STE 44 Metropolitan Borough of Stepney ANNUAL REPORT (ABRIDGED) For the Year 1939 OF THE Medical Officer of Health AND Administrative Tuberculosis Officer F. R. O'SHIEL, L.R.C.P.I., L.M., D.P.H., TOGETHER WITH A SUMMARY OF THE REPORT OF THE PUBLIC ANALYST, 2 STAFF OF THE PUBLIC HEALTH DEPARTMENT on the 31st December, 1939. Medical Officer of Health and Administrative Tuberculosis Officer: F. Roantree O'Shiel, l.r.c.p.i., l.m., d.p.h. (Liverp.) Deputy and Assistant Medical Officer of Health : J. W. Crawford, m.d., m.b., b.ch., d.p.h. Public Analyst: D. Henville, f.i.c. Analytical Assistant: W. M. Paulley, b.a.. f.i.c. Sanitary Inspectors : District. W. E. Anstee. (1, 3) H. J. Green. (1, 2, 4) J. Keniry. (3) J. H. Brownlee. (1, 3, 4) (Temporarily in charge of S. S- Lowther. (3, 4) J. J. Coveney. (3, 4) disinfestation.) J. G. McCarthy. (3) W. Cue. (1, 3) C. F. Guy. (2) R. Roper. (3, 4) R. W. G. Day. ( 3) W. H. Haworth. (3) W. F. Smith. (2, 4) G. D. Freeland. (1, 3, 4) W. H. Howard. (1, 3) W T. Twynhw. (2) Food. H. Abson. (1, 2, 4) T. W. Dee (2, 4) A. C. Brown. (2, 4) S. Vogler. (3, 4) Other G. Bottomley. (1, 2, 4) Housing and Canal Boats. E. J. Edwards. (2. 4) In charge of disinfestation. (Seconded as Anti Gas Instructor for A.R.P.) +Miss H. A. Whitty. Disinfestation and Female Common (3, 4, 5, 6, 8) Lodging Houses. Clerical Staff : W. F. Lellow, Chief Clerk (2) R. Bach. W. E. Hart. H. F. Mayo. Miss G. Boulton. (m. & c.w.) Mrs. H. Hiles. (m. & c.w.) M. Pliskin. Miss G.A.Carthy. (m.&c.w.) W.P.Howard. B. C. Reilly. w. J. Dixon. Miss M. w. Hunt. (m. & c.w.) Miss P. Romaine.(m. & c.w.) S. Embleton. C. H. Lowry. E. P. Webber. (3) (4) Miss M. Fitzgerald. J. G. Lyons. (Temporary Sanitary . (m. & c.w.) J. McMullon. Inspector). P. Goldman. R. Mahoney Vaccination Officers : E. Price. (3) E. J. Robertson. Medical Officers for Maternity and Child Welfare (Part Time): Norah Cotter, m.b., b.ch. Margaret Emslie, m.b., Ch.b. Doris M. Pollen, m.b., Ch.b. Margaret Ward, m.b., cb.b., d.p.h. †Health Visitors : Miss M. Bailey. (5, 6, 7) Miss A. Clifford. (5, 6, 7) Miss A. M. Stagg. (5, 6, 7) ,. W. Brazier. (6, 7) „ A. M. Cordwell. (1, 6, 8) „ M. F. E. Styles. ,, A. Carty, (5, 6, 7) „ S. Foucak. (2, 5, 6, 7) (5, 6, 7) „ E. Clements. (5, 6) ,, A. E. Gibbs. (5, 6) Tuberculosis Officer: R. M. Orpwood, m.r.c.s., l.r.c.p., d.p.h. Assistant Tuberculosis Officer: (Post at present temporarily filled) Tuberculosis Visitors : Miss M. E. Francis. (5, 6, 7) Miss E. Lindsley. (7) „ M. C. Hurley. (5, 6, 7) „ M. F. Weatherilt. (5, 6, 7) Nurse Dispensers : Miss M. Coulman. (5, 6, 7, 9), Miss A. O. Jones. (7, 8, 9) Cleric and Secretary to Care Committee : Miss M. Grant. Cleric: Miss P. Goldsmith. Consulting Gynecologist : R. Christie-Brown, M.B., M.S., F.R.C.S. Dental Surgeon (part-time) : F. L. Payne, L.D.S. Ancesthetist (part-time): M. J-. O'Toole, m.b., b.ch., b.a.o. Diphtheria Immunisation: W. W. King-Brown, m.b., b.s. (lon.) Part time Mtdical Officer. Guy Bousfield, m.d., b.s. (lon.) Hon. Advisory Expert. 1. Certificate Ruyal San. Inst. 2. ,, San. Insp. Exam. Bd 3. ,, Royal San. Inst, and San. Insp. Exam. Joint Board. 4. ,, Meat and Other Foods † Also Child Protection Officers, 5. Health Visitors Certificate. 6. State Certificated Midwife. 7. State Registered Nurse. 8. Trained Nurse. 9. Certificate Soc of Apothecaries 3 Public Health Department, 43, White Horse Road, Stepney, E.l. May, 1940. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies and Gentlemen, I beg to present herewith my Annual Report for the year 1939. Owing to the declaration of war on 3rd September, 1939, and the consequent disturbance to the work of the Public Health Department, it has not been possible to present a full report as in other years. An abridged report is therefore presented to you. The population of the Borough as estimated by the Registrar General is approximately 197,200. Large numbers of families evacuated from the Borough during the year and especially after the outbreak of war. Accurate comparisons cannot therefore be made with previous years. The Infantile Mortality rate was 53.7 deaths per 1,000 live births, which is the lowest figure recorded in the Borough. The Maternal Mortality rate was 3.35 per 1,000 live and still births. The incidence of Infectious Disease was low throughout the year although including figures for the notification of measles and whooping cough both of which diseases were made fully notifiable in October, 1938. * * * * Dr. J. W. Crawford, the tuberculosis officer, was appointed Deputy Medical Officer of Health on 22nd February, and Dr. R. M. Orpwood, the assistant tuberculosis officer was appointed Tuberculosis Officer as from the 27th July. ***** On the outbreak of war none of the Council's Health Services was discontinued. The full staff of Sanitary Inspectors and Health Visitors was retained and the full number of Infant Welfare Centres, Ante-Natal Clinics and Diphtheria Immunisation Clinics continued. Stepney Green Branch Tuberculosis Dispensary was temporarily closed, but the full tuberculosis services continued at the main dispensary in Steels Lane, Devonport Street, Commercial Road. *** The organisation of the Casualty Services for Civil Defence placed additional duties on the staff of the Public Health Department, and all concerned shouldered these burdens and responsibilities with commendable willingness and efficiency. I desire to express my thanks once more to the Chairman and Members, of all Committees associated with the work of the Public Health Department, and to the members of the staff for their help and co-operation. I am, Your Worship, Ladies and Gentlemen, Your obedient servant, F. R. O'SHIEL, Medical Officer of Health, 4 SUMMARY OF STATISTICS, 1939. Area of Borough (in acres) 1902.766 Population (Registrar-General's estimate) (a) For Birth Rate 197,200 (b) For Death Rate 183,600 Number of inhabited houses (end of 1939) according to Rate Books 35,846 Rateable value, 31st December, 1939 £1,724,313 Sum represented by a penny rate £6,790 Total. Male. Female. Birth Rate per 1,000 of the estimated resident population 12.5 Live Births Legitimate 2,373 1,263 1,110 Illegitimate 93 46 Total Live Births 2,466 1,309 1,157 Still Births 79 48 31 Rate per 1,000 total (live and still) births 31.0 Total Births 2,545 1,357 1,188 Deaths 2,213 1,251 962 Death rate per 1,000 of the estimated resident population 12.05 Deaths from puerperal causes (Headings 29 and 30 of the Kegistrar-General s Short List):— Deaths Rate per 1,000 total births. No. 29 Puerperal sepsis 2 0.84 No. 30 Other puerperal causes 6 2.51 Total 8 3.35 Death rate of Infants under one year of age :— All infants per 1,000 live births 53.7 Legitimate infants per 1,000 legitimate live births ... 49.5 Illegitimate infants per 1,000 illegitimate live births 107.5 Deaths from Cancer (all ages) • • • 319 ,, „ Measles (all ages) ... 1 ,, ,, Whooping Cough (all ages) ... 11 „ „ Diarrhoea (under 2 years of age) ... 19 I.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Population.—The estimate of the Registrar-General to the mid-year 1939 is 197,200 for birth rate and 183,600 for death rate. Births.—The total number of live births of Stepney residents during the year was 2,466—1,309 males and 1,157 females—or 153 less than in the previous year. The birth-rate was 12.5 per 1,000 of the population. Marriages.