AC 4365 SHOR 63 REPORT on the HEALTH AND SANITARY CONDITION of the METROPOLITAN BOROUGH OF SHOREDITCH IN THE COUNTY OF LONDON FOR THE YEAR 1958 BY B. BROADBENT, M. A. ,M. B. ,M. R. C. S. ,D. P. H. , Medical Officer of Health. •- £> I* S.S. 5663 REPORT on the HEALTH AND SANITARY CONDITION of the METROPOLITAN BOROUGH OF SHOREDITCH IN THE COUNTY OF LONDON FOR THE YEAR 1958 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. 5663 2 To the MAYOR, ALDERMEN and COUNCILLORS of the METROPOLITAN BOROUGH OF SHOREDITCH. Mr. Mayor, Ladies and Gentlemen, We have all tended in recent years to expect steady improvement in the health of the Borough, and attributed this largely to the improved housing, increased incomes and absence of real poverty among the residents. It well may be that these very factors were the reason for some of the setbacks which occurred in 1958, for it is an established fact that poliomyelitis (for example) is a more severe disease in highly-developed countries than among the backward races. Not only were there two polio deaths but these were very sudden - one lieing within 3 days of the onset of the disease, and the other (a man of 33 years) within a week, thus showing that our power to fight this disease unaided is very poor at any age. Luckily most of their child-contauts had been inoculated earlier, so that a total of only ten cases were notified in the year. Without that protection there might well have been a much wider spread despite all our efforts at localising the outbreak. The number of children born dead (stillbirths) jumped from 8 to 20 during 1958 for no apparent reason, and the illegitimate births increased from 48 to 64. Also, for the first time since a self-induced abortion in 1951, we lost not merely one mother but two from childbirth, despite every modern aid. Although this is the total list of calamities for the year, while everything else showed further improvement, it indicates that we cannot afford to relax our efforts, especially when we see how the wrong use of modern advances such as penicillin and D.D.T. has done harm in other directions. It is therefore incumbent upon each one of us to see that good use is made of all the protection available from immunisation and inoculation, because it is too late to begin trying to use them after we have been actually in contact with cases, whether of polio, diphtheria, or even whooping cough. The routine vital statistics showed an increased number of births, decreased deaths, an improvement in infant mortality rate so that Shoreditch is once more on the right side of the average, a decrease in deaths from tuberculosis, cancer of stomach, lung, and even a slight improvement in deaths from coronary disease. Acoidental deaths were down to half the previous year's total so that it appears as if the average resident is resisting the more normal hazards to hie life. On the other hand, although 1958 was not an epidemic year for the "old-fashioned" notifiable diseases,dysentery still attacked 120 people, which shows that our propaganda (about handwashing before handling food, and after toilet)is not getting driven home, even now, although this is such a simple way of avoiding an uncomfortable disease. Fortunately the food shops are not as careless as the home-dwellers, in this matter. In the matter of the fight against infection, the Borough suffered a blow by the enforced retirement of Doctor C.K. Cullen, who had reached the age limit after a lifetime devoted to the very successful treatment of tuberculosis in the Borough" He was replaced by Doctor W.F. Richards who we hope will uphold Doctor Cullen's remarkable tradition. 3. The Council's Social Welfare Services exceeded, all previous records both in amount and variety, and included more than 4000 visits to pensioners in their own homes as well as the entertainment of more than 800 guests at the Council's Holiday Home in Sussex (more detail on pages 2l/22). The Council's first Smoke Control Area was confirmed by the Minister of Housing and Local Government in October 1958, and the Council has since agreed in principle to implement the Act for the whole Borough in 5 stages, so that by 1966 we hope the whole Borough will be controlled. Luring the past 5 years, 1300 flats erected by the Borough Council have had single stack plumbing provided instead of the traditional types - thanks to the close co-operation of the Chief and Deputy Chief Public Health InspeEtors with the Council's Architectural Department - which is calculated to have led to a reduction of more than £20,000 in the capital costs (see page 34 ). The L.C.C. estates have since followed suit,spreading outwards from Shoreditch. Slum clearance, as such, has been incorporated in the plans for rebuilding the whole Borough, ratherthan being a separate entity, and is likely to continue in this way, even though there are still 1274 houses which will be ready for representation within the next 5 years. The Council's method of procedure is undoubtedly quicker, and also fairer to the owners than the methods hitherto adopted by most authorities under the slum clearance (Part III) Clauses, and it also ensures a more suitable site for modern blocks of flats. The rat-destroying services have had an unusually successful year in that the ship rat seems to have disappeared almost completely (he is the one who carried the fleas which caused the great plagues in London, as a result of which we still occasionally unearth thousands of human skeletons in Shoreditch). Also, the contracts for rodent servicing of business firms have brought in more than £1200. The absence of food poisoning in the Borough speaks well for the cooperation of the food handlers in the Borough and is probably linked with the constant propaganda and personal contacts which continue unabated. We trust that these good results are spread throughout the country in association with the prodigious quantities of foodstuffs passing through wholesalers in Shoreditch. The absence of flies from the Borough (or their continued susceptibility to the Gammexane in the dustbins) also must contribute, as well as the universally free handwashing facilities available. Paid pupillage for training Public Health Inspectors is beginning to pay dividends in that the shortage is becoming less acute in Shoreditch, and we should fill the gaps by the end of 1959, if luck continues. I acknowledge with gratitude the hard work and loyalty of all in the Department, and the willing cooperation given by so many colleagues. Yours faithfully, B. BROADBENT Medical Officer of Health. Town Hall, Old Street, E.C. 1. SHOreditch 76OO. 4. PUBLIC HEALTH COMMITTEE to May 1958) BOROUGH WELFARE COMMITTEE (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-Chairman: Coun. PAIN, Mrs. D.N. Alderman 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. " SIMMONDS, 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. PUBLIC HEALTH COMMITTEE (May 1958 to May 1959) BOROUGH WELFARE COMMITTEE (May 1958 to May 1959) Ex-officio: Councillor R.J. TALLANTIRE, 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. SMITH, Mrs. E.E. Vice-Chairman: Coun. PAIN, Mrs. D.N. Alderman Rev. MEREDITH DAVIES, M.B.E. Alderman WRAY, D. Councillor ANDERSON, J. " DEACON, F.J. " GIRLING, Mrs. H. O.B.E., J.P. " HAYES, T. " RICHARDSON, J. " ROBERTSON, H.T.L. " SIMMONDS, A.S. " SWALES, R.T.J. " TURNER, C ,H. (Co-opted) Lady Cynthia COLVILLE, D.C.V.O., D.B.E., J.P. 5. STAFF CF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health B.BROADBENT, M.A. ,M.B. ,B.Ch.,M.R.C.S., L.R.C.P.,D.P.H. Chief Public Health Inspector & Administrative Assistant. DAVID GRANT, F.A.P.H.I. (a)(b) Deputy Chief Public Health Inspector. T.H. MARSHALL, F.A.P.H.I. (a)(b) Food & Drugs and Food Premises Insnector. G. HARVEY, M.A.P.H.I. (a)(b) (Comm. 3.11.58) J.A. HOARE, M.A.P.H.I, (a)(b)(res.l6.8.58) Public Health Inspectors. D.L. DAVIES, M.A.P.H.I. (a)(b) fcarm.25.8.58) G.C.E. GIBBS, M.A.P.H.I, (a) (b) H.J. KEMP, M.A.P.H.I. (a) (comm. 4.12.58) J.P. McCORMACK.M.A.P.H.I. (a) (comm. 4-12.58) L.W. PARSLOE, (a)(b) (comm. 3.11.58) A.G. WATMORE, M.A.P.H.I, (a) (res.17.4.58) N.J. BURTON, M.A.P.H.I, (a) (res.20.5.58) Clerks. B.M.R. LEIGH E.A. CHRISTIAN G.A. POPE x H.J. KEMP (qualified as P.H.I. 4.12.58) x J.E. SCOTT Miss E. REEVES G. HARFIELD M. DAVIS (H.M. Forces) A.D.A. MELVIN J.V.A. JONES (Comm. 10.2.58) T, KEEN (res. 8.2.58) P.H.I. Trainees J.P. McCORMACK (qualified as P.H.I. 4J-2.58) J.W. REAVLEY W.N. BRAZIL Rodent Foreman/Clerk and Disinfecting Supervisor. H. BRYANT. Welfare Officer and Organiser of Clubs. Mrs. J. E. ADAMS. Assistant Welfare Officer. Mrs. I.E. PIKE. Assistant Organiser of Clubs. W.A. FANSHAW, M.A., B.Sc.(Econ). Shoreditch Holiday & Rest Home. Visiting Medical Officer. B.C. MORTON PALMER, B.A. ,M.B. ,B ,Ch. , L.M.S.S.A. Matron Miss F.M. STACEY, S.R.N., C.M.B. Public Analyst (part-time) 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-1958 3,330 Number of houses, including separately rated flats (end of 1958 according to rate books) 1,791 Rateable Value 965,880 Sum represented by penny rate £3,859 A great variety of industries is carried on in the Borough's 1,187 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 1958. Male Female Total Live births - Legitimate 341 325 666 — Illegitimate 41 23 64 Live birth rate per 1,000 population (crude rate) 16.84 Do. (adjusted for Area Comparability Factor 0.91) 15.32 Stillbirths 7 13 20 Stillbirths rate per 1,000 live and stillbirths 26.66 Total live and still-births 389 361 750 Infant deaths 9 6 15 Infant mortality rate per 1,000 live births - total 20.55 " " " - legitimate 22.52 " " " - illegitimate – Neo-Natal mortality rate per 1,000 live births 15.07 Illegitimate live births per cent of total live births. 8.76% Maternal deaths (including abortion) 2 Maternal mortality rate per 1,000 live and still-births 2.66 Deaths 235 238 473 Death rate per 1,000 population (crude rate) 10.91 Do. (adjusted for Area Comparability Factor 0.81) 8.84 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 theDistrict Transferable deaths Nett deaths belonging to the District Un corrected Number Nett Number Rate of Nonresidents registered in the District Of residents not regisered in the District Under 1 year of age it all ages Number Rate per 1,000 nett Births Number Rate Number Rate 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 16.1 517 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 1958 43330 193 730 15.3 522 9.8 215 166 15 21 473 8.8 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 Superintendent. Hospitals. - Within the Boroughs St.Matthew's Hospital, Shepherdess Walk, N.l. St.Leonard's Hospital, Nuttall Street, N.l. Ambulance Facilities. - Ambulances are provided by the London County Council. Venereal Diseases. - Posters and notices are displayed at the conveniences in the Borough, drawing attention to the facilities available at local Hospitals. Public Mortuary - The arrangement with Hackney Borough Council for the use of their oortuary 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 l 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 1 1 3 – 3 2. Tuberculosis, other forms – – – – – – – 1 – 1 1 3. Syphilitic disease – – – – – – 1 1 2 – 2 4. Diphtheria – – – – – – – – – – – 5. Whooping cough – – – – – – – – – – – 6. Meningococcal infections. 