AC 4367 Gekd STE 30 Metropolitan Borough of Stepney Annual Report Medical Officer of Health F. R. O'SHIEL L.R.C.P.I., L.M. D.P.H. for the year 1956 Together with the Report of the Public Analyst i .. ■ f ■ ! 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 19 5 6 together with the Report of the Public Analyst CONTENTS Page Map of Borough Frontispiece Public Health Committee 3 Introductory 4 Staff 6 Summary of Statistics 7 I. Statistics and Social Conditions of the Area 8 II. General Provision of Health Services 13 III. Sanitary Circumstances 23 IV. Housing 31 V. Food - Inspection and Supervision 34 VI. Infectious and other Diseases 42 Public Analyst's Report 50 Appendix 53 Index 75 PUBLIC HEALTH COMMITTEE at 31st December 1956 Ex-officio: His Worship The Mayor (Alderman A.E.Sealey, J.P.) Chairman: alderman W.G. Humphries Vice-Chairman: Councillor (Mrs.) E.B. Bolton Alderman J. Sambrook Councillor W.W.T.Bannell " A.D.Bermel " C.W.J.Bird " (Mrs.) M.K.Bryan " B.Donovan " E.Goodwin " B.Hart Councillor E.W.Hill " R.R.Howell " M.King " W.Landrigan " M.S.Levitas " D .Milrood " B.Seymour " H.Walvisch Other Committees of the Council concerned with Public Health Services HOUSING COMMITTEE Duties under the Housing Acts other than those delegated to the Health Committee. BATHS AND WASHHOUSES COMMITTEE Management of Public Baths and Washhouses. PUBLIC CLEANSING COMMITTEE . Collection, removal, and disposal of house and trade refuse, and cleansing of highways. WORKS COMMITTEE Maintenance of sewers, parks, gardens and open spaces. 3 METROPOLITIN 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 1956. The population of the Borough according to the Registrar-General's estimate is 98,160, a decrease of 20 from last year. The population in the Census year, 1951, was 98,581. The rateable value of the Borough increased by almost a million pounds, due to revaluation, and the penny rate now produces nearly double the former income. The live birth rate* is 19.44 (18.59)≠, the death rate 12.08 (12.04), the marriage rate 19.9 (19.5), the maternal mortality rate nil (1.07), the infant mortality rate 22.52 (23.00) and the neonatal mortality rate 17.81 (18.07). There were 42 stillbirths, giving a rate of 21.53 (21.95). The weather during the year was not good though the winter was mild. A full report appears in the text. There were no major epidemics of infectious diseases during the year. Notifications decreased from 2,677 to 1,324 chiefly due to the reduction in measles which tends to recur in biennial periods. *Rates Death rate - number of deaths per annum per 1,000 population. Stillbirth rate - number of stillbirths 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, 1955. 4 There was one confirmed case of diphtheria in a child of 5½ years. Three confirmed cases of poliomyelitis were notified, compared with 44 in 1955. Warm dry summers, such as we experienced last year, appear to increase the incidence of this disease. The total number of cancer deaths, viz. 234, was lower this year, but deaths from lung cancer increased by one to 70. Deaths from pulmonary tuberculosis numbered 17, the same as last year, and notifications of new cases decreased from 149 to 116. No cases of smallpox occurred in the Borough. No deaths occurred from scarlet fever, measles, whooping-cough, diphtheria, poliomyelitis, or non-pulmonary tuberculosis. Food poisoning notifications increased slightly from 18 to 22. Some important legislation was passed during the year including the Clean Air Act, 1956, parts of which came into operation on 31st December and which is designed in the course of time to clear our skies of smoke. The new Food and Drugs Act came into operation on 1st January and the Food Hygiene Regulations on 1st January and 1st July. Our Sanitary Inspectors changed their historic name this year by Act of Parliament to "Public Health Inspectors" following the example of the Royal Sanitary Institute which is now known as the Royal Society of Health. The shortage of public health inspectors continues, and there are still four vacancies to complete the reduced establishment, One of the Hospitals in the Borough closed in 1956, the St.George-inthe-East Hospital, Wapping. In 1938 the hospital had 410 beds which at that time included several for maternity. Prior to its closure the nominal number of beds was 208. Wapping, in which the Hospital was situated, is an island formed by the Docks and delays of twenty minutes not infrequently occur when the swing bridges are closed. The presence of a hospital on the island provided a service for out-patients and in-patients which was convenient for the residents. There was'much local disappointment when the hospital closed but representations made by the Council and other interested parties to the Minister of Health failed to prevent it. The tendency appears to be to centralise services more and more and there are rumours afloat of yet another local hospital closing. 