Ac 4363 II SHOR 68 REPORT on the HEALTH AND SANITARY CONDITION of the METROPOLITAN BOROUGH OF SHOREDITCH IN THE COUNTY OF LONDON FOR THE YEAR 1963 BY B. BROADBENT, M. A. ,M. B.,M. R. C. S. ,D. P. H., Medical Officer of Health. REPORT on the HEALTH AND SANITARY CONDITION of the METROPOLITAN BOROUGH OF SHOREDITCH IN THE COUNTY OF LONDON FOR THE YEAR 1963 BY B. BROADBENT, M. A. ,M. B. ,M. R. C. S. ,D. P. H. , Medical Officer of Health. Printed by WATERLOO & SONS LIMITED. S.S.8759 2. To the MAYOR, ALDERMEN and COUNCILLORS of the METROPOLITAN BOROUGH OF SHOREDITCH. Mr, Mayor, Ladies and Gentlemen, I herewith present my second "last" annual report on the health of the Borough, which follows once more the lines laid down by the Ministry of Health. Some of the vital statistics for 1963 are proving difficult to interpret, especially those for infant mortality rates. It will be noticed that, while the number of live births is somewhat lower, the stillbirths are only one-third of those of the previous year, and yet, at the same time, the number of children dying before the age of one year has jumped from 14 to 20, On the other hand, exactly half of those 20 died from bronchitis or pneumonia (i.e. 10 as against 2 in the previous year), and this would appear to be due solely to the very severe weather in 1963. Yet the figures for London as a whole were rather better than in 1962, and also, in Shoreditch, the perinatal mortality rate was halved (stillbirths+ under one week). Hence the most probable explanation would appear to be that the medical and nursing attention received is so good that the weaklings survive until external conditions become too severe for their resistance to overcome. But whatever the cause, I have satisfied myself that there is no local sinister effect in operation which could possibly be remedied by this Department. Deaths from infection were negligible, pulmonary tuberculosis yielding only 4 (as against 9 last year), but we had one death following whooping cough for the first time since whooping cough immunisation was begun in the Borough., As regards deaths from other causes, the only ones which increased to any extent were again coronary disease (from 89 to 105) and pneumonia (from 40 to 71), cancer of the lung having dropped, for once, from 35 to 28. Even the notifications of pulmonary tuberculosis are scarcely more than half of those for 1962 (13/24), and are in fact the lowest ever recorded in this Borough. Also, 1963 was a measles year, but resistance seems to have been excellent, there was not a single case of polio, and no instance of puerperal fever (with again no maternal deaths) The outstanding event of the year in the Social Welfare section of the department has been the introduction of the new Holiday Hotel on the seafront at St. Leonards-on-Sea to the pensioners of the Borough, Although it was not adapted to its future duties until after the end of the year (when a lift and other improvements are being installed), a preliminary run until September was so popular that no one could stay for more than one week and nothing but praise came from the guests. All the other facets of work for old people continue unabated (see pp. 20/21). While the work for old people has shown no loss of staff, the same cannot be said for our staff of public health inspectors which has again dropped perilously, for reasons shown under'Sanitary Circumstances'(p. 22 ) but the introduction of non-qualified technical assistants has momentarily 3. saved the day. We hope to have the whole Borough of Shoreditch covered "by smoke control by the time the link with Hackney and Stoke Newington occurs in 1965, and the sealing off of all disused drains bids fair to removing the rat nuisance almost completely. The noise nuisance of road drills is covered so completely in the body of this report that no further reference need be made here (see p. 25) Pood sampling was very thorough, and covered even the itinerant weekend vendors of shell fish, and also all suspected frozen egg products, as well as the more usual sources of possibly doubtful foodstuffs. Despite the diminished numbers of public health inspectors, routine inspections and attendance to complaints were kept at 100%. The special methods for ridding the Borough of rats make, interesting reading (pp. 46/47 ) and should reduce risks of rodent-borne infection and infestation even further than has ever before been possible. However, it is invidious to draw distinctions between one part and another of the Department's work, and I cannot praise too highly the way every member of the Health and Welfare Departments has worked on behalf of the people of this Borough. I would also thank all members of the Council and other departments in the Borough who have helped so much towards a healthier and happier life for its citizens. Yours faithfully, B. BROADBENT Medical Officer of Health. Shoreditch Town Hall, Old Street, E.C.I. SHOreditch 7600. 4* PUBLIC HEALTH COMMITTEE BOROUGH WELFARE COMMTTEE (May 1962 to May 1963) (May 1962 to May 1963) Ex-officio: Councillor J.A. WELCH, J.P. (Mayor) Chairman: Coun. ROBERTSON, H.T.L. Chairman: Coun. SIMMONDS, A.S, Vice Chairman: Coun. TURNER, C.H., Vice Chairman: Alderman SMITH, Mrs. E.E, B.E.M. Alderman Rev. MEREDITH DAVIES ,M.B.E. Alderman Rev. MEREDITH DAVIES, M.B.E. Councillor BOLTON, J.W. " GIRLING, Mrs. H., P.B.E,J.P. " BRADSHAW, P.W. Councillor BOLTON, J.W. " CLARIDGE, E.H. " DEACON F.J, " DEACON F.J. " JEPSON, Miss V.G. " GIBSON, S. " LEMMON, W.T. LINALE, R.G., M.B.E. " STOCKS, H.T. " ROBERTSON, W. " SWALES, R.T.J. " RUTMAN, P. " TURNER, C.H., B.E.M. " SCOTT, E.J. " WRAY, D. " SIMMONDS, A.S. " WRIGHT, Mrs. G.M. (Co-opted) Lady Cynthia COLVILLE, D.C.V.O., D.B.E., J.P. PUBLIC HEALTH COMMITTEE BOROUGH WELFARE COMMITTEE (May 1963 to May 1964) (May 1963 to May 1964) Ex-officio: Alderman Rev. MEREDITH DAVIES, M.B.E., J.P. (Mayor) Chairman: Coun. ROBERTSON, H.T.L. Chairman: Alderman SMITH, Mrs. E.E. Vice Chairman: Coun. TURNER, C.H. Vice Chairman: Coun. SIMMONDS, A.S. B.E.M. Councillor BOLTON, J.W. Alderman GIRLING, Mrs. H., O.B.E, J.P. " BRADSHAW, F.W. Councillor BOLTON, J.W. " CLARIDGE, E.H. " DEACON, F.J. " DEACON, F.J. " JEPSON, Miss. V.G. " GIBSON, S. " LEMON, W.T. " LINALE, R.G., M.B.E. " STOCKS, H.T. " FUGH,T.A. " SWALES, R.T.J. " ROBERTSON, W. " TURNER, C.H., B.E.M. " RUTMAN, P. " WELCH, J.A. " SCOTT, E.J. " WRAY, D. " SIMMONDS, A.S. " WRIGHT, Mrs, G.M. (Co-opted) Lady Cynthia COLVILLE, D.C.V.O., D.B.E., J.P. 5. STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health B. BROADBENT, M.A., M.B., B.Ch., M.R.C.S., L.R.C.P., D.P.H. Chief Public Health Inspector T.H. MARSHALL, F.A.P.H.I. (a)(b)(c)(d) Supervisory Public Health B.M. ROM, M.A.P.H.I. (a)(b) (comm.14.1.63) Inspectors. R.E.N. THOMAS, M.A,P.H.I. (a)(b) (comm.8.7.63) G.D. COULING, M.A.P.H.I. (a)(b) (res.18.8.63) T.B. MEANEY, M.A.P.H.I. (a)(b)(c) (res.31.3.63) R. STAPLES, M.A.P.H.I. (a)(b) (res. 15.6.63) Senior Food Inspector N.A.C. EARTHROWL, M.A.P.H.I., (a)(b) District Public Health Inspectors J.V.A. JONES, M.A.P.H.I. (a) (comm. 15.7.63) W.G.L. DICKS, M.A.P.H.I, (a) (res. 11.5.63) B. JONES, M.A.P.H.I, (a) (res. 10.11.63) J.E. SCOTT, M.A.P.H.I. (a) (res. 17.2.63) Student Public Health Inspectors J.V.A. JONES (qualified as P.H.I. 15.7.63) A.D.A. MELVIN I.S. FOX Technical Assistant A.E. TUCK, (comm. 19.8.63) Clerks B.M.R. LEIGH G.A. POPE E.A. CHRISTIAN P.K. GREENE Mrs. I. CHICK R.W. BRADFORD Mrs. F.R. GUNN (comm. 1.7.63) ) (welfare} Mrs. R.E. PETTIT (res. 11.5.63)) H.J. VANNER (ret. 27.12.63) Rodent Officer. 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. Deputy Matron Miss. E.D. JEPHSON (res.16.8.63) Public Analyst (part-time) H, AMFHLETT WILLIAMS, Ph.D., A.C.G.F.C., F.R.I.C. Notes:- (a) Public Health Inspectors' Certificate (b) Meat & Other Foods Inspectors' Certificate (c) Smoke Inspectors' Certificate (d) Certificate in Sanitary Science as applied to Buildings and Public Works. 6. STATISTICS AMD GENERAL INFORMATION Area of Borough 662 acres Population, Census 1961 40,455 Population, Registrar-General's estimate, mid 1963 38,330 Number of houses, including separately rated flats at end of 1963, according to rate books 12,031 Rateable Value £3,942,497 Sum represented by penny rate £15,228 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR 1963 Male Female Total Live Births 305 293 598 Rate per 1,000 population (crude rate) 15.60 Do. (adjusted for Area Comparability Factor 0.98) 15.29 Illegitimate live births (per cent of total live births) 9.69% Stillbirths 2 4 6 Rate per 1,000 total live and still births 9.93 Total Live and Still Births 307 297 604 Infant Deaths (deaths under 1 year) 9 11 20 Infant Mortality Rates - Total infant deaths per 1,000 total live births 33.44 Legitimate " " " 11 legitimate live births 37.03 Illegitimate" " " " illegitimate " " - Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 10.03 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 10.03 Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per 1,000 total live and still births) 19.86 Maternal Mortality (including abortion) - (Rate per 1,000 total live and still births) Deaths 241 276 517 Rate per 1,000 population (crude rate) 13.48 Do. (adjusted for Area Comparability Factor 1.02) 13.75 7. Comparative vital statistics of the Borough during recent years are given in the following table:- Year Population BIRTHS DEATHS INFANT DEATHS Number Rate Number Rate Number Rate per 1000 live births 1952 45800 829 18.10 559 12.20 23 27.74 1953 45770 815 15.66 615 13.96 18 22.08 1954 45960 765 14.64 560 12.67 17 23.10 1955 4548O 761 14.72 585 13.37 15 19.71 1956 44520 726 14.51 688 11.28 12 16.53 1957 43870 729 14.95 615 10.51 16 21.94 1958 43330 730 15.32 473 8.84 15 20.55 1959 43330 596 12.51 552 11.85 16 26.84 1960 42870 675 14.33 549 12.16 15 22.22 1961 40530 683 15.83 516 11.46 18 26.35 1962 39580 671 16.10 531 11.26 14 20.86 1963 38330 598 15.29 517 13.75 20 33.44 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 mortuary for Shoreditch bodies was continued throughout the year. 8. CAUSES OF DEATH, WITH AGE DISTRIBUTION, CAUSES OF DEATH Under 4 wks 4 wks to l yr 1 to 4 5 to 14 15 to 24 25 to 34 35 to 44 45 to 54 | 55 to 64 65 to 74 75 and over Male Female Total deaths due to each cause 1. Tuberculosis} respiratory - - - - - - 1 1 1 1 - 4 - 4 2. Tuberculosis, other forms - - - 1 - - - - - - - - 1 1 3. Syphilitic disease - - - - - - - - - 1 - 1 - 1 4.. Diphtheria - - - - - - - - - - - - - - 5. Whooping cough - 1 - - - - - - - - - 1 1 6. Meningococcal infections - - - - - - - - - - - - - - 7. Acute poliomyelitis - - - - - - - - - - - - - - 8. Measles - - - - - - - - - - - - - - 9. Other infective and parasitic diseases - - - - - - - 1 - - - 1 - 1 10. Malignant neoplasm, stomach - - - - - - - 1 1 - - 2 - 2 11. Malignant neoplasm, lung, bronchus - - - - - - 1 3 14 6 4 25 3 28 12. Malignant neoplasm, breast - - - - - - 1 2 1 1 2 - 7 7 13. Malignant neoplasm, uterus - - - - - - - 1 1 1 - - 3 3 14. Other malignant and lymphatis neoplasms - - 1 - - - 1 1 11 13 12 15 24 39 15. Leukaemia, aleukaemia - - - - l - - 1 1 1 - 3 1 4 16. Diabetes - - - - - - - - - 1 2 2 1 3 17. Vascular lesions of nervous system - - - - 1 - 2 9 11 24 12 35 47 18. Coronary disease, angina - - - - - - 3 9 24 30 39 60 45 105 19. Hypertension with heart disease - - - - - - - 1 2 4 4 2 9 11 20. Other heart disease - - - - - - 1 1 5 10 14 9 22 31 21. Other circulatory diseases - - - - - - - - 4 8 16 11 17 28 22. Influenza - - - - - - - - - 1 - - 1 1 23. Pneumonia - 5 - - - - - - 1 11 54 22 49 71 24. Bronchitis - 5 - - - - 1 2 8 17 28 39 22 61 25. Other diseases of respiratory system - - - - - - - - - 2 2 3 1 4 26. Ulcer of stomach and duodenum - - - - - - - 1 2 1 1 3 2 5 27. Gastritis, enteritis and diarrhoea - - - - - - - - 1 1 1 2 1 3 28. Nephritis and Nephrosis - - - - - - - - - - - - - - 29. Hyperplasia of prostate - - - - - - - - - - - - - 30. Pregnancy, childbirth, abortion - - - - - - - - - - - - - - 31. Congenital malformations 1 3 1 1 - - 2 - - - - 2 6 8 32. Other defined and illdefined diseases 5 - 1 - - - - - 8 2 8 9 15 24 33. Motor Vehicle accidents - - - - - 1 - - 2 - - 1 2 3 34. All other accidents - - - - - - 2 - 1 4 5 9 3 12 35. Suicide - - - - - 2 1 2 2 2 - 4 5 9 36. Homicide and operations of war _ _ - — _ — - — — — - - - - Total Deaths (all causes) 6 14 3 2 1 4 14 29 99 129 216 241 276 517 9 POPULATION, BIRTHS, MARRIAGES AMD DEATHS The Registrar-General's estimate for the mid-year 1963 population was 38,330, a decrease of 1,250 on the previous year. This figure is used for statistical purposes throughout this report. The density of the population is 58 persons per acre. The Area Comparability Factors for the Borough are Births O.98 and deaths 1.02 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 1963 were as follows:- Total live births - (legitimate and illegitimate) Ma1es 305 Females 293 Total 598 Illegitimate live births- Maies 32 Females 26 Total 58 The birth rate for the Borough was 15.29. For England and Wales the rate was 18.2 and for London 20.0. The illegitimate births represented 9.69 per cent of all births in the Borough STILLBIRTHS. The number of registered stillbirths allocated to the borough was 6, or 0.99 per cent of all births. MARRIAGES. The number of marriages during the year was 377 and the marriage rate was 19.6 per 1,000 population. The marriage rate for the Metropolis was 21.4 and that for England and Wales 14.9. DEATHS. The number of deaths registered in the borough in 1963 was — 542 Transferable deaths - Non-residents registered in Shoreditch - 211 Shoreditch residents registered elsewhere - 186 The number of deaths allocated to the borough is therefore - 517 This gives a death rate for the borough of 13.75 compared with 12.2 for England and Wales, and 12.5 for London. In connection with these deaths 17 inquests were held. 404 or 78% of the people belonging to Shoreditch who died during the year, died in hospital. The table on page 8 showing causes of death at all ages has been supplied by the Registrar-General. 