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 1954 Together with the Report of the PUBLIC ANALYST Metropolitan Borough of Stepneg. ANNUAL REP 0 R T of the Medical Officer of Health F.R.O'SHIEL, L.R.C.P.I., L.M., D.P.H. for the year 19 5 4 together with the Report of the Public Analyst. CONTENTS Page Map of Borough Frontispiece Public Health Committee ii Introductory iii Staff 1 Summary of Statistics2 I. Statistics and Social Conditions of the Area 3 II. General Provision ofHealth Services 9 III. Sanitary Circumstances 22 IV. Housing 33 V. Food - Inspection- and Supervision36 VI. Infectious and other Diseases47 Public Analyst's Report55 Appendix 58 Index 76 PUBLIC HEALTH COMMITTEE at 31st December 1954 Ex-officio: His Worship The Mayor (Councillor J.McCarthy, J.P.) Chairman: Councillor (Mrs.) C. Edwards Vice-Chairman: Councillor (Mrs.) M. Sambrook Alderman (Mrs.) A.Elboz Councillor T.W.Ashby Councillor W.W.T.Bannell Councillor (Mrs.) E.B.Bolton Councillor J.C.Callahan Councillor D.J.Collins Councillor W.S.Cox Councillor W.J.Curtis Councillor B.Donovan Councillor E.W.Hill Councillor W.G.Humphries Councillor (Mrs.) M.A.Long Councillor R.Milligan Councillor G.A.Rugg Councillor J.Sambrook Councillor (Mrs.) C.F.Woollon All public health matters are dealt with by the Public Health Committee, except those relating to public cleansing and baths and washhouses, which are under the control of the Public Cleansing Officer and Chief Baths Superintendent respectively, and are considered by ad hoc Committees. All housing matters are dealt with by the Housing Committee, at which the Medical Officer of Health represents the Public Health Department. Council's Representatives on L.C.C. Health Committees at 31st December, 1954. Division 5 Councillor W.G.Humphries Councillor (Mrs.) M.A.Long Councillor (Mrs.) M.Sambrook Central Councillor (Mrs.) C.Edwards ii METROPOLITAN BOROUGH OF STEPNEY Telephone PUBLIC HEALTH DEPARTMENT, Stepney Green 43, White Horse Road, 2484 ' Stepney, London, E.l. To the Mayor. Aldermen and Councillors . . of the Metropolitan Borough of Stepney. Your Worship, Ladies and Gentlemen, It is my privilege to present to you my Annual Report on the state of the public health in Stepney for the year 1954. There were no serious outbreaks of illness, and on the whole the year was a healthy one in spite of unfavourable weather. January and February were the coldest since 1947, and the summer, the worst since 1890, was cool, wet and dull, with very little sunshine from May to August. 0 The population, which was at its maximum of 298,600 in 1901, diminished gradually to 200,500 in 1938. The early years of the 1939/45 war brought a rapid reduction to 71,980, which increased to 98 ? 581 in the Census year 1951. The present estimated population is 97,900, a reduction of 670 on last year's figure. The live birth rate* is 18.90 (19.46), the death rate* 11,50 (12,04), the marriage rate 20.3 (17.o),.the maternal mortality rate* 0.51 (0,51)j the infant mortality rate* 22.15 (39.08), and the neonatal mortality .rate 17.28 (20.32), compared with the rates for last year shown in brackets above. Only one mother died in childbirth, and there were 38 stillbirths, giving a stillbirth rate* of 20.11 (19.91). * Death rate - number of deaths per annum per 1,000 population. Still birth rate - the number of still births per annum per 1,000 total live and still births. Live birth rate - number of live births per annum per 1,000 population. Infant mortality rate - number of deaths per annum of infants under one year of age per 1,000 live births. Maternal mortality rate - number of deaths per annum of wcinen ascribed to pregnancy, childbearing, abortion, etc., per 1,000 live and still births. iii The commonest cause of death in the Borough Is heart disease, from which there were 288 deaths, followed by cancer with 261 deaths. Cancer of all kinds is increasing, with the exception of cancer of the breast and womb. The death rate of cancer of the lung in males in Stepney, 9 per 10,000 population, is considerably greater than that for England and Wales, which is 6 per 10,000 population (see page 7). No cases of smallpox or typhoid occurred in the Borough, and only one case of diphtheria. No deaths occurred from diphtheria, scarlet fever, measles or whooping cough. There were 3 cases of poliomyelitis, all of which recovered. The notifications of tuberculosis increased fronj 180 to 183, but there were 7 fewer deaths from the disease. It is disappointing to find that, in spite of all the publicity to encourage food hygiene, there were 23 cases of food poisoning, the highest number notified in the Borough. Important new legislation made during the year was the Housing Repairs and Rents Act, 1954. and the Food and Drugs Amendment Act, 1954, to which further reference is made on pages 22, 33 and .36. The unsolved problem of the helpless aged in our midst is still with us, and no new legislation has come to their aid. Unfortunately for them, they are unable to force their claims on the attention of the public by means of strikes official or otherwise, and so the headlines of the press do not hum daily with the news of their grievances. However, in fairness, it must be recorded that from time to time special articles do appear in some of the newspapers drawing attention to their plight. Heaven helps those who help themselves, but the poor decrepit aged have few years to live and little time and energy left to fight their case. Meantime the value of their vote, unlike that""of the young, is a diminishing asset in the field. iv In the face of insuperable difficulties, efforts continue to be made in the Borough to try to help some of them, and examples of these activities are illustrated on pages 9 to 11. In presenting this report I would like once more to express my appreciation of the work of the staff of the Public Health Department, and my gratitude to the Chairman and Members of the Public Health Committee for their helpful support on several occasions during the year. I have the honour to be, Your Worship, Ladies and Gentlemen, Your obedient Servant, FRANK R. O'SHIEL Medical Officer of Health. June, 1955. v STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December 1954 Mcdical Officer of Health F.Roantree O'Shiel, L.R.C.P.I., L.M., D.P.H. Public Analyst (Part-time): D.F.H.Button, A.R.C.S., F.R.I.C. Deputy Analyst (Part-time): R.G.Minor, Ph.C., F.R.I.C. Assistant Administrative Officer: E.P.Webber (1, 2) Principal Assistant: S.J.Carr. District Sanitary Inspectors Disinfestation Inspectors Clerical Staff W.E.Anstee (1) E.J.Edwards (1, 2) T .Aylward W.Cue (1) Miss H.A.Whitty T .Bernstein R.W.G.Day (1) (1, 2, 4, 5, 6) D.J.Berry S.Firsht (1) M.E .Coker W.E.Hart (1, 2) Housing Inspector W.J.Dixon W.H.Haworth (1) C.F.Guy (1) W.E .Driscoll J.J.Keniry (1) S.W.Embleton B.C.Reilly (1) Rodent Control G.D.Freeland (1, 2, 3) Mrs.C.Gardner A.Trevethick (1, 2) S.S.Harris L.J.Windsor (1,2) E.Holt Miss. R.Levey Food Inspectors Woman Hygiene Assistant Miss A.J.Ballam (T) J.McMullon Mrs.M.Munday(T) A.C.Brown (1, 2) M.J.O'Connor H.J.Green (1, 2) M.Pliskin S.S.Lowther (1, 2) Rodent Investigators T.J.Fox S.C.Ludlow (T) T.T.Walker (T) C.E.Powell S.Vogler (1, 2) Caretakers Foreman W.Clark Disinfector A.N.Cook (and Messenger) Messenger Relie f-Care taker E.H.Vaughan W. Sexton (1) Sanitary Inspectors Certificate. (2) Meat & Other Foods Certificate. (3) Smoke Certificate. (4) Health Visitors Certificate. (5) State Certified Midwife. (6) Trained Nurse. (7) Temporary. NOTE - There were no staff changes during the year. 1 SUMMARY OF STATISTICS, 1954. Area of Borough 1902.7 acres. Population (RegistrarGeneral's Estimate of Home Population as at 30th June? 1954) 97,900. Number of inhabited houses (end of 1954) according to Rate Books 29,784. Rateable Value (1st April. 1954) £1,267,677. Sum represented by a penny rate £5,009.8.2d. Density of population (persons per acre) 55.43 BIRTHS .Total Male Female Rates Live Births Legitimate 1688i 857 831 Illegitimate 163 771 861 TOTAL 1851 934 917 LIVE BIRTH RATE per 1000 population 18.90 Still Births Legitimate 30 18 12 Illegitimate 8 4 4 TOTAL | 38 22 16 TOTAL BIRTHS 1889 956 933 STILL BIRTH RATE per 1000 total (live and still) births 20.11 DEATHS Total Male Female Rates TOTAL (All Ages) 1126 683 443 MATERNAL 1 DEATH RATE per 1000 population 11.50 MATERNAL DEATH RATE per 1000 total (live and still) births 0.52 CHILDREN UNDER 1 YEAR OF AGE. Legitimate 34 22 12 Illegitimate 7 4 3 TOTAL 41 26 15 RATE per 1000 legitimate live births 20.14 RATE per 1000 illegitimate live births42.94 RATE per 100.0 live births (total) 22.15 DEATHS from TOTAL Male Female Cancer 261 152 109 Measles - - - Whooping Cough - - - : Diarrhoea (under 2 years of age) 1 1 - Tuberculosis - Respiratory 30 27 3 - Other forms 6 3 3 2 1. STATISTICS & SOCIAL CONDI HONS OF THE AREA. General Information. The Metropolitan Borough of Stepney is bounded on the west side by the City of London, on the north by the boroughs of Shoreditch and Bethnal Green, on the east by the Borough of Poplar, and on the south by the River Thames, the river front being some 2.39 miles in length. It is roughly rectangular in shape, the length being 2.3 miles and the breadth vaiying from 1 to 1-g- miles, and possesses approximately 90 miles of streets. The area of the Borough is 1902 acres, and of this the river accounts for 136 acres and the inland water, consisting of docks and canals, 75 acres. Dark blue London clay is found under the whole Borough at a depth of between 20 and 30 feet frcm the surface. Above this level are layers and patches of gravel and sand, brown and yellow clays being found nearer the surface. In sane parts of the borough are layers of "made" ground, the result of earlier habitation, and, as is to be expected, the flow of sub-soil watei? is towards the river. The area is to a large extent industrial in character, factory pranises being spread throughout the borough but. tending to be concentrated towards the western end, with docks and wharves stretching along the whole of the river front, which foims the southern boundary. The chief industry of the Borough is the manufacture of clothing of all kinds, it being estimated that a third of the tailoring industiy of London is carried on in Stepney. Other major industries include brewing, cigarette making, engineering and the manufacture of furniture. Among the interesting industries situated in the Borough are the Manufacture of coinage at the Royal Mint and at Rothschild's Hint, and a bell foundry in White chap,al established in 1570, where were cast many famous bells, including Big Ben. 3 Stepney is also one of the most important wholesaling districts in Greater London, The third and final volume of the 1950 Census of Distribution, published at the beginning of the year, reports that the wholesale trade in the Borough amounted to £258 million per annum, of which £27 million was in respect of fruit and vegetables. Population. The Registrar-General's mid-year estimate for 1954 is 97,900. The census taken in 1951 showed the population to be 98,581. The density of population is now 55.43 persons per acre. The population of the Administrative County of London continued to decline, falling from 3j3435000 in 1953 to 3,322,000 in 1954, a decrease of 21,000. This decline is reflected to a certain extent in the increase in population of those out-county areas which contain London County Council Housing Estates such as Romford, Elstree and Reigate. Open Spaces. There is in the Borough approximately half an acre of parks and open spaces per 1,000 population. Births. The total number of live births registered in the Borough during the year was 3,502, and of this number 1,827 belonged to other areas. In addition, 176 births belonging to Stepney occurred outside the Borough, making a total of 4 1,851 births (934 male and 917 female) to Stepney residents. 3,213 births occurred in hospitals in the Borough, 1,388 of this number being born to Stepney residents. The live birth-rate is 18.90 per thousand of the population. The rate when adjusted by the comparability factor is 16.44, compared with the rate for England and Wales of 15.2. Illegitimate live births numbered 163, representing 8.8 per cent of the total live births. Still-births numbered 38, representing a rate of 20.11 per 1,000 total births. Marriages. The number of marriages registered during the year was 998, being 130 more than last year. The rate of marriages per 1,000 population is 20.3, and in 1953 it was 17.6. Deaths. The net number of deaths registered during the year was 1,126 (683 males and 443 females;, as compared with 1,187 last year. The rate of 11.51 is the lowest for 16 years and compares with 12.04 for 1953. Die principal causes of death were from heart disease, which accounted for 25 per cent of the total deaths, cancer 23 per cent, and diseases of the respiratory system 15 per cent. 61 per cent of the deaths were of persons over the age of 65, and included one woman aged 101. Details of deaths by cause and age are given in Table 1 of the Appendix. In Ehgland and Wales today the expectation of life of a boy at birth is 67.06 years and of a girl 72.35 years, compared with 48.53 and 52.38 years between the years 1901 and 1910. Road Accidents. Ten^ Stepney residents met their deaths through road accidents during the year. 5 Infant Mortality. The deaths of infants under one year of age numbered 41, giving a rate of 22.15 per thousand live births as compared with 39.08 last year. The rate for Ehgland and Wales for the year is 25.5. Of the infant deaths 32 were -under 4 weeks old, representing a rate of 17.28 per thousand live births. Last year there were 39 nco-natal deaths, and the rate was 20.32 per thousand live births. The neo-natal mortality rate for England and Wales is 17.7 per thousand live births. On analysing the 41 deaths of infants which occurred in Stepney this year it is found that 35 died from causes which from the first probably gave little chance of survival. Those included 20 casos of prematurity and 13 of congenital malformation. Of the 20 premature cases 17 died within 24 hours and 14 were below 3-lbs. in weight. Of the 13 cases of congenital malformation all but one appeared to be incapable of survival; 9 of these died within a week and 5. were below 5^-lbs. in weight. The Tables on page 61 show deaths from stated causes at various ages under one year, together with comparative figures over the last 4 years. Maternal Mortality. There was only one maternal death this year - a married woman, aged 42, mother of two childi*$n. She was diagnosed as pregnant at a Hospital ante-natal clinic in November 1953. Later she had several small haemorrhages frcm the wanb and after two periods in two hospitals was delivered by Caesarian section in about the 30th week of pregnancy on the 2lst May, 1954, but died the day after. Following a coroner's post mortem without an inquest the death was registered as "Placenta praevia, Anaemia, Caesarian section." As this mother had practically continuous supervision from early pregnancy, and for the last 92 weeks of her pregnancy was in hospital, it may be assumed that her death was unavoidable. Comparative Statistics. A table showing vital statistics for the Borough from the year 1901 is given on page 62. 