Metropolitan Borough of stepnen 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 195 I Together with the Report of the PUBLIC ANALYST ^ / Metropolitan Borough of Stepnen. 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 1951. Together with the Report of the PUBLIC ANALYST. CONTENTS Page Public Health Committee ii Introductory iii Staff 1 Summary of Statistics 2 I. Statistics and Social Conditions of the Area 3 II. General Provisions of Health Services 6 III. Sanitary Circumstances 19 IV. Housing 28 V. Food - Inspection and Supervision 31 VI. Infectious and other Diseases 38 Public Analyst's Report 45 Appendix 50 Index 67 (11) PUBLIC HEALTH COMMITTEE at 31st December 1951 Ex-officio: His Worship The Mayor (Councillor W.G.Humphries, J.P.) Chairman: Councillor (Miss) E. Upton Vice-Chairman: Councillor (Miss) E. Aylward Alderman T. Aylward Alderman J. Moore, J,P. Alderman (Mrs.) M. Sambrook Councillor A. Butler Councillor M. Levitas Councillor W.J.Curtis Councillor R. Milligan Councillor (Mrs.) K. Edwards Councillor B. Mushin Councillor (Mrs.) F. Finlay Councillor (Mrs.) A. Taylor Councillor M. Lerner Councillor H.J.Vanloo Council's Representatives on L.C.C. Health Committees, at 31st December 1951:- Division 5 Alderman (Mrs.)M. Sambrook Councillor (Mrs.) A. Elboz Councillor (Miss ) E. Upton Central. Councillor (Mrs.) K. Edwards (iii) 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 and Gentlemen, I have the honour to present my Report on the state of the public health in Stepney for the year 1951. The population of the borough according to the fifteenth Census of the Registrar-General, which was made this year on April 8th, is 98.581. The last Census was made in 1931, when the population was 225,238. The midyear estimate of the population according to the RegistrarGeneral is 98,850. The comparable estimate for 1950 was 99,730. The Census population figure is used for statistical purposes in this report. The total number of births registered was 1,886. compared with 1,888. last year. The live birth rate is 18.72. Once again the infant mortality rate has reached a record low figure, viz. 21.12, compared with 26.55 last year. The continued drop in infantile mortality not only in Stepney but throughout the country is the most reliable index of the improved :health of the nation. At the commencement of the century Stepney's infantile mortality rate Was 165. The maternal mortality rate has also shown a great improvement, and there were no maternal deaths this year in Stepney. The general borough death rate is 13.83, a..slight increase on last year's 12*5$.. Sixty-six per cent of all deaths occurred over the age of 65. There were again" no deaths; from diphtheria, scarlet fever or whooping- cough. No cases of smallpox or typhoid (iv) occurred but there were 9 cases of paratyphoid fever, all of which recovered. There was an unusually large outbreak of measles, numbering 1.459 notified cases, all of which recovered. This, the highest incidence of measles since the disease became notifiable in 1938, was common throughout the country. Deaths from tuberculosis showed a slight decline from last year, being 49 compared with 56. Cancer deaths have also declined from 255 to 232. The revocation this year of the 1930 regulations prohibiting the importation of parrots recalls the tragic death from psittacosis of Stepney's first Medical Officer of Health? Dr.Dan Thomas, in December, 1929. Up to the time of his death, little had been heard in this country of this typhoid-like disease. Several cases .were subsequently brought to the London Hospital, and. because the disease was believed to be due to the importation of infected parrots, the prohibition regulations were made by the Minister of Health, Further research has shown that the disease also occurs in seagulls, pigeons and other birds. Modern drugs such as penicillin have rendered it less dangerous, and only one death occurred in England and Wales in the last ten years. The general improvement in the health of the country has greatly extended the expectation of life, and the care of the increasing numbers of aged persons in the population becomes each year a more difficult problem. This is particularly so in East London, and the Secretary of the Stepney Old People's Welfare Association at Butcher Row, Cable Street, would welcome the assistance of kindly persons living in the borough. Aged persons living alone often require the help of neighbours, and if this could possibly be organised on a street basis, as was the Wardens' Service during the war, it would be a great asset. During and since the war, the number of coloured immigrants coming to reside in the borough has increased, and a recent calculation, which is necessarily approximate, estimates the total coloured population to be (v) 2,150, made up of - approximately 200 West Africans, 500 West Indians, 50 East Africans and Somalis, 300 East Indians and Pakistanis and about 100 Sikhs. All are British subjects and have come to this country, either as fare-paying passengers or stowaways, to seek work. Other immigrants of British nationality consist of about 100 Cypriots and Greeks and 250 Maltese. The majority of immigrants referred to above reside in the south-western area of the borough. An estimate in 1944 gave the- figure as 400. Whether immigrants, coloured or Otherwisej will increase, is difficult to say, but probably"the influx was attributable directly or indirectly to the recent war. The photographs facing page 29 of the report illustrate the worst and best of Stepney, housing, and show hoto the building drive made by thq Borough Council and the London County Council is gradually altering the face of the Borough. Progress was made in many fields, and the health department's work was not made less by the usual spate of new legislation during the year, some of which was necessary. A list of new acts and orders is set out on page 13. I would like to express my gratitude to the. Chairman and members of.the Public Health Committee for their . • interest and support, to my fellow Chief Officers for their helpful co-operation, and particularly to the members of my staff for their good work throughout the year, not least those who helped me in compiling this report. I have the honour to be, Your Worship, Ladies and Gentlemen, Your, obedient Servant, F. R. 0'SHIEL. Medical Officer of Health. 1. STAFF OF THE PUBLIG HEALTH DEP-HRIMENT at 31st December 1951 Medical Officer of Health FJHoantree 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 Jidministrative Officer: E.P.Webber (1, 2) Principal Assistant: S.J.Carr District Sanitary Inspectors Disinfestation Inspectors Clerical Staff T.ylward W.E.Anstee (1) E.J.Edwards (1, 2) D .J.Berry W.Cue (1) Miss H.A.Whitty (1, 2, 4, 5, 7) M.E.Coker (+) R.W.G.Day (1) H.I.Davies (T) S.Firsht (1) W .J.Dixon W.E.Hart (1) Housing Inepector. C.F.Guy (1) W.E.Driacoll E.C.Hawker (1, 2) S.W.Snbleton W.H.Haworth (1) Mrs.C.Gardner J.J.Keniry (1) Rodent Control G.D.Freeland (1, 2, 3) S.S.Harris S.S.Lowther (1, 2) Miss R.Levey P.W,Thorn (1) J .McMullon B.Reilly (1) Rodent Mrs.M.Munday (T) (and 2 vacancies) Investigators M.J.O'Connor (*) Food Inspectors S.C.Ludlow (T) M.Pliskin A.C.Brown (1, 2) T.T.Walker (T) J.Pratt (T) H.J.Green (1, 2) W.F.Smith (1, 2, 6) Foreman Rodent Operative Foreman Disinfect or W. Sexton S. Vogler(1,2) T.J.Fox Caretakers W.Clark A.N.Cook E.H.Vaughan (Messenger/Relief-Caretaker) (1) Sanitary Inspectors Certificate. (2) Meat & Other Foods Certificate. (3) Smoke Certificate. (4) Health Visitors Certificate. . (5) State Certified Midwife. (6) Diploma Social Science. (7) Trained Nurse. (T) Temporary. (+) H.M.Forcos. (*) Permanent employee temporarily transferred from another department. 2. SUMMARY OF STATISTICS, 1951 Area of Borough 1902.7 acres. Population (Census 8th April, 1951) 98,581 Population (Registrar-General's Estimate, of Home Population as at 30th June, 1951) 98,850 Number of inhabited houses (end of 1951), according to Rate Books 28,561 Rateable Value (1st April, 1951) £1,241,272 Sum represented by a penny rate, gross £5,172 Density of Population (persons per acre) 55.8 BIRTHS Total M F Legitimate 1674 857 817 Illegitimate _172 92 80 TOTAL LIVE BIRTHS 1846 949 897 LIVE BIRTH RATE per 1000 population =18.72. STILL BIRTHS 40 20 20 STILL BIRTH RATE per 1000 total (live and still) births = 21.20. TOTAL BIRTHS: 1886 969 917 DEATHS 1364 776 588 DEATH RATE per 1000. population = 13.83. MATERNAL-DEATHS Nil. DEATHS OF INFANTS UNDER ONE YEAR OF AGE:- Total M F Legitimate 35 23 12 Rate per 1000 live births (legitimate)' = 20.90. Illegitimate 4 - 4 Rate per. 1000 live births (illegitimate) = 23.26. 39 23 16 Rate per 1000 live births (total) = 21.12. DEATHS FROM:- Total M F Cancer 232 133 99 Measles - - - Whooping Cough - - - Diarrhoea (under 2 years of age) 3 1 2 Tuberculosis - respiratory 46 32 14 Tuberculosis - other forms 3 3 - (*) All statistics and rates in this Hcport aro based on the census population. 3. 1. STATISTICS & SOCIAL CONDITIONS OF THE AREA. General Information; Stepney is situated on the North bank of the Thames, having a river frontage of 2.39 miles. It is roughlyrectangular in shape, its length being 2.3 miles and breadth varying from 1 to1½ miles, with 90 miles of streets. The acreage is 1,902 of ' vfrtich ' the river accounts for 136 acres and the inland water, consisting of docks and canals, 75 acres. The height above sea level varies from 8-feet at the dock side to 45-feet in the.northern part of the Borough. A considerable part of the Borough consists of made up ground to a depth of 8 to 10-feet, clay being reached at depths varying from 12 to 25-feet. The area is to a large extent industrial in character, factory premises being spread throughout the borough but concentrated somewhat towards the western end, apart from the docks and wharves on the river frontage. The chief industries carried on besides those associated with docks and wharves are the manufacture of clothing of all kinds, brewing, cigarette making, furniture and upholstery manufacture and motor vehicle repairs, (See Tc.ble on pp.57 & 58). Population. The fifteenth census of the population of England and Wales, taken on 8th April 1951, revealed that Stepney's population is 98,581. The Registrar-General's mid-year estimate for 1951 is 98,850, viz. 269 more than the census figure, whilst the estimate for mid-year 1950 was 99,730, i.e. 880 more than the 1951 estimate. The census figures show that the ratio of males to females in Stepney is 1,000 to 1,028, compared with London as a whole where the ratio is 1,000 to 1,135. The density of population is now 55.8 persons per acre, and in the previous census year -1931- was 127.5 persons per acre. Births. The total number of live births registered in the Borough during the year was 3,671,of which1,998 belonged to other areas. In addition, 173 births belonging to Stepney occurred outside the Borough, making a total of 1,846 births (949 male and 897 female) to Stepney residents. 3,273 births 4. occurred, in hospitals in the Borough, of which 1,354 were to Stepney residents. Triplets were born in the East End Maternity Hospital, two of the babies being delivered 3 days after the first. The live birth rate for the year is 18.72 per 1,000 of the population, which is 0,22 higher than that for 1950. The rates for the County of London and for England & Wales are 17.8 and 15.5 respectively. Illegitimate births numbered 172, representing 9*3 per cent of live births. Still-births numbered 40, representing a rate of 21.2 per 1,000 total births, a decrease of 1.5 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 3 , page 53. Marriages. The number of marriages registered during the year was 831, being 225 less than last year, and.440 less than in 1948. The rate of marriages per 1,000 population is 16.8 and in 1950 was 21.16. Deaths. The net number of deaths registered during the year was 1,364, of which 776 were males and 588 females, as compared with 1,255 for last year. The Rate of 13.83 compares with 12.58 for 1950. The principal causes of death were-heart disease, which accounted for 34 per cent of the total deaths, cancer 17 per cent and diseases of the respiratory system including influenza 17 per cent. A Table on page 51 shows deaths by cause and age. Sixtysix per cent of deaths were of persons over 65 years of age —ten years ago the percentage was 46. Road Accidents. Reference to the Table on page 52, which shows deaths by cause and age, reveals that 8 deaths of Stepney residents were due to motor-vehicle accidents. For the second year in succession no fatal accidents occurred to children, and non fatal accidents to children decreased. Of the 100 children who received injuries, 67 were boys and 33 were girls. 