—The total number of marriages which took place during the year was 2,629, or 512 more than in the previous year. The proportion of persons married was 26.2 per 1,000 of the population. 5 Deaths.—The total number of deaths, after deducting deaths of nonresidents who died in the Borough and adding those residents who died in Outlying Institutions was 2,213—1,251 males and 962 females—or 4 less than in the previous year. The death-rate for the whole Borough was 12.05 per 1,000 of the population. II.—GENERAL PROVISION OF HEALTH SERVICES. Air Raid Precautions.—There are six First Aid Posts in the Borough established at the following premises:— The London Hospital. The Mile End Library (adjacent to the Mile End Hospital). The Robert Montifiore School (adjacent to St. Peters Hospital). The London Jewish Hospital. The Princess Elizabeth of York Hospital. The St. Peters Junior Mixed School (adjacent to St. George in the East Hospital). There are five Stretcher Party Depots in the Borough situated at the following premises:— Commercial Street School. Berner Street School. 35 Stepney Green. Single Street School. Northey Street School. Emergency Mortuaries for Civilian Dead have been established at Branch Road and at the London Hospital. The Deputy Medical Officer of Health, Dr. J. W. Crawford, attended Course of Instruction at A.R.P. Staff School, London, from the 5th to 13th July. Nursing in the Home.—76 visits were made by the East London Nursing Society, i.e., 12 to Measles, 10 to Ophthalmic Neonatorum, 26 to Pemphigus Neonatorum, and 28 to Puerperal Pyrexia. Laboratory Facilities. -The number of examinations carried out were as follows :— 1,466 Swabs (for Diphtheria bacilli). Of these 79 were found to be positive. 5 Blood ( „ Typhoid bacilli). „ „ None 3 Faeces ( „ Dysentery). „ „ None „ „ „ TUBERCULOSIS DISPENSARIES. Number of attendances, 4,964. Number of consultations with medical practitioners: Personal, 324; Other, 366. Number of visits by Tuberculosis Officers to houses, 470. Number of specimens of sputum examined 707. (Of these 111 were positive). Number of X-ray examinations made 402 Number of children boarded out 30 6 Memo. 37/T (Revised). Ministry of Health form T. 145. Return relating to the work of the Dispensaries during the Year ending 31st December, 1939: — Diagnosis Pulmonary. Non-Pulmonary. Total. Grand Total. Adults. Children Adults. Children Adults. Children M. F. M. F. M. F. M. F. M. F. M. F. A.—Number of Definite Cases of Tuberculosis on the Dispensary Register at the beginning of the Year 693 331 68 52 62 50 92 57 755 381 160 109 1,405 B.—Number of New Cases diagnosed as Tuberculosis during the Year 152 53 13 8 14 11 11 6 166 64 24 14 268 Transfers in to Borough 21 15 — — — 2 4 2 21 17 4 2 44 C.—Number of Cases included in A and B written off the Dispensary Register during the Year as:— (1) Recovered 9 7 5 2 2 1 2 4 11 8 7 6 32 (2) Dead (all causes) 88 25 1 5 4 1 — 2 92 26 1 7 126 (3) Removed to other areas 42 33 1 3 2 4 1 4 44 37 2 7 90 (4) For other reasons 6 1 — 2 1 2 1 7 2 2 1 12 D.—Number of Definite Cases of Tuberculosis on the Dispensary Register at the end of the Year 722 333 74 50 66 56 102 54 788 389 176 104 1,457 Special treatment. Pneumo-Thorax refills given to Tuberculosis patients at :— No. of Patients No. of Attendances Tuberculosis Officer's Clinic 46 501 Brompton Hospital 8 168 London Chest 15 175 Royal Chest 9 108 Colindale Hospital 4 27 Finsen Light treatment at the London Hospital 8 92 Gold injections at the London Chest Hospital 1 9 Extra Nourishment.—456 grants were made to 151 persons, the approximate cost being £410. 7 SUMMARY OF WORK DONE AT THE DENTAL CLINIC—(a) TUBERCULOSIS. Particulars of Patients. Number of Fillings. Extraction Cases. Dentures. Number of Dressings. Number for Advice. Denture Visits. Number of New Patients. Number of Attendances. Simple. Root. Number of Scalings. Without Anaesthetic. Local Administrations. Gas Ad ministrations. Number of Teeth Extracted. Upper. Lower. Re-models Repairs. Males 41 8 — 5 - 1 6 2 2 4 7 29 4 Females 90 3 — 6 — — 7 46 8 8 7 3 19 66 9 Children - — - - - - - - - - - - - - - - Total 131 11 — 11 — — 8 52 10 10 — 11 3 26 95 13 No. of Ordinary sessions held 14 No. of Gas „ „ 13 (b) MATERNITY. Women 629 9 — 47 — 8 74 666 48 43 — 31 21 101 364 84 Children 57 — — — — — 22 101 — — — — 3 30 1 28 Total 686 9 — 47 — 8 96 767 48 43 — 31 24 131 365 112 No. of Ordinary sessions held 26 No. of gas „ „ 26 8 Maternity and Child Welfare Services (Form M.C.W. 96 revised).—Return (1) showing the arrangements made for maternity and child welfare by the Council and by Voluntary Associations providing maternity and child welfare services in respect of which the Council pay contributions under Section 101 of the Local Government Act, 1929, or otherwise; and (2) giving particulars of the work done during the year 1939. 1.—Population of the area served by the Council as Welfare Authority :— 197,200. 2.—Number of births notified in that area during the year under Section 203 of the Public Health Act, 1936, or Section 255 of the Public Health (London) Act, 1936, as adjusted by any transferred notifications : (a) Live births, 2,425. (b) Still births, 73. (c) Total, 2,498. (d) By midwives, 1,988. (e) By doctors and parents, 510. 3.—Health Visiting. (a) Number of health visitors employed at the end of the year: (i) by the Council and working in the area served by the Council 10 (ii) by the Council and working in the areas of other Local Authorities nil (iii) by Voluntary Associations and working in the area served by the Council 14 (iv) by Voluntary Associations and working in the areas of other Local Authorities nil (b) Equivalent of whole-time services devoted by the whole staff to health visiting (including attendance at infant welfare centres) :— (i) in the case of Health Visitors employed by the Council 10 (ii) in the case of Health Visitors employed by Voluntary Associations 135 (c) Num'ber of visits paid during the year by all Health Visitors:— (i) to expectant mothers :—First visits, 1,305. Total visits, 2,455. (ii) to children under 1 year of age:—First visits, 2,032. Total visits, 15,913. (iii) to children between the ages of 1 and 5 years :—Total visits, 32,083. 4.—Infant Welfare Centres. (a) Number of Centres provided and maintained by the Council 6 (b) Number of Centres provided and maintained by Voluntary Associations 9 (c) Total number of children who first attended at the Centres during the year and who, on the date of their first attendance, were : (i) under 1 year of age, 2,118; (ii) between the ages of 1 and 5 years, 352. (d) Total number of children under 5 years of age who attended at the Centres during the year and who, at the end of the year, were : (i) under 1 year of age, 1,881 ; (ii) over 1 year of age, 3,286. 5.—Ante-natal and Post-natal Services. (a) Ante-natal and Post-natal Clinics (whether held at Infant Welfare Centres or at other premises):— Ante-natal Post-natal (i) Number of Clinics provided and maintained by the Council 2 These cases attend the Council's A.N Clinics. (ii) Number of Clinics provided and maintained by Voluntary Associations 3 3 (iii) Total number of women who attended at the Clinics during the year 3,781 586 9 (b) Total number of expectant mothers ante-natally examined and of cases post-natally examined during the year, under arrangements made by the Council with private medical practitioners, excluding cases included under 5 (a) (iii) nil nil 6.