6 Loss of Expected Years of Life. In a recent article, Dr.Logan and Dr.Benjamin, statisticians attached to the Registrar-General's Office, suggested that it would be of value to -extend the study of mortality changes by considering the years of expected life lost by each death, rather than by simply counting the number of people who die. Subsequently, the Registrar-General published for England and Wales a table expressing, mortality in terms of years of life lost, obtained from analysing death rates from all causes and from particular causes at various ages. Statistics have been calculated on these lines for Stepney's deaths and are given below, in comparison with those for England and Wales. Since local rates, when compared with national rates, need to be adjusted by a weighting factor which allows for any differences in population age-structures, the figures given relate to the year 1953? as the standard weights for 1954 are not yet available. For the purpose of calculating "loss" rates, working life is taken as the period between 15 and 64 years, and the age of natural death as at 85 years. Cause of Death Death Rate per 10,000 Population Years of Life Lost per 10,000 Population. Ages 15-64 Total to age 85 Sterpnefy Eng.& Wales StepM. Eqr.& Wales Stepney EC1K.& Wales All causes M 148 122 998 806 3066 2491 F 92 107 734 538 2011 1717 Pulmonary Tuberculosis M 6 3 47 29 141 73 F 1 1 31 20 63 39 Cancer (all sites) M 29 22 133 112 549 415 F 18 18 129 97 397 330 Cancer (lung & bronchus) M 9 6 55 35 209 131 Coronary Disease M 19 18 48 65 281 305 F 11 10 23 16 155 109 Other Cardiac Disease M 11 20 30 39 161 249 F 12 24 46 38 189 247 Bronchitis & Pneumonia M 27 14 87 93 416 293 F 12 9 67 54 214 157 7 A perusal of the foregoing table reveals the following points of interest. Although Stepney's female death- rate from all causes is lower than that for Ehgland and Wales, the loss of years of both working life and total life is greater. The years of life lost from tuberculosis is higher than the national average. The female death rate from cancer (all sites) is average, but the loss of expected years of life is greater. The male death rate in the Borough frcm coronary disease is.average, but the loss of years of life is considerably lower than average. Unfortunately cancer of the lung in Stepney males is approximately 50 per cent, greater than in England and Wales in rate and also in loss of years of both working and total life. The loss of years of working life from deaths from bronchitis and pneumonia is about the same as the national figure, although both the death rate and loss of years of total life are considerably higher. 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 yesir : - Men Boys Women Girls 1,080 8 168 2 = Total 1,258. The total number of unonplqyed at the end of 1953 was 2,002. 8 ii. general provision of health services WELFARE OF AGED PERSONS. The Council is empowered by Section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendment) Act, 1951) to make application to the Courts for orders for the removal to hospitals or institutions of aged, infirm or physically incapacitated persons who are living in insanitary conditions and who are in need of care and attention. During the year it was necessary to apply for 14 Removal Orders and 3 Extension Orders, details of which are given below. The orders operate for 6 weeks, unless otherwise stated. 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, or (b) aged and/or infirm, or (c) physically incapacitated. Person Age Reason for Action * Removed to - Remarks Miss F.R. 70 a.b. Hospital. Order for 3 months. Died. Mrs.J.I. 79 b.c. Hospital. Emergency Order for 3 weeks, 9.12.53, then - Extension for 3 months in Hospital. Extension for 6 weeks in an Institution. Mrs.R.P. 78 b. Institution. — Mr.I.N. 80 a.b.c. Hospital. Emergency Order for 3 weeks. Removed to Mental Hospital under Lunacy Acts. Died. Mr.G.P. 78 a.b. Institution. — Mr.A.F. 72 b. Institution. — Miss L.P. 84 a.b.c. Institution. — Mr.J.W. 44 b.c. Institution. — Mrs.A.F. 73 b. Institution. — Miss M.T. 90 a. b. c. Hospital. — 9 Person Age Reason for Action Removed to - Remarks Mr.A.P. 72 b.c. Hospital. Emergency Order for 3 weeks. Mrs.L.G. 74 a.b.c. Hospital. Emergency Order for 3 weeks. Extension for 6 weeks in an Institution. Miss E.K. 82 b. Institution. - Miss F.S. 76 b. Institution. A variation in the Order was made for her transfer to an institution where Kosher meals were supplied. Miss M.S. 77 b. Institution. Removed from Institution to Hospital for observation under Lunacy Acts. In addition to the foregoing persons removed under Court Orders, admission was gained to hospitals or institutions for 24 other persons. The Council's Inspector occasionally visits old people after their removal to a welfare home or hospital, and reports in the majority of cases that they have settled down well and appear to be happy in their new surroundings. The majority of visits to aged persons made by officers of this Department are carried out by the Council's woman Sanitary Inspector and woman Hygiene Assistant, and 2,208 visits were made by these officers during the year. Many of these persons were visited and medically examined by Dr.J.E.Epsom, who is engaged on a part-time sessional basis for duties including a survey of aged persons in the Borough who are in need of care and attention. This survey is proving valuable in helping to assess the size of the problem in the Borough. A register of old people so visited is kept in the Department. Amendments made to the register during the year are as follows:- Number on register at 1st January, 1954 745 Additions to the register during the year 333 Removals from the register during the year 77 Number on. register at 31st December, 1954 1001 10 The Council provides a service for disinfesting and cleansing bed linen and personal clothing, under Section 122 of the Public Health (London) Act, 193&. This service, although not provided solely for old folk, affords most benefit to such people. In addition, household effects from the homes of 5 old persons were removed and destroyed under this section. The London County Council (General Powers) Act, 1953, made further provision for the cleansing in their own homes of aged persons who are verminous or otherwise in need of cleansing to prevent injury or danger of injury to health, and who are so enfeebled that they are unable to cleanse themselves properly. During the year 492 baths were given to 45 old persons in these circumstances, the Council's cleansing attendants carrying out the work with the aid of portable bath equipment. There are 15 old people's clubs in the Borough, whose activities are co-ordinated by the Stepney Old People's Welfare Association. The Council is represented on this body by the Chairman of the Public Health Committee and other members of the Council, and by the Medical Officer of Health, and applications to the Council by old persons' clubs for grants under Section 31 of the National Assistance Act, 1948, are referred to the Association for investigation. Grants made to the Stepney Old People's Welfare Association and to old people's clubs by the Council during the year amounted to approximately £2,000. Grants may be made under the Act to voluntary associations whose activities include the provision of meals for old persons, and a photograph facing this page shows the mobile meals service in operation. This service is run jointly by the 0M People's Welfare Association and the Women's Voluntary Services, over 14,000 meals being delivered during the year. Four of the clubs include Luncheon Clubs among their facilities, and provided nearly 10,000 meals in 1954. A Chiropody Service is provided by the Stepney Old People's Welfare Association at clinics which are situated in five of the old persons' clubs in the Borough. A photograph of one of these clinics also appears facing this page. FREE WASHING FACILITIES. The Council provides free washing facilities in 16 of the 22 public conveniences, with the aim of promoting food hygiene as well as personal hygiene and cleanliness. Some 42,000 free washes were taken during the year. 11 CARE AND ATTENTION OF AGED PERSONS Meals delivered to the house-bound by the Stepney Old People's Welfare Association (" Meals on Wheels " Chiropody Clinic at an Old People's Club MATERNITY AND CHILD WELFARE I am indebted to Dr.G.O.Mitchell, Divisional Medical Officer of the London County Council, for the following information relating to the personal health services administered by the London County Council 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 1,422 1 to 5 years of age 279 Total number of children who attended - Children born in 1954 1,228 Children born in 1953 1,119 Children born 1949/1952 1,044 Total attendances by children - Under 1 year of age 19,399 1 to 5 years of age 6,988 Ante-Natal and Post-Natal Clinics (exclusive of Hospital Ante-Natal Clinics). Ante-Natal consultations - No. of women who attended first time 120 No. of women who attended 122 Total attendances 793 Post-Natal consultations - No. of women who attended 24 Health Visitors. No. of infants under 1 year of age visited for first time 1,646 Total visits to children under 1 year of age 8,909 Total visits to children aged 1 year but under 2 years 4,916 Total visits to children 2 to 5 years of age 11,772 No. of expectant mothers visited 555 Total visits to expectant mothers 1,072 12 Infant Life Protection. No. on Register - 1st Jan. 1954 Ust Dec. 1954 Foster Mothers 17 20 Foster Children 15 25 Child Minders (daily guardians). No. of child minders - Voluntary 17 Statutory. 1 No. of children minded - Voluntary 13 Statutory 1 Care of Premature Infants. No. of' premature births during the year 129 No. of deaths under 1 month 28 Immunisation and Vaccination. For details of immunisation and vaccination see pages 48 and 5l. Domestic Help Service. This service, covering the boroughs of Bethnal Green, Poplar and Stepney, is divided into three districts, irrespective of borough boundaries, and 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) 16 Tuberculosis 16 Aged and Infirm Cases. 753 Other 106 13 2. Services Provided, Infant Consultation. Afternoons 673, Commercial Road - Monday, Tuesday, Thursday and Friday. 17, Rhondda Grove - Monday and Thursday. Mary Hughes Centre, Underwood Road - Monday,Wednesday & Eiursday. St.George's, Library Place - Tuesday, Wednesday and Friday. 5 Pier Head, Wapping - Wednesday. Dame Colet, Duckett Street - Tuesday and Wednesday. Ante-Hatal. 673 Commercial Road - Wednesday. Vaccination against Smallpox. St.George's, Library Place - Friday. 35 Stepney Green - Friday. Immunisation against Diphtheria or Whooping Cough. 35 Stepney Green - Friday (Tuesday from 5th April, 1955). Note: Diphtheria and Whooping Cough immunisations are also carried out at the Infant Welfare sessions. Toddlers Clinic. St.George's, Library Place - First Tuesday morning each month. Dame Colet, Duckett Street - Fourth Tuesday each month. Mary Hughes Centre, - Second and fourth Tuesday Underwood Road afternoons ca.ch month (from 26th April, 1955). Day Nurseries. Underwood Road. Old Church Road. Christian Street. Voluntary Day Nursery. 2 Beaumont Grove. (St.Paul's, Wellclose Square closed 16th July, 1954) Nursery School. Thirza Street. 14 Mazy Hughes Infant Welfare Centre, Underwood Road, E.l. On 29th October an official opening took place at the London County Council's premises in Underwood Road of their new infant welfare centre on the first floor of this building. It will be recalled that these premises were originally built for the Jewish Maternity Hospital which transferred from Stepney during the war. For some years most of the ground floor has been used as a day nursery and the remainder formed the infant welfare centre. The latter accommodation however was not sufficiently spacious. In its new situation the infant welfare centre occupies most of the first floor and the numerous large rooms provide ample scope for all its activities. An interesting innovation is the liaison which has been arranged between the centre and the famous teaching hospital nearby - The London Hospital, by which on one afternoon session a week (Wednesday) the infant welfare centre is medically staffed by the paediatrician and his registrar from the hospital. At this session senior medical students are present. This valuable contact between the London Hospital and the centre enables students in training to obtain first hand knowledge of the diet and care of normal infants and nursing mothers, an important part of a doctor's training which cannot be so easily obtained in a hospital where infants and toddlers attend usually for the treatment of some form of illness or injury. The centre was formally opened by Councillor (Mrs.) F. E. Cayford, Chairman of the London County Council Health Committee, and amongst those present were Alderman (Mrs. ) B.L.Tate, Chairman of Division 5 Health Committee, Councillor (Mrs.) C.Edwards, Chairman of the Public Health Committee of the Borough of Stepney, Dr.H.B.May, Doan of the London Hospital Medical School, together with the local Modical Officers, Health Visitors and representatives of the staffs of local authorities and voluntary associations. The Underwood Road premises now accommodate the Mary Hughes Day Nursery and Infant Welfare Centre and Toddlers Clinic, the Ida Samuel School Treatment Centre and Dental Clinic, and also a diabetic clinic. 15 SPECIAL REPORTS of Medical Officer of Health to the Public Health Cammittee. Special reports on the following subjects were made to the Canmittee during the year: Basement Bakehouses - Quinquennial examination. The Housing Repairs and Rents Act, 1954. Hairdressers and Barbers Premises. Aged Persons (Dr.Epsom's appointment and Holiday Home). Survey of Sanitary Accomodation facilities in Licensed Premises. Report of the Committee on Synthetic Detergents. Report of the Committee on Air Pollution. DECEASED PERSONS. Mortuary. Five bodies were received in the Council's Mortuary during the year. Inquests. Inquests were held on 54 residents of the Boroug: 13 deaths were due to suicide, 20 were accidental, and 21 due to other causes (5 natural causes, 8 misadventure, 6 open verdict, 1 chronic alcoholism, and 1 manslaughter (person charged acquitted)). Burials. Section 50 of the Rational 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 have been made. Thirty-one such burials (25 adults and children over ten, 2 under one month and 4 stillborn babies) took place during the year at a cost of £310. There were arrears of charges outstanding at the beginning of the year amounting to £123, but this gum, together with the charges for 1954, is partly offset by the recovery of £103 from the estates of the deceased persons and £250 was written off as irrecoverable. The requests for burials came from the following sources; H.M. Coroner's Officer 12 Relatives of the deceased 18 Friends of the deceased 1 16 HOSPITAL FACILITIES. The undermentioned hospitals are situated in the Boroughs: No. of Beds The London Hospital, Whitechapel Road 686 Mile End Hospital, Bancroft Road 475 St.George-in-the-East Hospital, Raine Street 208 The London Jewish Hospital, Stepney Green 130 Queen Elizabeth Hospital for Children, Glamis Road 50 East End Maternity Hospital, Commercial Road 60 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. 