182 of the adult casualties were over 50 years of age. The Table on page 52 showsroad accidents occurring in the Borough compared over the past six years, for which 5. tion I am indebted to Mr. A.S. Monckton, the Council's Road Safety Organiser. Statistics show that more children under 15 years of age die from accidents in their own homes than frcm accidental causes elsewhere,(including road accidents), or from any single infectious disease. In children between 1 and 5 years a fatal home accident is the third largest cause of death in England and Wales. Statisticians estimate that 4 per cent of the population suffer 'annually from home accidents of sufficient severity to require hospital treatment, which involves a direct cost to the nation of £4 million to £5 million per annum. If local government public health authorities applied their resources to the reduction of such accidents, good results would ensue perhaps equal.to those achieved in the field of infectious disease. Infant Mortality. The deaths of infants under one year of age numbered 39, giving a rate of 21,12 per 1,000 live births, the lowest rate ever, recorded in Stepney, as compared with 26.55 last year-. The rate for England & Wales is 29.6, and that for London 26.4. There were 27 deaths of infants under 4. weeks old, representing a rate of 14.6 per 1,000 live births. The main cause of death among infants under one year of age was prematurity. Maternal Mortality: No maternal deaths occurred during the year. 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 1,896 24 389 12 2,321. The total unemployed at the end of 1951 was 1,741. 6. II. GENERAL PROVISIONS OF HEALTH SERVICES WELFARE OF AGED PERSONS. Under Section 31 of the National Assistance Act5.1,948, a Local Authority may contribute to the funds of any voluntary organisation -whose activities include the provision of recreation or meals for old people. During the year the Council made grants of £1,600, under this section, to eight such organisations in the Borough. The activities of. the various old people's clubs etc. in the. area are co.-ordinated by The Stepney Old People's Welfare Association. Section 47 of the National Assistance Act, 1948., empowers the Council to make application, to the Courts.for an order for the removal to hospital or ail institution pf aged, infirm or physically incapacitatcd 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 17 such Removal Orders and 1 Detention Order in respect of 5 men and 12 women, whose average age was 78. Details of the Court Orders,which operate for a period of three months in each case, are given below. In addition to living in insanitary conditions and being unable to devote to themselves and not receiving from other persons proper care and attention, the persons removed were also either - + (a) Suffering from a grave chronic disease; 5 or (b) aged and/or infirm; or (c) physically incapacitated. Person Age +Reasons for action Removed to Remarks Mrs.E.F. 93 a.b. c. Hospital. - Mr. E.F. 80 a .b. Institution. Died. Miss M.S. 77 a.b.c. Hospital. Died. Miss E.L. 68 b .c. Institution. - Mr.W.N. 58 a.b.c . - Absconded before enforcement of Order. Mrs.D.L. 87 b. - Removed to hospital under Lunacy Acts. Died. 7. Person Age +Reasons for action Removed to Remarks Mr. A.S. 90 b. Institution. - Mr. L C. 78 a.b . c . Hospital. Died. Mrs.R.A. 78 a .b . c. Hospital. Detention Order for further period of 3. months was made in this case. Died. Mr. C.G. 76 a .b . c. Hospital. - Miss M.W. 70 a .b . c . Hospital. - Mrs. F.P. 76 b. Institution. - Mrs. S.M. 81 a «b . c. Institution. - Mrs. J.I. 73 b. Institution. - Miss A.C.J. 82 b. Institution. - Miss S.F. 79 b .c. institution. - Mrs. S.C. 74 b .c. Institution. - In addition to the above persons removed under Court Orders, admission was gained to hospitals or institutions for eleven other persons. The National Assistance (Amendment) Act, 1951, which became operative from 1/9/51, filled an urgent need byproviding expeditious arrangements for the compulsory removal of persons to hospitals or institutions as legislated for by Section 47 of the National Assistance Act, 1948. The amending Act obviates the need for giving seven days notice to the person and to the Hospital Board or Welfare Authority; application may also be made to a single Justice instead of to a court of summary jurisdiction. An application for an Order must be certified by a general practitioner as well as the medical officer of health, and the period of removal-is for three weeks. The Council has continued its efforts in the field of aged persons' welfare. During the year equipment was provided and a woman engaged for the purpose of disinfesting and cleansing infested bed-linen and personal clothing, under• Section 122 of the Public Health (London) Act, 1936. This service is of great benefit to old folk, although not provided solely for them. Another contribution by the Council towards the welfare of old people takes the form of the provision of small flats and maisonettes for their particular needs. So far 1-12 such dwellings have been completed and occupied on the 8. Borough Council's Housing Estates and 53 more are in course of construction. Though most old people in Stepney are well cared for by their relatives and live the final years of their life in comfort and companionship, there are unfortunately many others living ail one under most unsatisfactory conditions. This problem will increase during the next thirty years. Probably 13.5 per cent of the population, viz. 13,000, are pensioners to-day. In thirty years, 20 per cent, viz. 20,000, will be of pensionable age. During the same period the number of young persons will decrease and there will be fewer to care for the aged. No doubt before then special legislation will have been introduced to deal with the problem. I do not think it can be covered adequately by voluntary effort and existing legislation. The Stepney Old People's Welfare Association. This Association has been in existence 2½ years. The Borough Council is represented on the Association by five members of the Council and the Medical Officer of Health, and applications to the Borough Council by affiliated old persons' clubs for grants under Section 31 of the National Assistance Act, 1948, are referred to the Association by the Borough Council for investigation and recommendation. The Association assists the aged through clubs, meals services, visiting and other services made available through its affiliated bodies. Fourteen clubs are now affiliated, whose activities include concerts, films, parties and outings. In some clubs classes are held by the Local Education Authority for handicrafts, dressmaking, singing and old-time dancing. The Meals on Wheels service is organised by the W.V.S., who use two vans (one maintained by the Borough Council) and serve 253 meals per week. Four of the clubs have luncheon clubs operating, where 302 dinners are served per week. In five of the clubs chiropody clinics have been established, and approximately 80 old persons are treated each month. Visiting. Old persons -in Stepney are visited by the Council's wofaian sanitary inspector, the district sanitary Inspectors, voluntary visitors, doctors, clergy, Assistance Board and local Welfare Department officers, parish staffs, members of congregations, church sisters of various denominations and club workers, who all help to put the old folk 9. in touch with statutory and voluntary facilities available. Even so, many more voluntary visitors are required, and it would be well if visiting could be arranged on a street basis by kind neighbours, as was the Warden's Service during the war. Library books are distributed by the W.V,S.,and.the Association arranges holidays for pensioners . Home Bathing of Aged Persons. Under the schemeccramenced'last year ,for the bathing of aged persons in their own homes by means of portable bathing equipment, 31 persons wore bathed, and 48 baths were given. DECEASED PERSONS. Mortuary. Fifteen bodies were received in the Council's Mortuary during the year. Inquests. Inquests were held on 56 residents of the Borough, two-of whom were children under 5 years of ago: 13 deaths were due to suicide, 23 were accidental, and 20 duo to other causes (5 natural causes, 6 misadventure, 2 self neglect, 4 open verdict, 1 manslaughter, 1 excessive drinking and 1 want of attention at birth). Burials. Section 50 of the National Assistance Act 1948 places, a duty on the Council to arrange for the burial of any persons found dead within the borough, where no private arrangements are made. . Forty such burials took; place during the year at a cost to. the Council of £193, which was irrecoverable from the estates of the deceased persons. FREE WASHING FACILITIES. To promote-food hygiene and,cleanliness and hygiene generally, the Council inaugurated in May free washing facilities in the public conveniences-. The service is necessarily limited at present because of structural adaptations required in some of the conveniences. So far there have been 3,000 free washes per month. Moreover, the number of prepaid washes has shown an Increase during the same period. 10. HEALTH PROPAGANDA Diphtheria Immunisation. A Diphtheria Immunisation campaign was carried out in the Borough during January and February. Combined advertisements giving particulars of facilities for immunisation for Poplar and Stepney residents appeared,inthe local press for six weeks. Slides were shown at six cinemas, and 10,000 leaflets and 200 posters were distributed arid displayed throughout the Borough. Mas is X-ray Unit. In.anticipation of the visit of the Mass X-ray Unit, 4,300 leaflets were distributed in the BorOUgh through various Channels, 20Q posters exhibited, and'the names dnd addresses of 3,500 firms arid shops were supplied to the organisers of the Unit. Details of the Unitls visit are given on pages 41. and 42. Films. Films dealing with venereal disease ("The People at No.19") and Diphtheria ("The Empty Bed") were shown to an atidience of the Public Health Committee and social workers. Empire Marketing Boards. These two boards, sited in Commercial Road and Mile End Road, ftdtfe during the year. exhibited the following posters obtained from the Central Council for Health Education: Diphtheria Immunisation, Health cf Mother and Child, Protection from Flies, Measles, and Food Hygiene iand Washing of Hands. Other subjects included Civil 'Defence dnd "warning notices against the depositing of rubbish on bbmbed and other sites. Exhibition Stand. A portable exhibition stand was purchased from the Central Council for Health Education and erected in Mile End Library. The main topic on this stand is changed every three months. Several thousand leaflets on various health subjects have also been distributed from the stand. GENERAL In addition to the foregoing a total of 100 posters and 3,000;leaflets were distributed during the year, dealing with Venereal Disease, Tuberculosis. Vaccination, Food Hygiene, Rent Restrictions Act, Depositing of Rubbish ByeLaws, etc. Display panels on Food Hygiene and also on Tuberculosis were loaned for display to business firms. 11. STEPNEY BOROUCH COUNCIL INFORMATION SERVICE. (Under the direction of the Borough Librarian). During the year under review, the number of persons seeking information or advice at the Information Centre, situated at 671a, Commercial Road, E.14, has again shown an increase. A total of 12,296 enquirers either called, wrote or telephoned the Centre, this number being an increase of 1,063 over the previous year. The scope of the enquiries has remained as varied as ever, the staff of the Service having to deal daily with a number of problems covering a very wide field and although the administration of the Health, Insurance and Assistance Acts have now become a feature of everyday life, problems arising out of these Acts still form a considerable percentage of the total enquiries dealt with at the Information Centre. The enquiries received can be broadly classified under two main headings: (a) General and Local Information and (b) Personal Problems. This latter heading covers numerous matters and it is the attention given to these which forms the most socially important activity of the Information Service. Although there has been a decrease in the number of postal enquiries during the past year, the number received by telephone has increased, this reflecting the greater use of the Service being made by local firms and organisations. In order to give a prompt reply to these telephoned enquiries, an index'of general and local information has been built up at the Centre, and this index has proved of immense value in dealing with enquiries from a variety of sources. Liaison has been maintained with the statutory and voluntary bodies in the borough and as a result of the co-operation by these bodies, many of the problems brought to the Information Centre were settled expeditiously, thereby giving a better service to the citizens of Stepney. The nature of the enquiries for the year included requests for information on.the following subjects Allowances, family, special and dependant; Civil Defence; Employment and Training ; Family Wfelfare and Assistance; Holidays, Travel and Agricultural Schemes; Housing and Accommodation; Income Tax; Landlord and Tenant; Legal Aid; Marital; Local and Civic Information; National Health; Maternity and Child Welfare ; National Insurance ; Pensions; 12. Registrations; Rent and Rates; Supply Problems and Pricc Complaints; Tracing Missing Persons; Traders Permits, Licences; War Damage; Youth Service, Education, Clubs etc.; Miscellaneous. A second edition of the list of organisations, etc. in the borough was compiled and circulated during the year. This list now fills almost twelve foolscap pages and is an indication of the amount of social activity that exists in Stepney. Copies of the list have been kindly supplied to the Public Health Department by the Information Officer, 1 am indebted for this information to the Information Officer , Mr. J. Mordsley, who administers the Service under the direction of the Borough Librarian. , HOSPITAL FACILITIES. The undermentioned hospitals are situated in the Borough: No. of Beds London Hospital, Whitechapel Road 700 Mile End Hospital, Bancroft Road ; 485 St.George-in-the-East Hospital, Raine Street 200 London Jewish Hospital, Stepney Green 130 Queen Elizabeth Hospital for Children, Glamis Road 50 East End Maternity Hospital, Commercial Road 60 Stepney is in the area of the North-East Metropolitan Regional Hospital Board. 