AC 436 Ack. 11/9156 P.B. Metropolitan Borough of Stepney 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 1955 Together with the Report of the PUBLIC ANALYST Metropolitan Borough of Stepney. ANNUAL REPORT of the Medical Officer of Health F.R.O'SHIEL L.R.C.P.I., L.H., D.P.H. for the year 19 5 5 together with the Report of the Public Analyst. CONTENTS Page Map of Borough Frontispiece Public Health Committee iii Introductory iv Staff 1 Summary of Statistics 2 I. Statistics and Social Conditions of the Area 3 II. General Provision of Health Services 10 III. Sanitary Circumstances 22 IV. Housing 35 V. Food - Inspection and Supervision 39 VI. Infectious and other Diseases 50 Public Analyst's Report 59 Appendix 63 Index 82 ii PUBLIC HEALTH COMMITTEE at 31st December 1955 Ex-officio: His Worship The Mayor (Councillor J .Sambrook, 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 S.Berry 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 (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, 1955 - Division 5 Councillor W.G.Humphries • Councillor (Mrs.) M.A.Long Councillor (Mrs.) M.Sambrook Central Councillor (Mrs.) C. Edwards (iii) METROPOLITAN BOROUGH OF STEPNEY Telephone Stepney Green 2484 PUBLIC HEALTH DEPARTMENT, 43, White Horse Road, Stepney, London, E.l. To the Mayor. Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies and Gentlemen, I have the honour to present my report on the state of the public health in Stepney for the year 1955. The population of the Borough according to the RegistrarGeneral's estimate is 98,180, an increase of 280 over last year. The population in the census year, 1951, was 98,581. The live birth rate* is 18.59 (18.90)‡, the death rate 12.04 (11.50), the marriage rate 19.5 (20.3), the maternal mortality rate 1.07 (0.51), the infant mortality rate 23.00 (22.15), and the neonatal mortality rate 18.07 (17.28). Two mothers died as a result of childbirth, and there were 41 stillbirths, giving a stillbirth rate of 21.95 (20,11). The year was notable for the very large number of cases of measles which occurred, viz, 1,834, all of which recovered. This, the highest incidence of measles since the disease became fully notifiable in 1938, was common throughout the country. The second highest measles year was in 1951, when there were 1,459 notifications in the Borough, ♦ Rates. 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 women ascribed to pregnancy, childbearing, abortion, etc., per 1,000 live and still births. ‡ The figures in parenthesis refer to the previous year, 1954. iv Forty-four confirmed cases of poliomyelitis were notified, compared with 3 in 1954. Warm dry summers, such as we experienced this year, appear to increase the incidence of this disease. Although the total number of cancer deaths was lower this year, deaths from lung cancer increased from 52 to 69. Deaths from pulmonary tuberculosis decreased from 3° to 17, and notifications of now cases from 160 to 149. There was an increase in deaths from pneumonia and bronchitis from 151 in 1954 to 214 in 1955. Practically all of these occurred in persons over the age of 45. No cases of smallpox or diphtheria occurred in the Borough, and only one case of paratyphoid-B, which recovered. No deaths occurred from scarlet fever, measles or whooping cough. Food poisoning notifications dropped slightly from 23 to 18. A description of the Borough, and an interesting aerial photograph showing the dock area and some notable landmarks, will be found on pages 3 and 4. Few changes occurred in the staff throughout the year. The shortage of district sanitary inspectors continues, and there are still three vacancies to complete the reduced establishment. Miss Henrietta Whitty, a senior Sanitary Inspector and Health Visitor, who gave valuable service to the Borough for 34 years, retired during the year, and will be much missed, especially by the old folk in the Borough, amongst whom she worked so devotedly during the last decade of her service with the Borough Council. Important new legislation during the year included the Food and Drugs Act, 1955* and the Food Hygiene Regulations, 1955, which will come into operation on 1st January, 1956. Through the Housing Repairs and Rents Act, which came into operation in August, 1954, the legislators hoped to bring about an improvement in the standard of repair and maintenance of old dwellings owned by private landlords. After 18 months' experience of the Act, it is fairly obvious that it has been a failure in this respect. v Landlords were to be permitted to raise rents by a specified amount, provided they could show that a satisfactory standard of repair had been carried out. However, rather than incur the expense of these repairs, most landlords in the Borough seem to have preferred not to attempt to increase their rents. Although there are about 20,000 privately owned dwellings in the Borough, only about 500 applications for disrepair certificates have been made by tenants following the landlords' notices of intention to increase rents. The majority of these applications were made in the early months of the Act's operation, and over 95 per cent were granted. In presenting my report I desire to express my thanks to the Chairman and Members of the Public Health Committee for their support, and my appreciation of the work of the Staff of the Public Health Department, particularly those who assisted me in compiling this report. I have the honour to be, Your Worship, Ladies and Gentlemen, Your obedient Servant, FRANK R. 0'SHIEL Medical Officer of Health. June, 1956. vi STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December 1955. Medical Officer of Health F.Roantree O'Shiel, L.R.C.P.I., L.M., D.P.H. Assistant Administrative Officer E.P.Webber (1, 2) District Sanitary Inspectors W.E.Anstee (1) W.Cue (1) R.W.G.Day (1) S Firsht (1) W.E.Hart (1, 2) W.H.Haworth (1) J.J.Keniry (1) L.J.Windsor (1, 2) Food Inspectors A.C.Brown (1, 2) H.J.Green (1, 2) S.S.Lowther (1, 2) S.Vogler (1, 2) Caretakers W.Clark A.N.Cook (and Messenger) Messenger/ Relief-Caretaker E.H.Vaughan Disinfestation Inspector E.J.Edwards (1, 2) Housing Inspector C.F.Guy (1) Assistant Rodent Officer G.D.Freeland (1, 2, 3) Hygiene Officer Miss M. Guest (4, 5, 6) Hygiene Assistant Miss A.J.Ballam (T) Clerical Staff T .Aylward M.Bernstein D.J.Berry W.J.Dixon W.E.Driscoll S .W.Embleton Mrs.C.Gardner S.S.Harris E.Holt Miss R.Levey J .McMullon Mrs. M.Munday(T) M.J.O'Connor M.Pliskin C .E .Powell Foreman Disinfector W. Sexton Rodent Investigators T.J.Fox S.C.Ludlow (T) T.T.Walker (T) (1) Sanitary Inspectors' Certificate. (5) State Certified (2) Meat & Other Foods Certificate. Midwife. (3) Smoke Certificate. (6) State Registered (4) Health Visitors Certificate. Nurse. (T) Temporary. NOTE - For staff changes during the year see page 21. 1 SUMMARY OF STATISTICS. 1955. Area of Borough 1902.7 acres. Population (Registrar-General's mid-year Estimate of Home Population) 98,180. Number of inhabited houses according to Rate Books 29,900. Rateable Value £1,273,835 Sum represented by penny rate £5,069.5.1 Density of population (persons per acre) 55.59 BIRTHS . Total Male Female[/##3] All Births 1867 959 908 Live Births - legitimate 1656 854 802 illegitimate 170 83 87 Total 1826 937 889 Stillbirths - legitimate 34 18 16 illegitimate 7 4 3 Total 41 22 19 DEATHS. All Causes 1183 705 478 Maternal 2 - 2 Infants under 1 year - legitimate 35 21 14 illegitimate 7 1 6 Total 42 22 20 RATES(*) Live Birth Rate per 1,000 population 18.59 Death Rate per 1,000 population 12.04 Stillbirth Rate per 1,000 total births 21.95 Maternal Death Rate per 1,000 total births 1.07 Infant Death Rate (under 1 year) per 1,000 live births 23.00 Illegitimate Infants Death Rate per 1,000 illegitimate live births 41.17 Neo-natal Death Rate (under 4 weeks) per 1,000 live births 18.07 (*) See footnotes to page iv. 2 1. STATISTICS AND SOCIAL CONDITIONS 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 varying from 1 to l½ miles, and possesses approximately 90 miles of streets. The area of the Borough is 1,902 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 from the surface. Above this level are layers and patches of gravel and sand, brown and yellow clays being found nearer the surface. In some 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 water is towards the river. The area is to a largo extent industrial in character, factory premises 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 forms 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 industry of London is carried on in Stepney. Other major industries include brewing, cigarette making, engineering and the manufacture of furniture. Interesting industries carried on in the Borough include the manufacture of coinage, both at the Royal Mint and at Rothschild's private mint and bell casting at the Whitechapel Bell Foundry. In 1955 over 505 million coins were struck at the Royal Mint, approximately 60% being for Britain. At the bell foundry referred to, which was established in 1570, many famous bells including Big Ben have been cast and more recently new bells for St.Clement Dane's (of "Oranges and Lemons" fame) as well as those for St.Mary-le-Bow (the renowned "Bow Bells"), both destroyed in the last war. 3 Stepney is also one of the most important wholesaling districts in Greater London. The report on the 1950 Census of Distribution, published last year, records 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 1955 is 98,180. Last year's estimate was 97,900. The census taken in 1951 showed the population to be 98,581. The density of population is now 55.59 persons per acre. During the year there was a natural increase of population of 643, i.e. there were 643 more births than deaths. This year's estimate of the population of the Administrative County of London shows a further fall of 27,000, which refects the continuation of the flow of population from London. Open Spaces. There is in the Borough a little over half an acre of parks and open spaces per 1,000 population. A list of the open spaces in the Borough will be found on page 81. Births. The total number of live births registered in the Borough during the year was 3,524, and of this number 1,852 belonged to other areas. In addition, 154 births belonging to Stepney occurred outside the Borough, making a total of 1,826 births (937 male and 889 female) to Stepney residents. The live birth-rate is 18.59 per 1,000 of the population. The rate when adjusted by the comparability factor is 16.17, compared with the rate for England and Wales of 15.0. Illegitimate live births numbered 170, representing 9.3 per cent of the total live births. Stillbirths numbered 41, representing a rate of 21.95 per 1,000 total births. 4 AERIAL VIEW OF THE SOUTH-WESTERN AREA OF THE BOROUGH OF STEPNEY The Picture shows the London Docks, Tower Bridge and the Tower of London. On the left is seen part of Wapping. On the right are post-war Hats of Stepney Borough Council and London County Council. King Edward VII Memorial Park is in the foreground. Marriages. The number of marriages registered during the year was 961, being 37 less than last year. The rate of marriages per 1,000 population is 19.5, compared with 20.3 in 1954. Deaths. The net number of deaths registered during the year was 1,183 (705 males and 478 females), as compared with 1,126 last year. The rate of 12.04 compares with 11.51 for 1954. The principal causes of death were heart disease, which accounted for 25 per cent of the total deaths, cancer 21 per cent, and diseases of the respiratory system 19 per cent. Deaths of persons over the age of 65 accounted for 63 per cent of the total deaths. Details of deaths by cause and age are given in Table 1 of the Appendix. In England and Wales to-day the expectation of life of a boy at birth is 68 years, and of a girl 73 years, compared with 40 and 42 years respectively in 1841, and with 59 and 63 between the years 1930/1932. Infant Mortality. The deaths of infants under one year of age numbered 42, giving a rate of 23.00 per thousand live births, as compared with 22.15 last year. The rate for England and Wales for the year is 24.9. Of the infant deaths 33 were under 4 v/eeks old, representing a rate of 18.07 per thousand live births. Last year there were 32 neo-natal deaths, and the rate was 17.28 per thousand live births. The neo-natal mortality rate for England and Wales is 17.3 per thousand live births. On analysing the 42 deaths of infants which occurred in Stepney this year it is found that 23 died within 24 hours of birth. 31 died from causes which from the first gave little chance of survival. These included 19 cases of prematurity and 5 others of congenital malformation. Of the 19 premature cases, 13 died within 24 hours and 13 were below 3-lbs, in weight. Of the 5 cases of congenital malformation, 3 died within 24 hours. The term "perinatal mortality" was introduced in the Ministry of Health's Annual Report for 1953, being used to describe the combination of stillbirths with deaths occurring during the first week of life. Stillbirths and early 5 natal deaths have many features in common, and it is often a matter of chance whether the foetus dies in the womb or while being born or just after birth. Nationally, the perinatal mortality shows little tendency to fall, but the death rate for infants of one week and over continues to fall steadily, with only temporary interruptions. In Stepney the perinatal mortality figure for 1955' is 37.4 per 1,000 total births, compared with 34.9 and 34.7 for last year and the year before respectively, thus showing a tendency to increase. The rate for England and Wales for 1954 was 38.0, and for 1953 was 36.9. The Tables on page 66 show deaths from stated causes at various ages under one year, together with comparative figures over the last 5 years. Maternal Mortality. Two maternal deaths occurred this year. One, a married woman aged 31, who had had six previous children, four of whom are living, died from congestive heart failure within 17 days of confinement. She was delivered of a whole-term child on 24th February, 1955, by Caesarean section, which was performed owing to an impacted transverse lie of the foetus. This mother was also suffering from diabetes mellitus. According to further information received from the Registrar General, the cause of death was later found to be due to an infected abdominal wound. It is difficult to say whether or not this death could have been avoided, but from the history it would certainly appear that the woman was in a poor state of health, and not in a good condition to survive the complications of her pregnancy. The other death was of an 18-year-old unmarried girl who died from eclampsia at the 31st week of pregnancy, within 3 weeks of first being seen at hospital. This would appear to have been an "avoidable" death which might not have occurred had the patient attended for ante-natal care early in pregnancy and regularly. Home Accidents. The disturbing thing about home and other accidents is that they do not appear