1 – – – – – – – 1 – 1 7. Acute poliomyelitis – 1 – – 1 – – – 2 – 2 8. Measles – – – – – – – – – – – 9. Other infective and parasitic diseases – – – – – – – – – – – 10. Malignant neoplasm,stomach – – – – – 2 6 8 10 6 16 11. Malignant neoplasm, lung, bronchus. – – – – 1 16 9 4 25 5 30 12. Malignant neoplasm, breast – – – – – 4 5 4 1 12 13 13. Malignant neoplasm, uterus – – – – 1 1 1 2 – 5 5 14. Other malignant and lymphatio neoplasms – – – 1 1 14 10 18 26 18 44 15. Leukaemia, aleukaemia – – – – – – – 1 – 1 1 16. Diabetes – – – – – – 1 2 2 1 3 17. Vascular lesions of nervous system – – – – 1 3 12 38 17 37 54 18. Coronary disease, angina. – – – – 3 8 15 35 30 31 61 19. Hypertension with heart disease – – – – – 2 2 2 1 5 6 20. Other heart disease – – – – – 9 8 25 12 30 42 21. Other circulatory disease – – – – 1 – 2 15 7 11 18 22. Influenza – – – – – 1 2 – 1 2 3 23. Pneumonia 2 – – – 2 3 10 16 17 16 33 24. Bronchitis – 1 – – 1 13 20 34 49 20 69 25. Other diseases of respiratory system – – – – – 2 – 3 2 3 5 26. Ulcer of stomach and duodenum – – – – – 1 – 3 2 2 4 27. Gastritis, enteritis and diarrhoea – – – – – – 1 2 1 2 3 28. Nephritis and Nephrosis. – – – – – – 2 1 1 2 3 29. Hyperplasia of prostate. – – – – – – – 1 1 – 1 30. Pregnancy, childbirth, abortion – – – – 2 – – – – 2 2 31. Congenital malformations. 5 – – – – 1 – – 3 3 6 32. Other defined and illdefined diseases 7 1 – – 1 5 2 14 14 16 30 33. Motor Vehicle accidents. – – – – – – 1 – 1 – 1 34. All other accidents – 1 – – 1 l 1 2 2 4 6 33 . Suicide – – – – 1 1 1 1 1 3 4 36. Homicide and operations – – – – – l – – 1 – 1 Total Deaths (all causes) 15 4 – 1 17 89 113 234 235 258 473 9. II. POPULATION. BIRTHS, MARRIAGES AMD DEATHS. The Registrar-General's estimate for the mid-year 1958 population was 43,350, a decrease of 540 from the previous year. This figure is used for statistical purposes throughout this report. The density of the population is 65 persons per acre. The Area Comparability Factors for the Borough are Births 0.91 and Deaths 0.81, 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 1958 were as follows:– Total live births - (legitimate and illegitimate) Males 382 Females 348 Total 730 Illegitimate live births:– Males 41 Females 23 Total 64 The birth rate for the borough was 15.32., For England and Wales the rate was 16.4 and for London 16.7. The illegitimate births represented 8.76 per cent of all births in the borough. STILLBIRTHS. The number of registered stillbirths allocated to the Borough was 20, or 2.66 per cent of all births. MARRIAGES. The number of marriages during the year was 401 and the marriage rate was 18.5 per 1,000 population. The marriage rate for the Metropolis was 20.0 and that for England and Wales 15.1. DEATHS. The number of deaths registered in the borough in 1958 was - 522 Transferable deaths - Non-residents registered in Shore ditch - 215 Shoreditch residents registered elsewhere - 166 The number of deaths allocated to the borough is therefore - 473 This gives a death rate for the borough of 8.84 compared with 11.7 for England and Wales, and 11.8 for London. In connection with these deaths 11 inquests were held. 369 or 78 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 15 of which 9 were males.These deaths amounted to 3.17 per cent of the total net Shoreditch deaths from all causes, as compared with 2.60 per cent in 1957- The infantile mortality rate (death rate of infants under one year per 1,000 live births) for Shoreditch was 20.55, the rate for England and Wales being 22.6 and that for London 22.6. No illegitimate infant died. The number of deaths of infants under 4 weeks of age was 11, which gives a neo-natal rate of 15.07• INFANTILE MORTALITY IN THE BOROUGH DURING 1958. CAUSE OF DEATH AGES SEX Total deaths under 1 year. 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 Pneumonia – – – – – – 1 – 1 – 1 1 2 Meningococcal Infection – – – – – – – 1 – – 1 – 1 Prematurity 3 2 – – – 5 – – – – 3 2 5 Congenital malformation Haemolytic disease of 1 1 – 1 2 5 – – – – 3 2 5 new born 1 – – – – 1 – – – – – 1 1 Strangulated inguinal hernia – – – – – – 1 – – – 1 – 1 Total 5 3 – 1 2 11 2 1 1 – 9 6 15 MATERNAL MORTALITY. 1958. Two maternal deaths were recorded during the year. The maternal mortality rates in England and Vales and in Shoreditch during the past seven years are given below Maternal Mortality Rate per 1,000 Live and Still Births. 1958 1957 1956 1955 1954 1953 1952 1951 England and Wales 0.42 0.47 0.56 0.64 0.69 0.76 0.72 0.79 Shoreditch 2.66 Nil Nil Nil Nil Nil Nil 1.18 11. CANCER. The deaths from cancer in the Borough during the year numbered 108 as compared with 119 in 1957. 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 6 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 401 notifications of infectious disease were received, but in seven cases diagnosis was revised after examination of the patients 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. CASES OP INFECTIOUS DISEASE NOTIFIED DURING 1958 (confirmed diagnoses). NOTIFIABLE DISEASE. Total number of confirmed cases AGES Under 1 year 1-5 years 5-15 years 15 - 25 years 25 -45 years 45 - 65 years 65 years + Deaths. Diphtheria – – – – – – – – – Dysentery 121 8 46 49 4 11 1 2 – Acute encephalitis- infective 1 – – 1 – – – – – post-infectious 1 – – 1 – – – – – Enteric (paratyphoid) 1 – – 1 – – – – – Erysipelas 6 1 – – 1 – 4 – – Measles 132 3 67 61 – 1 – – – Meningococcal infection – – – – – – – – – Ophthalmia Neonatorum – – – – – – – – – Pneumonia 19 – 4 4 1 2 5 3 – Acute Poliomyelitis- paralytic 7 – 5 1 – 1 – – 2 - non-paralytic 3 – 2 1 – – – – – Puerperal pyrexia 1 – – – – 1 – – – Scabies 6 – 1 2 – 2 1 – – Scarlet fever 40 – 16 23 – – 1 – – Whooping cough 17 2 10 5 – – – – – Tuberculosis- - pulmonary 31 1 – – 3 13 9 5 3 - non-pulmonary 4 – – 2 2 – – – 1 Food Poisoning 4 – – 2 2 – – – – Total 394 15 151 153 13 31 21 10 6 The following diseases are notifiable in this Boroughs 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 (l.4.53). 13. Disease Authority for notification Enteric fever (including Public Health (London) Act,1936 (Section 192 and 304). typhoid and para-typhoid) Reg.No.299 made by Minister of Health 1953 (l.4.53). Erysipelas Public Health (London) Act,1936 (Section 192 and 304). Food Poisoning Food & Drug Act, 1955 (Section 26). Glanders Public Health (London) Act,1936 (Section 192 and 305). Hydrophobia Do. Leprosy Public Health,Act I936 (Section 143) Reg.No.1036. made by Minister of Health, 1951 (22.6.51). Malaria Public Health Act,1936 (Section 143) Reg. No.299. made by Minister of Health, 1953 (1.4.53). Measles Public Health Act,1936 (Section 143) Regs.Nos.1100 205 and 420 made by Minister of Health, 1938, 1940 and 1948. Membranous croup Public Health (London) Act,1936 (Section 192 and 304). Meningococcal infection Public Health Act, 1936 (Section 143) Reg.No.2259 made by Minister of Health, 1949 (1.1.50). Ophthalmia neonatorum Public Health (London) Act,1936 (Section 192 and 305) and Reg.No.971 made by Minister of Health, 1926 (1.10.26) amended by S.R.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 Public Health (London) Act,1936 (Section 192 and 304). Scabies (first case in house within 4 weeks) 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 (l.5.52.). Typhus fever Public Health (London) Act, 1936 (Section 192 and 304). 'whooping cough Public Health Act, 1936 (Section 143). Regs.Nos.1100, 205 and 420 made by Minister of Health, 1938, 1940 and 1948. 14. BACTERIOLOGICAL EXAMINATIONS. Bacteriological examinations were undertaken by the Bacteriological Laboratory of the Medical Research Council which is accommodated at County Hall. Records of examinations carried out are as follows:– Nose and Throat Swabs: C.Diphtherial mitis isolated – Haemolytic Streptococci present 9 Negative results 50 59 Faeces Specimens: Shigella Sornnei isolated 228 Salmonella typhi-murium isolated 18 Salmonella Anatum isolated 1 Salmonella Newport isolated 1 Negative results 489 735 Swimming bath water examinations 7 well water examinations 2 Milk samples 72 Foodstuff samples 8 IV. TUBERCULOSIS. Notifications - Thirty one cases of pulmonary tuberculosis and four of nonpulmonary tuberculosis were notified during 1958 compared with 31 pulmonary and 3 non-pulmonary notifications in 1957' The following table gives the age grouping of new cases notified. FORMAL NOTIFICATIONS. Number of primary notifications of new cases. AGE PERIODS. 0-1 1-2 2-5 5-10 10 - 15 15 - 20 20 - 25 25 - 35 35 - 45 45 - 55 55 - 65 65 - 75 75 and upwards Total (all ages) Pulmonary, Males 1 – – – – – 2 4 3 2 6 2 2 22 „ Females – – – – – – 1 2 4 – 1 1 – 9 Non-pulmonary,Males – – – 1 – – – – – – – – – 1 „ Females – – – 1 – 1 1 – – – – – – 3 Total 1 – – 2 – 1 4 6 7 2 7 3 2 35 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 – – – 1 Transfers from other areas 12 9 – – Other sources – 1 – – Total 12 10 – 1 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 19 29 2 2 Death 8 2 – 1 Otherwise (e.g. removal from district) 26 30 11 9 Total 53 61 13 12 Revision of Notification Register:– Pulmonary Non-pulmonary TOTAL M F M F No. of cases on Register at 31st December, 1957 348 317 99 75 839 No. added during year 34 19 1 4 58 No. removed during year 53 61 13 12 139 No. of cases on Register at 31st December, 1958 329 275 87 67 758 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 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 1958 0.71 0.09 0.80 0.07 0.02 0.09 The following table gives the age grouping of deaths from tuberculosis:– Age periods 0-1 1 - 5 5-15 15 - 25 25 - 45 45 - 65 65 - 75 75 and upwards Total Pulmonary, Males – – – – – 1 1 1 3 " Females – – – – – – – – – Non-pulmonary, Males – – – – – – – – – " Females – – – – – – – 1 1 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 1925. These regulations prohibit a person suffering from tuberculosis, and who is in aninfectious 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. 