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. 511 such investigations were carried out during the year on specimens received from medical practitioners in the Borough. Details of specimens are as follows:- Nasal and Throat swabs 275 Faeces. 234 Urines 2 AMBULANCE FACILITIES. The L.C.C. is responsible for the provision of ambulance transport within the administrative County of London. 13. LEGISLATION. The following Acts, Orders and Regulations affecting the Department were made or became operative during the year Act. Order or Regulation. Date operative from Food and Drugs (Milk, Dairies & Artificial Cream) Act. 1950. 1/1/51 London County Council (General Powers) Act, 1951. 1/8/51 National Assistance (Amendment) Act, 1951. . 1/9/51 Pet Animals Act, 1951. 1/4/52 Rag Flock & Other Filling Materials Act, 1951. 1/11/51 Rivers (Prevention of Pollution) Act, 1951. 1/10/51 Slaughter of Animals (Amendment) Act, 1951 1/10/51 Cream (Revocation) Order, 1951. 30/4/51 Dried Egg (Control of Use) (Revocation) Order 1951. 1/6/51 Food Standards (Edible Gelatine) Order, 1951. 1/2/52 Do. (Fish Paste) Order. 1951 7/3/52 Do. (Fish Paste) (Amendment) Order 1951. " Do. (Meat Paste) Order, 1951. " Do. (Meat Paste) (Amendment) Order 1951. " Do.' (Cream) Order, 1951. 30/4/51 Do. (Ice Cream) Order, 1951. 1/3/51 H.C.N. (Fumigation of Buildings) Regulations, 1951. 1/2/52 " (Fumigation of Ships) Regulations, 1951. " Ice Cream (Heat Treatment) (Amendment) " 1951. 18/1/51 Labelling of Food (Amendment) Order, 1951. 25/3/51 Meat Products &.Canned Meat (Amendment) Order 1951. 4/3/51 Do. (Amendment No.2) Order 1951. 14/6/51 Do . (Amendment No.3) Order 1951. 22/7/51 Milk (Special Designations) (Special Areas) Order, 1951. 1/10/51 Parrots (Prohibition of Import) (Revocation) . Regulations, 1951. 8/1/52 Poisons List (Amendment) Order, 1951. 1/6/51 Poisons Rules, 1951. " Prevention, of Damage by Pests (Application to Shipping) Order 1951. 1/10/51 Public Health (Leprosy) Regulations, 1951. 22/6/51 Puerperal Pyrexia Regulations, 1951. 1/8/51 Rag Flock & Other Filling Materials Regulations, 1951. 1/11/51 Sanitary Officers (London) Regulations, 1951. 1/7/51 Sampling of Food (Revocation) Order, 1951. 13/8/51 Soft Drinks (Amendment) Order, 1951. 1/2/51 Transfer of Functions (Ministry of Health & Ministry of Local Government & Planning) Order N°1 .30/1/51 " No.2 1/5/51 14. Other Statutory Instruments issued during the year dealt with borax in bacon, dogs in foodshops, use of the word "butter" in the description of confectionery, orange squash; and official certificates for the purpose of the Public Health (Imported Food) Regulations, 1937 & 1948, in respect of the countries of Austria, Cyprus, Italy, Luxembourg, Portugal and Tanganyika. 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 (Central Council for Health Education). Stepney. (1-Day Course) Sanitary Inspectors (Food). National Smoke Abatement Society Annual Conference. Blackpool. Cllr.Mrs.Edwards & Mr.Anstee (Sanitary Inspector ). Royal Sanitary Institute Annual Congress. Southport. Medical Officer of Health & Chairman. Sanitary Inspectors' Association Annual Conference. Margate. Cllr. W.J. Curtis & Mr. S. Vogler (Sanitary Inspector (Food) Welfare of Old People (L.C.C. Central Consultative Committee). County Hall. Medical Officer of Health & Chairman. SPECIAL R:IP0aTS OF MEDICAL OFFICER OF HEALTH TO PUBLIC HEALTH COMMITTEE. Special reports on the following subjects were made to the Committee during the year : Catering Trade Working Party Report on Hygiene in Catering Establishments. Care of Old Persons. Mass Radiography Survey. Rag Flock & Other Filling Materials Act, 1951. Snack Bars, Catering Vans and similar structures in Stepney. 15. MATERNITY AND CHILD WELFARE. I am indobted to Dr .Mitchell, Divisional Medical Officer of the London County Council, for the following information relating to the personal health services administered by the L.C.C. in the Borough. 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 1,484 1 to 5 years of age 169 Total number of children who attended and who at the end of the ypar were - Undfsr 1. year of age 1,135 1 to 5 years of age 1,154 •Total attendances by children - Under 1 year of age 19.185 1 to 5 years of age 7,953 Ante-Natal and Post-Natal Clinics . Ante-Natal consultations - No. of women who attended first time 113 No. of women who attended 167 Total attendances 851 Post-Natal consultations - No. of women who attended 30 Dental Clinic. No. of expectant and nursing mothers treated. 27 No. of cases in which general anaesthetic for extraction was administered 63 No. of teeth extracted 287 No. of teeth filled 4 No. of pro-school children treated 16 No. of cases in which general anaesthetic for extraction was administered 23 No. of temporary teeth extracted 52 16. Health Visitors. No, of infants under 1 year of age visited for first tine 1,234 Total visits to infants under 1 year of age. 11,028 Total visits to children 1 to 5 years of age 30,860 No. of expectant mothers visited 650 Total visits to expectant mothers 2,142 Infant Life Protection. No, on Register Foster Mothers Foster Children 1st Jan. 1951. 12 10 ttst Dec. 1951. 10 11 Child Minders (Dally Guardians). No. of daily guardians - voluntary 3 statutory 1 No. of children minded - voluntary 38 statutory 1 Care of Premature Infants. No. of premature births during.the year 114 No, of deaths under 1 month 13 Immunisation and Vaccination. For details of immunisation and vaccination see pages 38 and 40. 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 (including expectant mothers) 10 Tuberculosis 7 Other 573 17. 2. Services Provided. Infant Corisultation. Afternoons. 673, Commercial Road - Monday,Tuesday,Thursday and Friday. 52-54, Ashfie'ld Street - Tuesday and Wednesday. 17, Rhondda Grove - Monday and Thursday. Mary Hughes, Underwood Road - Monday and Thursday. St.George's Town Hall - Tuesday, Wednesday and Friday. 5, Pier Head, Wapping - Wednesday. Dame Colet, Duckett Street - Tuesday and Wednesday. Ante-Natal. 673 Commercial Road - Wednesday. Vaccination against Smallpox. St.George's Town Hall - Friday. 35, Stepney Green - Friday. Immunisation against Diphtheria or Vhooplng Cough. . 35, Stepney Green - Friday. Toddler's Clinic. St.George's Town Hall - First Tuesday morning in each month. Note:- Diphtheria and Whooping Cough immunisations are also carried out at the infant welfare sessions. Day Nurseries. Underwood Road. Old Church Road. Christian Street. Voluntary Day Nurseries. St. Paul's, Wellclose Square. 2, Beaumont Grove. Nursery School. Thirza Street. 18. STAFF CHANGES. The following staff changes took place during the year s (a) Commenced duty M. Coker J.G. Pratt (b) Ceased duty M. Coker E.C.' Hawker J.G. McCarthy S. Smith E.A. Sheppard (c ) Change in duties G.D. Freeland W.E. Driscoll Office Junior. Do. (Temporary) Office Junior (to H.M.Forces). Sanitary Inspector.. Assistant Rodent Officer. Rodent Investigator. Sanitary Inspector. Sanitary Inspector to Assistant Rodent Officer. Sanitary Clerk to Section. Clerk (P.H.) (Temporary). 12/2/51 13/8/51 24/7/51 31/12/51 31/5/51 9/12/51 20/5/51 28/11/51 1/1/51 SWIMMING. BATHS. The three swimming baths in the Borough are Council Baths. During the year the number of swims amounted to 98,588 comprising 22,956 adults, 30,220 juveniles ;and ,, 45»412 schoolchildren receiving L.C.C. swimming instruction. The wdter ris subjected to continuous chlorination ,and filtration and samples are taken periodically for analysis. Efforts have been made, through the education authority and elsewhere to obtain details of the percentage of Stepney children who are able to swim by the time they reach school leaving age. Apparently such statistics are not kept. In view of the number of drowning accidents which occur each summer to non swimmers or poor swimmers It is regrettable that, with all the opportunities now available, so many physically fit children reach adult age without being able to swim. Not infrequently good swimmers lbse their lives trying to save those who cannot swim. 19. III. SANITARY CIRCUMSTANCES The present shortage of housing accommodation has prolonged the life of worn-out property. Until houses can be "buried" at the end of their life worn-out property will remain a problem. Some owners are cutting their losses by the simple expedient of abandoning property, and not collecting rents, but leaving the tenant to pay the rates, and in some cases considerable arrears of Schedule A Tax. Over fifty properties in these circumstances have come to our notice during the past 12 months or so, and there are probably considerably more than this number. When the owners who can be- found - and not all are found - ate confronted with summonses for non-compliance with nuisance notices, they apply to the Courts for Closing Orders, of which 13 have been made over the past two years. The Council is then faced with the alternative' of allowing the tenants to remain in rapidly deteriorating conditions, or permitting them to take priority over more urgent cases which have been a long time on the Council's housing list. If the owner is pressed to comply with the Closing Order he must evict the tenant, who would -then have to be temporarily accommodated by the L.C.C. in a welfare institution. A possible solution of this problem would be that no closing orders should-be granted by the magistrate until the rehousing position has been fully investigated, and that the old property should be temporarily repaired pending suitable rehousing. The Tables on pages 54 and' 55 summarise the work of the Sanitary Inspectors during the year. Complaints. 5,391 complaints were recorded in the register, but in addition numerous complaints were made direct to the sanitary inspectors. The total number of visits made in investigating complaints was 10,037. Pangeroug Structure?. The District Surveyor was notified on 395 occasions of premises or parts of premises alleged to be structurally dangerous. 20. Drainage. 1,463 drains were tested with smoke, and 297 were found to be defective. 6,779 visits of inspection were made to drainage works during the year, and 736 drains were cleansed or repaired and 709 constructed or reconstructed. Observations were submitted to the Borough Engineer and Surveyor on 93 Plans of new drainage works and 27 Combined Drainage Orders were made. 86 Plans were certified that drainage work was carried out in accordance with the plans. Some provisions regarding drainage of the Public Health (London) Act, 1936, as to appeals and recovery of expenses have been amended by the London County Council (General Powers) Act, 1951. Factories. 3,001 inspections under the Factories Acts, 1937 & 1938 were made of the 3,138 factories on the register, and 167 Notices were served. Details will be found in Table 6 on page 56. Outworkers. During the year two instances of work being carried on in unsuitable premises were found, i.e. sweet wrapping, which was discontinued after the service of notices. Sweet wrapping at home is now common in the Borough. It would seem undesirable that it should be done in any place where supervision to ensure hygienic essentials is impossible. 484 inspections were made of the 579 outworkers' premises on the register. The trades concerned are as follows s- Wearing Apparel 498 Umbrellas 5 Artificial Flower's 3 Christmas Crackers,etc 5 Feather Sorting 1 Paper Bags 1 Carding etc. of Buttons 2 Chocolates and Sweetmeats 50 Cardboard Boxes 12 Brush Making 1 Basket Making 1 579 There were two notifications of infectious disease relating to outworkers' premises. 