291 investigations were carried out during the year on specimens received from medical practitioners in the Borough, throat swabs accounting for 69, nasal 3, faeces 192, rectal 26 and pus 1. AMBULANCE FACILITIES. The London County Council is responsible for the provision of ambulance transport within the Administrative County of London. CONFERENCES. The Council was officially represented at the undermentioned Conferences during the year: Conference Held at Attended by National 3noke Abatement Society Annual Conference. Scarborough (September) Vice-Chairman and Sanitary Inspector (Mr. A. Trevethick ). Royal Sanitary Institute Annual Congress. Scarborough (April) Chairman and Medical Officer of Health. Sanitary Inspectors' Association Annual Conference. Southport (September) Chairman and Sanitary Inspector (Food) (Mr .A. C.Brown). Annual Conference of Central Consultative Committee for Welfare of Old People. County Hall, London. (June) Chairman and Medical Officer of Health. 17 LEGISLATION. The following Acts, Orders and Regulations affecting the Department were made during the year: Act, Order or Regulation. Date Operative from Food and Drugs Amendment Act, 1954. Date to be appointed. Housing Repairs and Rents Act, 1954. 30.8.54 London County Council (General Powers) Act, 1954. 5.7.54 Slaughter of Animals (Amendment) Act, 1954. 1.10.54 Slaughterhouses Act, 1954. 5.7.54 Food Standards (Margarine) Order, 1954. 12.5.54 Food Standards (Soft Drinks)(Amendment) Order, 1954. 22.8.54 Housing (Declaration of Unfitness) Regulations, 1954. 17.12.54 Housing (Form of Orders and Notices) (Amendment) Regulations, 1954. 17.12.54 Housing Repairs (Increase of Rent Regulations, 1954. 30.8.54 Milk (Special Designations)(Raw Milk) Amendment Regulations, 1954. 30.9.54 Milk & Dairies (Amendment) Regulations, 1954. 30.9.54 Mineral Oil in Food (Amendment) Order, 1954. 8.8.54 Poisons List Order. 1954. 1.4.54 Poisons List (No.2) Order, 1954. 16.9.54 Poisons Rules, 1954. 1.4.54 Poisons Rules (No.2) Order, 1954. 16.9.54 Public Health (Aircraft) (Amendment Regulations, 1954. 12.6.54 Public Health (Ships) (Amendment) Regulations, 1954. 12.6.54 Rag Flock & Other Filling Materials Regulations, 1954. 3.8.54 Rent (Restrictions) Rules, 1954. 30.8.54 Rent Restrictions Regulations, 1954. 30.8.54 Slaughter of Animals (Prevention of Cruelty) Regulations, 1954. 1.10.54 Slaughter of Animals (Prevention of Cruelty)(No.2) Regulations, 1954. 1.12.54 Circulars issued during the year from various Ministries dealt also with official certificates under the Public Health (Imported Food) Regulations. 1937 and 1948, in respect of Spain and Hong Kong; Licensing, provision and registration of Slaughterhouses; Model Byelaws for Knackers Yards; Milk (Special Designations) Regulations; Public Health (Meat) Regulations; Public Health (Preservatives, etc., in Food) Regulations; Meat Content of Sausages; Prevention of Tuberculosis; Diphtheria Publicity Campaign; Influenza; Poliomyelitis; Housing Repairs and Rents Act; Slum Clearance; Sewerage and Sewage Disposal; Frozen Pipes; Rivers (Prevention of Pollution) Act; and Approved Oxidising and Preserving Agents. 18 STEPNEY BOROUGH COUNCIL INFORMATION SERVICE. I am indebted for the following information to the Information Officer, Mr.J.Mordsley, who administers the Service under the direction of the Borough Librarian. The past year has seen the first full year of the establishment of the Information Service at the Municipal Offices at 227/233, Commercial Road, E.l., since its transfer from 671A; Commercial Road, and during this period the number of enquiries reached a total of 11,686, an increase over the previous year. An analysis of the enquiries is given on the next page. The scope of the enquiries has remainded as varied as ever, and in general, except for one important item, the relative number of enquiries under the headings given vary little from last year. The exception to this is the heading "Rates and Rents", which shows an increase of well over a thousand, due to the coming into operation at the end of August of the Housing Repairs and Rents Act, 1954. For several months after this Act became law there was a flood of applicants seeking information and advice on the Notices of Increase they had received under the new Act, and it was quickly realised by the citizens of Stepney that the Information Bureau was the office where their queries would be dealt with authoritatively. As a result of the information and advice given, many of the Notices of Increase served on tenants were withdrawn because of errors they contained or upon which they were based. Many other tenants were referred to the Public Health Department for the issue of Certificates of Disrepair. Another outcome of the new Act brought to light the fact that many tenants of 'old controlled' properties were being overcharged on their existing rents, and as a result of the information given them the overcharges were recovered in accordance with the law and the correct rents reinstated. Many enquiries connected with the aged are brought to the Information Bureau as old age continues to produce its own problems despite the efforts made through social legislation and,voluntary organisations to provide special facilities and amenities for the more elderly of the Borough. Accommodation in Stepney remains as scarce as ever, and this brings with it numerous enquiries, included among which are those relating to the alleged overcharging for furnished 19 accommodation, disputes between tenants and sub-tenants, and between members of the same family sharing homes. A satisfactory feature of the work of the Service is the fact that those who have used it in the past rarely fail to come to it again when in need of information, and it is by this 'yardstick' that the success of the Information Service can be measured. Analysis of Enquiries, 1954. Civil Defence 3 Education, Youth Service, Clubs 413 Employment and Holiday Pay 349 Family and Personal 155 General Information 821 Health and Medical 366 Holidays, Travel, etc. 78 Housing and Accommodation 690 Income Tax 187 Legislation (Miscellaneous) 2,722 Local and Civic Information 2,840 Missing Persons 27 National Assistance and Supplementary Allowances 214 Registration 78 Rates and Rents 1,753 Service Questions and War Pensions 296 Social Insurance 537 Trading Questions and Licences 115 War Damage 10 Miscellaneous 32 Total Number of Enquiries 11,686 SWIMMING AND SLIPPER BATHS. The three swimming baths in the Borough are Council Baths. During the year the number of swims amounted to 106,602, comprising 29,049 adults and 77,553 children. The water is subjected to continuous chlorination and filtration and 20 samples were taken during the year for bacteriological analysis. The number of slipper baths taken during the year, at the four Council establishments, was 300,918, which included 7,569 attendances of Old Age Pensioners and unemployed persons, who were admitted free of charge. 20 HEALTH EDUCATION. A further means to assist in putting across health education material to the public was adopted during the year by the erection of poster frames on lamp columns in each of the street markets of the Borough, including. "Petticoat Lane" and "Mile End Waste". These frames are mainly used for the exhibition of posters dealing with food hygiene and for drawing the attention of the public to various aspects of food law, e.g. the wrapping and handling of food by retailers, the requirements of the Merchandise Marks Act as to the marking of various imported foods for sale. Assistance was given to the Director of the North East Metropolitan Regional Hospital Board's Mass X-ray Unit, not only in setting 'up the Unit, in various locations in the Borough, but also in publicity of the event. Posters were exhibited and leaflets distributed throughout the Borough during the three months in which the Unit operated in the area. The publicity helped in no small way to bring the satisfactory number of 15,188 persons to be x-rayed. The annual Diphtheria Immunisation Campaign was held in the Borough during March and April. An Exhibition Stand, supplied with Topics obtained from the Central Council for Health Education, was displayed in the entrance hall of one of the Council's Public Libraries and at two secondary grammar schools. During the year posters and leaflets on various health matters were exhibited and distributed through the media of the Council's establishments, social clubs, infant welfare centres, day nurseries, hospitals, Council's vehicles and outside notice boards. STAFF CHANGES. No staff changes took place during the year. 21 III. SANITARY CIRCUMSTANCES The Borough is divided into 11 Sanitary Inspectors' districts, and the Tables on pages 64 and 65 give summaries of inspections made and insanitary conditions remedied during the year by the District Sanitary Inspectors. New legislation which includes the Housing Repairs and Rents Act, 1954, and the Heating Appliances (Fireguards) Act, 1952, (which came fully into operation only this year), threw additional duties on the staff. No less than 1,227 Statutory Notices were served under the various Acts and Byelaws during the year, and in 127 cases legal proceedings had to be resorted to in order to enforce compliance with the Notices. Atmospheric Pollution. Last year two stations were set up in the Borough for the measurement and recording of atmospheric pollution. Each station consists of a deposit gauge which collects grit, ash, etc., and a lead peroxide instrument which measures sulphur activity. Monthly readings continued to be taken during the year and the results were forwarded to the Department of Scientific and Industrial Research. The results of the monthly readings at the Stepney stations and, for comparison, those of the.highest and lowest in London will be found in Table 5 on page 63. Twenty-five complaints of industrial smoke nuisance were received during the year, and observations kept on pranises numbered 108. Complaints received relating to Public Health Nuisances. 3,949 complaints were received in the Office during the year, but in addition numerous complaints were made directly to the District sanitary Inspectors. The number of visits made by them in investigating complaints was 8,129. Dangerous Structures. The District Surveyor of the London County Council was notified on 301 occasions of premises or parts of premises alleged to be structurally dangerous. srepair Certificates. The Housing Repairs and Rents Act, 1954, which came into force on 30th August, 1954, dealt with among other things the permission of repairs increases in respect of controlled dwellings and made other amendments to the Rent and Mortgage Interest (Restrictions ) Acts, 1920-1939. 22 Part II of the Act permits landlords who are responsible for repairs to increase rents by specified amounts, provided that certain conditions justifying increases are fulfilled, and subject to the production of evidence that repairs to values specified have been carried out on the premises during certain periods. One of the conditions is that the dwelling must be in good repair and the other that it must be reasonably suitable for occupation, regarding which a standard of fitness is set out in the Act, Provision is made for tenants who have been served with notices of increase of rent to apply to the Local Authority for certificates that either or both of the aforementioned conditions are not fulfilled. Regulations made under the Act prescribe the form of certificate of disrepair, which form must also be used for applications made under the Rent and Mortgage Interest (Restrictions) Acts, 1920-1939, where no rent increases have been made under the new Act. Provision is also made in the Act for the revocation of Disrepair Certificates on application by the landlord. The landlord is allowed, if he so wishes, to elect not to be responsible for internal decorative repairs with a consequent reduction in the permitted repairs increase. Applications made under the now Act for Certificates of Disrepair numbered 255 at the end of the year, 243 being granted, and applications received during the year for certificates under the Rent and Mortgage Interest (Restrictions) Acts amounted to 128, of which 113 wore granted. Twenty-two applications for revocation certificates were granted during the year and 21 refused. Drainage. 1,873 drains were tested with smoke and 202 were found to be defective. 6,035 visits of inspection were made to drainage works during the year, and 556 drains were cleansed or repaired and 426 constructed or reconstructed. Observations were submitted to the Borough Engineer and Surveyor on 124 plans of new drainage works. Dustbins. An appeal, lodged by an owner against the service of a notice under the Public Health (London) Act, 1936, as amended by the London County Council (General Powers) Acts, 1939 and 1951, for the provision of a dustbin, was subsequently withdrawn as the bin was supplied meantime by the tenant. Following Court decisions concerning the liability of owners or occupiers to provide dustbins, at the instance of the Metropolitan Boroughs Standing Joint Committee, legislation was promoted in the London County Council (General Powers) 23 Act, 1954, amending the law so that sanitary authorities are now authorised to serve notices for the provision of dustbins upon the owners of premises in all cases and never on the occupier. The owner has a right of appeal and the sanitary authority may, in default of the owner, provide the dustbin and take steps to recover the costs thereof. Factories. 