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, May, 1957. Your obedient Servant, FRANK R. O'SHIEL, Medical Officer of Health. 5 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December 1956 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 Public Health Inspectors W.Cue (l) R.W.G.Day (l) S.Firsht (l, 2) W.H.Hart (l, 2) W.H.Haworth (l) J.J.Keniry (l) L.J.Windsor (l, 2) Food Inspectors A.C.Brown (l, 2) H.J.Green (l, 2) S.S.Lowther (1, 2) S.Vogler (l, 2) Disinfestation Inspector E.J.Edwards (1,.2) Housing Inspector C.F.Guy (1) Assistant Rodent Officer G.D.Freeland (1, 2, 3) Clerical Staff T.Aylward D.J.Berry W.J .Dixon W.E.Driscoll S.W.Embleton W.T.Gardiner S.S.Harris E.F.Holt Miss R.Levey J.McMullon Mrs.M.Munday (T) M.J.O'Connor W.A.O'Sullivan M.Pliskin Caretakers W.Clark (& Mortuary Keeper) A.N.Cook (& Messenger) Hygiene Officer Miss M. Guest (4, 5, 6) Foreman Disinfector W, Sexton Messenger/ Relief-Caretaker E.H.Vaughan Disinfecting Staff 9 Males Hygiene Assistant Miss A.J.Ballam (T) Cleansing Station Attendants 2 Females, 1 Male Rodent Investigators T.J.Fox S.C.Ludlow (T) T.T.Walker (T) Rodent Operatives 4 Males (1) Public Health Inspectors' Certificate. (2) Meat & Other Foods Inspectors' Certificate. (3) Smoke Inspectors' Certificate. (4) Health Visitors' Certificate. (5) State Certified Midwife, (6) State Registered Nurse. (T) Temporary. Note: For staff changes during the year see page 22. 6 SUMMARY OF STATISTICS. 1956 . Area of Borough 1902.7 acres Population (Registrar-General's mid-year Estimate of Home Population) 98,160 Number of inhabited dwellings according to Rate Books 25,475 Rateable Value £2,261,525 Sum represented by penny rate £9,423 Density of population (persons per acre) 55.58 BIRTHS Total Male Female All Births 1951 1053 898 Live Births - Legitimate 1729 939 790 Illegitimate 180 93 87 Total 1909 1032 877 Stillbirths - Legitimate 38 19 19 Illegitimate 4 2 2 Total 42 21 21 DEATHS All Causes 1186 678 508 Maternal - - - Infants under 1 year - Legitimate 35 19 16 Illegitimate 8 6 2 Total 43 25 18 RATES* Live Birth Rate per 1,000 population 19.44 Death Rate per 1,000 population 12.08 Stillbirth Rate per 1,000 total births 21.53 Maternal Death Rate per 1,000 total births Nil Infant Death Rate (under 1 year) per 1,000 live births 22.52 Illegitimate Infant Death Rate per 1,000 illegitimate live births 44.44 Neo-Natal Death Rate (under 4 weeks) per 1,000 live births 17.81 (*) See footnotes to page 4. 7 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 1½ 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 subsoil water is towards the river. The area is to a large 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. Stepney is also one of the most important wholesaling districts in London. The Spitalfields wholesale fruit and vegetable market and the London Fruit Exchange are situated in the Borough. Interesting industries carried -on in the Borough include the manufacture of coinage both at the Royal Mint and at the Rothschild private mint, and bell casting at the Whitechapel Bell Foundry. In 1956 over 499 million coins were struck at the Royal Mint, approximately 68 per cent being for Britain. At the bell foundry referred to, which was established in 1570, many famous bells, including Big Ben, were cast, and more recently new bells for St. Clement Dane's (of "Oranges and Lemons" fame), as well as for St. Mary-le-Bow (the renowned "Bow Bells"), both destroyed in the last war. Apart-from its residential and industrial population, the Borough attracts large numbers of visitors who come to see such places of interest as the Tower of London, Tower Bridge, the Royal Mint, and "Petticoat Lane" Market. 8 Population. The Registrar-General's mid-year estimate for 1956 is 98,160. Last year's estimate was 98,180. The census taken in 1951 showed the population to be 98,581. The section of the Registrar-General's Report on the 1951 Census dealing with the usual residence and workplace of the population, published this year, revealed that the Borough's daytime population was 141,400, compared with 98,581 night-time population, an increase of over 44 per cent. The density of population is now 55.58 persons per acre. During the year there was a natural increase of population of 723, i.e. there were 723 more births than deaths. This year's estimate of the population of the Administrative County of London shows a further fall of 22,000, which reflects the continuation of the flow of population from Central London. Open Spaces. There is in the Borough a little over half an acre of parks and open spaces per 1,000 population. Births. The total number of live births registered in the Borough during the year was 3,743, and of this number 1,998 belonged to other areas. In addition, 164 births belonging to Stepney occurred outside the Borough, making a total of 1,909 births (1,032 male and 877 female) to Stepney residents. The live birthrate is 19.44 per 1,000 of the population. The rate when adjusted by the comparability factor is 16.91, compared with the rate for England and wales of 15.7. Illegitimate live births numbered 180, representing 9.4 per cent of the total live births. Stillbirths numbered 42, representing a rate of 21.53 per 1,000 total births. Marriages. The number of marriages registered during the year was 976, being 15 more than last year. The rate of marriages per 1,000 population is 19.9, compared with 19.5 in 1955. 