21. No. of Firms in the Borough employing Outworkers 40 No. of Outworkers residing in and employed in the Borough 121 No. of Outworkers residing outside the Borough 156 No. of Outworkers residing in the Borough employed by firms outside 458 Fairgrounds. One observes today an increase in the number of living vans attached to fairs temporarily in the Borough, and in some cases living vans alone. This is, possibly, the result of the increased number of open spaces due to bombed sites and also of housing difficulties. These fairgrounds and caravans are causing some concern from the sanitary aspect, and although improvised arrangements have been made dealing with pail closets, better sanitary accommodation and main water supply will have to be enforced if caravan settlements are to be a permanent feature of the landscape. The Council is proposing to make byelaws, under Section 68 of the London County Council (General Powers) Act, 1939, for regulating hours, prevention of nuisances, and for preserving sanitary conditions and cleanliness in fairgrounds. Whether or not caravan dwellers should be tolerated in the metropolitan area appears to be a question for the Town Planning Authority, and a clear-cut expression of policy on this point would be helpful to local medical officers of health. Houses Let In Lodgings. There are 1,770 such premises in the Borough, to which 938 inspections were made during the year. Six complaints were remedied under the byelaws. Land Charges Act. 1925. The number of enquiries dealt with during the year regarding outstanding notices under the Public Health and the Housing Acts, and reported to the Town Clerk, amounted to 664, concerning 1489 properties. 22. Legal Proceedings. A summary of legal proceedings instituted during the year, showing penalties imposed, is as follows:- No.of Summonses Fine? Costs Food and Drugs Act, 1938. 36 £209.0.0. £fl. 9. 0 Public Health (London) Act, I936. 34 117.0.0. 70. 4. 0 London County Council (General Powers) Act,' 1939. 1 – 2. 4. 0 71 £326.0.0. £123.17. 0 The Magistrates made Closing Ordersi under the Public Health (London) Act, 1936, on three dwellinghouses in the Borough on the application of the landlords. Lodging Houses - Common. There are 4 Common Lodging Houses in the Borough, providing accommodation for 1,103 persons, as follows 15 & 16, Calvin Street - 41 Married Couples 10-22, Johnson Street - - 258 Men 177 5 Whitechapel Road - 535 Men Hostel for Women, Hopetown Street - 228 Women 133 inspections were made during the year, including 12 inspections, carried out at night. There are now thirty such premises in 14 of the Metropolitan Boroughs, providing accommodation for 6,388 males, 918 females and 41 married couples. . Lodging Houses - Seamen's. There are 5 Seamen's Lodging Houses in the Borough, providing accommodation for 488 seamen, as follows:- The Sailors' Home & Red Ensign Club, Ensign Street & Dock Street 235 Seamen The Empire Memorial Hostel, 0 Passage 11 " 220, Cable Street 30 " 9, Ensign'Street 22 " 109 inspections were made during the year, including 23 inspections carried out at night. 23 Noise Nuisances. 19 complaints of alleged noise nuisance were investigated during the year, under Section 66 of the London County Council (General Powers) Act, 1937. Notices Served. Informal Notices under the various Acts and byelaws were served during the year, as follows :- Public Health (London) Act, 1936 4,946 Factories Acts, 1937 & 1948 152 Shops'. Act, 1950 8 Drair\age Byelaws 1 Water Closet Byelaws 3 Houses-let-in-Lodgings Byelaws 4 Miscellaneous Act and Byelaws 9 Total: 5,123 Offensive Trades. There are 19 offensive businesses in the Borough, of which 273 inspections were made during the year, and one Notice was served. The premises are situate as under: Tripe Boiler: (1) 94, Wentworth Street. Dressers of Fur skins : (3) 34/38, Brodlove Lane. 48,50,50a,54 & 56, Old Church Road. 29, Spelman Street. Poultry Slaughterhouses: (15) 21/22, Hessel Street 28, Burslem Street 36, Hessel Street l6l, Cannon Street Read 42, Hessel Street 16/18, Cobb Street 75, Hessel Street 49, Globe Road 13, Leyden Street 9, Gun Street 15, Leyden Street 8a, Hessel Street. Fish Hall, 10a, Monthope St. 14, Hessel Street 82, Stepney Way. The Borough's last remaining cowhouse closed during the year. Fifty years ago there were 44 such premises. 24. Pharmacy and Poisons Act. 1933. & Pharmacy and Medicines Act. 1941. 113 premises are listed for the sale of poisons included in Part II of the Poisons List. Applications received during the year were as follows For - Entry 8 Retention 105 251 visits were made to these premises, and 28 samples of poisons were taken, all of which were satisfactory. Rag and Bope Dealers. Seven inspections were made of such premises during the year. Rag Flock & Other Filling Materials Act. 1951. This Act,which came into operation on 1/11/51, repealed the Rag Flock Acts, 1911 & 1928 and Section 136 of the Public Health (London) Act, 1936, and is designed to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined. All premises on which filling materials, as prescribed, are used,must be registered by the Local Authority and premises used for manufacture or storage of rag flock must be licensed. It is an offence to use filling materials on unregistered premises, to have unclean filling materials on registered premises, to sell unclean filling materials, to manufacture or store rag. flock on unlicensed premises, to receive rag flock into registered premises except from licensed premises and to fail to keep records in the prescribed form. The Rag Flock and Other Filling Materials Regulations, which also operated from 1/11/51, prescribes standards of cleanliness for each type of filling material to which the Act applies; the form in which records are to be kept, the analysts for purposes of tests under the Act, and the fees payable for analyses. Fifteen premises were registered under the Act during the year and no premises were licensed. Visits made to Rag Flock premises during the year numbered 58. 25. Refuse Disposal. The Public Cleansing Officer has kindly supplied the following information on refuse and salvage disposed of during the ye ar : House and Trade 34,241 Tons Street and Market 7,368 " Salvage : Waste Paper 130 " Kitchen W&ste 601 " Scrap Iron 4 " Rent and Mortgage Interest Restrictions Acts. During the year, 153 applications were received from occupiers for certificates stating that premises were not in a reasonable state, of repair. 150 were granted and 3 refused. 59 applications'were received from owners for revocation certificates: 46 were granted arid 13 refused. V 373 visits were fri&de.by Inspectors in collection yd.th these applications. Rodent Control. "The Ministry of Agriculture and Fisheries have carried " out preliminary trials of an entirely new type of rodenticidex, the active ingredient being an anti-coagulant chemical - Warfarin - which, contains hydroxycoumarin., sometimes known as Compound 42. It is claimed; "that Warfarin is undetectable by rats and mice and consepuently there is no poison prejudice as with a normal poison bait. Pre–baiting is therefore unnecessary. It is not a "one–shot" killer and must be eaten by rodents for 3 to 10 days before its slow but inevitable action causes death. Warfarin is used in ve??y low concentration and is relatively safe to man and animals. There are, hawever, limitations to its use. Treatments with Warfarin are now being carried out by this Department for suitable infestations, and it is hoped that it will prove as efficacious as some of the claims made for it. The methods at present in use for the extermination of rats and mice are those laid down by the Ministry of Agriculture and Fisheries. The usual treatment includes a pre-baiting and a poisoning period, which is repeated after 26. an, interval of two weeks. In each full treatment different pre-baits and poisons are used in the first and second treatments. Pre-baiting is done with damp plain food baits and poison baits are laid on pre-determined dates. Whatever food is used as pre-bait, the same type of food is made into poison bait by the admixture of a poison for that phase of the treatment. In the treatment for rats on premises where domestic animals are kept, in order to avoid the risk of poisoning the animals, the pre-baits and poison baits are placed in special wooden containers, which are so constructed that rats can enter and eat the baits, whilst the bait is inaccessible to domestic animals and fowls. During the year, 9,440 properties were inspected, 898 complaints being referred to the Rodent Department by the district sanitary inspectors. Further statistics are set out in Table 8, page 59. Shops. During the year, 1,283 inspections were made under the Shops Act, 1950, and 5 Notices were served in respect of sanitary accommodation. The number of premises in the Borough covered by the provisions of the Act is 2,951. No applications were received for exemption from complying with sanitary accommodation requirements. Sites Cleared of Refuse. 112 cubic yards of refuse and other material were cleared from two sites in the Borough under Section 93 the Public Health (London) Act, 193°• Smoke Abatement. The number of complaints of smoke nuisance received during the year was 80, and the number of observations kept was 128. Water Supply. The vihole of the Borough is supplied with water by the Metropolitan Water Board, which is the authority responsible for its purity. Quantity and quality of water supplied by the Board during the year have been satisfactory, and no complaints were received. 27. All premises in the Borough are supplied individually direct from public water mains, with the exception of two plaoes which are supplied by means of a common standpipe. The number of instances where water supply to premises in the Borough was repaired or reinstated .totalled 131, and the Metropolitan Water Board was notified on 68 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 230 flats and 15 houses. Workplaces. Inspections during the year of the 1.294 workplaces in the area (other than those covered by the Factories Act, 1937), amounted to 373. 28 IV. HOUSJNG. Overcrowding. During the year 559 cases of alleged overcrowding were investigated, 217 of which were confirmed and referred to the London County Council. 158 overcrowded families were rehoused, 112 by the London County Council and 46 by the Borough Council, and the number of known overcrowded families on the register increased from 1,048 to 1,107. 11 visits were made to premises to ascertain "permitted numbers," and the owners of the premises were informed. In order to-prevent overcrowding, two inspections were made, for the Government of Cyprus, of accommodation alleged to be available in the Borough for intending immigrants. Underground Rooms. There are approximately 4,000 underground rooms in the Borough used for living or sleeping purposes, about 3,760 of which are unfit. During the year, 226 inspections were carried out, as a result of which 39 Closing Orders were made, 67 rooms being closed and the modified occupation of 10 rooms approved. The total number of underground rooms closed since 1936 amounts, to date, to 160. Progress on closure generally is held up for lack of suitable alternative accommodation. Slum Clearance. Slum clearance was resumed during the year by the Borough Council and the London County Council undertook clearance on a fairly large scale. Representations were made by the Medical Officer of Health of three small areas. The photographs facing page 29 show some typical property in areas being represented, together with some Council dwellings . completed during the year. Building Licences and Essentiality Certificates. Of the 502 applications received, 492 were recommended, involving 943 visits by the inspectors. The value of the Building Licences issued during the year amounted to £184,350. Approximately 20 per cent of the licences were issued in connection with the service of sanitary notices. 29. Defence Regulation 68 C.A. (Use of living accommodation for business -purposes). 73 investigations of premises were made for possible contravention of this Regulation regarding "Change of User", •which involved 140 visits by the inspectors. Preferential Housing on Health Grounds. Of the 119 cases investigated, 59 recommended for rehousing : 7 to the London County Council and 52 to the Borough Cornell. Applications for Rehousing. At the end of the year, there were 4,550 applications for rehousing on the Housing Manager's register (an Increase of 900 over 1950), including 219 tenants of Council dwellings and 503 licencees of requisitioned premises. Temporary Hutments. 