to be getting less. In 1955, accidents caused the death of 27 residents of the Borough. In 1954 no fewer than 6,617 deaths were recorded in England and Wales from accidents at home and in institutions, some four-fifths of which occurred in childhood and old age. The main types of home accidents are falls, 63%, followed by 6 burns and scalds, 11%, and coal gas poisoning, 9%. The. Heating Appliances (Fireguards) Act, 1952, came into operation on 23rd March, 1953, after which date all gas and electric fires sold to the public must be provided with efficient fireguards, but hundreds of unguarded fires purchased prior to the Act will continue to be used for many years. The home fatalities have increased from 5,081 in 1950 to 6.617 in 1954, but what of the much larger numbers who survive to live a life of permanent disablement? In England and Wales, one quarter of the deaths of children under 4 are caused by home accidents. Fire Risk in Sub-divided Tenements. Heavy penalties ought to be imposed on landlords or tenants of dwellings who infringe the London Building Acts by creating veritable death traps for their occupants. This was instanced by a case which occurred in the Borough in the early hours of Sunday, 2nd January, 1955. An old house of five storeys, rented by immigrants from Malta, was divided up on each floor by means of timber and Essex board partitions. An upset oil stove in the basement started an uncontrollable conflagration, which resulted in the death of 3 of the occupants. I am of the opinion that the tendency to divide up houses in this way has recently increased in London, and it may well be that similar tragedies will occur in the future. It would seem that at the present time there is insufficient supervision of premises to prevent undesirable adaptations, and that no serious punishment is meted out to those responsible when such adaptations are discovered. With the emphasis to-day on home accidents, more supervision and powers of control should be given, perhaps by means of additional legislation. Road Accidents. Nine Stepney residents met their death through road accidents during the year. A comparative table given on page 65 reveals that road accidents in the Borough increased during the year by more than 28 per cent over those in 1954. Comparative Statistics. A table showing vital statistics for the Borough from the year 1901 is given on page 67. 7 Loss of Expected Years of Life. A table was published in last year's report showing . mortality in 1953 in the Borough, as compared with England and Wales, expressed in terms of years of life lost. Figures for 1953 and 1954 are given below. Local rates, when compared with national rates, need to be adjusted by a weighting factor which allows for any difference sin population age structures, and as the standard weights for 1955 are not yet available, statistics for this year cannot be compiled. 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 Stepney Eng .& Wales Stepney Eng.& Wales Stepney Eng .& Wales 1954 11953 1954 1954 1953 1954 |1954 1953 1954 All Causes M 139 148 122 900 998 773 2884 3066 2433 F 88 92 105 518 734 502 1752 2011 1644 Pulmonary Tuberculosis M 5 6 2 36 47 25 129 141 64 F 0.6 1 1 3 31 17 13 63 33 Cancer (all sites) M 31 29 22 170 133 113 619 549 422 F 21 18 19 145 129 96 489 397 331 Cancer (lung & bronchus M 9 9 7 39 55 38 172 209 140 Coronary Disease M 19 19 20 80 48 71 367 281 331 F 10 11 11 39 23 17 177 155 114 Other Cardiac Disease M 13 11 19 31 30 38 192 161 243 F 14 12 24 30 46 37 186 189 238 Bronchitis & Pneumonia M 22 27 13 61 87 80 333 416 252 F 7 12 8 15 67 44 93 214 127 Although Stepney's female death rate from all causes is much lower than that for England and Wales, the loss of years of both working life and total life is greater. The years of life lost from tuberculosis by males are twice as much as the national average, but in females are less than half the national figure. 8 The cancer death rate and loss of expected years of life from deaths from the disease both show increases over 1953, but the figures for lung cancer show improvement, although still higher than those for the country as a whole. 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 years- Men Boys Women Girls Total 740 4 147 4 895 The above figures included 265 men and 32 women of the clothing industry who were only temporarily unemployed, and who would return to their usual employers within a week or so. The total number of unemployed at the end of 1954 was 1,258. 9 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 12 Removal Orders, details of which are given below. In addition to living in insanitary conditions and being unable to devote to themselves, and not receiving from other persons, proper care and attention, the persons removed were also either - * (a) suffering from a grave chronic disease, or (b) aged and/or infirm, or (c) physically incapacitated. Person Age Reason for Action * Removed to - Remarks Mr.W.A. 85 a.b.c. Hospital. Emergency Order for 3 weeks. Transferred voluntarily to an Institution. Died. Miss M.M. 88 a. b. c. Hospital. Emergency Order for 3 weeks. Died. Mrs.E.K. 71 b. Not proceeded with. Admitted to Hospital then transferred to Home for Incurables, Miss L.W. 81 b. Institution. Remaining voluntarily. Mr.C.B. 82 a.b.c. Hospital. Emergency Order for 3 weeks. Mr .M .R. 84 a.b.c. Hospital. Emergency Order for 3 weeks. Died. Mr .G .M. 80 b. c. Institution. Transferred to Hospital. Died, Miss C.T. 53 b.c. Hospital. Emergency Order for 3 weeks. Transferred voluntarily to an Institution, Mrs.L.H. 65 b.c. Not proceeded with. Mr. F.S. 73 b. - Not proceeded with. Mrs. S .S. 64 a.b. Hospital. Discharged home. Mrs. A.K. 80 b. Hospital Transferred to an Institution. 10 In addition to the persons removed under Court Orders, admission was gained to hospitals or institutions for 22 other persons. Two women officers are employed for the visiting of aged persons in the Borough, one of whom is a State Registered Nurse and Certificated Health Visitor, and 2,053 visits were made by these officers during the year. Many old persons were also visited by Dr.J.E.Epsom who is engaged on a part-time sessional basis for such duties. A register of old people so visited is kept in the Department. Amendments made to the register during the year were as follows:- Number on register at 1st January, 1955 1,001 Additions during the year 689 Removals during the year 101 Number on register at 31st December, 1955 1,589 The Council provides a service for disinfesting and cleansing bed linen and personal clothing, under Section 122 of the Public Health (London) Act, 1936. In order to prevent injury or danger of injury to health the London County Council (General Powers) Act, 1953, makes provision for the personal cleansing in their own homes of aged persons who are verminous or otherwise in need of a bath, 570 baths were given to 59 old persons during the year by the Borough Councils Home Bathing Service. There are 16 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 £2,200. Grants may be made under the Act to voluntary associations whose activities include the provision of meals for old persons. A mobile meals service is run jointly by the Old * Hon, Sec,, Stepney Old People's Welfare Association, St.Katharines, Butcher Row, Cable Street, E.14. (Tel.No. STEpney Green 3659). 11 People's Welfare Association and the Women's Voluntary Services, a weekly average of 326 meals being delivered to home-bound old people. Three of the clubs which include Luncheon Clubs among their facilities, provide an average of 175 meals each week. A Chiropody Service is provided by the Stepney Old People's Welfare Association at clinics which are situated in six of the old persons' clubs in the Borough, and an average of 204 treatments are given each month. Raphael House, Mile End Road, a block of 15 one-room flats for old people, was opened by the Borough Council during the year. 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 Smoke Abatement Society Annual Conference. Bournemouth. (September) Chairman and Sanitary Inspector (Mr.G.D.Freeland). Royal Society of Health Annual Congress. Bournemouth. (April) Chairman and Medical Officer of Health. Sanitary Inspectors Association Annual Conference. Scarborough. (September) Vice-Chairman and Sanitary Inspector (Mr.L.J.Windsor). Annual Conference of Central Consultative Committee for Welfare of Old People. County Hall, London. (July) Vice-Chairman and Medical Officer of Health. Commonwealth Conference of the National Association for the Prevention of Tuberculosis. Royal Festival Hall, London. (June) Chairman and Medical Officer of Health. 12 DECEASED PERSONS. . Mortuary. Fifteen bodies were received in the Council's Mortuary during the year. Inquests. Inquests were held on 55 residents of the Borough: 11 deaths were due to suicide, 26 were accidental, and 18 were due to other causes (4 natural causes, 6 misadventure, 6 open verdict, 1 chronic alcoholism, and 1 where there was no evidence as to cause of death). Burials. Section 50 of the National Assistance Act, 1948, places a duty on the Council to arrange for the burial of any persons found dead within the Borough where no private arrangements have been made. Thirty-eight such burials (32 adults and children over ten, 1 under one month and 5 stillborn babies) took place during the year at a cost of £374, of which amount £109 had been recovered by the end of the year from the estates of the deceased persons, from liable relatives, or by way of grants made under the National Insurance Act:, 1946. The requests for burials came from the following sources: H.M. Coroner's Officer 23 Relatives of the deceased 13 Friends of the deceased 2 FREE WASHING FACILITIES. The Council provides free washing facilities in 16 of the 22 public conveniences, with the aim of promoting food hygiene and cleanliness. Some 54,000 free washes were taken during the year. 13 HEALTH EDUCATION The annual Diphtheria Immunisation Campaign was held In the Borough during February and March. The Council cooperated with the London County Council in the Home Accidents Week in November. The Topic in the Exhibition Stand at Mile End Library was changed at quarterly intervals during the year, the topics including food and drink infections, homo accidents and milk pasteurisation. Some 3,500 leaflets on various subjects were distributed from this stand. Posters on the large poster frames situated in the two main roads in the Borough were changed each month during the year. Seven types of poster were displayed on the Council's official notice boards during the year. Posters relating to the Clean Food Byelaws, Merchandise Marks Act, marking of imported food, fish wrapping and poultry plucking were exhibited on lamp-post frames in the Borough street markets. During the year the Council took part in staging a Food Hygiene Exhibition (see page 42). Notices were published in the local press and 19,000 leaflets were distributed during the Poliomyelitis season. Leaflets and posters on various health matters were distributed and exhibited at hospitals, welfare centres, day nurseries, public libraries, social clubs, the Council's vehicles and public conveniences. HOSPITAL FACILITIES The undermentioned hospitals are situated in the Borough:- 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 14 STEPNEY BOROUGH COUNCIL INFORMATION SERVICE. I am indebted for the following information to the Information Officer, Mr. J. Mordsley. The Information Centre Is situated at the Municipal Offices, 227/233 Commercial Road, E.1. (Telephone STEpney Green 1818). The work of the Information Service during the past year has been well maintained, there being an increase in the number of enquiries of 402 over the previous year, the total for 1955 being 12,088 against 11,686 for 1954. The impact of new social 'legislation on the work of the Information Service has been noted in previous years, notable examples being the National Assistance, National Health and National Insurance Acts. The Housing Repairs and Rents Act, which came into force in August, 1954, had a similar effect, and for some considerable time after there were many problems arising out of this Act submitted to the Information Service. Towards the end of the year the new Valuation List, operative from 1st April, 1956, was deposited for public inspection in the office of the Information Service, and there was an immediate rush of ratepayers to see how they were affected. At first this was confined to owners of property and agents, and to occupiers of factory and business premises, but since the rate poundage was declared by the Council, the majority of applicants have been tenants and sub-tenants of dwelling houses, for whom the weekly difference in inclusive rents has had to be calculated. Telephone enquiries and requests for local information continue to increase. Many such enquiries are for addresses of official departments, societies, schools, clubs, firms, etc., and the index of the Information Service continues to expand so that these enquiries are dealt with quickly and accurately. In general the scope of the enquiries has remained as varied as ever, as will be seen from the following analysis of enquiries, which once again denotes the valuable function of the Information Service in the present-day life of the citizen. 15 Analysis of Enquiries, 1955. Civil Defence 2 Education, Youth Service Clubs, etc. 270 Employment and Holiday Pay 394 Family and Personal 416 General Information 1,499 Health and Medical 589 Holidays, Travel, etc. 75 Housing and Accommodation 1,074 Income Tax 141 Legislation (Miscellaneous) l,533 Local & Civic Information 2,276 Missing Persons 29 National Assistance and Supplementary Allowances 650 Registration 160 Rents and Rates 1,917 Service Questions and War Pensions 142 Social Insurance 640 Trading Questions and Licences 258 War Damage 7 Miscellaneous 16 Total Number of Enquiries 12,088 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. 217 investigations were carried out during the year on specimens received from medical practitioners in the Borough, throat swabs accounting for 73, nasal 3, faeces 99, rectal 40, pus 1, and urethral smear 1. In addition, reports were received from the London County Council's Public Health Laboratory on 32 specimens (20 rectal, 8 throat and 4 faeces) submitted by the Divisional Medical Officer and by doctors practising in Poplar and Bethnal Green. 16 LEGISLATION. The following Acts, Orders and Regulations affecting the Department were made during the year:- Date Operative from Food and Drugs Act, 1955. 1.1.56 London County Council (General Powers) Act, 1955. 21.12.55 Anthrax Disinfection Fee (Amendment) Rules, 1955 1.8.55 Food and Drugs Amendment Act, 1954 (Appointed Day) Order, 1955. 16.12.55 Food Hygiene Regulations, 1955. 1.1.56 Food Standards (Butter & Margarine) Regulations,1955 1.1.56 Food Standards (Table Jellies)(Amendment) Order, 1955 16.6.55 Labelling of Food (Amendment) Regulations, 1955. 1.1.56 Mineral Oil in Food (Amendment) Regulations, 1955. 