9 Deaths. The net number of deaths registered during the year was 1,186 (678 males and 508 females), as compared with 1,183 last year. The rate of 12.08 compares with 12.04 for 1955. The principal causes of death were heart disease, which accounted for 29 per cent of the total deaths, cancer 20 per cent, and diseases of the respiratory system 17 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 on pages 54 and 55. 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 43, giving a rate of 22,52 per 1,000 live births, as compared with 23.00 last year. The rate for England and Wales for the year is 23.8. Of the infant deaths 34 were under 4 weeks old, representing a rate of 17.81 per 1,000 live births. Last year there were 33 neo-natal deaths, and the rate was 18.07 per 1,000 live births. The neo-natal mortality rate for England and Wales is 16.9. On analysing the 43 deaths of infants which occurred in Stepney it is found that 26 died from causes that from the first gave little chance of survival. These included 16 cases of prematurity and 8 others due to congenital deformities. Of the 16 premature cases, 8 died within 24 hours of birth and 12 weighed under 3 lbs. One infant aged two weeks died from a cancerous tumour of the brain (medullo blastoma). The "peri-natal" mortality rate of infants (viz. the stillbirths plus deaths occurring in the first week of life) was 29.21, compared with 37.49 last year. The Chief Medical Officer of the Ministry of Health, in his annual report for 1955, stated that though the peri-natal mortality had been about halved since 1928, it has shown little improvement since 1949, the most striking improvement which has taken place in the infant mortality rates as a whole in recent years being due entirely to the saving of infant life after the first week. The Tables on page 56 show deaths from stated causes at various ages under one year, together with comparative figures over the last 5 years. 10 Maternal Mortality. There were no maternal deaths during the year. One mother, a multipara, not certified as a maternal death, died seven days after the birth of a full term male child. Five days after the birth the case was "notified" to me as a puerperal pyrexia. Following a post-mortem the cause of death was found to be broncho-pneumonia. The pyrexia was due to pneumonia and pyelitis, the onset being two days after the confinement. Accidental Deaths. The number of deaths from accidents of all kinds continues to increase, and rose in the Borough from 36 to 49. These included 9 due to motor vehicles, the same as in the previous year (see Table on page 55 ), 16 at home, 5 at work, 6 due to drowning, 1 intoxication, 3 falls in street, 1 fall in hospital, 1 mauling by lion, 1 under anaesthetic, 1 blow on head, and 5 due to causes not stated. In England and Wales, 6,651 deaths from accidents were recorded in 1955, and four-fifths of these occurred in children under 5 and in elderly people. The Ministry drew attention to the dangers from inflammable fabrics used for clothes. Mothers should buy for their children non-inflammable fabrics which are now widely available. Loss of Expected Years of Life. Mortality rates in the Borough for the years 1953-1955, in terms of years of life lost, are given in the Table on page 57 , together with the figures for 1955 for the country as a whole. Local rates, when compared with national rates, need to be adjusted by a weighting factor which allows for any differences in population age structures, and as the standard weights for 1956 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. The statistics show that, although the death rate from all causes for 1955 was higher than that for 1954, the loss rates on the whole were less. Cancer (all sites) death rate of the Borough was higher than that of England and Wales, as were the loss rates. Cancer (lung) in males death rate was 33% greater than the previous year and nearly twice that for the country as a whole, the loss rates being proportionately higher. Bronchitis and Pneumonia death rates and loss rates were much higher than in 1954, an increase not reflected in the figures for England and Wales, The fall in both the death and loss rates for Pulmonary Tuberculosis over the three years reviewed is quite appreciable, and much greater than the national reduction. 