—Supply of Milk and Food. (a) Arrangements made for this service :— Terms of Supply. Milk. Meals supplied at Dining Centres. Other Food. Expectant mothers. Nursing mothers. Children under 5 years of age. Expectant mothers. Nursing mothers. Children under 5 years of age. Expectant mothers. Nursing mothers. Children under 5 years of age. Free, or at less than cost price, in necessitous cases. Yes Yes Yes Yes Yes Yes Yes Yes Yes At cost price in other cases (e.g., sale of Yes Yes Yes No. No. No. Yes Yes Yes (b) Total quantity of milk supplied during the year to expectant and nursing mothers and young children :— (i) By the Council (ii) By Voluntary Associations operating in the area of the Council Totals Liquid Dried Gallons Pounds Under arrangement approved in accordance with circular 1840 Otherwise 27,0875/8 9,380½ — 27,0875/8 9,380½ 7.—Maternity Homes and Hospitals. I. Separate maternity institutions provided by the Council. Other institutions with maternity wards provided by the Council. Institutions provided by Voluntary Associations and subsidised by the Council. Number of Institutions Number of maternity beds (exclusive of isolation and labour beds) - - The Council make a grant of £100 per annum to the East End Maternity Hospital for one bed. (a) Normal complement before the emergency nil nil 1 (b) Complement at 31st December, 1939 nil nil 1 Total number of women admitted to these beds during the year.. nil nil 23 Number of beds (included in the figures above) allocated to, and reserved for, expectant mothers in need of hospital treatment nil nil - Total number of women admitted to these beds during the year. - - - 10 II. Number of women (if any) sent by the Council during the year to other Maternity Institutions nil 8.—Day Nurseries. (a) Number of day nurseries: (i) provided by the Council (a) prior to the emergency nil (b) and working in the Council's area on the 31st December, 1939 nil (ii) provided by Voluntary Associations (a) prior to the emergency 5 (b) and working in the Council's area on the 31st December, 1939 nil 4 evacuated, 1 closed (b) Number of places for children under 5 years of age in the nurseries: (i) provided by the Council (a) prior to the emergency nil (b) at the 31st December, 1939 nil (ii) provided by Voluntary Associations (a) prior to the emergency 194 (b) at the 31st December, 1939 evacuated with 113 children (c) Total number of attendances of children at these nurseries during the year 34,015 9.—Infectious Diseases. Disease. Number of cases notified during the year, Number of cases visited by officers of the Council. Number of cases for whom home nursing was provided by the Council. Number of cases removed to hospitals. (1) Ophthalmia Neonatorum *10 10 1 9 (2) Pemphigus Neonatorum — 1 1 - (3) Puerperal fever 5 — — 5 (4) Puerperal pyrexia 22 22 1 21 (5) Measles and German measles (in children under 5 years of age) 41 77 1 30 (6) Whooping Cough (do.) 443 605 — 126 (7) Epidemic Diarrhoea (do.) — — — — (8) Poliomyelitis (do.) 4 — — 4 *Number of cases in which vision was unimpaired 10, impaired —, or lost — „ ,, ,, the patient died —, removed from district —, or was still under treatment at the end of the year — „ ,, any other category —. 10.—Home Nursing. (a) Number of Nurses employed at the end of the year (otherwise than for purposes of the Midwives Act, 1936) for the nursing of expectant mothers and children under 5 years of age, maternity nursing, or the nursing of puerperal pyrexia :— (i) by the Council, nil; (ii) by Voluntary Associations, 2. (b) Total number of cases attended during the year by these nurses, 646. 11.—Maternal Deaths. (a) Number of women who died in, or in consequence of, childbirth in the area served by the Council for maternity and child welfare during the year:— (i) from sepsis 2 (ii) from other causes 9 (b) Number of these cases which died:— (i) at home 2 (ii) in institutions 9 12.—Child Life Protection (Sections 206 to 220 of the Public Health Act, 1936, or Part XIII of the Public Health (London) Act, 1936). (a) Number of persons who were receiving children for reward at the end of the year 14 (b) Number of children:— (i) at the end of the year 15 (ii) who died during the year nil (iii) on whom inquests were held during the year nil (c) Number of Child Protection Visitors at the end of the year who were :— (i) Health Visitors 10 (ii) Female, other than Health Visitors 1 (iii) Male nil (d) Number of persons (in addition to or in lieu of Visitors under (c) above) or societies authorised to visit under the proviso to Sec. 209 (2) of the Public Health Act, 1936, or Sec. 258 (3) of the Public Health (London) Act, 1936 nil (e) Proceedings taken during the year :— No. of cases. Act and Section under which proceedings were taken. 1 Public Health (London) Act, 1936, section 261 (1b) and section 259 (a). 31 12 Visits by Health Visitors.—The following table shows the number of visits, etc., paid by the Municipal Health Visitors during the year. HEALTH VISITORS' REPORT. DISTRICT Wapping Shadwell, S.W. Mile End N.WSpitalfields. VVhitechapel, M Mile End, W. and part S. Whitechapel, E. Limehouse, S. i Ratcliffe, S. 1 St. George's, N. and part S. Shad-well, N. Whitechapel, S. St. George's, W. Tower. Mile End, S.E. Mile End, N.E., part N. part S. Mile End, C. Limehouse, N.W. Mile End, N.W. Spitalfields. Whitechapel, M Do. Limehouse, N. Ratcliffe, N. Mile End, part S. NAME Miss Railey Miss Blackmore (to 13 April) Miss Brazier | Miss Carty Miss Clements Miss Clifford Miss Cordwell Miss Foucar Miss Gibbs Miss Hudson (19June to 25 Nov.) Miss Stagg (from 1 Sept.) Miss Styles Total Visits:— Primary 97 85 281 173 209 262 253 238 64 59 58 253 2,032 Revisits:— To infants under 1 year 205 103 421 247 333 231 564 373 142 80 98 581 3,378 To children between 1-5 years 646 285 803 772 724 654 1,002 682 349 193 254 1,023 7,392 Ante-natal:— Primary 18 29 41 34 50 65 87 50 14 9 16 50 463 Subsequent - 3 1 1 - 38 3 - 1 - - - 47 Ophthalmia Neonatorum - - 1 - 4 1 2 - - 2 - - 10 Puerperal Fever 1 - 1 - - 1 - 1 - 1 - - 5 „ Pyrexia 2 2 5 2 1 3 1 1 4 - - 1 22 Measles - - 3 - - 3 2 1 - 1 - 17 27 „ Revisits ... - - 7 - 14 1 48 1 0 - 1 - 1 82 Miscellaneous 226 92 96 89 143 390 399 100 6 114 115 76 1,846 Attempted visits ... 109 71 430 325 129 381 299 130 109 180 102 364 2,629 Child Life Protection: Visits to homes of foster mothers - 10 18 - - 7 5 11 - - - 2 53 Visits to foster children - 19 19 11 - 3 8 15 1 - - 5 81 Other visits ... - 2 - 1 — - - - - - - - 3 Totals 1,304 701 2,127 1,655 1,607 2,040 2,673 1,612 690 645 643 2,373 18,070 CENTRES ATTENDED:— Municipal Voluntary 135 46 62 - 126 20 163 - 137 140 - 136 - 115 68 20 51 41 1 26 7 140 4 1,241 197 Totals 1.81 62 146 163 137 140 136 183 71 42 33 144 1,438 13 Municipal Infant Welfare and Ante-Natal Centres. Details of the work at the Municipal Infant Welfare and Ante-Natal Centres will be seen in the following table. MUNICIPAL INFANT WELFARE AND ANTE-NATAL CENTRES. Limehouse. Mile End. St. George's. Spitalfields. Wapping. Whitechapel. Total. Mon. Wed. Thurs. Tues. Thurs. Tues. Fri. Tues. Thurs. Wed. Fri. Wed. No. of Infant Welfare Sessions (total) 48 35 — 51 35 33 49 36 51 52 33 52 475 „ Attendances of Infants 1,312 958 — 1,676 1,144 770 915 590 1,376 1,119 132 943 10,935 „ „ Children 1 to 5 767 566 — 1,009 954 832 796 337 1,153 981 78 494 7.967 „ Infants on Registers at end of the year 144 — 168 168 124 62 62 728 Children on Registers at end of the year 367 201 321 299 83 126 1,397 Ante-Natal Sessions — — 62 — - — — 51 — — — — 103 „ „ New Cases — — 98 — — — — 63 — — — — 161 „ „ Subsequent Attendances — — 257 — — — — 283 — 540 „ Doctors' Consultations 48 35 52 51 35 33 48 50 51 52 — 52 507 Toddlers Clinics : 4th Friday in cach month 2nd Friday in each month No. of sessions held 12 — — — — 12 — — - 24 No. of first attendances 36 — — — — 45 — — - 81 Total Attendances 97 — — — — 115 — — - 212 No. of toddlers found with defects 41 — — — — 57 — — - 98 Total No. of defects found 67 — — — — 86 - — — 153 14 Health Visiting.