17. MASS MINIATURE RADIOGRAPHY. I am indebted to Dr. Thompson, Medical Director of Unit 6D for the following report:– "Introduction During 1958 the Unit examined 39,943 males and 28,016 females, making a total of 67,959 which is an increase of nearly 4% on the previous year's figures. Up to the end of 1958 the Unit has examined 288,413 males and 205,585 females making a grand total of 495,998 since it commenced operations in May 1950. Ninety-four cases with significant tuberculous lesions have been discovered which gives a rate of 1.38 per 1,000 examinees. There were also discovered sixteen cases of carcinoma of the lung, which is an increase of approximately 23% on the previous year's findings, and gives a rate of .24 per 1,000 examinees. The zone of the Unit has remained the same, viz City of London and the Metropolitan Boroughs of Finsbury and Shoreditch. The modus operandi of the Unit has continued as in past years - about nine months at the Mass Radiography Centre, 20, Golden Lane, E.C.1., with the remaining period (excluding three weeks holiday leave) allocated to various firms and organisations. As space, electric current and other services have to be placed at the disposal of the Unit we gratefully acknowledge all the assistance rendered by the organisations concerned. Early in January 1958 the Unit discontinued the practice of arranging separate sessions for men and women, so that both sexes are now X-rayed during the same sessions. This is a method which has proved acceptable to the majority of firms. After the announcement by the Adrian Committee in the Autumn of 1958 that the radiation dosage received by people attending a Mass Radiography Unit was negligible, the opportunity was taken of emphasising this fact in our contacts with firms, and others. Doctors' referrals As intimated in our last Annual Report a new procedure for Doctors' referrals was introduced in January 1958. Now doctors' patients can attend the Unit while it operates at the Mass Radiography Centre without a prior appointment. A supply of the specially designed form was sent to all general practitioners within our zone. The response has been encouraging, and has produced an incident rate of 21.4 per 1,000 examined. Medical procedure. The practice adopted in previous years has continued throughout 1958. All clinics have recorded their sputum findings and 18 cases with a positive sputum have been reported, of which 14 were male and 4 were female. Where an investigation was outside the province of a Chest Clinic the co-operation of St. Bartholomew's Hospital is secured, and I acknowledge my indebtedness to Dr. N.C. Oswald and his colleages. Propaganda The normal forms of propaganda have been employed where necessary although in most cases contact with firms has been made by personal contact or special letters. 18. Staff During the year under review there has been several changes in the personnel on the Unit. I would like to express my appreciation of the good work done by the staff throughout the year. Conclusion Throughout the year helpful relationships have existed between 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 as well as with the Divisional Medical Officers in Health Divisions 3, 4 and 5. Our appreciation of the services rendered by the Central Group Hospital Management Committee and the Regional Hospital Board must also be recorded". DETAILS OF SOME SURVEYS DURING 1958. Centre & period Groups examined No. of persons examined Male Female Total Mass Radiography Centre, 20,Golden Lane, E.C.I. 1st January - 30th April Office and Factory Staff in the City of London, Boroughs of Finsbury and Shoreditch. Health and Teaching Staff in Divisions 3, 4 and 5. Individuals. Doctors' patients. 14,252 10,676 24,928 Allied Suppliers Ltd. 179-189, City Road, E.C.1. 30th May - 4th June. Office staff. 431 599 1,030 Mass Radiography Centre, 20,Golden Lane, E.C.1. 6th August - 31st Dec. As above. 17,618 12,252 29,870 19 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, 1958• "Members of Care Committee. Councillor F.G. Aldred, (Chairman) Shoreditch Borough Council Miss R. Glennie, (Vice Chairman) Soldiers', Sailors' and Airmen's Assn. Mrs. H. Alsford, Dr. B. Broadbent, Medical Officer of Health, Shoreditch. Mrs. W.G. Dibble, Women's Voluntaiy Service. Councillor Mrs. L.S. Calfe, Hackney & Stoke Newington Tuberculosis Care Committee. The Almoner, St. Leonard's Hospital. Dr. S. King, Divisional Medical Officer, London County Council. Miss M.W. Sweeney, Superintendent, Shoreditch and Bethnal Green District Nursing Associatioi Councillor J. Temple, L.C.C. Divisional Health Committee. Miss M. Turnbull, Invalid Children's Aid Association. Ex Officio. Dr. C.K. Cullen (and later Dr. W.F. Richards) Chest Physician. Miss M. Nutt, Tuberculosis Health Visitor. Mrs. D.E. McLean, Tuberculosis Health Visitor. Miss E.B. Guest, Secretary. Retirement of Dr. C.K. Cullen. It was with great regret that this Committee heard of the retirement in June 1958, of Dr. C.K. Cullen, who had for so many years been the Chest Physician at Shoreditch Chest Clinic, first under the Shoreditch Borough Council and then under the Hospital Service and the London County Council combined. Many were the tributes paid to Dr. Cullen, who had done such great work and fought so hard, both medically and socially, for the welfare of tuberculous patients and their families. The Committee welcomed Dr. W.F. Richards, Consultant Chest Physician, of Highwood Hospital, Brentwood, who was appointed Chest Physician to this clinic in June, 1958. In Januaiy, a new Occupational Therapist, Miss L. Ogbourn, was appointed to teach patients various handicrafts, both in the home and at a weekly class held at this clinic. Miss Ogbourn visited, under the supervision of the Stepney, Metropolitan and Shoreditch Chest Clinics, patients who were confined to their homes, and also supervised the weekly class, consisting of patients from the Metropolitan and Shoreditch Clinics. The number of these patients averaged twelve at the beginning of the year but decreased in numbers during 1958, as patients improved in health and went back to work. This Committee is affiliated to the National Association for the Prevention of Tuberculosis, which recently changed its title to "The Chest and Heart Association" The Association has decided to dissociate itself from the 1959/60 Appeal for tuberculous patients, concentrating on an appeal for sufferers from other chest diseases, with a separate Christmas Seal, under its new title. This 20 Committee will "be sending out its usual appeal and has decided, in an endeavour to keep down the heavy woiking costs, to send only to former contributors of the Seal Sale, hoping thus that the net amount next year will, at any rate, not be reduced. Although helping tuberculous patients still remains our primary aim, the Committee also help other cases, such as sufferers from bronchitis and asthma. Many cases of lung cancer are also supervised at this clinic and financial help obtained from the National Society of Cancer Relief, which is paid to patients from here at regular intervals. Last year our expenditure exceeded income by £16. The net amount received through the 1958/59 Christmas Seal Sale was £173 (which v/as somewhat less than last year); from the United Charities of St. Leonard's £17.10. 0 and from the Shoreditch Rotaiy Club £5. 0. 0. When making the annual grant from the Sunday Cinema Entertainments Fund, the London County Council, in administering the fund, took into consideration the increased responsibilities of the Committee on account of the extra calls upon it because of the increase in the territory supervised by Shoreditch Chest Clinic. Although, as the County Council pointed out, the money available for distribution is decreasing each year, because of the extra calls on our fund now that part of Hacknqy is included in our area, the allocation made to us (i.e.£40) was the same as before, whereas to many other applicants the amount of the grant had been reduced. As usual, the largest inroad into our fund was made by fares for relatives to visit patients in Sanatoria, and during the year the Committee decided that fares should be paid twice monthly (instead of once) to hospitals and sanatoria outside London. The Committee also increased the scope of the Christmas gifts - giving £30. to help elderly patients and £20. for toys for children whose parents could not afford to give them. Also at Christmas, the Mayor of Shoreditch gave cash gifts to some of our elderly patients, for which we were very grateful. The Committee wish to express thanks for the various grants - particularly through the Soldiers', Sailors' and Airmen's Association, the Forces Help Society and the Mayor of Shoreditch Fund - which, with help from other voluntaiy societies, all so quickly and generously given, added greatly to the comfort and recovery of our patients." 21 SOCIAL WELFARE SERVICES. The Borough Council has continued to provide for the old people, every amenity which the law allows it to provide directly. The other non-statutory facilities were still provided chiefly by the Joint Welfare Committee of whom one half (and the Chairman this year) were elected by and from the Borough Council. A newly-formed charitable body, created by this year's Mayor (Mr. Councillor Tallantire) and named the "Shoreditch Association" began to collect funds for both old-and young-people's causes in the Borou^i. It is hoped that in future years this Association may be able to supplement some of the additional amenities hitherto coming almost exclusively from the Joint Welfare Fund. Its first Annual Carnival week gave at least a psychological uplift to both old and young residents. The visiting of old people by Council staff progressed apace so that every known pensioner was visited at least once and those in difficulty many more times, to a total of more than 4,000 visits. The Council's Old People's Clubs, consisting as before of 3 full-time and 4 part-time clubs, continued to be just as popular as before, and we hope that during the coming year the Bell Club will be accommodated in bright new premises, so that we hope for a further increase of its membership in the future. The weekly concert for enfeebled pensioners by professional entertainers at the Hoxton Club continued to have full houses despite the opening of a rival club once weekly in the same road by the National Federation of Old Age Pensioners' Association. The handicrafts classes at the various clubs again earned nearly £100 at their Christmas sale of work as well as providing from Haggerston Clubs more than 100 soft toys for the Children's Wards at Mile End Hospital. The Council's Holiday and Rest Home in Sussex has again given its good country air and food to well over 800 visitors from both Shoreditch and (through Local Health Authorities) from the whole area covered by King Edward's Hospital Fund, the majority remaining for 2 weeks and some for a longer period. The usual 45 or so old people had also two weeks there at Christmas. The Meals on Wheels service has been maintained as before by the W.V.S. and the Salvation Army, each supplying one half of the Borough, and financed by the Borough Council. Meals were also supplied to members of the three full-time old people's clubs run by the Council, and the charges remained at lOd for the old people; but unfortunately owing to increased cost, the Borough Council had to implement their quota by 4d and later 6d a meal for the 100 meals supplied daily. St. Matthew's Hospital continued their laundry facilities at a nominal charge, the Lion Boys' Club continued free shoe repairs, the free distribution of furniture, wheelchairs, blankets, mattresses, coal, etc. from this department, chiropody, library books, radio, etc. to homebound and other services formed a comprehensive contribution to the old folks' comfort. The financial and moral help of King Edward's Hospital Fund for the Holiday Home, the financial help towards our full-time visitor by "the City of London & East London Dispensary, the services rendered by St. Matthew's Hospital, L.C.C. Home Helps, District Nursing Association and many other bodies, made a great difference to the old people's comfort. 