11 Unemployment. The Ministry of Labour has kindly supplied me with the following information as to the estimated number of persons residing in the Borough registered as unemployed at the end of the year:- Men Boys Women Girls Total 1100 21 273 7 1401 The above figures included 170 men and 49 women who were temporarily unemployed. The total number of unemployed at the end of 1955 was 895. Comparative Statistics. A table showing vital statistics for the Borough at various years from 1901 is given on page 58. 12 II. GENERAL PROVISION Of HEALTH SERVICES VELFARE 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 an Order for the removal to hospital or an institution 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 11 Removal and 2 Detention 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 thronic disease, or (b) aged and/or infirm, or (c) physically incapacitated. Person Age Reason for Action * Removed to - Remarks Mr.D.D. 90 b.c. Hospital Transferred to Institution still away. Mr.G.C. 87 b.c. Hospital Discharged home. Mrs.G.A. 74 b.c. Hospital Died. Miss S.M. 63 b.c. Hospital Discharged home - died. Miss N.M. 72 a.b.c. Hospital Emergency Order for 3 weeks. Transferred to Mental Hospital under Lunacy Act - still away. Mrs.S.D. 79 b. Hospital Discharged home. Mrs.R.G. 78 b. Hospital Transferred to Institution - Mr.H.G. 76 b. Hospital still away. Miss E.L. 73 a.b.c. Hospital Emergency Order for 3 weeks. Transferred to Institution still away. Mr.T.T. 81 b. Institution Still away. Mr.M.S. 37 a.c. Hospital Transferred to Mental Hospital as voluntary patient - still away. In addition to the persons removed under Magistrates' Orders, admission was gained to hospital or institution for 31 other persons. 13 Among the old people who were assisted by the Department during the year was one old lady, reputed to be 105 years of age, who is at present accommodated in Mile End Hospital. Two women officers, one of whom is a State Registered Nurse and Certificated Health Visitor, are employed for visiting aged persons in the Borough, and 2,461 visits were made by these officers during the year. Many old people were also visited by Dr. J.E.Epsom, up to the time of his resignation from the post of part-time Assistant Medical Officer on 1st June. 1956. A register of all old people visited is kept in the Department. Amendments made in the register during the year were as follows:- Number on Register at 1st January, 1956 1,589 Additions during the year 277 Removals during the year 185 Number on Register at 31st December, 1956 1,681 The Council provides a service for disinfesting and cleansing bedlinen and personal clothing, under Section 122 of the Public Health (London) Act, 1936. In order to prevent injury or danger of injury to health, Section 43 of the London County Council (General Powers) Act, 1953, operated by the Borough Council, makes provision for the personal cleansing in their own homes of aged persons who are verminous or otherwise in need of a bath, 659 baths were given to 62 old people during the year by the Borough Council's Home Bathing Service. . Grants may be made under Section 31 of the National Assistance Act to voluntary associations whose activities include the provision of recreation and meals for old people. There are 18 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 People's clubs for grants under the National Assistance Act, 1948, are referred to the Association for investigation. Grants made by the Council to the Stepney Old People's Welfare association and to Old People's clubs during the year amounted to approximately £2,900. A list of the Clubs and facilities thereat will be found on page 59. A Mobile Meals Service is run jointly by the Old People's Welfare. Association and the women's Voluntary Services, and a weekly average of 322 meals was delivered to home bound old people. Three of the clubs, which include luncheon clubs among their facilities, provide an average of 188 meals each week. (*) Hon. Secretary, Stepney Old People's Welfare Association, St.Katharine's, Butcher Row, Cable Street, E.14 (STEpney Green 3659). Voluntary visitors are urgently required, and should apply to the Secretary. 14 Owing to rising costs, the County Council increased its contribution towards the cost of meals for old people to l0d a meal from 1st September, the recipient paying lOd. A Chiropody Service is provided by the Stepney Old People's Welfare Association at clinics which are situated in six of the Old People's clubs in the Borough, and an average of 261 treatments was given each month 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 Royal Society of Health Annual Congress. Blackpool (April) Chairman (Councillor Mrs.C. Edwards) and Medical Officer of Health. Sanitary Inspectors' Association Annual Conference. Bournemouth (September) Chairman (Alderman W.G.Humphries) and Public Health Inspector (Mr.A. C.Brown). National Smoke Abatement Society Annual Conference. Southport (October) Vice-Chairman (Councillor Mrs.E.B.Bolton) and Public Health Inspector (Mr.R."W.Day). Royal Society of Health Conference on Food Hygiene. Caxton Hall, London (March). Vice-Chairman (Councillor Mrs. E.B.Bolton) and Medical Officer of Health. London Council of Social Service Conference on West Indians in London, County Hall, London (June). Alderman J. McCarthy and Medical Officer of Health. DECEASED PERSONS. Inquests. Inquests were held on 66 residents of the Borough. 