AC6367 LIBRARY Ste 55 Metropolitan Borough of Stepned ANNUAL REPORT of the Medical Officer of Health F.R. O'SHIEL, L.R.C.P.I., L.M., D.P.H. for the year 1950 Together with the Report of the PUBLIC ANALYST CONTENTS Page Public Health Committee 2 Introductory 3 Staff 5 Summary of Statistics 6 I. Statistics and Social Conditions of the Area 7 II. General Provisions of Health Services. 9 III. Sanitary Circumstances. 21 IV. Housing 28 V. Food - Inspection and Supervision 30 VI. Infectious and other Diseases 38 Public Analyst's Report 42 Appendix 47 Index 65 Metropolitan Borough of Stepned. ANNUAL REPORT of the Medical Officer of Health F.R. O'SHIEL, L.R.C.P.I., L.M., D .P .H . for the year 1950 Together with the Report of the PUBLIC ANALYST PUBLIC HEALTH COMMITTEE (at 31st Dec. 1950) Ex-officio: His Worship The Mayor (Councillor F.G.Spearing, J.P.) Chairman: Councillor (Miss) E. Upton Vice-Chairman: Councillor (Mrs.) K. Edwards Alderman T. Aylward " (Mrs.) A. Elboz " J. Moore, J .P. " G. Pendley " (Mrs.) N. Sambrook Councillor D.M. Ahearne Councillor M. Lerner " (Mrs.) E. Armsby " M. Levitas " (Miss) E. Aylward " J. Lomas " S. Callaghan " J.J .A. Long " W.J. Curtis " (Mrs.) F. Marsh " M. Davies " M. Mazin " R.A. Durell " J, McGlashon " (Mrs.) F. Finlay " R. Milligan " N. Finlay " J. Sambrook " J.A. Hanshaw " (Mrs.) A. Taylor " J.F. Jolly " H.J. Vanloo " A. Karstadt Council's Representatives on Division 5 Health Committee, at 31st Dec. 1950, were. Councillors Miss Upton, Mrs.Edwards and Mrs .Marsh. -2- METROPOLITAN BOROUGH OF STEPNEY PUBLIC HEALTH DEPARTMENT, 43, White Horse Road, Stepney, E.l. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies & Gentlemen, I have the honour to present my report on the state of the public health in Stepney for the year 1950. The estimated population of the Borough shows some decrease and is "estimated" by the Registrar-General to be 99,730. The total number of births registered has however slightly increased, and is 1,888 compared with 1,872 last year. The live birth rate is 18.50. It is pleasant to record that the infant mortality rate of 26,55 is the lowest recorded in the history of the Borough, and is in fact below the average figure for England and Wales, viz. 29.8. The maternal mortality rate is 1.05. The Borough of Stepney was formed in 1901 from the union of the parishes of Mile End Old Town and St. George's in the East and the districts of the Limehouse and Whitechapel Boards of Works including the Tower of London. This year, 1950, is the Golden Jubilee of the Borough. During the fifty years which have elapsed the state of the public health has greatly Improved. It is interesting to glance through the early annual reports of Dr. Daniel Thomas, the Borough's first Medical Officer of Health. In 1901 Stepney with a population of 298,600 was the third most populous borough in London, only exceeded by Islington and Lambeth, and-much gross overcrowding existed. There were 31>462 inhabited houses in the Borough and an average of 9.4 persons per house. In 1938, just before the -3- war, there were 36,744 houses with 5.4 persons per house, and to-day 28,114 houses with 3.5 persons per house. Dr.Thomas describes a special survey on overcrowding in the St.George's area in 1902. The 654 houses inspected contained 3>217 adults and 2,06l children, an average of 8 persons per house. 629 of the 1,378 families visited occupied one-room tenements. In 1901 the death rate was 20.8 per 1,000 of the population, this year's rate being 12.58. In ±901, 22 persons died of Smallpox (252 in 1902; 47 from Typhoid, 41 from Scarlet Fever, 91 from Whooping Cough, 155 from Measles, and 78 from Diphtheria. In 1950 there were no deaths from any of these diseases. In 1901, 165 children in every 1,000 born died before they reached the age of one year. Only 26.5 per 1,000 died in 1950. Six times more infants died in 1901 than to-day. 626 persons died of Pulmonary Tuberculosis in 1901 (mortality rate 2.09) as compared with 50 in 1950 (mortality rate 0.50). An interesting item showing the change in method of milk distribution - in 1901 there were 44 cowsheds with 842 cows in Stepney; to-day only one remains with 8 cows. Of 283 samples of Milk taken in 1901, 63 (22%) were adulterated resulting in 43 prosecutions; in one case the adulteration by added water was as much as 37 .75%. In the year under review none of the 186 samples taken was found to be adulterated. In ending the introduction to my report I wish to express my thanks to the Chairman and Members of the Public Health Committee for their support and interest during the year, to the Chief Officers of the Council for their willing co-operation, and to the members of my staff for the loyalty and good service given by them throughout the year. I have the honour to be, Your Worship, Ladies and Gentlemen, Your obedient Servant, F. R. 0'SHIEL , » Medical Officer of Health. -4-. STAFF of the PUBLIC HEALTH DEPARTMENT (at 31st December 1950) Medical Officer of Health F.Roantree O'Shiel, L.R.C.P.I.,L.M.,D.P.H. Deputy Medical Officer of Health - Vacant Public Analyst': W.M.Paulley, B .A. ,F .R.I .C . Assistant Analyst: C.J .P .McGinn, B.Sc .,A.R.I .C. Assistant Administrative Officer Principal Assistant E.P.Webber (1.2) S .J .Carr Sanitary Inspectors District: J.J.Keniry (1) W.E.Anstee (1) G.D.Freeland (1.2.3) S.S.Lowther (1.2) W.Cue (1) W.E.Hart (1) E.A.Sheppard (1.2) R.W.G.Day (1) E.C .Hawker (1.2) P.W.Thorn (1) S.Firsht (1) W.H.Haworth (1) B.Reilly (1) Food: •A.C.Brown(1.2) H .J .Green(1.2 ) W'.F.'Snith(1.2.6) S .Vogler (1.2) Pis infestation: E.J.Edwards (1.2) Miss H.A.Whitty (1.2 ,4-.5.7) Housing: C.F .Guy (1) Rodent Control: J.G.McCarthy (1) Clerical Staff T.Aylward W.E.Driscoll S.S.Harris Mrs .M.Munday (T) D.J .Berry S.Embleton Miss R.Levey M.J .0'Connor (+) H.I .Davies (T) Mrs ,C .Gardner J .McMullon M.Pliskin W.J .Dixon Craretakers: A.N.Cook, Public Health Offices. W. Clark, Mortuary & Disinfecting Depot. Messenger/Relief Caretaker: E. H. Vaughan. Rodent- Investigators: S.Smith(T) T.T.Walker (T) S.C .Ludlow(T) Foreman Dislnfector Foreman Rodent Operative W.Sexton T.J.Fox 1. Sanitary Inspectors Cert. 5: State Cert. Midwife. 2. Meat and Other Foods Cert. 6. Diploma Social Science. 3. Smoke Certificate. 7. Trained Nurse. 4. Health Visitors Cert. (+) Permanent employee temporarily transferred from the Public Cleansing Department. (T) Temporary. -5- SUMMARY OF STATISTICS, 1950, Area of Borough 1902.7 acres Population (Registrar-General's estimate) 99,730 Number of inhabited houses (end of 1950) according to Rate Books 28,114 Rateable Value (1st April 1950) £1,231,293 Sum represented by a penny rate, gross £5,130 Density of Population (persons per acre) 52.4 BIRTHS. Total M. F. Legitimate 1714 871 843 Illegitimate. 131 65 66 TOTAL LIVE BIRTHS 1845 936 909 Live-birth rate per 1000 population= 18.50. STILLBIRTHS 43 21 22 Still birth rate per lOOO total (live and still) births = 22. 77• •TOTAL BIRTHS: 1888 957 931 DEATHS. 1255 703 552 Death Rate per 1000 population = 12.58, MATERNAL DEATHS 2. Rate per 1000 total (live & still) births = 1.05. DEATHS OF INFANTS UNDER ONE YEAR OF AGE. Total M. F. Legitimate 43 29 14 Rate per 1000 live births (legitimate) = 25.08 Illegitimate . 6 3 3 Rate per 1000 live births (illegitimate) = 45.80 TOTAL: 49 32 17 Rate per 1000 live births (total) = 26.55 DEATHS FROM Total M. F. Cancer 255 153 102 Measles — — — Whooping Cough - - - Diarrhoea (under 2 years of age) 4 3 1 Tuberculosis - respiratory, 50 37 13 “ - other forms 6 3 3 -6- I. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. POPULATION. The population of the Borough has fallen slightly, the Registrar-General’s mid-year estimate "being 99,730, which is 820 less than in last year. The area of the Borough is. 1902.76 acres, and the density of population is therefore 52.4 persons per acre. The number of inhabited houses, 28,114, shows an increase of 1,433 over the figure for 1949. The natural increase of population (i.e. the number by which births exceed deaths) was 590. BIRTHS. The total number of live births registered in the Borough during the year was 3,828, of which 2,103 belonged to other areas. In addition, 120 births belonging to Stepney occurred outside the Borough, making a total of 1,845 births (936 male and 909 female) to Stepney residents, an increase of 15 over that of the previous year. The live birth rate for the year is 18.50 per thousand of the population, which is 0.31 higher than that for 1949. The rates for the County of London and for England & Wales are 17.8 and 15.8 respectively. Illegitimate births numbered 131, representing 7.1% of live births, Still births numbered 43, representing a rate of 22.7 per 1,000 total births, an increase of 0.3 per 1,000 on last year. Comparative vital statistics for the year as between England & Wales, the Administrative County of London, and Stepney, are shown on Table 1 on page 48. MARRIAGES. The number of marriages registered during the year was 1,056, being 97 less than last year. The rate of marriages per 1,000 population was 21.16. DEATHS. The net number of deaths registered during the year was 1,255, of which 703 were males and 552 females, as compared with 1,339 for last year. The Rate of 12.58 compares with 13.3 for 1949. It is of interest to record that 62% of the total deaths were of persons over the age of 65. A graph on page 49 compares this figure over the last 50 years. A table on page 50 shows deaths by cause and age, -7- INFANT MORTALITY. The deaths of infants under 1 year of age numbered 49, giving a rate of 26.55 per 1,000 live births, the lowest rate ever recorded in Stepney, as compared with 32.2 last year and 28.4 in 1948. The rate for England & Wales is 29.8, and that for London 26.3. Comparative infant mortality rates since the Borough's formation are given in graph form on page 49. There were 34 deaths of infants under 4 weeks of age, which represents a rate of 18,42 per 1,000 live births. MATERNAL MORTALITY. There were 2 maternal deaths during the year, representing a rate of 1.05 per 1,000 total (live and still) births, UNEMPLOYMENT. The Ministry of Labour has kindly supplied me with the following information as to the estimated number of persons residing in the Borough registered as unemployed at the end of the. year Men Boys Women ' Girls Total 1506 16 210 9 1741 The total unemployed at the end of 1949 was 2196. -8- II . GENERAL PROVISIONS OF HEALTH SERVICES WELFARE OF AGED PERSONS Removal Orders. Section 47 of the National Assistance Act, 1948, empowers the Council to make application to the Courts for orders for the removal of aged, infirm or physically incapacitated persons who are living in insanitary conditions and who are in need of care and attention. During the year it was found necessary to apply for 12 such Removal Ofders and 1 Detention Order in respect of 4 men and 8 women, average age of whom was 77. Details are given below. The Court Orders are for a period of 3 months in each case. Person. Age. Reasons for Removed to. Remarks. action. Mrs.E.G. 84 a. b, c. d. - Removed to hospital by Police. Died. Mrs.B.J. 78 a, b. c. d. Institution. Died. Miss M.P. 70 a. b. c. d. Hospital. -do- " a. b. c, d. Institution. Extension Order. Transfer to Institution, Mrs.M.W. 78 a. b. c. d. Hospital. Died. Mr.A.W. 83 a. c. d. Institution. Died. Mr.W.H. 65 c. d. Institution. Mrs.M.G. 88 a. b. c. d. Hospital. Died. Mr.J.F. 81 • a. b. C. d. - Previously removed to hospital. Mrs.I.S. 75 b. c. d. Hospital, Mr.G.W.D, 69 a. b. c. d. Hospital. Died. Miss L.T. 83 a. b. c. d. Institution. Mrs. H.I. 75 b. c, d. Institution. (*)(a) Suffering from grave chronic disease. (b) Physically incapacitated. (c) Aged, infirm, and living in insanitary conditions. (d) Unable to devote to himself/herself