1.1.56 Poisons List Order, 1955. 15.8.55 Poisons List (No.2) Order, 1955. 20.1.56 Poisons Rules. 1955. 15.8.55 Poisons (No.2) Rules, 1955. 20.1.56 Public Health (London)(Rate of Interest) Order, 1955. 1.1.56 Slaughter of Animals (Prevention of Cruelty) (Amendment) Regulations, 1955. 1.7.55 Transfer of Functions (Ministry of Food) Order, 1955. 7.4.55 Transfer of Functions (Food & Drugs) Order, 1955. 6.7.55 Circulars Other subjects dealt with by means of the issue of circulars were as follows:- Ministry of Health. Annual Reports of Medical Officers of Health, Chinese Egg Albumen, Public Health (Tuberculosis) Regulations, 1952, Residential Accommodation for the More Infirm, Diphtheria Publicity Campaign, Clean Food and Venereal Diseases Educational Campaigns. Ministry of Food. Myxomatosis in Rabbits and Hares, Official Certificates under the Public Health (Imported Food) Regulations in respect of Hungary, Portugal and Yugoslavia, and Approved Oxydising and Preservative Agents. Ministry of Housing and Local Government. Returns of Certificates of Disrepair issued under the Housing Repairs and Rents Act, 1954, Housing Statistics and Improvement Grants. 17 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 1,455 1 to 5 years of age 376 Total number of children who attended- Children born in 1955 1,348 Children born in 1954 1,179 Children born 1950/1953 770 Total attendances by children- Under 1 year of age 19,383 1 to 5 years of age 5,962 Ante-Natal and Post-Natal Clinics (exclusive of Hospital Ante-Natal Clinics). Ante-Natal consultations- No. of women who attended first time 220 No. of women who attended 262 Total attendances 1,660 Post-Natal consultations- No. of women who attended 80 Health Visitors. No. of infants under 1 year of age visited for first time 1,668 Total visits to children under 1 year of age 10,308 Total visits to children aged 1 year but under 2 years 6,217 Total visits to children 2 to 5 years of age 13,276 No. of expectant mothers visited 647 Total visits to expectant mothers 1,367 18 Infant Life Protection. No. on Register- 1st Jan. 1955 31st Dec. 1955 Foster Mothers 20 19 Foster Children 25 19 Child Minders (daily guardians). No. of child minders-Voluntary 12 Statutory 1 No. of children minded- Voluntary 14 Statutory 4 Care of Premature Infants. No. of premature births during the year 132 No, who died under 1 month 19 Immunisation and Vaccination. For details of immunisation and vaccination see pages 51 and 55. 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) 17 . Tuberculosis 13 Aged and Infirm Cases 773 Other 102 19 2, Services Provided. Infant Consultation. 673, Commercial Road 17, Rhondda Grove. Mary Hughes Centre, Underwood-Road. St. George's Centre, Library Place. 5, Pier Head, Wapping. Dame Colet House, Duckett Street. Ante-Natal. 673, Commercial Road. Vaccination against Smallpox. St. George's Centre, Library Place. 35, Stepney Green. Afternoons Monday, Tuesday, Thursday and Friday. Monday and Thursday. Monday, Wednesday and Thursday. Tuesday, Wednesday and Friday. Wednesday. Tuesday and Wednesday. Wednesday. Friday. Tuesday. Immunisation against Diphtheria or Whooping Cough. 35, Stepney Green. Tuesday. Note: Diphtheria and Whooping Cough immunisations are also carried out at the Infant Welfare sessions. Toddlers Clinic. St. George's Centre, Library Place. Mary Hughes Centre, Underwood Road. Day Nurseries. Voluntary Day Nursery. Nursery School. First Tuesday morning each month. Second and fourth Tuesday afternoons each month. Underwood Road, Old Church Road, Christian Street. 2, Beaumont Grove. Thirza Street. 20 SPECIAL REPORTS of Medical Officer of Health to the Public Health Committee. Special reports on the following subjects were made to the Committee during the years:- Report of the Committee on Air Pollution. Vacant Sites. Sale of Soft Drinks in Street Markets. Mass X-ray Survey, 1954. Report of County Medical Officer for 1954. Food and Drugs Act, 1955. Housing Repairs and Rents Act (Houses Let in Lodgings). London County Council proposal to erect maisonettes without natural lighting and ventilation to Water Closets. STAFF CHANGES. The following staff changes took place during the year:- Ceased duty. Arnold, A.H. General Clerk 11/11/55 Carr, S.J.C. Principal Assistant 30/4/55 Coker, E.J.M. General Clerk 24/7/55 Reilly, B.C. Sanitary Inspector 31/3/55 Trevethick, A. " " 24/7/55 Whitty, Miss H.A. " " 2/4/55 Commenced duty. Arnold A.H. General Clerk 22/8/55 Guest, Miss M. Hygiene Officer 8/8/55 SWIMMING AND SLIPPER BATHS. The three swimming baths in the Borough are provided by the Council. During the year the number of swims amounted to 135,646, comprising 32,912 adults and 102,734 children, an increase of 27 per cent over last year, due, no doubt, to the fine summer experienced in 1955. The water is subjected to continuous chlorination and filtration and 17 samples were taken during the year for bacteriological analysis, four of which were found to be unsatisfactory. The number of slipper baths taken during the year, at the four Council establishments, was 269,419, which included 6,487 attendances of Old Age Pensioners and 154 unemployed persons, who were admitted free of charge. The total number of persons admitted to all sections of the Baths Department, including the Laundry, during the year was 449,619. 21 III. SANITARY CIRCUMSTANCES The District Sanitary Inspectors served some 4,300 notices during the year, and in 60 cases legal proceedings had to be employed to enforce compliance with them. These figures are somewhat less than last year's, which is explained partly by the fact that two Inspectors resigned during the year, leaving the Borough 3 below the establishment of 11 Inspectors. Included in new legislation which came into effect during the year were some provisions contained in the London County Council (General Powers) Act, 1955, amonding existing legislation and extending the powers of the Council under the Public Health (London) Act, 1936, relating to stopped up and defective drains, defective water supply, and nuisances under the Fifth Schedule of the 1936 Act. Atmospheric Pollution. Towards the end of the year, two stations were set up in the Borough for the daily measurement and recording of atmospheric pollution. The new stations measure the concentration of sulphur dioxide and of smoke in the air by means of a combined smoke filter and volumetric sulphur dioxide apparatus. Briefly, air from outside a building is drawn at a steady rate, by means of a small electric motor, through a filter paper, and then through a bubbler containing dilute hydrogen peroxide, which combines with the sulphur dioxide removed from the air to form sulphuric acid. The volume of air is measured with a gas meter. At the end of a day's run the concentration of sulphur dioxide is calculated by formula and the concentration of smoke is ascertained by comparing the stain on the filter paper with a standard scale of shades. These stations are sited at the Public Health Department and at the Mile End Library, and are in addition to the stations set up in 1953 at St.George's Town Hall and at the London Jewish Hospital. Instruments at the latter stations consist of deposit gauges which collect grit, ash, etc., for the measurement of deposited matter, and lead peroxide tubes for calculating the activity of sulphur dioxide in the atmosphere. Monthly readings continued to be taken at these stations during the year, and the results, which will be found in Table 6 on page 68 , were forwarded to the Department of Scientific and Industrial Research. 22 Following the publication of the Clean Air Bill, arrangements were made for the District Sanitary Inspectors to attend special three-day courses of study on modern domestic fuel appliances, organised by the Coal Utilisation Council in co-operation with the Sanitary Inspectors' Association. Forty-three complaints of industrial smoke nuisance were received during the year, and observations kept on premises numbered 94. Complaints received relating to Public Health Nuisances. 3)394 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 the Inspectors in investigating complaints was 6,343. Dangerous Structures. The District Surveyor of the London County Council was notified on 196 occasions of premises or parts of premises alleged to be structurally dangerous. Disrepair Certificates. Test cases were brought against some tenants in the local County Court during the year under Section 26(2) of the Housing Repairs and Rents Act, 1954, by a landlord who aimed to obtain orders from the Court that the Certificates of Disrepair issued by the Council should cease to be in force. The main arguments advanced on behalf of the landlord were that the standard of good repair adopted by the Council was too high, and that certain items specified in the certificates as defects of repair were inappropriate. In the course of the proceedings, at which the Medical Officer of Health and the Sanitary Inspector were called by the tenants to give evidence, the Judge stated that in his view, which he supported by reference to case law, "good repair" meant "such repair as, having regard to the age, character and locality of the house, would make it reasonably fit for the occupation by a reasonably minded tenant of the class who would be likely to take it." The Judge indicated that he could not hold that a certificate should cease to be in force merely because in his opinion certain items had been wrongly included in the certificate, and stated that theowner should execute such repairs as were appropriate, and then seek the revocation of 23 the certificate under Section 26(4), and by making application to the Court under Section 26(5) if necessary. Judgement was found for the defendants, the tenants. The landlord subsequently took the cases to the Court of Appeal, contending that to ascertain the correct standard by which to define "good repair", regard must be had to the house as a whole; and further, that as the County Court Judge had held that certain items of disrepair included in the Certificate of Disrepair were inappropriate, then the whole of the certificate was thereby made invalid. In the judgement it was made quite clear that the disrepair could be in any room or any part of the house which was in constant use, and it seemed from the judgement that even one item of disrepair could make the dwelling house in a state of disrepair. The Court of Appeal dismissed the appeals with costs for the respondents and refused leave to the appellants to take the cases to the House of Lords. Applications received during the year from tenants for Certificates of Disrepair and from owners for the revocation of certificates were dealt with as under:- Housing Repairs and Rents Act, 1954. Rent and Mortgage Interest (Restrictions) Acts, 19201939. Certificates issued 175 81 Certificates refused 17 3 Applications withdrawn or cancelled 5 25 Total Applications 197 109 Revocations issued 201 25 Revocations refused 44 10 Revocations outstanding 2 — Total Applications 247 35 Visits made to premises by the Sanitary Inspectors in connection with the above applications totalled 1,098. 24 Drainage. 1,345 drains were tested with smoke and 160 were found to be defective, 4,978 visits of inspection were made to drainage works during the year, and 338 drains were cleansed or repaired and 104 constructed or reconstructed. Observations were submitted to the Borough Engineer and Surveyor on 149 plans of new drainage works. Dustbins. The Sanitary Inspectors served 112 notices during the year on owners of premises to supply dustbins, under the provisions of the London County Council (General Powers) Act, 1954. In two cases the Council supplied bins in default of the owners, from whom the costs, amounting to £4.4.0d, were recovered. Factories. 467 inspections under the Factories Acts, 1937 and 1948, were made by the Sanitary Inspectors, and 100 notices were served. A copy of the Annual Return furnished to the Ministry of Labour and National Service will be found in Table 7 on page 69. Hairdressers and Barbers Premises. The Council fixed 1st October, 1955, as the "Appointed Day" from which all hairdressers and barbers in the Borough, together with their establishments, have to be registered by the Council under the provisions of Section 18 of the London County Council (General Powers) Act, 1954. At the end of the year 126 such premises were registered. Byelaws made by the Council for securing the cleanliness of premises, equipment and materials used therein, and of persons employed in the business, also came into operation on 1st October. The Act requires the Certificate of Registration and copy of the Byelaws to be displayed in each premises, and Certificates and copies of the Byelaws of a type suitable for display were sent to all registered premises. The Sanitary Inspectors visited all registered premises in the area and gave advice to the occupiers on compliance with the Act and Byelaws. As a result of 171 visits made by the Inspectors, it was found necessary to serve 45 notices. 25 Heating Appliances (Fireguards) Act, 1952. The Heating Appliances (Fireguards) Act, 1952, prohibits the sale or letting on hire of gas and electric fires and oil heaters which are not fitted with effective fireguards conforming to certain prescribed standards. Regulations made under the Act specify tests of efficiency to be carried out in order to ascertain whether the guards comply with the standard of construction and fitting required. Nineteen shops and showrooms were visited during the year, entailing 46 visits by Inspectors, and the guards on 17 electric, 5 gas and 2 oil heaters were tested. Electric appliances in one premises, and both gas and electric heaters in another premises, which failed to pass the prescribed tests, were immediately withdrawn from sale. Houses Let in Lodgings. There are approximately 762 such premises in the Borough, and 35 complaints were investigated during the year. House-to-House Inspection. 1136 inspections under this heading were carried out during 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 725, and related to 1,712 properties. Licensed Premises. 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 Licensing Act, 1953. The Sanitary Inspectors' reports are taken into consideration when the applications come before the Sessions. Reports on 79 premises were submitted during the year. 26 Legal Proceedings. Legal proceedings instituted by the District Sanitary Inspectors during the year, showing penalties imposed, were as follows:- No. Of Summonses Fines Costs £. s. d. £. s. d. Public Health (Lomdon) Act, 1936- Nuisance Orders 39 5. 0. 0 91. 12. 0 Non-compliance with Nuisance Orders 21 175. 0. 0 36. 1. 0 60 £180. 0. 0 £127. 13. 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 Street. 228 women. 