6 deaths were due to suicide, 39 were accidental, and 21 were due to other causes (3 natural causes, 9 misadventure, 4 open verdict, 1 murder, 1 want of attention at birth, and 3 where there was no evidence as to cause of death). 15 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. Twenty-four such burials (18 adults, 1 child under 10 years, 2 under one month and 3 stillborn babies) took place during the year at a cost of £218, of which sum £110 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 net, 1946. Requests for burials came from the following sources:- H.M. Coroner's Officer 15 Relatives of the deceased 9 Human Remains. During the year the remains of persons buried between 1670 and 1849 were discovered beneath the site of Holy Trinity Church, Minories. This church was destroyed by enemy action in 1940. The Secretary of State consented to the sale of the site by the Church Commissioners subject to the proper removal and re-interment of the human remains. Some 25 lead coffins were unearthed, together with a large quantity of uncoffined remains, and temporarily stored in the Council's Mortuary. The coffins contained the bodies of members of the Earl of Dartmouth's family buried during the period mentioned above, and were subsequently removed to a crematorium by the agent of the Church Commissioners under the supervision of a Public Health Inspector. Four bodies recovered from the river were received in the Mortuary during the year. 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 67,000 free washes were taken during the year. HEALTH EDUCATION. The annual Diphtheria Immunisation Campaign was held in the Borough during December. The Council also co-operated in a Home Accidents Vveek in November and the Road Safety Campaign in August. Posters on the large poster frames situated in the two main roads in the Borough were changed each month, and 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 street markets in the Borough. Posters on various health matters were exhibited at hospitals, welfare centres, day nurseries, public libraries and social clubs, on the Council's vehicles and in public conveniences, and leaflets were made available at many of these establishments. 16 Vacant sites in the Borough were kept posted with notices warning the public against depositing rubbish. The Inspectors engaged in the supervision of food premises issued leaflets to the occupiers on the Food Hygiene Regulations, 1955, together with metal notices regarding handwashing and "no smoking". 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 The London Jewish Hospital, Stepney Green 130 Queen Elizabeth Hospital for Children, Glamis Road 50 East End Maternity Hospital, Commercial Road 60 The St.George-in-the-East Hospital in Wapping was closed on 30th September, 1956, by the North-East Metropolitan Regional Hospital Board, which decision was confirmed by the Minister of Health, despite representations made by the Council and other interested bodies. The hospital was re-opened as a hostel at the beginning of December to accommodate 500 of the' refugees who fled from Hungary. The London County Council Welfare Department temporarily undertook the care of these refugees in cooperation with the British Council for the Relief of Refugees. STEPNEY BOROUGH COUNCIL INFORMATION SERVICE. The enquiries dealt with by the Stepney Borough Council Information Service during "the year" totalled 13,155, representing an increase over the previous year of2,067 (16%). As in previous years, a fair proportion of these enquiries was directly connected with health and medical problems. and many others on kindred subjects were satisfactorily settled. Some idea of the scope of the service given is indicated by the details given below, which have been supplied to me by the Borough Librarian Health and medical 710 Employment; Wages 348 Family and Personal 393 Housing and Accommodation 1056 Income Tax 139 Legislation (miscellaneous) 1049 Missing Persons 26 National Assistance and Supplementary Allowances 449 Rents and Rates 2485 Social Insurance 681 17 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. Investigations on 390 specimens were carried out during the year, 133 being submitted by the Public Health Department in connection with epidemiological investigations, and 257 by medical practitioners in the Borough. The specimens comprised 287 faeces, 77 throat swabs, 25 rectal swabs and 1 nasal swab. LEGISLATION. The following Acts, Orders and Regulations affecting the Department were made during the year:- Date Operative From Clean Air Act, 1956 Various Sanitary Inspectors (Change of Designation) Act, 1956 2.8.56 London County Council (General Powers) Act, 1956 2.8.56 Clean Air Act (Appointed Day) Order, 