—Details of the work of the Health Visitors and of the work at the Municipal Infant Welfare Centres are given on pages 12 and 13. Convalescent Treatment.—52 mothers and 98 children were sent away to various convalescent homes during the year. Supply of Milk to Mothers and Children.—13,321 grants of milk, Virol, etc. were authorised under the Council's Scheme during the year at an approximate cost of £3,838 18s. l£d. Home Helps were supplied in 76 cases. Child Life Protection.—121 visits were made to foster mothers, 178 and to foster children, and 139 miscellaneous visits. The number of persons receiving children for reward at the end of the year was 14, and the number of children was 15. 15 Infantile Mortality.—The deaths from stated causes at various ages under one year of age are shown in the table below :— Cause of Death Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 1 month. 1-3 month";. 3-6 months. 6-9 months. 9-12 months, Tot?l Deaths under One Year All Causes. Certified... ...j m 26 2 3 6 37 15 14 9 8 83 F. 15 1 ... ... 16 3 10 8 8 45 Small-pox m ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... Chicken-pox m. ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 2 Measles m. ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 3 Scarlet Fever m. ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... 4 Whooping Cough m. ... ... ... ... ... ... 2 2 3 7 F ... ... ... ... ... ... ... 2 ... 2 5 Diphtheria and Croup m. ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 10 Tuberculous Meningitis m. ... ... ... ... ... ... 1 ... ... 1 F. ... ... ... ... ... ... ... ... ... ... 10 Abdominal Tuberculosis M ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 10 Other Tuberculous Diseases m. ... ... ... 1 1 ... ... 1 ... 2 F ... ... ... ... ... .... ... ... 1 1 11 Syphilis m. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 19 Bronchitis m. ... ... ... ... ... 1 ... ... ... 1 F ... ... ... ... ... ... ... 1 1 20 Pneumonia (all forms) m. ... ... 1 1 2 5 2 4 1 14 F. ... ... ... ... ... ... 2 2 4 8 23 Diarrhoea M. ... ... ... ... ... 1 2 1 1 5 F. ... ... ... ... ... ... 3 2 1 6 23 Enteritis M. ... 1 ... ... 1 1 1 1 ... 4 F. ... ... ... ... ... 1 1 1 ... 3 27 Gastritis m. ... ... ... ... ... ... 2 ... ... 2 F. ... ... ... ... ... ... 2 ... ... 2 31 Congenital Malformations m. 5 ... 1 1 7 4 1 ... ... 12 F. 3 ... ... ... 3 ... 1 ... ... 4 31 Premature Birth m. 9 1 ... 1 11 ... ... ... ... 11 F 7 ... ... ... 7 ... ... ... ... 7 31 Atrophy, Debility & Marasmus m. 2 ... ... ... 2 ... 1 ... ... 3 F. 1 ... ... ... 1 1 ... ... ... 2 31 Atelectasis m. 2 ... ... ... 2 ... ... ... ... 2 F. 2 ... ... ... 2 ... ... ... ... 2 31 Injury at Birth m. 3 ... ... 1 4 ... ... ... ... 4 F. 1 ... ... ... 1 ... ... ... ... 1 31 Convulsions m. 1 ... ... ... 1 ... ... ... ... 1 F. ... ... ... ... ... ... ... ... ... ... 34 Suffocation, overlying m. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 35 Rickets m. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 35 Meningitis (not tuberculous) m. ... ... 1 ... 1 ... ... ... ... 2 F. ... ... ... ... ... ... ... ... ... ... 35 Laryngitis m. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 35 Erysipelas m. ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 35 Other causes m. 4 ... ... 1 5 2 ... ... 2 11 F. 1 1 ... ... 2 1 ... ... 1 6 36 Illdefined m. ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... Totals 41 3 3 6 53 17 24 17 16 127 16 III. SANITARY CIRCUMSTANCES OF AREA. Sanitary Inspection -The following tables show the work of the District Sanitary Inspectors: — REPORT OF INSPECTIONS, Etc. BY THE DISTRICT SANITARY INSPECTORS—1939. W. E. Anstee. H. Brownlee. J.J. Coveney. W. Cue. R. W. G. Day G. D. Freeland. C. F. Guy. W. H. Haworth W. H. Howard. j. Keniry. S. Lowther. J. G. McCarthy. R. Roper. W. F. Smith. W. T. Twynham. E. P. Webber. Totals Bakehouses 31 34 9 18 50 50 17 — 15 31 17 17 26 27 16 12 370 Common Lodging Houses 29 15 — — — 11 — 12 — 14 — — 20 — 28 19 148* Complaints 494 692 483 382 936 588 414 489 1,052 791 618 907 655 566 595 833 10,495 Houses let in Lodgings 115 103 72 50 231 259 237 68 23 103 32 60 103 252 63 156 1,927 House to House 11 8 — 3 6 107 — 74 — 21 37 22 55 68 144 33 589 Infectious Disease 63 44 74 78 73 40 55 33 63 78 74 90 35 91 39 47 977 Offensive Trades — 13 9 — — 47 5 — — 46 16 32 14 5 6 198 Outworkers 28 25 - 1 3 15 18 60 2 19 2 4 11 18 36 98 340 Restaurants and Eating Houses 51 53 6 80 38 28 10 36 11 72 29 65 21 28 30 558 Markets (week-end) - 3 1 2 3 3 6 . 5 1 2 2 2 7 4 2 3 47 Seamen's Lodging Houses - - - 82 - - - - - 35 - - - - - - 117 Shops Act 93 40 20 53 7 15 - 37 1 117 64 — 63 14 1] 6£ 600 * In addition, 21 inspections to Women's Common Lodging Houses were made by Miss Whitty. REPORT OF INSPECTIONS, Etc. BY THE DISTRICT SANITARY INSPECTORS—1939—Continued. W. E. Anstee. J. H. Brownlee. J.J. Coveney. W. Cue. R. W. G. Day G. D. Freeland. C. F. Guy. W. H. Haworth W. H. Howard. J. Keniry. S. Lowther. J. G. McCarthy. R. Roper W. F. Smith. W. T. Twynham. E. P. Webber. Totals Pharmacy & Poisons Act 25 13 6 63 31 10 2 4 9 11 12 2 14 10 8 3 223 Rag Flock Acts — — 2 2 — 2 - - - - - - 8 2 — 16 Miscellaneous 1,324 705 509 547 1,325 374 944 634 643 858 708 627 1,097 1,227 710 880 13,112 Observations re Smoke Nuisance 4 8 113 88 83 11 1 1 6 16 12 — 19 26 1 — 389 Re-Visits 1,080 1,527 778 672 1,951 1,220 1,183 630 1,115 772 1,046 1,557 1,228 1,319 1,488 1,267 18,833 Intimations served 542 391 306 190 660 494 436 394 953 232 421 705 461 482 621 745 8,033 Statutory Notices served 46 98 23 23 184 117 156 122 258 40 153 97 89 147 134 225 1,912 No. of Summonses taken out — 2 — — — — 1 — — 4 — — — 5 — — 12 Factory Act— Factories with mechanical power 129 112 130 69 110 93 56 152 34 64 29 35 181 112 84 144 1544 Factories without mechanical power 65 59 17 23 15 61 21 42 8 73 1 4 11 36 29 75 540 Other premises under the Act 20 4 — — — — — 50 — 15 — — 12 9 — 16 126 18 RETURN OF SANITARY WORK, 1939. W. E. Anstee. J. H. Brownlee. J. J. Coveney. W. Cue. R. W. G. Day G. D. Freeland. C. F. Guy. J W. H. Haworth j W. H. Howard. J. Keniry. S. Lowther. j J. G. McCarthy. | R. Roper. W. F. Smith. W. T. Twynham. E. P. Webber. Totals. Animals kept so as to constitute a nuisance, removed - 3 4 - - - 3 - - 2 - - 1 6 - 1 20 Bakehouses: No. of cleansings of 14 6 10 12 15 18 14 12 6 10 10 16 — — 4 14 161 Cisterns cleansed, covered and repaired 10 23 10 — — — 25 1 57 14 6 — — 18 5 169 Dampness in premises remedied 123 232 171 83 197 