45 inspections were made during the year, including 10 inspections carried out at night. Lodging Houses-Seamen's. The use of the premises 11. Ensign Street, as a Seamen's Lodging House, was given up during the year. There are now five such premises in the Borough, providing accommodation for 488 seamen, as follows:- 27 The Sailors' Home & Red Ensign Club, Ensign Street and Dock Street. 235 seamen. The Empire Memorial Hostel, 747, Commercial Road. 190 „ 5. North East Passage. 11 „ 220, Cable Street. 30 „ 9, Ensign Street. 22 „ 53 inspections were made during the year, including 21 inspections carried out at night. One notice was served under the Byelaws. Noise Nuisance. Nineteen 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. Notices served under the various Acts and Byelaws during the year were as follows Public Health (London) Act, 1936:- Section 82 (nuisances) (Intimations 3128, Statutory 808) 3,936 Section 38 1 " 40 61 " 105 1 " 108 1 " 109 6 Factories Acts 1937 & 1948 99 Shops Act, 1950 22 London County Council (General Powers) Act, 1937-Noise Nuisance 3 London County Council (General Powers) Act, 1954-Dustbins 112 Prevention of Damage by Pests Act, 1949-Section 4 7 Stepney Borough Council (Hairdressers) Byelaws 45 London County Council (Seamen's Lodging Houses) Byelaws 1 London County Council (Water Closet) Byelaws 7 Total 4,302 28 Offensive Accumulation of Refuse. Accumulations of refuse in basements which were used during the war as emergency 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 invoked, and by the application of these powers refuse has been cleared away and fences erected around the sites by the owners. Offensive Trades. There are now 21 offensive businesses in the Borough, and 410 inspections were made during the year. The premises at 19, Bell Lane, and 4, Monthope Street, were added to the register, and the Tripe Boilers' premises at 94, Wentworth Street, were removed. The register now comprises the following premises:- Dressers of Furskin (3). 34/38, Brodlove Lane. * 48, 50, 50a, 54 & 56, Old Church Road. 29, Spelman Street, Kosher Poultry Slaughterhouses (18). * 19, Bell Lane. 28, Burslem Street. l6l, Cannon Street 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, Leyden Street. 13, Leyden Street. 15, Leyden Street. * 7, Lower Hessel Street. * 4, Monthope Street. * 6, Monthope Street. 10a, Monthope Street, 82, Stepney Way. The Establishment Orders of premises marked (*) are subject to renewal from time to time by the Council. Under the Transfer of Powers (London) Order, 1933, the Borough Council took over from the County Council the control of offensive trades. From that year, the Borough Council has dealt with applications for orders to establish anew offensive 29 trades, among which are included Kosher poultry slaughterhouses, and is empowered by Section 141 of the Public Health (London) Act, 1936, to impose such conditions as is thought fit when making establishment orders. An establishment order made by the Borough Council authorises the carrying on of the business for a specified period, whereas those orders made by the London County Council prior to 1933 were made "in perpetuity". To enable the Council to secure more effective control of the Kosher slaughterhouses set up under establishment orders made by the County Council, that body has been requested to promote legislation in the next General Powers Bill to empower the Borough Council to impose and enforce such conditions on the carrying on of any business of slaughterer of poultry established prior to 1st April. 1933, as it may impose on any business established anew in the Borough. Considerable nuisance is experienced in the Borough from blood and feathers arising from the plucking of poultry in connection with the above trade, and the County Council has also been requested to declare the business of poultry plucking to be an offensive business within the meaning of Section 140 of the Public Health (London) Act, 1936. The matter was still being considered at the end of the year. Following representations made by the Minister of Agriculture, Fisheries and Food, and by the Public Control Department of the London County Council, seeking the cooperation of the Council in an effort to eliminate sources of infection leading to the spread of fowl pest, the Sanitary Inspectors assisted the veterinary officers of the Ministry and the County Council's Inspectors under the Diseases of Animals Act in supervising the cleansing and disinfection of all poultry slaughterhouses in the Borough, together with all premises occupied by live poultry dealers. Outworkers. 42 inspections were made of Outworkers' premises. There are 647 premises on the register, an increase of 173 over last year, the trades concerned being as follows:- Wearing Apparel 599 Brushes 6 Umbrellas 5 Carding &c. of Buttons 4 Christmas Crackers &c. 8 Cardboard Boxes 13 Feather Sorting 1 Stuffed Toys 9 Artificial Flowers 1 Lampshades 1 30 There were 12 notifications of infectious disease relating to Outworkers' premises. Firms in the Borough employing Outworkers 70 Outworkers residing in and employed by firms in the Borough 166 Outworkers residing outside the Borough employed by firms in the Borough 369 Outworkers residing in the Borough employed by firms outside the Borough 481 Pet 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 10 persons were licensed under the Act. and 17 inspections were made by the Sanitary inspectors of the premises concerned. Pharmacy & Poisons Act, 1933, and Pharmacy & Medicines Act, 1941. 101 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 7 For Retention 94 134 visits were made to these premises. The Poisons List Order, 1955, made some amendments to the Poisons List and amended Poisons Rules were also issued during the year. Rag Flock and Other Filling Materials Act. 1951. Premises in the area registered under this Act number 20, and 3 others are licensed. During the year 52 inspections were made of these premises, and 21 formal samples of filling materials were taken, all of which the Analyst reported as being satisfactory. A weakness of the Act is that there is no provision enabling the Council to refuse to license unsatisfactory premises - for example, on one occasion during the year the 31 Council had to licence a railway arch for the storage of rag flock, although the premises were unsuitable for the purpose. Refuse Disposal. The Public Cleansing Officer has kindly supplied the following information on refuse and salvage disposed of during the years:- House and Trade 35,512 tons. Street and Market 8,191 " Salvage-Waste Paper 27 " A modern method of refuse collection, mainly for blocks of flats, known as the "Paladin" system, has recently been introduced into the Borough. A refuse container, of 1¼ cubic yards capacity, is placed on a low concrete kerb immediately below the refuse chute in the chamber. When refuse is collected, a hand-operated trolley is placed under the container, which is lifted from the kerb and wheeled to the collection vehicle. The container is clamped in a girdle fitted at the rear of the vehicle, and is automatically raised, emptied into the vehicle, and then returned to the trolley, and thence to the dust chamber. Approximately 300 such containers have been installed in the borough. Rodent Control. In accordance with the request of the Ministry of Agriculture, Fisheries and Food, statistics on rodent control work carried out by the Department are submitted to the Ministry covering the period 1st April, 1955, to 31st March, 1956. During this period, 10,986 dwellings and business premises were inspected, and 2,350 were found to be infested either by mice or rats. Treatments were carried out by the Department's rodent staff to 2,057 of the properties found to be infested, charges for servicing business premises amounting to £806. 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. A copy of the return furnished to the Ministry is on page 70. 32 Shops. During the year, 160 inspections were made under the Shops Act, 1950, and 22 notices were served, 9 in respect of sanitary accommodation, 10 in respect of ventilation and 3 in respect of temperature. The number of premises in the Borough covered by the provisions of the Act is 2,801. No applications were received during the year for exemption from complying with sanitary accommodation requirements. 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 545 flats and 1 house. 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 146, and the Metropolitan Water Board was notified on 12 occasions of premises where wastage of water was taking place. During the year notices were received from the Metropolitan Water Board to the effect that the water supply from 5 premises had been withdrawn, in 2 premises for non-payment of rates and in 3 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. All were reported as being satisfactory. Workplaces. There are known to be 409 workplaces in the area (other than those covered by the Factories Act, 1937). 33 Windowless Water Closets. There appears to be a tendency in recent years for architects and planners, including those of the London County Council, to provide windowless internal water closets in large blocks of flats, with a view to economy in space and building costs, the ventilation being mechanical. The Borough Council has protested against this tendency, which is a retrograde step, and a departure from the previous custom in this country of providing each water closet with natural light and ventilation from a window of adequate size. Whatever may be said in favour of artificially lighted and ventilated water closets, there is no doubt that, unless conscientiously maintained, a grave public health nuisance can arise. This will not be apparent in new buildings, but as most have a life of anything from 70 to 100 years, they will almost inevitably give rise to difficulty in maintenance in the future. As property ages and deteriorates, it usually passes into the ownership of less-conscientious landlords. In our experience of such landlords in the past, the maintenance of glazing and sashlines to ordinary windows has proved sufficiently difficult. There will be much greater difficulty in future in persuading them to maintain satisfactorily artificial lighting and electric motors for the mechanical ventilation of such water closets. Where there is good natural lighting, water closets in poorer areas are more likely to be maintained in a cleanly condition. Work executed bv Council in default of Owner. Work was carried out by the Council at the following premises in default of the owners, from whom the costs incurred are recoverable:- £. s. d. 41 Timothy Road. No Notice re defective water closet 6. 7. 11. " " " " " " " " 5. 0. 2. 40 We11close Square, Notice re drainage. 198. 0. 0. 41 " " " " " 222. 2. 10. 111/121 Salmon Lane) " " " 2. 19. 1. 1/13 Parnham Street) 5/7 Christian Street, Notice under Prevention of Damage by Pests Act, 1949. 130. 0. 0. 46 Diggon Street. Notice re dustbin. 2. 2. 0. 108A Whitechapel Road, " " " 2. 2. 0. Statistics. Summaries of inspections carried out by District Sanitary Inspectors, and insanitary conditions remedied, are on pages 71 and 72. 34 IV. HOUSING The Housing Repairs and Rents Act, 1954, which received Royal Assent on 30th July, 1954,' required the Council to submit to the Minister of Housing and Local Government, within a year of the passing of the Act, its 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. Accordingly, an extensive survey of the Borough was carried out during the year, and as a result it was decided, in consultation with the London County Council, that there were 2,645 unfit houses in the Borough, of which 1,888 are to be demolished in five years, and the remainder within the following two years. In a White Paper presented to Parliament in November by the Minister, a summary of returns under the Act, together with proposals submitted by local authorities under Section 1 of the Act, showed that Stepney had the highest number of unfit houses in London. Clearance Areas. During the year official representations were made by the Borough Council in respect of one clearance area of two houses. In addition, 8 areas, involving approximately 300 houses, were declared by the London County Council, Approximately 208 properties were demolished under the Housing Act, 1936, during the year, 204 by the London County Council under Part III of the Act, and 4 by the Borough Council. Demolition and Closing Orders. No Closing Orders Tinder Section 11 of the Housing Act, 1936, or under Section 3 of the Housing Act, 1949, were made this year, but one house was demolished in pursuance of an Order made in 1954. Closing Orders under Section 12 of the Act were made with respect to two flats and 63 underground rooms. One Closing Order was made under the provisions of the Local Government (Miscellaneous Provisions) Act, 1953. 35 Improvement Grants. During the year observations and recommendations were submitted on 6 applications for improvement grants made under the Housing Act, 1949. Overcrowding. During the year, 149 cases of alleged overcrowding were investigated, 65 of which were confirmed and referred to the London County Council. 26 overcrowded families were rehoused, 22 by the London County Council and 4 by the Borough Council, and the number of known overcrowded families on the register decreased from 1,061 to 1,040. 132 visits were made to premises to ascertain "permitted numbers", and the owners of the premises were informed. In order to prevent overcrowding, 34 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 3,200 underground rooms in the Borough used for living or sleeping purposes, about 3,080 of which are unfit. During the year 514 inspections were carried out, as a result of which 63 rooms were closed and the modified occupation of 8 rooms approved. The number of underground rooms closed since 1936 amounts to date to 341, or 11 per cent of the total of those unfit. Progress on closure generally is held up for lack of suitable alternative accommodation. Town and Country Planning (Housing Accommodation) Direction, 1952. 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 33 such applications were carried out during the year. 36 Main block (Ansell House) of Stepney Council Sydney Street Estate. The completed estate will comprise over 500 dwellings. North Front South Front Applications for Rehousing. At the end of the year there were 4,400 applications for rehousing on the Housing Manager's register, including 347 tenants of Council dwellings and 412 licensees of requisitioned promises who applied for transfers. Preferential Housing on Health Grounds. Of the 44 cases investigated, 22 were recommended to the Borough Council for rehousing. Temporary Hutments. 