1956 31.12.56 Smoke Control Areas (Authorised Fuel) Regulations, 1956 31.12.56 Rent Restriction Regulations, 1956 1.4.56 Prevention of Damage by Pests (Application to Shipping) (Amendment) Order, 1956 1.3.56 Poultry Premises and Vehicles (Disinfection) Order, 1956 12.1.56 Housing (Form of Orders and Notices)(Amendment) Regulations, 1956 10.8.56 Flour (Composition) Regulations, 1956 30.9.56 Food Hygiene (Amendment)(No.l) Regulations, 1956 30.6.56 Food Hygiene (Amendment)(No.2) Regulations, 1956 31.12.56 Food Standards (Curry Powder)(amendment) Regulations, 1956 2.8.56 Food Standards (Tomato Ketchup)(Amendment)Regulations, 1956 2.8.56 Milk and Dairies (Channel Islands & South Devon Milk) Regulations, 1956 1.7.56 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, Diphtheria Immunisation Publicity Campaign, Poliomyelitis Vaccination. Ministry of Food. Official Certificates under the Public Health (Imported Food) Regulations in respect of Falkland Islands, Iceland and New Zealand; Approved Oxydising and Preservative Agents; Model Byelaws for Slaughterhouses. Ministry of Housing arid Local Government. Sewage and sewerage disposal; Frozen Pipes; Moving from the Slums. 18 MATERNITY AND CHILD WELFAHE. 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 in the Borough by the London County Council. 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 1,549 1 to 5 years of age 354 Total number of children who attended - Children born in 1956 1,442 Children born in 1955 861 Children born 1951/1954 675 Total attendances by children - Under 1 year of age 20,155 1 to 5 years of age 6,295 Ante-Natal and Post-Natal Clinics (exclusive of Hospital Ante-Natal Clinics) Ante-Natal consultations - No. of women who attended 149 No. of new cases included in above 120 Total attendances 914 Post-Natal consultations - No. of women who attended 49 Health Visitors. No. of children visited 7,856 No. of infants under 1 year of age visited for first time 2,184 Total visits to children under 1 year of age 10,635 Total visits to children aged 1 year but under 2 years 6,872 Total visits to children 2 to 5 years of age 12,801 No. of expectant mothers visited 639 Total visits to expectant mothers 1,545 19 Infant Life Protection. No. of Foster Mothers on register at end of year 16 No. of Foster Children on register at end of year 13 Child Minders (daily guardians) No, of child minders - Voluntary 17 Statutory 1 No. of children minded - Voluntary 17 Statutory 4 Care of Premature Infants.. No. of premature live births during the year 152 No. who died under 1 month 21 Immunisation and Vaccination. For details of immunisation and vaccination see pages 43 and 46 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) 26 Tuberculosis 17 Aged and Infirm Cases 733 Other Cases 136 20 2. Services Provided, Infant Consultation. Afternoons 673, Commercial Road. Tuesday and Thursday (and Friday morning). 17, Rhondda Grove Mary Hughes Centre, Underwood Road Monday and Thursday. Monday, Wednesday and Thursday. St.George's Centre, Library Place Tuesday, Wednesday and Friday. 5, Pier Head, Wapping. Wednesday. Dame Colet House, Duckett Street. Tuesday and Wednesday. Ante-Natal. 673, Commercial Road Wednesday. Vaccination against Smallpox. St. George's Centre, Library Place Friday. 35, Stepney Green 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 1st and 3rd Tuesday mornings each month. Mary Hughes Centre, Underwood Road Tuesday afternoons. 673, Commercial Road Monday afternoons. Day Nurseries. Underwood Road. Old Church Road. Christian Street. Voluntary Day Nursery. Beaumont Grove (Alice Model Day Nursery). Nursery School. Thirza Street (Sisters of Mercy). 21 SPECIAL REPORTS Special reports on the following subjects were made to the Public Health Committee by the Medical Officer of Health during the year:- Clean Air Act, 1956. Fish Curing Premises. STAFF CHANGES. The following staff changes took place during the year:Ceased duty. Anstee, W.E, Public Health Inspector. 28/12/56 Bernstein, M. General Clerk. 24/3/56 Gardner, Mrs.C. General Clerk. 5/5/56 Hurston, R. General Clerk. 25/8/56 Powell, C.E. General Clerk. 14/10/56 Silverthorne,F. W. Clerk/Trainee Public Health Inspector. 11/11/56 Commenced duty. Gardiner, W.T. Clerk/Trainee Public Health Inspector. 5/3/56 Hurston, it. General Clerk. 2/1/56 0'Sullivan, W.A. Clerk/Trainee Public Health Inspector. 10/12/56 Silverthorne,F.W. Clerk/Trainee Public Health Inspector. 1/6/56 SUMMING AND SLIPPER BATHS. Three Swimming Baths in the Borough are provided by the Council. During the year the number of swims amounted to 183,753, comprising 58,706 adults and 125,047 children, an increase of 35 per cent over last year . The water is subjected to continuous chlorination and filtration, and 19 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 269,233, which included 6,812 attendances of Old Age Pensioners and 129 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 497,224. 