22 The numbers of persons who attended the Shoreditch Holiday & Rest Home at Copthome during 1958 were as follows:- Adults 234 10-18 years 36 5-10 years 82 9 months - 5 years 185 Under 9 months 35 Old Age Pensioners 260 Conference members - Total 832 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. Pri. Sat. Dinners Teas Hoxton Hall M. 1 - - - 6 - - 119 (2.3O-4.3O p.m.) F. 23 "" - - 89 - Bell M. 16 16 17 16 15 - 66 107 (10.30 a.m.- 4.30 p.m.) F. 5 8 10 7 13 - Haggerston M. - - 11 1 - - - 83 (2.3O-4.3O p.m.) F. - - 36 35 - - Moorfields M. - 1 1 - 39 78 (10.3O a.m.-4-30 p.m. F. 6 14 14 9 11 - Wenlock M. 13 13 12 16 12 72 380 (10.3O a.m.-4.30 p.m.) F. 46 48 46 67 33 - 23 VI. - SANITARY CIRCUMSTANCES. The following tables summarize the visits of inspection and the work of the Public Health Inspectors during 1958* INSPECTIONS. Housing Act, 1957, Section 3 238 Housing Act, 1957, Section 9 42 Housing Act, 1957, Section 18 60 Rent Act, 1957 165 Clearance Areas 283 Clean Air Act 150 Other Dwellings 4,632 Premises not specified below 1,809 Factories - mechanical 1,584 Factories - non-mechanical 139 Rag Flock Act, 1951 129 Pet Animals Act 1951 35 Outwoikers 218 Hairdressers 150 Bakehouses 74 Milkshops 347 Cookshops 81 Fried Fish shops 31 Ice Cream shops 219 Butchers' shops, stalls, stores, etc. 188 Rag & Bone dealers 17 Food stalls 165 Registered Food shops or premises 1,301 Fish curers1 premises 20 Fur skin dresser's premises 3 Stables 19 Shops Act, 1950 638 Smoke observations 412 Pharmacy & Poisons Act, 1933 53 Markets 159 Canteens 172 Vacant sites 386 Dangerous buildings 30 Infectious disease visits 326 Rodent Infestations 659 RE-INSPECTIONS. Housing Act 1957,Section 3 19 Housing Act, 1957,Section 9 120 Housing Act, 1957, setion 18 44 Rent Act, 1957 114 Clearance Areas 16 Other Dwellings 6,270 Factories 754 24 RE -INSPECTIONS (Contd.) Rag Flock Act, 1951 100 Outworkers 21 Hairdressers 27 Bakehouses 30 Milkshops 33 Cookshops 11 Fried Fish Shops 8 Ice Cream Shops 35 Butchers' shops, stores etc. 22 Rag & Bone dealers 3 Food stalls 33 Food shops and premises 434 Fish curers 3 Shops Act 1950 277 Smoke observations 20 Canteens 25 Vacant sites 169 Infectious disease visits 63 Rodent Infestations 374 Non-effective visits 3,052 SUMMARY OF DEFECTS FOUND. Premises requiring cleansing throughout 4 Premises requiring partial cleansing 4 Premises - total rooms 11 Verminous premises 46 Verminous rooms 103 Premises requiring general repair 224 Light & ventilation requiring remedying 25 Roofs, gutters, rainwater pipes defective 374 Premises damp 262 Windows requiring repair or adjustment 468 Premises overcrowded 34 Water reinstated 3 Water supply required to upper floors - Drains, new 582 Drains requiring reconstruction 9 Drains requiring improvement or repair 25 Drains requiring obstructions removed 91 Drains tested 651 Old drains sealed off from sewer 165 Soil vent pipes requiring repair or renewal 6 W.C's. new 28 W.C's. requiring improvement or repair 127 W.C's. requiring obstructions removed 17 Sinks new 18 Sinks requiring improvement 16 Sinks requiring traps to be provided - Sinks requiring obstructions removed 13 Waste pipes requiring repair or renewal 28 25 SUMMARY OF DEFECTS FOUND (Contd.) Waste pipes requiring obstructions removed 6 Other items not specified 421 Outdoor Premises. Floors or paving requiring repair 12 Requiring cleansing or limewashing 2 Dustbins requiring renewal 31 Ashpits requiring abolition 2 Accumulations requiring removal 113 Urinals requiring cleansing or repair 2 Animals improperly kept 2 NOTICES SERVED. Public Health (London) Act, 1936- Intimation Notices 856 Nuisance Notices 123 Housing Act, 1957 - Factories Act, 1937 102 Shops Act, 1950 - Prevention of Damage by Pests Act, 1949 3 Food & Drugs Act, 1955 71 Clean Air Act, 1956 4 COMPLAINTS RECEIVED 1,811 personal cieansing The arrangement with the Finsbury Borough Council wherebyresidents 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 NewCases Total new cases Reattendances Total treatments 0 to 15 years Over 15 years - 2 2 1 3 SCABIES. New Cases Total new cases Reattendances Total treatments 0 to 15 years Over 15 years 7 11 18 17 35 (Until school-leaving age, the L.C.C.treat all affected children at their own Centre). 26 DISINFECTION AND DISINFESTATION. The number of disinfections of rooms after infectious disease and for other reasons was 88. The number of articles disinfected in this connection at the Council's disinfector was 451. During the year 499 rooms were sprayed for verminous conditions and the number of articles disinfected was 7184. In this connection sanitaiy notices were served in respect of 46 houses (103 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 £20 were ma.de. The new method of disinfection reported in 1956 continues to prove 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 is £170. During the year 334 families were removed to new housing accommodation on the Borough Council's housing estates, as compared with 322 families in 1957. This work entails a considerable amount of additional work for the staff. All furniture is disinfested by Hydrogen Cyanide 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 Housirg Department of the families to be removed, an officer of the Public Health Department visits 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 disinfecting apparatus and returned at the same time as the furniture. The next morning the whole of the furniture is chemically tested to make sure that the whole of the HCN has been removed from the furniture and furnishings. Much work has been done during the year in connection with the prevention of the breeding of cockroaches and beetles. Hot water ducts in 27 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 insanitaiy and other putrescible matter on vacant sites and other places by unauthorised persons is a practice which is not easily controlled and las 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 45> 108 articles of clothing, mattresses etc., were removed. HOUSING REPAIRS & RENTS ACT 1954. The Rent Act 1957 repealed Sections 23 to 32 of the Housing Repairs & Rents Act 1954 which dealt with Repairs Increase in respect of Controlled dwellings. Para. 3 (l) of the seventh schedule of the 1957 Rent Act authorised that any certificate of defects issued by a local authority made under the 1954 Act, being a certificate in force immediately before the commencement of the Rent Act 1957, shall, to the extent that it specifies any defects as regards the state of repair of any dwellings, have effect after the commencement of the Act of 1957. During the year two applications were made by owners for the revocation of certificates of defects granted by the local authority under the 1954 Act. In each case the dwellings were inspected and both applications for revocation of the certificates were approved. RENT ACT 1957. The Rent Act 1957 has now been operative for almost two years and many of the difficulties of applying this complicated legislation have resolved themselves. Its application, apart from considerably increasing the work of the Department, has proceeded smoothly and no major problems have arisen. This may be, in no small measure, attributed to the time, considered to be well spent, in the main by the Chief Public Health Inspector and his Deputy, who have been responsible for both the administrative and practical work connected with the Act in advising and assisting the numerous owners and tenants seeking advice who have been interviewed by them since the Act became operative. There has not been a single appeal made against decisions of the Council in respect of the issue of Certificates of Disrepair, the acceptance of owners' undertakings or the issue of Revocation Certificates since the Act came into operation. Before enumerating the information resulting from applications of disrepair, an explanation of the work involved upon the receipt of applications gives an indication of the amount of work involved which figures alone fail to convey. 