324 hutments owned by the Borough Council remained at the end of the year. 19 were recommended for demolition because of structural deterioration. Requisitioned Properties. The number of dwellings under requisition by the Borough Council at the end of the year was 1,886, involving 2,613 lettings, and 7 dwellings were recommended to the Housing Manager f.or de-reculsitioning for. various reasons, and 20 basement flats (35 rooms) which did not comply with the regulations were recommended for closure New Housing. This year saw the commencement of the erection of the second portion of the Borough Council's Bancroft Estate, The London County Council's Ocean Estate, too, began to take shape and the first 8-storey block of flats in the Borough was completed. Heretofore the Borough has had only 5-storey flats, and this new feature of Stepney life will be a matter of some interest as to its success or otherwise. Another innovation was the construction of a 2-storey building on.this Estate, comprising a communal laundry on the ground floor and a community hall above. During the year 378 new dwellings were completed in the Borough, 80 flats and 35 houses by the Borough Council and 263 flats by the London County Council, At the end of the year, new permanent dwe]lings completed in the Borough since Drivers Buildmgs Norman Court Alderney Place Virginia Place Borough Council terrace houses - Ibbott Street. Borough Council Bancroft Road Estate. Old persons' one-room flats, ground floor. Maisonettes above, with entrance at rear. 30. the war numbered 2,195: 999 by the London County Council, 1,160 by the Stepney Borough Council, and 36 by private owners; and 1,029 were under construction. Summary of Inspections made bv the Housing Inspector. Overcrowding 55 9 Preferential housing on health grounds 119 Underground rooms 226 "Permitted Numbers" under Housing Act, 1936 11 Temporary Hutments 179 Requisitioned premises 80 Premises situated in Clearance Areas 146 Defence Regulation 68 C.A. 15 Building Licences 16 Section 5, Housing Act, 1936 39 Section 11, Do. 25 Miscellaneous 270 Statistics. Further Housing statistics are given in the Appendix pages 65 and 66. 31. V. INSPECTION AND SUPERVISION. OF FOOD. Owing to absence through illness the normal complement of 4 Food Inspectors? was reduced to three during the greater part of the.year. In recent years much public attention has been focussed on the necessity, for adopting greater care in protecting and handling food so as to prevent it from becoming contaminated with those germs-which cause food poisoning. In this country, during and since the war, many more persons eat.meals away from home.in restaurants, canteens and school.meal centres. Careless handling of food at heme endangers the health, of one family only, but the same degree of carelessness, in a.restaurant kitchen affects a much larger number of . persons. The result has been a considerable increase in foodspread diseases, although Stepney has not been affected more than any other part of the country. In consequence the Ministry of Food has produced 'Model Byelaws for Food Hygiene.' In the near future these byelaws for London will be adopted by the L.C.C. and administered by the Borough Council. To eliminate food poisoning due to the poor standards of hygiene in catering establishments, the Ministry of Food set up in 1948 the Catering Trade Working Party to make recommendations for securing the observance of sanitary and cloanly conditions in the catering trade. The Working Party, under the chairmanship of Sir. W. Savage (former County Medical Officer of Health of Somerset) took evidence from catering trade associations, officers of local authorities, representatives of Ministry of Health and Ministry of Food and of various trade unions, and published its report on 31st January 1951. Food is more likely to become contaminated when restaurant kitchens are too small for the amount of work done. This is particularly the case in "mobile" snack bars, which are, unfortunately, becoming increasingly common in London. The very low rents for bombed sites, the avoidance of rates, and the extremely limited amenities and equipment enable comparatively large profits to be made on a small outlay of capital. These shacks and vans are permitted by the town 32. planning authority and may become an increasing, though probably undetectable source of food infection in the future. They are unsightly and unnecessary in London which is so well provided with permanent restaurants and cafes, and should be discouraged. On 1st October 1951 the Milk (Special Designations) (Special Areas) Order, 1951, came into force. The effect of the Order is that London is now an area in which only specially designated milks may be sold, which provides a further safeguard against the sale of infected milk. Another Order, the Food Standards (Ice Cream) Order, 1951, came into force at the beginning of the summer. This provides a standard for the composition of ice cream and samples taken showed that ice cream produced and sold in Stepney contained, on an average, more than double the quantity of milk fat required to comply with this standard. (See Analyst's report, p. 47). Five summonses were taken against the occupiers of three restaurants for failing to display a notice in legible letters stating that horseflesh intended for human consumption was for sale on the premises. The defendants were ordered to pay fines and costs amounting to £54.4.0. . A summary of the visits made during the year by the Sanitary Inspectors (Food) will be found on page 60. Table 10 on page 6l shows the number and types of food premises in the area. Milk Supply. There are 249 distributors in the Borough, including 22 with dairies and 29 itinerants. During the year -379 inspections were made and 9 Notices served. Ten samples of milk, 9 for chemical and 1 for bacteriological examination, were taken in the course of delivery to hospitals and a day nursery in the borough. All the samples were satisfactory. Milk (Special Designations) (Pasteurised & Sterilised Milk ) & (Raw Milk ) Regulations. 1949. 427 licences wore issued during the year, including 174 for "Pasteurised" milk, 202 for "Sterilised" milk, 50 for "Tuberculin Tested" milk and 1 Pasteuriser's licence. 33. Bacteriological examination of foodstuffs. The following samples were submitted for bacteriological examinations:- Nature of Sample No. of Samples No. Unsatisfactory Pasteurised milk 63 1 Tuberculin Tested (Pasteurised) milk 1 - Sterilised milk 2 - Canned Ham 1 - Caramel and Priming 2 - Saveloys 1 - Pork Sausages 1 - Canned Luncheon Meat 9 8 Ice Cream 51 (See below) With regard to the unsatisfactory sample of Pasteurised milk, the producer was advised as to the methods of production, and subsequent samples proved to be satisfactory. The Area Officer of the Ministry of Pood was notified. In five instances, the tests were void as the atmospheric shade temperature exceeded 65°F at the time of sampling. The samples of Canned Meat, taken from a consignment of 675 cases, revealed the growth of Clostridium butyricus and Clostridium botulinus type organisms. The parcel was surrendered as unfit for human consumption and destroyed. Ice Cream. There are 264 registered premises in the Borough. 37 are registered for manufacture, 224 for sale, and 3 for storage only. 195 inspections were carried out and 12 Notices served for cleansing and other requirements. Fifty-one samples of ice cream were submitted for bacteriological examination, with the following results:- Manufactured In Borough. Outside Borough. Total Grade 1 3 23 26 (46) " 2 4 11 15 (24 " 3 1 4 5 (14) " 4 3 2 5 (12) The figures in parentheses show the totals for 1950, There has been a steady improvement in the bacteriological standard of ice cream samples examined over the past five years, as shown in the following table:- •34.  No. of Samples Examined Percentage Unsatisfactory (Grades 3 & 4) 1947 42 78.5 per cent 1948 162 61.1 " 1949 155 45.1 " 1950 99 27.0 " 1951 51 19.6 " Butchers' Shops and Stalls. 374 inspections were carried out during the year and 25 Notices served. Two summonses were issued in respect of defective walls and ceilings at one shop and fines totalling £20 with £.3.3.0. costs were imposed. v Transport and Handling of Meat. (Circular M.F.20/49). 125 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 veins inspected were generally satisfactory. Caseous Lymphadenitis - Examination for. 668 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. None of the carcases was found to be affected with the disease. Bakehouses and Bakers' Shops. 240 inspections were carried out and 21-Notices served. There are 64 bakehouses in use in the Borough. Of these, 18 are basement bakehouses, 9 of which are under notice to close on 18th May, 1952. 129 cleansings were carried out but it was found necessary to issue three summonses respecting dirty conditions at one bakehouse. Fines amounting to £30 with £5.5.0 costs were imposed. Butter and Margarine Factories. There are 35 of these factories in the Borough, and during the year 50 inspections were made and l Notice served. Prepared Food Premises. The number of prepared food premises on the register is 180, to which 502 inspections were made and 41 Notices served. Poultry Shops and Stalls. 1,258 inspections were carried out and 12 Notices served. 35. Fish (Wet) Shops and Stalls. 595 inspections were made and 4 Notices served. Greengrocers and Fruiterers' Shops and Stalls. 87 inspections were carried out and 58 Notices served. Grocers and Miscellaneous Food Premises. 599 inspections were made and 34 Notices served. Eleven summonses were issued regarding dirty and dilapidated conditions 9 at food manufacturing premises and 2 at a confectioner's shop. Fines totalling £46 with costs of £11.11.0 were Imposed. Public Houses. 194 inspections were carried out and 36 Notices served. Catering Establishments (including Industrial Canteens &c.). 743 inspections were made and 70 Notices served. Five summonses were issued in respect of dirty conditions at one cafe and fines totalling £20 with £4.4.0 cost's were imposed. Improvements effected at Food Establishments. Lavatory basins Installed 21 Premises where hot water supply installed 58 Premises where washing facilities for staff have been improved 30 Sinks provided 25 Premises where clean towels have been provided 20 Additional W.C .'s provided 1 Food storage accommodation provided 15 Refrigerators or ice box installed or repaired 12 Walls, ceilings, floors, windows repaired 281 do. cleansed 934 Shop fronts, repaired or renewed 6 Premises where ventilation provided or improved 27 Premises where natural lighting improved 14 Protective covers provided for displayed food 14 Refuse bins provided 28 Miscellaneous improvements 344 Public Health (Imported Food) Regulations, 1937. 114 detention and 90 release notices were served under the Regulations, affecting a variety of foodstuffs including frozen mutton, cocoa, assorted canned goods, milk powder, cereals, dried fruits, etc. It was found necessary to serve detention notices on several consignments of Imported meat products which arrived unaccompanied by the "Official 36. Certificate."With three exceptions, the official certificates were subsequently produced and the foodstuffs released. In two cases the foodstuffs were re-exported to the country of origin, and in the other they were surrendered and destroyed . Export Certificates. 43 certificates were issued in respect of the examination of foodstuffs for export, as follows:- South America 28 Egypt 10 Sweden 3 Austria 1 Italy 1 Unsound Food. The following auantities of unsound foodstuffs were disposed of during the year under the Public Health (Imported Food) Regulations, 1937, and the Public Health (London) Act, 1936:- Premises Tons cwts qrs. lbs. Wharves 394 3 3 . 0 London Fruit Exchange and Spitalfields Market 54 7 2 6 Railway Depots 30 12 1 19 Zeebrugge-Harwich Train Ferry (at Bishopsgate Goods Station) 20 19. 3 23 Other premise 99 4 3 2 • 599 8 1 22 More than half of this total, i.e. 338 tons, was allowed 'to be used for animal feeding purposes or for manufacturing purposes, other than for human consumption. This included 22 tons of dried cut peel and 296 tons of canned barracouta fish (the latter, detained at several of the wharves during 1949, were re-labelled and used as pet food). Over 3,000 condemnation certificates were issued during the year. Zeebrugge -Harwich Train Ferry. 