10 INFANTILE MORTALITY The deaths of infants under one year numbered 20 of which 9 were males. These deaths amounted to 3.87 per cent of the total net Shoreditch deaths from all causes, as compared with 2.64 per cent in 1962. The infantile mortality rate (death rate of infants under one year per 1,000 live births) for Shoreditch was 33.44, the rate for England and Wales being 21.1 and that for London 21.8. No illegitimate infant died. The number of deaths of infants under 4 weeks of age was 6, which gives a neo-natal rate of 10.03. INFANTILE MORTALITY IN THE BOROUGH DURING 19630 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 Whooping cough - - - - - - - - - 1 - 1 1 Pneumonia - - - - - - 2 2 1 - 4 1 5 Bronchitis - — - - - - 1 3 - 1 2 3 5 Congenital malformation - 1 - - - 1 3 - - - 1 3 4 Prematurity 4 - - - - 4 - — - - 1 3 4 Atelectasis - 1 - - - 1 - - - - 1 - 1 TOTAL 4 2 - - - 6 6 5 1 2 9 11 20 11. COMPULSORY REMOVAL OF AGED AMD 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. A woman aged 92, who was living in insanitary conditions, was incapable of caring for herself, yet refused to go to hospital even after having a fall. In her interests it was considered necessary to use powers under the Amendment Act for compulsory removal and she was admitted to hospital. 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 1963 four cases occurred where the Council had to arrange for burial. 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. INFECTIOUS AND OTHER DISEASES. During the year 740 notifications of infectious diseases were received of which over 85% were in respect of measles. 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 1963. (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 29 1 9 11 2 6 - - - Acute encephalitis- infective - - - - - - - - - post-infectious - - - - - - - - - Enteric (paratyphoid) - - - - - - - - - Erysipelas 4 - - - 2 1 1 - - Measles 644 30 328 286 - - - - - Meningococcal Infection 1 1 - - - - - - - Ophthalmia Neonatorum - - - - - - - - - Pneumonia Acute Poliomyelitis- 3 - 1 - - - — 2 - - paralytic - - - - - - - - - - non-paralytic - - - - - - - - - Puerperal Pyrexia - - - - - - - - - Scabies 3 - - - 1 2 - - - Scarlet fever 14 - 1 13 - - - - - Whooping cough 21 3 8 10 - - - - 1 Tuberculosis - pulmonary 13 1 - - 3 2 5 2 4 - non-pulmonary 4 - - 1 - 2 1 - 1 Food Poisoning 4 - - — - 4 - - - Total 740 36 347 321 8 17 7 4 6 The following diseases are notifiable in this Borough: Disease Authority for notification Acute encephalitis Public Health Act, 1936 (Section 143) Reg.No.2259 male by Minister of Health, 1949 (l.l.50) Acute primary or influenzal pneumonia Public Health Act, 1936 (Section 143) Reg.No.299 made by Minister of Health, 1953 (l.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 (infectious Diseases) Amendment Regulations 1960. Cholera Public Health (London) Act, 1936 (Section 192 and 304) Continued fever Do. Diphtheria Do. Dysentery Public Health Act,1936 (Section 143) Reg.No. 299 made by Minister of Health, 1953 (1.4.53) 13. Disease Authority for notification Enteric fever (including typhoid and para-typhoid) Public Health (London) Act, 1936 (Section 192 and 304) Reg.No.299 made by Minister of Health 1953 (l.4.53). Erysipelas Public Health (London) Act, 1936 (Section 192 and 304). Pood Poisoning Pood & Drug Act, 1955 (Section 26). Leprosy Public Health Act, 1936 (Section 143) Reg.No.lO36. made by Minister of Health, 1951 (22.6.51). Malaria Public Health Act, 1936 (Section 143) Reg.No. 299. 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.225). made by Minister of Health, 1949 (1.1.50). Ophthalmia neonatorum Public Health (London) Act, 1936 (Section 192 and 305). and Reg.No.971 made by Minister of Health, 1926 (1.10.26) amended by S.R.O. 1928 No.419 and 1937, No.35. Plague Public Health Act, 1936 (Section 143). Regulations of Local Government Board, 1900. Puerperal pyrexia Public Health Act, 1936 (Section 143), Regulations made by Minister of Health, 1951• No.1081 and 1954 No. 1691. Relapsing fever Public Health (London) Act, 1936 (Section 192 and 304). Scabies (first case in house within 4 weeks) Public Health Act, 1936 (Section 143) Reg.No.1016 made by Minister of Health, 1943 (l.8.43). Scarlatina or scarlet fever Public Health (London) Act, 1936 (Section 192 and 304). Small pox 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)• Reg.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 Hal; Records of examinations carried out are as follows Nose and Throat Swabs: C. Diphtheriae mitis isolated - Haemolytic Streptococci present 2 Negative results 43 45 Faeces Specimens: Shigella Sonnei isolated 77 Salmonella typhi-murium isolated 14 Salmonella Newport isolated - Negative results 190 281 Swimming bath water examinations 8 Milk samples 38 Ice Cream samples 35 Foodstuff samples 18 TUBERCULOSIS Notifications - Thirteen cases of pulmonary tuberculosis and four of non-pulmonary tuberculosis were notified during 1963 compared with 24 pulmonary and 3 non-pulmonary notification in 1962. The following table gives the age grouping of new cases notified. AGE PERIODS FORMAL NOTIFICATIONS Number of primary notifications of new cases 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 - - - - 1 1 - 3 1 2 - 9 " Females - - - - - 2 - 1 - 1 _ - - 4 Non-pulmonary, Males - - - - 1 - - — - 1 — - - 2 " Females - - - - - - - - - - - - - 2 Total 1 - - -- 1 3 - 2 2 5 1 2 - 17 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 11 6 - - Other sources - - - - Total 12 6 - - Details of cases removed from Register during the year:- Reason for removal Pulmonary Non-pulmonary M F M F Withdrawal of notification — 1 — — Recovery from disease 7 8 — 1 Death 12 — — 1 Otherwise (e.g. removal from district) 14 6 1 2 Total 33 15 1 4 Revision of Notification Register- Pulmonary Non-pulmonary TOTAL M F M F No. of cases on Register at 31st December 1962 214 176 55 25 470 No® added during year 21 10 2 2 35 No. removed during year 33 15 1 4 53 No. of cases on Register at 31st December 1963 202 171 56 23 452 16 The following table shows the incidence of cases of tuberculosis and of deaths from that disease fur the last twelve years:- Year Notification rate per 1,000 population i Death rate per 1,000 population Pulmonary Non Pulmonary All Forms Pulmonary Non Pulmonary All Forms 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 0.15 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 1959 0.78 0.11 0.89 0.09 0.00 0.09 1960 0.81 0.05 0.86 0.11 0.00 0.11 1961 0.64 0.02 0.66 0.27 0.02 0.29 1962 0.61 0.07 0.68 0.22 0.00 0.22 1965 0.54 0.10 0.44 0.10 0.02 0.12 The following table gives the age grouping of deaths from tuberculosis:- Age periods Under 4 weeks 4 weeks to 1 yr. 1-5 5-15 15-25 25-35 35-45 45-55 55-65 65-75 Over 75 Total Pulmonary, Males - - - - - - 1 1 1 1 - 4 " 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 an infectious condition, from following any employment or occupation in connection with a dairy which would involve the milking of cows, the treatment of milk, or the handling of vessels used for containing silk. 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 1963 the Unit examined 44,200 males and 23,636 females making a total of 67,836s Up to the end of 1963 the Unit has examined 497>267 males and 330, 368 females-making a grand total of 827,635 since it commenced operations in May 1950. Thirty-six cases (22 males and 14 females) with a significant tuberculous lesion have been discovered which gives an overall rate of .531 per 1,000 examinees. While the number of men X-rayed during 1963 was 5.8% above the average of the past few years, the females showed a 5.3% decrease on the average figure. The rate of significant cases for men was .498 and for women it was .592 per 1,000. The highest incidence of tubercle was discovered in men within the 60-64 and 65 plus Age Groups which was contrary to our visual experience, as the highest incidence has, for the past few years, been found in the 45-54 Age Group. The highest incidence for women was found in the 15-19 and 20-24 Age Groups which confirms our usual findings. Sixteen cases of carcinoma of the bronchus (all males) were discovered during the year, which is a considerable increase on the previous year's results when five cases only were found. Unit's Operations The zone of the Unit has remained the City of London and the Metropolitan Boroughs of Finsbury and Shoreditch. The Unit operated for a large part of the year at the Mass Radiography Centre, 20, Golden Lane, E.C.1., while for the remaining period it visited various firms, etc®, which could offer appropriate accommodation. This included a Survey at the Geffrye Museum, Kingsland Road, E.2.- by kind permission of the Museum's Curator, Mrs.M. Harrison-for the benefit of Shoreditch firms unable to attend the Mass Radiography Centre. When the Unit was operating at the"Evening Standard" over eighty firms in the vicinity participated. This co-operative method is generally adopted when the Unit visits firms and organisations. The Unit has continued to approach, and encourage, new firms to use the services offered by the Unit, and a considerable number of new firms have been added to the Unit's register. Doctors' Referrals. It is gratifying to report that the year under review has shown an increase in Doctors' referrals® Such referrals have produced an incident rate of 10.38l per 1,000. Medical Procedure The Unit has continued its procedure of referring abnormal cases to the appropriate Chest Clinic through the examinee's own doctor. Clinics have recorded their sputum findings and twelve cases with a positive sputum have been reported, of which nine were male and three were female. 18 Conclusion Friendly relationships have been maintained with the Medical Officers of Health of the City of London and the Boroughs of Finsbury and Shoreditch as well as the Divisional Medical Officers of Divisions 3. 4 and 5. Gratitude must be expressed to Dr. Neville C. Oswald, Dr. Graham Hayward and their colleagues at St. Bartholomew's Hospital for their helpfulness over cases outside the scope of a Chest Clinic, to the Central Group Hospital Management Committee and the Regional Hospital Board for their assistance whenever needed, and finally to all members of my staff for their loyal support and co-operation" DETAILS OF SURVEYS DURING 1963 CENTRE & PERIOD GROUPS EXAMINED No.OF PERSONS EXAMINED MALE FEMALE TOTAL MASS RADIOGRAPHY CENTRE, 20 Golden Lane, E.C.l. 1st January 6th August Officet Technical & Factory Staff in the City of London, Boroughs of Finsbury & Shoreditch.Teaching & Health Staff in Div's®3t4 & 5« Individuals t. Doc tors 'Patients 22583 14409 36992 SHOREDITCH SURVEY at Geffrye Museum Kingsland Road E2 24th September3rd October Office & Factory Staff in the neighbourhood. General Public. 