278 290 201 442 65 336 185 157 261 316 150 3,487 Drains—Cleansed or repaired 47 30 32 42 89 25 74 30 63 45 28 53 45 25 55 119 802 Constructed or reconstructed 23 — 15 25 19 34 11 28 22 42 13 17 — 1 20 270 Dust receptacles provided 41 23 37 57 91 69 89 25 107 9 129 102 11 40 59 86 975 Number of dwelling rooms cleansed 183 305 524 420 974 482 554 333 1159 177 744 675 316 486 399 463 8,194 Houses ventilated beneath the lower floor 3 2 — 14 — — 7 5 — — — 2 — 19 1 — 53 Improved light and ventilation provided to rooms 4 4 1 3 — 1 2 1 — 5 16 — 3 — 13 5 58 Manure receptacles provided or reconstructed 1 — 1 2 - - - - - - - - - - - - 4 Offensive accumulations removed 8 15 19 3 22 27 38 25 8 16 14 13 24 28 48 46 354 19 RETURN OF SANITARY WORK, 1939—Continued. W. E. Anstee. J. H. Brownlee. J. J. Coveney. W. Cue. | R. W. G. Day G. D. Freeland. C. F. Guy. W. H. Haworth | W. H. Howard. J. Keniry. S. Lowther. J. G. McCarthy. R. Roper W. F. Smith. W. T. Twynham. E. P. Webber. Totals. No. of gutters and rain-water pipes fixed or repaired 75 51 48 107 140 26 127 23 92 75 52 59 36 74 66 88 1,139 No. of repairs to roofs 209 115 481 200 348 371 284 199 432 109 163 361 53 211 141 207 3,884 Sink, bath and lavatory pipes fixed or repaired 135 59 42 94 157 50 73 23 111 144 81 126 60 36 87 76 1,354 Smoke nuisances abated 6 2 4 1 2 1 4 — — 6 — — — 10 1 — 37 Urinals fixed or repaired 8 1 3 3 1 16 1 1 21 — 4 1 — 2 8 74 Verminous rooms cleansed — 21 6 5 7 29 29 19 48 13 8 — 33 23 30 43 314 Waterclosets—Cleansed or repaired 51 109 61 73 133 83 130 21 178 39 134 82 155 105 175 232 1,761 " Light and ventilation provided 73 11 11 — — 1 11 13 16 7 27 21 11 15 217 „ Pans and traps fixed 91 42 83 93 73 11 51 44 37 157 81 88 44 19 50 128 1,092 „ Provision or repair of flushing apparatus 74 24 90 87 61 27 38 23 59 139 19 115 37 15 55 127 990 Water supply to houses reinstated or repaired 4 27 18 23 22 6 24 13 5 17 23 8 18 26 53 287 Yards, areas and forecourts cleansed, paved, or paving repaired 53 23 20 112 98 61 89 10 98 10 74 22 36 82 52 12 852 Floors,windows, staircases, fireplaces and coppers repaired 207 160 358 394 611 413 290 269 578 129 475 569 218 258 228 323 5,480 Miscellaneous 113 97 32 85 372 103 133 174 216 91 194 14 107 114 193 110 2,148 20 Canal Boats.—16 canal boats were inspected and there were no contraventions of the Act and Regulations. Six children were found on the boats. No boats were registered during the year. Factories Act, 1937.—Particulars of inspections and defects found are as follows :— Premises. (1) Number of Number. Inspections. (2) Written Notices. (3) Occupiers prosecuted. (4) Factories with mechanical power 2,449 1,544 216 — Factories without mechanical power 939 540 104 — Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) 62 126 2 l Total 3,450 2,210 322 1 f Electrical Stations should be reckoned as factories. Defects Found. Particulars (1) Number of Defects Number of defects in respect of which Prosecutions were instituted (5) Found (2) Remedied (3) Referred to H.M. Inspector (4) Want of cleanliness (S. 1) 144 142 5 — Overcrowding (S. 2) 1 — 1 — Unreasonable temperature (S. 3) 14 11 3 — Inadequate ventilation (S. 4) 11 11 — — Ineffective drainage of floors (S. 6) 17 17 — — Sanitary Conveniences (S- 7) insufficient 25 25 — — unsuitable or defective 119 121 — — not separate for sexes 40 40 — — Other nuisances 126 126 2 — Other offences (Not including offences relating to Homework or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937.) — — — — Total 497 493 11 — 21 Outworkers :— Nature of Work No of Inspections No. resident in the Borough Unwhole some premises Notices served Prosecutions No. of premises where infectious disease occurred Wearing apparel— Making, etc. 284 1511 65 59 — 17 Cleansing and washing 15 3 — — — — Household linen — — — — Hats 4 4 — — — — Lace, lace curtains and nets — — —- — Boots 2 22 — — — — Curtains and furniture hangings 5 — — — — Furniture and upholstery 12 — 8 6 — — . Electro-plate — — — — — File making — — — — — — Brass and brass articles — — — — Furriers 4 10 — — — Cables and chains — — — — Anchors and grapnels — — — — — — Cart gear — — — — — — Locks, latches and keys — — — — Umbrellas, etc. 11 13 — — — Artificial flowers 1 . — — — Nets, other than wire nets — — — — Tents — — — — Sacks — — Racquet and tennis balls — — — — — Paper, etc., boxes, paper bags 2 — — — — — Brush making — 1 — — — — Pea picking — — — — — - — Feather sorting — — — — — — Carding, etc., of buttons, etc. — 1 — — — — Stuffed toys 1 — — — — — Basket making — — — — — — Chocolates and sweetmeats — — — — — — Cosaques, Christmas crackers, Christmas stockings, etc. Textile weaving — — — — — — Lampshades — — — — — Leather goods — 2 — — — — Flag making 1 — — — — Cardboard boxes — 5 — — — — Handbags — 1 — — - — Total 340 1575 73 65 17 No. of firms in the Borough employing outworkers 89 No. of outworkers residing in the Borough 1,575 „ ,, „ outside the Borough 612 „ „ employed by firms outside the Borough 939 Basement Bakehouses.—In the year beginning 1st July, 1938, and in every fifth year subsequently, examinations of Basement Bakehouses must be carried out under the Factories Act, 1937. In accordance with the above, I made an examination of Basement Bakehouses during the year and reported to the Committee that 69 were certified in 1903/4 under the Factory and Workshop Act, 1901. Of these 33 remained open at the time of my inspection and 21 of the latter were considered by me unfit to retain certificates. 22 Legal Proceedings. No. of Summons. Fines. Costs. £ s. d. £ s. d. Public Health (London) Act, 1936 23 31 15 0 53 0 0 Food and Drugs (Adulteration) Act, 1928 35 50 0 0 61 19 6 Milk and Dairies Order, 1926 2 4 0 0 2 2 0 L.C.C. Bye-laws—Rag and Bone Dealer ... 1 0 10 0 0 10 6 Merchant Shipping Act, 1894 1 2 0 0 2 2 0 62 88 5 0 119 14 0 IV.—HOUSING. Slum Clearance.—During the year the Council made a Compulsory Purchase Order, as follows :— Persons to be Houses. displaced. Solebay Street area 24 106 The Council also made Clearance Orders, as follows :— Amos Court area 15 64 St. Anne's Row No. 1 area 30 138 St. Anne's Row No. 2 area 6 26 Chusan Place area 4 11 Claydens Buildings area 5 12 Copenhagen Place area 3 11 Paragon Mansions area 42 112 Hayfield Passage area 2 7 Hayfield Yard area 4 2 In the case of four of the above areas—Solebay Street, Amos Court, St. Anne's Row No. 1 and Paragon Mansions—a Local Inquiry should have been held on 26th September but, owing to the outbreak of war, the Inquiry was postponed indefinitely. As regards the remaining six areas, they were all confirmed without modification and the tenants have all been rehoused. A small area known as the Cottage Court area, including two houses, was represented, but this was cleared by the owner shortly afterwards. A Demolition Order was made affecting 72, Hermitage Wall. The occupants were rehoused and the house demolished. No areas were declared by the L.C.C. during the year. Overcrowding.—The Overcrowding Survey, in 1935, revealed the fact that 7,632 families were overcrowded. The number of cases to date not included in the above total is 456. 23 From May, 1936 to the end of December, 1939, 2,108 certificates of overcrowding (Orange Forms) had been sent to the L.C.C. Of this number the L.C.C. have rehoused 609 families, 101 within the borough and 508 outside. In the process of slum clearance, 636 cases of overcrowding fiave been abated. 