297 special midnight or early morning visits were made to Bishopsgate Goods Station for the purpose of examining 4,450 trucks of foodstuffs arriving from the following countries:- 37. Italy 4,044 trucks Belgium 226 " Germany 57 " Greece 50 " Austria 35 " Switzerland 20 " Yugo-Slavia 8 " Argentine 5 " France 5 " The weight of the foodstuffs examined was as follows Fresh fruit and vegetables 30,725 tons, preserved fruit and vegetables 201 tons, cheese 279 tons, fish 50 tons, canned meats, salami, etc. 1,121 tons, frozen rabbits 4 tons, mustard and vinegar 5 tons, pig rinds 33 tons, biscuits, chocolate and confectionery 739 tons, and poultry 12 tons a total of 33,169 tons. The foodstuffs found to be unsound, and which were stopped and destroyed, amounted to almost 21 tons. During July, a truck of Italian peaches arrived in a 'wasty' condition. Examination showed about 30 per cent to be unsound. The importers were requested to arrange sorting but refused to accept delivery alleging that, the major portion was unfit for human consumption. After consultation between interested parties including Dr. G. Fois of the National Institute for Foreign Trade, the peaches were released and accepted by the importers for sorting under proper supervision. A further consignment which arrived some weeks later, also in a 'wasty' condition, was similarly dealt with. During September, a truck of pears arrived contaminated with lead arsenate spray. Notification was received from Harwich that samples showed excessive contamination. Arrangements were made for the pears to be released on arrival at Bishopsgate, on'the understanding that they were washed, under supervision, before sale to the public. Samples taken from a further truck of pears revealed only slight contamination and these were released. From time to time, samples of Italian apples, also contaminated with lead arsenate spray, have been analysed, but in all cases the amount of contamination was not excessive. 38. VI. PREVALENCE OF MP CONTROL OVER INFECTIOUS AND OTHER DISEASES. Notifications. A total of 2,448 notifications of cases of infectious disease were received during the year as compared with 1,321 in 1950 (an increase due to measles). Table 11 on page 62 shows details of the notifications received, together with age groups. The diagnosis was not confirmed in 14 of the above notifications. A list of the diseases notifiable in the County of London is shown in Table 12 on page 63., Diphtheria. Three notifications were received, but the diagnosis was not confirmed in any of the cases. The number of children immunised at L.C.C. clinics was 1,499, 1,037 being under five years of age. 900 children were given a reinforcing injection. A supply of anti-toxin is kept in the Department for use by general practitioners in emergency cases. 275 swabs were forwarded by general practitioners to Mile End Group Laboratory, where bacteriological examinations are carried out on behalf of the Borough Council. Dysentery. 222 notifications were received during the year, as compared with 19 the previous year. The diagnosis was not confirmed in six of the above notifications. Food Poisoning. There were no outbreaks of food poisoning, but 7 individual cases of suspected food poisoning were notified. In four cases a salmonella organism was isolated from the patients' stools. In no case was the source of infection traced to any particular article of food, It should be pointed out that the number of cases notified does not reflect the incidence of food poisoning, for many other persons affected do not consult a doctor and are consequently hot notified. Measles. Notifications for the year amounted to 1,459, the highest since the disease became notifiable. The incidence 39. was general throughout the country —in week-ended March 17 the national figure was 31,837, as compared with the previous highest of 25,507 in week-ended March 24, 1945. Stepney's previous highest figure was 1,127 for the year 1949, the figure for 1950 being 504. There were no deaths from the disease. Paratyphoid. Two small outbreaks of Paratyphoid B, consisting of 9 cases, occurred in Stepney in the months of June and July. The first case was a Child, J .B., aged 1-7A2 years, who became ill on 10th June and was admitted to a local general hospital "A" on 14th June. The second Case was a nurse, C.E., who nursed J .B., and who became ill on 27th June. About the same time, in another general hospital "B" in the Borough, six young nurses residing in the nurses' home became ill with paratyphoid - J.W. S.G. M.Br. Onset 22nd June " 24th " " 24th " M.Be. D.L. B.P. Onset 25th June " 29th "or 1st July " 5th " and on 3rd July a wardmaid, J.G. Enquiry failed to show a connection between the two outbreaks. Cultures from the seven cases in hospital "B" were submitted to the Central Reference Laboratory at Colindale, and all were found to belong to the strain "Kent". It was not possible to identify the strain in the two cases of hospital "A". The Widal blood test of Nurse C.E. gave agglutination for Paratyphoid B, but no organism was obtained from the bowel. A culture of Paratyphoid B was obtained from the child J.B., but was not available for V-phage typing. Both cases were undergoing treatment with antibiotics, and subsequent attempts to obtain cultures failed. It was not possible to trace the source of infection of either outbreak, and no further cases occurred. Pneumonia. Of the various forms of pneumonia, only acute primary and acute influenzal are notifiable. 97 cases were notified during the year, compared with 6l last year. 40. Puerperal. Pyrexia. The Puerperal Pyrexia Regulations, 1951, which came Into operation on 1st August, 1951, replace with slight modifications those made in 1926 and 1928 and include a revised definition of the disease. The new definition accounts for the increase in notifications this year to 34. Notifications of the disease for the 7 months totalled 11, whilst the notifications for the remaining 5 months of the year, under the new regulations, amounted to 23. Had the notifications for the latter period continued at the same rate as those for the first 7 months, the total notifications for the year would have been 19. Scabies. Scabies is still notifiable under the County of London (Scabies) Regulations, 1943. The number of cases formally notified was 28, compared with 67 in 1950.' Seventy-two scabies patients were treated with medicinal baths at Branch Road Treatment Centre and their clothing was disinfested, viz:- Males Females Children 32 21 19 - Total 72. The number of baths given amounted to 176 during the year. Scarlet Fever. There were. 135 cases notified, an increase of 24 over last year. Only 23 per cent were admitted to hospital as compared with 96 per cent of 968 cases notified in 1938. There were no deaths from the disease. 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 number of children successfully vaccinated at L.C.C. clinics during the year was 742. A supply of vaccine is kept in the Department for emergency use. 41. Tuberculosis. The number of primary notifications of pulmonary tuberculosis received was 173 as compared with 160 last year, and the number of non-pulmonary cases was 16 the same as last year. The mortality rate for the year of pulmonary tuberculosis is 46 and of non-pulmonary 3 Per 100,000 population, as compared with 50. and 6 respectively in 1950. See details of register on page 64. Public Health (prevention 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. The Tuberculosis Care Committeemen which are represented voluntary and official bodies, and whose meetings are attended by the Medical Officer of Health, continues to supply help to tuberculous persons and their relatives who require assistance which cannot be obtained from official sources, or where urgency or special circumstances indicate that the voluntary sources of the Care Committee are preferable. Six meetings were held during the year at which 172 cases were considered and help given to 118. Clothing was given to 27, extra nourishment to 7and help to others included the provision of convalescehce and holiday expenses, beds, bedding, rent, coal and wireless licences, besides fares to to relatives to visit sanatoria. The annual Christmas Seal Sale Fund amounted to £289. Mass X-rav Survey. A mobile Mass X-ray Unit of the Regional Hospital Board was set up in the Borough from. 17th April to 18th June, the Public Health Department assisting In the organisation of mass X-ray examinations of the public, including employees of firms in the Borough, and also employees of the Council. The unit was sited for the first half of the survey in a large mission hall, and for the second period, through the good offices of the management, in the waiting room of 42. a cinema, where the examinees were X-rayed on their way into and out of the cinema. Details of examinations are as follows: Males Females Total No. of attendances for Miniature X-ray 5458 2996 8454 No. passed as normal on Miniature or subsequent large film examination 4998 2881 7879 Percentage normal 91.57 96.10 93.20 No. showing some abnormality 460 115 575 Percentage showing some abnormality 8.43 3.90 6.80 Of the 575 films showing some abnormality, 242 showed tuberculous conditions, and 136 showed chronic bronchitis and emphysema. The 242 tuberculous conditions are further analysed as follows: Males Females Total Inactive Tuberculosis (a) Primary 51 24 75 Adult type 104 39 143 Total: 15 63 218 Active Tuberculosis (a) Primary - - - Adult type 20 4 24 Total: 20 4 24 There were thus 24 cases of active Pulmonary Tuberculosis disclosed by the survey, giving an incidence rate of 2,84 per 1000 examinations. This compares favourably with the national figure for Mass Radiography, which is over 3 per 1000. The incidence was greater in male than in female examinees, the respective ratios being 3.66 and 1.33 per 1000 approximately. All necessary action was taken in respect of cases, both tuberculous and non-tuberculous, requiring further medical attention. 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. 43. Typhus. One person arriving in this country from a typhus infected area was kept under observation. Authentication of International Certificates of Vaocination 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 271 such certificates were authenticated by me during the year. Disinfection. 296 premises were disinfected because of infectious disease, of which 14 were for pulmonary tuberculosis. 130,084 articles of clothing and bedding were steam disinfected, including 117,783 articles for export, for which 185 certificates were issued. Formaldehyde disinfection of 67,327 articles for export also took place during the year, for which 78 certificates were issued. Charges for the export disinfecting service amounted to £877. Disinfe station (bed bugs and other insect pests). The following is a summary of the work 'carried out by the specialist inspectors: General inspections for vermin 1,625 (including 58 evening visits) No. of premises found verminous 323 No. of re-visits 537 No, of miscellaneous visits 1,464 No, of premises sprayed 772 (164 Borough Council property) No, of rooms sprayed 1,709 (408 do. ) +Including 645 rooms dealt with at the request of Sanitary Inspectors. As a precautionary measure the furniture and effects of all families transferred to Borough Council dwellings are treated, prior to removal, with hydrogen cyanide at the Council's Disinfestation Station, 42 Narrow Street. 44. The furniture and effects of 203 such families were treated during the year. In addition, disinfestation by steam and formaldehyde was carried out on 20 occasions during the year of the furniture and effects of families rehoused by the L.C.C. Charges for miscellaneous disinfestations carried out during the year amounted to £40. The law relating to the fumigation by cyanide of buildings and ships was revised during the year by the H.C.N. (Fumigation of Buildings) & (Fumigation of Ships) Regulations, 1951, which operate from 1st February 1952. The specialist inspector reported that he was unable in many cases to gain entry during normal hours into dwellings for the purpose of inspection, as so many wives of tenants were out at work. Accordingly arrangements were made to carry out evening inspections, when the occupants of the dwellings returned home from work. 58 such inspections were carried out during the year. Verminous Persons. . The number of louse infested persons bathed and whose clothing was disinfested at Branch Road Cleansing Station was as follows:- Males Female s Children 431 14 1 = Total 446. The number of baths and treatments given amounted to 463. 45. 28th Annual Report. Summary of Borough Analyst's Quarterly Reports for the year 1951. To the Mayor, Alderman 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 1951. During the year, 1,306 samples were submitted for . analysis. These comprised 1,151 samples (75 Formal and 1,076 Informal) under the Food and Drugs Act, 28 informal samples under the Pharmacy and Poisons Act, 121 miscellaneous samples, 4 samples from the Public Cleansing Officer and 2 samples from a private purchaser. The 1,151 samples (877 Foods and 274 Drugs) purchased by Inspectors under the Food and Drugs Act are classified as follows:- 15 Baking Powder. 11 Meat Paste. 10 Beer and Spirits. 55 Miscellaneous Foods. 7 Butter. 265 Milk. 17 Cocoa. 7 Salad Cream. 4 Coffee. 25 Sauces and Pickles. 9 Coffee Essence. 86 Sausages. 7 Soft Cheese. 35 Spices. 29 Custard Powder, 5 Tinned Fish and Soups. 17 Dried Fruits. 18 Tinned Vegetables. 12 Fish Paste and Cakes. 17 Vinegar and Condiment. 26 Flour. 61 Pure Chemicals, 31 Other Cereals. 7 Lotions. 22 Soft Drinks. 27 Oils. 9 Flavourings. 30 Ointments. 19 Herbs and Stuffing. 12 Powders. 77 Ice Cream. 62 Tablets. 11 Jam. 8 Tinctures. 14 Jelly. 67 Miscellaneous Preparations. 