1776 909 2685 MASS RADIOGRAPHY CENTRE,20 Golden Lane, E.C.I. 1st November31st December As above 6742 3811 10553 19 SHOREDITCH TUBERCULOSIS CARE COMMITTEE I am grateful to Mrs. J.M. Rix, the Secretary, for the following report of Care Work for the year from April 1963, to March 1964. "The Shoreditch Tuberculosis Care Committee now consists of the following members:- Councillor F.G. Aldred (Chairman.) Shoreditch Borough Council Miss R. Glennie (Vice-Chairman) Soldier's, Sailor's & Airmen's Families Association. The Rev. Meredith Davies M.B.E. L.C.C. Health Committee. Dr. S. King Divisional Medical Officer. Dr. B. Broadbent Medical Officer of Health Shoreditch. Mrs. W.G. Dibble Women's Voluntary Services. Miss M.W. Sweeney Superintendent-Shoreditch & Bethnal Green District Nursing Association. Miss Hartigan Almoner - St. Leonard's Hospital Councillor J.D. Welch Shoreditch Borough Council. Ex-Officio:- Dr. W.F. Richards Chest Physician. Miss M.D.M. Nutt Health Visitor. Mrs. D.M. Burke Health Visitor. Mrs. J.M. Rix Care Committee Organiser. We have pleasure in presenting our Annual Report for the year ending March 31st 1964. Although income was less than last year, we were able to meet requests for help from patients and their families either from our own Fund or by calling upon other voluntary agencies such as S.S.A.F.A., The Glasspool Trust, The Benevolent Society of St. Patrick, The Mayor's Fund, The Society for the Relief of Distressed Widows, Stoke Newington & District Sick Poor Charities and others. To all of these, as always, we extend our sincere thanks. The sale of Christmas Seals resulted in £131.5.5d. being added to our fund and a gift of £25 from the Radlett Parish Church was gratefully received as were donations of £45 from the Sunday Cinematograph Entertainments Fund of the London County Council, £10 from the United Charities of St. Leonard, and £5 from the Rotary Club of Shoreditch. Several Jumble Sales were held in the Clinic which realised £17. This Christmas we increased the amount of our gifts to elderly patients from 10/- to £1 each. Twenty eight of them were helped in this way* Christmas gifts were also given to many of our needy families by the Mayors of Shoreditch & Hackney Boroughs. In conclusion we would like to thank the Borough Treasurer of Shoreditch for so kindly auditing our accounts, also Mr. Kirkland, his assistant, who looks after our finances throughout the year." 20 SOCIAL WELFARE SERVICES. The various services provided for the welfare of old people continued to function throughout the year and the four full time old people's clubs again proved very popular places where the pensioners can meet their friends to sit and talk in comfort, play games, listen to wireless or television, and find from 10 a.m. to 4.30 p.m. that companionship which so many of them lack in their homes. The Council's small coach is still used to transport some of the crippled and inactive pensioners to and from the clubs daily and at the end of the year 22 old people were taking this opportunity to enjoy the club amenities which they could not otherwise have done. The special club concert given at Hoxton Hall every Friday afternoon still attracts a full attendance. Early in the year the Council purchased a hotel on the seafront at St. Leonards-on-Sea for use as a Holiday Hotel for Shoreditch pensioners and some of the poorer families. Some structural alterations including the installation of a lift were needed, but in order to have the hotel available for the old people without delay, it was decided to use the lower floors only and to close down at the end of September for the building work to be carried out during the winter months. During the four summer months it was open, 389 residents enjoyed a week's stay. Since the Council's staff canteen undertook the supply of meals for the "Meals on Wheels" service, the demand has continued to grow, and at the end of the year around 150 meals were being supplied each day,- 75 at the Clubs, and 75 delivered to homebound folk by the Salvation Army and part-time Council staff who had to be engaged when the F.V.S, were no longer able to help, Our three lady visitors maintained their good work of visiting the old people and arranging for any of the countless services available to be provided where needed. Over 5,000 visits were made, A reasonably comprehensive list of amenities provided directly by the Borough Council, (through my department) for old people in the Borough, includes free baths, free chiropody (though 4/- at home), clubs (full and parttime) with almost every amenity, home visiting (twice annually to every pensioner by one visitor, and for emergencies, etc. by one of the three visitors) assisted holidays, free laundry facilities for the incontinent, 1Od mid-day two-course meals both at clubs and for the homebound (32,000 in all), provision of bedding, clothing, furniture, etc. where needed, Christmas parcels (670), Christmas dinner for 400, Church Service at St. Paul's Cathedral, clothes mending at one club, redecorating of premises, entertainments, talent competition, exhibition of handicrafts (and annual sale of work), assistance with fuel, Harvest festival gifts distribution, home nursing requisites (including 20 wheel chairs), library books delivered to housebound, assistance with ophthalmic and dental services where needed, lowering of gas and electric meters where needed, a regular shoe repair service (free, by Lion Boys' Club), S.O.S. cards for pensioners living alone, summer outings for both active and housebound groups, various goods at reduced prices or free, wireless for the bedridden, legal aid assistance - and. in fact other help such as collection of pensions for housebound and almost every possible assistance in any form of difficulty. Birthday cards and Christmas cards are sent to all club members, 21 even if in hospital at the time. Since 1953 a register of all known pensioners has been kept and has remained fairly constant at about 4,000, despite the fact that we are able to keep up-to-date on all deaths and removals, while at the same time not receiving information of new pensioners unless and until they need help (or unless they are discovered during the routine street-by-street six-monthly visits to the whole Borough). In addition to these services, and in very close liaison with our own welfare visitors, the pensioners receive a great deal of help from the District Nursing Association, the L.C.C. Home Help Service (incidentally, by local arrangement the L.C.C. Health Visitors pass on to our visitors any old age pensioners who apply to them for help), the staff of St. Matthew's (geriatric) Hospital, and of course the National Assistance Board. We have appreciated the help given by the W.V.S. and Salvation Army in distributing meals-on-wheels in Council-owned vehicles, and we are indebted to the City of London and East London Dispensary Fund for £275 towards the salary of the full-time visitor. The following table shows the average attendances at the Old People's Clubs during the year. (1) Old People's Clubs (2) Average number of attendances (3) Av. weekly No. of Mon. Tues. Wed. Thu. Fri. Dinners Teas Hoxton Hall (2.30-4.30 p.m.) M. - - - - 2 - 54 F. - - - - 52 Be11 (10.30 a.m.- 4-30 p.m.) M. 19 19 19 20 19 82 203 F. 19 33 24 22 21 Haggerston (10.30- 4.30 p.m.) M. 5 9 15 9 9 123 166 F. 14 18 45 24 17 Moorfields (10.30 a.m.- 4.30 p.m.) M. l 1 2 1 1 46 88 F. 11 16 12 10 14 Wenlock (10.30 a.m.- 4.30 p.m.) M. 4 6 5 7 4 50 152 F. 15 28 24 51 15 22 SANITARY CIRCUMSTANCES. General. Before elaborating under the various headings which go to make the sanitary circumstances section of the Annual Report, one must emphasise that while figures alone may indicate a trend this way or that, particularly in respect of mortality, sickness and disease, they may indicate nothing at all, or even far worse they may give a false impression of the amount of effort employed by Public Health Inspectors in gaining results and also the magnitude of the results achieved due to such effort. The number of complaints received, the numbers of Notices served and the number of notices complied with, convey no impression at all as to the volume of work involved unless these tabulations are suitably amplified. One would go so far as to say that a gradual increase in the number of complaints received by the Department is a sad reflection upon the staff, in that one would expect a gradual reduction in the number of complaints received, should the basic routine inspections be carried out efficiently by the Public Health Inspectors, Too often is it assumed that as the numbers of complaints received by a Department decrease, so automatically the amount of work to be done by Public Health Inspectors is diminished. Nothing could be farther from the truth. An enormous amount of work in preventing cause for complaint has been done by the staff of this Department, which could never be recorded in figures alone even if one wished to do so, and a brilliant example of this is the splendid results of investigation and research carried out particularly by the Chief Public Health Inspector referred to at some length in this report. One sincerely hopes therefore that the reader will find interest in reading the efforts made to amplify the work of the Public Health Inspectors in conjunction with the figures tabulated in the various sections of the Report, and at the same time consider our criticisms of doubtful legislation, suggestions as to how legislation may be strengthened, and in seme instances energetic measures which can be employed to overcome the lack of legislation and how real progress can be made by compromise and persuasion. Staff. Unfortunately one must again report with regret the loss of experienced Public Health Inspectors throughout the year, for whereas we commenced the year with a full complement of Inspectors, at the end of the year we suffered a loss of 50% on the establishment. Prom a careful study of this loss, the fact that Inspectors can find employment under better conditions away from the Central London area with no loss of salary, a considerable financial saving and a great deal of discomfort in travelling from their homes to the Central London area, seems to suggest that until ways and means are found to overcome such a state of affairs, Central London Boroughs will never be able to maintain a full complement of Public Health Inspectors. The general shortage of Public Health Inspectors throughout the country aggravates this situation, and in this respect one must acclaim the proposals 23 of the Association of Public Health Inspectors, that until such time as sufficient Public Health Inspectors, are available, a greater use must be made of unqualified technical staff working under the control and supervision of Public Health Inspectors, During the year the establishment was increased in Shoreditch to include a non-qualified technical assistant working under the supervision of Public Health Inspectors on smoke control work and drainage work. Consideration is also being given to increasing the establishment so as to include a second unqualified technical assistant whose duties will be to work under the control of the Public Health Inspectors doing work under the Offices, Shops and Railway Premises Act which will shortly become operative. Towards the end of the year the Committee decided to appoint a Deputy Chief Public Health Inspector because of the increase of work due to additional legislation, in order that the Chief Public Health Inspector may be able to devote his time more fully to policy matters rather than general administration. Noise Abatement. This has been a very significant year resulting in investigations and research being carried out by the Department employing measures of compromise and persuasion, particularly with manufacturers of road breaking equipment and the principal users of the same, the results of which have gained in impetus providing repercussions not only throughout Shoreditch and the London area, but far beyond this country to continents overseas. Results of such investigations and research, compromise and persuasion are very fully amplified under the Noise Abatement section of this Annual Report. Pood & Drugs. To ensure that the correct type of benefits are available, the procedure in relation to the problems connected with Pood & Drugs Administration must of necessity endeavour to keep abreast of modern techniques. It would, in fact be a better concept if Government legislative policy could be formulated in such a way as to be a step ahead of manufacturers rather than lagging behind. Such a policy could engender a steadying influence on manufacturers and producers and encourage the development of their particular products along lines which would give priority to health-giving properties rather than purely sales gimmicks. The more unscrupulous adulterations of foodstuffs of the past have disappeared, but their place has been taken by the deliberate addition of new chemicals and additives with all their associated claims. With the introduction of prepacked foods of all kinds, the need for 'know how' to entirely prepare a meal is fast becoming a lost art of housewives. It is not intended to suggest that this is a retrograde step but rather to emphasise the need to review the system of control in the knowledge that additives and chemicals are introduced into foods for reasons other than health giving value. Antibiotics undoubtedly serve a useful purpose when applied correctly, but the connection between their use and the possible sensitizing effect on some people could be studied more closely. To confuse the effects of an allergy 24 with suspected food poisoning, whilst not being disastrous, could be misleadiring, A very important aspect in association with the performance of duties under the Food & Drugs Act involves economics and requires thoughtful planning. Some of the every day commodities which are sampled require lengthy laboratory processes to complete particular examinations which have become necessary, in order to be in a position to make a decision. These cost more in time and money, and some of the equipment essential to complete the analysis is very expensive. The sampling officer is thus restricted in his choice of sample range, particularly in the field of drugs, for fear of exceeding budgetary allocations. Quite a strong case could be made out in support of either centralising laboratory work, or for Boroughs to claim monetary assistance from the Minister to augment this sampling programme. In fact, the whole field of Food and Drugs Administration could benefit greatly by being carefully reviewed collectively and a closer relationship formulated at national, if not . international, level to establish agreed bacteriological, chemical