696 cases of overcrowding have been abated by owners transferring tenants and by reduction or removal of families. Summary. Number of families overcrowded as per survey 7,632 Additional to December, 1939 456 8,088 Number abated— By L.C.C. as result of Orange Forms 609 By Slum Clearance 636 Abated privately 696 1,941 Number of families overcrowded December, 1939 6,147 Underground Rooms.—At the beginning of the year there were 5,843 underground rooms which did not comply with the Housing Act and the Regulations made thereunder. During the year 48 unfit underground rooms were demolished in Clearance Areas and in the demolition of unfit houses, thus leaving 5,795 still to be dealt with. Statistics (required by the Ministry of Health). 1. Inspection of dwelling houses during the year :— Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 18,136 Number of inspections made for the purpose 21,109 Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 8,544 2. Remedy of defects during the year without service of formal Notices :— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 6,811 3. Action taken under Statutory Powers during the year.—Proceedings under Public Health Acts :— Number of dwelling houses in respect of which notices were served requiring defects to be remedied 1,733 Number of dwelling houses in which defects were remedied after service of formal notices :— (a) By owners 1,733 (b) By Local Authority in default of owners — 24 HOUSING ACT, 1936 re Overcrowding Mr. Anstee „ Brownlee „ Coveney „ Cue - Day „ Freeland „ Green „ Guy „ Haworth n Howard „ Keniry „ Lowther „ McCarthy „ Roper „ Smith „ Twynham „ Webber „ Bottomley Total No. of houses in which the rooms were measured and the permitted numbers ascertained during the year. 196 267 284 37 62 57 256 98 165 49 180 266 167 11 438 767 858 4,158 Total to date 356 328 313 50 76 166 22 695 339 202 265 184 423 438 157 522 781 2,023 7,340 No. of visits for such purpose during the year Total to date 232 426 279 362 298 327 67 75 61 70 168 374 22 313 844 394 754 248 291 346 571 232 236 80 213 189 477 209 407 476 585 877 898 873 2,038 5.342 8,970 No. of houses for which information has been supplied on request to owners and occupiers during the year 79 249 282 60 63 145 253 283 229 204 225 417 113 132 556 765 858 4,913 Total to date 150 310 312 73 77 184 22 682 489 229 364 229 574 384 234 640 779 1,943 7,675 25 V. INSPECTION AND SUPERVISION OF FOOD. The following is a summary of the inspections, etc., by the four special Inspectors engaged in the supervision and inspection of food :— H. Abson A. C. Brown T. W. Dee S. Vogler Totals Bishopsgate Goods Station *4 +l48 152 Butcher and Bacon shops 317 — — — 317 Butcher and Bacon stalls 293 — — — 293 Butter and Margarine premises — 8 — 19 27 Complaints 30 37 8 32 107 Cowsheds — 40 — 72 112 Fish shops — 10 — 21 31 Greengrocers and Fruiterers |— ! — 142 — 142 Grocers and Provision shops — 97 — 20 117 Ice Cream premises — 299 — 295 594 London Fruit Exchange — — 263 — 263 Markets (Daily) 365 223 24 364 966 Markets (Week-end) 2 2 2 2 8** Milkshops — 411 — 515 926 Poultry shops 532 442 — 379 1,353 Poultry stalls 990 330 — 742 2,062 Prepared Food premises 122 60 — 89 271 Spitalfields Market — — 249 — 249 Wharves 443 — 640 — 1,083 Wholesale Grocers. 38 — 73 111 Miscellaneous visits 184 114 309 196 803 Revisits 142 358 371 318 1,189 Samples taken—Food and Drugs — 783 — 769 1,552 „ Other 48 35 26 45 154 No. of Summonses taken out 1 21 — 27 49 *Of these 1 was a special night inspection. +Of these, 45 were special night or early morning inspections. **47 Inspections were also made by the District Sanitary Inspectors. Unsound Food.—The quantity of foodstuffs destroyed during the year is as follows Under the Public Health Imported Food Regulations— Tons. Cwts. Qtrs. Lbs. (a) From the Wharves 506 5 3 13 (b) Zeebrugge—Harwich Train Ferry 35 17 2 26 Under the Public Health (London) Act, 1936— (a) From the Spitalfields Market and the London Fruit Exchange 36 8 0 8 (b) From the Meat Depot, Mile End Road 3 16 2 4 (c) From other premises 39 15 1 10 Total 622 3 2 6 156 Detention Notices and 220 Release Notices were issued in respect to various foodstuffs. 26 VI.—PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. Notifications.—1,643 notifications (other than tuberculosis) were received, particulars of which are given in the table below :— NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING THE YEAR, 1939. Disease. Total Cases Notified. In Age ".roups. Cases admitted to Hospital Total Deaths. Under 1 year. l— 2— 3— 4— 5— 10— 15— 20— 35— 45— 65 and over Total Anthrax — — — — — — — — — — — — — — — Smallpox — — — — — — — — — — — —. Scarlet Fever 5 20 30 54 49 160 57 n 26 1 413 397 1 Diphtheria 8 8 17 26 17 63 28 13 18 4 2 204 204 — Enteric Fever — — — — — — — 1 1 — 1 3 3 Measles 12 9 8 4 8 3 — 4 2 50 33 1 Puerperal Fever — — — — — — — — 4 1 5 5 — Puerperal Pyrexia 1 15 6 — — 22 21 — Erysipelas 1 1 3 — 2 1 — 4 24 11 50 10 107 58 — Encephalitis Lethargica — — — — — — — — — — — — — — 2 Cerebro-spinal Fever 3 — 1 2 — — 1 — 2 — — 9 9 Ophthalmia Neonatorum 10 10 9 — Food Poisoning — — — — — — — — 6 5 2 1 14 2 — Polio-myelitis -— — 2 2 — — — — — — — — 4 4 1 Polio-encephalitis — — — — — — — — — — — — — — — Membranous Croup — — — — — — — — — — — — — — — Dysentery 4 9 9 7 2 4 — — 1 — — 36 30 — Malaria — — — — — — — — — 1 — — 1 1 Pneumonia 7 9 10 7 6 18 11 12 33 21 54 31 219 144 199 Whooping Cough 83 96 93 106 65 99 2 1 1 — — — 546 126 9 Totals 133 152 173 208 149 348 99 47 133 50 109 42 1,643 1,046 213 21 Diphtheria immunisation.—The year's report on the Council's Clinic is as follows:— (a) Total number of clinics held 43 (b) Total number of all attendances of children at same (either for Schick or Immunisation) 1119 (c) Number of Primary Schick tests 186 (d) Number of Final Schick tests 343 {&) Number of Immunisation Inoculations given 344 (/) Number of Immunisation Certificates given 311 (g) Number of individuals who have attended the clinic for the first time during the year 198 (h) Number aged 12 months and under when they made first attendance 8 (i) Number aged 1 year to 5 years inclusive when they made first attendance 86 (j) Number aged 6 years to 14 years inclusive when they made first attendance 100 (,k) Number of adults, viz., from 15th birthday upwards who attended 4 (I) Number who failed to return for reading of first Schick 4 (m) Number who began but failed to complete their immunisation doses 54 («) Number who failed to come for final Schick (or for reading of final Schick) 27 (o) Number found immune after first Schick and not therefore inoculated 31 (p) Number found to be still susceptible after one complete course 4 (q) Number of latter given a second course 4 (r) Number of (q) found immune after second course 4 (s) Number still in course of treatment at end of year and not yet completed 120 (t) Number of cases notified as diphtheria in the Borough during the year who were found to have been immunised at the Borough clinic at any time 0 (m) Number of cases"(from t) found to be suffering from Diphtheria 0 (v) Number removed from Borough before treatment completed Indefinite owing to evacuation Bug Eradication.