covered etc. 22 Nail brushes provided 14 Food Cabinets provided 7 Food preparation tables covered with non- absorbent materials 18 Premises or parts of premises re-decorated 57 Improvements to urinals 3 First-aid materials provided 4 Additional dustbin provided 1 Cleansing of equipment 17 Cleansing of food rooms 30 Refuse etc. 7 47. STALLS. Screening of stall provided 1 Refuse bin provided 1 ANTI-FLY CAMPAIGN The campaign to combat the fly nuisance was continued. By arrangement, 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 Council'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. CHEMICAL ANALYSIS OF FOOD. 254 samples were submitted to the Public Analyst during the year, giving a rate of 5.7 per 1,000 population. These were as follows ;- Aspirin Tablets 4; Almonds, ground 1; Bread & Butter 7; Butter 4; Cake & Pudding mixtures 9; Chocolate, drinking 2; Cocoa 1; Coconut, dessicated 1; Coffee, extract dry 1; Coffee & Chicory, essence 1; Codeine, linctus 2; Cough Medicines 3; Cream 3; Curry, powder 1; Dessert Powder 1; Drinks, soft 8; Eucalyptus Oil 1; Fish Paste 3; Fish, canned 1; Flour, self-raising 1; Flour, batter 1; Fruit, canned 3; Fruit, dried 1; Fruit Juice 1; Gin l; Gelatine 2; Glycerine of Thymol 1; Glpuber's Salt 1; Health Salts 1; Jam 6; Jelly, Tablet 1; Lard 1; Margarine 5; Marzipan 1; Marmalade 1; Mayonnaise 1; Meat products, canned 6; Meat products, pie 1; Liver Sausage 1; Meat products, minced 3; Meat, paste 2; Milk 103; Milk, condensed 5; Mincemeat 1; Mustard 2; Olive Oil 1; Pastry, mixture 1; Pepper 1; Pickles 2; Proprietary Medicines 4; Pudding, Xmas 2; Ravioli, canned 1: Sauce 5; Sausages 2; Semolina 1; Soup, canned 3; Soda, bicarb 2; Spices 2; Suet, shredded 1; Tapioca 1; Tea 4; Tomatoes, canned 1; Vegetables, canned 5; Vinegar 4; Vitamin Tablets 1; Whisky 3. 48. A sample of semolina submitted was found to contain insects (booklice). Remaining stock was destroyed. Sample of golden pudding mixture was found to be caked and mouldy, and a buttered roll was found to be spread with margarine. In each case formal samples taken were satisfactory. A warning letter was sent to a retailer in respect of sausages which contained a very small quantity of foreign matter which was not a potential danger';to health. UNSOUND FOOD. During the year 343 certificates were issued in respect of food unfit for human consumption, which includes the following Meat 419 tins; 25 cwts.3 qtrs. 24 lbs.; Meat Products 69 cartons; Ham 114 tins; 82 lbs.; Bacon 12 cwts. 1 qtr. 11 lbs.; Turkey 18 lbs.; Cheese 50 cwts.O qtrs.7 lbs.; Peas^ 131 tins: Peas 18 cases; Dried Peas 1 cwt.3 qtrs.20 lbs.; Split Peas 3 cwts.2 qtrs.3 lbs.; Marrowfat Peas 1 cwt.O qtrs.7 lbs,; Butter Beans 25 tins; 58 lbs.; Beans 20 tins; Spaghetti 1 tin; Ravioli 21 tins; Tomatoes 3 cases; Various Fruits 1,551 tins; Dried Fruit 165 packets; 6 cwts.3 qtrs.2 lbs.; Fruit 178 Flat Bushel Boxes of Various Fruits; Ground Almonds 15-g- lbs.; Evaporated Milk 44 tins; Libby Milk 2 tins; Ideal Milk 2 tins; Soup 12 tins; Vegetables 121 cartons; 1 tin; Mixed Vegetables 34 cartons; Potatoes 72 lbs.; Beetroot 1 tin; Onions 14 tins; Red Cabbage 1 tin; Semolina 6 packets; Oatmeal 12 lbs.; Rice 5 cwts.O qtrs.20 lbs.; Barley 1 cwt.; Pearl Barley 1 cwt.2 qtrs.3 lbs.; Farinoca 2 qtrs.; Farinoca and Coconut 22 lbs.; Lentils 5 cwts.O qtrs.17 lbs.; Rolled Oats 102 lbs.; Sago 2 qtrs.4^- lbs.; Scotts Oats 31 packets; Shredded Wheat 36 packets; Puffed Wheat 1 packet; Salt 25-g- lbs.; Suet 26 tins; 59 lbs.; Lard 44g- lbs.; Sponge Mixture 2 packets; Cake Mixture 24 packets; Royal Instant Pudding 1 carton; Cakeoma 2 cartons; Glace Cherries 2 packets; Mixed Peel 19 lbs. Pickled Walnut 1 tin; Sauce 1 bottle; Fish Paste 2 jars; Fish 7 tins; Fish Fingers 11 cartons; Shrimps 52 lbs.; 44 tins; Sardines 7 tins; Salmon 27 tins; Pilchards 4 tins; Dressed Crab 7 tins; Fish Products 73 cartons; Bourn Vita 6 tins; Jam 5 lbs.; Lemon Curd 1 lb.; Kia Ora 4 bottles; Household Flour 48 packets; Loaves, Currant 11; Loaves, Plain 80; Continental Loaves 98; Continental Rolls, 1224; Cakes 120; Cholas 120; Cornish Pasties 11; Tomatoe Puree 1; Selad Cream 2; Sandwich Spread 1 tin; Baby Strained Food 2 tins; Creamed Rice 1 tin;. 