and qualitystandards. Atmospheric Pollution. Perhaps the most significant feature which will be gleaned from the atmospheric pollution section of this report is that at the end of the year more than three quarters of the Borough are included in Smote Control Areas, the latest Area coming into operation on November 1st this year. This means that we are in advance of our original programme by at least one year, and if progress is maintained the whole of the Borough should be under smoke control some time in 1965® It is encouraging to be able to report that up to now not one objection has been received prior to the four Smoke Control Areas now in operation. It will be noted that our work in connection with the prevention of fumes from diesel engines has been brought almost to a standstill due to the amendment of the law and a charge of five shillings being made by the licensing authority, whereas previously this was one shilling, per enquiry for the name and address of the owners of vehicles, and if local authorities are to be encouraged, and be able to continue with this important work, it is suggested that they should make very strong representation for the law to be amended and some reasonable arrangements made with the licensing authorities to produce the information required in respect of offending vehicles« Rodents. A feature of this section of the Annual Report is the very marked reduction in the rat population in sewers and surface infestations undoubtedly due to the assiduous work being effectively carried out in abolishing all disused drains when premises are demolished particularly in slum clearance schemes. Of the utmost significance is the introduction of an entirely new method of rodent control in sewers throughout the borough, working in very close liaison with the Ministry of Agriculture Pests Department. It is believed that Shoreditch is the first London borough to be engaged in such an important new venture, and it is confidently hoped that if this experiment is as successful as we feel sure it will be,Shoreditch will be the first London Borough to be able to claim that the sewers are completely free from rate. Details of the method employed are enumerated under the appropriate section of this report. 25 REDUCTION OF UNNECESSARY NOISE FROM ROAD BREAKERS The significance of this Section of the Annual Report cannot be over estimated, for progress in this field of administration during the year of pioneer work commenced in Shoreditch has had repercussions not only throughout the length and breadth of this Country but throughout the World and in particular our work has been recognised in Europe, United States of America, Canada and Rhodesia. All engaged on this important work pioneered by this Council, particularly the Chief Public Health Inspector are to be commended on the results of the research and investigations carried out by them. Compromise and persuasion have been the hallmark of the success enjoyed. Confidence of al1 the principal makers and users of pneumatic equipment has been fostered to such a degree that many who four years ago resented any suggestion of modification to their equipment now work with us as part of a team with the one objective of ridding roadbreaking equipment of all unnecessary noise. After several years hard work of sowing the seed and after many disappointments, the first major break through came in February this year. At the invitation of the Chief Public Health Inspector for the very first time, all the principal makers and users of road breakers met together with members and officers of local authorities throughout the London Area, Building Research Station and the National Physical Laboratory representatives, Acoustic Engineers and others interested in this vital subject to see if we could together agree a standard of noise from road breakers acceptable to local authorities and makers alike. A small working committee was therefore formed to investigate how best to reach this goal and it was at the suggestion of one of the Engineers on that Committee that an entirely new approach was made to the subject. In co-operation with the Chief Public Health Inspector research continued in an entirely new direction,for contractors had opposed any attemptin the past to suppress noise on the grounds that this reduced the efficiency of the breaker, delayed the work, and consequently increased the cost of the job. An attempt was made to isolate those of the sounds which annoy and irritate. Working in accordance with the British Standard Code of Practice entitled 'Sound insulation and noise reduction dated 1960, our efforts were devoted to the conversion of the high frequency sounds, (these which cause the irritation and annoyance) into low frequency sounds which are more acceptable to the ear. Our efforts were eventually rewarded and what is now known as a Noise Converter' , designed to fit any existing type of pneumatic hammer, was produced and tried out in the field, scientific and subjective tests being carried out. A dramatic improvement in noise acceptability was immediately evident. At the same time there was no loss of efficiency in the hammer. Having gained this measure of success a Conference was called and some 300 delegates from all parts of the country and overseas met together in 26 Shoreditch Town Hall on October l6th this year, when the inventor addressed' the audience together with the Chief Public Health Inspector and myself and described the progress, the research and investigations which had "been made to date, together with an explanation of the function and construction of the Noise Converter' This meeting was followed by a practical demonstration of the noise converter in Shoreditch, Octave band analysis together with a strike rate of the hammers was carried out both on the 'naked' hammer, and the hammer equipped with the noise converter. At the same time a ballot was taken from those present and information was collated therefrom in order to be able to assess the success or otherwise of the noise converter, as judged by the ear alone. The octave band, analysis proved beyond doubt, that a dramatic reduction had been achieved in the 'speech interference levels' of the sounds which go to make up the noise, and the subjective tests proved almost unanimous in the acceptance of the noise converter. It is with the greatest of pleasure that I am able to report that all the principal manufacturers (10) have now adopted the noise converter to their breakers and by the end of the year orders have been placed in the London Area alone of upwards of 1100 for these noise converters. At the request of manufacturers, your Chief Public Health Inspector has visited the works of three firms where hammers and compressors are made,to advise them as to the best way of ridding their hammers of unnecessary and irritating noise. In connection with this, visits have been made to Glasgow, Gloucester and Bristol and arrangements are already being made for conferences and demonstrations to be held both in Gloucester and Bristol early in the coming year. It also is interesting to note that several local authorities have followed Shoreditch's example of inserting a clause in contracts to the effect that no pneumatic road breaker shall be used within the Borough unless equipped with an effective silencing arrangement, and also that the hours of operation are limited except in cases of emergency. Many local authorities are following the work being done by Shoreditch with interest. The main object of research and investigation has not as yet been achieved, but progress has been so marked during the year that it is confidently hoped that in the near future the Department will be able to recommend a standard of noise from pneumatic road breakers both acceptable to all the makers and users of pneumatic hammers and to the local authorities. It is with gratitude one must acknowledge the invaluable assistance afforded to the department by both the Building Research Station and the Scientific Branch of the London County Council and it is most encouraging to know that the full blessing of both these establishments'has been given to the policy of converting the annoying and high frequency sounds (those responsible for annoyance and irritation) into the more acceptable low frequency, sounds, and confirming, that it is upon 'Speech interferences levels' of sound that standards should be based, as opposed to the overall decibel measurement of noise. One can never assess a Noise Nuisance by overall decibel measurements alone. It is essential to employ octave band analysis if one is to be able to discover and either eliminate or reduce those mid-frequency sounds, which are usually responsible for noise nuisance. 27. FOOD & DRUGS ADMINISTRATION INTRODUCTION 'Change' has become an accepted feature of our every day life, and has inevitably made itself evident in our food and eating habits. The main policy employed for the past few years by the Staff of the Food & Drugs Section has been to instil into food handlers the need to adopt every effort to avoid the introduction of dirt of any kind into our food supplies as it could be the means of transmitting disease-carrying microorganisms, certain strains of which are known to be heat resistant, to those commodities which the ordinary person believes to be rendered harmless by cooking. Now, as a result of 'change' we are confronted with an additional approach to the problem of safeguarding the food supplies. The pointer has moved again in the direction of the manufacturer, in that 'additions' are being made to commodities in the form of emulsifiers, stabilisers, antioxidants etc. Whilst no doubt serving a useful purpose they do nevertheless change the composition of the food. To advertise the commodity as being easier to spread does not necessarily mean that it will be anymore wholesome because of it. One of the important factors in relation to the protection of food supplies is that which is afforded by the administration of those sections of legislation governing food, intelligently applied in the correct perspective; this factor is also applicable in relation to drugs. The implementation of requirements under the Food & Drugs Act has taken on a somewhat different interpretation 'not of the nature, substance or quality demanded ' is still one of the most appropriate phrases in connection with food and the Section of the Act in which it appears is the most adaptable. Whilst there have been instances reported during the year which could be classified under this heading, no major issue involving legal action has materialised. The growth of 'change' has extended to involve the taste for continental dishes necessitating the importation of a variety of foods which demand a watchful eye being kept on certain commodities not only for fitness for human consumption but also conformity to our required legislative standards. Co-operation with importing companies has been on the best of relations and where, following examination, certain commodities have been found not to conform to required standards, specific treatment has been advised, and on one occasion re-exportation recommended and acted upon. Local authorities are responsible for the administration of certain legislation in connection with drugs and it would be very remiss not to mention 'DRUGS' when alluding to 'change'. One of the objects of sampling in this field is to be able to arrive at certain conclusions relative to the strength and purity of the drug. The control of the concoctions that are available over the chemists 28. FOOD & DRUGS ADMINISTRATION (Contd.) counter these days is very complex and leaves much to be desired. There are some compounds which contain mixtures of new drugs or constituents for which no method of analysis is known, and the cost involved in completing the laboratory examination is far in excess of the regular amount allocated per sample. Careful handling is required until the problem is resolved at national level. New Legislation The Emulsifiers and Stabilisers in Food Regulations 1962 Part 2 of Regulation 5, regulation 6 and the 2nd schedule became operative on 14th January 1963, prohibiting the sale of permitted emulsifiers or permitted stabilisers unless in containers bearing labels on which is printed a true statement of the chemical nature of the contents, and regulation 6 prohibits advertising or the use of any display which could be said to be ambiguous or misleading in character. The Ice Cream (Heat Treatment) (Amendment) Regulation 1963 These regulations became operative on the 18th June 1963 and amend the principal regulation of 1959 to allow the addition of sugar to sterilised or pasteurised mixtures used in the manufacturer of ice cream. Egg Products As a result of a confidential communication from the Ministry of Health concerning the bacterial contamination of three specific consignments of Chinese frozen whole eggs, it was decided to investigate the 9 bakeries within the Borough to determine the kind of egg products used therein, and to take samples for bacteriological examination. Two of them used only English shell eggs, three others used 'Lion' brand B.E.M.B. frozen whole eggs, two more