library METROPOLITAN BOROUGH OF STEPNEY. ANNUAL REPORT (Abridged) FOR THE YEAR 1941. OF THE MEDICAL OFFICER OF HEALTH AND ADMINISTRATIVE TUBERCULOSIS OFFICER F R 0 'SIIIEL, L.R.C.P.I., L.M., D.P.H. TOGETHER WITH A SUMMARY OF THE REPORT OF THE PUBLIC. ANALYST. Public Health Department, Queen Mary College, Mile Er.d Road, London, E. 1. To the Mayor, Alderman and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies & Gentlemen, I beg to present my report for the year 1941. It is again an abridged report in accordance with the direction of the Ministry of Health (Circular 2504). The Registrar General's estimate of the population of the Borough is not recorded, because of war conditions it fluctuated and no accurate comparisons can be made with the figures of former years. The birth rate was 15.5 per 1,000. The death rate increased in 1941. The death rate of infants under 1 year of age was 79.5 per thousand live births. Maternal mortality was 3.58 per thousand births. Infectious disease during the year was low, as compared with pre-war years. 1027 notifications xvere received in 1941 compared with 867 in the previous year. Scarlet fever decreased from 135 to 66. Diphtheria from 166 to 120. Pneumonia from 142 to 108. The only increases of note were Measles from 20o to 382 and Whooping Cough from 44 to 214, compared with last year. There were no cases of Smallpox. The number of cases of Tuberculosis notified during the year was 217. The Public Health Department was transferred on 1st December frcm 43, Wiiitehorse Road, E.l. tc the Temporary Municipal Offices which are at present at Queen Mary College, Mile End Road, E. 1. All the peace-time health services carried on as throughout the year. A residential day-nursery was opened at Syston Court on the 13th January by a voluntary committee under Lady Gunston, representing the American War Relief Committee. The majority of the places were reserved for pre-school children from the East End Boroughs, mainly Stepney. Defence Reg. 31a came into operation early in the year and gave power to local authorities to compulsorarily evacuate children suffering from the effects of air raids. Circular 2261 of the Ministry of Health, dated 8th January, dealt with the administration of these regulations. Provision was made for the Council's part-time Modical Officers of the infant welfare r centres to medically examine children under these regulations. The facilities for Medical Aid Posts in Public A^r Raid Shelters and medical supervision were continued. Arrangements were made, as suggested by the Ministry of Health for immunising against Typhoid Fever those persons who so desired. Tlie diphtheria immunisation clinic at 35, Stepney Green continued and for part of the year an extra session was opened. The attendances have increased considerably viz. from 714 in 1940 to 1893 this year. Tne Scabies Order 1941 came into operation and gave useful new powers for dealing with Scabies and Vormin. Tne Council opened a Scabies Cxinic at the Lonuo.4 Hospital and a Scabies & Vermin clinic at Branch Road, The Sanitary Inspectors and Health Visitors were released from part-time supervision of Stretcher Party depots and First Aid Posts and thus were enabled to give more time to normal duties. The Sanitary Inspectors still assist in manning the rota for the Casualty Services at the Civil Defence Control Centre, after office hours. Upon inspection of underground bakehouses it was ascertained that eight such bakehouses had been closed for a period of twelve months or more and in consequence they were removed from the register. There are now in the Borough only 30 out of the original 69 which remained open in 1904. Once more I desire to express ray gratitude to the staff who have worked hard to maintain the services of the department under difficult conditions and to the Chairmen and Members of Committees for their help and co-operation, I am, Your Worship, Ladies & Gentlemen, Your obedient servant, F. R. O'SHIEL Medical Officer of Health metropolitan borough op stepney ANNUAL (ABRIDGED) REPORT OP THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1941. AREA OF BOROUGH (In acres) 1902,766 POPULATION: Registrar-General's estimate for the midyear 1941 is not available for publications BIRTHS. Live legitimate and Illegitimate. Rate per 1000 of the estimated resident population 15.5 Live and Still; Rate per 1000 total births 76.3 DEATHS. M. F. TOTAL. 