675 inspections under the Factories Acts, 1937 & 1948, were made by the Sanitary Inspectors of the 2,905 factories on the register, and 98 Notices were served. Details will be found in Table 8 on page 66. An occupier of one factory was convicted on three summonses for failing to maintain and keep clean the sanitary accommodation provided for the employees. Hairdressers and Barbers Premises. Section 18 of the London County Council (General Powers) Act, 1954, provides that, as from a day to be appointed, and subject to certain oxomptions, no person shall carry on the business of a barber or hairdresser on any premises in the Borough unless he and the premises are registered by the Council. In addition, the Council may make byelaws for securing the cleanliness of the employees, premises and utensils. It is anticipated that this new legislation, which will affect some 115 premises in the Borough, will be brought into operation in 1955. Pleating Appliances (Fireguards) Act, 1952. The Heating Appliances (Fireguards) Act, 1952, which came into operation on 23rd March, 1953, prohibits the sale or letting on hire of gas and electric fires and oil heaters which are not fitted with effective fireguards conforming to the prescribed standards. Regulations made under the Act allowed any appliances (other than imported ones) manufactured before 1st October, 1953, to be sold or let on hire at any time up to 1st October, 1954, so that the provisions of the Act did not come into full effect until the latter date. The Regulations specify tests of efficiency to be carried out in order to ascertain whether the guards comply with the standard of construction and fitting required. Thirty-one shops and showrooms were visited during the year, and the guards on 19 electric, 4 gas and 2 oil heaters were tested. One type of gas heater failed to pass the prescribed test and the stock of such heaters was immediately withdrawn from sale and the guards modified. 24 Houses Let in Lodgings, There are approximately 762 such premises in the Borough, and 27 complaints were investigated during the year. Section 6 of the Housing Act, 1936, and Section 155 of the Public Health (London) Act, 1936, under which byelaws were made in respect of houses let in lodgings, were replaced by Sections 11 and 12 of the Housing Repairs and Rents Act, 1954. Under Section 11, local authorities may serve notices for securing fitness of houses let-in-lodgings for occupation by the number of families acconmodated, and the standards of fitness are laid down. In order to conply with a notice, the person on whom it is served may either carry out the work specified on the notice or take steps to limit the families accommodated on the premises in any manner so specified. House-to-House Inspection. House-to-house inspection of their districts was resumed by the District Sanitary Inspectors in April, and 1,042 houses, involving 1,290 visits, had been so inspected at the end of the year. Land Charges Act, 1925. The number of enquiries dealt with during the year regarding outstanding notices under the Public Health and Housing Acts, and reported to the Town Clerk, amounted to 772, which related to 2,084 properties. Licensed Premises. A survey of sanitary accommodation facilities in licensed premises in the Borough was carried out during the year. The survey revealed that, taking the minimum standard of accommodation for each premises as being one W.C. for females and one W.C. and urinal for males, 158 of the 225 licensed premises in the area fell short of the minimum standard. The Licensing Justices are aware of the problem and steps are being taken to seek the co-operation of the brewers to effect the necessary improvements in accommodation. At the request of the Licensing Justices, inspections are made of Public Houses and Off Licences when applications for grant or transfer of licences are being made under the 25 Licensing Act, 1953. The Sanitary Inspectors' reports are taken into consideration when the applications come before the Sessions. Reports on 82 premises were submitted during the year. Legal Proceedings. A summary of legal proceedings instituted during the year, showing penalties imposed, is as follows:- No. of Summonses Fines Costs Food and Drugs Act, 1938 18 £98. 5.0 £28. 4.0 Public Health (London) Act, 19 Nuisance Orders 36 112 22. 0.0 234. 6.0 Non-compliance with Nuisance Orders 10 102.15.0 21.12.0 Common Lodging House 2 (Dismissed) L.C.C. Byelaws for Protection of Food, 1952 3 7. 0.0 2.10.0 L.C.C. Byelaws for Fish Frying Premises, 1913 1 3. 0.0 2. 6.0 Factories Act, 1937 3 - 5. 5.0 149 £233. 0.0 £294. 3.0 . The Magistrates made Closing Orders, under the Public Health (London) Act, 1936, on three dwelling-houses in the Borough, application for the Orders being made by the owners. Lodging Houses - Common. There are five Common Lodging Houses in the Borough, providing accommodation for 1,111 persons, as follows:- 86, Cable Street. 8 men. 15 & 16, Calvin Street. 41 married couples. 10-22,. Johnson Street. 258 men. 177, Whitechapel Road. 535 men. Hostel for Women, Hopetown St. 328 women. Fifty-nine inspections were made during the year, including 15 inspections carried out at night. Lodging Houses - Seamen's. An application for transfer of licence to keep the pranises 9? Ensign Street, as a Seamen's Lodging House, was 26 granted during the year. There are now six such pranises in the Borough, providing accommodation for 499 seamen, as follows:- The Sailors' Home & Red Ehsign Club, Ehsign Street and Dock St. 235 seamen. The Empire Memorial Hostel, 747, Commercial Road. 190 " 5, North East Passage. 11 " 220, Cable Street. 30 " 11, Ehsign Street. 11 " 9, Ensign Street. 22 " Thirty-eight inspections were made during the year, including 22 inspections carried out at night. Noise Nuisance. Fifteen complaints received during the year of alleged noise nuisance were investigated, the necessary action being taken in those cases where nuisances-were found to exist. Notices Served. Informal notices served under the various Acts during the year were as follows:- Public Health (London) Act, 1936. Nuisance Notices 4467 Section 40 20 " 109 2 " 105 2 " 95 1 Factories Acts. 1937 & 1948 98 Shops Act, 1950 8 Byelaws for Houses in Separate Tenements London County Council (General Powers) Act, 1937 (Noise Nuisance) 1 1 London County Council (General Powers) Act, 1954 (Dustbins) 7 London County Council Seamen's Lodging House Byelaws 1 4608 Formal statutory notices served during the year amounted to 1,227. 27 Offensive Accumulation of Refuse. Accumulations of refuse in basements which were used during the war as energency water supply tanks were removed by the Borough Council, acting as agents for the County Council. Efforts continue to be made to clear up the war-damaged sites in the Borough on which refuse is deposited,, and for this purpose the powers contained in the Prevention of Damage by Pests Act, 1949, have been successfully evoked and by the application of these powers refuse has been cleared away and fenccs erected around the sites by the owners. Offensive Traders. There are now 20 offensive businesses in the Borough, and 223 inspections were made during the year. The premises at 6, Monthqpe Street and 7, Lower Hessel Street were added to the register, which now includes Tripe Boiler (1) 94, Wentworth Street. Dressers of Furskin (3) 34/38,. Brodloye Lane. *48,50,50a, 54 & 56, Old Church Road. 29, Spelman Street. Kosher Poultry Slaughterhouses (16) 28, Burslan Street. l6l, Cannon Stre.et Road. 16/18, Cobb Street. 49, Globe Road. *14, Hessel Street. *21/22, Hessel Street. 36, Hessel Street. 42, Hessel Street. 75, Hessel Street. *7, Ley don Street, 13, Leyden Street. 15, Leyden Street. *7, Lower Hessel Street. * 6, Monthope Street. 10a, Monthope Street. 82, Stepney Way. The Establishment Orders of pranises marked (*) are subject to renewal from time to time by the Council. 28 Outworkers. Forty-four inspections were made of Outworkers' premises. There are 475 premises on the register, a reduction of 78 on last year, the trades concerned being as follows:- Wearing Apparel 452 Brushes 1 Umbrellas 3 Carding etc. of Buttons 3 Christmas Crackers, etc. 7 Cardboard Boxes 7 Feather Sorting 1 Stuffed Toys 1 There were no notifications of infectious disease relating to Outworkers' premises. Firms in the Borough employing Outworkers 39 Outworkers residing in and employed by firms in the Borough 101 Outworkers residing outside the Borough employed by firms in the Borough 190 Outworkers residing in the Borough employed by firms outside the Borough 374 Pot Animals. All keepers of pet shops must be licensed by the local authority under the Pet Animals Act, 1951, and conditions to be complied with are specified with respect to accommodation, feeding, fire precautions, age of animals sold, etc. No pets may be sold in streets, except in markets at stalls or barrows, nor may they be sold to persons under 12 years of age. During the year six persons were licensed under the Act, and 16 inspections were made by the Sanitary Inspectors of the premises concerned. The Public Health Committee authorised the sending of a cautionary letter to a person for keeping an unlicensed pet shop. Pharmacy & Poisons Act, 1933, & Pharmacy & Medicines Act, 1941. One hundred 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 6 " Retention 94 172 visits were made to these premises. The Poisons List Order, 1954, made some amendments to the Poisons List. Amended Poisons Rules were also issued during the year. 29 Rag Dealers. A rag dealer and his anployee were cautioned for a contravention of the London County Council (General Powers) Act, 1952, for giving an articlc of food (toffee apple) in exchange for rags. Rag Flock 6c Other Filling Materials Act, 1951. Premises in the area registered under this Act number 17, and another is licensed. During the year 40 inspections were made of these premises, and 28 formal samples of filling materials were taken. The Analyst reported that a sample of curled feathers was found on analysis not to. comply with the prescribed standards, and the occupier of the pranises from which the sample was obtained was cautioned. Letters of warning were also sent to the occupiers of two premises one of whom was found to be using the premises as a rag flock store without the necessary licence from the Council, and the other was found to be carrying on the business of an upholsterer on unregistered premises. The Rag Flock and Other Filling Materials Regulations, 1954, which came into operation on 3rd August, 1954, made amendments to the requiranents of the impurities tests for certain types of woollen felt and to the list of prescribed Analysts. Refuse Disposal. The Public Cleansing Officer has kindly supplied the following information on refuse and salvage disposed of during the year House and Trade 34,265 tons Street and Market 8,004 " Salvages Waste Paper 44 " Scrap Iron, etc. 5 " Rodent Control. In accordance with the request of the Ministry of Agriculture and Fisheries, statistics on rodent control work carried out by the department are submitted to the Ministry covering the period 1st April, 1954, to 31st March, 1955. During this period, 10,921 dwellings and business pranises were inspected. Charges for servicing made to occupiers of business premises amounted to £874. A copy of the report furnished to the Ministry will be found on page 67. 30 By the implementation of Section 4 of the Prevention of Damage by Pests Act, 1949, it has been found possible to clear bombed sites of refuse which would otherwise act as possible harbourage for rats and other vermin. Moreover, under the same section,' which permits specified works to be carried out, it has been possible to require the sites to be fenced in by the owners. Shops. During the year 214 inspections were made under the Shops Act, 1950, and 8 notices were served in respect of sanitary accommodation. The number of premises in the Borough covered by the provisions of the Act is 2,606. Two applications were received for exemption from complying with sanitary accommodation requirements, that in respect of 41A, Brick Lane, E.1.. being granted. The application regarding 3, Wentworth Street, E.l., was not acceded to. 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 664 flats and 35 houses. Water Supply. The whole of the Borough is supplied with water by the Metropolitan Water Board, which is the authority responsible for its purity. Quantity and quality of the water supplied by the Board during the year have been satisfactory. All the premises in the Borough are supplied individually direct from public water mains, with the exception of two places 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 333, and the Metropolitan Water Board was notified on 35 occasions of premises where wastage of water was taking place. 31 During the year notices were received from the Metropolitan Water Board to the effect that the water supply frcm 6 premises had been withdrawn, in one premises for non-payment of rates and in five because of defects in the service. Wells. Bacteriological and chemical analyses of water from the 7 deep Wells in industrial use in the Borough are made periodically, and the results of such analyses are reported to this Department. Workplaces. There are known to be 365 Workplaces in the area (other than those covered by the Factories Act, 1937), and in connection therewith 7 complaints were investigated during the year. 32 IV. HOUSING The Housing Repairs and Rents Act, 1954, which received Royal Assent on 30th July, 1954, makes further provision for the clearance and redevelopment of areas of unfit housing accommodation and for securing or promoting the reconditioning and maintenance of houses. Consequential amendments were made by the new Act to the existing Housing Acts. This Act requires the Council to submit to the Minister of Housing and Local Government, within a year of its passing, proposals for dealing with all unfit property in the Borough, and with any other houses which are, or which ought to be, included in clearance areas. Clearance Areas. During the year official representations were made by the Borough Council in respect of two clearance areas, comprising 12 houses. In addition, three areas, declared by the London County Council, involving 81 houses, were confirmed by the Minister. Approximately 422 properties were demolished under the Housing Acts during the year, 400 by the London County Council and 22 by the Borough Council. Demolition Orders. Under the provisions of Section 11 of the Housing Act, 1936, 7 Demolition Orders were made during the year. If it is inexpedient to make a Demolition Order under Section 11 of the Housing Act, 1936, having regard to the effect of demolition of the house upon any other house or building, the Local Government (Miscellaneous Provisions) Act, 1953? gives power to the Council to make a Closing Order in lieu thereof. The Council may at any time revoke the Closing Order and make a Demolition Order. 4 Closing Orders were made under this provision during the year. Overcrowding. During the year, 163 cases of alleged overcrowding were investigated, 85 of which were confirmed and referred to the London County Council. 86 overcrowded families were rehoused, 69 by the London County Council and 17 by the Borough Council, and the number of known overcrowded families on the register decreased from 1172 to 1061. 