used Australian frozen whole eggs, and the remaining two used an Israel frozen whole egg. In addition to these products it was discovered that a Chinese egg albumen was used in one of the bakeries and a Polish dried egg product was used in another. All egg products except the shell eggs were sampled and submitted for bacteriological examination. Laboratory reports showed that no organisms of Salmonella group were isolated in any of the samples. Regular routine visits have been made during the year to ascertain any changes in commodities used. Shell Fish The popularity of shell fish meals at the weekend justifies sampling for laboratory examination, and it can be stated that all samples taken were very favourably reported upon by the bacteriologist. Milk Whilst the total number of milk samples taken this year shows a slight decrease, it will be noted that the numbers in relation to schools and vending 29. FOOD & DRUGS ADMINISTRATION (Contd.) machines show an increase. This is in line with the policy decided upon as being the places where sampling procedure can best serve its purpose for obvious reasons. Of all the samples taken only one school milk was reported as failing one of the bacteriological tests applied to it. Complete investigation into the cause was not possible, but repeat samples satisfied all the tests. General Schools Vending Machines Totals Chemical 20 5 14 39 Bacteriological 13 16 9 38 33 21 23 77 (1962) (67) (13) (5) (85) Milk (Special Designation) Regulations 1960 Licences under the above Regulations issued during the year were as follows:- Pasteurised Sterilised (TT) Pas. TT New Licences 2 3 2 - Transfers 3 2 2 - Total 5 5 4 - Ice Cream The introduction of soft ice cream was thought to present doubts in connection with the bacteriological control of the commodity, and in fact certain strict measures are necessary to ensure that the standard does not drop below recognised levels. A break down of the ice cream sampling into types of ice cream enables the results to be presented more clearly. It will be observed that ready mixed ice cream, supplied chiefly to cafes in the gallon cans, lends itself more readily to contamination by micro organisms. Investigations have shown that certain contributory factors are instrumental in creating this situation. Wherever practices were found that could contribute to possible contamination of the commodity they have been deprecated and advised against. Bact. samples of soft ice cream 1 - Grade I 6 - " 11 1 - " 111 8 30. FOOD & DRUGS ADMINISTRATION (Contd.) Ready mixed ice cream 7 - Grade 1 2 - " 11 2 - " 111 13 - " IV Ice cream 5 - Grade II During a period when it was considered prudent, a series of observations were conducted "between the hours of 7 p.-nu and 9.30.Pm. in connection with the systems of trading and methods of sale of ice cream from mobile vending vans operating within the Borough, The general standard of cleanliness was reported upon as satisfactory and in every case the person in charge of the vehicle was aware of the requirements under the Food Hygiene Regulations and Noise Abatement Act. It was found necessary in a few instances to issue verbal warnings to van operators who were heard to be sounding their chimes outside the permitted period. One prosecution was taken and the offender was fined the sum of £5 plus £2 costs- Drugs Drag sampling presents a difficulty which is increasing in intensity. Concoctions are displayed on chemist's counters and can be purchased by anybody. Although the ingredients are declared on the label, some drugs are compounded from ingredients which cannot be separated once they are mixed, so to prove their presence in the stated amount by analysis is quite impossiblej and where an analysis can be completed, the expense incurred is sometimes out of all proportion and does not justify the end,. A workable system of control in relation to the sale of drugs which will ensure safety for the consumer is long overdue. Food Hygiene The implementation of such of the basic principles as are considered to serve the best interests of food hygiene in general, namelys regular routine visits and public health education by personal contact, has shown that the trend of hygiene in premises within the Borough frequented by members of the public has continued to be towards higher standards. Even where it is realised that there still exist premises which are sub-standard - the reasons being found in proposed spheres of major 31. FOOD & DRUGS ADMINISTRATION (Contd.) development - the standard of cleanliness can be reported as having shown an improvement. Public Health education plays such an important role today that its results are instrumental in dictating the policy of proprietors of cafes. The general public have come to expect a higher standard of service and competition is so keen that hygiene was bound to be included in the "race". Those establishments where standards are low leave the proprietor no alternative, if he wishes to remain in business, but to effect such alterations as will attract customers; this has been evident again this year in three instances where improvements have been carried out far in excess of anything that could be required on a Food Hygiene Regulation notice. It is gratifying to report a noticeable decline in instances of employees of food premises and food stalls found to be smoking whilst handling open food. It has been necessary to issue verbal warnings in a few border-line cases, and the police prosecuted two offenders for committing offences, both of which occurred outside the normal hours of duty operated by the inspectorate of the Food & Drug section. Markets Owing to the conditions in the street markets showing a tendency to fall below the recognised standard of good hygiene practice, it was felt necessary to draw the attention of food stall holders in particular, to their obligations under certain legislation. A circular letter was delivered to each food stall holder pointing out the need to repair certain omissions and to endeavour to improve the standard of street trading generally to the benefit of everybody. The correspondence was quite well received and being followed by a communication on similar lines from their own Association, it is hoped that improvements will materialise. 32. FOOD & DRUGS ADMINISTRATION (Contd.) Routine Inspections There are 921 types of food businesses and food stalls in Shoreditch designated as follows:- Cafes and Restaurants 102 Dining Clubs & School Meals Service 27 Factory & Warehouse Canteens 75 Ice Cream Shops 122- Butchers Shops and Stalls 48 Milk Shops and Depots 72 Fried Fish Shops 9 Wet Fish Shops 6 Bakers 16 Food Warehouses 18 Grocery & Provision Shops 88 Confectioners' Shops 84 Public Houses 108 Food Stalls 92 Coffee Stall 1 Greengrocers 30 Chemists 17 Off Licences 6 The number of routine Inspections made to all premises in the Borough which are in any way connected with the preparation, distribution, handling, storage, or sale of food were as follows:- Basic routine inspections made 2654 Re-inspections made 629 Total number of inspections 3283 53. FOOD & DRUGS ADMINISTRATION (Contd.) Sampling of foodstuffs for Chemical examination. 307 samples were submitted to the Public Analyst for chemical analysis during 1963. Details are as follows:- Almonds, ground 1 Lard 21 Aspirin tablets 2 Lemon Curd 1 Bread 1 Margarine 3 Breadcrumbs 1 Marmalade 1 Bread mixture 1 Marzipan 4 Bread and butter 1 Meat paste 1 Butter 6 Meat products 3 Camphorated Oil 1 Meat Products, canned 10 Cascara tablets 1 Medicines, proprietary 8 Cheese spread 2 Milk 39 Codeine Linctus I Milk, dried 2 Codeine tablets 1 Mincemeat 1 Coffee extract 6 Pastilles 5 Colouring matter 6 Peel, candied 2 Confectionery, sugar 3 Petroleum jelly 1 Cream (sterilised) 8 Pholcodine Linctus 1 Curry powder 4 Rennet, essence 1 Drinks, Soft 14 Rum 1 Fish paste 7 Saccharin tablets 6 Flavouring essence 8 Sauce 1 Flour 1 Sausages 51 Friars Balsam 1 Soup, canned 2 Fruit, canned 2 Spices 7 Fruit, dried 8 Suet, shredded 1 Fruit, glace 1 Sweetening compound 1 Fruit Concentrates 2 Tea 1 Gelatine 1 Toothache tincture 1 Gin 3 Vegetables, dried 5 Ginger, ground 1 Vinegar (malt) 3 Ice Cream 10 Vinegar imitation 8 Jam 2 Whisky 3 Jelly, tablet 2 Wine Alcoholic 3 34. FOOD & DRUGS ADMINISTRATION (Contd.) SAMPLING Random sampling having been proved to be of very little purpose, the policy this year has been directed along systematic lines from which helpful conclusions could be arrived at. Certain commodities have been scheduled for "sampling series", records of results to be kept, which will enable suitable comparisons to be made-thus stimulating interest in food compositions. Sausages Although a meat product not subject to any specific legislative standard, it is generally recognised that a beef sausage should contain a minimum of 5$ meat and a pork sausage 65$^ meat It was decided to discover by a series of samples what standard of meat content was being maintained in the sausages offered for sale in Shoreditch with the following results. A total coverage of 51 samples were taken, divided into 29 pork and 22 beef and only 6 samples of sausages were reported upon in unfavourable terms. The makers were informed and advised to check their ingredient weights; repeat samples were found to conform to the accepted standards. Lard A series of samples of a particular commodity which was operated during the year, after interchange of correspondence with importing companies, had its finality in agreement on all sides. The particular commodity was lard for which there is no legal standard as such, but the composition of which is governed by The Antioxidants in Food Regulations 1958 allowing the presence of c ertain antioxidants within prescribed limits in lard} this then brings the commodity within the venue of The Labelling of Foods Order 1953 requiring that each of the ingredients of a prepacked food for sale by retail shall be declared on the label. Twenty-one samples of different brands of lard from 4 different countries were taken and submitted for chemical analysis. Eleven samples were found upon laboratory examination not to conform to the requirements of The Labelling of Food Order 1953 in that the commodities contained antioxidants not declared on the label. The letters sent to the offending companies were at first received with certain doubts as to the veracity of the alleged offence, but when the Lard Association accepted Counsel's ruling that an offence was being committed, all companies rectified their omission. 35. FOOD & DRUGS ADMINISTRATION (Contd,) Details of Unsound Food., No instance occurred during 1963 which required seizure of unfit food. All food found upon inspection to "be unfit for human consumption was voluntarily surrendered. Certain commodities were allowed to go forward for technical processes under guarantee that no portion would "be used for any other purpose whatsoever. Herewith is a list of surrendered unsound foodstuffs:- Apples 14 cans, Apricot Pulp 20 lbs, , Asparagus 12 tins, Bacon 36 cwt 1 qr 9 lb 4 oz, Beans 99 tins, Blackberries 227 tins, Blackcurrants 13 lb 4 oz, Brisling 2 tins, Blackcurrant Syrup 4 jars, Carrots 8 tins, Cherry Syrup 174 jars. Chicken 104 tins, Condensed Milk 1 tin, Corned Beef 75 tins, Corned Mutton 4 tins, Cream 1 tin, Creamed Rice 116 tins, Cucumbers 617 jars, 303 cartons, 477 barrels, Evaporated Milk 11 tins, Frankfurters 105 tins, Fruit Cocktail 3 tins, Fruit tinned 459 tins, Gherkins 140 jars, Goulash 55 cans, Ham 7 cwt 3 ars 14 lb 5 oz. Ham tinned 36 tins, Herring Roes 10 tins, Horseradish Sauce 3 tubes. Hot Dog Sausages 1 lb 4 oz, Irish Stew 1 tin. Jellied Veal 13 tins, Jam 936 jars, Liver Paste 2 lb 4 oz, Liver Sausage 61 cwt 1 qr 27 lb 13 oz, Luncheon Meat 53 tins, Minced Steak 39 tins, Mincemeat 21 lbs, Mixed Salad 19 jars. Mustard 3s" oz, Ox Liver 1 cwt 2 qrs 17 lb 8 oz, Ox Tongue 25 tins, Paprika 62 tins, Pate Truffle 2 lb 7s" oz. Peas garden 3 tins, Peas processed 8 tins. Pigs Liver 24 lbs, Pilchards 7 tins, Pineapples 20 tins, Pineapple Juice 1 tin, Plums 434 tins, 75 cwt 3 qrs 9 lbs 4oz, Pork 1 cwt 0 qrs 18 lbs 4 oz, Pork Brawn 6 tins, Pork Kidneys 8 tins, Potato Salad 2 lbs, Prunes 31 lbs 8 oz, Rabbits Chinese 45 lbs, Raspberry Syrup 61 jars, Salmon 11 tins, Sardines 4 tins, Sauerkraut 1O48 jars, 74 barrels Sausage Rolls 4, Spaghetti 10 tins, Spam 2 tins, Sprats 10½ oz, Steak & Kidney Pie 15s oz, Stewed Steak 14 tins, Stuffed Cabbage 60 jars, Tomatoes 600 grms, 293 tins. Tomato Ketchup 13 oz, Tomato Paste 121 tins, 96 tubes, Tomato Puree 6 lbs, Tripes 25 jars. Pharmacy & Poisons Act, 1933 Thirty one licences under the above Act were renewed during the year. Regular observations and routine visits were made to shops and stalls for unauthorised sellers. Pharmacy & Medicines Act, 1941. Observations were kept in connection with the requirements under the above Act but no contraventions were noted during the year. 36. FOOD & DRUGS ADMINISTRATION (Contd.) Merchandise Marks Act, 1926. There were no contraventions of the above Act during the year and strict observation was kept of all food premises and stalls in the Borough in relation to this subject. Food Complaints. Taking into consideration the vast quantity and variety of food that is now available, the number of complaints received at the office from members of the public represents a negligible percentage. Nevertheless, they do reveal in certain significances, inspite of automation and mechanisation the human element is still the most important factor to be reckoned with. The cause of the complaint in the majority of cases, when investigated, indicates that the product has not necessarily been rendered injurious to health, but the laxity on the part of somebody in some form or other has been responsible for either the condition of the product or for the presence of the foreign matter in the product. During the course of investigations, certain recommendations have been made to obviate the possibility of recurrence of such complaints, and attention has been directed to the cleanliness of those parts of the machinery which could have been instrumental in causing the complaint. Complaint Result of action taken Mouldy condition of sausage roll. Investigations revealed that errors of judgement on all sides were the causeo The Company concerned undertook to institute necessary disciplinary measures to prevent recurrence. Mouldy condition of Pork pie. Conflicting reports confused the issue of purchase date. The Company was sent a letter pointing out the advisability of correct date coding. Foreign substance adhering to inside of milk bottle. Failure of human element to detect unsatisfactory condition of bottle - No damage to milk. Letter of reprimand to Company. Foreign substance in loaf of bread. Proved to be dirty aggregate of vegetable and mineral fragments - Bakehouse in general is kept clean. Letter sent to Company - assurance given to attend to possible sources of contamination. 