and not receiving from other persons proper care and attention. -9- A single case sometimes involves two or three consecutive days' visiting, not only to the patient, which takes time, but also to relatives, and other contacts with statutory and voluntary authorities, together with much letterwriting and record-keeping. The following two problem cases are not untypical,, and there is much work to be done which cannot be covered by casual "visiting". (a) Mr. and Mrs. X. Mr.X, a man of 65, and his wife, some ten years older, were discovered by the Sanitary Inspector in a dark 100$ basement room in the Spitalfields area. Both were ill and undernourished, and Mrs.X suffered from partial paralysis of the legs which kept her in bed or in a chair. The husband did the shopping. The room was stacked high with furniture and rubbish, which even overflowed on to the large double bed. I visited the case with the Sanitary Inspectors, and after consultation decided to try and -rehabilitate the. couple and prevent their home from being broken up. To clear the decks, both husband and wife were removed reluctantly under a Magistrate's Order for three months - she to a hospital and he to a welfare institution. The district Sanitary Inspector got the landlord to repair and decorate the room, impossible to tackle beforehand. Under Section 122 of the Public Health (London) Act, 1936, the contents of the room were-removed for disinfesting or destruction. The Assistance Board was approached and gave extra financial assistance, which made possible the purchase of a new bed, bedding and underclothing. After three months the couple came home much improved in health. The W.V.S. and Invalids' Kitchens provided "Meals on Wheels". A male home help attended and the couple were registered with a local general practitioner. Our mobile bathing squad provided home-bathing for the woman, and the man attended the public baths occasionally. Thus supported from various angles, the household held together precariously for 12 months or more. But gradually they began again to deteriorate mentally and physically. "Meals on wheels" were refused; they preferred fish and chips and bought-pies. It was impossible to keep up the constant supervision necessary The husband developed pneumonia and refused hospital treatment, but in a few days was removed to hospital by -10- ambulance. The wife, helpless without him, also had to go to hospital. After a period of convalescence, the husband was taken to a welfare institution in London, but in spite of every care he declined in health and died. The old woman, paralysed, is still in hospital, and it is quite impossible for her to return to the basement room without her husband to help her. This case, which extended over nearly two years, involved hours of work by many staff over a long period. The clerical work associated with the case accumulated a file of many pages, (b) Miss M.P. and Miss S.P. These two old sisters were found by the Sanitary Inspector in war-damaged 100% basement rooms in the Whitechapel area. Mary, aged 65, the younger sister, was the dominating personality. All her life a cripple, she was formerly employed making artificial flowers at home. Sarah,- aged about 70, of low mentality but physically active, earned money ostensibly by charring, but we suspect she spent most of her time begging, rather successfully, and seemed to be wellknown in the shops in the area. Sarah was dominated by Mary, and spent most of every day out of the house foraging. Unlike Case (a), the two rooms were scantily furnished except for a large bed and dirty bedding used by Mary, and a broken chair-bed used by Sarah. Both received assistance from the Assistance Board. They apparently used no ration books, and neither was registered on a doctor's panel. There were no cooking facilities except on an open coal fire at which Mary sat all day, the coal supply heaped on the wooden floor. There was neither china nor cutlery, and little else but rags and rubbish. Both women were incredibly dirty and unkempt. When I.visited Mary with our lady Sanitary Inspector she was unco-operative, and refused medical examination. Her reluctance to examination was explained by the presence of an elongated parcel bound round her body, suspected to contain money. Mary reluctantly accepted hot meals from the W.V.S. Later she refused to allow the visitors to take the meals downstairs. The plates, knives and forks provided disappeared, and she then accepted the meals on a newspaper. It was obvious that nothing constructive could be done for these two women, and Mary, on a Magistrate's Order, was removed by ambulance and' taken to hospital. Later Sarah was picked up wandering by'the police,and admitted to an institution. -11- After Mary's departure, £400 in notes and silver in bundles was found in the room, and taken away for safe keeping by the welfare officials under Section 48 of the National Assistance Act. 1948. Twenty-four hours later the rooms were burgled, Mary's miserly habits were obviously known locally. Our lady inspector has visited these sisters in the rest-home where they now are, and reports that they are well and happy, Mary worried at first about her money until she knew it was safe, and the sisters are allowed the reasonable use of it for additional comforts. Such cases as are outlined above are usually brought to my notice through the Sanitary Inspectors, neighbours, or the Old People's Welfare Association, During the year 663 visits were made to the homes of aged persons by the Woman'Sanitary Inspector, Close liaison is maintained with the L.C.C, for provision of domestic home helps, and with the District Nursing Association for the provision of district nurses to needy cases. Home Bathing. A scheme commenced during the year for the bathing of aged persons in their own homes by means of portable bathing equipment. 22 persons were so bathed, involving 27 baths. Home Cleansing. The female Cleansing Orderly undertook on seven occasions during the year to clean up the homes of aged persons. Action under Sections 122 and 127, Public Health (London) Act, 1936. In connection with old people's welfare, action had to be taken on 4 occasions during the year under Section 122 of the Public Health (London) Act, 1936, for the cleansing, disinfection or destruction of various articles. Compensation for goods destroyed was paid on one occasion. In addition, an Order was obtained from the Court under Section 127 of the Public Health (London) Act, 1936, for the removal of a verminous person for cleansing to the Council's Cleansing Station. Supply of Hot Mid-day Meals. Hot mid-day meals were supplied to aged persons during the year as follows:- "Meals on Wheels", through the W.V.S. .. 11,176, At Old Persons' Luncheon Clubs 12,042, -12- MATERNITY AND CHILD WELFARE. The personal health services are since July 1948 the responsibility of the L.C.C., and the administration of the services in Stepney, together with those in Poplar, Bethnal Green and the.City of London, is carried out by Dr. G.O. Mitchell, the Divisional Medical Officer, who is assisted in the day to day administration by the Borough Medical Officers of Health. I am indebted to Dr .Mitchell for the following' information pertaining to the services in Stepney. 1. Statistics. Infant Welfare Centres Total number of children who first attended during the year and who, on the date of their first attendance, were - Under 1 year of age 1,471 1-5 years of age 99 Total number of children who attended and who at the end of the year were- Under 1 year of age 1,318 1-5 years of age 2 ,080 Total attendances by children - Under 1 year of age 20,903 1-5 years of age 9,096 Ante-Natal and Post-Natal Clinics Ante-Natal consultations- No. of women who attended first time 135 No. of women who attended 157 Total attendances 1,010 post-Natal consultations- No. of women who attended 27 Dental Clinic No. of expectant and nursing mothers treated 41 No. of cases in which general anaesthetic for extraction was administered 56 No. of teeth extracted 250 No. of pre-school children treated 27 No. of cases in which general anaesthetic for extraction was administered 31 No. of temporary teeth extracted 87 -13- Health Visitors No. of infants under 1 year of age visited for first time 1,714 Total visits to infants under 1" year of age 13,331 Total visits to children 1-5 years of age 23,450 No. of expectant mothers visited 635 Total visits to expectant mothers 1,259 Infant Life Protection No. on Register:- 1st Jan. 1950 31st Dec. 1950 Foster Mothers 6 12 Foster Children 9 10 Child Minders (Daily Guardians) No. of daily guardians - voluntary 3 No. of children minded - " 2 Care of Premature Infants No, of premature births during the year 156 No. of deaths under 1 month 23 Supply of Milk Foods , &c. Foodstuffs distributed included Ostermilk, Cow & Gate, and Humanised Trufood. Immunisation and Vaccination For details of immunisation and vaccination see pages 38 & 39. Domestic Help Service The service covering the Boroughs of Bethnal Green, Poplar and Stepney has been divided into three districts, irrespective of borough boundaries, and the statistics for each separate Borough are not available. However, the number of cases in which help was provided in the "Southern" district (which comprises the Borough of Stepney less the area east of the Canal and two areas north of the east-west line - Whitechapel High Street, Whitechapel Road and Mile End Road) was as follows:- Maternity 15 Tuberculosis 12 Other 624 -14- 2. Services Provided. Infant Consultation Afternoons 673 Commercial Road - Monday,Tuesday,Thursday and Friday 52-54 Ashfield Street - Tuesday, Wednesday 17 Rhondda Grove - Monday, Thursday Mary Hughes, Underwood Rd. - Monday, Thursday St.George's Town Hall - Tuesday,Wednesday; Friday 5 Pier Head, Wapping - Wednesday Dame Colet, Duckett St. - Tuesday, Wednesday Ante-Natal 673 Commercial Road - Wednesday Toddlers' Clinic St.George's Town Hall - 1st Tuesday morning in each month. Vaccination Afternoons St .George's Town Hall - Friday 35 Stepney Green - Friday Immunisation 35 Stepney Green - Friday Note: Diphtheria and Whooping-cough immunisations are also carried out at the infant welfare sessions. Day Nurseries Nursery Creche 57 White Horse Road. Old Chureh Road Christian Street. Voluntary Day Nurseries Nursery School 2 Beaumont Grove. Thirza Street. St.Paul's, Wellclose Square. -15- STAFF. The following changes in the staff of the Department took place during the year:- (a) Commenced duty P. Cashman Temporary Clerk 24 November 1950 H.I. Davies do 11. December 1950 (b ) Ceased duty P. Cashman Temporary Clerk 9 December 1950 W.P. Howard Section Clerk (P.H.) 28 December 1950 W.F. Lellow Assistant Administrative Officer 31 January 1950 (c) Change in duties etc. B. Reilly Sanitary Clerk was appointed Sanitary Inspector 7 December 1950 E.P. Webber Sanitary Inspector was appointed Assistant Administrative Officer 1 August 1950 DECEASED PERSONS. Mortuary. Nine bodies were received in the Council's Mortuary during the year. Inquests. Inquests were held on 47 residents of the Borough, 3 of whom were children under five years of age; 7 deaths were due to suicide, 2 road accidents, 18 accidental and 20 due to other causes. Burials. Section 50 of the National Assistance Act 1948 places the duty on the Council to arrange, when no private arrangements exist, for burial of any persons found dead or dying within the borough. 