33 57 visits were made to premises to ascertain "permitted Numbers", and the owners of the premises were informed. In order to prevent overcrowding, 69 inspections were made for the Governments of Cyprus and Malta of accommodation alleged to be available in the Borough for intending immigrants. Underground Rooms. There are approximately 3,535 underground rooms in the Borough used for living or sleeping purposes, about 3,415 of which are unfit. During the year 349 inspections were carried out, as a result of which 42 rooms were closed and the modified occupation of 19 rooms approved. The number of underground rooms closed since 1936 totals to date 278. Progress on closure generally is held up for lack of suitable alternative accommodation. Town and Country Planning (Housing Accommodation) Direction. Under this Order, the Borough Council is consulted by the London County Council (the Planning Authority) before applications are determined for planning permission' for development involving change of user of premises from use as a dwelling. Investigations on 48 such applications were carried out during the year. Applications for Rehousing. At the end of the year there were 5,563 applications for rehousing on the Housing Manager's register (109 less than in 1953), including 312 tenants of Council dwellings and 469 licensees of, requisitioned premises who applied for transfers. Preferential Housing on Health Grounds. Of the 116 cases investigated, 60 were recommended for rehousing: 1 to the County Council and 59 to the Borough Council. Temporary Hutments. 154 hutments owned by the Borough Council remained at the end of the year. Hutments recommended for demolition during the year because of structural deterioration numbered 21. 34 Requisitioned Pranises, The number of dwellings under requisition by the Borough Council at the end of the year was 1,584, involving 2,163 lettings. Four dwellings were recommended to the Housing Manager for derequisitioning for various reasons, and 12 basement rooms which did not comply with the regulations were recommended for closure. New Housing. During the year 699 new dwellings were completed in the Borough: 269 by the Borough Council, 426 by the County Council, and 4 by private owners (see Appendix, page 68 ). Total new permanent dwellings constructed in the Borough since the war is 4,078: 2,303 by the London CountyCouncil, 1,700 by the Stepney Borough Council, and 75 by private persons. Immigration into the Borough and Coloured Persons. From an analysis of the figures of the 1951 Census indicating the place of birth of persons, it would appear that there are probably 1,750-2,000 coloured persons in Stepney, Although many new coloured persons have arrived since then, thore is no doubt that large numbers leave Stepney and take up jobs in other districts of London and other parts of England, so that it is very doubtful if there are today in Stepney more than 2,000 coloured persons. Summary of Inspections made by the Housing Inspector, Housing Act, 1936 (Section 5) 69 " " (Section 11) 42 " " (Section 12) 11 Housing Act, 1949 (Section 20) 14 Housing Accommodation Direction 1952 53 Immigrant Enquiries - for Malta Government 31 - for Cyprus Government 38 Miscellaneous Inspections 106 Overcrowding 202 "Permitted Numbers" under Housing Act, 1936 57 Preferential Housing on health grounds 116 Premises situated in Clearance Areas 212 Requisitioned Pranises 58 Temporary Hutments 48 Underground Rooms 349 Statistics. Further Housing statistics are given on pages 69 and 70. 35 v. INSPECTION AND SUPERVISION OF FOOD Improvement has been made during the year to Stepney's industrial canteens, and in this connection, attention is drawn to the photographs facing page 37 which show the facilities provided in the kitchen of the Port of London Authority's large canteen in the London Dock. This canteen caters for dock workers throughout most of the dock areas in the district. The Food and Drugs Amendment Act received the Royal Assent on 25th November, 1954, but apart from one section, does not come into operation until a date to be appointed. Ihe Act amends the Food and Drugs Act, 1938, and the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, and regulations provided for in the Act need to be made before its full effect is made known. Included among the new Orders made during the year was the Food Standards (Margarine) Order which came into force on 16th May, 1954, and which prescribed standards for margarine concerning Vitamin A and Vitamin D content. During the year the inspectors commenced a systematic survey of the food premises in the Borough on "house-to-house" lines, and by the end of the year 283 premises had been inspected and details of construction, hygienic conditions and facilities etc. had been recorded. A summary of the visits made during the year by the Sanitary Inspectors (Food) will bo found on page 71. Bakehouses and Bakers' Shops. 284 inspections wore carried out and 38 Notices served. There are 53 bakehouses in use in the Borough, of which 8 are basement bakehouses. There are in addition 74 bakers shops. 111 cleansings of bakehouses wore carried out during the year. Proceedings wero taken against the proprietor of one bakehouse and shop in respect of dirty conditions and for exposing for sale a cake which was unfit for human food. Finos amounting to £25 and £5 costs were imposed. (A Condomnation Order had been obtained for the cake). 36 Basement Bakehouses; (Sec.54, Factories Act, 1937). At the beginning of the century when the Borough was first formed and the population was 298,600, records show that there were no less than 93 basement bakehouses in the area. Ihe condition of very many of those in Stepney and throughout the country was so bad that provision was made in the Factory and Workshop Act of 1901 to close them. Under the above Act it was made unlawful to use any underground bakehouse whenever established unless the Borough Council was satisfied that it was suitable for the purpose as regards construction, light, height, and other hygienic respects, and had given it a "certificate of suitability." This provision applies to all basement bakehouses whether wholesale or retail and the Act forbade the establishment of any new basement bakehouses. At the examination made under the Factory and Workshop Act of 1901 the then Medical Officer of Health, Dr. Daniel Thomas, recorded that he had inspected each bakehouse personally, and found many of them so structurally defective that it was impossible for the owners to remedy them. As a result he recommended the closure of 23 basement baikehouses and eventually they were duly closed by the Council. The 70 remaining ones were granted the necessary "certificates of suitability" under the Act. At the end of the 1914/18 war the latter number was found to have been reduced to 59 and at the coming into operation of the new act, the Factories Act, 1937, this number had been further reduced to 38. The powers and procedures relating to basement bakehouses under the new Act differ considerably from those in the Factory and Workshop Act of 1901. It should be noted that under the new Act (the Factories Act, 1937) no power is given to issue certificates of suitability, but basement bakehouses found to be suitable may be allowed to retain the existing certificates of suitability issued under the 1901 Act. On the other hand the Act lays down that the certificates of those bakehouses found on inspection to be unsuitable are to be revoked and the bakehouses closed, within a specified time, after notice to the owners of not less than one month. Moreover, where the certificates of bakehouses found fit are allowed to continue to operate, they do so without prejudice to their being found unfit at a subsequent quinquennial examination and closed. 37 MODERN INDUSTRIAL CANTEEN IN THE LONDON DOCKS Central gas cooking stoves with canopies and extractor fans Electric hot cabinets Examinations must be made beginning in the year 1st July, 1938, and in every fifth succeeding year. I personally carried out in the year commencing 1st July, 1938, an inspection of all the 38 basement bakehouses then in operation, and found 21unfit to retain the certificate of suitability. Owing to the war no bakehouses were closed. The first quinquennial examination occurred in the year 1943/44 when it was found that only 23 basement bakehouses remained in operation, and I reported 12 of these unfit. The Council wrote to the owners informing them that their premises were unsuitable but, because of the exceptional conditions prevailing, would not be closed. The second quinquennial examination, in 1948/49, found 11 of the twelve unfit bakehouses still unsuitable, and the Council gave the owners 3 years' notice to close them. Only one bakehouse owner appealed within the statutory period of 21 days and after a lengthy adjournment the appeal was finally heard and dismissed. Eventually all the 11 unfit bakehouses were duly closed. During the third quinquennial period in 1953/54, I made a survey of the Borough, and found that, compared with the pre-war period of 1938/39, the bakehouse position was as shown in the table below: No. of Bakehouses Population of Borough Concentration Rate of Bakehouses in the Borough. Basement Surface Total 1938/39 38 65 103 200,500 One bakehouse per 1,946 of population 1953/54 8 48 . 56 98,000 One bakehouse per 1,750 of population At the quinquennial examination of 1953/54 I reported 7 of the eight basement bakehouses as unsuitable. The Council, after considering the matter fully, including the report of a sub-ccmmittee of the Public Health Committee which also inspected the bakehouses, decided to 38 permit the existing "certificates of suitability" to remain in force without prejudice to revoking same as a result of subsequent quinquennial examinations under the Act. A list of the basement bakehouses closed so far "under the Factories Act 1937 or otherwise since 1938/39 is appended below, showing the position at each quinquennial examination except that for 1953/54 : 1938/9. 1943/4. 1948/9. 58, Burdett Road, Unfit Closed-B 111, " " Closed-B 293, " " Closed-B 192,Commercial Road. " Closed-B 336/8, " " Closed-B 72, Commercial Street. " Closed-B 71, Hessel Street. – Closed-B 32, Kingward Street. Unfit Closed-B 7, Limehouse Cswy. " Closed-B 84, Locksley Street. " Closed-B 33, St.Mark Street. " Closed-B 92, Solebay Street. " Closed-B 41, Westport Street. " Closed-B 147,White Horse Road. – Closed-B 54, Whitechapel High Street. Unfit Closed-B 81, Ben Jonson Road. " Unfit Unfit Closed-A 1952 67, Bigland Street. " " " Closed-A " 86, Cable Street. " " " Closed-A " 20, Cavell Street. " " " Closed-A " 6, Cephas Avenue. " " " Closed-A 1949 36, Christian Street. " " " Closed-A " 13, Devonport Street. " " " Closed-A 1952 32, Hermitage Wall. " " " Closed-A " 640 Mile Did Road. " " " Closed-A " 34, Now Road. " " " Closed-A " 49, Watney Street. " " " Closed-A " 43, Stainsby Road. " " CLosed-B 4, Hanbury Street. – – CLosed-B 32, Whitehorse Lane. – – Closed-B 91, Wentworth Street. – – – Closed-B 1953 57/9, Umbers ton St reel – - – Closed-B 1955 A = Closed by the Council under Sec.54, Factories Act, 1937. B = Closed for other reasons e.g. business given up, war damage, demolition etc. 39 Bacteriological Examination of Foodstuffs. Eighty-six samples were submitted for bacteriological examination, as follows; No. of Samples. Unsatisfactory Observations Pasteurised Milk 21 1 "Failed to comply with Methylene Blue test. Subsequent samples examined proved satisfactory. T.T. (Pasteurised) Milk 3 – Sterilised Milk 3 – Synthetic Cream 13 2 Both samples were manufactured outside the Borough; the M.Os.H. were notified accordingly. pineapple Juice 2 – Canned Corned Beef 3 3 Stock surrendered and destroyed. Canned Herring Fillets 2 – •t + Specimen School Dinners 2 1 Cultures of Ham from sample shewed growth of Bacillus proteus. + " " Sweets 2 – Canned Condensed Milk 1 – +Canned Broad Beans 1 – Egg Galantine 1 1 Cultures showed growth of Staphylococcus pyogenes. Beef Sandwich 1 – Chopped Ham 1 1 Cultures showed growth of Bacillus proteus. +Choese & Tcmato Spread 1 – Canned Luncheon Meat 1 – Chicken Salami 1 – +Ham,Chicken & Meat Past e 1 – Fancy Filled Fondants 1 – +Chopped Liver 1 1 Cultures showed a moderate growth of Bacillus coli (faecal type) and Bacillus proteus. +Salami Sausage 1 – Ice Cream 23 1 Grade IV. (+) Samples examined in connection with suspected food poisoning. 40 Butcher. Shops and Stalls* 429 inspections were carried out during the year and 63 Notices served. Butter and Margarine Factories and Wholesale Dealers in Margarine. * There are 33 of these premises in the Borough, and during the year 40 inspections were made. Catering Establishments (including industrial Canteens). Inspections of catering establishments in the Borough totalled 1,184 and 140 Notices were served. The proprietor of a cafe', summoned for having in his possession for sale, horseflesh for human consumption, without a notice being displayed, was fined £25 and £2,6.0 costs. Proceedings in respect of the dirty conditions at another cafe' resulted in fines totalling £20 and £5 costs being imposed. A summons taken out for failing to provide a sufficient supply of clean towels for persons employed in a canteen at a building site, resulted in a fine of £2 and £2.6.0 costs. Two further summonses were taken out against the proprietors of caf£s - one for selling milk which was deficient in fat and the other for selling hot milk which contained added water. Fines amounting to £6 with £4.12.0 costs were imposed. In addition to the above, proceedings were also instituted against a firm of bakers outside the Borough for selling a loaf of broad which was unfit for human food (the loaf contained a nail), to a canteen in the Borough. They were fined £5.5.0 with £5.5.0 costs. Cautionary Letters. On the instructions of the Public Health Committee, cautionary letters were sent in respect of the following contraventions : Selling from a stall wet fish wrapped in newsprint in such a manner that it came directly into contact with the fish 2 Falling to have name and/or address conspicuously and legibly inscribed on stall 9 Selling milk containing added water 2 41 Selling buttered rolls, the fat of which consisted of margarine or a mixture of margarine and butter . 2 Manufacturing and selling a sweet containing a piece of wire 1 Selling marshmallow cornet which contained a beetle 1 Selling minced meat to which sulphur dioxide preservative had been added 2 Selling rye loaf which contained a piece of glass 1 Manufacturing and selling buttered brazils which were deficient in butter fat 1 Export Certificates. Seventeen certificates were issued in respect of the examination of foodstuffs for export to South America, Mexico, Egypt, Sweden, France, Cuba and the U.S.A. Fish (Wet) Shops and Stalls. 298 inspections and visits were made and 48 Notices served. Greengrocers and Fruiterers Shops and Stalls. 982 inspections were carried out and 229 Notices served. Proceedings were taken against a stallholder under the L.C.C. Bye-laws for failing to have his name and address displayed on the stall, and resulted in a fine of £1. Another stallholder summoned under the Food and Drugs Act for obstructing the Inspector in the course of his duties was discharged absolutely on payment of £2.2.0 costs. Grocers and Miscellaneous Food Premises. 