37. FOOD & DRUGS ADMINISTRATION (Contd.) Complaint Result of action taken Suspected unfit condition of contents of packet of milk food Abnormal smell and taste confirmed by laboratory examination - thorough'investigation by Company failed to reach decision as to possible cause - Repeat sample of milk food from same batch proved satisfactory - deduced that contents of packet became tainted after purchase. Mouldy condition of Sliced bread. Investigation pointed in direction of bread being insufficiently cooled before slicing and wrapping. Strong letter of protest to bakery Company. Foreign substances in Farm-House loaf. Foreign substance proved to be small piece of burnt fat and flour, quite harmless - Letter sent to bakery Company. Foreign matter in Brown loaf. Harmless substance of burnt caked dough. Bakehouse maintained in clean condition generally. Letter sent to Company directing attention to possible sources of contamination. Insect in can of Pineapple Slices Importers of this South African product could offer no explanation, but gave assurance that they would take the matter up with Cannery Company Mouldy condition of meat pie« Result of investigations indicated that error of judgement had been committed by one of the parties concerned - it was considered advisable to send a warning letter to shop-keeper and"copy tto manufacturer. Mouldy condition of Brown loaf. Bread was probably wrapped before cool accelerating growth of mould - Letter of protest sent to company. Foreign substance in scone. Microscopic examination of 'foreign substance' proved that it consisted of 'dirty dough' interwoven with fibrous material. Strong censure to bakery company. Suspected condition of special bread. No known germs inhabit bread that would cause conditions reported - no further action. Peculiar taste to orange drink. Laboratory reported traces of iron in excess of accepted amount - investigations found thatminor defects in lining of chums was possible cause of contamination suspected churns with drawn from service - repeat samples proved satisfactory - Letter to company directing that periodical samples be taken for chemical analysis. 38 ATMOSPHERIC POLLUTION Smoke Control Areas This has been a decisive year in this Council's Smoke Control Programme. The Shoreditch (Kingsland and Hoxton) Smoke Control Order was confirmed on the 26th April, 1963 and became operative on the 1st November 1963. An objection to this Order was lodged with' the Minister and concerned the price of smokeless fuels but was later withdrawn when it became known that the Council were equally concerned about this matter. I have written a separate paragraph which sets out the Council's views and policies relating to the price and availability of smokeless fuels. The Shoreditch (Haggerston) Smoke Control Order was confirmed on the 11th December 1963, and will become operative as from the 1st September 1964. This is in step with my previous report to you and it is expected to complete the Smoke Control Programme by 1965. Details of the numbers of applications received this year for adaptations and replacement of fireplaces together with the number of conversions completed are given below:- 808 applications approved in respect of 908 fireplaces. Number of conversions completed 402. Two thirds of the Borough is now covered by operative smoke control areas and the attitude of the occupiers is very encouraging and keener appreciation, of clean air is now much more frequently expressed. Again I have to report that the only complaints are with regard to the availability and the price of the premium smokeless fuels. Winter Conditions The months of January and February this year will readily be remembered for their abnormally severe weather conditions. The scarcity of solid fuel and the difficulty in securing its distribution then became apparent and early in February 840 questionnaires were delivered to homes in the Pitfield and Wenlock Smoke Control'Areas to find out the difficulties being experienced,, Some 341 replies were completed and'returned and of this number 119 occupiers were using electricity, gas or oil leaving 222 relying on solid, fuel. The following information abstracted from the returns indicates some essential factors governing the operation of Smoke Control Areas generally and during the severe winter. 39 No, 1. Shoreditch (Hyde Road) S.C.O. Operative 1st September, 1959 No. 2. Shoreditch (Pitfield) S.C.O. Operative 1st June, 1962 No, Shoreditch (Wenlock) S.C.O, Operative 1st September, 1962 No. 4 & 5 Shoreditch (Kingsla.nd & Hoxton.) S.C.O. Operative 1st November, 1963# 40 4U 1)ffl That slightly over 50% were buying prepacked fuel. 2). Slightly over 50% had. storage capacity of 3 cwts. or less of smokeless fuel. 3). Choice of fuels Cleanglow Gloco Coalite Others Total 185 49 17 4 255 * Some indicated, two fuels. Smoke Observations During the winter months last year observations were made in the Smoke Control Areas, and chimneys emitting smoke were noted and the cause investigated. In some blocks of flats the tracing of these guilty chimneys to the particular offending occupier proved a lengthy operation, For example, some blocks of flats have chimney stacks without pots containing up to a dozen flues and it is seme times virtually impossible to establish from which flue the smoke is being emitted. Generally the difficulty of finding somebody at home to answer the door is another obstacle to this work and on average only 50% of the calls are effective. The Clean Air Act 1956 does not provide a right of access to a private dwelling house for the purpose of ascertaining whether coal is being burned on the grate and this is surely an omission which should be remedied. I have enlarged on the difficulties encountered in enforcement and I would like to add that generally there is a lot of goodwill and co-operation existing between the Public and the Department, Rise in price of solid fuel A very informative table of prices is given showing the rise in cost of solid fuels in the last thirteen months:- Price at December 1962 per cwt. Price at January I964 per cwt. Rise in Price per cwt. Cabinet coal ll/lld. 12/5d. 6d. Stirling Coal lO/lOd. ll/4d. 6d. Excelite lO/lOd. ll/4d. 6d. Sunbrite ll/lOd. 12/ 8d. lOd. Gloco 12/lld. 14/2d. l/3d. Coalite 14/ 7d. 15/7d. l/Od. Cleanglow 14/l1d. l6/6d. l/7d. Phurnacite 16/lld. 17/5d. 6d. 41 This very noticeable increase in the price of premium smokeless fuels is of very great concern to me as it is undoubtedly exerting an influence on the operation of the Smote Control Orders and adding to the difficulty of maintaining complete enforcement. Fuel Delivery in the Borough Resulting from the rebuilding of Shoreditch two thirds of its population are now living in Council flats and have severely limited storage space for solid smokeless fuel. The borough has a high proportion of elderly people and generally speaking solid fuel is ordered in small quantities no more than 1 cwt. or 2 cwts. at a time because of the limited storage facilities. The larger merchants do not handle much business in the Borough as these circumstances tend to make business uneconomical. An adequate service to all is difficult to maintain and there are complaints of delivery men refusing to hump fuel above the first floor of blocks of flats even when sufficient supplies are available. The Public Health Department became aware of these difficulties and recommended the Council to consider establishing a policy of siting automatic vending machines on convenient sites to enable occupiers, (particularly those living in upper flats) to obtain small quantities of solid fuel at reasonable prices. Our experience has been that prepacked fuel sold from retail shops in small quantities ha.s been available but usually at a prohibitive cost. The Council made a recommendation to the Metropolitan Boroughs Standing Joint Committee to the effect that unless distributors fulfilled their obligations of maintaining satisfactory delivery of solid fuel, local authorities should be empowered to undertake this function. Atmospheric Pollution from heavy vehicles. The very useful work carried out in previous years of writing to owners of vehicles which emit an undue amount of smoke has I regret to say, been cut to a trickle this year. Unfortunately this is being brought about by the financial provisions of the Road Vehicles (Registration and Licensing) (Amendment) (No. 2) Regulations 1962 which has increased the search fee from l/-d to 5/-d. Surely Councils endeavouring to reduce the level of pollution caused by vehicles passing through their area should not be required to pay such fees. 42 Smoke Pollution Daily measurements of the quantity of smoke and sulphur dioxide in the air are. recorded by the Volumetric apparatus installed in the Town Hall. The monthly averages of the quantity of the smoke is given in the graph for the two years 1962-1963 and they show fairly close proximity to each other. It is interesting to note that in this "busy manufacturing Borough the level of smoke pollution compares favourably with the other London and Greater London Boroughs The low summer figures are very satisfactory. The measuring apparatus at the Town Hall is not present included in a Smoke Control Area and the effect of this will' not "be known until 1965. 43 Sulphur Dioxide Pollution The monthly averages of the quantity of sulphur dioxide in the air are given on the graph for the years 1962 and 1963 and again the general pattern for the 2 years is similar. However the general level of sulphur dioxide pollution is rather above average in comparison with other London and Greater London areas. The Clean Air Act is dealing effectively with smoke pollution "but does nothing to help the removal of this very corrosive invisible pollutant. This is an important subject which demands greater scientific effort in order to bring about a reduction in this cause of atmospheric pollution. 44 HOUSING Details of Redevelopment Work carried out during 1963. 11 Clearance Areas were resolved involving 339 premises 3 Compulsory Purchase Orders were confirmed involving 105 premises 1 Demolition Order was made 1 Closing Order was made 31 Undertakings not to re-let until premises were made fit, were accepted. 382 Premises were demolished. 356 New flats were completed. 1244 New flats were in course of erection 94 Routine inspections under Section 3, Housing Act, 1957. Loans and Grants. 4 Applications for Standard Improvement Grants were received and approved. 2 Applications for Discretionary Improvement Grants were received and approved. Underground Rooms During 1963 representations were made to the Public Health Committee resulting in - 2 Closing Orders being made 3 Undertakings being accepted not to re-let until premises rendered I fit. Derelict sites Derelict sites throughout the Borough still present many problems but gradually are disappearing as new buildings take their place. Their value as parking places for cars, now that parking meters are in operation in Shoreditch, has greatly increased and this automatically results in keeping many sites presentable which would otherwise develop into refuse dumps. Drainage plans All drainage plans submitted to the local authority are perused by the Public Health Inspectorsbefore they are submitted to the appropriate committee for approval® During the year 99 plans were perused and numerous interviews have taken place with architects, builders, owners and others concerned in the works involved. Overcrowding and Preferential Treatment At the end of 1962 the number of overcrowded cases on the Public Health Departmental Register was 35 and "the number of cases on the Register 45 HOUSING, (continued) . Overcrowding and Preferential Treatment (continued). for Preferential Treatment on medical grounds was 14. During the year 3 cases of families living in overcrowded conditions were found and added to the Register, and a survey of all premises on the Register revealed that 11 families had been rehoused or had found alternative accommodation themselves. 