42 such burials took place during the year at a cost of £356.7.0, of which £240.7.9 was irrecoverable from the estate of the deceased persons. -16- CONFERENCES. The following Conferences were attended during the year by members of the Committee and of the Department' Conference Held at Attended by Food and.Drink Infection London. Medical Officer of (Central Council for (Olympia) Health and Cllr. Health Education). Curtis. National Smoke Abatement Margate. Medical Officer of Society Annual Conference. Health and Vice- Chairman. Royal Sanitary Institute Eastbourne. Medical Officer of Annual Congress, Health and Chairman. Sanitary Inspectors Assoc- Bridlington. Mr.W.F.Smith (Saniation Annual Conference. itary Inspector) and Cllr. Curtis. National Old People's Wei- Brighton. Medical Officer of fare Committee Conference. Health and Chairman. SPECIAL REPORTS OF MEDICAL OFFICER OF HEALTH TO PUBLIC HEALTH COMMITTEE. Special Reports on the following subjects were made; to the Committee during' the year:- Industrial Health Services Committee. Mass Radiography - Council Employees. Temporary Structures - Vans, "Mobile" Snack Bars, etc. Proposed Scheme for Cleansing Service for Clothing etc. of Aged Persons. Clean Food Campaign held in Borough, 13th-20th May, 1950. -17- HEALTH PROPAGANDA. Clean Food Campaign. The main feature of health propaganda during the year took the form of a Clean Food Campaign, which was held in the Borough for a week in Kay. The campaign was an outdoor one, past, experience having shown that health exhibitions and leatures held indoors are not well attended by the public. The exhibition unit comprised 3 vans,- ohe being used as a mobile cinema, the second as an information stall and the third as a model mobile food kiosk. The unit visited' all the street markets of. the Borough, where speakers held question and answer sessions. A recorded talk by the Medical Officer of Health was relayed and films on food hygiene were shown. For two weeks prior to the campaign advertisements of the programme and time-table of the exhibition appeared in the local press, on posters and on .leaflets. I desire to express my thanks to local firms, police and various government bodies for their assistance in making the campaign a success. It achieved its object of conveying information to approximately 6,000 members of the public, including a large number of food traders. Two of the films shown by the mobile cinema van were subsequently shown by four of the local cinemas. A report on the campaign is reproduced in full on pages 60-64. Metropolitan Boroughs'Golden Jubilee Exhibition. The Public Health Department took part in an exhibition organised in connection with the Metropolitan Boroughs Golden Jubilee Celebrations and which was held at the Limehouse Town Hall during November. The theme of the exhibition dealt with 50 years of progress, and the Department's exhibits portrayed the last half century's improvements in the mortality rates, particularly of infants, and the efforts that have been made by legislation and otherwise to combat disease, increase expectation of life, improve sanitation, and reduce sophistication of food. Venereal Disease. In compliance with the Ministry of .Health Circular of 8th May, 1950, a publicity campaign comprising poster display and leaflet distribution on the subject of venereal diseases was carried out. -18- General. Propaganda leaflets and' posters were also distributed during the yeai" concerning Whooping Cough-, Measles, Diphtherlia Immunisation, and Vaccination. : LABORATORY. FACILITIES, Bacteriological investigations are carried out on behalf of the Public Health Department by the Regional Hospital Board's Group Laboratory at Mile End Hospital. 1,029 such investigations, were carried-out during the.year on 348 specimens received from medical practitioners. In the Borough. Details of specimens are as follows:- Nasal and. Throat swabs 264 Faeces 35 Sputa 13 Blood Examinations (miscellaneous)36 LEGISLATION. Included in new .legislation which became operative during the year are the following it:- Prevention of Damage'by Pests Act, 1949 (which rescinded the Rats & Mice Destruction Act, 1919). Shops Act, 1950 (which consolidated the Shops Acts, 1912 to 1938). Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcol Infection) Regulations, 1949. -19- STEPNEY BOROUGH COUNCIL INFORMATION SERVICE. This, the second full year's work of the Information Centre, situated at 671a Commercial Road, E.14, has seen the Service grow from strength to strength. It has now become firmly established in the minds of the citizens of the borough who do not hesitate to make full use of its service, resulting in an ever growing demand for information and assistance with personal problems. These latter form a very large part of the enquiries dealt with at the Centre and because of the manner in which they are dealt with, members of the public grow more confiding and appreciative of the real attempt being made to help them in their difficulties. The past year has seen the number of enquiries reach a total of 11,233, this being an increase of 1,417 over the previous year. Again the field covered by the enquiries was very extensive and those enquiries relating to the Social Services once more formed a large proportion of the whole. With the coming into operation of part of the Legal Aid and Advice Act, in October 1950, the Information Service was instrumental in obtaining Legal Aid Certificates for a number of applicants with mainly marital problems and these, in a borough like Stepney with such a cosmopolitan character, are quite numerous. Another notable feature of the Information Service is the number of calls made upon it by local firms and organisations for information both of a civic and general nature, and as a result of the prompt attention to these calls, more and more are being received at the Centre. This Service is under the direction of the Borough Librarian, who has kindly supplied me with the above Information. -20- III. SANITARY CIRC UMSTANCES. The improvement during the year, in the previous staffing difficulties of the Sanitary Inspectors is reflected in a considerable increase in the work of this section of the Department. The number of visits 'and, inspections carried out by the Sanitary Inspectors shows an increase of nearly 4,000 over the previous year. A summary of the sanitary work of the Department will be found in Tables 5 & 6 on p.52 & 53• Increasing difficulties are being experienced in the.abatement of nuisances, as is evidenced by the high proportion of Statutory notices to" Intimation notices. These difficulties are due, no doubt, to the rising cost of repairs, rents remaining unchanged, continued deteripration of property, building licensing, age of property, and the adverse conditions of the war years. However, the Department continues to implement the provisions of the Public Health Act as far as possible, as is shown by the service of 1,499' statutory notices and 108 cases of legal proceedings. COMPLAINTS. 3,438 complaints were recorded in the register, but in addition, numerous, complaints were made direct to the Sanitary Inspectors and 10,127 visits were made in connection therewith. 5,340 intimation notices were served during the year. DANGEROUS STRUCTURES. The District Surveyor was notified on 199 occasions of premises or parts of premises alleged to constitute dangerous structures. DRAINAGE. 1,707 drains were tested with smoke, of which 251 were found to be defective. 7,432 visits of inspection were made to drainage works during the year, and 1,137 drains were cleansed or repaired and 1,902 constructed or reconstructed. Observations were submitted to the Borough Engineer and Surveyor on 141 plans of new drainage work and 40 Combined Drainage Orders were made. -21- FACTORIES. The Factories Act, 1937, was designed to secure safe and healthy working conditions In factories. The principal requirements of the Act are dealt with by the Ministry of Labour through H.M. Inspectors of Factories, the Local Authority's Sanitary Inspeotorsbeing responsible for administering those sections of the Act dealing with sanitary accommodation in all factories and with cleanliness, temperature, ventilation, overcrowding, and drainage of floors in factories where no mechanical power is used. 2,283 inspections were made of the 3,640 factories on the register, and 101 notices were served. For details please refer to Table 7 on page 54. OUTWORKERS. 142 inspections were made of the 725 outworkers on the register, who are employed in the following trades Wearing Apparel 655 Umbrellas 4 Artificial flowers 10 Christmas Crackers etc. 11 Feather sorting 1 Paper bags 6 Carding etc. of Buttons 4 Chocolates and sweetmeats 1 Locks, latches and keys 1 Cardboard boxes 32 725 There were no notifications of infectious disease relating to outworkers premises. No. of firms in the Borough employing Outworkers 45 No. of Outworkers residing in and employed in the Borough 232 . No. of Outworkers residing outside the Borough 227 No. of Outworkers residing in the Borough employed by firms outside 493 HOUSES LET IN LODGINGS. There are 1,887 such premises in the Borough, to which 795 inspections were made during the year. 53 complaints were remedied under the byelaws. -22- HOUSE TO HOUSE INSPECTIONS. The streets in which all the houses were inspected house to house were Bermuda Street and Hadleigh Street, which involved 43 inspections. LEGAL PROCEEDINGS. ' ' A summary of legal proceedings instituted during the year, showing penalties imposed, is as follows:- No.of Summonses Fines Costs Food and Drugs Act, 1938 76 £289.10.0. £59. 3. 0. Merchandise Marks Act, 1926, Merchandise Marks (Imported Goods ) No.4 Order, 1949 1 2.0.0. 2.2.0. Public Health (London) Act,1936 92 156. 3,0. 190.2,0. Merchant Shipping Act, 1894 & L.C.C. Byelaws (1916) made thereunder 1 5. 0.0. 3. 3. 0. London County Council (General Powers) Act, 1939 1 2. 0.0. 2. 2. 0. 171 £454.13.0. £256.12. 0. The Magistrates made Closing Orders under the Public Health (London) Act, 1936, on 10 dwelling-houses in the Borough. LODGING HOUSES COMMON. There are 4 such premises in the Borough: two Men's, one Women's and one for couples, providing accommodation for 793 men, 228 women and 41 couples. 103 inspections were made during the year, including several inspections at night, and 5 Notices were served. LODGING HOUSES - SEAMEN'S. A license was granted during the year for premises 9, Ensign Street to be used as a Seamen Lodging House. There are now 5 such premises in the Borough, accommodating 483 seamen. -23- 65 inspections were made during the year, including several inspections at night, and 2 Notices were served. Legal proceedings were instituted under the Merchant Shipping Act, 1894 and Byelaws made thereunder in respect of an unlicensed lodging house, the defendant being fined £5 and ordered to pay £3.3.0 costs. NOISE NUISANCES. 25 complaints were investigated during the year of alleged noise nuisance. OFFENSIVE TRADES. There are 23 offensive businesses in the Borough, of which 334 inspections were made during the year, and 13 Notices were served. The premises are situate as under: Cow House: (1) 56, Swedenborg Square. Tripe Boilers: (2) 5, Whitechapel High Street. 94, Wentworth Street. Dresser of Furskins: 48,50,50a,54 & 56, Old Church Road. (3) 34/38, Brodlove Lane. 29, Spelman Street. Poultry Slaughterhouses: (17) 21/22,Hessel Street 28, Burslem Street 36,„ l6l, Cannon Street , Road 42, „ 16/18, Cobb Street 75, „ 49, Globe Road 13,Leyden Street 8, Gun Street 15,„ 9, 11 26,Maplin Street 8A, Hessel Street 82,Stepney Way 14,„ 39,Woodseer Street PHARMACY AND POISONS ACTS- 120 premises are listed for sale of poisons included in Part II of the Poisons List. Applications received during the year were as follow For - Entry 10 Retention 108 Transfer 2 216 visits were made to these premises. -24- RAG AND BONE DEALERS 11 Inspections were made of such premises during the year and 1 Notice served. REFUSE DISPOSAL. The Public Cleansing Officer has kindly supplied the following information on refuse and salvage disposed of during the year: House and Trade 36,240 Tons Street and Market 7,462 „ Salvage: Waste Paper 104 „ Kitchen Waste 6l7 „ RENT AND MORTGAGE INTEREST RESTRICTIONS ACTS. During the year , 165 applications were received from occupiers for certificates stating that premises were not in a reasonable state of repair . 