17 Meats. Of these 1,151 samples, 25, or 2.2%, were adulterated. Proceedings were taken in 3 cases, and in one case the vendor was cautioned. 46. Milk. 265 samples were examined during the year; the average composition of the samples is shown in the following table:- Month No. Examined Fat, per cent Solids-notFat, per cent January 30 3.70 8.73 February 32 3.58 8.66 March 27 3.58 8.66 April 25 3.58 8.64 May 21 3.41 8.70 June 23 3.32 8.76 July 17 3.39 8.60 August 17 3.43 8.61 September 21 3.58 8.70 October 19 3.65 8.80 November 15 3.73 8.78 December 18 3.74 8.78 Whole Year 265 3.56 8.70 Legal Minimum 3.00 8.50 Average composition for the past 10 years is as follows:- Year No. Examined Fat, per cent Solids-notFat, per cent 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 1951 265 3.56 8.70 9 samples of milk were taken in course of delivery to Institutions in the Borough, All were satisfactory. For the third year in succession, no milk has been reported as adulterated. 47. Ice Cream. 77 samples were examined chemically, the average composition being: Fat 10.32%, Milk-Solids-not-Fat 9.04%, Sugar 13.3$. The Food Standards (Ice-Cream) Order, 1951, came into force on 1st March, 19511 and requires Ice Cream to contain not less, than 5% Fat, 7½% Milk-Solids-not-Fat and 10% Sugar. 2 samples from the same source did not comply with this standard, being deficient in Fat:- A294. Informal. 67% deficient in Fat. D256. Formal. 52% " " " Proceedings were taken' and the case was dismissed, the vendor paying £5-5-0 costs. The Methylene Blue Test for Ice Cream was started in October, after a long delay in obtaining delivery of the necessary apparatus, 6 samples were examined, 5 being classed as Grade I and 1 as Grade II. In 1952 it is intended to commence regular examination of Ice Cream by this test. Sausages Of 86 samples, 11 were adulterated, as follows B24. Informal. Pork Sausages. 38% deficient in meat. B26. " " " 19% " " B76. " " " 30% " " B83. " " " 18% " " B137. " " " 26% " " B145. " " " 47% " " B156. " " " 23% " B190. " " " 16% " " Further samples of the Pork Sausages proved to be genuine. B75. Informal, Beef Sausages. 28$ deficient in meat. C101. " " " 38% " " C104. Formal. " " 34% " " Proceedings were taken in respect of C104, the case being dismissed on payment of £5.5.0 costs. Cream Cheese. One Informal sample sold as Cream Cheese was found to be a cheese of the Camembert type made from whole milk. Bicarbonate of Soda. 2 samples from the same vendor were adulterated. D575. Informal. Contained 62% of Sodium Sulphate. D605. Formal. " 80% " " Proceedings in respect of D605 resulted In the vendor being fined £5 with £3-3-0 costs. 48. Camphorated Oil. One sample, D640, Informal, was 13% deficient in Camphor. A further formal sample was genuine. Glauber Salts. 3 Informal samples were whlly or partially dried and thus did not comply with the British Pharmacopoeia. Zinc and Castor Oil Cream. 3 Informal samplers were deficient in Zinc Oxide to the extent of 17$. 12$ and 10$ respectively. Further samples were not obtainable. Fines and costs in three cases under the Food and Drugs Act totalled £5 and £13.13.0 respectively. Pharmacy and Poisons Act. 28 Informal samples were examined and all complied with the requirements of Part II of the Poisons List. Sweets. A circular dated 6th November, 1951; from the Ministry of Food, states that where the word "Butter" is used In the description of sweets, the Butter-fat content should be not less than 4 per cent. Two samples of Buttercreams from the same vendor did not comply with this standard. D683. Informal. Contained only 0.43% Fat, D699. Formal. " " 0.48% Fat. The vendor,was cautioned. Miscellaneous Samples. 121 samples examined consisted of:- 14 Apples & Pears. 6 Apricot Pulp. 1 Bacon. 2 Bread. 1 Biscuits. 1 Cake. 2 Cake Flour. 1 Soft Cheese. 2 .Fruit Paste. 1 Fruit Salad. 2 Meat. 2 Meat Extract. 4 Cooked Meats. 1 Milk. 1 Milk Powder, 2 Bottled Pears. 2 Peppers. 1 Pineapple. 1 Rolled Oats. 2 Shredded Suet. 1 Sweet Wrappers, 4 Tea. 8 Tinned Cherries. 1 Tinned Fish. 8 Tinned Sandwich Spread. 1 " Sausages. 4 " Vegetables. 7 " Soups. 24 Tomato Juice. 1 " Paste. 2 Mineral Waters. 4 Water. 1 Soft Soap. 6 Methylene Blue Tests (see Ice Cream). Of these samples, 37 were unsatisfactory, as shown below CIO, Cll, C12, C13, C25. Apples. Contained Arsenic, 2.1 to 2.5 parts per million, and Lead, 7 to 20 parts per million. 49. B15. Apricot Pulp. Contained Tin, 425. parts per million. B18. " " " " 330 " " " C58. Bread. Contaminated with dirt and rust. D780. Cake. " " mice excrements A166. Bottled Pears. Foetid smell; unfit for food. A222. Meat. Consisted of Horse-meat. D56. Pastry Mix. Excess acidity; unfit for food. D543. Sweet Wrappers. Coloured paper containing .1.6% of copper. C110. Sandwich Spread. Contained 540 parts per million Tin. C112 " " " 880 " " " " D364. Tomato Soup, " 345 " " " " D365, " " " 425 " " " " B92,B93,B94,B95, ) Tomato 16 samples from the same B96.B9o,B99,B100,) Juice. source contained Tin in B10l,B102,B103, ) amounts varying from D484,D485, D487, ) 300 to 770 parts per million. D488, D490. ) D493. Mineral Water. Contaminated with dirt, flies. PH52. Water. Slight vegetable contamination. D733) Shredded Suet. Tallowy taste; unfit for food. D734) Arsenic in Fruit. 14 samples of Apples and Pears were examined. Of these, 5 samples (listed on previous page) contained excessive amounts of Lead and Arsenic, derived from Lead Arsenate spray. In all cases this contamination could easily be removed by washing. Public Cleansing Officer. 4 samples of Disinfecting Fluid were examined; all complied with their specification. Private Purchaser. 2 samples of Sausage were examined and fees of £2-2-0 received. 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 cooperation shown by the staff of the Food Section in the work of the Laboratory. I have the honour to be, Ladies and Gentlemen, Your obedient Servant, W.M.PAULLEY, 43 White Horse Road, E.l. Public Analyst. 50. A P P E N D I X OF STATISTICAL TABLES 51. Table 1. TOTAL DEATHS BY CAUSE AND AGE OF STEPNEY RESIDENTS - 1951 (Registrar-General's Return) CAUSES OF DEATH. ALL AGES -1 1- 5- 15- 25- 45- 65- 75- M F Total 1. Tuberculosis - Respiratory 32 14 46 - - - 2 10 16 16 2 2. " - Other 3 3 - - - - 1 2 - - 3. Syphilitic Disease 8 2 10 - - - - 1 2 5 2 4. Diphtheria - - - - - - - - - - - 5. Whooping Cough - - - - - - - - - - - 6. Meningococcal Infection - 1 1 - 1 - - - - - - 7. Acute Poliomyelitis - - - - - - - - - - - 8. Measles - - - - - - - - - - - 9. Other infective and parasitic Diseases 2 2 4 1 - - - 2 1 - - 10. Malignant Neoplasm - Stomach .. 24 14 38 - - - - 4 14 11 9 11. " - Lung Bronchus 44 8 52 - - - 1 2 23 17 9 12. " - Breast - 14 14 - - - - 3 4 4 3 13. " - Uterus - 6 6 - - - - 1 1 2 2 14. " - Other 64 54 118 - 1 1 1 3 30 42 40 15. Leukaemia, Aleukaemia 1 3 4 - - - - 1 l 2 - 16. Diabetes 7 9 16 - - - - - 2 8 6 17. Vascular Lesions of Nervous System 49 55 104 - - - - 1 26 12 45 18. Coronary disease, Angina 104 83 187 - - - - 6 50 80 5i 19. Hypertension with Heart Disease 32 33 65 - - - - - 19 21 25 20. Other Heart Disease 104 109 213 - - - 3 5 25 66 114 21. Other Circulatory Diseases 23 19 42 - - - - 2 9 8 23 22. Influenza 9 6 15 - - - - 2 3 6 4 23. Pneumonia 44 34 78 4 2 - - 2 17 21 12 24. Bronchitis 87 41 128 2 - - - 3 28 15 60 25. Other diseases of Respiratory System .. .. 9 2 11 - - - - 1 5 4 1 52. Table l. (Contd.) CAUSES OF DEATH. ALL AGES -1 1- 5- 15- 25- 45- 65- 75- M F. Total 26. Ulcer of Stomach and Duodenum 20 7 27 - - - l 2 10 7 7 27. Gastritis, Enteritis & Diarrhoea 2 4 6 3 - - 1 - 1 1 - 28. Nephritis and Nephrosis 2 3 5 - - - - 2 2 - 1 29. Hyperplasia of Prostate 19 - 19 - - - - - 2 6 11 30. Pregnancy, childbirth, abortion - - - - - - - - - - - 31. Congenital malformations 2 5 7 5 1' - - - - 1 - 32. Other defined and ill-defined diseases 49 45 94 23 - - - 10 28 18 15 33. Motor vehicle accidents 6 2 8 - - - 1 2 3 1 1 34. All other accidents 19 9 28 1 1 - 1 1 5 8 11 35. Suicide 10 4 14 - - - - 5 3 4 2 36. Homicide and operations of war 1 - 1 - - - - - - 1 - Sub Totals: M 776 23 3 - 6 41 204 255 242 F 588 16 3 1 5 29 128 172 234 GRAND TOTAL 1364 39 6 1 11 72 332 427 476 Table 2. Comparative Table of ROAD. ACCIDENTS IN THE BOROUGH YEAR Children under 7 yrs. Children 7-14 yrs. Adults TOTALS Killed Injured Killed Injured Killed Injured Killed Injured 1946 2 52 2 59 8 481 12 592 1947 2 48 - 48 13 390 15 486 1948 2 49 1 43 8 411 11 503 1949 2 57 - 54 8 415 10 526 1950 - 61 - 48 7 474 7 583 1951 - 49 - 51 10 525 10 625 53. Table 3. COMPARATIVE VITAL STATISTICS FOR 1951 Stepney London Administrative County England and Wales Rates per 1,000 Home Population Births Live births 18.72 17.8 15.5 Still births 0.40 0.37 0.36 Deaths All causes 13.83 13.1 12.5 Typhoid and paratyphoid 0.00 - 0.00 Whooping cough 0.00 0.01 0.01 Diphtheria 0.00: 0.00 , 0.00 Tuberculosis 0.49 0.38 0;31 Influenza 0.15 0.23 0.38 Smallpox 0.00 - 0.00 Acute Poliomyelitis (including polioencephalitis) 0.00 0.00 0.00 Pneumonia 0.79 0.61 0.61 Notifications (Corrected) Typhoid fever 0.00 0.01 0.00 Paratyphoid fever 0.09 0.01 0.02 Meningococcal infection 0.09 0.03 0.03 Scarlet fever 1.36 1.10 1.11 Whooping cough 2.26 3.11 3.87 Diphtheria 0.00 0.01 0.02 Erysipelas 0.17 0.15 0.14 Smallpox 0.00 - 0.00 Measles 14.80 14.64 14.07 Pneumonia 0.09 0.72 0.99 Acute poliomyelitis (including polioencephalitis): Paralytic 0.00 0.02 0.03 Non-paralytic 0.00 0.02 0.02 Food poisoning 0.00 0.23 0.13 . Deaths Rates per 1,000 Live Births All causes under 1 year of age 21.12 26.4 29.6 Enteritis and diarrhoea under 2 years of age 1.62 0.7 1.4 Notifications (Corrected) Rates per 1,000 Total (Live and Still) Births Puerperal fever and pyrexia 18.02 14.90 10.66 54. Table 4. SUMMARY OF INSPECTIONS. VISITS AND ACTION TAKEN BY DISTRICT SANITARY INSPECTORS DURING THE YEAR Complaints 10,037 Drainage 6,779 House-to-House 77 Houses-Let-in-Lodgings 938 Infectious Diseases and Contacts 492 Common Lodging Houses 110 Seamen's Lodging Houses 109 Markets (Week-end) 37 Offensive Trades 273 Pharmacy and Poisons Acts, 1933 251 Rent Restrictions'Acts 373 Shops Act, 1950 1,283 Smoke Nuisances - Observations 128 Building Licences - Surveys 927 Defence Regulation 68 C.A. 125 Factories Acts Mechanical 2,741 Non-mechanical 214 Other 10 Outworkers premises 448 Workplaces 373 Miscellaneous Visits and Inspections 7,466 Revisits 11,880 Attempted Visits 3,150 Total Visits and Inspections 48,221 Intimation Notices Served: On County and Borough Council Housing Departments 504 On Owners 4,619 Statutory Notices Served 1,327 Legal Proceedings Taken 35 55. Table 5. SUMMARY OF WORK CARRIED OUT UNDER THE SUPERVISION OF DISTRICT SANITARY INSPECTORS DURING THE YEAR Animal nuisances abated 6 Cisterns cleansed, covered and repaired 15 Dampness in premises remedied 1,732 Drains cleansed or repaired 736 Drains constructed or reconstructed 709 Dust receptacles provided 189 Dwelling rooms cleansed 3,746 Houses ventilated beneath lower floor 17 Improved light and ventilation provided to rooms 28 Offensive accumulations removed 222 Gutters and rainwater pipes fixed or repaired 459 Repairs to roofs 1,951 Sinks, baths and lavatory basins fitted 540. Sink, bath etc., waste pipes fixed or repaired 550 Smoke nuisances abated 13 Urinals fixed or repaired 59 Verminous rooms cleansed 645 Water-closets cleansed or repaired 522 " - light and ventilation provided 32 " - pans and traps fixed 523 " - provision or repair of flushing apparatus 406 Water supply to houses reinstated or repaired 131 Yards, Areas and Forecourts paved or repaired 159 Floors and Staircases repaired 891 Fireplaces and Coppers renewed or repaired 673 Windows repaired 976 Miscellaneous 1,020 Total 17,950 56. Table 6. 