—The furniture and effects of 218 families were treated at the Council's Disinfesting Station in the H.C.N. Fumigation Chamber, before being rehoused, and the bedding was dealt with by steam disinfection. Of this number 10 were done for the Stepney Housing Trust, thus leaving a total of 208 for families rehoused in Council flats. 28 989 inspections were made to 810,Council flats during the year, and of this number 163 were found verminous and suitable steps taken for the eradication of vermin either by means of fumigation or spraying with insecticide. The following table gives the summary of work done. Mr. Green Miss Whit y Inspections for vermin 614 682 Premises found verminous 308 172 Miscellaneous visits 488 337 Re-visits 168 197 Miss Whitty also has charge of Women's Common Lodging Houses and Child Life Protection investigations. Return of these inspections are to be found under their appropriate headings. Council. Private. Premises fumigated 38 371 Rooms fumigated 97 501 Premises sprayed 172 323 Rooms sprayed 411 463 Sets of furniture treated by H.C.N. 208 10 A quantity of old furniture, etc. amounting to 14 tons 10 cwts. 2 qtrs. was collected from houses vacated by tenants on being rehoused by the Council. This was all destroyed in the incinerator. The number of : (a) Council houses (i) found to be infested 163 (ii) disinfested 163 ('b) Other houses (i) found to be infested:— (a) by disinfestation inspection 136 (b) by district sanitary inspectors or or otherwise 489 (ii) disinfested by Council 625 Three methods are employed for freeing infested houses of bed bugs :— (a) Stripping woodwork, where necessary, and application of blow-lamp. (b) Fumigation with sulphur. (c) Spraying with insecticides, vermicene, or our own preparation. Cleansing and Disinfection.—183 adults were cleansed during the year because of vermin. 486 rooms were fumigated because of infectious disease and 194 as a result of puln onary tuberculosis. 60,636 second-hand articles of clothing were disinfected prior to export. The total number of articles disinfected by steam for all purposes was 82,485. 29 During the year, 54 complaints were received from the School Medical Officer of school children found to be in a verminous condition. In each case the home conditions were investigated by the Specialist Inspectors, and, as a result, 51 premises were disinfested. Notice was received from the L.C.C. that 44 families were being rehoused. Each family was visited by the Specialist Inspectors and the old premises and the tenants' effects were disinfested previous to the removal. Public Health (Tuberculosis) Regulations, 1930. Ministry of Health. Form T.157 Revised 1939. PART I—Summary of Notifications during the period from the 1st January, 1939. to the 31st December, 1939, in the area of the Metropolitan Borough of STEPNEY. Age periods Formal Notifications. Number of Primary Notifications of new cases of Tuberculosis Total Notifications. 0— 1— 5— 10— 15—20— 25— 35- 45— 55— 65— Total (all ages) Pulmonary Males 4 3 6 8 17 35 32 29 25 13 172 206 ,, Females 1 2 1 2 9 10 22 4 5 4 2 62 74 Non-pulmonary Males 1 5 3 3 6 3 2 1 — 1 2 27 31 „ ,, Females 4 3 1 2 2 3 1 1 " " 17 19 SUPPLEMENTAL RETURN. PART II.—New cases of Tuberculosis coming to the knowledge o£ the Medical Officer of Health during the above-mentioned period, otherwise than by formal notification. Age periods 0— 1- 5— 10- 15— 20—25— 35— 45— 55- 65— Total Pulmonary Males 1 — — — 1 5 1 2 8 3 2 23 „ Females — 1 — — 1 3 2 2 — — 1 10 Non-pulmonary Males ... — 2 — — — — — — — 2 „ „ Females — 2 1 — — 2 5 The source or sources from which information as to the above-mentioned cases was obtained is stated below :— Source of Information. No. of Cases. Pulmonary NonPulmonary. Death Returns from local Registrars 12 4 transferable deaths from Registrar General — — Posthumous notifications 2 — " Transfers " from other areas (other than transferable deaths) 19 3 Other Sources — — Small Pox and Vaccination.—No cases of smallpox were notified. There were 2,796 births registered during 1938. Of these 1,125 were successfully vaccinated. 1,112 Statutory declarations were received. .30 VII.—STATISTICS PROVIDED BY THE REGISTRAR GENERAL. CAUSE OF DEATH AT DIFFERENT PERIODS OF LIFE IN THE METROPOLITAN BOROUGH OF STEPNEY—1939. S.D.25 CAUSES OF DEATH. Sex. All Ages. 0— 1— 2— 5— 15— 25— 35— 45— 55— 65— 75— ALL CAUSES M. 1,251 83 10 4 13 33 56 61 134 272 341 244 F. 962 45 5 8 11 38 40 42 93 174 254 252 1. Typhoid and paratyphoid fevers M. ... ... ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... ... ... 2. Measles M. ... ... ... ... ... ... ... ... ... ... ... ... F. 1 ... 1 ... ... ... ... ... ... ... ... ... 3. Scarlet Fever M. 1 ... ... ... 1 ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... ... ... 4. Whooping cough M. 7 7 ... ... ... ... ... ... ... ... ... ... F. 4 2 ... ... ... ... ... ... ... ... ... ... 5. Diphtheria M. ... ... ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... ... ... 6. Influenza M. 12 ... ... ... 1 1 2 ... ... 6 ... 2 F. 25 ... ... ... 1 1 2 1 ... 1 ... 6 7. Encephalitis lethargica M. 5 ... ... ... ... ... 1 1 ... 3 ... ... F. 2 ... ... ... ... ... 1 ... ... 1 ... ... 8. Cerebro-spinal fever M. ... ... ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... ... ... 9. Tuberculosis of respiratory system. M. 100 1 1 ... ... 12 16 13 24 25 8 ... F. 34 1 ... 1 12 10 5 2 ... 2 1 10. Other tuberculous diseases M. 9 3 2 ... 1 1 1 1 ... ... ... F. 5 1 ... ... ... ... ... 1 ... ... 1 1 11. Syphilis M. 3 ... ... ... ... ... ... 2 1 ... ... ... F. 2 ... ... ... ... ... ... ... ... 1 ... ... 12. General paralysis of the insane, tabes dorsalis. M. 10 ... ... ... ... ... ... 3 2 3 1 1 F. 1 ... ... ... ... ... ... ... 1 ... ... ... 13. Cancer, malignant disease M. 167 ... ... ... ... 1 5 8 16 47 72 18 F. 152 ... ... ... ... ... 2 5 32 45 40 27 14. Diabetes M. 20 ... ... ... ... ... ... ... 2 6 11 1 F. 27 ... ... ... ... ... ... 1 3 7 13 3 15. Cerebral haemorrhage, etc. M. 28 ... ... ... ... ... ... 2 1 8 11 6 F. 31 ... ... ... 1 ... 1 ... 4 10 9 6 16. Heart disease M. 360 ... ... ... 2 4 2 6 24 70 132 118 F. 195 ... ... ... 2 13 4 10 20 37 88 121 17. Aneurysm M. 7 ... ... ... ... ... ... ... 3 2 2 ... F. 2 ... ... ... ... ... ... ... ... 1 1 ... .18 Other circulatory diseases M. 68 ... ... ... ... ... 1 1 7 20 20 19 F. 78 ... ... ... ... ... 2 l 1 19 32 23 19. Bronchitis M. 44 1 ... ... ... 2 2 l 9 10 9 9 F. 27 2 ... ... ... 1 ... l 2 3 5 13 31 CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN THE METROPOLITAN BOROUGH OF STEPNEY, 1939—(continued). CAUSES OF DEATH. Sex. All Ages. 0— 1— 2— 5— 15— 26— 35— 45— 55— 65— 75— 20. Pneumonia (all forms) M. 94 10 2 ... 1 1 2 3 12 17 25 21 F. 64 7 1 ... ... ... 3 2 4 16 21 10 21. Other respiratory diseases M. 13 ... 1 ... 1 ... ... ... 2 1 4 4 F. 2 ... ... ... ... 1 ... ... ... ... 1 ... 22. Peptic ulcer M. 19 ... ... ... ... ... 1 2 3 6 3 4 F. 3 ... ... ... ... ... ... ... ... 2 1 ... 23. Diarrhoea, etc. [Under 2 yrs.] M. 11 10 1 ... ... ... ... ... ... ... ... ... F. 8 8 ... ... ... ... ... ... ... ... ... ... 24. Appendicitis M. 7 ... ... ... ... 2 l 1 ... 1 1 ... F. 5 ... ... ... 1 1 ... ... ... 1 1 1 25. Cirrhosis of liver M. 5 ... ... ... ... ... ... ... 2 1 2 F. 2 ... ... ... ... ... ... ... 1 1 ... ... 26. Other diseases of liver, etc. M. 1 ... ... ... ... ... ... 