163 were granted and 2 refused. 78 applications were received from owners for revocation certificate. 59 were granted and 19 refused. 340 visits were made by Inspectors in connection with these applications. RODENT CONTROL. On 31st March 1950, the Prevention of Damage by Pests Act 1949 came into operation, and repealed the Rats and Mice Destruction Act 1919. The new Act greatly strengthens the powers of the local authority, to which it furnishes the means of achieving radical Improvement in the control of rats and mice. The new Act emphasizes the primary obligation as being upon the local authority to ensure that as far as practicable its area is kept free from rats and mice whereas under the old Act the primary duty was laid upon the individual occupier, coupled with the right of the local authority to enforce the requirements upon him. The occupier who fails to take practicable steps to destroy rats or mice, or to prevent infestation by them, is guilty of an offence and liable to penalties. The occupier is now required to give written notice that he has knowledge that rats or mice are present in substantial numbers, and owners or occupiers are now required, by notice to comply with requirements specified, including where neeessary the execution of structural work. Individual notices, -25- of requirements may be dispensed with where infestation occurs in a group of separately occupied premises in a "block" and where it is necessary to treat the block as a unit. Provision is made for the recovery of expenses incurred in carrying out work pursuant to notices served and also by arrangement with owners or occupiers. An owner or occupier may employ a commercial servicing firm to disinfest his property, subject to the methods adopted by such firms being to the satisfaction of the local authority. Statistics on the prevalence of rats and mice and measures of control will be found in Table 8 on page 55 SHOPS ACT. On 1st October, 1950, the Shops Act 1950 came into operation. This Act consolidates the Shops Acts 1912-1938. During the year, 681 inspections were made and 2 Notices served in respect of sanitary accommodation, ventilation, and temperature. No applications were received for exemption from complying with sanitary accommodation requirements. SITES CLEARED OF REFUSE. Refuse and other material was cleared from 104 sites in the Borough: (a) Under Sec. 93 of the Public Health (London) Act, 1936 2 Sites 55 cub.yards. (b) By War Damage Department under the War Debris Clearance Scheme 102 Sites 1,751 cub .yards. Owners are encouraged to fence in vacant sites to prevent nuisances arising from the depositing of rubbish, and 8 sites were enclosed during the year. Where any person can give evidence as to the use of the site for any indecent purpose, the matter is referred to the Town Clerk for action under the London County Council (General Powers) Act, 1925, which Act empowers the Council to fence in the land in default of the owner, and recover the cost. -26- SMOKE ABATEMENT. The number of complaints-received during the year of smoke nuisance was 42, and the number of observations kept was 228. 3 Notices were served and 87 nuisances abated. WATER SUPPLY. Water supply in Stepney is derived from several sources viz., River Thames water, stored in the Thames Valley Reservoirs, filtered and chlorinated at Kempton Park Works and Hampton Works; River Lea water, which is treated at the Lea Bridge Works, and New River water which is treated at Stoke Newington Works. Samples of water are collected at least five times a week by the Metropolitan Water Board from all stages of the purification process, and from houses and mains in the distribution system. Quantity and quality supplied during the year has been satisfactory. All premises in the Borough are supplied direct from public water mains, with the exception of two places which are supplied by means of standpipe. The number of instances where water supply to premises in the Borough was repaired or reinstated totalled 553. The Metropolitan Water Board was notified on 160 occasions of premises where wastage of water was taking place. Wells. Bacteriological and chemical analyses of water from the 7 deep Wells in industrial use in the Borough are made periodically, and are duly reported to this Department. WATER CERTIFICATES. Water Certificates; under the provisions of the Public Health (London) Act, 1936, as to new dwellings having a proper and sufficient supply of water, were issued in respect of 575 flats and 30 houses. -27- IV. HOUSING Overcrowding. During the year 835 cases of alleged overcrowding were investigated , 351 of which were confirmed and referred to the London County Council. 555 overcrowded families were rehoused, 306. by the L.C.C. and 249 by the Borough Council. The number of overcrowded families on the register was reduced from 1,252 to 1,048. 214 visits,were made to premises to ascertain Permitted Numbers, of which the owners of the premises were Informed. In order to prevent overcrowding, four inspections were made for the Government of Cyprus of accommodation alleged to be available in the Borough for intending immigrants. It is interesting to note that in 1938 the number of persons per dwelling averaged 5.4 as compared with 3.5 in 1950. Underground Rooms. There are 5,166 underground rooms in the Borough which are used for living or sleeping purposes. .212 inspections were made during the year, as a result of which 28 rooms were closed and the modified occupation of five approved. The total number of underground rooms closed since 1936 amounts, to date, to 93. Building Licences and Essentiality Certificates. Of the 647 applications received, 633 were recommended, involving 804 visits by the Inspectors. Defence Regulation 68 C.A. (Use of Living Accommodation for Business purposes). 68 investigations of premises were made for possible contravention of this regulation regarding Change of User, which involved 89 visits by the inspectors. Preferential Housing on Health Grounds. Of the 160 cases investigated, 56 were recommended for rehousing; 17 to the L.C.C. and 39 to the Borough Council. -28- New Dwellings Erected. Borough Council 210 Flats 22 Houses London County Council 321 Flats Total: 553. Temporary Hutments. 381 owned by the Borough Council remained at the end of the year. 24 were recommended for demolition because of their structural condition. Requisitioned Properties. The number of dwellings under requisition by the Borough Council at the end of the year was 2,019, involving 2,773 lettings , of which 6 were recommended to the Housing Manager for de-requisitioning for various reasons, and 10 basement flats, which did not comply with the Regulations, were recommended for closure. Slum Clearance. A survey of "Black Spots" in the area was completed during the year, and up to date 65 small areas have been classified as black-spots. The resumption of slum clearance is under consideration. Summary of Inspections made by the Housing Inspector. Overcrowding 835 Preferential housing on health grounds 160 Underground Rooms 212 Permitted Numbers under Housing Act, 1936 214 Temporary Hutments 133 Requisitioned premises 88 "Black Spots" 5 Defence Regulation 68 C.A. 2 Building Licences 28 Section 5, Housing Act, 1936 44 Section 11, Do. 33 Section 20, Do. 1949 2 Miscellaneous 191 Applications for Rehousing. At the end of the year, there were 3?649 applications for rehousing on the Housing Managers register, including 168 tenants of Council dwellings and 447 licencees of requisitioned premises . Statistics . For further housing statistics, please refer to Table 9, page 56. -29- V. INSPECTION AND SUPERVISION OF FOOD. It has been a particularly arduous year for the Food Section, and every endeavour has been made, despite the many difficulties, to improve the hygiene of food premises. Every effort is made to get these improvements effected without recourse to the Courts, but nevertheless it was necessary to apply for 63 summonses in respect of contraventions of Section 13 of the Food and Drugs Act, 1938. The work of the Food Section covers a wide field, as can be appreciated from the following list showing the. variety of food premises in the Borough:- Bakehouses 69, Butcher and Bacon Shops and Stalls 137, Butter and Margarine Fremises 41, Fish Shops and Stalls 108, Grocers 349, Greengrocers 490, Ice Cream Premises 240, Milkshops 206, Public Houses 258, Catering Establishments 913. These figures are necessarily approximate because there is no statutory register of most food premises, the exceptions being milkshops, ice cream and prepared food premises, butter and margarine factories, and basement bakehouses, for which registration is necessary. A summary of visits made by the Food Inspectors is in Table 10 on page 57. Increased attention has been given to Industrial Canteens and to those of the. School Meals Service. So far as industrial canteens are concerned, these vary in standard, but there is a fair proportion of which the standard is high. On the whole, the equipment and conditions of school canteens are satisfactory, but the structures of a number of school restaurants (where dinners are Served, not prepared) are not in all respects satisfactory. The amount of unsound food condemned shows an increase of 160 tons over the. previous year. It is satisfactory to note that the improvement in the bacteriological standard of ice cream has been maintained. Milk Supply No on Register No of Inspections No of Notices Served. Distributors (with Dairies) 36 356 10 Distributors (including 39 Itinerant) 209 -30- 22 samples of milk, all of which were satisfactory, were taken in course of delivery to schools, hospitals and L.C.C. establishments" in the Borough, as follows:- Chemical analysis. Bacteriological examination. Schools 5 2 Hospitals 13 — Day Nursery 1 – Meal Centre 1 - Milk (Special Designations) (Pasteurised & Sterilised Milk) & (Raw Milk) Regulations, 1949. 399 licences were issued during the year, as follows:- Dealer's Licences Supplementary Licences. "Pasteurised" milk 144 15 "Sterilised" milk 172 18 "Tuberculin Tested" milk 16 Pasteurisers Licence 1. Bacteriological Examination of Foodstuffs. The following samples were submitted for bacteriological examination Nature of Sample. No. of Samples Observations. Pasteurised Milk. 95 Satisfactory. Raw Milk. 2 Both unsatisfactory. (Taken from milk delivered into the Borough for pasteurisation.) Ministry of Agriculture & Fisheries notified. Sterilised Milk. 2 Satisfactory. T.T.(Pasteurised) Milk. 1 „ Dried Egg Powder. 1 „ Roconstituted Salad Cream. 1 „ Jam. 1 „ Boneless Cooked Gammon (canned) 1 „ Jellied Eels. 3 „ Ice Cream. 99 (See Special Report on Top cream). -31- In addition, one sample of artificial vinegar containing worms was submitted to the British Museum. The worms were found to be the "vinegar eel" - Anguillula Aceti (Müller 1783) also called Turbatrix Aceti (Müllier) Peters, 1927. Nothing definite is yet known concerning the origin of eelworms in vinegar, and there is no evidence to show that these worms are pathogenic to man. The artificial vinegar from which the sample was obtained was made up by a caterer for use in his business, and the barrel in which it was being made had been in use for some considerable time. The owner readily agreed to destroy all stocks and to replace the existing barrel by a new one. Ice Cream. The number of ice cream premises registered in the Borough is 240, of which 37 are registered for manufacture, 200 for sale, and 3 for storage only. 372 inspections were carried out and 17 notices served for cleansing and other requirements. 