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 309 214 8 Factories with mechanical power 2,825 2,777 159 Other premises under the Acts (building operations and works of engineering construction) 4 10 - TOTAL: 3,138 3,001 167 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars Found Remedied Referred to H.M. Inspector by H.M. Inspector want of cleanliness 75 75 2 11 Unreasonable temperature 4 4 - - Inadequate ventilation 6 6 - 1 Ineffective drainage of floors 7 7 - - Sanitary Conveniences (a) insufficient 10 10 - - (b) unsuitable or defective 45 45 - 35 (c) not separate for sexes 68 68 - 28 Other offences against the Acts (not including those relating to Outwork) 76 76 3 - TOTAL: 291 291 5 75 57. Table 7. • ' ' ' '' : FACTORIES & TRADES IN THE BOROUGH cal. NonMechan ical. cal. NonMechan ical. Adhesives 2 - Electrical Repairers 24 - Aerated Waters 10 - Animal Foods - 1 Electricity Supply stations 2 - Artificial Flowers - 2 Artificial Teeth 1 - Engineering & Repairs 91 5 Asbestos 2 - Bacon Smokers 2 1 Essence, Bottlers - 1 Bakers 67 2 'Face Cloths l - Banana Ripeners 2 - Feathers - 3 Barrels 10 7 Feather Bedding 4 - Barge Builders 8 - Fish Curers 13 1 Baskets, wicker - 1 Food Packers 27 - Beer Bottlers 4 - Fountain Pen Makers 1 - .Bitumen Mills 1 - Furniture & Cabinet Makers 97 40 Bookbinders 2 1 Boot & Shoe Makers and Repairers 38 12 Furskin Dressers 3 — Furriers 77 5 Bottle Washers 15 - Gas Supply Stations, 2 - Boxes, wooden 22 i 2 Breweries 3 Brushes, 3 - Glass 12 - Builders 1 15 Handbags 5 1 Builders1 Merchants 15 - Harness - 2 Bullion Dealers l - .Ice Cream 6 - Carpets l 2 Ironmongers 1 - Chaff Cutters 2 - Lampshades 1 - Chemicals 11 - Lampshades 13 1 Chemists' Sundries 4 - Lead Mills 2 - China & Glass - 1 Leather Goods 20 2 Cigarettes & Tobacco 5 1 Lenses & Spectacle Frames 7 - Cleaners & Pressers 10 12 Coach Builders 10 - Locksmiths - 1 Coffee Roasters & Grinders 6 - Milk Pasteurisers 2 - .Motor Body Painters - 2 Confectioners 7 11 Corks 4 1 Motor Vehicle Repairers 80 4 Cycle Repairers - 1 58. (Table 7 (contd.) Me chani cal. NonMechan ical. Mechani cal. NonMechan ical. Oil Blenders 1 - Soap 1 _ Spice Grinding 6 - Paints - 1 Spirit Rectifies 5 7 - Paint Sprayers 2 - Stencil Cutting - 2 Paper Bags - 1 Stonemasons 10 1 Paper 4 - Surgical Ligamerts 1 - Perfumers 3 - Tarpaulins 9 - Pewterers 2 - Photograph Printing 4 - Tea Packers 11 - Photographers - 1 Timber Merchants - 3 Pickles 3 1 Tinware 6 - Plasties 7 - Tools 3 - / Printers 59 13 Toys 9 1 Pulley Blocks 3 — Trucks 2 - Radio Repairers - 3 Umbrellas 6 - Rag Sorters 11 18 Upholsterers 22 - Ropes 1 1 Veneer 2 - Rubber Scrap 1 3 Vinegar Bottlers 1 — Sack Repairers 10 3 Sails 2 - Waste Paper Merchants 3 1 Sausages 9 - Sawmills 16 - Watch & Clock Repairers 6 7 Scrap Metal 10 3 Secondhand Clothes Dealers 13 2 Wearing Apparel 272 86 Wharfingers 8 - Seed Packers 5 - Wheelwrights 2 - Sewing Machine Repairers 15 1 Winemakers & Bottlers 3 3 Shopfitters 3 - Wool Washing 1 - Signs 2 - 59. Table 8. RODENT CONTROL Total Properties in Area Council Property Dwelling Houses iBusiness Premises TOTAL 56 23,562 12,750 36,368 No. Properties Inspected (a) as result of notification by Occupier 4 1,110 392 1,506 (b) otherwise 3 4,930 3,001 7,934 No, Properties infested by rats: Major - 3 34 37 Minor 4 831 393 1,228 No. Properties seriously infested by mice 1 112 32 145 No. infested properties treated by Local Authority 5 83O 224 1,059 No. Sec.4 Notices served (i) Treatment - - - - (11) Structural works - - - - No. "block" control schemes carried out 1 Severs-"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 21st May to 5th July and 3rd December 1951 to 18th January 1952. 1,470 manholes were treated during the first period and 1,472 during the second, the estimated number of rats destroyed being 12,445 and 13,235, respectively. 60. Table 9. SUMMARY OF INSPECTIONS, VISITS & ACTION TAKEN BY THE SPECIALIST INSPECTORS ENGAGED IN THE SUPERVISION & INSPECTION OF FOOD. Bakehouses 240 Butcher and Bacon shops and stalls 374 Butter and Margarine premises 50 Complaints 66 Fish shops: and stalls 595 Grocery and Provision shops 599 Greengrocers and Fruiterers shops and stalls 871 Ice Cream premises 195 London Fruit Exchange 170 Markers (Daily) 680 Markets (Week-end) 11 Milkshops 379 Poultry shops and stalls 1,258 Prepared Food premises 502 Public Hovises 194 Railway Depots 370 Restaurants, Caf£si, Canteens, etc. 743 Spitalfields Market 119 Vfaarves 877 Wholesale Grocers 372 Miscellaneous Visits 481 Samples: Food and Drugs 1,156 Other 237 Re vi sits 923 No. of Summonses taken out (13 premises involved) 36 Total Visits, Inspections etc. 11,478 + Includes 297 special night or early morning inspections at Bishopsgate Goods Station. 6i. Table 10. Type and Number of Food Premises in the Borcugh Premises registered under more than one category. Butter & Marg. Factories. Restaurants, Cafes, &c. Canteens &c. Chemists. Confectioners Fruit. Vegetables. Grocers (Retail) Grocers (Wholesale) Ice Cream. Milkshops. Poultry. Prepared Food. Wholesale Marg.Dealers. Bakehouses (Basement) 18 - 3 - - - - - - 2 - - - - " (Grd.level) 45 - - - - - - - - - 2 - - - Bakers Shops 15 - — — - 1 - — - 1 - - - - Butter & Marg.Factories 2 2 - - - - - - - - - - - - Butchers Shops 134 - - - - - - - - - - 130 95 - Cafes, Restaurants 344 - 344 - - 2 3 2 - 58 8 - 1 - Canteens (incl. Clubs, Sctool Meal Centres &c . ) 302 - - 302 - - - - - - - - - - Chemists, Druggists 41 - - - 41 - - - 1 - - - - - Confectioners 243 - - - - 243 2 - - 136 - - - - Fish Shops 106 - 17 - - - - 1 - - - 1 54 — Fruit and Vegetables 481 - - - - - 48l - - - - - - - Grocers (Retail) 338 - 5 - - - 3 338 - 59 204 - - - " (Wholesale) 99 2 - 9 1 2 1 - 99 1 1 - - 30 Ice Cream Premises 7 - - - - - - - - 7 - - - - Milk shops 5 - - - - - - - - - 5 - - - Public Houses 273 - 199 - - - - - - - - - - - Poultry Dealers 52 - - - - - - - - - - 52 - - Prepared Food Premises 30 - - 1 - - - - - - - - 30 - Iviiscellaneous (Wharves &c.) 116 - - 20 - - - - 1 - - - - 1 2651 4 568 333 42 248 490 341 101 264 220 183 180 31 + It is estimated that 75 per cent of Grocers sell confectionery. 62, Table 11. NOTIFIABLE DISEASES NOTIFIED DURING THE YEAR 1951. DISEASES. Total Cases Notified. In Age Groups. Total Notifications Corrected Total Cases admitted to Hospital No. of Deaths+ -1 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- 65- Diphtheria - 1 1 1 - - - - - - -- - 3 - 3 - Dysentery 14 26 26 16 10 49 8 4 16 2 21 30 222 216 103 - Erysipelas - - - - - - - - 2 3 11 1 17 17 6 - Food Poisoning 2 - - - - - 1 - 1 2 1 - 7 7 5 - Malaria - - - - - - — - - 1 - - 1 1 - — Measles 74 160 198 235 306 459 12 3 10 2 - - 1459 1459 45 - Meningoc. Irrfec -1 3 2 1 1 — - - — - 1 - 9 9 9 1 Ophth.Neonatorum 9 - - - - - - - - - - - 9 9 7 - Pneumonia 4 4 3 4 1 7 7 1 11 8 22 25 97 97 15 78 Ac.Poliomyelitis Paralytic - - - 1 - - 1 - 1 - - - 3 1 3 - -Non-paralytic - - - - - - - - - - - - - - - - Puerp. Pyrexia - - - - - - - 3 26 5 - - 34 34 32 - Scarlet Fever - 4 8 13 33 60 15 2 - - - - 135 135 32 - Enteric Fevor - 1 - - - - - 3 5 - - - 9 9 9 - Whooping Cough 42 36 29 35 28 49 3 1 2 - 1 - 226 223 19 - Tuberculosis: Pulmonary 2 1 4 2 1 7 4 17 54 41 31 9 173 173 - 46 Non-pulmonary - - - - 1 4 3 1 4 1 1 1 16 16 - 3 Scabies - - - 2 - 5 - 3 13 4 1 - 28 28 - - Totals: 148 236 271 310 381 640 54 38 145 69 90: 66 2448 2434 288 128 There were no notifications of Smallpox, Membranous Croup or Acute Encephalitis, +Deaths reported in 1951 do not necessarily refer to cases notified in that year. 63. Table 12. DISEASES NOTIFIABLE IN LONDON Disease Authority for notification Acute encephalitis P.H.Act ,1936 (S.143). SI .1949/2259. Ac. influenzal pneumonia Do. SRO.1927/1207. Ac. primary pneumonia Do. do. Ac. poliomyelitis Do. SI.1949/2259. Anthrax L.C.C .Order, 1909. P.H.(L) Act , 1936 (S.192 & 304). Chlcken Pox (Notifiable in Port of London only) Cholera P.H.(L) Act,1936, (S.192 & 305). Continued Fever Do. do. Diphtheria Do. do. Dysentery P.H.Act,1936 (S.143).SRO.1927/1207. Enteric Fever (inc. typhoid and paratyphoid P.H.(L) Act,1936 (S.192 & 304) SRO.1927/1207. Erysipelas P.H.(L) Act,1936 (S.192 & 304). Food Poisoning F.& D.Act,1938 (S.17 as amended by N.H.S.Act,1946 (10th Schedule). German Measles (Notifiable in Port of London only) Glanders L.C.C.Order,1909 - P.H.(L) Act,1936 (S.192 & 305). Hydrophobia Do. do. Leprosy P.H.Act,1936 (S.143). £1.1951/1036. Malaria Do. SRO.1927/1207. Measles Do. SRO.1940/205 and SI.1948/420. Membranous croup P.H.(L) Act ,1936 (S.192 & 304). Meningococcal infection P.H. Act ,1936 (S.143). St. 1949/2259. Ophthalmia neonatorum L.C.C.Order,1910 - P.H.(L) Act,1936 (S.192 & 305). SRO.1928/419 1936/971 and 1937/35. Plague P,HfAct,1936 (S.143). LGB.Regs.1900. Puerperal pyrexia Do. SI.1951/1081. Relapsing Fever P.H.(L) Act,1936 (S.192 & 304). Scabies P.H.Act,1936 (S.143). SRO.1943/1016. Scarlet Fever P.H.(L) Act ,1936 (S.192 & 304). Smallpoxi Do. Tuberculosis P.H.Act,1936 (S.,143). SRO.1930/572. Typhus Fever P.H.(L) Act,1936 (S.192 & 304). Whooping Cough1 P.H.Act,1936 (S.143). SRO.1938/1100, 1940/205 and SI.1948/420. Yellow Fever (Notifiable in Port of London only) Zymotic enteritis or (Notifiable in 9 Metropolitan Boro's summer diarrhoea only-not. notifiable in Stepney). +Replaced by SI.1952/704. 64. Table 13. * TUBERCULOSIS-New Cases and Deaths. New Cases. 249 Pulmonary cases notified included 173 Primary Notifications, 15 from death returns, 57 transfers, 1 posthumous notification and 3 from other sources. 21 Non-Pulmonary cases notified included 16 Primary Notifications and 5 transfers. Deaths(*). 48 Pulmonary; 3 Non-Pulmonary. Age Distribution of new cases and deaths is as follows:- 1 l 2 5 10 15 20 25 35 45 55 65 75 Total (all ages) (a) New Cases. Pulmonary M 1 l 7 6 2 6 9 41 43 25 17 13 3 174 F 2 - 1 1 2 11 17 IB 10 7 4 1 1 75 Non-Pulmonary M - - 1 3 2 - - 4 - - - - 1 11 F - - - 2 1 l 1 2 2 l - - - 10 (b) Deaths(*) Pulmonary M - - - - - - - 2 5 5 9 12 2 35 F - - - - - 2 - 3 - l 4 2 1 13 Non-Pulmonary M - - - - - - - - l 2 - - - 3 F - - -r - - - - - - - - - - - (*) Compiled from local death returns. Table 14. TUBERCULOSIS-Variations in Register. Pulmonary Non Pulmonary Total Cases M F M F (a) Cases on Register at 1/1/51 545 385 98 81 1109 (b) New cases notified 115 59 11 4 189 (c) Cases restored to Register 16 2 - - 18 (d) Other cases added 43 15 - 5 63 (e) Removals 105 57 4 9 175 (f) Cases remaining on Register tat 31/12/51 614 404 105 81 1204 65. Table 15. HOUSING STATISTICS I. Inspection of dwelling houses during the year:- (l)(a) Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 8,738 (b) Inspections made for the purpose 31,119 (2)(a) Dwelling-houses inspected and recorded under Housing Consolidated Regulations, 1925 39 (b) Inspections made for the purpose 52 (3) Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 25 (4) Dwelling-houses found not to be in all respects reasonably fit for human habitation 4,731 Ill 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 3,404 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 1,327 (2) Dwelling-houses in which defects were remedied after service of Formal Notices:- (i) By Owners 1,327 (ii) By Local Authority in default of owner Nil. 66. (Table 15 (contd.) (c) Proceedings under Sections 11 and 13 of Housing Act, 1936:- (i)-Dwelling-houses.in respect of which Demolition Orders were made 2 (ii) Dwelling-houses demolished in pursuance of Demolition Orders 2 (d) Proceedings under Section 12 of Housing-Act, 1936:-. (i). Separate tenements or underground rooms in respect of'which Closing Orders were made 39 (ii). Closing' Orders determined, the tenements or robins having been rendered fit * * • • Nil. (e) Proceedings under Section 25 of Housing Act, 1936:- (i) No. of -houses included by representation by Medical Officer of Health ' 13 (ii} No. of houses demolished in pursuance of representations Nil. IV-.- Housing.Act, Part IV - Overcrowding:- (i) No. of overcrowded families on register at beginning of year 1,048 (ii) Now of new cases encountered during year 217 (iii) No, of cases relieved during year- 158 (iv) Np, of overcrowded families on register at end of year 1,107 67. INDEX Page Accidents 5 Aged Persons 6 Analyst's-Report 45 Bacteriological examination of Foodstuffz 33 Bakehouses 34 Births 2, 3 Building Licences 28 Butchers Shops 34 Butter & Margarine Factories 34 Cancer, Deaths from 2 Catering Establishments 35 Common Lodging Houses 22 Complaints of Nuisances 19 Conferences 14 Deaths 2,4,51,52 Defence Regulation 68 C.A. 29 Diarrhoea - Deaths from 2 Diphtheria 38 Disinfection & Disinfestation 43 Drainage 20 Dysentery 38 Factories 20, 56-58 Fairgrounds 21 Fish Shops & Stalls 35 Food: Inspection & Supervision 31, 60 Unsound 36 Food Establishments - Improvements 35 Food Poisoning 31, 38 Free Washing'Facilities 9 General Information 3 Greengrocers & Fruiterers Shops and Stalls 35 Grocery & Provision Shops 35 Health Propaganda 10 Health Services, General Provision of 6 Home Bathing 9 Houses-let-in-lodgings 21 Houses - Number in Borough 2 Housing 28 Housing Statistics 30, 65, 66 Ice Cream 32, 33, 47 Illegitimate Births 2, 4 Infant Mortality 2,5 Infectious Disease 38, 62, 63 Information Service 11 Inquests 9 Laboratory Facilities 12 Legal Proceedings 22 68. Legislation 13 Marriages 4 Mass X-ray 41 Maternal Mortality 2, 5 Maternity & Child Welfare 15 Meals on Wheels 8 Measles 38 Milk Supply 32,46 Mobile Snack Bars 31 Mortuary 9 National Assistance Act, 1948 6, 9 Noise Nuisances 23 Offensive Trades 2| Old People's Welfare Association 8 Outworkers 20 Overcrowding 28 Paratyphoid 39 Pharmacy & Poisons Act. 24 Pneumonia 39 Population 2,3 Prepared Food Premises 34 Puerperal Pyrexia 40 Rag Flock & Other Filling Materials Act 24 Rateable Value 2 Refuse Disposal 25 Removal of Persons in need of care and attention 6 Rent & Mortgage Interest Restrictions Acts 25 Road Accidents 4, 52 Rodent Control 25, 59 Sanitary Circumstances 19 Sanitary Inspectors: Summary of Inspections 54 Return of Sanitary Work 55 Scabies 40 Seamen's Lodging Houses 22 Shops 266 Slum Clearance 28 Smallpox 40 Smoke Abatement 26 Social Conditions of Area 3 Special Reports to Public Health Committee 14 Statistics, Summary of 2 Stillbirths 2,4 Staff 1,18 Swimming Baths 18 Tuberculosis 41, 64 Underground Rooms 28 Unemployment 5 Vital Statistics 2,3,4,53 Water Supply 26,27