28 When an application for a Certificate of Disrepair is received the procedure is as follows- Details are entered in a register after making sure the application is valid. A check is made to ensure- (i) that the dwelling is not in a clearance area or subject to a demolition or closing order. (ii) that there is no notice outstanding under the Public Health (London) Act 1936 or Housing Acts 1936-57. (iii) that the owner has not already given a satisfactory undertaking to the applicant that he will remedy the defects as specified on the applicant's 'G' form. (iv) that at least six weeks has elapsed from the time the applicant served a copy of the 'G' form on the owner. An inspection of the dwelling is made which involves the following procedure- (i) should any defects as per the 1G* form he justified a recomnendation is made to Council to issue a Certificate of Disrepair with the proviso that should the owner submit within three weeks a satisfactory undertaking to remedy the defects within six months this undertaking be accepted and the Certificate of Disrepair be not issued. (ii) if such an undertaking is not received a recommendation to the Council to issue a Certificate of Disrepair is made. (iii) If an undertaking is received, it has to be checked in detail before acceptance or rejection. (iv) In any case, notices under the Public Health (London) Act 1936 or the Housing Act 1957 are served on the owner in respect of any serious defects found which are not (as frequently happens) included on the applicant's 'G' form. When an undertaking is received from an owner, the Council may refuse to accept it if- (i) a previous Certificate of Disrepair has been issued. (ii) the landlord has become liable under Sec. 10 Housing Act 1936 to repay to the local authority any expenses incurred by them under that section. (iii) the landlord has previously given an undertaking in respect of this or any other dwelling and any defects on the expiration of six months remain unremedied, or 29 (iv) the landlord, has previously been convicted, for an offence for failing to comply with a Nuisance Order or an Abatement Order or contravening a Prohibition or Closing Order. These details have to be carefully checked before a recommendation for the acceptance of an undertaking can be made to the Council. When the owner considers the defects have been remedied he may apply to the local authority for a Revocation Certificate. The tenant may also apply for a Certificate to say that the defects have not been remedied. In all such cases further inspection of the premises has to be made and recommendations made to the Council accordingly. The following is a summary of work done during the year- Number of applications for Certificates of Disrepair 61 Number of decisions not to issue certificates 5 Number of decisions to issue certificates (a) in respect of some but not all defects 48 (b) in respect of all defects 8 Number of undertakings given by landlords under paragraph 5 of the First Schedule 32 Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule 2 Number of Certificates issued 27 APPLICATIONS FOR CANCELLATION OF CERTIFICATES. Applications by landlord to Local Authority for cancellation of certificates 11 Objections by tenants to cancellation of certificates 6 Decision by Local Authority to cancel in spite of tenants' objection — Certificates cancelled by Local Authority 5 After nearly two years of operation, it is considered that the Rent Act 1957 is not completely satisfying the function for which it was originally designed, particularly regarding the raising of the standard of fitness of dwellings. The onus placed upon tenants in determining as to the extent of works required to be carried out is far from satisfactory. In the majority of cases dealt with it has been found that tenants have not the technical knowledge to express themselves of the existing defects and in many cases the essential items of disrepair necessary to render the premises fit for habitation according to the minimum standards enumerated in the Housing Acts are neglected. Action can only be taken by a local authority under the Rent Act 1957 in respect of items as specified by the tenant on a 'G' form. 50 It is considered that the method of issuing a list of defects under the Housing Repairs and Rents Act 1954 by the local authority would have greatly increased the possibility of achieving the results of raising standards of fitness in existing dwellings, stated to be one of the main purposes for which the Rent Act 1957 was designed. The contracting out (which is allowed under the Act) by the owner of his responsibility for the redecoration of the walls and ceilings has placed a hardship on many tenants particularly in the old sub-standard dwellings. REGISTRATION OF HAIRDRESSERS. The number of Hairdressers registered in Shoreditch is 50. 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. SWIMMING BATH WATER. 7 Samples of water from the Haggerston Bath were sent for bacteriological examination, and 7 for chemical examination. All were found to be satisfactory. 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 a factory, the water from the well is used for all purposes. A sample of water from the latter well was taken for analysis and found to be satisfactory. OFFENSIVE TRADE PREMISES. An establishment order under Section 140, Public Health (London) Act, 1936, was renewed during the year in respect of the business of a Fur Skin Dresser. The number of visits made was 3. 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. 31 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. 7 Certificates of exemption in respect of sanitary conveniences was issued during the year. The number of inspections and re-inspections made during the year was 915. 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 periods not exceeding three weeks may be enforced by the Courts. No action under this Section was necessary during the year. RAG DEALERS. There are 14 premises in the Borough in which the business of Rag Dealer is carried out. 20 visits of inspection were made during the year. THE PREVENTION OF ATMOSPHERIC POLLUTION. The Clean Air Act came into operation on 1st June 1958. Provisions concerning the prohibition of dark smoke from chimneys, measures for dealing with grit and dust from furnaces, abatement of smoke nuisances and the application of the Act to railway engines, vessels and Crown premises became operative. For the first time, legislation has been provided for dealing with the emission of smoke from domestic chimneys. Section 1 of the Act provides that - "Subject to the provisions of this Act, dark smoke shall not be emitted from a chimney of any building". All buildings, which includes dwelling houses, are subject to this section. Proof of a public health nuisance is not required to obtain a conviction. 32 Smoke Control Area. The resolution of the Council to declare the Colville Estate and adjoining factories and dwellings a Smoke Control Area was confirmed by the Minister of Housing and Local Government on 21st October 1958, and will become operative on 1st September 1959. Letters have been sent to the occupiers of all premises in the area advising them of the implications of the Order. Abolition of hand-fired furnaces in Shoreditch Borough Council flats. During the year, one of the significant features has been the abolition of all hand-fired furnaces serving domestic hot water to local authority flats. During the year 14 hand-fired furnaoes were converted to oil firing. The result of these conversions means that there are now 41 oil-fired furnaces and 8 underfeed stokers servioing 123 blocks of Council flats with domestic hot water. The abolition of hand firing and the substitution of proper oil burning equipment will do much to reduce atmospheric pollution, providing that properly trained operators are employed who understand the plant and the plant is well maintained to a high degree of efficiency. Trend from solid fuel to oil. The general trend from solid fuel to oil firing during the year is an indication that apart from any economic factors involved, industrialists and others are influenced by the requirements of the Clean Air Act, particularly bearing in mind the possibility of the steady development of Smoke Control Areas. All new factories in Shoreditch, completed during the year, including several in course of construction, are equipped with oil fired furnaces, the largest being Messrs. Waterlow's new premises in Worship Street where oil fired sectional boilers have been installed. The new Shoreditch Secondary School has also been equipped with oil fired boilers fully instrumented. Both these plants are attended by properly trained personnel and are producing excellent results. The prevention of atmospheric pollution in existing premises. During the year 412 smoke observations were made. 4 Notices were served concerning smoke nuisance under the Clean Air Act. The growing interest in the Clean Air Act has resulted in numerous enquiries for advice in connection with many types of furnaces and frequent visits have been made to premises by the Public Health Inspectors to give advice to stokers and operators of plant. This has considerably increased the work of the Department. 33 Notifications received as to new boiler installations. Under Section 3 of the Clean Air Act notifications must be given to the local authority where new boiler plant is to be installed. 4 notifications were received during the year. 3 applications for prior approval of proposed boiler plant were approved during 1958. Measurement of atmospheric pollution. The measurement of atmospheric pollution by means of the volumetric system of measurement of both solids and sulphur dioxide has continued throughout 1958. Your Council are represented on the National Society for Clean Air by Mr. Councillor R.G. Linale and Mr. Grant, Chief Public Health Inspector (who is also an elected member of the Council of the South East Division of the National Society for Clean Air) who attended the Annual Conference of the National Society for Clean Air held at Llandudno in October 1958. The Council's representatives on the Standing Conference for Co-operating Bodies on Atmospheric Pollution are Mr. Councillor T. Keen and Mr. T.H. Marshall, Deputy Chief Public Health Inspector. PLUMBING AND DRA.INAGE. Modern Trends. In recent years there has been a marked tendency to depart from the traditional plumbing and drainage designs where the possibilities of success in reducing costs and speeding up the work justified it. Some local authorities have had the enterprise to experiment in this field, usually basing their designs on research work carried out at The Building Research Station, and in London, with an eye on the draft drainage bye-laws now under consideration by the London County Council. The close co-operation enjoyed between the Chief Public Health Inspector, his Deputy and the officers of the Borough Architect's Department has resulted in a number of developments being evolved in the plumbing and drainage design of flats and maisorettes, including multi-storey blocks in Shoreditch. Some of the drainage innovations have passed the experimental stage and are now adopted as regular features of design. Further measures to effect improvement and reduce costs even more are being considered. To reduce these facts to figures, the result of simplification of plumbing alone has reduced the capital cost by at least £16 per flat and not only has efficiency been maintained but it has been improved. 