22 iii. SANITARY circumstances The District Public Health Inspectors served 3,722 notices during the year, and in 56 cases legal proceedings had to be employed to enforce compliance. The Department now has 7 district inspectors, which is four below the establishment. Legislation passed during the year included the Clean Air Act, 1956, which receives further mention below, and the London County Council (General Powers) Act, 1956, in a section of which power is given to Borough Councils to make byelaws regarding the artificial lighting of common staircases. Draft byelaws have been prepared and submitted to the Minister. Another Act of Parliament passed this year changed the designation of Sanitary Inspectors to Public Health Inspectors. Clean Air. The Clean Air Act, 1956, an act to make provision for abating the pollution of air, received the Royal Assent on 5th July, 1956. Certain provisions of the Act, as far as Borough Councils are concerned, came into operation on 31st December, 1956, namely, those relating to the installation of new furnaces, smoke control areas and researqh and publicity. It is understood that the remaining provisions of the Act will come into force early in 1958. The Minister of Housing and Local Government is empowered to make regulations dealing with various aspects affecting the implementation of the Act, and so far the only regulations made are those relating to authorised fuels in Smoke Control Areas. Measurements of air pollution are regularly taken in the Borough by means of deposit gauges and lead peroxide instruments which give monthly records of deposited matter and concentration of sulphur in the air, and also by combined smoke filters and volumetric sulphur dioxide apparatus which afford daily readings. Summaries of the recordings obtained from these instruments during the year will be found in Tables 8 and 9 on pages 60 and 61. In view of the present criticism of motor traffic in London creating fumes either from petrol or diesel oil it is interesting to refer to the report of Stepney's Borough Engineer in the Annual Report of the Council for the year 1906, in which he states: "A very reprehensible feature in connection with the mechanically propelled motor vehicles passing through the Borough is the quantity of oil and grease which is allowed to escape from the machinery on to the roadway. The chief transgressors in this respect seem to be the petrol omnibuses. Another very serious imperfection is the emission of hot greasy smoke from the forepart of motor vehicles... while the partial combustion of petrol may be assigned as the chief contributory cause of most of the noxious dense vapour which in this instance escapes by way of the exhaust pipe at the rear... At the beginning of last year only a score of these vehicles (motor omnibuses) were running in the Metropolis, but by 31 December the number had increased to 230." 23 All London buses now run on diesel oil and there are some 5,600 on the roads at any one time, in addition to 1,400 trolley buses. Drainage. Owners of premises were summoned on two occasions for failing to reconstruct defective drains to comply with notices served upon them under Section 40 of the Public Health (London) Act, 1936. In one case a fine of £3.0.0d and £5.5.0d costs were imposed. The other case was adjourned sine die on an undertaking given by the defendant to complete an Agreement for the Council to carry out the necessary work, on his behalf, and to pay the Council's cost of such agreement; the Court also awarded costs to the Council of £3.5.0d. Factories. A copy of the annual return furnished to the Ministry of Labour and National Service will be found in Table 10 on page 62. Heating appliances (Fireguards) Act. 1952. A retailer, summoned for exposing for sale an electric fire not fitted with a guard, was fined £1.0.0 and required to pay £2.2s costs to the Council. Secondhand electric heaters not fitted with guards, found exposed for sale at another premises, were immediately withdrawn from sale. Legal Proceedings. Legal proceedings instituted by the Public Health Inspectors during the year, showing penalties imposed, were as follows:- No. of Summonses Fines Costs Public Health (London) Act, 1936: £. S. d £. s. d Nuisance Orders 40 — 145. 8. 0 Non-compliance with Nuisance Orders 10 132. 0. 0 23. 9. 0 Defective Drains (Sec,40) 2 3. 0. 0 8. 8. 0 Rag Flock & Other Filling Materials Act, 1951 1 - 2. 2. 0 Heating Appliances (Fireguards) Act, 1952 1 1. 0. 0 2. 2. 0 London County Council (General Powers) Act, 1952 (Rag Dealers) 1 1. 0. 0 1. 0. 0 Factories Act, 1937 1 - 3. 3. 0 56 £137. 0. 0 • £185. 12. 0 An owner who was fined £25.0.0d for non-compliance with an Abatement Order, appealed to the Quarter Sessions against the decision of the Magistrates, whose decision was confirmed,and the appellant was allowed seven days in which to pay the fine and ordered to pay £5.5.0d costs to the Council for attending to oppose the appeal. 