2,011 inspections and visits were made and 67 Notices served. Ice Cream. There are 286 registered prenises in the Borough: 29 are registered for manufacture,254 for sale, and 3 for storage only. 187 inspections were carried out and 15 Notices were served for cleansing and other requirements. 42 Twenty-three samples of ice-cream were submitted for bacteriological examination, with the following results: Manufactured Total In Borough Outside. Borough Grade I 5 14 19 (27) " II l 2 3 (11) " III - - - ( 1) " iv l - 1 (-) The figures in parenthesis show the totals for 1953. The high bacteriological standard of ice-cream samples examined has been maintained, the percentage of unsatisfactory samples having decreased from 61.1 in 1948 to the present percentage of 4.3. Licensed Premises. 207 inspections were carried out and 21 Notices served. Milk Supply. There are 296 distributors in the Borough, including 19 with dairies and 32 itinerants. During the year, 339 inspections were made and 7 notices served. Fifteen samples of milk, 14 for chemical and one for bacteriological examination, were taken in the course of delivery to hospitals and schools in the Borough. All the samples were satisfactory, and the results of the analyses were forwarded to the Hospital Management Committee and to the London County Council. Milk (Special Designations) (Pasteurised & Sterilised Milk) & (Raw Milk) Regulations, 1949-1953. 518 licences were issued during the year, including 201 for "Pasteurised" milk, 253 for "Sterilised" milk, 63 for "Tuberculin Tested" milk, and one Pasteuriser's Licence. Monthly returns of results of analyses of samples of heattreated milk are sent to the Milk Division of the Ministry of Food, who are at once notified of any unsatisfactory report. By virtue of the Milk (Special Designations) (Raw Milk) Regulations, 1949. the use of the designation "Accredited" milk ceased on 1st October, 1954. Fran that' date also, the 43 Milk (Special Designations) (Pasteurised Milk). Regulations, 1949, required all pasteurised milk ' to be put into the bottles etc. in which it is to be delivered by retail on the premises on which it is pasteurised. October 1st 1954 is also the appointed date from which it is compulsory to use overlapping caps on containers of pasteurised milk. Poultry Shops and Stalls. 521 inspections and visits were made mainly for the purpose of examining poultry exposed for sale, and 27 notices were served. One dealer, summonsed for failing to protect rough-plucked poultry from contamination by dirt, dust, etc. was fined £1 with £1.5.0 costs. Prepared Food Premises. The number of prepared food premises on the register is 166, and 424 inspections were made and 64 notices served. Proceedings were taken against the proprietors of two fish-frying establishments, one for the dirty and dilapidated condition of the premises, and the other for using for fish gutting a shed not provided with a roof. Fines totalling £23 and £7.4.0 costs were imposed in these cases. Public Health (Imported Food) Regulations. 1937-1948. Seventy-four Detention and 85 Release Notices were served under these regulations, affecting a variety of foodstuffs, including canned meats, cocoa,' sheeps casings, ground nuts, tallow, dried and canned fruits, sugar, coffee, coconut, etc. It was found necessary to serve Detention Notices on five consignments of produce which arrived unaccompanied by the official certificates. These were subsequently produced and the foodstuffs released. 44 Improvements effected at Food establishments:- Lavatory basins installed 22 Premises where hot and cold water supply installed 68 Premises where washing facilities for staff have been improved 85 Sinks provided 34 Food storage accoramodation provided 21 Refrigerators or ice-boxes installed-or repaired 12 Walls, ceilings, floors, windows cleansed 767 Floors renewed or repaired 46 Shop-fronts improved 15 Premises where ventilation provided or improved 45 Premises where natural lighting improved 16 Protective covers provided for displayed food 60 Refuse bins 145 Miscellaneous improvements 1092 Transport and Handling of Meat. 170 inspections were made of vehicles delivering meat into. the Borough from Islington Cattle Market and Smithfield Market, The vans inspected were found to be satisfactory. Unsound Food. The following quantities of unsound foodstuffs were disposed of during the year under the Public Health (Imported Food) Regulations, 1937-1948, and the Public Health (London) Act, 1936:- Premises. Tons Cwts. qrs. lbs. Wharves 64 9 2 12 London Fruit Exchange & Spitalfields Market 68 12 0 14 Railway Depots 9 10 3 4 Zeebrugge-Harwich Train Ferry (at Bishcpsgate Goods Station) – 3 0 23 Other Premises 45 2 0 9 187 17 3 6 Approximately 51/4-tons of this was allowed to be used for animal feeding purposes or for manufacturing purposes other than for human consumption, the remainder being delivered to the Public Cleasing Department where it was mixed with household refuse under the supervision of the Public Cleansing Officer, and removed by barge to a controlled tipping site in Kent. 45 Over 2,500 Condemnation Certificates were issued during the year Zeebrugge-Harwich Train Ferry. 309 special midnight or early morning and 46 other visits were made to Bishcpsgate Goods Station for the purpose of examining 6.135 trucks of foodstuffs arriving from the following countries Austria 5 trucks. Italy 5,668 trucks Belgiun 107 " Holland 5 " Cyprus 107 " 39 " Denmark 12 " Switzerland 28 " Germany 43 " Yugo Slavia 192 " Greece 34 " The weight of the foodstuffs examined was 53,581 tons, comprising fresh fruit and vegetables 51,168 tons, preserved fruit etc. 267 tons, cheese 109 tons, fish 160 tons, canned 267 meats, sausages etc. 1,290 tons, offal 140 tons, butter and lard 47 tons, eggs 32 tons, biscuits, chocolates and confectionery 72 tons, canned soup and soup powders 273 tons, fruit juices.12 tons and miscellaneous foods 71 tons. The foodstuffs found to be unsound, and which were stopped and destroyed, amounted to 3 cwts. One truck of Yugo Slavian pork arrived unaccompanied by the official certificate. The goods were detained and subsequently released on production of the certificate. Samples of Yugo Slavian salami and Italian ham sausages examined were found to be satisfactory. During October, Danish frozen pigs livers and kidneys arrived, properly certificated and in very good condition. In October, 1953? 340 cases of Yugo Slavian hollow chocolate-figures arrived. Samples taken showed that the chocolate contained 11 parts of lead per million, an excess of 6 parts per million, and action was taken to withhold the goods from sale. The importers were involved in legal proceedings with the. manufacturers and the case was heard in Belgrade. As a result the chocolate was ordered to be re-exported to Yugo Slavia, and the goods were sent back on 27th October, 1954, almost a year to the day after the goods had been sampled. Details of the number and types of Food premises in the Borough will be found in Table 13 on page 72. 46 VI. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DI SEA SES. Weather Conditions. The Meteorological Office reports that for combined dullness, wetness and coolness, 1954 was the worst year since 1941, and the worst summer since 1890, with a marked deficiency of sunshine from May to August. Following the driest winter (1953-54) since 1933-34, a dry spring preceded a dull wet summer and a mild and some times stormy late autumn and early winter. The winter generally was dry, but it was the coldest January and February since 1947. Snow occurred for 10 days in January, 7 in February and 6 in March. April, which was sunny and cool, was the driest since 1938. May was a rather wet month and June, the wettest for 40 years, was cool and dull. August was cool, dull and rather wet. September proved to be the first sunny month since April and registered the warmest day of the year at 87°F., whilst October taken as a whole was the warmest month of the year and was generally rather dry though windy, November was wet and fairly mild with few dense fogs. The year ended with an unusually mild December and from the 15th onwards rain was scarce and sunshine above average. The holiday weekends were disappointing and except for Easter which was dry and sunny though cool, Whitsun was the wettest and August the dullest since the beginning of the century. The weather on the whole was not such as to produce a serious effect on health, though the cold spell after Christmas and the disappointing holiday weather must have had its effect. Notifications. A total of 956 notifications of cases of infectious diseases were received during the year, as compared with 1,496 in 1953, the reduction being largely accounted for by fewer notifications of measles this year. 350 visits were made by the Sanitary Inspectors in connection with infectious diseases. Table 14 on page 73 shows details of notifications 47 ceived, together with age groups. The diagnosis was not confirmed in 11 of the above notifications. A. list of the diseases notifiable in the County of London is shown in Table 15 on page 74. Diphtheria. Five notifications were received, but the diagnosis was not confirmed in 4 of the cases. The number of children immunised at L.C.C. clinics was 1,858, and of these 1,386 were under five years of age. 1,239 children were given a reinforcing injection. Referring to the publicity campaign on Diphtheria prophylaxis for 1954/5 the Minister of Health remarked on the fall of the incidence of the disease. Notifications and deaths in England and Wales have fallen from 18,596 and 722, respectively, in 1945 to 182 and 9 in 1954. The Minister warned against any relaxation of efforts made to maintain immunisation against diphtheria at the highest possible level. Seventy-two swabs were forwarded by general practitioners to the Mile End Group Laboratory, where bacteriological examinations are carried out on behalf of the Borough Council. Dysentery. 118 notifications of Sonne dysentery were received during the year, as compared with 68 the previous year. Erysipelas. During the year 11 notifications were received as compared with 10 last year. Food Poisoning. Twenty-five individual cases of suspected food poisoning were notified. In 5 cases a Salmonella organism was isolated from the patients' stools, and in no case was the source of infection traced to any particular article of food. Malaria. Two cases of induced malaria were notified during the year. 48 Measles. Measles is one of the few diseases where little impression has so far been made upon incidence although modern treatment and nursing have greatly reduced the number of deaths. For instance in the years between 1901 and 1910 no less than 1,728 deaths from the disease occurred in the Borough, equivalent to an average annual rate of 5.63 per 10,000 population; in the decade 1928-1937, deaths totalling 409 reduced the rate to 1.82, and during the past 10 years, 1945-1954, there were 7 deaths, the rate being 0.07 per 10,000 population. Notifications for the year numbered 144, and there were no deaths. There were 656 cases notified in 1953. Meningococcal Infection. There were 7 notifications and 2 deaths during the year, compared with 8 notifications and 3 deaths last year. Ophthalmia Neonatorum, Of the ten cases notified, 4 belonged to Stepney. Paratyphoid Fever. One case of Paratyphoid B, type 3a, occurred in August. The patient, a married woman aged 32, and mother of four young children, ate a meat pie on the 22nd July, some 16 days before her serious illness. On or about the 25th-27th July she suffered from mild diarrhoea for three days and also vomited and had nose bleeding. On the seventh day she became more acutely ill, and her doctor tentatively diagnosed cerebrospinal meningitis and she was admitted to a fever hospital on the 9th August. On 2lst August the hospital notified the case as Paratyphoid B, having found stools positive. The patient recovered and was discharged on the 26th October. None of the patient's children ate any of the pie, nor did they become ill, and specimens taken from them on the 25th August and subsequently were negative. Specimens taken from the employees of the shop where the pie was made and sold were also negative. The Central Public Health Laboratory at Colindale, which reported the patient as being type 3a, followed up seven cases of a similar type which occurred between the the 14th17th August at Wembley, Edgware and Pinner (all possibly infected by cream cakes), but could not find any connection between them and "the Stepney patient. 49 Poliomyelitis. There were 3 confirmed cases' of poliomyelitis in the Borough. Last year there were 7 confirmed cases. Pneumonia. Of the various forms of pneumonia, only acute primary and acute influenzal are notifiable. 64 cases were notified during the year, compared. with 78 last year. Puerperal Pyrexia. \ There were 163 notifications during the year, campared with 98 in 1953. ' Of the 163 cases notified, 66 were residents of the Borough. Scabies. Scabies is still notifiable under the County of London (Scabies) Regulations, 1943. The number of cases formally notified was 29, compared with 22 last year. Seventy-six scabies patients were treated by medicinal baths at Branch Road Treatment Centre, and their clothing disinfested, viz.:- Males Females Children Total 27 26 23 76 The number of baths given amounted to 107 during the year. Scarlet Fever. There were 61 cases notified, being 14 less than last year. 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. Frequent notifications are received from Port and "airport" authorities of persons coming into the Borough who may have been in contact with smallpox. Observation for the necessary period is kept on such persons by officers of the Public Health Department. . 