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 area the dealers are situated is notified when unsound food is sent to the manufacturers. 49. PRESERVATIVES IN FOOD REGULATIONS. All articles taken were in accordance with the Regulations. PHARMACY AND POISONS ACT, 1933. 37 Licences were granted during the year. 86 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 ten 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 four deal on a very small scale only, two in dogs and the other two in pigeons. During the year 26 inspections were made of these premises, and in no case were the conditions of the licence being contravened. RAG FLOCK AND OTHER FILLING MATERIALS ACT,1951 At the end of 1957 the number of registered premises where filling materials were used was 109, and during the year 11 licences were issued in respect of premises where rag flock is manufactured or stored. 289 Inspections of the premises were made. 23 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 eddition to this Public Health leaflets have been distributed through the courtesy of the Borough Librarian at the Public Libraries. 50. 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 have completed or are exempt from National Service. One sat for his examination in July 1957 and was successful. Another, who has qualified as a Public Health Inspector in Southern Ireland, is now in his last year of training and sits for the examination in 1958, whilst the "third, who is undergoing his theoretical training, will sit for the examination in 1959. In replacement of the successful candidate, another pupil qualified as a Public Health Inspector in Southern Ireland, was appointed. He will also take 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 trfin 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 1957 two student Public Health Inspectors being trained are in the last year of their theoretical training and will sit for the examination in 1958. Since the beginning of the scheme in 1946 seven students have been successfully trained and passed their qualifying examination. FOOD & DRUGS (MILK & DAIRIES) ACT 1944 ~MTLK (SPECIAL PES IGNAT IONS) ACT , 1949 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 68 90 Supplementary Licences 27 30 Totals 95 120 Milk (Special Designations) (Raw Milk) Regulations, 1949. Tuberculin Tested. Dealers' Licences 43 Supplementary Licences 27 Tota1 70 51. EXAMINATION OF MILK SUPPLIED TO L.C.C.SCHOOLS 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 65 samples of pasteurised milk were submitted for phosphatase and methylene blue tests. All samples conformed to the prescribed standard. BACTERIOLOGICAL SAMPLING OF ICE CREAM. 12 samples were submitted to the methylene blue test with results as follows a Grade 1 8 ,, 2 3 ,, 4 1 CONDENSED MILK REGULATIONS 5 samples of condensed milk were submitted for analysis under these regulations and all conformed with the prescribed standard. HOUSING STATISTICS. 1. INSPECTION OF DWELLING-HOUSES DURING THE YEAR. (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 8,320 (b) Number of Inspections made for the purpose 16,872 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under Section 3, Housing Act, 1957 470 (b) Number of inspections made for the purpose. 522 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for humen habitation 36 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 defeats 1,125 52. 3. ACTION UNDER STATUTORY POWERS DURING THE YEAR. A . Proceedings undor Public Health Acts :- (1) Number of dwelling-houses in respect of which nuisance notices were served requiring defects to be remedied 188 (2) Number of dwelling-houses in which defects were remedied after service of nuisance notices (a) by owners 185 (b) by local authority in default of owners - B . Proceedings under Sections 9,10 and 12 Housing Act 1957:- (l) 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 defsult of owners ... - C . Proceedings under Sections 16 and 23 of the Housing Act 1957. (1) Number of dwelling-houses in respect of which Demolition Orders were made or Undertaking accepted... ... 