1145 738 1883 DEATHS FROM PUERPERAL CAUSES. Rate per 1000 total (Live • ; ' ' and still births) Puerperal sepsis JL . ? 1.19 Other puerperal causes 2, 2.39 3 3.58 DEATH-RATE OF INFANTS UNDER ONE YEAR OF AGE:- All infants per 1000 live births 79,5 Legitimate infants per 1000 legitimate live births 78.5 Illegitimate infants per 1000 illegitimate live births 89,5 Deaths from Cancer (all ages) 203 " Measles " " 7 " " Whooping Cough (all ages) " " Diarrhoea (under 2 years of age 11 RATES FOR ENGLAND, WALES AND LONDON COMPARED T>1TH RATES FOR THE BOROUGH OF STEPNEY. England & Wales. London. Stepney. Live births. 14.2 8.9 15-5 Deaths. 12.9 16*3 Infant Mortality. 59.0 68,0 79.5 Puerperal Causes. 2,23 (Not available) 3.58 NURSING IN THE HOME. The facilities were provided as usual but not availed of during the year. LABORATORY FACILITIES. Total number of Bacteriological Examinations was 387, 373 for Diphtheria Bacilli (of these 45 were found to be positive) and 14 for Dysentry (all of which were negative). -1- TUBERCULOSIS DISPENSARIES. Number of attendances at the Dispensary. 3624 " " consultations with medical practitioners Personal 128 Other 544 " visits by Tuberculosis Officers to homes 389 " " specimens of sputum examined 447 (of these 89 were positive) " " X-ray examination: films 617, screening 333 950 " " children boarded out 11 " " visits by Tuberculosis Health Visitors to homes 5436 Special treatment was given to Tuberculosis patients as follows:- Pneumo-thorax refills to 45 patients necessitating 448 attendances Finsen light to 1 patient necessitating 68 attendances Number of patients recommended for Sanatorium treatment 222 " " contacts examined 385 Extra nourishment to tuberculous patients. 461 grants were made to 110 patients during the year. Each grant was for a period of 28 days. DENTAL CLINICS. fa] Tuberculosis: Total attendances 71 " number of new patients 9 (b) Maternity & Child Welfare:- Total attendances 293 " number of new patients 54 MATERNITY AND CHILD WELFARE AND HEALTH VISITING. Taf" Number of Health" Visitors employed: Municipal 10 Voluntary _9 Total: 19 (b) Number of all Health Visitors' visits, .to. expectant mothers, first visit's' 601 Total 1303 (c) Number of all Health Visitors' visits to children under 1 year, first visits 673 Total .7733 (d) Number of all Health Visitors' visits to children between 1 and 5 years. Total 19688 (e) Number of Infant Welfare Centres on 31st December, Municipal 6, Voluntary 6. (f) Number of children a't -first attendance under 1 year old, 828, betwe-en 1 and 5 years 434 (g) Number of attenders under 1 year old at end of year 681, over 1 year old 1628. (h) Total number of visits made during the year for all purposes by ^jalth Visitors:- (a) Municipal 14732 (b) Voluntary 30194 ANTE & POST NATAL CLINICS. fa] Number of clinics:- Municipal 2, Voluntary 3. (b) Total number of women who attended, 2192 (including 110 post natal). Note:- These figures include women who are not Stepney residents. SUPPLY OF MILK. The National Milk Scheme came into operation in July 1940. Free, Cheap rate Number of beneficiaries 1941:- Liquid milk 3437 4354 Dried " 214 214 In addition the Council continue their scheme in supplying virol and oil and malt to mothers and children attending the centres. -2- CHILD LIFE PROTECTION:- Number of persons who wore receiving children for reward at the end of the year .. . 