126 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 13. Requisitioned Premises. The number of dwellings under requisition by the Borough Council at the end of the year was 1,396, involving 1,930 lettings. Two dwellings were recommended to the Housing Manager for derequisitioning, and 8 basement rooms which did not comply with the regulations were recommended for closure. New Housing. During the year 546 new dwellings were completed in the Borough: 27 by the Borough Council, 518 by the County Council, and 1 by a private owner (see Appendix, page 73 ). Total new permanent dwellings constructed in the Borough since the war is 4,784: 2,851 by the London County Council, 1,857 by the Stepney Borough Council, and 76 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, 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 to-day in Stepney more than 2,000 coloured persons. 37 There appears no doubt that the numbers in Stepney are increasing yearly, and as many coloured women are also arriving in the Borough, we may expect our coloured population to increase rapidly in the future. Summary of Inspections made by the Housing Inspector. Housing Act, 1936 (Section 11) 28 " " " (Section 12) 18 Housing Act, 1949 (Section 20) 3 Housing Accommodation Direction, 1952 55 Immigrant Enquiries - for Malta Government 32 - for Cyprus Government 6 Miscellaneous Inspections 133 Overcrowding 186 "Permitted Numbers" under Housing Act, 1936 132 Preferential Housing on health grounds 44 Premises situated in Clearance Areas 702 Requisitioned Premises 427 Temporary Hutments 37 Underground Rooms 514 Statistics. Further Housing statistics are given on pages 74 and 75. 38 V. INSPECTION AND SUPERVISION OF FOOD. The Food and Drugs Act 1955 received Royal Assent on 22nd November 1955 and, together with the Food Hygiene Regulations 1955 made under the Act, comes into operation on 1st January 1956. The Act consolidates the Food and Drugs Act 19385 the Food and Drugs (Milk, Dairies and Artificial Cream) Act 1950 and the Food and Drugs Amendment Act 1954, together with certain sections of the Slaughterhouses Act 1954 and the Slaughter of Animals (Amendment) Act 1954. Provision is made in the new legislation for certain changes in the law, the more important of which are briefly summarised below:- Food and Drugs Act. 1955. 1. In future, in determining whether an article of food is injurious to health, regard shall also be had to the probable emulative effect of consuming the food over a long period. 2. The former defences relating to patent foods and proprietary medicines have been removed. 3. Inspectors may examine and detain containers and vehicles, excepting the detention of vehicles belonging to certain transport undertakings. 4. A court is now empowered, on the application of the Local Authority, to disqualify a caterer who is convicted of a serious offence against the Food Hygiene Regulations from using the premises as catering premises for a period up to 2 years. 5. Certain changes have been made in the procedure relating to the registration of food premises, including dairies. The time limit for attendance before the Council following the service of a notice cancelling or refusing registration is increased from 7 to 21 days, and the applicant may be legally represented, 6. New provision has been made as to the description of cream substitutes. 7. Important changes have been provided for in the procedure for sampling and analysis. 39 8. Powers are given to enter ships, aircraft, vehicles, etc., and to restrict the movement of food imported into the district. 9. Penalties have been increased, and there is now no distinction in penalties between first and subsequent offences. 10. The time limit within which prosecutions must be made in respect of samples procured is increased from one month to two months for foods other than milk, 11. Changes are made in the conditions for the acceptance of a warranty as a defence. 12. Provision is made entitling a personal representative, as well as the widow, or other member of the family, to the temporary continuance of a licence or registration on the death of the holder, 13. The meaning of "sale" of food for the purpose of the Act has been extended, as also has the definition of "food", which now includes, among other things, chewing gum, ana "preparation" is defined as including manufacture and any form of treatment, and "preparation for sale" includes packaging. 14. Registration is no longer required of butter and margarine factories, or of premises used for the sale of artificial cream. Food Hygiene Regulations, 1955. Most of the Regulations come into operation on 1st January, 1956, except certain provisions which may involve alterations to premises or equipment, which are deferred until 1st July, 1956. The Regulations extend the hygiene requirements of Section 13 of the Food and Drugs Act, 1938. For example, some provisions now affect stalls and vehicles, instead of premises only as formerly. Also, whereas Section 13 related to sales, actual or intended, the Regulations apply whether or not there is any question of sale. They apply to the supply of food in the course of a business, which includes canteens, clubs, and schools, as well as undertakings carried on by public and local authorities. 40 The principal extensions of the previous law relate to the following:- (i) Specific requirements designed to prevent the contamination of food. (ii) Provision of sinks or other facilities for washing food and equipment. (iii) The provision of a constant supply of hot water for sinks, wash-basins, etc., in food premises, and of a supply of hot water on stalls and vehicles. (iv) Restrictions on the preparation and packing of food in or about domestic premises. (v) The conditions under which certain foods that provide a particularly favourable medium for food poisoning organisms are to be kept in food premises. (vi) A requirement to provide vehicles used for the transport of meat with duckboards and separate receptacles for offal, and, where the vehicles are not enclosed, a covering supported by a frame or poles. (vii) The circumstances in which persons carrying meat are required to wear overalls and head coverings. (viii) With regard to hand-washing, Section 13 has been extended with the object of securing that an adequate number of wash-hand basins are provided in positions conveniently accessible to food handlers, so that frequent washing of hands will be encouraged during working hours. (ix) The Council is empowered to issue certificates of exemption in cases where compliance with certain of the Regulations cannot reasonably be required because of restricted accommodation, or other especial circumstances, A person may appeal to a court of summary jurisdiction against the refusal or withdrawal of such a certificate. Separate regulations are under consideration with regard to the handling of food at docks, wharves, public warehouses and cold stores, carriers' and wholesale vegetable merchants' premises, storehouses and slaughterhouses. Reduction in the incidence of food poisoning is one of the prime objects of the new legislation, and it is hoped that the Act and Regulations will assist in bringing about improvements in food hygiene. 41 Stepney co-operated with the Public Health Departments of neighbouring boroughs in staging a pictorial food hygiene exhibition at Shoreditch Town Hall on two days in November. The exhibition was held with the object of bringing to the notice of traders various methods v/hich can be adopted to bring food premises up to a good standard of hygiene. Personal invitations to attend the exhibition were sent to food traders in the Borough, The Department's inspectors were present at the exhibition to answer questions and to give advice on particular problems. During the year the inspectors continued the survey of the food premises in the Borough on "house-to-house" lines, and during the year 535 premises were inspected and details of construction, hygienic conditions and facilities etc. recorded, A summary of the visits made during the year by the Sanitary Inspectors (Food) will be found on page 76, and details of the number and types of food premises in the Borough are given in Table 14 on page 77. Bacteriological Examination of Foodstuffs. Seventy-four samples were submitted for bacteriological examination, as follows:- No. of Samples Unsatisfactory Observations Pasteurised Milk 10 — — Beer 3 — — Custard 2 — — Synthetic Cream 2 — — Coconut Macaroon 1 — — Macaroon Biscuits 1 — — Blancmange 1 — — Dried Milk Powder 1 — — Canned Stewed Steak 1 — — Assorted Sausage (Salami, mortadella, etc.) 8 1 Cultures showed growth of Bacillus proteus. Importers taken up matter with Yugoslav manufacturers. Dried Egg Albumen and Powder, 30 1 Salmonella senftenberg isolated. Consignment detained. Re-export arranged. Ice Cream 14 4 Grade IV - manufactured outside the Borough. 42 Bakehouses and Bakers' Shops. 364 inspections were carried out and 31 notices served. There are 49 bakehouses in the Borough, 7 of these being basement bakehouses. The basement bakehouse at 57/59, Umberston Street, was removed from the register during the year, the premises being demolished. There are in addition 58 bakers' shops. 109 cleansings of bakehouses were carried out during the year. The proprietor of a baker's shop, summoned for selling sausage rolls which were unfit for human consumption, was fined £1 with £3.3.0d costs. Butchers' Shops and Stalls. 394 inspections were carried out during the year and 48 notices served. Legal proceedings were instituted on two occasions against butchers for selling minced meat containing preservative, and on three occasions for defective condition of the premises. Fines totalling £13 and costs of £8.13.0d were imposed. Butter and Margarine Factories and Wholesale Dealers in Margarine. There are 31 of these premises in the Borough, and during the year 40 inspections were made and one notice served. Catering Establishments (including Industrial Canteens). Inspections of catering establishments in the Borough totalled 1,301 and 202 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 £50 and £4.4.0d costs. Proceedings in respect of the dirty conditions at another cafe resulted in fines of £2 being imposed. Two further summonses were taken out against the proprietors of cafes - one for selling hot milk which contained 14% added water, and the other for selling buttered slices of bread, the "butter" consisting of margarine. Fines amounting to £3, with £8.12,0d costs, were imposed. Market Stalls - Sale of Soft Drinks. Owing to the difficulty in providing proper washing facilities for glasses on market stalls, a report was submitted to the Public Health 43 and Markets Committees during the year suggesting that street trading licences be issued to vendors of soft drinks only on condition that bottled soft drinks with straws be supplied, or that drinks be supplied in disposable waxed cups. However, it appears that there is no existing legislation which enables the enforcement of such a condition. Export Certificates. 27 certificates were issued in respect of the examination of foodstuffs for export to South America, Mexico, Sweden, Canada and Italy. Fish (Wet) Shops and Stalls. 318 inspections and visits were made, and 15 notices served. Greengrocers' and Fruiterers' Shops and Stalls. 947 inspections were carried out and 87 notices served. Summonses dealt with in respect of the dirty and defective conditions of a wholesaler's premises resulted in fines of £4 and costs of £2.2.0d being imposed. Grocers' and Miscellaneous Food Premises. 2,021 inspections and visits were made and 59 notices served. The magistrates inposed fines totalling £10, with £2.12.0d costs, in respect of summonses issued for the dirty condition of a shop premises, and in another case, concerning the sale of curry powder containing excessive amount of lead, the defendant was discharged absolutely on payment of £2.6.0d costs. Ice Cream. There are 306 registered premises in the Borough: 29 are registered for manufacture, 273 for sale, and 4 for storage only. 179 inspections were carried out and 8 notices were served for cleansing and other requirements. Fourteen samples of ice-cream were submitted for bacteriological examination, with the following results:- 44  Manufactured - Total In Borough Outside Borough Grade I — 3 3 (19) " II 2 5 7 (3 " III — — — (—) " IV — 4 4 (1) The figures in parenthesis show the totals for 1954. The respective Local Authorities were notified of the 4 unsatisfactory (Grade IV) samples manufactured outside the Borough. In one instance the shopkeeper was advised regarding improvements to his method of storage. Fourteen samples submitted for chemical analysis were found to be genuine, their average fat content being 10.3%. Legal proceedings were Instituted against the proprietor of one establishment in respect of the dirty condition of the premises and utensils, and he was fined £21 with £6.5.0d costs. Legal Proceedings. Summonses taken out during the year by the Sanitary Inspectors (Food) were as follows Act, etc. No. of Summonses Fines Costs £. s. d. £. s. d. Food and Drugs Act, 1938. 25 87. 0. 0. 32. 15. 0. London County Council Food Byelaws. 1952. 4 5. 0. 0. 2. 10. 0. Ice Cream (Heat Treatment) Regulations, 1947. 2 12. 0. 0. 2. 10. 0. Total: 31 £104. 0. 0 £37. 15. 0 Cautionary Letters. On the instructions of the Public Health Committee, cautionary letters were sent In respect of the following contraventions:- Selling buttered rolls, the fat of which consisted of margarine 1 Selling a loaf of bread containing a piece of metal 1 Selling milk containing added water 1 Selling milk deficient in solids other than fat 1 45 Licensed Premises. 2.57 inspections were carried out, and 17 notices served. Milk Supply. There are 287 distributors in the Borough, including 18 with dairies and 30 itinerants. During the year, 303 inspections were made and 14 notices served. Thirteen samples of milk were taken at day nurseries, 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) and (Raw Milk) Regulations. 1949-1954." 522 licences were issued during the year, including 208 for "Pasteurised" milk, 254 for "Sterilised" milk, 59 for "Tuberculin Tested" milk, and 1 Pasteuriser's Licence. Monthly returns of results of analyses of samples of heattreated mill: are sent to the Milk Division of the Ministry of Agriculture, Fisheries and Food, which is at once notified of any unsatisfactory report. Poultry Shops and Stalls. 532 inspections and visits were made mainly for the purpose of examining poultry exposed for sale, and 21 notices were served. Prepared Food Premises. The number of prepared food premises on the register is 160, and 452 inspections were made and 53 notices served. Public Health (Imported Food) Regulations. 