31 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 2 D . Proceedings under Section 18 of the Housing Act 1957. (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made or Undertaking accepted 21 (2) Number of separate tenements or underground rooms ip. respect of which Closing Orders were determined, the tenement or room having been rendered fit 2 E . Proceedings under Section 42 of the Housing Act, 1957. (l) Number of houses included in representations by Medical Officer of Health (2) Number of houses demolished in pursuance of representations - F . Proceedings under Section 10 of Local Government (Miscellaneous Provisions) Act, 1953. (l) Number of Closing Orders made 5 (2) Number of Closing Orders determined. - 53. 4. HOUSING ACT, Part IV - OVERCROWDING. (1) (a) Number of overcrowded families on register at beginning of year 169 (b) Number of new cases found during year 8 (c) Number of cases rehoused or found other accommodation during year 116 (d) Number of overcrowded families on register at end of year 61 LEGAL PROCEEDINGS. PUBLIC HEALTH (LONDON) ACT 1936. Date Nature of Offence Fine Costs Result May 3rd Non-compliance with Nuisance Notice - 32,Queensbridge Road 3. 3. 0 Order for Notice to be complied with within 28 days and to pay £3.3.0 costs. May 3rd Non-compliance with Nuisance Notice - 46,Queensbridge Road 3. 3. 0 Order for Notice to be complied with within 28 days and to pay £3.3.0 costs. Sep.11th Non-compliance with Nuisance ) Notice - Granville Buildings ) ) 4. 4. 0 Notices complied with.Summonses withdrawn on payment of four guineas costs. Sep.11th Non-compliance with Dustbin ) Notice - 99-103,105 & 106, ) Granville Buildings. FOOD & DRUGS ACT, 1955. Date Nature of Offence Fine Costs Result Feb. 8th Selling a sausage containing a metal staple. 2. 2. 0 Discharged absolutely. Ordered to pay two guineas costs, 54. STATISTICAL REPORT OF HOUSING WORK DONE BY THE PUBLIC HEALTH INSPECTORS, 1957. Overcrowding, Number of new cases reported 8 Number of new cases referred to L.C.C. 8 Number of cases relieved 116 Number of Inspections and Visits by Inspectors 217 Preferential treatment on health grounds. Number of new cases investigated and reported on to L.C.C. 1 Number of cases known to have been found accommodation 29 Number of inspections and visits by Inspectors 7 Underground rooms. Number reported on 14 Number closed 13 Number where undertakings received - Number made to comply with regulations 2 55. INDEX Aged - care of 22,32 Analysis of food samples 47 Anti-fly campaign 47 Area of Borough 6 Atmospheric pollution 33 Bacteriological examinations 14 Birth rates 9 Burials 11 Cancer 11 Clearance Areas 36 Committees - Public Health 4 Borough Welfare 4 Deaths, causes of 8 Death rates 9 Disinfection 28 Disinfestation 28 Factories Act, 1937 37 Food Hygiene 44 Free washing facilities 47 Hairdressers registration 31 Health propaganda 49 Heating Appliances (Fireguards) Act 42 Holiday Home 23 Housing Statistics 51 Infantile mortality 10 Infectious diseases 11 Legal Proceedings 53 Marriages 9 Mass Miniature Radiography 17 Maternal mortality 10 Milk (Special Designations) 50 Milk Sampling 51 National Assistance Act - Section 47 32 Section 50 11 Noise Nuisances 44 Offensive Trades 31 Old People's Clubs 23 Outworkers 41 Overcrowding 53 Paid Pupillage 50 Personal Cleansing 27 Pests Act 1949 42 Pet Animals Act 1951 49 Phannacy & Poisons Act 49 Pigeons 44 Population 9 Preservatives in food regs 49 Public Health Propaganda 49 Rag Dealers 32 Rag Flock Act 1951 49 Rodent Infestation 43 Rent Act 1957 29 Sanitary circumstances 25 Shops Act, 1950 32 Social Welfare services 22 Staff 5 Stillbirths 9 Student Public Health Inspectors 49 Swimming Baths 31 Single Stack Drainage 36 Tuberculosis 14 Tuberculosis Care Committee 20 Underground rooms 37 Unsound food 48 Venninous houses 27 Vital statistics 6 Water supply 31 Water from wells 31