1 ... ... ... ... F. 5 ... ... ... ... 1 ... 2 ... ... 1 1 27. Other digestive diseases M. 20 3 ... ... ... 2 ... 3 2 3 3 4 F. 23 4 ... ... 1 1 1 2 9 2 3 28. Acute and chronic nephritis M. 26 1 ... ... ... ... 4 1 4 7 3 6 F. 33 ... ... ... ... 3 2 2 7 6 8 6 29. Puerperal sepsis F. 2 ... ... ... ... ... 1 1 ... ... ... ... 30. Other puerperal causes F. 6 ... ... ... ... ... 2 3 1 ... ... ... 31. Congenital debility, premature birth, malformations etc. M. 39 37 1 ... 1 ... ... ... ... ... ... ... F. 16 16 ... ... ... ... ... ... ... ... ... ... 32. Senility M. 3 ... ... ... ... ... ... ... ... 1 1 1 F. 9 ... ... ... ... ... ... ... ... ... 1 8 33. Suicide M. 10 ... ... ... ... ... 1 4 3 1 1 f. 6 ... ... ... ... ... 1 1 1 2 1 34. Other violence M. 64 1 1 1 4 3 8 3 9 ii 11 12 f: 29 ... ... 1 3 ... 3 1 6 6 9 35. Other defined causes M. 98 9 1 ... 1 4 9 6 7 23 24 15 f. 62 5 ... 2 1 4 6 5 8 9 12 11 36. Causes ill-defined, or unknown M. — ... ... ... ... ... ... ... ... ... ... ... F. 1 ... ... ... ... ... ... ... ... ... ... 1 32 S.D.52. (1) ESTIMATED POPULATION (а) For Birth-rate 197,200 (б) For Death-rate 183,600 (2) LIVE BIRTHS- Total (Legitimate and Illegitimate) Illegitimate For Birth-rate Male. 1,309 46 Female. 1,157 47 For Infant and Maternal Mortality. Male. 1,268 46 Female. 1,113 47 STILL BIRTHS— Total (Legitimate and Illegitimate) 48 31 Illegitimate 2 2 (3) DEATHS UNDER ONE YEAR— Legitimate—Males 74. Females 44. Illegitimate—Males 9. Females 1. (4) NOTIFIABLE INFECTIOUS DISEASES— (number of cases notified during the 52 weeks ended 30th December, 1939) Smallpox Scarlet fever Diphtheria Enteric fever Pneumonia Puerperal fever Pueperal pyrexia Erysipelas — 412 204 3 220 5 22 107 (5) AREA COMPARABILITY FACTOR— applicable to the '* All Causes " crude death rate only, 1.17 33 Birthrates, Death rates, Analysis of Mortality Maternal Mortality, and Case-notes for certain Infectious Diseases in the year 1939. s.d.56 England and Wales, London, 126 Great Towns and 148 Smaller Towns. (Provisional Figures based on Weekly and Quarterly Returns.) England and Wales. 126 County Boroughs anc Great Towns including London. 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 census). London Administrative County. Rates per 1,000 population. Births:— Live 15.0 14.8 15.6 12.3 Still 0.59 0.59 0.57 0.44 Deaths:— All causes 12.1 12.0 11.2 11.9 Typhoid and Paratyphoid Fever 0.00 0.00 0.00 0.00 Small-pox — — — — Measles 0.01 0.01 0.01 0.00 Scarlet Fever 0.01 0.00 0.00 0.00 Whooping Cough 0.03 0.03 0.02 0.03 Diphtheria 0.05 0.05 0.04 0.02 Influenza 0.21 0.19 0.20 0.18 Notifications:— Small-pox 0.00 Scarlet Fever 1.89 1.96 1.78 1.53 Diphtheria 1.14 1.21 1.16 0.98 Enteric Fever 0.04 0.03 0.04 0.03 Erysipelas 0.34 0.40 0.31 0.37 Pneumonia 1.02 1.21 0.89 0.99 Rates per 1,000 Live Births. Deaths under 1 year of age 50 53 40 48 Deaths from Diarrhoea and Enteritis under 2 years of age 4.6 6.3 3.0 8.2 Maternal Mortality:— Puerperal Sepsis 0.77 Not available. Others 2.16 Total 2.93 Rates per 1,000 Total Births (Live and Still.) Maternal Mortality:— Puerperal Sepsis 0.74 Not available. Others 2.08 Total 2.82 Notifications:— Puerperal Fever 14.35 17.26 12.99 3.31 Puerperal Pyrexia 14.22 34 Summary of Borough Analyst's Report for the Year 1939. 1,665 samples were submitted for examination. Of these 1,542 consisted of foods and drugs. The remaining samples were received from various Borough Departments and Private Purchasers. Out of 850 formal samples 45 or 5.3 per cent. were adulterated, and of 692 informal samples 39 or 5.6 per cent. were adulterated, making a total of 1,542 samples, out of which 84 or 5.4 per cent. were adulterated. Of the samples taken under the Act 1,410 consisted of foods, and of these 76 or 54 per cent. were adulterated (19 samples contained an allowed amount of preservative). Of 132 drugs 8, or 6.1 per cent., were adulterated. Legal Proceedings.—-Offences were committed in 87 cases. These were dealt with as shown below :— Adultered. Other offences. T otal. Formal Proceedings 28 3 31 Caution 15 — 15 No action 2 — 2 Informal 39 — 39 84 3 87 Fines and costs totalled £95 15s. 0d. Milk.—845 samples of milk were examined. The average composition, including 24 adulerated samples, was :—Fat, 3.48 per cent., and solids-not-fat, 8.72 per cent. 34 samples of milk taken from hospitals, etc. averaged:— Fat, 3.58 per cent. and solids-not-fat, 8.79 per cent. 30 samples of milk taken from schools averaged :—Fat, 3.34 per cent. and solids-not-fat, 8.69 per cent. ADULTERATED SAMPLES. Nature. Adulterated. Legal Proceedings. Fines. Costs. Informal. Formal. Percentage Aulterated. Foods. £ s. d. £ s. d. Bread and Butter 22 18 16.7 15 28 0 0 28 7 0 Cream 1 1 50.0 — — —. Cream Cheese 2 — " 11.8 — — — Ground Ginger 3 — 50.0 — — — Lard 1 — 20.0 — — — Milk 3 21 2.8 13 8 0 0 21 11 0 Suet 1 1 20.0 — — — Vinegar 1 I 66.7 — — — Drugs. Ammoniated Quinine Tablets 2 1 27.3 Liniment of Turpentine 1 1 100 — — — Parrish's Food 1 1 50.0 — — — Sulphur Ointment 1 16.7 — — — Poor quality samples.—44 samples, including 21 samples of milk, were reported as of inferior grade or doubtful quality. Offences other than Adulteration.-—In three cases vendors paid a total of £9 17s. Od. in fines and costs. Miscellaneous Samples.—123 miscellaneous samples were submitted for analysis. These included 11 cowshed samples (5 of which were below the standard). Of the remaining 112 samples 85 were foods, and of these 14, or 165 per cent., were unsatisfactory. D. HENVILLE, Borough Analyst, 35 INDEX. PAGE. I. Statistics and Social Conditions of the Area 4 II. General Provision of Health Services 5 III. Sanitary Circumstances of the Area 16 IV. Housing 22 V. Inspection and Supervision of Food 25 VI. Prevalence of, and Control over Infectious and other Diseases 26 VII. Statistics provided by the Registrar-General 30 Air Raid Precautions 5 Analyst's Report 34 Ante-Natal and Post-Natal Services 3 Area of Borough 4 Bacteriological Examinations 5 Bakehouses 21 Births 4 Births Act, Notification of 8 Bug Eradication 27, 28 Canal Boats Acts 20 Child Life Protection 11, 12, 14 Cleansing of persons 28 Convalescent Treatment 14 Day Nurseries 10 Deaths 5, 31 Dental Clinic 7 Diphtheria Immunisation 27 Disinfection 28 Extra Nourishment, Supply of 6 Factories Act 20 Finsen Light 6 Food Inspection 25 Food Poisoning 26 Food Regulations (Imported) 25 Health Visitors, work of 8, 12 Home Helps 14 Home Nursing n Home Office, report to (form 572) re. Factories Act 20 Housing:—Statistics 23 Infant Welfare Centres, Work at 8,13 Infantile Mortality 15 36 PAGE. Infectious Diseases 10, 26 Laboratory facilities 5 Legal Proceedings 22 Marriages 4 Maternal Mortality 11 Maternity Nursing 9 Maternity and Child Welfare Services (Form MCW 96 Revised) 8-11 Milk, Analysis of 34 Milk and Meals to mothers and children 14 Notifiable diseases 26 Outworkers 21 Overcrowding 22, 24 Pneumo-Thorax refills 6 Population 4 Registrar General Statistics 30 Sanitary Inspectors:—Inspections 16, 17 „ „ Return of sanitary work 18, 19 Slum Clearance 22 Small-pox 29 Special Treatment (Tuberculosis) 6 Staff 2 Statistics 4,30 Toddlers' Clinics 13 Tuberculosis: Dental clinic 7 „ Dispensaries, Report on 5, 6 „ „ Returns (Forms T145) 6 „ Summary of Notifications, (Form T 137) 29 Underground Rooms 23 Unsound Food 25 Vaccination 29 Verminous persons and premises 28