34 Single stack plumbing. Since the introduction of single stack plumbing in Borough Council flats in the past five years, of over 1500 flats completed or in course of erection, the single stack system of plumbing was provided in over 1300 of them. The nett saving in capital cost therefore, as compared with traditional plumbing designs, has been estimated to be in the region of more than £20,000. These are striking figures. Economies have been achieved by reducing labour costs by at least 50% fo and tho cost of materials by over 30%. Experiments carried out by the Building Research Station in 1954/5 confirm these figures. The latest development carried out in single stack plumbing by the Shoreditch Borough Council has been in the drainage designs applied to multi-storey blocks of flats of ten and eleven storeys. Three such blocks have been occupied during 1958. four are in various stages of construction and one is almost ready for occupation. In the first two multi-storey blocks, duplicate 4" stacks were incorporated in the design, one stack receiving roof water and all wastes from W.C's, sinks, baths and washbasins up to a height of six storeys and the other stack all such fitments from- the remaining storeys in addition to roof water. No anti-siphonage system was provided and in practice full efficiency has been maintained. On the third multi-storey block, one 6" stack was provided receiving the wastes of all W.C's, sinks, baths and washbasins together with roof water in plaoe of the two 4" stacks provided in the previous two multistorey blocks, further reducing the costs and speeding up the work. Again no anti-siphonage system was provided and once again full efficiency has been maintained. This latest method of drainage has been included in the remaining three multi-storey blocks now in course of erection. To sum up, whereas traditional plumbing required the provision of three stacks, one for rainwater, one for sink, bath and basin wastes, and one for soil from W.C'S, together with elaborate systems of anti-siphonage, experiments carried out have enabled us to provide one stack to receive all soil and waste water and to omit all anti-siphonage pipes without loss of efficiency. Detergent Foam. The risk of the back flow of detergent has had to be taken into consideration in the application of this design, but we are confident that the increased size of the diameter of pipes used in the single stack system will eliminate any risk of this happening. There has been up to the present no evidence of any back flow of detergent foam in any single stack construction. 35 London County Council flats, Ivy Walk site. The L.C.C. development on the Ivy Walk site is well advanced. Of the eight blocks of flats commenced in 1957 tut one are occupied and the remaining block will be completed soon. These include four, five and eight storey blocks, making a total of 175 flats. Recommendations made by the Chief Public Health Inspector, Mr. Grant, and his deputy, Mr. Marshall, to the L.C.C. Architects were adopted and resulted in 'single stack' plumbing with relief gulleys being provided throughout the whole scheme, with a capital cost saving estimated to be at least £3000 on plumbing and drainage. The relief or safety valve gulley is provided at the base of each single stack and immediately above a three foot radius bend. In the event of any stoppage in the long radius bend or in the drain beyond, the back surge of drainage will escape to the open air via the relief gulley whereas without this provision flooding of the ground floor premises through the TV. C. would occur. In addition, the complete underground drainage system has been constructed in cast iron dn the advice of these officers. The first flats were occupied at the beginning of 1958 and the 'singlestack' plumbing has proved to be entirely successful. In three instances the relief gulleys operated successfully and prevented the flooding of the lower flats due to obstruction in the long radius bends, the result of carelessness on the part of tenants by disposing of articles not suitable for discharge into the drainage system. The happy relationship and willing co-operation extended by the Architects of the L.C.C. has been greatly appreciated by the officers of this Department in achieving such satisfactory results. Underground drainage as integral part of structure. Another interesting experiment was made in an endeavour to reduce the cost of underground drainage, in preventing the settlement of drains on 'made up' land as well as speeding up the work. On our recommendation, departure from traditional drainage design has been made with the full support and the co-operation of the Borough Architect's Department. To prevent the settlement of drains which could take place if they are laid outside the blocks of flats on 'made up1 ground, a cast iron drain was laid supported on the cross wall foundations under the ground floor slab and along the length of the building. Adequate access was provided for rodding purposes above the large radius bend of each single stack, thus eliminating the construction of several inspection chambers. No excavations and no concrete foundations were required in the construction of this drain. Efficiency has been maintained, the reduction in labour costs and materials is very considerable, the danger 36 of drainage settlement due to subsidence of 'made up' land has been eliminated and the risk of heavy maintenance cost in the future has been eliminated. Consideration will be given to the application of this design in future development schemes, the officers of the Public Health Department and the Borough Architect's Department working in close collaboration. Pitch fibre pipes. An experiment was made in the use of pitch fibre pipes for the main runs of drains on two of the Council's blocks of flats on the Wenlock Barn Estate. These pipes have been in use for forty years in the U.S.A. with success and their use has been accepted by the British Standards Institutio (BSS 176O). The pipes are made of fibre impregnated under vacuum and pressure with a thermoplastic compound and are supplied in lengths up to 10 feet. No concrete foundation is required to support drains constructed of pitch fibre, fewer joints are required and the jointing is extremely simple by means of a few light blows with a hammer. No jointing material is required. It is said that owing to its resilience the pipe will not rupture with uneven ground settlement, nor will it be affected by surface vibration. As yet, it is too early to be able to report on the saving in costs but it is believed that the saving will be considerable. The sealing of disused drains. It is of the utmost importance that strict supervision be maintained t the Public Health Inspectors to ensure that all disused drains are effectively sealed to prevent the passage of rats from the sewers. The amount of clearance in Shoreditch has meant a great deal of work for the Public Health Inspectors in this direction. This work requires to be carried out methodically and it is essential that plans of existing drainage must be prepared before the demolition of premises is commenced. Working in close liaison with the Borough Architect's Department this object has been achieved. In practice, the Contractor is sent a letter reminding him of his obligation under the L.C.C. Drainage Bye-Laws to notify the local authority of intention to seal off disused drains. The Public Health Inspector then directs and supervises the work and satisfies himself that the disused drains are effectively sealed. The value of this work being done efficiently cannot be over-estimated if rat infestations on future development areas are to be eliminated. During the current year, the disused drains of I65 premises which were demolished were effectively sealed under the direction and supervision of the Chief Public Health Inspector and his staff. 37 SLUM CLBARANCE. During the year the Borough Council were requested to prepare a list of dwellings in Shoreditch which may he dealt with in the Slum Clearance Programme I96I - 1965, and this work was undertaken by the Chief Public Health Inspector and his Deputy, and subsequently a list of some 1274 houses, consisting of approximately 2005 families was submitted to the Council for consideration. The list was tentatively agreed to and sent to the London County Council for consideration. The next step is a meeting at officer level between the Shoreditch Borough Council and the London County Council to decide which Authority should carry out the various clearances of the houses submitted. This matter will be further reported on in the next Annual Report. HOUSING - OVERCROWDING AND PREFERENTIAL TREATMENT. At the end of 1957 "the number of overcrowded cases on the Public Health Department register was 61, and the number on the medical preferential treatment register was 37. During the year two new cases of overcrowding were found and added to the register and 8 overcrowded families and 4 preferential treatment cases had been rehoused. The number of overcrowded cases remaining on the register at the end of the year was therefore 55> and the number on the preferential treatment register was 33. 74 visits of inspection were made. UNDERGROUND ROOMS. During the year 11 underground rooms were reported on. Closing Orders were made in respect of 13 rooms, and in two cases Closing Orders were determined, the rooms being made to comply with the Underground Rooms Regulations. The total number of underground rooms on the register at the end of the year was 772. FACTORIES ACT, 1937. The number of factories on the register at the end of 1958 was:Power Factories 1,055 Non-Power Factories 132 Total 1,187 During the year 98 factories were added to the register and 126 were deleted, making a nett decrease in the number of factories in the Borough of 28. 38. The particulars of inspections made during the year are as follows •- Premises. Number of Inspections Written Notices Occupiers Prosecuted Power Factories 2,281 91 - Non-Power Factories 196 11 - Other Premises under the Act (including works of building and engineering construction but not including out-workers1 premises) - - - Total 2,477 102 - 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 l) 2 3 - _ _ Overcrowding (Section 2) 1 1 - 1 - Unreasonable temperature (Section 3) _ - - - - Inadequate Ventilation (Section 4) 3 3 - 2 - Ineffectual drainage of floors (Section 6) - - - - - Sanitary Conveniences: (l) Insufficient 30 26 - - - (2) Unsuitable or defective 112 87 - 11 - (3) Not separate for sexes 2 2 - 1 - Other offences against the Act (not including offences relating to outwork) 3 3 _ _ - Total 153 125 - 15 - 39. HOME WORK. During the year 58 lists of outworkers were received from employers in the Borough, 29 in the first half-year due in Februaiy, and 29 in the second half-year due in August. These lists contained the names of 837 outworkers, of whom 656 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 361 outworkers living in Shoreditch and employed by firms outside the Borough. The total number of out-workers reported was therefore 1,198. 