1937-1948. Eighty-five Detention and 64 Release Notices were served under these regulations, affecting a variety of foodstuffs, including cocoa, tallow, dried fruits, sugar, coconut, pork, beef, frozen mutton, dried egg albumen, cheese and ham spread, sausage, butter, goose legs, fruit pulp, assorted canned goods, etc. . Consignments of Dutch fresh pork, Danish beef fillets and Hungarian bacon arrived at the wharves and at Bishopsgate 46 Goods Station (Zeebrugge-Harwich Train Ferry). They were officially certificated and found on examination to be in sound condition. Chinese Egg Products. Two outbreaks of Paratyphoid Fever occurred in August at Worthing and at Weymouth, and investigations showed that the vehicle of infection was imitation cream used as a cake filling, in the composition of which the only common factor was Chinese frozen whole egg. It is generally found that frozen liquid egg rapidly decomposes after its container is opened, and therefore has to be used up quickly. Synthetic cream is not subjected to any heat treatment after being added to articles of confectionery, so that they become an excellent breeding ground for pathological organisms. A statement was issued by the trade, in agreement with the Ministry of Healthy for publication in the baking trade press and for circulation to bakers' sundriesmen and other trades allied to the baking trade, warning against the use of Chinese egg in the manufacture of cream filling, icing or any product in which it is not subjected to a sterilising temperature of 212 degrees Fahrenheit for 10 minutes or more during manufacture. Several consignments of Chinese hen-egg albumen were landed at wharves in the Borough, These were detained and samples taken for bacteriological examination for the presence of Salmonella and other food poisoning organisms. All the samples were found to be satisfactory. The egg albumen is being released, and, as an added precaution, notifications are being sent to the Medical Officers of Health of the areas to which the albumen is consigned, so that it can be used in accordance with the methods approved by the Ministry of Health and the Bakery & Allied Trades Association. At one wharf in the Borough, samples of Chinese spraydried whole hen-egg powder were submitted for examination for Salmonella organisms, and Salmonella senftenberg was found in one of the samples. Of three further samples taken from this batch, two were positive to Salmonella senftenberg, and the 112 cases concerned are under detention at the wharf with a view to being re-exported. At the request of the Central Public Health Laboratory, Colindale, which is carrying out investigations into the presence of food poisoning organisms in dried egg powder and frozen liquid egg, 12 samples of Chinese whole hen-egg powder procured from a consignment at a wharf were submitted for examination. All were found to be satisfactory. 47 Smoked Spiced Sausage. In June a consignment of Yugo-slavian cooked and smoked spiced sausage of an expensive brand caused sonie concern with an outbreak of Paratyphoid B. in Sheffield, where a sliced portion of the sausage was bacteriologically examined and found to contain the organism of Paratyphoid B. Enquiries were submitted to Stepney, as the sausage was distributed by a wholesaler in this Borough. Investigation showed that the sausage had been despatched from Stepney in the same wrapped and packed condition as received from abroad. It was possible, therefore, that the contamination arose in Sheffield during the course of the slicing. It was not possible to take samples from Stepney, as the whole consignment had already been distributed, but specimens taken in Bolton and Leeds proved to be bacteriologically negative. Zeebrugge-Harwich Train Ferry. 295 special midnight or early morning, and 52 other visits, were made to Bishopsgate Goods Station for the purpose of examining 6,906 trucks of foodstuffs arriving from the following countries:- Australia 19 trucks. Austria 1 truck. Belgium 585 trucks. Belgian Congo 12 " Bulgaria 43 " Germany 39 " Greece 6 " Hungary 493 trucks, Italy 5,501 " Holland 32 " Spain 3 " Switzerland 14 " West Indies 1 truck. Yugo-slavia 157 trucks. The weight of the foodstuffs examined was 62,319 tons, comprising fresh fruit and vegetables 55,715 tons, cheese 47 tons, fish 8 tons, preserved meats, sausages, etc., 1,574 tons, butter 900 tons, eggs 2,425 tons, biscuits, cakes and confectionery, 57 tons, canned soup 210 tons, bacon 923 tons, fresh pork 286 tons, honey 132 tons, egg powder 26 tons, and miscellaneous foods 16 tons. The foodstuffs found to be unsound, and which were stopped and destroyed, amounted to 1 ton 7 cwts. Samples taken included mushrooms, sausages, Yugo-slavian dried walnut kernels, Italian ravioli and Hungarian butter, Detention notices were served in respect of consignments of Yugo-slavian minced meat roll and Belgian cheese and spiced ham, which arrived unaccompanied by official certificates, and which were subsequently released on the production of the certificates. Transport and Handling of Meat.. 139 inspections were made of vehicles delivering meat into the Borough from Islington Cattle Market and from Smithfield Market. Two of the vans inspected were found to be unsatisfactory, and notices were served under the Public Health (Meat) Regulations for cleansing and other requirements. 48 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, 1930:- Premises Tons cwts. qrs. lbs. Wharves 97 18 2 21 London Fruit Exchange & Spitalfields Market 58 5 2 9 Railway Depots 1 9 1 6 Zeebrugge-Harwich Train Ferry (at Bishopsgate Goods Station) 1 6 3 22 Other Premises 44 3 0 24 203 3 2 26 Approximately 6 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 Cleansing 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. Over 2,300 Condemnation Certificates were Issued during the year. Improvements Effected at Food Establishments. Lavatory basins installed 38 Premises where hot and cold water supply installed 95 Premises where washing facilities for staff have been improved 120 Sinks provided 32 Food storage accommodation provided 13 Refrigerators installed or repaired 5 Premises where walls, ceilings, floors, windows cleansed 1,023 Floors renewed or repaired 49 Shop-fronts improved 11 Premises where ventilation provided or improved 15 Premises where natural lighting improved 2 Protective covers provided for displayed food 30 Refuse bins provided 80 Miscellaneous improvements 734 49 VI. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES Weather Conditions. I am indebted to the Meteorological Office for the following survey of the year's weather. Although the summer was dry and sunny, it is interesting to note that throughout the year as a whole the mean temperature was somewhat below normal. Of the twelve months, only May was particularly wet and only June especially dull; most of the other months were markedly dry and sunny. It is of particular interest that during the months April to November (inclusive), of the 36 Saturdays only 4 produced any measurable rain between 9 a.m, and 9 p.m. in Central London (April 2nd, May 14th, August 13th and October 22nd); of these only August 13th could be described as very wet. Total rainfall for the year was about four-fifths of the normal. August was the warmest month, though the hottest days were in July. Five of the first six months had below average temperature - at Kew, March had the largest deficit (-4.6 degrees), but February was the coldest month. The year was remarkably fog-free In Central London. There was rather more thunder than usual. Easter was dry and rather warm. The Sunday was dull and other days sunny. At Whitsun the Saturday was dull and cold, but the Sunday was sunny and warmer and the Monday brilliant. August Bank Holiday Saturday was rather cloudy, but the Sunday and Monday were warm and sunny. Christmas was very mild, with temperatures over 8°F. above average. It was the sunniest Christmas Day since 1909, but other days in the period were dull, with some rain on each. Notifications. A total of 2,677 notifications of cases of infectious diseases were received during the year, as compared with 956 in 1954, the increase being largely accounted for by the high number of notifications of measles this year. 4ol visits were made by the Sanitary Inspectors in connection with infectious diseases. Table 15 on page 78 shows details of notifications received, together with age groups. The diagnosis was not confirmed in 21 of the above notifications. A list of the diseases notifiable in the County of London is shown in Table 16 on page 79. 50 Cancer. The number of deaths from cancer of all sites occurring in residents of the Borough during the year was 247, being 15 less than last year. Deaths from lung cancer, however, numbered 69, showing an increase of almost 33$ over 1954, and of the increased 17 deaths, 16 occurred in males. It is now common knowledge that the association between cancer of the lung and smoking is so obvious as to leave little doubt that smoking is a direct cause of lung cancer. As pointed out last year, the mortality from lung cancer in males in Stepney is half as much again as that for the country as a whole. Diphtheria. No notifications of diphtheria were received during the year. The numbers of children immunised at London County Council clinics, as compared with last year, are as follows 1955 1954 Completed primary courser- Children under 5 601 1,386 Children 5-15 84 472 Children given secondary injection 893 1,239 It will be seen from these figures how seriously the progress of diphtheria immunisation is interfered with during epidemics of Poliomyelitis, owing to the policy of deferring immunisation whilst Poliomyelitis is occurring in the district. Referring to the publicity campaign on diphtheria prophylaxis for 1955, 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 161 and 11 in 1955. The Minister warned against any relaxation of efforts made to maintain immunisation against diphtheria at the highest possible level. Seventy-six 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. There has been an increase in the incidence of Sonne dysentery, 147 cases being notified, as compared with 118 51 cases last year. Several cases occurred amongst the elderly inmates of a Welfare Home, two of whom died, Sonne dysentery seldom causes fatalities except In the very young or very old. The Ministry of Health points out that notifications in 1954 reached the highest total ever recorded, but that due to more laboratory Investigations in recent years, symptomless excreters of the organism have come to the fore, and this may to some extent explain the increase in notifications. Erysipelas. During the year 11 notifications were received, the same number as last year. Food Poisoning. Whilst the numbers of notified cases of food poisoning in Stepney have not increased, the Chief Medical Officer of the Ministry of Health has drawn attention in his report for last year to the fact that the incidence of food poisoning is increasing throughout the country. To some extent this might be due to better reporting. In England and Wales there were 5,277 cases in 1953 and 6,016 in 1954. Once again the principal source of infection was "made up" meat dishes, which are dangerous because of the time which elapses between preparation and consumption. Other foods causing a high incidence of food poisoning are milk and egg products, and it is most important that none of these foods is consumed unless freshly made, as delay greatly increases the danger of the multiplication of food poisoning organisms. During the year there were 68 known cases of suspected food poisoning in the Borough, 18 of which were officially notified. In 5 cases a Salmonella organism was Isolated from the patients' stools, but in no case was the source of infection traced to any particular article of food. Leukaemia. The last quarter of a century has seen an increase in deaths in England and Wales attributable to leukaemia. Leukaemia is not a common disease amongst children, but in Stepney during the year an unusual coincidence occurred in that two children aged 3 and 5 years died within two days of each other In one of our hospitals. The children were not related, nor could any contact be found between them. Leukaemia is a form of cancer of the blood cells, and its occurrence in young children is to some extent emphasised by the fact that other diseases of childhood, such as diarrhoea 52 and the infectious diseases, have greatly decreased during recent years. Research into the occurrence of leukaemia in children under 10 is being undertaken by the Oxford Department of Social Medicine. Malaria. One case of induced malaria was notified during the year. Measles. This was an abnormally high year for measles, 1,834 cases being notified in the Borough, but there were no deaths from the disease. Notifications were the highest for many years, the previous highest since the war being 1,459 in 1951, Epidemics tend to recur at intervals of just under two years, the peak month this year being April, when over 500 cases were notified. 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 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, 1946-1955, there were 6 deaths, the rate being 0.06 per 10,000 population. Meningococcal Infection. There were 5 notifications and 1 death during the year, compared with 7 notifications and 2 deaths last year. Ophthalmia Neonatorum. Of the 20 cases notified, 10 belonged to Stepney. Pneumonia. Of the various forms of pneumonia, only acute primary and acute influenzal are notifiable. >4 cases were notified during the year, compared with 64 last year. Poliomyelitis. This year saw an increase in the number of cases of poliomyelitis, 44 cases being confirmed compared with 3 last 53 year. There were 90 suspected cases removed to hospital, and 58 notifications received. Two deaths occurred from the disease, and of the 27 paralytic cases, 14 still had some degree of paralysis at the end of the year. The epidemic started in April, reaching its peak in July, and continued to the end of the year. The number of non-paralytic cases (39 per cent) was disproportionately high compared with the paralytic type (61 per cent). As usual, the 5-14 age group had more incidence of non-paralytic cases, as is shown in the following summarys:- Age Group Cases Paralytic Non-Paralytic Cases Per cent 0-4 22 14 8 36 5-14 17 9 8 47 15 + 5 4 1 20 The incidence of the disease tends to be greater in hot summers. In addition to the clinical cases occurring in the Borough, there appeared to be several other abortive cases about the same time which did not give the clinical picture. Puerperal Pyrexia. There were 134 notifications during the year, compared with 163 in 1954. Of the 134 cases notified, 56 were residents of the Borough. The Puerperal Pyrexia (Amendment) Regulations, 1954, came into operation on 1st March, 1955, and require the cause of the disease, if known, to be stated on the prescribed form of certificate of notification. Scabies. Scabies is still notifiable under the County of London (Scabies) Regulations, 1943. The number of cases formally notified was 39, compared with 29 last year. 100 scabies patients were treated by medicinal baths at Branch Road Treatment Centre, and their clothing disinfested, viz. :- Males Females Children Total 27 29 44 100 The number of baths given amounted to 174 during the year. 54 Scarlet Fever. There were 26 cases notified, being 34 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. The number of children successfully vaccinated or revaccinated at L.C.C. clinics during the year was 838. A supply of vaccine is kept In the Department for emergency use. Tuberculosis. The number of primary notifications of pulmonary tuberculosis received was 149, compared with 160 last year, and the number of non-pulmonary cases notified was 23, the same number as last year. The mortality rate for the year of pulmonary tuberculosis is 17, and of non-pulmonary 3 per 100,000 population, as compared with 30 and 6 respectively in 1954. (For details of register and notifications see page 80.) In England and Wales in the six years up to 1954, mortality from tuberculosis had fallen by 64 per cent, but notifications from pulmonary tuberculosis fell by only 14 per cent. Public Health (Prevention of Tuberculosis) Regulations. 