50 The number of children successfully vaccinated or revaccinated at L.C.C. clinics during the year was 623. A supply of vaccine is kept in the Department for emergency use. Tuberculosis. The number of primary notifications of pulmonary tuberculosis received was 160, compared with 167 last year, and the number of nan-pulmonary cases was 23 as compared with 13 in 1953. The mortality rate for the year of pulmonary tuberculosis is 30, and of non-pulmonary 6.0 per 100,000 population, as compared with 39 and 4.0 respectively in 1953. (For details of register and of notifications see page 75). Public Health (Prevention of Tuberculosis) Regulations, 1925. These regulations provide that persons suffering from tuberculosis of the respiratory tract shall not be employed in the handling of milk or milk receptacles. Power is given to the Council to cause such persons to discontinue their employment. It was not found necessary to take action under the regulations during the year. Tuberculosis - Mass X-Ray Survey. During the year the Public Health Department assisted in setting up a mass X-ray unit, under the control of the North East Metropolitan Regional Hospital Board, in fourteen centres in the Borough, and the number of persons examined, which included employees of firms in the Borough and Council employees, as well as members of the public, was 15,188. Thirty-two persons were found to be suffering from active Pulmonary Tuberculosis, equivalent to an incidence rate of 2.10 per 1,000 persons examined. The corresponding rate in 1951, when the Unit last visited the Borough, was 2.84. Other conditions, including a number of cases of cancer of the lung, were discovered. Among the interesting abnormal conditions found was one case of dextra-cardia, where the individual concerned had the internal organs of the body transposed, so that the heart was on the right side and the liver on the left side, etc. This condition does not in any way affect health. A summary of the analysis of the results is as follows:- 51 Examinations. Male Female TOTAL Total,number of persons X-rayed 9702 5486 15188 Number recalled for large films 457 224 681 Number failing to attend for large films 10 6 16 Number failing to attend for investigation 5 – 5 Number failing to attend chest clinic 3 1 4 Abnormalities Discovered. Cases of active Pulmonary Tuberculosis 20 12 32 Cases of inactive Pulmonary Tuberculosis 128 54 182 Cases of Bronchial Carcinoma 13 1 14 Other Abnormalities 51 28 79 Incidence Rate per 1000 Persons Examined. Active Pulmonary Tuberculosis 2.06 2.18 2.10 Bronchial Carcinoma 1.34 0.18 0.92 Other Abnormalities 5.25 5.12 5.19 Tuberculosis Care Committee. The Tuberculosis Care Committee, on 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. Extra nourishment was given to 176 patients in the year through the L.C.C. Extra Nourishment Scheme and 35 patients went for recuperative convalescent holidays. Help was also given during the year to 81 persons by way of clothing, extra nourishment, provision of laundry, bedding, holiday expenses, rent, wireless licences and fares to relatives to visit patients in sanatoria. 62 patients were referred to the National Assistance Board and to voluntary societies for help with clothing and miscellaneous items. The annual Christmas Seal Sale Fund amounted to £277. 52 Whooping Cough. 127 cases were notified during the year, the figure for 1953 being 249. There were no deaths from the disease. 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, 1948, 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. Authentication of International Certificates of Vaccination and Inoculation A person proceeding abroad is required in certain countries to produce a certificate of recent successful vaccination and inoculation. The signatures on 249 such certificates were verified by me during the year as those of medical practitioners practising in Stepney, and the certificates were endorsed accordingly. Disinfection. 221 premises were disinfected because of infectious disease, of which nine were for pulmonary tuberculosis. 59,753 articles of clothing and bedding were steain disinfected, including 45,985 articles for export, for which 82 certificates were issued. Formaldehyde disinfection of 363,515 articles of clothing for export was also carried out during the year, for which 322 certificates were issued. Charges for export and other disinfections carried out amounted to £493. Disinfestation (Bod hugs and other insect pests). The following is a summary of work carried out by the specialist inspectors:- 53 General inspections for vermin 1,201 Attempted visits 275 No. of premises found verminous 217 No. of re-visits 437 No. of miscellaneous visits 846 No. of. premises sprayed 641 No. of rooms sprayed 1441+ (+) Including 112 rooms dealt with at the request of District 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. The furniture and effects of 393 such families were treated during the year. Major structural works were carried out to the river wall at the Disinfestation Station from July 1954 to April 1955. During this period it was necessary to make special provisions for carrying out disinfestation by cyanide. In addition, disinfestation by steam and formaldehyde was carried out on 34 occasions during the year of the furniture and effects of families rehoused by the London County Council. Many treatments were also carried out for infestations of cockroaches, beetles, ants, silverfish and the like. Verminous Persons. The number of lice infested persons bathed and whose clothing was disinfested at Branch Road Cleansing Station was as follows:- Males Females Children Total 419 25 4 448 The number of baths and treatments given amounted to 463. 54 SOMMARY OF PUBLIC ANALST'S QUARTERLY REPORTS for" the year 1954 During the year 299 samples were submitted for analysis, 141 being purchased formally and 158 informally. The samples are classified as follows:- 10 Alcoholic Spirits 2 Arrowroot 2 Baking Powder 1 Beef Steak 1 Brine 17 Butter, Margarine, Cooking Fat and Suet 6 Buttered Rolls 1 Cake Mixture 3 Cheese and Cheese Spread 1 Chicken Salami 4 Cocoa 3 Coffee and Chicory Essence 1 Custard Powder 1 Doughnuts 4 Dried Fruits 4 Fish Paste 5 Fish and Canned Fish 10 Fruit and Fruit Juice 10 Fruit Squashes 2 Glauber's Salts 2 Glycerin 3 Ground Ginger 5 Horseflesh 8 Ice Cream 1 Jam 2 Jellied Eels 2 Jelly 2 Lemon, Glycerin and Honey 3 Lemonade Powder and Sherbet 1 Marzipan 2 Meat Pies and Puddings (canned) 17 Meat (minced) 8 Meat (potted and canned) 4 Meat Paste 87 Milk 1 Non-brewed Condiment 4 Oranges 1 Pork Liver 37 Sausages (raw and cooked) 3 Soup and Canned Soup 1 Soup Tablets 16 Sweets and Chewing Gum 1 Zinc Ointment 55 Of these 299 samples 21, or 7.0 per cent, were adulterated, details of which follow:- Article Formal or Informal Nature of Irregularity Remarks Hot Milk. Formal 7% added Water. Fined £5 with £2.6.0 Costs. Hot Milk. Formal 1% Water added. Cautioned. Milk. Formal 40% deficient in Fat. Fined £5 with £2.6.0 Costs. Buttered Rolls. Formal Contained Margarine, Cautioned. Buttered Rolls. Formal Contained a mixture of Butter and Margarine. Cautioned. Oranges. (2 samples) Informal 20 parts per million Thiourea. Ministry of Food informed. Oranges. Informal 25 p.p.m.Thiourea. Do. Milk. Formal 4.7$ added Water. Cautioned. Minced Beef. Formal Sulphur dioxide 5100 p.p.m. Cautioned, Minced Beef. Formal Sulphur dioxide 2100 p.p.m. Cautioned. Canned Chopped Pork. Informal Contained 3% starchy matter not disclosed on label. Taken under Public Health (Imported Food ) Regulations. Labelling Order not applicable . as not for retail sale. Buttered Brazils. Formal 12.5% deficient in Butter Fat. Cautioned. Pineapple Flavoured Milk. Informal Misleading description. Sale discontinued, Producers considering alterations to wording of label. (Contd.) 56 (Contd. ) Article Formal or Informal Nature of Irregularity Remarks Minced Meat. Informal Sulphur dioxide 1600 parts per million. Formal sample to be obtainted. Canned. Cherries. (4 samples) Informal Odour of Hydrogen sulphide and objectionable taste. Samples taken under Public Health (Imported Food; Regulations - detained at Wharf. Minced Meat. Informal Sulphur dioxide 1600 parts per million. Formal sample taken Genuine. Buttered Brazils. Informal 6% deficient in Butter Fat. Manufacturer advised: Further samples will be taken. Ice Cream. 8 samples were examined chemically, and all were found to be satisfactory. The Methylene Blue Test of 23 samples of Ice Cream resulted in one being classed as Grade IV and none as Grade III. Milk. 87 samples were examined during the year, the average composition of the samples being 3.50 per cent Fat and 8.56 per cent Solids other than Fat. The average composition of milk samples taken over the past 10 years is as follows:- Year No. Samples Examined. Fat, per cent. Solids-not-Fat, per cent. 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 1952 307 3.55 8.72 1953 201 3.54 8.72 1954 87 3.50 8.56 57 APPENDIX 0F STATISTICAL TABLES 58 Table 1. TOTAL DEATHS BY CAUSE AMD AGE OF STEPNEY RESIDENTS - 1954 (Registrar-General's Return) CAUSES OF DEATH ALL AGES Age Groups Total M F -1 1- 5- 15- 25- 45- 65- 75- 1. Tuberculosis - Respiratory 30 27 3 - - - - 4 15 10 1 2. " - Other 6 3 3 - 1 - 4 - 1 - - 3. Syphilitic Disease 10 4 6 - - - - - 2 7 1 4. Diphtheria - - - - - - - - - - - 5. Whooping Cough - - - - - - - - - - - 6. Meningococcal Infection 2 1 1 - 2 - - - - - - 7. Acute Poliomyelitis - - - - - - - - - - - 8. Measles - - - - - - - - - - - 9. Other Infective and Parasitic Diseases - - - - - - - - - - - 10. Malignant Neoplasm - Stomach 37 23 14 - - - - 4 13 8 12 11 " - Lung, Bronchus 52 44 8 - - - - 1 24 18 9 12. " - Breast 15 - 15 - - - - 3 7 4 1 13. " - Uterus 5 - 5 - - - - - 4 1 - 14. " - Other 145 82 63 - - 2 - 8 57 54 24 15. Leukaemia, Aleukaemia 7 3 4 - - 1 1 1 1 2 1 16. Diabetes 9 2 7 - - - - - 5 2 2 17. Vascular Lesions of Nervous System 104 52 52 - - - - 1 18 38 47 18. Coronary Disease, Angina 151 97 54 - - - - 4 57 41 49 19. Hypertension with Heart Disease 35 16 19 - - - - - 1 13 21 20. Other Heart Disease 102 49 53 - - - - 3 26 21 52 59 Table 1 (contd.) CAUSES OF DEATH ALL AGES. Age Groups Total M F -1 1- 5- 15- 25- 45- 65- 75- 21. Other Circulatory Diseases 61 37 24 - - - - 2 8 25 26 1 1 - - - - - - 1 - - 23. Pneumonia 62 39 23 3 - - - - 10 18 31 24. Bronchitis 89 73 16 - - - - 1 16 33 39 25. Other Diseases of Respiratory System 22 15 7 - 1 - - 2 7 3 9 26. Ulcer of Stomach and Duodenum 16 12 4 - - - - 1 5 6 4 27. Gastritis, Enteritis and Diarrhoea 4 2 2 1 - - - - - 2 1 28. Nephritis and Nephrosis 10 4 6 - - - 2 3 2 1 2 29. Hyperplasia of Prostate 13 13 - - - - - - - 4 9 30. Pregnancy, childbirth, abortion 1 - 1 - - - - 1 - - - 31. Congenital malformations 8 4 4 7 1 - - - - - - 32. Other defined' and ill-defined diseases 84 48 36 29 1 - 1 3 19 17 14 33. Motor vehicle accidents 10 6 4 - - 1 1 5 1 1 1 34. All other accidents 22 17 5 1 1 3 1 3 7 2 4 35. Suicide 13 9 4 - - - - 6 6 - 1 36. Homicide and operations of war - - - - - - - - - - - Males 683 - 26 4 6 6 33 189 213 206 Females - 443 15 3 1 4 23 124 118 155 . GRAND TOTAL: 1126 41 7 7 10 56 313 331 361 60 (*)Figures ill parenthesis denote deaths in 1953. Table 3. Comparative Table showing Deaths of Infants at Various Ages under 1 year. YEAR Under 24 Hours 1-6 Days 1-4 Weeks Total under 4 weeks 1-12 Months Total under 1- year Percentage Deaths under 4 weeks of Total Infant Deaths 1951 10 13 5 28 12 40 70 1952 6 16 2 24 11 35 68 1953 18 11 7 36 38 74 49 1954 17 11 4 32 9 41 78 6l Table 2. INFANT MORTALITY. 1954 Deaths from stated causes at various ages under 1 year. (Compiled from Local Death Returns) CAUSES OF DEATH AGE PERIODS TOTAL DEATHS UNDER 1 YEAR PERCENT OF TOTAL. Under 24 hours 1-6 days. V/eeks T.otal under 4 wks . Months 1- 2- 3- 1- 4- 7- 10- Whooping Cough - - - - - - - - - - - (1)* - Measles - - - - - - - - - - - (1) - Pneumonia - - - - - - 1 2 - - 3 (7) 7.32 Gastritis, enteritis, &c. - - - - - - 1 - - - 1 (9) 2.44 Congenital Malformations 3 4 2 1 - 10 2 1 - - 13(12) 31.70 Premature Birth 12 6 1 - - 19 1 - - - 20(17) 48.78 Birth injuries 1 - - - - 1 - - - - 1 (1) 2.44 Atelectasis 1 1 - - - 2 - - - - 2 (4) 4.88] Overlying - - - - - - - - - - - (1) - Accidental smothering - - - - - - - 1 - - 1 (-) 2.44 TOTAIS : . 17 11 3 1 - 32 5 4 - - 41 100.00 Table 4. COMPARATIVE VITAL STATISTICS. Year Population Live Births Deaths Deaths under 1 Year Maternal Deaths Cancer Deaths Tuberculosis Deaths (all forms) No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate 1901 298,600 11052 37.0 6217 20.8 1817 165 17 1.5 211 0.7 865 2.8 1911 279,560 8464 30.2 4854 17.3 1261 148 24 2.8 236 0.8 647 2.3 1921 249,657 6169 24.7 3244 12.9 550 89 10 1.6 263 1.0 346 1.3 1931 225,238 4010 17.8 2958 13.1 313 78 9 2.1 342 1.5 254 1.1 1938 200,500 2619 13.0 2217 11.0 163 62 6 2.2 343 1.7 128 0.6 1939 197,200 2466 12.5 2213 12.0 127 53 8 3.3 319 1.6 148 0.7 1940 136,030 2144 15.7 2729 20.0 86 43 5 2.3 292 2.1 147 1.0 1941 74,780 1164 15.5 1883 25.1 64 79 3 3.5 203 2.7 145 1.9 1942 71,980 1271 17.6 1243 17.2 66 52 3.7 171 2.3 85 1.8 1943 72,920 1371 18.8 1368 18.7 73 53 3 2.1 188 2.5 107 1.4 1944 73,030 1306 17.8 1425 19.5 77 56 0 0.0 185 2.5 96 1.3 1945 77,610 1442 18.5 1469 18.9 81 56 4 2.6 201 2.5 110 1.4 1946 94,800 2147 22.6 1399 14.7 110 51 4 1.8 198 2.1 81 0.8 1947 100,020 2184 21.8 1419 14.1 82 37 2 0.8 229 2.2 99 0.9 1948 99,470 2077 20.2 1228 12.3 59 28 0 0.0 239 2.3 75 0.7 1949 100,550 1830 18.1 1339 13.3 59 32 l 0.5 255 2.5 71 0.7 1950 99,730 1845 18.5 1255 12.5 49 26 2 1.0 244 2.4 56 0.5 1951 98,581 1846 18.7 1364 13.8 39 21 0 0.0 232 2.3 49 0.4 1952 99,000 1894 19.1 1371 13.8 35 18 6 3.0 241 2.4 50 0.5 1953 98,570 1919 19.5 1187 12.0 75 39 1 0.5 237 2.4 43 0.4 1954 97,900 1851 18.9 1126 11.5 41 22 1 o.5 261 2.6 36 0.3 62 63 Table 5. atmospheric pollution SUMMARY OF MONTHLY READINGS AT TWO STATIONS IN the BOROUGH OF IMPURE TEES DEPOSITED DURING 1954, TOGETHER WITH THE HIGHEST AND LOWEST READINGS IN THE COUNTY. Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec INSOLUBLE MATTER DEPOSITED (Tons per square mile) St. George's Town Hall 13.54 14.01 11.90 8.14 13.54 7.54 15.77 9.10 9.91 * 12.44 9.41 London Jewish Hosp. 11.28 16.51 12.62 8.56 11.75 9.43 7.45 9.60 9.26 8.29 11.44 11.11 Highest in London ≠ 92.72 92.32 40.57 39.36 38.05 23.49 65.35 25.88 34.24 79.87 79.24 110.14 Lowest in London 4.01 6.95 6.03 2.16 6.37 3.80 2.26 3.41 2.53 2.13 3.11 2.82 SOLUBLE MATTER DEPOSITED (Tons per square mile) St.George's Town Hall 7.37 12.34 7.74 4.43 10.67 10.70 6.64 10.71 9.70 * 13.71 7.00 London Jewish Hosp. : 9.53 13.73 9.83 4.13 9.66 11.21 4.23 8.35 7.48 12.32 15.34 8.22 Highest in London 30.46 50.44 37.55 9.91 24.09 18.29 16.54 22.04 22.85 26.15 42.25 35.06 Lowest in London 3.51 5.30 4.70 1.77 4.90 4.39 2.20 3.82 2.92 2.80 7.23 3.61 SULPHUR TRIOXIDE COLLECTED (Mg. per day per 100.sq. cm, of lead peroxide) St.George's Town Hall 4.31 3.96 2.26 2.77 2.21 1.37 1.56 1.59 1.72 1.78 3.37 4.27 London Jewish Hosp. 4.84 5.33 3.24 2.93 2.66 1.56 1.84 1.98 2.08 2.79 5.33 5.08 Highest in London . 7.89 8.40 7.90 5.94 4.21 5.45 7.81 6.06 9.03 10.67 9.94 7.37 Lowest in London 1.23 1.39 1.34 0.99 0.57 0.46 0.32 0.42 0.32 0.52 0.68 1.07 ≠ Excluding abnormally high readings at one Station. * No reading. Table 6. SUMMARY OF INSPECTIONS, VISITS AND ACTION-TAKEN BY DISTRICT SANITARY INSPECTORS DURING THE YEAR Complaints 8,129 Drainage 6,035 House-to-House 1,290 Houses-Let-in-lodgings 27 Infectious Diseases and Contacts 350 Common Lodging Houses 59* Seamen's Lodging Houses 38 Markets (Weekend) 35 Heating Appliances (Fireguards) Act, 1952 35 Offensive Trades 223 Pet Animals Act, 1951 16 Pharmacy & Poisons Act, 1933 172 Rag Flock Act, 1951 40 Housing Repairs and Rents Act, 1954 and Rent & Mortgage Interest (Restrictions) Acts. 1920-39 447 Shops Act, 1950 214 Smoke Nuisances — Observations 108 Factories - Mechanical 603 Non-mechanical 40 Other 32 Outworkers premises 44 Workplaces 7 Miscellaneous Visits and Inspections 3,215 Re-visits 7,377 Attempted Visits 3,494 Total Visits and Inspections 32,030 Intimation Notice's served:- On County and Borough Council Housing Departments 569 On Owners 4,042 Statutory Notices served 1,227 Legal Proceedings taken 127 *Including 8 visits to Women's Common Lodging House by the Woman Sanitary Inspector. 