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 outworkers are employed by more than one firm, so that the numbers given irrust not be taken as representing actual numbers of individual workers. The tables on pages 40 and 41 show the distribution of outworkers as regards trades. During the year 239 visits of inspection isere 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. Outwoik in unwholesome premises Section III Outwoik in infected premises Lists received from Employers Notices served on Occupiers as to keeping or sending Lists Prosecutions Instances Notices served Prosecutions Instances Orders Mcde ProeecutLcns February August Failing to keep or permit inspections of Lists Failing to send Lists Lasts Outworkers Liste 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 14 1 14 _ _ _ _ _ _ _ _ _ Boxes 5 - 48 5 - 28 _ — _ _ _ _ _ _ _ Brushes 1 - 6 1 - 6 - _ — _ _ _ _ _ Button Mountirg 2 - 55 2 — 49 _ _ _ _ _ _ _ _ _ Paper Bags 1 - 6 - - _ - - - - — — _ _ _ Wearing Apparel 18 51 264 20 59 236 _ _ _ _ _ _ _ _ _ Upholstery 1 _ 1 - _ _ - - - - - - - - - 29 51 394 29 59 333 - - - - - _ — _ — 41 The following table shows the number of outworkers living in Shoreditch and employed by firms outside the Borough during 1958 as notified by the various sanitary authorities. NUMBERS OP OUTWORKERS RECEIVED PROM OTHER DISTRICTS DURING 1958. DISTRICTS Making Wearing Apparel Toys and Crackers Artificial Flowers Jewellery HandBags Umbrellas etc. Paper Bags and Boxes Sweet wrapping Furniture & Upholstery Card Mounting Brushes Feather mounting Totals Feb. Aug. Feb. Aug. Feb. Aug. Fsb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Bethnal Green 15 _ 3 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 18 _ Finsbury 33 30 - 3 61 61 3 - 3 5 - 1 7 6 - 1 2 2 - _ 2 2 111 1ll Hackney 31 - - - 8 1 3 - - - 5 - - - 7 - - - 1 - - _ 55 1 Holborn 1 1 1 1 - - - - - - - - - - - - - - - - - _ 2 2 Islington 6 - 9 - 2 _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ 18 - Kensington 1 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 Lewisham 1 l _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 Poplar 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 _ St.Marylebone 2 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2 1 London, City of _ 5 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 5 St.Pancras 3 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3 _ Southwark _ _ _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ 1 Stepney 4 7 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4 7 Stoke Newington 2 _ 1 _ _ _ _ _ _ _ 1 _ _ _ _ _ _ _ _ _ _ _ 4 _ Westminster _ 11 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 11 Totals 100 57 14 4 71 62 6 - 3 5 6 2 7 6 7 1 2 2 2 - 2 2 220 141 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 H]STS ACT 194^- The rodent staff employed for this particular woik 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 la3t year was again carried out with a full scale Warfarin 5 treatment. The results being satisfactory, this method was again used during the sewer treatments in 1958 e*nd has proved so satisfactory from many points of view that it will be continued. During the year 160 complaints were received of rat infestation and 95 of mice infestation. All complaints are thoroughly investigated, drains tested and the surrounding buildings surveyed, and where any old drains or drain outlets are found they are effectively sealed off from the sewer. In connection with rodent complaints received, 651 drains were tested as against 596 last year and in 125 cases it was found that the drainage was defective, as against 167 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 disinf estation was continued. During "the year 18 new contracts were entered into and with existing contracts were to the value of £1,275* 5« 0« Charges for servicing business firms by single treatments carried out from 1st April 1958 "to Jlst March 1959 amounted to £195- 5- 0. At 31st December 1958 there were 64 contracts in force for 64 premises, yielding an income of £1,200. 3. 6. for the year. 43. REPORT FOR 12 MONTHS ENDING 31.3.59 Council Property Dwelling Houses Business Premises Total No. of properties in Borough 16 11,791 3,662 15,469 No. of properties inspected as a result of : (a) Notification 1 126 64 191 (b) Survey under the Act - 29 507 536 (c) Otherwise 9 592 492 1,093 Total inspections carried out 165 3,203 3,585 6,953 No.of properties inspected which were found to be infested by : (a) Rats - (Major _ _ _ _ (Minor 1 26 36 63 (b) Mice - (Major _ _ _ _ (Minor 2 123 35 160 No,of infested properties treated by Local Authority 3 149 71 223 No.of notices served under Section 4 of the Act: (a) Treatment ) (b) Structural works ) (i.e. Proofing) ) - 2 1 3 No.of cases where action was taken following service of notice - - - - Legal Proceedings - - - - No.of "Block" control schemes carried out 36, 44. Details of treatment carried out are as follows - Business premises Dwellings. Rats Mice Rats Mice Warfarin trays laid 316 360 168 709 Traps set 828 558 26 128 Sewers. No, of manholes baited April. 416 October. 419 4th day. 8th day. 4th day. 8th day. Complete takes - poison bait 4 1 5 _ Partial takes - poison bait 114 94 149 151 No takes - poison bait 298 521 267 288 PIGEONS. During the year the nuisance from pigeons has increased. The Council granted permission to a specialist pigeon trapper to trap the pigeons which were causing a nuisance in the Borou^i. This work was carried out without any charge to the Council and the trapper worked under the general direction of the Chief Public Health Inspector. This arrangement has not worked out very satisfactorily during the year owing to the failure of the trapper to carry out orders, and in consequence of his failure to obey instructions this arrangement was determined after consultation with the Town Clerk.Investigations are proceeding to make other arrangements for the trapping of pigeons. NUISANCES FROM NOISE. Several complaints regarding nuisances from noise were made during the year. In all cases a satisfactory arrangement was made in connection with the use of machinery after inspections had been made by the Public Health Inspect or. FOOD HYGIENE. Routine duties in connection with Food Hygiene during the year were interrupted due to the resignation of the Specialist Inspector in August 1958. Every endeavour was made by the Chief Public Health Inspector and existing staff to carry on the duties of Food Inspection work during 45. the period from the resignation of the Food Inspector and the appointment of the present Food Inspector in November 1958. The following is a list of the food premises in the Borough - Cafes and Restaurants 114 Factory and Warehouse Canteens 86 Ice Cream Shops (including 2 manufacturers) 116 Butchers Shops and Stores 43 Milk Shops and Depots 91 Fried Fioh Shops 8 Wet Fish Shops 6 Fish Curing premises 4 Bakehouses (including 1 underground bakehouse) 12 Food Warehouses 7 Grocery and Provision Shops 108 Confectioners Shops 110 Public Houses 121 Food Stalls 97 Coffee Stall 1 Chemists (including 2 Drug Stores) 21 There are no slaughterhouses in the Borough, the butchers' meat supplies being obtained mainly from Islington and Smithfield. The sale of poultry from butchers shops has shown a marked increase. The quality of goods sold and the general standard of hygiene maintained in food premises compare very favourably with other Boroughs and provincial towns. The practice of distributing educational pamphlets to shopkeepers was continued during the year and it was pleasing to see the manner in which such literature was received by stallholders and shopkeepers. During the year some 2598 visits of inspection were made to food premises and Intimation Notices of defects found were served in 71 instances. 634 visits of re-inspection to food premises were made. Regular periodical samples of milk were taken from the 18 schools, 2 hospitals and 2 day nurseries in the Borou^i and submitted for chemical analysis and bacteriological examination. In all cases, the reports from the analyst and bacteriologist were satisfactory. A regrettable feature is the number of empty milk bottles to be seen lying about the streets. One of the causes may be lack of interest by the customer in returning the bottles to the distributor. Losses from the non-return of bottles to dealers must be hi^i. The delivery of milk in waxed cartons would be more hygienic. There are two automatic milk machines in the Borough from which milk is sold in these cartons. Owners of these machines are well satisfied with the sales results. 46. Despite the small acreage of the Borough stocks of food in the warehouses are extremely large and total millions of pounds sterling. The owners of the large food warehouses welcome inspectorial visits and give every assistance to the Public Health Inspectors. The range of stock is varied and includes Household Provisions, Tea, Food Essence and Flavouring Materials, Drugs, Spices and other articles of food. The 1955 Food Hygiene Regulations are one of the principal factors concerning the duties of the Food Inspector. Most people in the food trade now realise that these Regulations were introduced to protect the trader as well as the general public. The result is, there are few habitual offenders and Intimation Notices are complied with more or less immediately. Notices served under the Food Hygiene Regulations 1955 were responsible for the follwoing items of work and apparatus being completed and installed - Wash-hand basins provided 5 Sinks - not wash-hand basins - provided 6 Provision of hot water over sinks and wash-hand basins 12 Accommodation for clothing 3 Refrigerators installed 4 Li^it and ventilation provided or increased 7 General repairs completed 26 Dirty floors cleaned, covered, repaired etc 31 Nail brushes provided 11 Food cabinets or storage accommodation provided 4 Food preparation tables renewed or covered with non-absorbent materials 12 Premises or parts of premises re-decorated 37 Improvements to urinals (Public Houses) 8 First-aid materials provided 2 Cleansing of equipment 26 Cleansing of Food Rooms 33 Refuse, abatement of nuisance due to storage etc 10 Drainage defects 8 Stalls Warning letters were sent to the owners of two fish stalls who were reluctant to put up their back covers during warm periods of weather. In one case the stallholder has now provided Perspex side covers. UNSOTJND FOOD. There were no seizures of unsound food during the year and the amount found unfit for human consumption and for which certificates were issued was very small in comparison with the amount prepared, distributed and sold in the Borough. 47. 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 Borougji. 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. 