1925. These regulations provide that persons suffering from tuberculosis of the respiratory tract shall not be employed in the handling of milk or milk receptacles. Power is given to the Council to cause such persons to discontinue their employment. It was not found necessary to take action under the regulations during the year. Tuberculosis Care Committee. The Tuberculosis Care Committee, on which are represented voluntary and official bodies, and whose meetings are 55 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 200 patients in the year through the L.C.C. Extra Nourishment Scheme, and 59 patients went for recuperative convalescent holidays. Help was also given during the year to 71 persons by way of clothing, extra nourishment, bedding, holiday expenses, rent, wireless licences and fares to relatives to visit patients in sanatoria. The annual Christmas Seal Sale Fund amounted to £255, and this was supplemented by donations from various organisations, for which the Care Committee is most grateful. Where possible, grants were obtained from statutory and voluntary funds, those of the Committee being used only where such could not be obtained. The London County Council has now appointed an Occupational Therapist to visit homebound patients to teach them handicraft work, the Care Committee paying for most of the materials and tools, and helping with the sale of the articles made. Vaccinia. One of the rare complications of vaccination is the development of generalised vaccinia. Four cases occurred in a family after the vaccination of the baby aged one year. Apparently this was a devoted family, all those affected being particularly attached to the baby, whom they frequently nursed. Some two weeks after the baby was vaccinated, the 6-year-old sister was admitted to hospital with a three-day history of fever and rash, and was found to be suffering from generalised vaccinia. The father and two brothers were also admitted to hospital subsequently, suffering from accidental vaccinal infection of the face. All made uneventful recoveries. The mother, who was not affected, was vaccinated in infancy, and the rest of the family were unvaccinated. Whooping Cough. 147 cases were notified during the year, the figure for 1954 being 127. There was one death from the disease. 56 Infectious Disease Contacts. Where a person is precluded from continuing at work by reason of being a carrier or having been in contact with infectious disease, benefits under the National Insurance Act, 1946, are only paid on production of a certificate from the Medical Officer of Health. It was found necessary to issue one such certificate during the year in respect of a worker in a school meals kitchen who was suspected of suffering from food poisoning. 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, and in addition the signature of the vaccinating doctor must be verified by the Medical Officer of Health of the district. The signatures on 347 such certificates were verified by me during the year as those of medical practitioners practising in Stepney, and the certificates were endorsed accordingly. Disinfection. 245 premises were disinfected because of infectious disease, of which 10 were for pulmonary tuberculosis, 42,613 articles of clothing and bedding were steam disinfected, including 29,907 articles for export, for which 52 certificates were issued. Formaldehyde disinfection of 96,174 articles of clothing, 109 tons of boots and 100 tons of waste paper for export was also carried out during the year, for which 156 certificates were issued. Charges for export and other disinfections carried out amounted to £348, Disinfestation (Bed bugs and other insect pests). The following is a summary of work carried out by the specialist inspectors engaged on disinfestation duties 57 General inspections for vermin 1,071 Attempted visits 192 No. of premises found verminous 207 No. of revisits 245 No. of miscellaneous visits 475 No. of premises sprayed 591 No. of rooms sprayed 1,489 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 145 such families were treated during the year. In addition, disinfestation by steam and formaldehyde was carried out on 13 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 335 41 11 387 The number of baths and treatments given amounted to 418. • ' 58 SUMMARY OF PUBLIC ANALYST'S QUARTERLY REPORTS For the Year 1955 During the year 445 samples were submitted for analysis, 159 being purchased or taken formally and 286 informally. The samples are classified as follows 2 Acetic Acid 17 Alcoholic Spirits 1 Arrowroot 2 Baking Powder 2 Blancmange Powder 1 Bread 34 Butter,Margarine,Cooking Fat 6 and Lard 14 Buttered Rolls and Slices 2 Candied Peel 12 Cheese and Cheese Spread 3 Chocolate and Chocolate Cup 6 Cream 5 Condensed Milk 10 Curry Powder 1 Desiccated Coconut 19 Dried Fruits 1 Dripping 1 Egg Extender 1 Egg Mundelech 2 Fish Paste 2 Flour 1 Fruit (Canned) 7 Fruit Squashes 1 Garlic Salt 3 Gelatine 2 Gherkins 1 Glucose Tablets 3 Ground Ginger 4 Ground Nuts 1 Herrings 4 Honey and "Sunny" Spread 14 Ice Cream 2 Boracic Ointment 2 Castor Oil 2 Eucalyptus Oil 1 Fullers Earth Cream 1 Fullers Earth Powder 2 Infant Powders 1 Jam Sandwich 3 Jam and Marmalade 1 Jelly (Turtle) 1 " (Table) 2 Lemonade 2 Lemonade Powder & Sherbet Meat (potted and canned) 17 Meat (minced) 2 Meat Paste 84 Milk 5 Mint Sauce & Dried Mint 1 Mushrooms (dried) 4 Non-brewed Condiment 3 Oranges 8 Olive Oil, Nut Oil and Frying Oil 1 Peanut Butter 2 Peas (canned) 6 Pepper and Pepper Compound 1 Potato Crisps 1 Ravioli 40 Sausages 4 Spice, Sage, Turmeric 9 Soda Bicarbonate 10 Soup and Canned Soup 4 Soup Tablets & Powders 3 Stuffing 12 Sweets 7 Tea, Coffee,Cocoa 2 Vermicelli 1 Walnut Kernels 1 Wine 1 Iodised Throat Tablets 2 Syrup of Figs 2 Wintergreen Ointment 3 Zinc Ointment 4 Zinc & Castor Oil Ointment. 59 Of the 445 samples analysed 10 formal and 25 informal were found to be unsatisfactory, as follows:- Article Formal or Informal Nature of Irregularity Remarks 1. Milk Informal 1% Added Water. See following formal sample. 2. " Formal 2% " " Cautionary letter sent. 3. " " 6% " " Do. 4. " " 14% " " Fined £1,0.0d Costs £6.6.0d. 5. " " 8% deficient in Fat. Taken from 2 churns of bulk of 4 churns. Average content satisfactory. 6. " " 5% " " " 7. Buttered Bolls " Fat consisted of Margarine. Cautionary letter sent. 8. " " Informal Fat consisted of 20$ Margarine. Formal sample to be obtained. 9. Buttered Slices Formal Fat consisted of Margarine. Fined £2.0.0d Costs £2.6.0d. 10. Buttered Brazils Informal 65% deficient in Fat. Subsequent sample satisfactory. 11. " " " 7.5% " " " Manufacturers advised re butter content. 12. Buttered Almonds " 62.5% " " " Manufacture discontinued. 13. Buttered Walnuts " 55% " " " Do. 14. Nut Chocolate " Rancid. Remaining stock in shop satisfactory. (Contd.) 60 Article Formal or Informal Nature of Irregularity Remarks 15. Curry Powder Informal Lead 20 parts per million. See following Formal sample. 16. " " Formal " 15 " " Discharged absolutely on payment of £2.6.0 Costs. 17. " " Informal " 16 " " Subsequent sample satisfactory. 18. Minced Meat Formal Sulphur Dioxide 1100 parts per million. Fined £5.0.0d Costs £2.12,0d. 19. " " Formal Sulphur Dioxide 360 parts per million. Fined £5.0.0d Costs £2,6,0d. 20- Bleached Raisins Informal Sulphur Dioxide varied from 930 to 1400 parts per million. Taken under the Imported Food Regulations. Released conditionally . 29. (10 samples) 30. Lemonade " Contained White Spirit. No action justified. 31. (2 samples) 32. Bread " Contaminated with Mineral Oil. Taken up with Manufacturer. 33. Acetic Acid " Incorrectly labelled. Stock withdrawn from sale. 34. Boracic Ointment " Made to British Pharmacopoeia 1932 formula. do. 35. Pickled Gherkins " Benzoic Acid 520 parts per million. Subsequent sample satisfactory . 61 Milk. 84 samples were. examined during the year, the average composition of the samples being 3.53 Per cent fat and 8.54 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. 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 1955 84 3.53 8.54 62 APPENDIX OF STAT ISTICAL TAB LES 63 64 Table 1. TOTAL DEATHS BY CAUSE AND AGE OF STEPNEY RESIDENTS - 1955 (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 17 11 6 - - - - 3 7 4 3 2. " - Other 3 3 - - - - - 2 - - 1 3. Syphilitic Disease 6 4 2 - - - 1 2 2 1 4. Diphtheria - - - - - - - - - - 5. Whooping Cough 1 - 1 1 - - - - - - - 6. Meningococcal Infection 1 1 - - 1 - - — - - - 7. Acute Poliomyelitis 2 1 1 - 1 - - 1 - - - 8. Measles - - - - - - - - - - - 9. Other Infective and Parasitic Diseases 4 3 1 1 - - - - 1 1 1 10. Malignant Neoplasm - Stomach 40 24 16 - - - — - 14 15 11 11. " - Lung, Bronchus 69 60 9 - - — - 5 36 15 13 12. " - Breast 12 - 12 - - — - 3 4 2 3 13. " - Uterus 6 - 6 - - - - 2 1 3 - 14. " - Other 109 57 52 - - - - 5 36 33 35 15. Leukaemia, Aleukaemia 11 5 6 - 1 l - 1 2 4 2 16. Diabetes 7 1 6 - - - — 1 1 - 5 - 17. 18. Vascular Lesions of Nervous System 103 46 57 - - - - - 31 32 40 Coronary Disease, Angina 143 108 35 - - - - 4 54 46 39 19. Hypertension with Heart Disease 41 21 20 - - - - - 3 17 21 20. Other Heart Disease 114 51 63 - - - 1 4 16 25 68 21. Other Circulatory Diseases 65 31 34 - - - -_ 2 5 18 40 22. Influenza 4 - 4 - - l - - 1 - 2 23. Pneumonia 84 53 31 4 — - - - 15 14 51 24. Bronchitis 130 95 35 1 - - - 3 32 30 64 25. 26. Other Diseases of Respiratory System 15 8 7 - - - - - 5 6 4 Ulcer of Stomach and Duodenum 18 13 5 — - - -I 1 9 3 5 65 Table 1 (contd.) CAUSES OF DEATH ALL AGES Age Groups Total M F -1 1- 5- 15- 25- 45- 65- 75- 27. Gastritis, Enteritis and Diarrhoea 2 1 1 - - - - - - 1 - 28. Nephritis and Nephrosis 13 9 4 - - - l 6 6 - - 29. Hyperplasia of Prostate 9 9 - - - - - - - 2 7 30. Pregnancy, childbirth, abortion 2 - 2 - - - 1 1 - - - 31. Congenital Malformations 12 11 1 6 1 - - 1 4 - - 32. Other defined and ill-defined diseases 93 42 51 28 - 1 - 9 19 14 22 33. Motor Vehicle Accidents 9 8 l - - - - 4 - 3 2 34. All other accidents 27 20 7 - - - - 6 7 6 8 35. Suicide 11 9 2 - - - - 3 4 3 1 36. Homicide and operations of war - - - - - - - - - - - Males 705 - 22 2 - - 41 230 171 239 Females - 478 20 2 3 4 27 84 133 205 GRAND TOTAL: 1183 42 4 3 4 68 314 304 444 Table 2. Comparative Table of ROAD ACCIDENTS in the Borough. YEAR Children Under 7 years. Children 7 14 years Adults TOTALS Killed. Injured Killed Injured Killed Injured Killed lnjured 1950 - 61 - 48 7 474 7 583 1951 — 49 - 51 10 525 10 625 1952 1 45 1 54 7 521 9 620 1953 1 47 - 53 5 563 6 663 1954 No statistics available. ! 1955 - 70 - 56 7 726 7 852 1955 Pedestrians Motor Cyclists Pedal Cvclists Drivers Other Road Users TOTAL [Killed 6 - - - - 1 7 Injured 302 128 105 107 210 852 66 Table 3. INFANT MORTALITY. 1955 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 Weeks Total Months 1- 2- 3- under 4 wks. 1- 4- 7- 10- Whooping Cough — — — — — — — — 1 — 1(—) 2.44 Sonne Dysentery — — — — — — — — — — 1 (-) 2.44 Pneumonia — 1 — — — 1 l 1 — — 3 (3) 7.32 Bronchitis — — — _ — — — 1 — — — 1 (-) 2.44 Gastritis, eritis, &c — — — — — — — 1 — — 1 (1) 2.44 Congenital Malformations 1 3 — — — 4 1 — — — 5(13) 12.20 Premature Birth 10 7 — 1 — 18 1 — — — 19(20) 46.34 Birth Injuries — — 1 — — 1 — — — — 1 (1) 2.44 Atelectasis 5 — 1 — — 6 — — — — 6 (2) 14.62 Haemolytic Disease of the New Born 1 — — — — 1 — — — — 1 (-) 2.44 Cerebral Haemorrhage 1 — — — — 1 — — — — 1 (-) 2.44 "Sub-mandibular Abscess — — — 1 — 1 — — — — 1 (-) 2.44 TOTALS 18 11 2 2 — 33 4 3 1 — 41 100.00 (*) Figures in parenthesis denote deaths in 1954. Table 4. 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 1955 18 11 4 33 8 41 78 67 Table 5. 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 5 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 1 0.5 255 2.5 71 0.7 1950 99,???30 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 0.5 261 2.6 36 0.3 1955 98,180 1826 18.5 1183 12.0 42 23 2 1.0 247 2.5 20 0.2 68 * No reading. Table 6. ATMOSPHERIC POLLUTION Summary of Monthly Readings at Two Stations in the Borough of Impurities Deposited during 1955 and. for comparison, readings for 1954 in parenthesis. Station Jan. Feb. Mar. Apr. May June July Aug. Sep. Oct. ; Nov. Dec. INSOLUBLE MATTER DEPOSITED (Tons per square mile) St .George's 17.8 6.7 12.0 6.7 13.7 12.5 13.0 9.3 10.5 9.9 9.7 9.7 Town Hall. (13.5) (14.0) (11.9) ( 8.1) (13.5) ( 7.6) (15.7) ( 9.1) (9.9) (*) (12.4) (9.4) London Jewish 14.9 8.3 12.1 9.9 10.8 11.3 10.3 7.7 9.8 8.5 11.1 7.6 Hospital. (11.3) (16.5) (12.6) ( 8.5) (11.7) ( 9.4) ( 7.4) ( 9.6) ( 9.2) ( 8.3) (11.4) (11.1) SOLUBLE MATTER DEPOSITED (Tons per square mile) St .George's 14.3 7.8 7.5 4.9 11.1 7.9 7.4 11.8 5.8 6.6 4.6 8.7 Town Hall. (7.4) (12.3) ( 7.7) ( 4.4) (10.7) (10.7) ( 6.6) (10.7) ( 9.7) (*) (13.7) (7.0) London Jewish 12.2 7.2 9.0 6.1 8.1 6.1 6.4 5.1 6.3 9.8 6.7 9.3 Hospital. (9.5) (13.7) (9.8) (4.1) (9.6) (11.2) (4.2) (8.3) (7.4) (12.3) (15.3) (8.2) SULPHUR TRIOXIDE COLIECTED (Mg. per dav per 100 sq. cm. of lead peroxide) St .George's 4.3 4.6 4.0 1.5 1.3 1.8 1.7 1.8 1.8 3.6 4.2 3.9 Town Hall. (4.3) (3.9) (2.2) (2.8) (2.2) (1.4) (1.5) (1.6) (1.7) (1.8) (3.4) (4.3) London Jewish 5.5 5.2 4.5 1.6 1.5 2.0 1.8 1.9 2.0 4.4 5.5 5.0 Hospital. (4.8) (5.3) (3.2) (2.9) (2.6) (1.5) (1.8) |(2.0) (2.0) (2.8) (5.3) (5.0) Table 7. FACTORIES ACTS. 1917 & 1948. 1. Inspections for Purposes of Provisions as to Health. Type of Factory No. on Register Inspections Written Notices Factories without mechanical power 152 11 1 Factories with mechanical power 1,820 446 98 Other premises under the Acts (building operations and works of engineering construction) 74 10 TOTALS : 2,046 467 99 2. Cases in which Defects were Found. Particulars Found Remedied Referred - to H.M. by H.M. Inspector Inspector Want of cleanliness 1 1 - 4 Overcrowding - - - - Unreasonable temperature mm - - - Inadequate ventilation - - - 1 Ineffective drainage of floors - - - - Sanitary Conveniences (a) Insufficient 3 3 - 4 (b) Unsuitable or defective 96 96 - 62 (c) Not separate for sexes 32 32 - 28 Other offences against the Acts (not including those relating to Outwork) 3 - 3 - TOTAIS: 135 132 3 99 3. Prosecutions. There were no prosecutions during the year. 69 Table 8. RODENT CONTROL (Period 1st April 1955 - 31st March 1956) Council Property Dwelling Houses Business Premises TOTAL Total Properties in Area 56 25,879 12,412 38,347 No. Properties inspected as result of (a) Notification ., 12 1,046 352 1,410 (b) Survey under the Act 3 6,802 2,771 9,576 No, Properties inspected which were found to be infested by (a) Rats - Major - 1 1 2 Minor 7 780 247 1,034 (b) Mice - Major 5 137 164 306 Minor 4 806 198 1,008 No. infested properties treated by Local Authority 14 1,697 346 2,057 No. Sec.4 Notices served (i) Treatment - - - - (ii) Structural works - - 1 1 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 6th June to 23rd August, 1955, and from 28th November, 1955, to 16th February, 1956. 