64 Table 7. SUMMARY OF WORK CARRIED OUT UNDER THE SUPERVISION OF DISTRICT SANITARY INSPECTORS DURING THE YEAR Dampness in rooms remedied 2,818 Premises where - New drains constructed 409 Drains reconstructed 17 Existing drains repaired 174 Drain obstructions cleared 382 Dustbins provided 234 Dwelling-rooms, passages and staircase walls and ceilings cleansed or repaired 2,270 Factories - New W.C.s provided 19 Sanitary accommodation repaired 83 Other defects remedied 141 Floors repaired 613 Fireplaces and coppers repaired or renewed 519 Gullies, manholes, provided or repaired 289 Light and ventilation improved or provided to rooms and staircases 17 Roofs, gutters, rainwater pipes, renewed or repaired 1,475 Rubbish accumulations removed 195 Sinks, baths and lavatory basins fitted 1,220 Soil and vent pipes provided or repaired 163 Staircases - Treads, etc., repaired 133 Ventilation (under-floor) provided to rooms 4 Verminous rooms disinfested 112 Waste pipes provided or repaired 663 Water Closets and Urinals - New provided 375 Compartments cleanSed, repaired 415 Obstructions cleared 83 Flush apparatus repaired 362 Pans and traps fixed 359 Water Supply - Cisterns cleansed, repaired 14 Defective supply or fittings remedied 319 Windows repaired 1,397 Yards, areas, cleansed, or paving repaired 109 Miscellaneous Repairs 506 15,889 65 Table 8. 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 279 40 4 Factories with mechanical power 2,555 603 93 Other promises under the Acts (building operations and works of engineering construction) 71 32 1 Total: 2,905 675 98 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars Found , , . Remedied r Referred - to H.M. Inspector by H.M. Inspector Want of cleanliness 25 25 - 5 Overcrowding - - - - Unreasonable temperature - - - - Inadequate ventilation - - - Ineffective drainage Of floors 1 1 - - Sanitary Conveniences (a) Insufficient 9 9 - 3 (b) Unsuitable or defective 44 44 mm 31 (c) Not separate for sexes 40 40 - 17 Other offences against the Acts (not including those relating to Outwork) 21 21 10 - TOTAL: 140 140 10 56 3. PROSECUTIONS. During the year the occupier of a factory was convicted on 3 summonses for failing to maintain and keep clean the male and female sanitary accommodation provided for the employees. 66 Table 9. RODENT CONTROL (Period 1st April 1954 - 31st March 1955) Council Property Dwelling Houses Business Premises TOTAL Total Properties in Area 56 25,901 12,466 38,423 No. Properties inspected as result of (a) Notification 3 1,143 407 1,553 (b) Survey under the Act 5 6,815 2,548 9,368 No. Properties inspected which were found to be.infested by (a) Rats - Major l 1 3 5 Minor 5 681 284 970 (b) Mice - Major 1 169 155 325 Minor 2 925 181 1,108 No, infested properties treated by Local Authority 7 1,706 368 2,081 No. Sec.4 Notices served: (i) Treatment - - - - (ii) Structural works - 2 1 3 No. cases where default action taken following Sec. 4 Notice - - - - Legal Proceedings - - - - No. "block" control schemes carried out Nil, Sewers - "Maintenance Treatments". I am informed by the Borough Engineer and Surveyor that two treatments for the destruction of rats in sewers were carried out during the year, viz. from 14th June to 16th September, 1954, and from 29th November, 1954, to 11th February, 1955. 1,466 manholes were treated during the first period, and 1,471 during the second period, the estimated number of rats destroyed being 15,280 and 15,560, respectively. 67 Table 10. DWELLINGS ERECTED DURING 1954 Address NO. or Dwellings (-a) By Borough Council. Addis House 8 Callahan Cot images 14 Colverson House 60 Erlich Cottages 6 Hughes Mansions 19 Newton House 55 Pemell House 40 Richard Neale House 51 Rickman House 16 269 (b ) By London County Council. Bantry House 24 Bladen House 12 Bowry House 31 Charlesworth House 30 Dowler House 6 Fitzroy House 32 Galveston House 60 Gurdon House 14 / Hawke House 23 Landin House 25 Limborough House 44 Machin House 14 Magellan House. 23 Monteath House 14 Printon House 30 Sims House 30 white Horse Lane 14 426 (c) Other. Flats over 524/8, Commercial Road 3 John Knox Church Manse, Dampsey Street 1 4. Total; 699 68 Table 11. HOUSING STATISTICS I. Inspection of dwelling-houses during the year:- (l)(a) Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 6,154 (b) Inspections made for the purpose 22,376 (2)(a) Dwelling-houses inspected and recorded under Housing Consolidated Regulations, l925 57 (b) Inspections made for. the purpose 64 (3) Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 30 (4) Dwelling-houses found not to be in all respects reasonably fit for habitation 3,399 II. Remedy of defects during the year without service of Formal Noticess- Dwelling -houses rendered fit in consequence of informal action by the Local Authority or their officers 2,601 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 798 (2) Dwelling-houses in which defects were remedied after service of Formal Notices:- (i) By Owners 798 (ii) By Local Authority in default of Owners Nil 69 Table 11 (Contd. ) (c) Proceedings under Sections 11 and 13 of Housing Act, 1936:- (i) Dwelling-houses in respect of which Demolition Orders were made 7 (ii ) Dwelling-houses demolished in pursuance of Demolition Orders 6 (d) Proceedings under Section 12 of Housing Act, 1936:- (i) Separate tenements or underground rooms in respect of which Closing Orders were made 51 (ii ) Closing Orders determined, the tenements or room's having been rendered fit nil (e) Proceedings under Section 25 of Housing Act, 1936:- (i) Wo. of houses included by representation by Medical Officer of Health 14 (ii) No. of houses demolished in pursuance of representations 12 (f) Proceedings under Section 10 of Local Government (Miscellaneous Provisions) Act, 1953:- (i) Closing Orders made 4 (ii) Closing Orders determined nil IV. Housing Act, Part IV. - Overcrowding:- (i) Ho. of overcrowded families on register at beginning of year 1,172 (ii) Ho. of new cases encountered during year 85 (iii ) No. of cases relieved during the year 196 (iv) Ho. of overcrowded families on register at end of year 1,061 70 Table 12. SUMMARY OF INSPECTIONS & VISITS BY THE SPECIALIST INSPECTORS ENGAGED IN THE SUPERVISION AND INSPECTION OF FOOD 1. Visits to Premises Bakehouses (above ground) 222 " (basement) 62 Butcher and Bacon shops and stalls 429 Butter and Margarine premises 40 Fish vendors 298 Grocery and Provision shops 962 Greengrocers and Fruit vendors 982 Ice Cream vendors 187 Milk shops 339 Poultry vendors 521 Public Houses 207 Restaurants, Canteens and Snack Bars 1184 Railway Depots 372* Wharves 635 Registered Preserved Food premises (not included elsewhere) 424 Miscellaneous Visits 1049 Re-visits (not included above) 1203 9,116 2. Reason for Visit Food and Drugs Act (Section 13) 3153 London County Council Clean Food Byelaws 2969 Surrender of Unsound Food 726 Merchandise Marks Acts 503 Agricultural Produce Grading & Marking Acts 45 Labelling of Food Orders 194 Food Standards Orders 134 Sampling 380 Byelaws; Fish Curer and Fish Vendor 90 Public Health Meat Regulations 225 Complaints 170 8,589 3. Action Taken No. of Legal-Proceedings taken 22 " Notices served 721 " Samples taken 404 (*) Includes 309 special night or early morning inspections at Bishopsgate Goods Station. 71 72 Table 13. Type and Number of Food Premises in the Borough Premises registered under more than one category. Bakers Shops Butter & Marg. Factories Restaurants, Cafes. &c. Canteens, &c. Chemists Confectioners Fish Shops Fruit & Vegetables Grocers (Retail) Grocers (Wholesale) Ice Cream Milkshops Poultry Prepared Food Wholesale Marg. Dealers Type of Premises Number, Bakehouses (Basement) 8 4. - - - - - - - - - - - - - - " (Grd.level) 45 45 - - - - - - - - - - - - - - Bakers Shops 25 25 - 3 - - 1 - - 1 - 5 3 - - - Butter & Margarine Factories 2 - 2 - - - - - - - - - - - - - Butcher Shops 123 - - - - - - - - - - - - 119 92 - Cafes,Restaurants,&c. 342 - - 342 - - 9 - 4 5 - 64 9 - - - Canteens(incl.Clubs, Sch.Meal Centres .&c.) 270 - - - 270 - - - - - - 2 - - - - Chemists. Druggists 40 - - - 1 40 3 - - - - 1 - - - - Confectioners 220 - - - 2 - 220 - 2 - - l50 - — - - Fish Shops 151 - - 10 - - - 151 - 1 — —- - - 42 - Fruit & Vegetable Shops . 549 - - - - - - 2 549 — - - - 1 - - Grocers (Retail) 335 - - 10 - - 120 2 5 335 - 75 244 - — 3 " (Wholesale) 54 - 2 - 7 1 2 - 1 - 54 1 3 - 1 25 Ice Cream Premises 6 - - - - - - - - - - 6 - - - - Milkshops 5 - - - - - - - - - - - 5 — - — Public Houses 278 - - 211 - - - - - - - 1 - - - — Poultry Dealers 99 - - - - - - - - - - - - 99 - - Prepared Food Premises 31 - - - 1 - - - - - - - - - 31 - Miscellaneous (Wharves, &c.) 152 - - — 18 - - - - - 1 - - - - 1 i 2735 74 4 576 299 41 356 155 561 342 55 305 264 219 166 29 73 Table 14. NOTIFIABLE DISEASES NOTIFIED.DURING THE YEAR 1954 DISEASE CASES NOTIFIED. In Age Groups Notifications Corrected Total Admitted Hospital -1 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- 65— Diphtheria - - - 1 1 1 - 1 1 — - - 5 1 5 Dysentery 7 19 20 19 6 22 5 1 6 4 6 3 118 117 49 Erysipelas - - - - - - - 1 1 2 5 2 11 11 3 Food Poisoning 1 2 1 3 - - 3 2 5 6 2 - 25 23 4 Malaria - - - - - - - - 1 1 - - 2 2 1 Measles 9 28 20 27 21 37 1 - 1 - - - 144 144 10 Mening. Infection 3 2 - 1 - - - -. l - - - 7 6 7 Ophth. Neonatorum 10 - - - - - - - - - - - 10 10 9 Pneumonia 4 1 - 1 1 2 1 2 4 6 23 19 64 65 6 Ac.PoliomyelitisParalytic - - 1 - - - - - 1 1 - -- 3 3 3 Non-paralytic - - - - - - - - - 1 - - 1 - - Ac.Encephalitis Infective - - - 1 - 1 - - - - - - 2 2 2 Puerperal Pyrexia - - - - - - - 19 130 14 - - 163 163 163 Scarlet Fever - - 8 7 11 29 3 - 2 - 1 - 61 60 8 Enteric Fever - - - - - - - - 1 - - - 1 1 1 Whooping Cough 14 18 17 21 19 36 1 - 1 - - - 127 125 10 Tuberculosis Pulmonary 1 2 - 1 2 7 5 14 56 26 34 12 160 160 - Non-Pulmonary - 1 1 - - 3 1 2 8 2 5 - 23 23 - Scabies 1 3 1 - 1 2 1 1 12 2 4 1 29 29 - TOTALS: 50 76 69 82 62 140 21 43 231 65 80 37 956 945 281 There were no notifications of Smallpox, Membranous Croup or Acute Encephalitis (Post Infectious). Table 15 • DISEASES NOTIFIABLE IN LONDON Disease Authority for Notification Acute Encephalitis. P.H.Act. 1936 (S.143), SI. 1949/2259. Ac. Influenzal pneumonia " SI.1953/299. Ac, Primary pneumonia. " SI.1953/299. Ac. poliomyelitis. " SI.1949/2259. Anthrax, L.C.C. Order, 1909. P.H.(L)Act, 1936 (S.192 & 304). Chicken Pox. (Notifiable in Port of London only) Cholera. P.H.(L) Act, 1936 (S.192 & 305). Continued Fever. " " " Diphtheria. " " " Dysentery. P.H.Act, 1936(S.143), SI.1953/299. Enteric Fever (incl. P.H.(L) Act, 1936 (S.192 & 304), Typhoid & Paratyphoid). S1.1953/299, Erysipelas. P.H.(L) Act, 1936 (S.192 & 304). Food Poisoning. F.&.D.Act,193°(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. Leprosy. - P.-H.Act." 1936(S .143),SI. 1951/1036. Malaria. „ SI.1953/299. Measles. " SRO.1938/1100, SRO . 1940/205 & S-1.1948/420. Membranous Croup. P.H.(L) Act, 1936 (S.192 & 304), Meningococcal Infection. P.H.Act, 1936(S.143),SI.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.H.Act,1936(S.143). LGB.Regs.1900, Puerperal Pyrexia. " si.1951/1081, SI.1954/1691, 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). Smallpox. 11 n Tuberculosis. P.H.Act,1936(S.143), SI.1952/704. Typhus Fever. P.H.(L)Act,1936 (S.192 & 304). Whooping Cough, P.H.Act,1936(S.143), SRO.1938/1100, 1940/205 and S1.1948/420, Yellow Fever. (Notifiable-in Port of London only) Zymotic Enteritis (Notifiable in 9 Metropolitan or Summer Diarrhoea. Boroughs only - not notifiable- in Stepney.) 74 Table 16. TUBERCULOSIS - New Cases and Deaths New Cases. 169 Pulmonary cases wore notified and included 160 primary notifications md 9 from death returns. 24 Non-Pulmonary cases were notified and included 23 primary notifications and 1 from death returns. Deaths.(*) 28 Pulmonary, 6 Non-Pulmonary. Age Distribution of new cases and deaths is as follows .[##3] -1 1- 2- 5- L0- 15- 20- 25- 35- 45- 55- 65- 75- • Total (all ases) (a) New Cases Pulmonary M - 1 1 4 2 4 16 17 14 17 19 9 4 108 F 1 1 2 3 3 11 10 13 12 1 1 3 - 61 Non-Pulmonary M - 1 - 1 - 2 2 3 2 3 2 - — 16 F - - 1 2 1 - 2 2 - - - - - 8 (b) Deaths (* Pulmonary M - - - - - - - - 1 5 8 9 1 24 F - - - - - - - - 2 - - 2 - 4 Non-Pulmonary M - - - - - - 2 - 1 - - - - 3 F - - 1 - - - 1 - - — 1 - - 3 (* Compiled from local death returns. (Registrar-General's return shows 30 Pulmonary and 6 Non-Pulmonary deaths.) Table 17. TUBERCULOSIS - Variations in Register Pulmonary NonPulmonary Total Cases M F M F (a) Cases on Register at 1/1/54 599 369 87 82 1137 (b) New cases notified 98 60 15 7 180 (c) Cases restored to Register 19 8 - 3 30 (d) Other cases added 22 14 3 1 40 (e) Removals 120 60 13 16 209 (f) Cases remaining on Register at 31/12/54 618 391 92 77 1178 75 INDEX Page No. Aged Persons 9 Analyst's'Report 55 Area of Borough 2 Atmospheric Pollution 22, 63 Bacteriological Examination of Foodstuffs 40 Bakehouses 36, 37 Births 2, 4 Cancer, Deaths from 2 Catering Establishments 36, 41 Chiropody Clinics 11 Clearance Areas 33 Common Lodging Houses 26 Complaints of Nuisances 22 Conferences 17 Deaths 2, 5, 59 Diarrhoea, Deaths from 2 Diphtheria 48 Disinfection and Disinfestation 53 Disrepair Certificates 22 Drainage 23 Dustbins 23 Dysentery 48 Factories 24, 66 Food - Inspection and Supervision 36, 71 - Premises in the Borough 72 - Poisoning 48 - Unsound 45 Free Washing Facilities 11 General Information 3 Hairdressers & Barbers Premises 24 Health Education 21 Health Services, General Provision of 9 Heating Appliances (Fireguards) Act, 1952 24 Home Bathing 11 House to House Inspections 25 Houses - Number in Borough 2 Houses Let in Lodgings 25 Housing 33, 68 Housing Repairs and Rents Act, 1954 22 Housing Statistics 35, 69 Ice Cream 42, 57 Illegitimate Births 2, 5 Infant Mortality' 2,6, 61 Infectious Diseases 47,73,74 Information Service 19 In quests 16 Laboratory Facilities 17 Legal Proceeding's 26 Legislation 18 76 Licensed Premises 25, 43 Loss of Expected Years of Life 7 Marriages. 5 Mary Hughes Infant Welfare-Centre. 15 Mass X-Ray Survey 51 Maternal Mortality 2, 6 Maternity, and Child Welfare 12 Meals-on-rWheels 11 Measles 2, 49 Milk Supply 43,57 National.Assistance Act,1948 9, 11 Noise Nuisances 27 Notices Served 27 Offensive. Trades 28 Old People's Welfare Association 11 Open Spaces 4 Outworkers 29 Overcrowding 33 Paratyphoid 49 Pet Animals 29 Pharmacy. & Poisons Act 29 Poliomyelitis 50 Population 2, 4 Prepared Food Premises 44 Puerperal Pyrexia 50 Rag Dealers 30 Rag Flock & Other Filling Materials Act, 1951 30 Rateable Value 2 Refuse Disposal 28, 30 Removal, of Persons in need of Care and Attention 9 Rent and Mortgage Interest (Restrictions) Acts 22 Rodent Control 30, 67 Sanitary Circumstances 22 Sanitary Inspectors - Summary of Inspections 64 - Return of Sanitary Work 65 Scarlet Fever 50 Seamen's Lodging Houses 26 Shops 31 Smallpox 50 Social. Conditions of Area 3 Special Reports to Public Health Committee 16 Statistics, Summary of 2 Staff 1, 21 Stillbirths 2 Swimming Baths 20 Tuberculosis 2,5l,75 Underground Rooms 34 Unemployment 8 Vital. Statistics 2, 4, 62 Water Supply 31 Weather Conditions 47 Whooping Cough 2, 53 77