99 samples of ice cream were taken for bacteriological examination. 3 of the samples were examined in connection with a food poisoning inquiry, but no trace of any food poisoning organisms could be found in them. The remainder were graded as follows:- Manufactured Manufactured Totals in Borough" outside Borough. Grade 1 11 35 46 (41) Grade 2 3 21 24 (44) Grade 3 4 10 14 (42) Grade 4 6 6 12 (28) The figures in parenthesis show the numbers for 1949. Improvement in the bacteriological standard has been maintained; 27 per cent of the samples examined were graded 3 and 4. The percentage in 1949 was 45.1, and in 1948, 61.1. 96 samples submitted for chemical analysis showed a fat content as follows:- Over 15 per cent fat 2 10 - 15 „ „ „ 46 5 - 10 „ „ „ 41 2.5-5 „ „ „ 5 Under 2.5 „ „ „ 2 The average fat content of all samples examined was 9.54 per cent. -32- There was no legal standard for ice cream during 1.950, but the matter has received attention by the Ministry-of-Food, and a standard will be introduced in 1951. Butchers Shops and Stalls. 254. inspections were made during the year and 29 Notices served. Transport and Handling of Meat. (Circular M.F. 20/49). 108 inspections were made of vehicles delivering meat into the Borough from Islington Cattle Market and Smithfield Market. No contravention of the Public Health (Meat) Regulations, 1924-1948, was found, and the vans inspected were; generally satisfactory. Bakehouses and Bakers Shops. 227 inspections were made and 8 Notices served. 141 Cleansings were carried out to the 69 bakehouses in use in the Borough. Legal proceedings were taken in 17 cases regarding unsatisfactory conditions at two bakehouses, and fines totalling £105, with £8.5.0 costs, were imposed. There are 18 basement bakehouses in the Borough, 9 of which, under Section 54 of the Factories Act, 1937, are under notice to close in June, 1952. An appeal, made within the limiting statutory period of 21 days, against withdrawal of a.certificate , was heard and dismissed. (A writ which had been previously issued in the High Court, disputing the fact that the premises constituted a basement; bakehouse, was subsequently withdrawn). 2 basement bakehouses which had not-been in use for over 12 months were removed from the Register. Butter and Margarine Factories. No. on No. of No. of Register lnspecNotices tions. Served. Butter and Margarine factories 4 Wholesale dealers in Margarine 37 54 Prepared Food Premises. 185 312 63 Poultry Shops and Stalls. 1,616 inspections were made, and 13 Notices served. Wet-fish Shops and Stalls. 605 inspections were made, and 6 Notices served. -33- Greengrocers and Fruiterers Shops and Stalls. 773 Inspections were made, and 70 Notices served. Wholesale and Retail Grocery and Provision Shops, etc. 664 inspections were made, and 14 Notices served, 10 Notices were served in respect of miscellaneous food premises. Public Houses. 140 inspections were made, and 14 Notices served. Catering Establishments (including Industrial Canteens, etc.) 924 inspections were made, and 85 Notices served. In 1948, the Council, in order to encourage a high standard of cleanliness in catering establishments, instituted a Certificate of Hygiene, to be awarded to those which complied with the Councils Code of Standards for Catering Establishments. During the year under review, certificates were awarded to 3 industrial canteens, and the certificates of 2 others were renewed. The Councils standards are high, and the owners of some catering establishments who would like to apply for such certificates have been precluded from so doing owing to the present difficulty in expanding their property. Priority for building licences is largely reserved for dwelling accommodation at the present time. Examination of Meat for Caseous Lymphadenitis. 1,406 carcases of imported mutton arriving from Australia, New Zealand and South America, were examined by cutting of the lymphatic glands. This represents a 5 per cent examination. In several instances a lymphatic gland had been removed from the carcase, but examination showed that the carcases and remaining glands were not affected with the disease. None of the carcases-was condemned as unfit for human consumption. Public Health (Imported Food) Regulations. 1937. 102 detention and 91 release notices were served under the Regulations for a variety of foodstuffs, including frozen mutton, canned goods, dried and preserved fruits, confectionery, cocoa, sugar, etc. In many instances, meat and meat products landed at the various wharves in the Borough were not accompanied by the official certificate as required by the above-mentioned Regulations, and were detained. In all cases except two, the official certificates were subsequently obtained, and the foodstuffs released. The two exceptions -34- referred to were 1 cask of Pakistan sheep casings and 156 cases of Polish hams landed at Irongate Wharf. Both consignments were re-exported. Egyptian Onions. During April, a cargo of some 240 tons of Egyptian Onions arrived at one of the wharves, and-upon examination of the cargo, in the hold of the ship, the whole consignment was found to. be in a decomposing state and unfit for food. Efforts were made to land them with a view to destruction, but great difficulties were experienced. After some 40 tons had been landed, the wharfingers asked for permission to destroy the 200 tons still on board by jettison at sea, and requested the issue of a condemnation certificate to this effect. Authority was given for this to be done, and after receipt of an affidavit signed by the Master, Chief Officer and Bosun of the ship, to the effect that the onions had been jettisoned at sea, a condemnation certificate was issued. Pastry Mix. During the hot days of the summer, one of the Food Inspectors was called in by a local firm of biscuit manufacturers for advice. Whilst handling a consignment of pastry mix, several girls contracted a mild form of dermatitis. In consultation with the Factory Surgeon, the matter was traced to an excess of acid in the mixture caused by rancidity of the fat content, coupled with the hot weather. The pastry mix was, on the advice of the Food Inspector, used for animal food. Unsound Food. t The, following quantities of unsound foodstuffs were disposed of during the year under the Public Health (Imported Food) Regulations, and the Public Health (London) Act, 1936:- Premises tons cwts. qrs. lbs. Wharves 367 17 3 4 London Fruit Exchange and Spitalfields Market 189 12 3 15 Railway Depots - 3 3 16 Zeebrugge-Harwich Train Ferry (at Bishopsgate Goods Station) 5 0 0 2 Other Premises 57 1.9 1 11 620 13 3 20 -35- Export Certificates. 40 certificates were issued in respect of the examination of foodstuffs for export, as follows:- South America 33. Italy 2. Egypt 4. Sweden 1. Zeebrugge-Harwich Train Ferry. 290 night or early morning and 16 other visits were made to Bishopsgate Goods Station for the purpose of examining 4,526 trucks of foodstuffs arriving from the Continent, as follow Country of Origin. No. of Contents. trucks. Italy 4,058 Apples, apricots, asparagus, aubergines, beans, cabbage, carrots, cauliflowers, celery, cheese, cherries, chicory, confectionery, cucumbers, canned fruit and meats, endives, fennel, garlic, gooseberries, grapes, lemons, lettuce, mandarines, melons, nuts, onions, oranges, pastry, peaches, pears, peas, passion fruit, plums, potatoes, salami and tomatoes. Belgium 340 Bacon, biscuits, cherries, chicory, chocolate spread, citric acid, cheese, cucumbers, endives, fish, gingerbread, gooseberries, grapes, preserved fruit and vegetables, onions, peas, canned meats and salami. Switzerland 55 Cheese, chocolate, grapes and pears. Yugo-Slavia 38 Apricots, eggs, fruit pulp, grapes and salami. Austria 13 Biscuits and cakes. Australia 9 Frozen rabbits. Hungary 8 Canned meats and poultry. Czecho-Slovakia 2 Chocolate. Germany 2 Poultry and canned meat. France 1 Nuts. The total weight of the foodstuffs examined was 27,493 tons. -36- The following were found to be unsound, and. were stopped and destroyed:- tons cwts. qrs. lbs. 400 crates Italian Cauliflowers 4 18 0 0 6 trays Italian Apricots 1 3 2 2 trays Italian Passion Fruit l 0 5 0 0 2 9 trucks of Australian frozen rabbits originally landed in Belgium were transhipped via the train ferry. Samples of Italian salami and canned, hams, Austrian chocolate biscuits and Belgian citric acid and canned hams were taken for analysis and found to be satisfactory. The first consignment of German hams arrived in December, in good condition. Several trucks of Italian pears and plums appeared; to have been sprayed with an insecticide. Samples Were taken for analysis, but the amount of arsenic present in no case exceeded 0.4 parts per million. -37- VI. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES Notifications. A .total of 1,231 notifications of cases of infectious disease were received during the year. Table 11, page 58 shows details of the notifications received, together with age groups. There were no notifications of Smallpox, Enteric Fever, Acute Encephalitis, Cholera, Continued Fever, Relapsing Fever, Typhus, Glanders, Hydrophobia, Zymotic Enteritis or Plague. The Sanitary Inspectors paid 381 visits to premises where cases of infectious disease, or contacts, occurred. Diphtheria. Six notifications were received, but the .diagnosis was confirmed in only 3 cases, as compared with 10 last year. The number of children immunised at L .C ,C . clinics was 1,470, of which 1,016 were under 5 years of age. 1,143 children were given a secondary or reinforcing injection. A supply of anti-toxin is kept in the Department for use by general practitioners in emergency cases. 264 swabs were forwarded by general practitioners to Mile End Group Laboratory where bacteriological examinations are carried out on behalf of the Borough Council. The mortality rate for the year was nil, compared with 26 per 100,000 population in 1901. Food Poisoning. There were no outbreaks of food poisoning , but ten Individual cases of suspected food poisoning were notified. In one case the causal agent was said to be a duck egg, but this was not confirmed, although Salmonella Typhi-murium was Isolated. Scabies. Scabies is still notifiable under the County of London (Scabies) Regulations, 1943. The number of cases formally notified was 67, which shows a marked decrease from that notified in 1944, namely 1,155. The number of persons who received medicinal baths and whose clothing was disinfected was 99? as follows -38- M. F. Ch. Total At Branch Road Treatment Centre 36 12 3 51 At London Hospital 38 7 3 48 Owing to the decline in Scabies incidence the agreement with the London Hospital for the treatment of Scabies cases on behalf of the Council was terminated from the 1st November, from which date all cases were dealt with at the Councils Treatment Centre, Branch Road. Scarlet Fever. " There were 60 fewer cases notified this year than last year. There were 41 deaths from the disease "in 1901, whilst there have been only 2 deaths during the past 12 years. Measles. No-deaths from Measles- occurred during the year. In 1911 there were 291 deaths ,giving a mortality rate of 103 per 100,000 population. Smallpox. No cases of Smallpox were notified during the year and it was not necessary for me to take action under the Public Health (Smallpox) Regulations, 1917 . The mortality rate for the disease in 1902 was 83 per 100,000 population. A number of Smallpox contacts were reported