6 cases were removed from the Preferential Treatment Register. The number of cases remaining on the Overcrowding Register at the end of the year therefore was 47, the number remaining on the Preferential Treatment Register being 8. 22 visits of inspection were made. Rent Act 1957 1 application was received during the year under the Rent Act 1957 Housing Repairs & Rents Act 1954 No applications were made to the local authority under the Housing Repairs & Rents Act 1954 during the year. Housing Act I96I Houses let in multiple occupation do not represent a major problem in this Borough, and in implementing this work regard has been had. to the Ministry's Circular No. 3/62 in which the Minister advised that only houses of a squalid nature which are let in multiple occupation should receive attention for the time being, although plans should be made as to the future survey of houses let in multiple occupation which do not come in this category. During the year 2 houses let in multiple occupation have been dealt with successfully by the Department, and again following the Minister's requirements that every effort should be made to effect improvement without resort to Statutory Action, in each of these premises a full measure of success has been achieved by informal action. Already negotiations have taken place with several owners of properties in the Borough with a view to providing proper amenities and facilities in houses let in multiple occupation which are not in a squalid condition. 46 PREVENTION OF DAMAGE BY PESTS ACT 1949 RODENTS Complete eradication of rats in the sewers of Shoreditch is our aim, and whilst in previous Annual Reports we have referred to the term 'Rodent Control', success in the complete eradication of rats from drainage systems in limited areas within the Borough ' has convinced us that there is no reason why we should not gain equal success over the whole Borough. The result of the policy adopted during the year has produced success far beyond our wildest hopes, and at the end of 1963, 88% of all manholes and side entrances to sewers proved to be free from rats. The valuable assistance afforded to this Department by the Officers of the Ministry of Agriculture, Fisheries and Food is to be highly commended and we very much appreciate the encouragement given to us by them in this new venture. The whole campaign conducted as a military operation was organised as follows:- A persistent battle is being waged against the invasion of rats into the Borough at al 1 points where sewers enter or leave the Borough boundary. At the same time, a mopping up within the boundary is carried out. This briefly is the method in which the campaign is being"conducted, but no campaign could be successful unless breeding grounds within the perimeter of the Borough are abolished. The breeding grounds to which we refer are disused drains connected to the sewers, for it is here that rats breed and multiply and these must be destroyed and abolished, otherwise the whole campaign would be futile. Make no mistake this does not mean a reduction in the work of the Rodent Section of the Department, on the contrary it has made a considerable increase in the amount of labour involved in the preparing of drainage plans of premises in Clearance Areas whilst in occupation and before demolition takes place, and in the supervision of the effective sealing of these drains at the junction of the sewer when demolition takes place. Surely this positive action in preventing rats from establishing themselves in the sewers is more profitable than the negative approach of ignoring the attack at the source and dealing with them after infestation has become well established. The poison used is sodium-fluoracetemide as recommended by the Ministry, and it is used in the following manners:- 47 All manholes and side entrances to sewers entering and leaving the Borough are persistently "baited every two to three weeks so that poison baits are maintained at all times at these vital points. All manholes and side entrances within the perimeter of the Borough have "been "baited once a month for three months and then pre-baiting carried out to detennine the results achieved,, It is worth repeating that Q&fo of manholes and side entrances are already clear of rats and we have therefore devoted our attention to the monthly baiting of the remaining manholes and .side entrances and this will continue monthly until all indicate negative 'takes'. When this becomes apparent all manholes and side entrances throughout the Borough will be baited and the results observed. Then we shall be able to estimate the success of our enterprise. One would like to be able to report favourably on the situation so far as the mouse is concerned. Unfortunately this cannot be done, for although good work has been done towards the elimination of the mouse it must be recognised that this presents a very different problem. In the case of the mouse, resistance to poison is sometimes much greater than that of the rat, and it is also less predictable in its feeding habits and general behaviour than the larger rodents.. Research is stilly progressing, and it is to be hoped that the time-ds not too far distant when the mouse will be 'contained' as effectively as the rat. The presence of the mouse in factory and commercial premises is still a matter for concern and at the end of the year contracts were operative in respect of 74 premises, yielding an income of £1,569 per annum. 28 single treatments were carried out yielding £206. The Revealer The invaluable assistance afforded by the application of this instrument has resulted in a very big reduction in expenditure in discovering disused drains and enabled labour previously employed in discovering disused drains by •hit and miss' methods to be employed in other directions. It is considered that this instrument is one of the best investments made by the Department,, 48 REPORT FOR PERIOD 1st JANUARY - 31st DECEMBER 1963. Council Property Dwelling Houses Business Premises Total No. of Properties in Borough 16 12,031 3,480 15,527 No. of properties inspected as a result of (a) Notification 1 135 50 186 (b) Survey under the Act - 37 662 699 (c) Otherwise - 236 126 362 Total inspections carried out 52 1,794 4,795 6,641 No. of properties inspected which were found to be infested by (a) Rats - Major - - - - Minor 1 28 22 51 (b) Mice - Major - - - - kMinor - 95 60 175 No. of infested properties treated by Local Authority 1 123 102 226 No. of notices served under Section 4 of the Act. (a) Treatment ) - - - — (b) Structural works) — - - - (i.e. Proofing) No. of cases where action was taken following service of Notice - - - - Legal Proceedings - - - - No. of block schemes carried out - 41 Details of treatment carried out are as follows - Business premises Dwellings Rats Mice Rats Mice Warfarin trays laid 135 295 202 526 Traps set 312 - 175 - 49 DISINFECTION AND DISINFESTATION. 28 rooms were disinfected following infectious diseases and for other reasons. 397 rooms were sprayed against vermin, 44 articles were disinfected at the Council's disinfecting station, following infectious diseases. 6387 verminous articles were treated at the Council's Disinfecting Station. No Notice was served in respect of verminous premises. 182 visits were made to premises, 18 in respect of infectious disease enquiries and 164 in respect of vermin. Articles belonging to private firms were disinfected at their request and charges amounting to £14 were made. During the year 318 families were removed to new Council dwellings as compared with 268 in 1962. All furniture is subjected to Hydrogen Cyanide disinfestation and all mattresses are put through the" Council's disinfector prior to removal to their new accommodation by private removal contractors under the supervision of the Officers of the Department. Prior to removal the Officers of the Department visit the premises, assess the amount of furniture to be removed, and arrange for the number of removal vans required. On the day of removal an Officer of the Department supervises the placing of all furniture in the vans and arranges for the reception of soft furniture in a room which can be securely locked until tests carried out to ensure that the furniture is clear of Hydrogen Cyanide have proved satisfactory. 12 sites were sprayed to prevent further nuisance from vermin and flies and at the request of the Public Health Inspectors 26 mattresses and other articles were removed for destruction by the Cleansing Department. The measures taken to prevent the breeding of beetles in heating ducts on new Local Authority Estates whilst in construction are a vital duty of the Public Health Inspectors. Personal Cleanliness. The arrangement with Finsbury Borough Council whereby residents of Shoreditch requiring treatment for Scabies or vermin, are sent to that Authority's Cleansing Station at Pine Street, was continued throughout the year. The number of treatments carried out are shown in the following tables:- 50 DISINFECTION AND DISINFESTATION (Contd.) Verminous Persons. New Cases Total new cases Re- attendances Total treatments 0 to 15 years Over 15 years - - - - - Scabies New Cases Total new cases Re- attendances Total treatments 0 to 15 years Over 15 years - 4 4 4 8 (Until school leaving age, the L. C. C. treat all affected children at their own Centre.) 51 FACTORIES (Factories Act 1937 to 1959) Number of Factories in Shoreditch 1031 Number of (a) Basic Routine Inspections made 1278 (b) Re-inspections made 694 Total number of inspections made 1972 Whilst the erection of many new factories, offices, garages and petrol filling stations continues in the Borough the numerous small factories, because of lack of accommodation, provide a very serious problem where nothing more than the bare requirements of facilities and amenities for the staff according to the Factories Acts can be provided. The problem of the retention of trade refuse and its disposal in such limited accommodation continues to present a real problem, particularly in Smoke Control Areas where for economic reasons of disposal and the provision of cheap space heating an attempt is made to dispose of these trade wastes in inefficient fireplaces and appliances. Particulars of the administration of the Factories Act 1937 in. the form required by Ministry of Health Circular 1/64 are as follows:- Part 1 of the Act Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (1) Factories in which Sections 1, 2 , 3, 4 & 6 are to be enforced by Local Authorities 207 67 5 - (ii) Factories not included in (i) in which Section 7 is enforccd by L. A. 824 1885 73 - (iii) Other premises in which Secction 7 is enforced by the (excluding Outworkers Premises) 10 20 - - Total 1041 1972 78 - % 52 2. Cases in which defects were found Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted. Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.1.) - - - - - Overcrowding (S.2) — — — - - Unreasonable temperature (S.3) — — — - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 1 1 — - - (b) Unsuitable or defective 96 95 6 9 - (c) Not suitable for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) - - - - - Total 97 96 6 9 - (a) Outworkers Number of outworkers in Shoreditch 250 Number of basic routine inspections made 180 58 Lists of outworkers were received from employers in the Borough 750 persons of whom 589 were not resident in Shoreditch were included in these lists 266 outworkers living in Shoreditch but working for firms outside the Borough were notified by 20 Local Authorities Again one must refer to the vast amount of what one considers to be unnecessary administrative work thrust upon the local authority Public Health Departments in respect of outworkers. One must again repeat, that if an obligation were placed on the firms responsible for supplying local authorities with lists of outworkers, to notify the several authorities in which their outworkers reside, it would be to everyone's advantage, and very much reduce the work of the clerical staff of local authorities. 