2 Number of children so received 2 " " Protection Visitors, Health Visitors ...10 " " " " Others1 Visits made by above to Homes of Foster Mothers 11 " " " " " " " " Children 16 Proceedings taken during the year under part XIII of. the Public Health (London) Acty-1936 Sect. 239 (a) Nil. SALUTARY CIRCUMSTANCES OF AREA:-. The following is a summary of the inspections carried out by the nine District Sanitary Inspectors:- To houses and other premises (Complaints, Nuisances, Infectious Diseases, Restaurants, Lodging Houses, etc.) 5825 Miscellaneous Inspections 6178 To factories and other premises under'Factories Act 1£50 Number of re-visits 3975 " 1 Intimations Served 1748 " " Statutory Notices 186 " " Sui.imonses taken out-1 " " Visits to air raid shelters 2570 " '' Visits to Rest and Feeding Centres 109 A summary of sanitary work carried out as a result of notices served is as follows:- Repair to roofs, gutters and rain water pipes 519 Cleansing or repairs to drains, Water Closets, Sinks, baths and lavatory wastes 926 Miscellaneous repairs 795 Dampness in premises remedied and rooms cleansed . 780 Drains tested 223 of which 16 were defective 223 Transfer of Sanitary Inspectors to Town Clerk's Deportment On 15th November 4 Sanitary Inspectors were transferred to the Town Clerk's department to assist in the work concerned with repair to war damage! properties Oi. 1st December another 4 Sanitary Inspectors were similarly transferred. Whilst so temporarily engaged these officers are designated District Technical lr?opectors. HOUSING. Number of houses inspected for housing defects 10594 inspections made for such purposes 12016 " " houses not reasonably fit 1828 houses rendered fit informally 1679 " " houses in respect of which notices were served 1246 " " houses in which defects were remedied after service of formal notice 191 " " bombed properties inspected 40474 Special survey of the above 35692 OVERCROWDING. May 1936 to Dec. 1941. Houses in which the rooms were measured and the permitted number ascertained 7565 Number of visits to the above 9214 " " houses in which the information has been supplied to owners and occupiers 7Q91 INSPECTION iiND SUPERVISION OF FOOD. Total number of inspections and re-inspections made by the four Inspectors engaged in the supervision and inspection of food amount to 7538. -3- Legal Proceedings were taken out in 39 instances. The quantity of foodstuffs destroyed during the year amounted to 1295 "tons'under the Public Health ( Imported Food) Regulations, and 76 tons under the Public Health (London) Act, 1936 (see also Analyst's Report). 1294 samples of food and drugs and 98 other samples were taken and submitted' for analysis. Assistance was also rendered by these Inspectors to the. Food Control Committee on Food Salvage',' new registrations etc. NOTIFICATION OF INFECTIOUS DISEASES.{.Other than Tuberculosis) 1027 notifications were received during the year, particulars of which are given as follows:- Scarlet Fever 66, Diphtheria 120, Enteric Fever 2, Measles 382, Puerperal Fever 5, Puerperal Pyrexia 4, Erysipelas 66, Cerebrospinal Fever 52, Ophthalmia Neonatorum 2, Food Poisoning 3, Dysentery 3, Pneumonia, 108 -and- Whooping Cough 214. No notifications were received with respect to Anthrax, Encephalitis Lethargic a Poliomelitis, Polio-encephalitic, Membranous Croup, Malaria- and Smallpox.- NOTIFICATIONS OF TUBERCULOSIS. Pulmonary 190, Non-Pulmonary 27, Total 217. BUG- ERADICATION:- 1103 'Inspections and re-inspections of premises were' carried out by the Inspectors on bug eradication. 355 premises and 729 rooms were sprayed during the year. During the year the Housing Committee decided not to disinfest as a preventative against bug infestation the effects of any families prior to their removal to the Council's dwellings.' 30 lots of furniture were'treated at the Cyanide disinfestation chamber for the'rehousing of bombed-out families before the tenants were removed to other premises. There were 45. lots of bunks treated in the Cyanide chamber for the Shelter Department of Civil Defence. 118 loads of straw were fumigated as a precaution against foot and mouth disease - as required by the Ministry of Agriculture. CLEANSING AND DISINFECTION;f- 1081 rooms were fumigated because of infectious disease and 88 because of pulmonary tuberculosis. 84482 articles of clothing and bedding were disinfected. SMALLPOX &.VACCINATION:- No cases of smallpox were notified. There were 1962 births registered during 1940, of these 417 were successfully vaccinated, 692 Statutory declarations were received. In addition, 631 children who were registered outside the Borough were successfully vaccinated. The total number of persons vaccinated was 104" 4/43 -4- METROPOLITAN BOROUGH OF STEPNEY. SUMMARY OF BOROUGH ANALYST'S QUARTERLY REPORTS FOR THE YEAR 1941. 