arriving in the Borough from abroad, and they were kept under observation for the period of possible incubation. A supply of vaccine is kept in the Department for emergency use. The number of children successfully vaccinated at L.C.C. clinics during the year was 609. Tuberculosis. The number of primary notifications of Pulmonary Tuberculosis received was 16O, as compared with 150 last year, and the number of Non-Pulmonary cases was 16 as compared with 12 last year. The mortality rate for the year of Pulmonary. Tuberculosis was 50 and of Non Pulmonary 6 per 100,000 population, as compared with 203 and 80 respectively in 1901 For details of age distribution and variations in Register see Tables 12 and 13, page- 59. The position in the Borough as regards beds for tuberculous persons has improved, and there are now 30 male beds in St. George in the East Hospital and 20 female beds in Mile End Hospital, so that it is not now necessary to keep urgent cases waiting at home. -39- Public Health (Prevention of Tuberculosis) Regulations, 1925. These regulations provide that persons suffering from tuberculosis of the respiratory tract shall not be employed in the handling of milk or milk receptacles. Power is given to the Council to cause such persons to discontinue their employment. It was not found necessary to take action under the regulations during the year. Tuberculosis Care Committee. During the year, 148 patients have received help from the Care Committees voluntary fund, and a considerably larger sum of money has been expended than in former years. This is partly due to the increased cost of clothing, fares, etc., and also to the larger number of applications for help. More patients are now nursed at home, and they need extra nourishments, warm clothes, blankets, and dressing gowns. Several patients have received help towards the cost of holidays and convalescence, and families moving to better housing conditions have been helped with the purchase of curtains, lino, beds and bedding etc. At Christmas time gifts of money are given to some of the poorest families for the purchase of extra food and coal, and these gifts are always very gratefully received, many appreciative letters being received from patients . The Committee in turn, thank the Christmas Seal Sale subscribers, without whose generous response to their appeal it would not have been possible for them to meet the calls . made upon them. They also acknowledge with thanks the help of the London County Council in continuing the grant from the Sunday Cinema performances, and assistance and co-operation of the;Natlonal Assistance Board, the Red Cross Society, the Invalid Childrens Aid Association, members of the Care Committee for gifts of clothing, and all Societies co-operating with them in helping, their patients. Infectious Disease Contacts. Where a person is precluded from continuing at work by reason of being a carrier, or having been in contact with infectious disease, benefits under the National Insurance Act, 1946, are only paid on production of a certificate from the Medical Officer of Health. It was not found necessary to issue any such certificates during the year. -40- Authentication of Certificates of Vaccination and Inoculation. A person proceeding abroad is required in certain countries to produce a certificate of recent successful vaccination and inoculation. The medical signatures of 104 such certificates were authenticated by me during the year. Disinfection. 371 premises were disinfected because of infectious disease, of which 29 were for pulmonary tuberculosis. 184,051 articles of clothing and bedding were steam disinfected, and of these 164,79° related, to articles for export, for which 426 certificates were issued. Disinfestation (Bed Bugs and other insect pests). The following is a summary of work carried out by the specialist inspectors" General inspections for vermin 1,717 No. of premises found verminous 417 No. of revisits 940 No. of miscellaneous visits 1,436 No. of premises sprayed 1,096 (251 Borough Council property) No. of rooms sprayed +2,394 (657 do. ) + Including 976 rooms dealt with at request of District Sanitary Inspectors. As a precautionary measure the furniture and Effects of all families- entering Borough Council dwellings are treated with Hydrogen Cyanide. The furniture and effects of 417 families rehoused during the year in Borough Council houses and flats were treated, prior :-to removal, with Hydrogen Cyanide Gas at the Councils Disinfestation Station, 42 Narrow Street, E.14. The bedding in the above cases was treated by steam. Verminous Persons. The number of persons,bathed and whose clothing was disinfected at the Branch Road Cleansing Station was as follows:- Males Females Children - Total 304 38 12 354 The number of baths and treatments given amounted to 395. -41- 27th Annual Report. Summary of BOROUGH ANALYSTS Quarterly Reports for the year 1950. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Ladies and Gentlemen, I have the honour to submit to you my Annual Report on the work of the Borough Laboratory for the year 1950. During the year, 1,222 samples were submitted for analysis Of these, 1,131 (943 Foods and 188 Drugs) were taken under the Food and Drugs Act; 88 were received from the Public Health Department, 1 sample from the Food Executive Officer and 2 samples from private purchasers. The 1,131 samples (200 Formal and 931 Informal) purchased by the Inspectors under the Food and Drugs Act are classified as follows: 21 Baking Powder 3 Beer and Spirits 21 Cocoa 11 Coffee 14 Coffee Essence 12 Soft Cheese 10 Curry Powder 42 Custard Powder 10 Dried Fruits 8 Fats 14 Flour 31 Cereals 8 Flavouring Essences 23 Fish Paste 16 Herbs and Stuffing 4 Honey and Syrup 96 Ice Cream 11 Jam 11 Table Jelly 15 Meats 19 Meat Paste 186 Milk 45 Miscellaneous Foods 20 Edible Oils 11 Pickles 23 Saccharin Tablets 21 Salad Cream 37 Sauces 69 Sausages 26 Soft Drinks 44 Spices 18 Tinned Fish and Soups 20 Tinned Vegetables 21 Vinegar & Condiments 15 Aspirin etc. Tablets 5 Calamine Lotion 7 Glycerine 5 Hydrogen Peroxide 6 Iodine Solution 7 Liquid Paraffin 56 Miscellaneous Drugs 14 Oils 38 Ointments 5 Parrishs Food 10 Salt 10 Seidlitz Powders 5 Tartaric Acid 5 Vaseline Of the 1,131 samples 26, or 2.3%, were adulterated. Proceedings were taken in 8 cases and in two cases the vendors were cautioned. -42- Milk. 186 samples were examined during the year, and the average composition of the samples is shown in the following table:- Month No. Examined Fat, per cent. Solids-not-Fat, per cent. January 15 3.52 8.72 February 17 3.46 8.81 March 13 3.43 8.70 Apri1 6 3.42 8.75 May 9 3.43 8.74 June 6 3.43 8.79 July 12 3.46 8.71 August 33 3.50 8.68 September 16 3.61 8.80 October 20 3.72 8.81 November 23 3.86 8.80 December 16 3.75 8.76 Whole Year 186 3.58 8.75 Legal Minimum 3.00 8.50 Average composition for each of the past 10 years is as follows:- Year No. Examined Fat, per cent. Solids not Fat, per cent. 1941 750 3.54 8.64 1942 580 3.58 8.65 1943 561 3.61 8.68 1944 572 3.64 8.72 1945 578 3.50 8.67 1946 575 3.53 8.70 1947 530 3.52 8.68 1948 389 3.47 8.71 1949 290 3.50 8.67 1950 186 3.58 8.75 20 samples of Milk were taken In course of delivery at Hospitals, Schools and Day Nurseries in the Borough. All were satisfactory. For the second successive year no milk has been reported as adulterated. This may be related to the fact that most of the milk supplied in the Borough is in the hands of a few large firms who maintain careful control over their products. -43- Ice Cream. 96 samples were examined, the average composition being Fat 9.54%; Milk Solids-not-Fat 7.77%; Sugar and Starch 15.42%. Only 7 samples contained less than 5 per cent of Fat. The Food Standards (Ice-Cream) Order 1951) which is to come into operation on March 1st 1951, requires Ice-Cream to contain not less than 5 per cent Fat, 10 per cent Sugar and 7½ per cent Milk Solids-not-Fat. Lemon Curd. 2 samples from the same vendor were adulterated: A163. Informal. 88% deficient in Fat, 85%)deficient in Citric A184. Formal. 84% „ „ 82%) Acid. The vendor was fined £1 with £2-2-0 costs. Meat. 2 samples from the same vendor were adulterated": D601. Formal. Beef Stew. Contained at least 80% Horse-meat. D602. Formal. Meat. Consisted entirely of Horse-meat. The vendor was fined £10 with £3-3-0 costs. Dried Parsley. sample was adulterated: A9. Informal. Contained 8.15% of sand. A further sample proved to be genuine. Sausages. 12 samples were adulterated: Bll. Informal. Beef Sausages. 19% deficient in Meat. B46.„ „ 24% „ „ Bill. „ „ 18%„ „ B143. „ „ 28% „ „ Further samples of the Beef Sausages were genuine. B121. Informal. Pork Sausages. 32% deficient in Meat. B128. „ „ 36% „ „ B130. Formal. „ 24% „ „ B135. Informal. „ 31% „ „ BI36. Formal. „ 30% „ „ B137. „ „ 22% „ „ B140. „ „ 30% „ „ B144. Informal. „ 23% „ „ These 8 samples of Pork Sausages were obtained from the same vendor, who was convicted on four cases and fined a total of £8 with £6-6-0 costs. By the Meat Products and Canned Meat (Amendment) Order 1950, which came into operation on 5th November 1950, Pork Sausages must now contain at least 65% of meat, the minimum meat content for Beef Sausages remaining unaltered at 50%. -44- Non-brewed Condiment. 2 samples from the same vendor were adulterated: B123. Informal. 22% deficient in Acetic Acid. B131. Formal. 23% „ „ „ The vendor was cautioned. By a recent decision in the High Court the solution of acetic acid coloured with caramel, formerly known as non-brewed vinegar, must not be described as Vinegar and is accordingly now known as Non-brewed Condiment or by some similar description. Hydrogen peroxide.1 sample was adulterated: D3. Informal. 74% deficient in Peroxide. A further sample was genuine. Boric Ointment. D514. Informal. " Contained 9.9% Boric Acid. This complies with the British Pharmacopoeia 1932, but the present Pharmacopoeia (1948) requires Boric Ointment to contain 0.9% - 1.1% Boric Acid. Medicinal Peppermints. D8l". Informal. 79% deficient in Magnesium Carbonate. D91. Formal. 80% " " " Both samples were obtained from the same,vendor, who was fined £5 with £2-4-0 costs. Parrish's Food. 2 samples from the same vendor were adulterated: D547. Informal. 86% deficient in Ferrous Phosphate. D574. Formal. 88% „ „ „ The vendor was cautioned. Tartaric Acid. 1 informal sample consisted entirely, of arrowroot, apparently due to a mistake in labelling. A further sample was genuine. Total Fines and Costs in 8 Cases under the Food and Drugs Act Fines £24. Costs £13-15-0. Public Health Department. 88 samples examined for the. Department consisted of:- 4 Bread 4. Fruit 8 Tinned Fish 1 Cement 2 Fruit Juice 1 „ Fruit 2 Citric Acid 2 Gelatine 4 „ Jam 2 Cocoa 1 Lemonade 5 „ Meat 2 Condensed Milk 2 Meat 1 „ Soup 10 Confectionery 1 Pickles 6 „ Vegetables 20 Cooked Meats , 1 Tea 1 Tomatoes 1 Fat 1 Spices 1 Tomato Paste. 5 Flour Of these, 11 were unsatisfactory as shown below Pl8. Bread. Contained excrement of mice. P71. Bread. Contaminated with oil. P5. Cocoa. Old stock 5 rancid. p6. Cocoa. „ P78. Coconut Filling. Rancid. P90. Desiccated Coconut. „ P79. Condensed Milk. Sour taste or smell. P23. Sardines in Soya Oil. Rancid taste. P75. Sponge Sandwich. Contaminated with soot. P77. Tinned Mandarines. 560 parts per million of Tin. P56. Tinned Pork. 285 „ „ „ Arsenic in Fruit. 4 samples of imported fruit were examined and found: to be satisfactory, showing only traces of arsenic. Food Executive Officer. 1 sample of Bread was examined for the Food Executive Officer. Private Purchasers 1 sample of Sauce and 1 sample of Sausage Casings were examined for private purchasers. I wish to express my indebtedness to Mr. C.J.P. McGinn, B.Sc.