1,471 manholes were treated in each period, the estimated number of rats destroyed being 13,545 in the first treatment and 14,085 in the second treatment. 70 Table 9. SUMMARY OF INSPECTIONS. VISITS AND ACTION TAKEN BY DISTRICT SANITARY INSPECTORS DURING THE YEAR Complaints 6,343 Drainage 4,978 House-to-House 1,136 Houses Let-in-Lodgings 35 Infectious Diseases and Contacts 481 Common Lodging Houses 45* Seamen's Lodging Houses 53 Markets (Week-end) 28 Heating Appliances (Fireguards) Act, 1952 46 Offensive Trades 410 Pet Animals Act, 1951 17 Pharmacy & Poisons Act, 1933 134 Rag Flock Act, 1951 52 Housing Repairs and Rents Act, 1954, & Rent and Mortgage Interest (Restrictions) Acts, 1920-39 1,098 Shops Act, 1950 160 Smoke Nuisances - Observations 94 Factories - Mechanical 446 Non-mechanical 11 Other 10 Outworkers Premise's 42 Miscellaneous Visits and Inspections 2,411 Revisits 4,811 Attempted Visits 2,506 Total Visits and Inspections: 25,347 Intimation Notices Served:- On County and Borough Council Housing Departments 369 On Owners 3,125 Statutory Notices Served 808 Legal Proceedings Taken 60 * Including 3 visits to Women1s Common Lodging House by the Woman Sanitary Inspector. 71 Table 10 SUMMARY OF WORK CARRIED OUT UNDER THE SUPERVISION OF DISTRICT SANITARY INSPECTORS DURING THE YEAR Dampness In rooms remedied 2,211 Premises where - New'drains constructed 79 Drains reconstructed 25 Existing drains repaired 117 Drain obstructions cleared 221 Dustbins provided 150 Dwelling-rooms, passages and stairce.se walls and ceilings cleansed or repaired 1,760 Factories - New W.Cs. provided 4 Sanitary accommodation repaired 153 Other defects remedied l Floors repaired 429 Fireplaces and coppers repaired or renewed 373 Gullies, manholes, provided or repaired 264 Light and ventilation improved or provided to rooms and staircases 2 Roofs, gutters, rainwater pipes, renewed or repaired 1,432 Rubbish accumulations removed 110 Sinks, baths and lavatory basins fitted 607 Soil and vent pipes provided or repaired 96 Staircases - Treads, etc,, repaired 96 Ventilation (under-floor) provided to rooms 1 Waste pipes provided or repaired 427 Water Closets and Urinals - New provide 233 Compartments cleansed, repaired 413 Obstructions cleared 50 Flush apparatus repaired 237 Pans and traps fixed 185 Water Supply - Cisterns cleansed, repaired 14 Defective supply or fittings remedied 132 Windows repaired 901 Yards, areas, cleansed or paving repaired 101 Miscellaneous repairs 572 11,398 72 Table 11. DWELLINGS ERECTED DURING 1955 Address No.of Dwellings (a) BY Borough Council Cephas House 12 27 Raphael House 15 (b) By London County Council Andaman House 36 Atlantic House 36 Barents House 10 Biscay House 36 Bridgen House 15 Delafield House 79 Dowler House 3 Dickson House 12 Galway House 20 Genoa House 24 Lowder House 25 Marmora House 26 Mellish House 10 Panama House 24 Pegasus House 30 Seagrave Close 50 Sligo House 17 Trendell House 14 Welstead House 35 Welton House 16 518 (c) Other Schoolkeeper's House SS.Mary & Michael's Primary School, Commercial Road 1 TOTAL 546 73 Table 12. HOUSING STATISTICS I. Inspection of dwelling-houses during the year:- (l)(a) Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 6,699 (b) Inspections made for the purpose 18,435 (2)(a) Dwelling-houses inspected and recorded under Housing Consolidated Regulations, 1925 1,269 (b) Inspections made for the purpose 1,276 (3) Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 782 (4) Dwelling-houses found not to be in all respects reasonably fit for habitation 2,870 II. Remedy of defects during the year without service of Formal Notices Dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 2,242 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 628 (2) Dwelling-houses in which defects were remedied after service of Formal Notices:- (i) By Owners 617 (ii) By Local Authority in default of owners 11 74 Table 12 (contd.) (c) Proceedings under Sections 11 and 13 of Housing Act, 1936- (i) Dwelling-houses in respect of which Demolition Orders were made Nil. (ii) Dwelling-houses demolished in pursuance of Demolition Orders 1 (d) Proceedings under Section 12 of Housing Act, 1936:- (i) Separate tenements or underground rooms In respect of which Closing Orders were made 65 (ii) Closing Orders determined, the tenements or rooms having been rendered fit Nil. (e) Proceedings under Section 25 of Housing Act, 1936:- (1) No. of houses included by representation by Medical Officer of Health 2 (ii) No. of houses demolished in pursuance of representations Nil. (f) Proceedings under Section 10 of Local Government (Miscellaneous Provisions) Act, 1953:- (i) Closing Orders made 1 (ii) Closing Orders determined Nil. IV. Housing Act, Part IV - Overcrowding (I) No. of overcrowded families on register at beginning of year 1,061 (ii) No. of new cases encountered during year 65 (iii) No. of cases relieved during the year 86 (iv) No. of overcrowded families on register at end of year 1,040 75 Table 13. SUMMARY OF INSPECTIONS & VISITS BY THE SPECIALIST INSPECTORS ENGAGED IN THE SUPERVISION AND INSPECTION OF FOOD 1. Visits to Promises Bakehouses (above ground) 291 (basement) 73 Butcher and bacon shops and stalls 394 Butter and margarine premises 40 Fish Vendors 318 Grocery and provision shops 1,152 Greengrocers and fruit Vendors 947 Ice Cream Vendors 179 Milk shops 303 Poultry Vendors 532 Public Houses 257 Restaurants, Canteens and Snack Bars 1,301 Railway Depots 361* Wharves 682 Registered Preserved Food premises (not included elsewhere) 452 Miscellaneous Visits .. .. ... 869 Revisits (not included above) 1,264 9,415 2. Reason for Visit. Food and Drugs Act,.1938 (Section 13) 4,1?0 London County Council Clean Food Byelaws 4,249 Surrender of Unsound Food 709 Merchandise Marks Acts 766 Agricultural Produce Grading & Marking Acts 40 Labelling of Food Orders 183 Food Standards Orders 151 Sampling 395 Byelaws: Fish Curer & Fish Vendor 111 Public Health Meat Regulations 332 Complaints 180 11,266 3. Action Taken. No. of Legal Proceedings taken 31 " " Notices served 552 " " Samples taken 522 * Including 295 special night or early morning inspections at Bishopsgate Goods Station. 76 77 Table 14. 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 i Milkshops Poultry Prepared Food Wholesale Marg, Dealers Type of Premises Number. Bakehouses (Basement) 7 3 — — — — — — — — — — — — — — " (Grd.level) 42 41 — — — — — — — —— — — — — — — Bakers Shops 24 24 — 3 — — 1 — — 1 — 5 3 —- — — Butter & Margarine Factories 2 — 2 — — — — — — — — — — — — — Butcher Shops 120 — . . — — — — — — — 2 — — — 118 89 — Cafes,Restaurants *&c. 353 — — 353 — — 9 — 4 5 — 64 9 —- — — Canteens (incl. Glubs, Sch. Meal Centres,&c. 285 — — — 285 — — — — — — 2 — — — — Chemists, Druggists 40 — — — 1 40 3 — — — — 1 — — — — Confectioners 236 — — — 2 — 236 — 2 — — 150 — — — — Fish Shops & Stalls 166 — — 10 — — — 166 — 1 — — — — 39 — Fruit &Vegetable Shops 630 — — — — — — 2 618 2 — — — 1 - —1 Grocers (Ret3.il) 338 — — 12 — — 120 3 5 338 — 76 238 — — 2 " (Wholesale) 52 — 2 — 7 1 2 — 1 — 52 1 2 —- 1 25 Ice Cream Premises 6 — — — — — — — — — — 6 —- —- — — Milkshops 5 — — — — — — — — — — — 5 — — — Public Houses 280 — — 208 — — 1 — — — — 1 — — — — Poultry Dealers 96 — — — — — — — — — — — — 96 — — Prepared Food Premises 31 — — — — — — — — — — — — — 31 — Miscellaneous (Wharves, &c.) 153 — — — 18 — —- — — — 1 — — — — — 2866 68 4 586 314 41 372 171 630 349 53 306 257 215 160 27 78 Table 15. NOTIFIABLE DISEASES NOTIFIED DURING THE YEAR 1955. DISEASE CASES NOTIFIED In Age Groups Notifications Corrected Total Admitted to Hospital 1- 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- 65- Ac .Encephalitis Infective 1 - - - - l 1 - - - - - 3 3 3 Ac .PoliomyelitisParalytic 1 1 4 4 4 7 2 3 1 1 - - 28 27 28 Non-paralytic - 1 4 4 2 9 5 - 5 - - - 30 17 30 Dysentery 8 17 14 8 9 25 11 4 5 5 13 36 155 147 46 Enteric Fever - -- - - - - - 1 - - - - 1 1 1 Erysipelas - - - - - 1 - -- 2 3 4 1 11 11 2 Food Poisoning - 1 - - - 3 - 1 4 2 4 - 15 18 9 Malaria - - - - - - - - - 1 - - l 1 1 j Measles 73 197 276 261 292 710 13 6 7 1 - - 1836 1834 65 Mening. Infection 1 - 1 - - 1 1 - 2 - - -- 6 5 6 Ophth. Neonatorum 20 - -- - - - - - - - - - 20 20 20 Pneumonia - 1 1 - 1 2 1 - 11 7 11 18 53 54 12 Puerperal Pyrexia - - - - - . -- - 17 112 5 -- - 134 134 134 Scabies - - 3 1 1 2 4 2 13 8 4 1 39 39 1 Scarlet Fever 1 2 3 - 5 9 2 1 3 -- -- -- 26 26 5 Tuberculosis Pulmonary 1 2 4 2 - 5 5 13 47 19 34 17 149 149 Non-Pulmonary -- 2 1 1 l 2 - 2 8 3 2 1 23 23 Whooping Cough 17 15 19 23 20 51 2 - - - -- - 147 147 6 TOTAIS: 123 239 330 304 335 828 47 50 220 j 55 72 74 2677 2656 369 There were no notifications of Diphtheria, Smallpox, Membranous Croup or Acute Encephalitis (Post Infectious) Table 16. DISEASES NOTIFIABLE IF 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 " " Diphthe ria " " Dysentery - P.H.Act, 1936 (S.143), SI.1953/299. Enteric Fever (incl. Typhoid & Paratyphoid) - P.H.(L) Act, 1936 (S.192 & 304), SI.1953/299. Erysipelas - P.H.(L) Act, 1936 (S.192 & 304). Food Poisoning - F.& D. Act, 1955, (S.26). German Measles - (Notifiable in Port of London only) Glanders - L.C.C. Order, 1909. P.H.(L) Act, 1936 (S.192 & 305). Hydrophobia " " Leprosy - P.H. Act, 1936 (S.143),SI. 1951/1036 Malaria " SI.1953/299. Measles - " SRO.1938/1100 SRO.1940/205 & SI.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, 1926/971 and 1937/35. Plague - P.H.Act, 1936 (S.143). LGB.Reg.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 " " 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, I94O/205 & SI.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). 79 Table 17. TUBERCULOSIS - New Cases and Deaths New Cases. 156 Pulmonary cases were notified and included 149 primary notifications and 6 from death returns, also 1 posthumous notification. 24 Non-Pulmonary cases were notified and included 23 primary notifications and 1 posthumous notification. Deaths.(*) 19 Pulmonary, 2 Non-Pulmonary. Age Distribution of new cases and deaths is as follows:- -1. 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total (all ages) (a) New Cases Pulmonary M - - 4 5 3 9 7 18 16 19 14 13 4 112 F 1 2 2 - 2 4 6 16 4 4 - 1 2 44 Non-Pulmonary M - 1 1 - - 1 1 3 2 1 - - 1 11 F - 1 2 2 - 1 - 5 1 1 - - - 13 (b) Deaths (*) Pulmonary M - - - - - - - - 1 2 4 4 1 12 F - - - - - - - 1 2 1 - - 3 7 Non-Pulmonary M - - - - - - - 1 - - - - 1 2 F - - - - - - - - - - - - - - (*) Compiled from local death returns. (Registrar-General's return shews 17 Pulmonary and 3 Non-Pulmonary deaths). Table 18. TUBERCULOSIS - Variations in Register Pulmonary NonPulmonary Total Cases (a) Cases on Register at l/1/55. M F M F 1178 618 391 92 77 (b) New Oases notified 111 40 11 13 175 (c) " " (corrected) 106 38 12 13 169 (d) Cases restored to Register 6 5 1 - 12 (e) Other cases added 49 17 2 6 74 (f) Removals 120 65 16 14 215 (g) Cases remaining on Register at 31/12/55 659 386 91 82 1218 80 Table 19. OPEN SPACES WITHIN THE BOROUGH LOCATION ACREAGE Maintained by Borough Council. Albert Square' Gardens 0.66 Arbour Square Gardens 0.66 Beaumont Square Gardens 1.00 Carlton Square Gardens 0.75 Christchurch Gardens, Spitalfields 1.2 5 Ford Square Gardens 0.40 Kingward Street Playground 0.13 Mile End Gardens 0,50 St.George's Gardons 0.75 St,James' Gardens, Ratcliff 2.00 Swedenborg Square Playground 0.67 St. George-in-the-East Churchyard 2.25 Shandy Street Recreation Ground 1.50 Sidney Square Gardens 0.33 Stepney Green Gardens including Clock Tower space 1.50 Trafalgar Square Gardens 0.60 Tredegar Square Playground 1.24 Trinity Square Gardens 1.13 Vallance Road Recreation Ground 1.193 Wakefield Gardens 0.067 York Square Gardens 0.20 Maintained by London County Council, King Edward VII Memorial Park. Shadwell 8.50 King George's'Playing Fields (part) 13.50 Limehouse churchyard 2.00 Stepney Churchyard 7.00 Wapping Recreation Ground 2.90 Turners Road Open Space 0.69 St,John's Churchyard, Wapping 0,60 Wapping New Riverside' Open Space 0.51 Locksley Street Public Open Space (part) 1.357 Total (approx.) 56 acres The above open Spaces represent 3.3 Per cent of the area of the Borough, Which is 1,691 acres, exclusive of the area covered bythe river, docks and canals, • • • • • > 81 INDE X Page No. Accidents - Home 6 - Road 7, 65 Aged Persons 10 Analyst's Report 59 Area of Borough 2 Atmospheric Pollution 22, 68 Bacteriological Examination of Foodstuffs 42 Bakehouses 43 Births 2, 4 Cancer 51 Catering Establishments 43 Chiropody Clinics 12 Clearance Areas 35 Common Lodging Houses 27 Complaints of Nuisances 23 Conferences 12 Deaths 2, 5, 64 Diphtheria 51 Disinfection and Disinfestation 57 Disrepair Certificates 23 Drainage 25 Dustbins 25 Dysentery 51 Factories 25, 69 Food - Inspection and Supervision 39, 76 - Premises in the Borough 77 - Poisoning 52 - Unsound 49 Free Washing Facilities 13 General Information 3 Hairdressers & Barbers Premises 25 Health Education 14, 42 Health Services, General Provision of 10 Heating Appliances (Fireguards) Act, 1952 26 Home Bathing 11 House to House Inspections 26 Houses - Number in Borough 2 Houses Let in Lodgings 26 Housing 35 Housing Repairs and Rents Act, 1954 23, 35 Housing Statistics 38, 73, 74 Ice Cream 44 Illegitimate Births 2, 4 Infant Mortality 2, 5, 66 Infectious Diseases 50, 78, 79 Information Service 15 Inquests 13 82 Laboratory Facilities 16 Legal Proceedings 27, 45 Legislation 17 Licensed Premises 26, 46 Loss of Expected Years of Life 8 Marriages 5 Maternal Mortality 2, 6 Maternity and Child Welfare 18 Meals-on-Wheels 11 Measles 53 Milk Supply 46, 62 National Assistance Act, 1948 10, 11, 13 Noise Nuisances 28 Notices Served 28 Offensive Trades 29 Old Peopled Welfare Association 11 Open Spaces 4, 81 Outworkers 30 Overcrowding 36 Pet Animals 31 Pharmacy & Poisons Act 31 Poliomyelitis 53 Population 2, 4 Prepared Food Premises 46 Puerperal Pyrexia 54 Rag Flock & Other Filling Materials Act, 1951 31 Rateable Value 2 Refuse Disposal 32 Removal of Persons in need of Care and Attention 10 Rent and Mortgage Interest (Restrictions) Acts 23 Rodent Control 32, 70 Sanitary Circumstances 22 Sanitary Inspectors - Summary of Inspections 71 - Return of Sanitary Work 72 Scarlet Fever 55 Seamen's Lodging Houses 27 Shops Smallpox 55 Social Conditions of Area 3 Special Reports to Public Health Committee 21 Statistics, Summary of 2 Staff 1, 21 Stillbirths 2, 4 Swimming Baths 21 Tuberculosis 55, 80 Underground Rooms 36 Unemployment 9 Vaccination 55, 56 Vital Statistics 2, 67 Water Supply 33 Weather Conditions 50 Whooping Cough 56 83