1,334 samples were submitted for analysis, Of these 1,285 consisted of foods and drugs. The remaining 49 samples were received from various Borough Departments. Out of 534 formal samples 31 or 5.8 percent, were adulterated and of 751 informal samples 38 or 5.1 percent, were adulterated making a total of 1,285 samples out of which 69 or 5.4 percent, were adulterated. Of the samples taken under the AGt 1,127 consisted of foods and of these 65 or 5.8 percent, were'adulterated (12 samples contained an allowed amount of preservative). Of 158 drugs 4-or 2.5 percent, were adulterated. Legal Proceedings. Offences were committed in 69 cases, these were dealt with as shown below:- Auulterated. Proceedings 17 Formal Caution 9 No action 5 Informal 38 69 Fines and costs totalled £51,13. Od. MILK. 750 samples of milk were examined. The average composition, including 22 adulterated samples was:- Fat 3.54 percent, and solids-not-fat, 8,64 percent. 5 samples of milk taken from hospitals, etc. averaged:Fat 3.47 percefrt, and solids-not-fat 8.69 percent. ADULTERATED SAMPLES. Nature. Samples taken. Adulterated Legal Proceed ings. Fines. Costs. Informal. Formal. Percentage adulterated. Foods. £. s . d. £. s. d. Bread and. Butter 58 16 6 37.9 6 - 8. 8. 0 Milk 750 7 15 2.9 8 7. 0. 0 13. 13. 0 Butter 17 1 — 5.9 — -- -- Cream 1 – 1 100 1 5. 0. 0 2. 2. 0 Butter and Margarine rolls 1 - 1 100 1 _ 2. 2. 0 Ground Almonds 5 1 - 33.3 - - -- Vinegar 6 2 2 66.7 - - -- Meat Roll 1 - 1 100 - - -- Ice Cream 7 1 - 14.3 - - -- Sausage 18 1 - 5. 5 - - -- Sugar Substitute 3 1 2 100 1 5. 0. 0 8. 8. 0 Egg Substitute 17 1 1 11.8 - - -- Salad Oil 3 1 1 66.7 - - -- Dried Egg 2 1 - 50.0 - - -- Cottage Spread 1 1 - 100 - - -- Creamy Spread 2 1 — 50.0 — - - DRUGS. Boric Ointment 6 1 - 16.7 - - - Tincture of Iodine 9 1 - 11.1 - - - Saccharin Tablets 10 -– 1 10.0 - –- - Sal Volatile 4 1 - 25.0 - - - Poor quality samples. 83 samples including 66 samples of milk were reported as of inferior grade or doubtful quality. p.t.o. CAUSES OE ALL. DEATHS DURIUC THE YEAR 1941. male 1145. Female 738 Total 1883. CAUSES OF DEATHS. TOTAL. Under 1 yr. 1-5 5-15 15-45 45-65 65 etc. M F M F M F M F M F M F M F Typhoid - - - - - - - - - - - - - - Cerebro spinal fever 3 5 - 1 1 - - - 2 1 - 1 - 2 Scarlet Fever — — - - - - - - - - - — — - Whooping cough 3 1 2 — 1 1 - - - - - - - - Diphtheria 1 1 — — — — - - 1 1 — 1 - - Tub. of resp. system 99 29 - 1 - - - 2 43 20 41 4 15 2 Other forms of tuberculosis 11 6 1 - 5 4 2 1 - 1 2 6 1 - Syphilitic diseases 13 8 — - — — — - 2 — 6 5 5 3 Influenza 9 7 - - — — — - 5 : 2 1 2 3 3 Measles 5 2 2 2 - - — — - - - - - - Ac.polio-myel. & polio-enceph. 1 - - - - - - - - - 1 - - - Ac. inf. encepli. 3 - - - - - - - 1 - 2 - - - Cancer of buc.cav.& oesoph. 11 - - - - - 2 - 9 - uterus 10 — - - 2 - 9 - 1 Cancer of all other sites. 78 49 - - - - 1 - 6 4 38 19 33 26 diabetes 8 11 — — - - - - 1 3 2 4 5 4 Intra-cranial Vascular lesions 40 43 - - - - - - - 1 13 10 27 32 Heart Disease. 214 183 - - - - - 2 11 12 43 30 160 139 Cancer of breast 14 - - - - - 2 - 7 7 5 Otherdis. of circ. system. 54 30 - - - - - - 2 - 16 10 36 20 bronchitis. 106 52 2 1 — - — — 2 - 39 13 63 38 Pneumonia 81 48 7 2 1 2 - - 6 4 31 13 36 27 Other resp.dis. 11 7 — — - - - - 4 2 2 2 5 3 Ucer of stomach or duodenum. 16 7 - - - - - - 1 — 12 1 3 6 Cancer of stomach & duodenum 30 11 - - - - - - 2 1 12 5 16 5 Diarrhoea under 2 yrs. 8 3 8 3 - - - - - - - - - - Appendicitis 1 - - - 1 - - - - — - - - — Other digve. dis. 18 13 - - - - - — 5 1 8 7 5 5 Nephritis Puor.& post-abort. 13 17 - 1 - — — 1 4 1 4 9 5 5 sepsis. Other maternal causes - 1 2 - - — - — - — - — - - - - - 1 2 - - - - - - - - Prem. birth. Con.mal.birth inj. 10 5 - - - - - - - - - - - — infant dis. 10 8 6 5 — 1 — - 3 - 1 1 - 1 Suicide 6 1 — - - - - - - 1 2 - 4 - Road traffic acc. 18 1 - — — — 1 - 4 - 6 1 7 - Other violent causes 204 112 1 2 1 2 9 7 92 50 66 28 35 23 All other causes 60 51 - 2 - - 1 10 10 21 12 28 27