(Lond.),A.R.I.C., for his capable assistance during the year and also my appreciation of the interest and co-operation shown by the staff of the Food Section in- the work of the Laboratory. I have the honour to be, Ladies & Gentlemen, Your obedient Servant. W.M. PAULLEY, Public Analyst. 43 White Horse Road, E.1. -46- APPENDIX OF STATISTICAL Table 1. COMPARATIVE VITAL STATISTICS FOR 1950 Stepney London Administrative County England 3 and Wales Births Rates per 1,000 Home Population Live births 18.5 17.8 15.8 Still births 0.43 0.36 0.37 Deaths All Causes 12.58 11.8 11.6 Typhoid and paratyphoid 0.00 0.00 0.00 Whooping cough 0.00 0.01 0.01 Diphtheria 0.00 0.00 0.00 Tuberculosis 0.56 0.39 0.36 Influenza 0.04 0.07 0.10 Smallpox - - – Acute poliomyelitis (including polioencephalitis) 0.01 0.01 0.02 Pneumonia 0.46 0.48 0.46 Notifications (Corrected) Typhoid fever 0.00 0.01 0.00 Paratyphoid fever 0.00 0.01 0.01 Meningococcal infection 0.04 0.03 0.03 Scarlet fever 1.06 1.23 1.50 Whooping cough 2.92 3.21 3.60 Diphtheria 0.03 0.03 0.02 Erysipelas 0.17 0.17 0.17 Smallpox – - – Measles 5.05 6.57 8.39 Pneumonia 0.61 0.50 0.70 Acute poliomyelitis (including polioencephalitis) Paralytic 0.09 0.08 0.13 Non-paralytic 0.09 0.05 0.05 Food poisoning 0.10 0.25 0.17 Deaths Rates per 1,000 Live Births All causes under 1 year of 26.55 26.3 29.8 Enteritis and diarrhoea under 2 years of age 2.16 1.0 1.9 Notifications (Corrected) Puerperal fever and Rates per 1,000 Total (Live and Still) Births pyrexia 7.41 6.03 5.81 -48- TABLE 2. DEATHS OF PERSOT'S OVER 65 YEARS OF AGE 1901 - 1950 (per-cent, or Total Deaths) TABIE 3. INFANT MORTALITY RATE 1901 - 1950. (Deaths of Children under 1 year per 1000 Births) -49- Table 4. TOTAL DEATHS BY CAUSE AND AGE IN THE METROPOLITAN BOROUGH OF STEPNEY - 1950 CAUSES OF DEATH. All Ages -1 1- 5- 15- 25- 45- 65- 75- 1. Tuberculosis - Respiratory 50 - - - 2 16 22 7 3 2. " - Other 6 - - — 2 — 1 3 — 3. Syphilitic Disease 6 - - - - - 3 2 1 4. Diphtheria - — - — — — — — 5. Whooping Cough — — — — — — - - — 6. Meningococcal Infection 1 -- 1 - - - - - - 7. Acute Poliomyelitis 1 - 1 - - - - - - 8.Measles - - - - - - - - - 9. Other infective and Parasitic Diseases 1 - 1 — - - - - - 10. Malignant Neoplasm - Stomach 47 - - • - 4 19 22 2 11. " - Lung, Bronchus 47 - - - - 1 24 15 7 12. " - Breast 24 — — — — 3 10 9 2 13. 11 - Uterus 10 — - - - 2 5 2 1 14. 11 - Other 126 - - 1 1 3 41 43 37 15. Leukaemia, Aleukaemia 1 - — - - - - - 1 16. Diabetes 10 - - - - - 4 4 2 17. Vascular Lesions of Nervous System 98 — — — — 2 17 32 47 18. Coronary disease, Angina 149 - - - - 6 53 63 27 19. Hypertension with Heart Disease .. 63 — — — 1 - 12 27 20. Other Heart Disease 187 •S 3 7 35 42 100 21. Other Circulatory Diseases 46 — — 1 8 14 23 22. Influenza 4 1 — — — — 2 - 1 23. Pneumonia 46 2 - - - 1 6 13 24 24. Bronchitis 92 3 - 1 - - 16 3b 3'/ 25. Other diseases of Respiratory System 22 — — — — 1 8 V 6 26. Ulcer of Stomach and Duodenum 20 — — 1 3 4 9 3 27. Gastritis, Enteritis and Diarrhoea 8 4 — - 1 1 1 - 1 Contd. -50- Contd.) CAUSES■OF DEATH All Ages -1 1- 5- 15-125- 45- 65- 75- 28. Nephritis and. Nephrosis 14 - - 1 1 1 6 3 2 29. Hyperplasia of Prostate 11 - - — - — 1 2 8 30. Pregnancy, childbirth, abortion 2 - - - - 2 - - - 31. Congenital malformations 8 4 1 - 1 - 2 - - 32. Other defined and ill-defined diseases 100 33 1 2 4 6 16 16 20 33. Motor vehicle accidents 10 - - 1 1 - - 4 4 34. All other accidents 34 2 1 2 1 3 5 6 14 35. Suicide 10 - - - — 4 3 — 3 36. Homicide and operations of war 1 - - - - 1 - — - Sub Totals-: M 703 32 4 5 10 38 200 206 208 F 552 17 2 3 9 30 124 172 195 GRAND TOTAL 1255 49 6 8 19 68 324 378 403 -51- Table 5. SUMMARY OF INSPECTIONS, VISITS AND ACTION TAKEN BY DISTRICT SANITARY INSPECTORS DURING THE YEAR. ! Complaints 10,127 Drainage 7,432 House-to-House 43 Houses-let-in-Lodgings 795 Infectious Diseases and Cohtacts 381 Common Lodging Houses 103 Seamen's Lodging Houses 65 Markets (Week-end) 35 Offensive Trades 334 Pharmacy and Poisons Acts, 1933 216 Rent Restrictions Acts 340 Shops Act, 1950 681 Smoke Nuisances - observations 228 Essentiality Certificates and Building Licences - Surveys 776 Defence Regulation 68 C .A. 87 Factories Mechanical 1,946 Non-mechanical 333 Other 4 Outworkers premises 142 Workplaces . 96 Miscellaneous visits and inspections 10,828 Revisits 15,162 Total Visits and Inspections 50,154 Intimation Notices served: On County and Borough Council Housing Departments 573 On Owners 4,767 Statutory Notices served 1,499 Legal proceedings taken 108 -52- Table 6. SUMMARY OF WORK CARRIED OUT UNDER THE SUPERVISION OF DISTRICT SANITARY INSPECTORS DURING THE YEAR Animal nuisances abated 10 Cisterns cleansed, covered and repaired 28 Dampness in premises remedied 2576 Drains cleansed or repaired 1137 Drains constructed or reconstructed 1902 Dust receptacles provided 273 Dwelling rooms cleansed 5629 Houses ventilated beneath lower floor 55 Improved light and ventilation provided to rooms 19 Manure receptacles provided or reconstructed 2 Offensive accumulations removed 258 Gutters and rainwater pipes fixed or repaired 827 Repairs to roofs 2283 Sinks , baths and lavatory basins fitted 1037 Sink, bath etc. waste pipes fixed or repaired 1385 Smoke nuisances abated 87 Urinals fixed or repaired 34 Verminous rooms cleansed 976 Water-closets cleansed or repaired 596 " - light and ventilation provided 68 " - pans and traps fixed 941 " - provision or repair of flushing apparatus 722 Water Supply to houses reinstated or repaired 553 Yards, Areas and Forecourts paved or.repaired 271 Floors and Staircases repaired 1002 Fireplaces and Coppers renewed or repaired 1011 Windows repaired 1394 Miscellaneous 2632 Total: 27,708 -53- Table 7. FACTORIES ACTS, 1937 & 1948, , 1. INSPECTIONS for purposes of provisions as to health Type of Factory. No .on Register Inspections Written Notices Factories without mechanical power 476 333 6 Factories with mechanical power 3114 1946 93 Other premises under the Acts (building operations and works of engineering construction) 50 4 2 TOTAL 3640 2283 101 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars. Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness 33 33 5 6 Inadequate ventilation - - - - Ineffective drainage of floors - - - - Sanitary Conveniences (a) insufficient 14 14 - 8 (b) Unsuitable' or defective 73 73 - 30 (c) Not separate for sexes 6 6 - 4 Other offences against the Acts (not including those relating to Outwork) 20 20 - 6 TOTAL : 146 146 5 54 -54- Table 8-. RODENT CONTROL. Counoil Property Dwelling Houses Business Premises TOTAL Total Properties in Area 56 23,101 12,504 35,661 No .Infestations notified by Occupier 6 1,078 379 1,463 No .Infestations otherwise discovered 4 617 320 941 No .Infestations: Major 1 3 60 64 Minor 4 920 462 1,386 Mice only 5 772 167 944 Properties inspected 9 8,482 4,180 12,671 Inspections made 10 8,657 4,213 12,880 Sec.4 Notices served - - - - No.Treatments given: By arrangement- with Occupier: Rats 5 888 196 1,089 Mice 5 720 122 847 Under Sec.5(1) - - - - Block Treatments: No. of Blocks - - 2 2 Surface.- No. of seperate occupancies - - 105 105 Associated sewers No.Manholes treated. - - - - + Does not include dwelling-houses. Sewers - "Maintenance Treatments." I am informed by the Borough Engineer and Surveyor that two treatments for the destruction of rats:in sewers were carried out during.the year, viz., from 5th June to 18th July and 4th December 1,950 to 18th January 1951. 1,470 manholes were treated during the first period and 1,436 during the second, the estimated number of rats destroyed being.11,735 and 11,300, respectively. -55- Table 9. HOUSING. Statistics. 1 I. Inspection of dwelling houses during the year (l)(a) Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 18,028 (b) Inspections made for the purpose 34,726 (2)(a) Dwelling-houses inspected and recorded under Housing Consolidated Regulations, 1925 44 (b) Inspections made for the purpose 53 (3) Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 (4) Dwelling-houses found not to be in all respects reasonably fit for human habitation 6,503 II. Remedy of defects during the year without service of Formal Notices:- Dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 5,077 III. Action under Statutory powers during the year:- (a) Proceedings under Sections 9} 10 and 16 of Housing Act, 1936:- Dwelling-houses in respect of which Notices were served requiring repairs Nil (b) Proceedings under Public Health Acts:- (1) Dwelling-houses in respect of which Notices were served requiring defects to be remedied 1,426 (2j Dwelllng-hou«©s in which defects were remedied after service of Formal Notices:- (i) Ey Owners. 1,426 (ii) By Local Authority in default of Owner Nil (c) Proceedings under Sections 11 and 13 of Housing Act, 1936:- (i) Dwelling-houses in respect of which Demolition.Orders were made 3 (ii) Dwelling-houses demolished in pursuance of Demolition Orders 1 3 (d ) Proceedings under Section 12 of Housing Act, 1936:- (1) Separate tenements or underground rooms in respect of which Closing Orders were made 29 (ii) Closing Orders determined, the tenements or rooms having been rendered fit Nil -56- Table 10. Summary of Inspections, Visits and Action Taken by the specialist inspectors engaged in the supervision and inspection of food. Bakehouses 227 Butcher and Bacon shops and stalls 254 Butter and Margarine premises 54 Complaints Fish shops and stalls 605 Grocery and Provision shops 306 Greengrocers and Fruiterers shops and stalls 773 Ice Cream premises 372 London Fruit Exchange 222 Markets (Daily) 930 Markets (Week-end) 11 Milkshops 356 Poultry shops and stalls 1616 Prepared Food premises 312 Public Houses 140 Railway Depots + 308 Restaurants, Caf4s , Canteens, etc 924 Spitalfields Market 133 Wharves 946 Wholesale Grocers 358 Miscellaneous visits 501 Samples:Food and Drugs 1126 Other 292 Revisits 1018 No. of summonses taken out 77 + Includes 290 special night or early morning inspections at Bishopsgate Goods Station. -57- Table 11. NOTIFIABLE DISEASES NOTIFIED DURING THE YEAR 1950 DISEASES. -1 .1- 2- 3- Total Cases Notified In Age Groups. 35- 45- 65- Toal Notifications Corrected Total Cases admitted to Hospital No. of Deaths[/##] 4- 5- 10- 15- 20- Diphtheria 1 - - - 1 1 2 - 1 - 1 - 6 3 6 - Dysentery 1 3 4 2 4 7 1 - - - - 1 23 19 15 - Erysipelas - - - - - - 1 - - 4 8 4 17 17 1 - Food Poisoning — — — — — — — 1 3 2 4 — 10 10. 2 - Malaria - - — — — — — — 1 1 — — 2 2 2 - Measles 43 80 73 100 85 121 2 — — — 1 — 505 504 56 - Membranous Group 2 1 — - - - - - - - 3 2 3 - Meningoc.Infectior 2 2 - - - - - - - - - - 4 4 4 1 Ophth.Neonatorum 4 - - - - - - - - - - - 4 4 4 - Pneumonia 3 — 2 3 1 5 1 1 12 2 21 10 61 61 18 46 Ac .Poliomyelitis; Paralytic — 3 2 3 l l - - - - - - 10 9 10 1 Non-paralytic 1 2 - 2 - l 1 1 1 1 - - 10 9 9 - Puerperal Pyrexia — - — — — - - 1 12 1 — — 14 14 13 2 Scarlet Fever - 3 9 20 10 48 12 5 4 - - - 111 106 34 - VJhooping Cough 22 42 38 43 45 74 28 l 2 3 - - 298 292 39 - Tuberculosis - Pul. - 5 3 4 2 5 4 15 60 14 35 13 160 160 - 50 Non-Pul. - l 1 1 — 1 1 2 6 2 1 - 16 16 6 Scabies 1 - - - 1 4 — 2 39 11 7 2 67 67 — - TOTALS: 78 143 132 179 150 268 53 29 141 41 77 30 1321 1299 216 106 There were no notifications of Smallpox, Enteric Fever or Acute Encephalitis. + Deaths reported in 1950 do not necessarily refer to cases notified in that year. -58- Table 12. TUBERCULOSIS - New Cases and Deaths, New Cases . 226 Pulmonary cases notified Included 160 Primary notifications, 13 from death returns and 53 transfers. 26 Non Pulmonary cases notified included 16 Primary notifications, 4 from death returns and 6 transfers. Deaths. 