53 Part VIII of the Act Outworkers Nature of Work Section 110 Section 111 No. of Outworkers in August list r'qd by Section 110 (l)(c) No. of cases of default in sending lists to Council No. of prosecutions for failure to supply No. of instances of work in unwholesome premises Notices served Prosecutions Wearing apparel (making, etc.) 360 - - - - - Artificial flowers 16 - - - - - Making of boxes 10 - - - - - Brush making 10 - - - - - Carding of buttons 42 - - - - - Leather goods 20 - - - - - Christmas crackers 8 - - - - - Envelope making 4 - - - - - Curtains, upholstery 8 - - - - - Total 478 - - - - - (b) Rag Flock premises Under the Rag Flock and Other Filling Materials Act 1951, the number of registered premises where filling materials were used at the end of 1963 was 114 and during the year 9 licences were issued in respect of premises where rag flock is manufactured or stored. (i) Number of basic routine visits made 62 (ii) Number of re-inspections made 4 (iii) Total number of inspections 66 All samples complied with prescribed standards. HAIRDRESSING ESTABLISHMENTS (London General Powers Act 1954) Total number of hairdressing establishments 57 Number of basic routine inspections 98 Number of re-inspections 47 Total number of inspections 145 Number of Notices - Hairdressing establishments in the Borough are kept extremely busy no doubt due to the great increase in daytime population and therefore the inspection of these premises is carried out most assiduously. SHOPS. (Shops Act 1950 and London General Powers Act 1958) Total number of shops, wholesale establishments and warehouses subject to the requirements of the Shops Act 1950 and London General Powers Act 1958, was 735. Number of basic routine visits made 2443 Number of re-inspections made 517 Total number of inspections made 2960 Number of notices served - During the year 1 application was made and 1 certificate of exemption was granted in respect of sanitary accommodation. PET ANIMALS ACT 1951 Six premises were licensed under this Act during the year. In 5 cases a considerable business is carried on, mostly in budgerigars and goldfish, but j the other one deals on a very small scale only, in pigeons. 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. 54 55 OFFENSIVE TRADES An establishment order under Section 140, Public Health (London) Act,1936, was renewed during the year in respect of the business of Fur Skin Dresser. The number of visits made was 4. WELLS There are 2 wells in use in the Borough. In 1 case the water is vised 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. PUBLIC SWIMMING BATHS Shoreditch has now only one swimming bath (indoor) built in 1904 situated in Whiston Road, Haggerston open all the year round for mixed bathing at all times. (Sunday swimming from May to September only). The pool is 100' long by 3' 5" wide constructed of blue and white glazed bricks, with a depth of 3' 4" at the shallow end, increasing gradually to 6' 4" at the deep end at which there is one 3 metre fixed diving stage and 3 lower fixed boards at each side. The surround is 3' wide, of non-slip tiles and seats rise in tiers from the surround up to the dressing cubicles at the back. The seats which are made of teak, also form clothes lockers for use by children during peak periods. Male and female toilets and foot-baths are situated at each side of the pool at the shallow end. Entry to the pool from the dressing cubicles is via the toilets and footbaths and into the pool by teak steps fitted at each corner. The pool has a capacity of 109,000 gallons continuously filtered through pressure sand filters at the rate of 20,000 gallons per hour, chlorinated and heated to a temperature of 74 degrees F. in winter. Chemical treatment of the pool is by Alumina Ferric and Sodium Carbonate. A chlorine content of 1.0 to 1.5 parts per million is maintained during trade, with a pH value of 7.6. Back washing of filters is done by air agitation of sand and washing through to waste by M. W. B. water from a main storage, tank. The pool is emptied and re-filled as conditions and analysis indicate. Cleaning of the pool sides and bottom is carried out every morning before opening and during the day as circumstances permit. During the year samples of water were taken from the bath and sent for Bacteriological examination and Chemical analysis. Results received from both laboratories showed the water to be satisfactory in every case. RAG DEALERS There are 2 premises in the Borough in which the business of Rag Dealer is carried out. 3 visits of inspection were made. WATER SUPPLY The water supply of the Borough is controlled by the M.W.B. and is relayed from public mains direct to premises. 56 PUBLIC HEALTH PROPAGANDA 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, in the Town Hall, and Public Libraries. There is also a large notice board situated in St. John's Churchyard. A rack containing leaflets of various type is kept filed, at the entrance to the Department, and in addition to this, Public Health leaflets have been distributed through the courtesy of the Borough Librarian and the Public Libraries. In-so-far as propaganda under the Clean Air Act is concerned, all occupiers and owners of properties have received information letters and booklets. Very wide publicity is being given to the requirements of the Clean Air Act, particularly those affecting Smoke Control Areas. All occupiers in proposed Smoke Control Areas and the owners of the properties have received relevant literature in this direction. Articles have been written and published in the "Newsletter" published monthly by the Council, but the main propaganda has been by direct verbal transmission in the kitchens of cafes and restaurants, factories, and offices, and all types of premises, for it is firmly believed that this type of propaganda. really carries a great deal of weight. A great deal of publicity of the work of the Public Health Department has been afforded through the medium of the Television Authorities, in the BBC's overseas programmes, in the National and local Press and in professional journals. ANTI-FLY CAMPAIGN The campaign to combat the fly nuisance has been continued. By arrangement and with the co-operation of the Cleansing & Transport Superintendent, all dust bins and dust chutes are dusted during the fly breeding season with gammexane after the receptacles are emptied by the Council's refuse collectors A full survey has been made of all refuse container compartments at the foot of dust chutes in local authority flats because of the rapidly changing nature of refuse as the Smoke Control Programme continues. Working in close harmony with the Borough Engineer, work of repair and improvement commenced to bring refuse container compartments up to the standard of the British Code of Practice No. 306 (1960). FREE WASHING FACILITIES Free washing facilities are installed in every public sanitary convenien in the Borough, but these are unfortunately not being used as much as we should like to see. PAID PUPILLAGE. Training of the three student Public Health Inspectors in the Department continued and of the two who sat for the examination, one qualified and was appointed as a P.H.I. but the other unfortunately was unsuccessful. The third student does not sit until 1964. 57 SANITARY CIRCUMSTANCES (tables) The following tables summarize the visits of inspection and the work of the Public Health Inspectors during 1963. INSPECTIONS & REINSPECTIONS Privately Owned Council Owned I RI I RI HOUSING ACTS House to House 91 13 3 - Individual houses 17 4 2 - Closure of whole house 4 - 1 - Closure of part of house 2 - - - Closure of underground rooms 3 - - - Houses let in lodgings 12 - - - Overcrowding 19 1 2 - Clearance Areas 14 3 3 - Improvement Grants 19 l - - Standard Grants 3 - - - PH(L) ACT Nuisances in dwellings 1282 1506 336 250 Nuisances in other premises 356 136 166 73 Construction drains - new bdgs 359 83 220 70 Reconstruction drains - other bdgs 436 112 37 12 Drains sealed off 32 44 192 55 Water Supplies 18 13 20 4 Verminous Premises (bugs, fleas, lice) 6 - 4 - Infectious disease 78 25 49 10 FOOD & DRUGS ACT Public Houses 139 45 5 - Canteens 16 4 - - Warehouses 34 122 3 2 Bakehouses 46 5 6 1 Food manufacturing premises 30 33 5 - CLEAN AIR ACT Dwellings 175 96 65 16 Factories 438 20 7 1 Offices & Commercial premises 87 10 13 3 Replacement/adaptation of fireplaces 625 1224 414 62 Observations - dwellings 14 7 11 - Observations - other premises 81 10 8 1 Observations - vehicles 2 6 4 - VARIOUS OTHER ACTS Shops Act 617 103 98 16 Rodents 95 11 141 5 Insect infestations 47 5 13 1 Pet Animals 9 - - - Rag Flock 62 4 - - Heating appliances 1 - - - Rag & bone dealer 3 - - - Pharmacy & Poisons 22 5 2 - Hairdressers 88 41 10 6 Outworkers 89 23 55 13 Factories - Power 1203 605 19 78 Factories - Non Power 55 11 1 - Vacant sites 50 6 46 2 Noise Abatement Act 103 6 17 1 TOTALS 6841 4343 1978 682 11,184 2,660 58 FOOD & DRUGS PREMISES SHOPS STALLS I RI I RI Poultry 9 3 9 - Groceries 351 103 51 2 Vegetables, fruit. 101 9 373 5 Milk 39 25 6 - Ice Cream 237 94 5 1 Cordials, etc. 1 1 1 - Sweets 205 13 22 1 Chemists 38 17 - - Cafes, etc. 372 76 7 2 Retail bakers 76 6 32 5 Butchers 228 45 40 - Fish fresh 33 1 49 - Fish fried 30 5 8 2 Fish shell 8 - 39 1 TOTALS 1728 398 642 19 2,126 661 Non-effective visits 1,648 SUMMARY OF DEFECTS REMEDIED. Private Council General repair of premises 67 12 Roofs, gutters, rainwater pipes repaired 138 17 Damp premises remedied 76 12 Windows repaired 143 7 Overcrowding abated 1 - Water reinstated 9 - Water supply provided 2 - Drains improved or repaired 13 2 Drain obstructions removed 27 22 Drains sealed off 44 382 Soil vent pipes repaired 1 - WCs repaired 96 28 Sink waste pipes repaired 9 3 Sink waste pipes cleared 4 6 Floors repaired 33 2 Dustbins renewed 8 1 Yard pavings repaired 2 - Accumulations of refuse removed 5 - Vacant sites cleared 12 - Nuisances from animals abated - - 59 NOTICES SERVED Public Health(London) Act, 1936 Intimation Notices 587 Nuisance Notices 67 Housing Act. 1957 - Factories Act, 1937 78 Shops Act, 1950 - Prevention of Damage by Pests Act, 1949 1 Clean Air Act,1956 - COMPLAINTS RECEIVED 1,448 HOUSING STATISTICS 1. INSPECTION OF DWELLING-HOUSES DURING THE YEAR (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 3,063 (b) Number of Inspections made for the purpose 5,168 (2) (a) Number of dwelling-houses(included under sub-head (l) above) which were inspected and recorded under Section 3, Housing Act, 1957 113 (b) Number of inspections made for the purpose 130 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 38 2. REMEDY OF DEFECTS DURING THE YEAR WITHOUT SERVICE OF NUISANCE NOTICES. Number of premises where it was found necessary to serve Intimation Notices under the Public Health (London) Act, 1936, to abate nuisances or remedy defects 587 3. ACTION UNDER STATUTORY POWERS DURING THE YEAR A. Proceedings under Public Health Acts:- (1) Number of dwelling-houses in respect of which nuisance notices were served requiring defects to be remedied 67 (2) Number of dwelling-houses in which defects were remedied after service of nuisance notices (a) by owners 50 (b) by local authority in default of owners 60 B. Proceedings under Section 9, 10 and 12 Housing Act 1957;- (1) Number of dwelling-houses in respect of which notices were served requiring repairs (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) by owners - (b) by local authority in default of owners - Go Proceedings under Sections 16 17 and 23 of the Housing Act 1957 (1) Number of dwelling-houses in respect of which Demolition Orders were made or Undertaking accepted 33 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 1 D. Proceedings under Section 18 of the Housing Act 1957. (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made or Undertaking accepted 5 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 1 E. Proceedings under Section 42 of the Housing Act, 1957. (1) Number of houses included in representations by Medical Officer of Health 5 (2) Number of houses demolished in pursuance of representations 4 4. HOUSING ACT. Part IV - OVERCROWDING (l) (a) Number of overcrowded families on register at beginning of year 55 (b) Number of new cases found during year 3 (c.) Number of cases rehoused or found other accommodation during year 11 (d) Number of overcrowded families on register at end of year 47 61 INDEX Aged - Care of 20 National Assistance Act- Anti-fly campaign 56 Section 47 11 Area of Borough 6 Section 50 11 Atmospheric pollution 38 Noise Abatement Act 1960 25 Bacteriological examinations 14 Offensive Trades 55 Birth rates 9 Old People's Clubs 20 Burials 11 Outworkers 52 Overcrowding 45 Cancer 10 Clearance Areas 44 Paid Pupillage 56 Committees- Personal Cleansing 49 Public Health 4 Pests Act, 1949 46 Borough Welfare 4 Pet Animals Act, 1951 54 Pharmacy & Poisons Act 35 Deaths, Causes of 8 Population 6 Death rates 9 Public Health Propaganda 56 Disinfection 49 Disinfestation 49 Rag Dealers 55 Drainage Inspection 44 Rag Flock Act, 1951 53 Rodent Control 46 Factories Acts, 1937-1959 51 Rent Act, 1957 45 Food Hygiene 30 Food Premises 32 Food Sampling 33 Sanitary Circumstances 22 Free washing Facilities 56 Shops Act, 1950 54 Social Welfare Services 20 Smoke Control Areas 38 Hairdressers 54 Staff 5 Health propaganda 56 Stillbirths 9 Heating Appliances (Fireguards) Act 54 Student P.H.I. 's 56 Swimming baths 55 Holiday Hotel 20 Housing 44 Housing Act, 1961 45 Tuberculosis 14 Tuberculosis Care Ctte 19 Ice Cream Sampling 29 Infantile mortality 10 Infectious diseases 12 Underground rooms 44 Unsound food 35 Marriages 9 Mass Miniature Radiography 17 Verminous persons 50 Maternal Mortality 10 Vital statistics 6 Milk Licences 29 Milk Sampling 29 Water supply 55 Water from wells 55