258 samples were submitted to the Public Analyst during the year, giving a rate of 5.9 per 1,000 population. These were as follows :- Bread 3; Butter 1; Cafedrine linctus 1; Cake mixture 1; Coconut, desiccated 1; Codeine tablets 1; C'ffee essence 1; Confectionery, sugar 1; Cooking fat 1; Cornflour 1; Cream 35 Curry powder 1; Custard power 1; Drinks, soft 7? Fish, canned 4; Fish paste 65 Fruit, dried 4; Fruit, canned 3; Fruit, curd 1; Gelatine 1; Gin 2; Glycerine, lemon and honey 2 ; Glycerine, lemon and ipecac 1; Glycerine of Thymol I5 Halibut liver oil capsules 1; Influenza mixture 2; Indigestion lozenges 1; Jam 5; Jelly tablet 1; Lard 1; Margarine 1; Marmalade 1; Marzipan 1; Meat, minced 4; Meat products 2; Meat products, canned 8; Meat paste 3! Milk 125; Milk, condensed 3; Olive oil 1; Oil, cooking 1; Pease pudding, canned 1; Peel 1; Pepper 35 Pickles 5; Pudding mixture 1; Rice 2; Sauce 55 Soda bicarb. 1; Soup preparation 4; Spice 6; Suet, shredded 1; Sugar 2; Sulphur tablets 1; Tapioca 1; Tea 1; Tomato nuree, canned 3; Tonic syrup 1; Vegetables, canned 2; Vinegar, cider 1; Vinegar, malt 2; Whiskey 4. Slices from a loaf were submitted by a complainant and were found to contain a partly-burnt cigarette end which had been baked in the bread. Legal proceedings were taken and the defendant was fined £5 and ordered to pay £5 costs. 48. Slices of bread, covered by mould were submitted by another complainant, and legal proceedings resulted in the defendant being fined £10 in this case. An informal sample of minced meat was found to contain excessive sulphur dioxide, but formal sample taken was f^und to be genuine. Samples of orange drink were found to oontain an excessive amount of preservative. Warning letter was sent to the manufacturers but Council's solicitor advised that no legal action should be taken. One of the milk samples taken contained 2% added water and one was deficient in milk-fat. In each case formal samples taken were found to be satisfactory. Warning was given to the manufacturers in respect of influenza mixture in which the morphine content was less than the amount stated on the list of active ingredients on the label, and a warning letter was sent to the producers in respect of ground nutmeg contaminated by insects. UNSOUND FOOD. During the year 299 certificates were issued in respect of food unfit for human consumption, which included the following:- Meat 260 tins; 22 cwts.3 qtrs. 23 lbs.; Bacon 1 tin; 5 cwts.l qtr. 15 lbs.; Pork 426 tins; 2 cwts. 3 qtrs. 1 lb.; Chicken 2 tins; 3 qtrs. 221bs.; Sausages 8 lbs.; Ham 9 tins; 4 cwts.2 qtrs.17 lbs.; Cheese 71 cwts.2 qtrs. 9 lbs.; 118 packets; Peas 41 tins; 2 cwts.18 lbs.; Split peas 136 lbs.; Baked beans 14 tins; Butter beans 3 tins; 31 lbs.; Spaghetti 4 tins; Tomatoes 149 tins; Tomato puree 5 tins; Fruit 1,482 tins; 10 cartons; Dried fruit 6 cwts.3 lbs.; 178 tins; 18 pkts; Fruit juice 22 tins; Tapioca 70 lbs.; Farinoca 28 lbs.; Rolled oats 14 lbs.; Cereals 228 pkts; Soup 20 tins; Fish 27 tins; Skate 3½ stone; Salmon 8 tins; Sardines 4 tins; Pilchards 25 tins; Brisling 3 tins; Prawns 3 tins; Crab 72 tins; Lobster 5 tins; Biscuits 16 lbs.; Rice 4 cwt. 2 qtrs. 3 lbs.; Barley 62 lbs.; Almonds 97 lbs.; Jam 150 lbs.; Coffee 7 lbs.; Honey 41 lbs.; lard 26 lbs.; Flour 66 lbs.; Oatmeal 13 lbs.; Mixed Peel 11 lbs.; Baby food 2 tins; Cake mixture 4 pkts; Sugar 93 lbs.; Evaporated milk 8 tins; Coconut 3 pkts; Cornish wafers 25 lbs. 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 dealer is situated is notified when unsound food is sent to the manufacturers. PRESERVATIVES IN FOOD REGULATIONS. All articles taken were in accordance with the Regulations. 49. PHARMACY AND POISONS ACT, 1933. 40 Licences were granted during the year, 53 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. Verbal warning was given to six butchers regarding labelling of imported meat, PET ANIMALS ACT, 1951. There were fourteen premises licensed under this Act during the year. In ten 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 35 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 1958 the number of registered premises where filling materials were used was 114, and during the year 12 licences were issued in respect cf premises where rag flook is manufactured or stored. 229 Inspections cf the premises were made. 6 Samples of filling materials were taken and submitted to the Public Analyst. All were found to comply with the prescribed standards. PUBLIC HEALTH PROPAGANDA. During the year Public Health propaganda was continued. Health propaganda posters were posted and regularly changed from time to time on the Public Health notice boards which are fixed in positions on the Council's housing estates. There is also a large notice board situated at the Town Hall and also one at St.John's churchyard. In addition to this, Public Health 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 tc all shopkeepers and stall holders and "Do Not Spit" notices have been distributed to owners of blocks cf flats. Articles have been written and published in the"Newsletter" and in all cases of infectious disease food handlers' pamphlets are distributed. PAID PUPILLAGE. The system of paid pupillage continues. During the year two of the trainees were successful in passing the Statutory examination and were appointed as Public Health Inspectors. Unfortunately, cne has since been called up to H.M. Forces for National Service, The other successful candidate since his appointment has given good service and assistance to the Department and has justified the promise shown during his training. At the end of the^year under review there were three pupils undergoing training. One who failed to satisfy the Examination Board has since been called up to H.M. Forces, the other two sit for examination in July 1959 and it is hoped that they both pass as this appears to be the only successful way (short of offering inducements) tc get trained Public Health Inspectors in the East End London Boroughs. FOOD & DRUGS (MILK & DAIRIES) ACT 1944 MILK (SPECIAL DESIGNATIONS) 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 73 91 Supplementary Licences 26 29 Totals 99 120 Milk (Special Designations)(Raw Milk) Regulations, 1949. Tuberculin Tested. Dealers' Licences 42 Supplementary Licences 25 Total 67 51. EXAMINATION OF MILK SUPPLIED TO L.C.C. SCHOOLS AND DAY NURSERIES. 59 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. 68 Samples of pasteurised milk were submitted for phosphatase and methylene blue tests. All samples conformed to the prescribed standard. 4 Samples of sterilised milk showed negative results to turbidity test. CONDENSED MILK REGULATIONS. 3 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. (l) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acta) 6,773 (b) Number of Inspections made for the purpose 13,793 (2) (a) Number of dwelling-houses (included under sub-head (l) above) which were inspected and recorded under Section 3, Housing Act, 1957 238 (b) Number of inspections made for the purpose. 257 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 16 2. REMEDY OF DEFECTS DURING THE YEAR WITHOUT SERVIDE OF NUISANCE NOTICES. Number of premises where it was found necessary to serve Intimation Notices under the Public Health (London) Act, 1936, to abate nuisances or remedy defects 856 52. 3. ACTION UNDER STATUTORY POTERS DURING THE YEAR. A. Proceedings under Public Health Acts :- (l) Number of dwelling-houses in respect of which nuisance notices were served requiring defects to be remedied 123 (2) Number of dwelling-houses in which defects were remedied after service of nuisance notices (a) by owners 154 (b) by local authority in default of owners _ B. Proceedings under Sections 9>10 and 12 Housing Act 1957i— (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 default of owners _ C. Proceedings under Sections 16 and 23 of the Housing Act 1957- (l) Number of dwelling-houses in respect of which Demolition Orders were made or Undertaking accepted 16 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 3 D. Proceedings under Section 18 of the Housing Act 1957• (l) Number of separate tenements or underground rooms in respect of which Closing Orders were made or Undertaking accepted 74 (2) Number of separate tenements or underground rooms in 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 _ P. Proceedings under Section 10 of Local Government (Miscellaneous Provisions) Act, 1953• (l) Number of Closing Orders made _ (2) Number of Closing Orders determined _ 53 4. HOUSING ACT, Part IV - OVERCROWDING. (l) (a) Number of overcrowded families on register at beginning of year 61 (b) Number of new cases found during year 2 (c) Number of cases rehoused or found other accommodation during year 8 (d) Number of overcrowded families on register at end of year 55 LEGAL PROCEEDINGS. POOD & DRUGS ACT. 1955. Date Nature of Offence Pine Costs Result Sept. 17th Selling a loaf of bread which was in a mouldy condition. 10. 0. 0 Pined £10 Dec. 12th Selling a loaf of bread containing a cigarette end. 5. 0. 0 5. 0. 0 Pined £5- and ordered to pay five pounds costs. 54. STATISTICAL REPORT OF HOUSING WORK DONE BY THE PUBLIC HEALTH INSPECTORS. 1958. Overcrowding. Number of new cases reported 2 Number of new cases referred to L.C.C. 2 Number of cases relieved 8 Number of Inspections and Visits by Inspectors 67 Preferential treatment on health grounds. Number of new cases investigated and reported on to L.C.C. _ Number of cases known to have been found accommodation 4 Number of inspections and visits by Inspectors 7 Underground rooms. Number reported on 11 Number closed 13 Number where undertakings received _ Number made to comply with regulations 2 55. INDEX. Aged - care of 21,51 Analysis of food samples 47 Anti-fly campaign 47 Area of Borough 6 Atmospheric pollution 31 Bacteriological examinations 14 Birth rates 9 Burials 11 Cancer 11 Committees - Public Health 4 Borough Welfare 4 Deaths, causes of 8 Death rates 9 Disinfection 26 Disinfestation 26 Factories Act, 1937 37 Pood Hygiene 44 Free washing facilities 47 Hairdressers registration 30 Health propaganda 49 Heating Appliances (Fireguards) Act 42 Holiday Home 21 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 31 Section 50 11 Noise Nuisances 44 Offensive Trades 30 Old People's Clubs 21 Outworkers. 41 Overcrowding 37 Paid Pupillage 50 Personal Cleansing 25 Pests Act 1949 42 Pet Animals Act 1951 49 Pharmacy & Poisons Act 49 Pigeons 44 Population 9 Preservatives in food regs 48 Public Health Propaganda 49 Rag Dealers 31 Rag Flock Act 1951 49 Rodent Infestation 43 Rent Act 1957 27 Sanitary circumstances 23 Shops Act, 1950 30 Slum Clearance 37 Social Welfare services 21 Staff 5 Stillbirths 9 Student Public Health Inspectors. 50 Swimming Baths 30 Single Stack Drainage 34 Tuberculosis 14 Tuberculosis Care Committee 19 Underground rooms 37 Unsound food 48 Verminous houses 25 Vital statistics 6 Water supply 30 Water from wells 30