51 Pulmonary; 2 Non Pulmonary. Details of age distribution are as follows -1 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total (all ages  (a) New Cases. Pulmonary M — 1 7 2 1 11 21 24 10 20 19 15 1 132 F - 5 4 6 3 9 18 29 9 5 3 2 1 94 Non Pulmonary M - - - 1 l 2 6 1 2 l 2 - - 16 F - 1 2 1 2 - 1 - 1 1 - - 1 10 (b) Deaths. Pulmonary M - — - - - - 2 9 6 8 6 5 2 38 F - - - - - 2 - 5 1 1 3 1 - 13 Non Pulmonary M - - - - - - - - - .- - - F - - - - - - - - - - - 1 1 2 Table 13. TUBERCULOSIS -Variations in Register. Pulmonary Non Pulmonary Total Cases M. F, M. F. (a) Cases on Register at 1/1/50 533 362 94 81 1070 (b) New cases notified 90 75 9 6 180 (c ) Cases restored to Register 10 7 2 -• 19 (d) Other cases added 32 15 5 3 55 (e) Removals 120 74 12 9 215 (f) Cases remaining on Register at 31/12/50 545 385 98 81 1109 -59- REPORT ON- CLfeAN FOOD- CAMPAIGN, Saturday 13th to Saturday 20th May 1950. (1) Ministry of Health Circular 2198 - 20th August 1940. " " " Circular 46/49 -'24th May 1949. " " " Memorandum No.l88Med. do. " ,, Food Circular. MF/12/49 - 20t.h Aug. 1949. (2) The Public Health Committee of the Metropolitan Borough of Stepney have for some time conducted an education, campaign drawing the attention of the traders and the public to the necessity of improving the hygiene standards of food shops and catering establishments. On 24th January 1950, the Committee decided to launch an intensive outdoor paign. From past experience it was found that the public do not well attend indoor health exhibitions and lectures, and the Committee decided that- it would probably be more successful to take the exhibition to the public rather than expect the public to attend an indoor exhibition in a public hall. It was also felt that in this way the educational effect of the campaign would better reach those sections of the public who were probably most in need of enlightenment and who would certainly not visit an indoor health exhibition. i (3) Preparation of the Campaign and equipment acquired or hired. The Medical Officer of Health, the four Food Inspectors and the staff officer engaged in Health Propaganda conferred with the following:- (i) The Co-operative Wholesale Society - to acquire the hire of a mobile cinema van and .the necessary technical staff to operate It. (ii) The Local Police Superintendents to obtain their co-operation to place the van on suitable sites in the streets and assist in guiding the public, etc. (iii) The Central Council for Health Education - to obtain advice and the loan of exhibition material, leaflets and posters. (iv) The Central Office of Information- to obtain advice and-the loan of Ministry of Health films "Another Case of food Poisoning" and "A Fly About the House." -60- (v) The Ministry of Agriculture and Fisheriesfor film "Town Rat". (vi) The Gas Council - for film "A New Kitchen". (vii) Imperial Chemical Industries- for film "Fight Against Disease". (viii) The Central Public Health Laboratories, Colindalefor loan of exhibition material, charts, and cultures. (ix) The W.V.S. for a mobile canteen van which was used as a Mobile Information Stall to accompany the cinema van. (x) Makers of model Mobile Snack Bars, and Ice Cream Stalls - to invite them to exhibit these on the site and demonstrate modern Improvements, e.g., hot and cold water supply, food storage facilities, etc. (xi) Market and Street Inspectors - to ensure suitable sites in streets and open market places. (xii) Public Cleansing Officer - to obtain help in 'clearing some suitably situated bombed sites, (xiii) Borough Engineer - to remove or replace fencing on certain sites and to construct and adapt some exhibition material. (Xiv) A Sound Recording firm - to record a talk by the Medical Officer of Health on Food Poisoning. (4) Publicity. (i) For two weeks prior to the Campaign the local papers carried advertisements of the programme and timetable of the exhibition. (ii) The Empire Marketing Board sites in the Borough exhibited large posters giving the same information. (iii) Special posters announcing the Campaign were printed and generally exhibited. (iv) Leaflets were printed and distributed from Libraries and other public establishments. -61- (v) Leaflets and cards bearing invitations were mailed to all councillors and public representatives, and also to members of food trades through the Borough. (vi) A recorded talk on Food Poisoning was made by the Medical Officer of Health and broadcast frequently from the cinema van. (vii) Specially measured posters with slogans and figures of food infections were prepared to cover the sides of the cinema van and information van. (5) Description of Exhibition "Unit." The "Unit" consisted of three vans - (1) Mobile cinema van, (2) van used as an Information stall, and (3) Model mobile food kiosk. (6) Time-table of Campaign. i Saturday, 13th May - Whitechapel Road , 9 a.m. to 5 p.m., (in Court Street opposite the London Hospital). ' • j- •• - \ ,. Monday 15th May - Wentworth Street, 9 a.m. to 5 p.m., (Site Nos.6-10) Tuesday, 16th May - Watney Street, 9 a.m. to 5 p.m., (Brinsley Street corner) Wednesday, 17th May - Watney Street, 9 a.m. to 10.45 a.m. Tower Hill. 11 a.m. to 4 p.m. Thursday, 18th May - Wentworth Street, 9 a.m. to 5 p.m.. (Site Nos.6-10) Friday, 19th May - Hessel Street. 9 a.m..lt6 .5 -p.m., (in Wicker St., Burslem St.,-end) Saturday, 20 th May - Burdett Road. 9 a.m. to 11 a.m., (Mossford St., corner of Solebay St.) Whitechapel Road , 1 p.m. to 5.30 p.m. Speakers . The Mayor and Mayoress (Cllrs . F .B. Tyrrell and Mrs. Tyrell, the Chairman of•the Public Health Committeev (Cllr. Miss Upton) and the Medical Officer of Health opened the Campaign on 13th May. The Medical Officer of Health and the four Food Inspectors acted as speakers throughout the week and the Mayor and Chairman'paid other visits during the week. -62- Typical Morning Programme. 9.00 a.m. Vans on site, music by amplifier. 9.30 a.m. Recorded Talk by Medical Officer Of Health. 10,00 a.m. Film "Another Case of Food Poisoning". 10.30 a.m. Questions and Answers. 11.00 a.m. Film "A Fly About the House" 11,30 a.m. Questions and Answers . 12.00 noon Visit by Mayor and Mayoress. The afternoon programme continued until 5.30 or 6 p.m. Material for Questions . Prior to the Campaign a list of 30 selected questions and answers was prepared by the Medical Officer of Health. Copies of this list were supplied to all members of the staff manning the Unit. In slack moments, when public questions were not forthcoming, staff members in the crowd put up questions from the list, which were answered by the Speaker, and were usually followed up by supplementary questions from the public. Exhibits Shown. No attempt was made to hold a formal exhibition, but a few small exhibits likely to stimulate interest and start discussions were shown on the information stall. . .. > . "... • . The following were exhibited (a) A plate-culture of staphylococci mounted on a card with a dirty dish-cloth on same card. Caption: "Food Poisoning Germ's grown from a dirty.dish-cloth." . " (b) Framed copies of the Council's "Certificate of Hygiene for Catering Establishments." (c) ;Newspaper headlines of reported recent cases of'Food Poisoning. Caption; "Recent Cases of Food Poisoning in England and Wales." (d) Illustrated charts showing how Food Poisoning spreads from the hands of kitchen workers to food and from food to the public. (e) Enlarged statistical charts of Food Poisoning in England and Wales, and several photographs. -63- (7) Impressions of the Campaign. The campaign was certainly enjoyed by the public. The unit was seldom without a crowd of some 30 persons, and frequently several .hundreds crowded abound the-unit. • Great interest was taken in all the cinema films, and provided questions were quickly invited and disc-ussion started the crowd held its interest and remained after the film. The audience generally showed great concern and interest and was eager to learn the facts though not quite so willing to unlearn popular fictions. Not infrequently questions were irrelevant and turned on housing and personal economic difficulties, but it was usually possible to lead from these questions back to the subject under discussion. (8) Lessons Learned from the Campaign. We formed the opinion that the Unit should be;as mobile as possible. Should we repeat the campaign we would not remain on any one Site for more than 2 hours. We found that interest in the unit rises to its maximum after about half-an-hour and by the end of 2 hours most of the local people or passers-by have seen it. It is better then.to move quickly to another district and reap the maximum interest for a short period on several sites. For this reason posters and exhibition boards etc. on the sides of the vans must be quickly detachable. A further'objection to keeping- the cinema van too long on one site is-that the neighbouring business houses and market stall-holders are liable to complain of the disturbance to their trade and the work of the police may thus be made more difficult. The aim of all questions and answers was to convey to the public, as briefly as possible, simple information on the more vital points relating to food poisoning in such a way that they would clearly remember then and pass then on to their friends and relatives. (9) Number of Persons Attending. It was calculated that during the 7.days of the Campaign approximately 6,000 members of the public were in attendance. Health lectures before the,war held in the local public halls seldom had an attendance of nore than 50 to 100 people. On the whole the Campaign was worth while and achieved its object of conveying information to the public. 64 INDEX Page Aged Persons 9 Analyst's Report 42 Area of Borough 6 Bacteriological examination of foodstuffs 31 Bakehouses 33 Births 7 Building Licences 28 Burial of Dead Bodies .16 Butchers Shops 33 Butter & Margarine Factories 33 Cancer - Deaths from 6 Catering Establishments 34 Clean Food Campaign 18,60 Common Lodging Houses 23 Complaints of,Nuisances 21 Conferences17 Cow House 24 Deaths 6,7,49,50 Defence Regulation 68 C.A. 28 Diarrhoea - Deaths from 6 Diphtheria Immunisation38 Disinfection 41 Disinfestation 41 Drainage 21 Factories 22,54 Fish Shops and Stalls 33 Food: Inspections 30,57 Poisoning 38 Unsound 35 Fur Skin Dressers 24 Greengrocers & Fruiterers Shops and Stalls 34 Grocery and Provis'ion Shops 34 Health Propaganda 18 Health Services, General provision of 9 Home Bathing 12 Home Cleansing 12 Hot Mid-day Meals 12 Houses-let-in-Lodgings 22 Houses - Number in Borough 6 Housing: Inspections and Visits 28,29 Statistics 56 Ice Cream 32,44 Illegitimate.Births 6,7 Immunisation (Diphtheria) 38 Infant Mortality 6,8,49 Infectious Disease 38,58 Information Service 20 Inquests 16 -65- Page Laboratory Facilities 19 Legal Proceedings 23 Legislation 19 Marriages 7 Maternal Mortality 6,8 Maternity & Child Welfare 13 Milk Supply 30,43 Mortuary 16 National Assistance Act, 1948 9,16 Offensive Trades 24 Outworkers 22 Overcrowding 28 Pharmacy & Poisons Act 24 Population 6,7 Poultry Slaughterhouses 24 " Shops and Stalls 33 Prepared Food' Premises 33 Propaganda - Health 18 Public Health Committee 2 Rag and Bone Dealers 25 Rateable Value 6 Refuse Disposal 25 Removal of Persons in need of care and attention 9 Rent & Mortgage Interest Restrictions Acts 25 Rodent Control 25,55 Sanitary Circumstances of Area 21 Sanitary Inspectors: Summary of Inspections 52 Return of Sanitary Work 53 S c ables 38 Seamen's Lodging Houses 23 Shops Act 26 Sites, Rubbish cleared from 26 Slum Clearance 29 Smallpox 39 Smoke Abatement 27 Social Conditions of Area 7 Special Reports to Public Health Committee 17 Statistics, Summary of 6 Stillbirths 6,7 Staff 5,16 Tripe Boilers 24 Tuberculosis 39,59 Underground Rooms 28 Unemployment 8 Vaccination 39,41 Verminous Persons and Premises 12,41 Vital Statistics 6,7,48 Water Supply 27 -66- . 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