24 The Magistrates made a Closing Order under the Public Health (London) Act, 1936, on a dwelling-house in the Borough following an application by the owner. Lodging Houses - Common. There are five Common Lodging Houses in the Borough, providing accommodation for 983 persons, as follows:- 86, Cable Street. 8 men 15 & 16, Calvin Street. 41 married couples 10-22, Johnson Street. 258 men 177, Whitechapel Road. 407 men Hostel for Women, Hopetown Street. 228 women. Lodging Houses - Seamen's. There are five such premises in the Borough, providing accommodation for 488 seamen, as follows:- The Sailors' Home & Red Ensign Club, Ensign Street & Dock Street. •235 seamen The Empire Memorial Hostel, 747, Commercial Road. 190 " 5, North East Passage. 11 " 220, Cable Street. 30 " 9, Ensign Street. 22 " Lodging Houses - Other. In addition to the licensed Common and Seamen's Lodging Houses, there are two other premises in the Borough which are not subject to licensing or registration, namely, Rowton House and the Providence Row Night Refuge. Rowton House, in Fieldgate Street, Whitechapel, which was opened in 1902, provides accommodation for 796 men. Providence Row Night Refuge was founded in the Borough in 1858. "Providence Row Night Refuge" was the name of the original hostel established in Providence Row, Finsbury Square, Finsbury, and the name was retained when it moved to Crispin Street, Spitalfields in the Borough of Stepney. It is a non-sectarian charity which provides accommodation for the homeless and is run by Roman Catholic- Sisters of Mercy. The accommodation provided today is as follows:- 50, Crispin Street. 30 men ,, 30 women ,, 20 children Pursell House and Bolland House, Gun Street. 55 girls Gilbert House, Gun Street. 8 flats. 25 Notices Served. Notices served under the various Acts and Byelaws during the year were as follows:- Intimation Statutory Public Health (London) Act, 1936:- Section 82 (Nuisances) 2,813 656 Section 40 - 36 Section 109 22 5 Factories Acts, 1937 & 1948 64 - Shops Act, 1950 - 2 London County Council (General Powers) Act, 1955 Stopped up drains, etc. - 8 London County Council (General Powers) act, 1954 Dustbins 78 11 Prevention of Damage by Pests Act, 1949, Sec. 4 - 17 Stepney Borough Council (Hairdressers) Byelaws 8 - London County Council (Seamen's Lodging Houses) Byelaws 1 _ London County Council (Common Lodging Houses) Byelaws 1 - 2,987 735 Offensive Trades. There are 21 offensive business in the Borough. The register comprises the following premises: - Dressers of Furskin. (3) 34/38, Brodlove Lane. *48, 50, 50a, 54 & 56, Old Church Road. 29, Spelman Street. Kosher Poultrv Slaughterhouses. (18) *19, Bell Lane. 75, Hessel Street. 28, Burslem Street. *7, Leyden Street. l6l, Cannon Street Road. 13, Leyden Street. I6/I8, Cobb Street. 15, Leyden Street. 49, Globe Road. *7, Lower Hessel Street. *14, Hessel Street. *4, Monthope Street, *21/22, Hessel Street. *6, Monthope Street. 36, Hessel Street. 10a, Monthope Street. 42, Hessel Street. 82, Stepney Way. The Establishment Orders of premises marked (*) are subject to renewal from time to time by the Council. 26 Under the Transfer of Powers (London) Order, 1933, the Borough Council took over from the County Council in 1933 the control of offensive trades. From that year, the Borough Council has dealt with applications for orders to establish anew offensive 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". As mentioned in last year's Report, steps were taken by the Council to promote legislation to secure more effective control of those poultry slaughterhouses established in the Borough prior to 1st April, 1933 (after which date the establishment anew of such businesses became subject to conditions laid down by the Council). An appropriate clause was incorporated by the London County Council in the General Powers Bill, 1956, but a Member of the House of Commons, acting in the interests of the Board of Deputies of British Jews and the Board for the Affairs of Shechita, indicated his intention to oppose the clause on the Third Reading of the Bill. Having regard to various important matters in the Bill, the London County Council desired its speedy passage, and in consideration of a verbal undertaking given on behalf of the Board of Shechita that they would not permit the slaughter of poultry in their slaughterhouses to commence before 7 a.m., and would endeavour to ensure that the delivery of poultry would not occur before 6 a.m., the County Council withdrew the clause from the Bill without prejudice to the right to promote similar legislation in the future. Subsequently, an undertaking regarding the aforementioned points was given by all the occupiers of slaughterhouses established unconditionally by the London County Council prior to 1933. Outworkers. Forty inspections were made of Outworkers' premises. There are 687 premises on the register, an increase of 40 over last year, the trades concerned being as follows:- Wearing Apparel 626 Brushes 26 Umbrellas 5 Carding &c. of Buttons 3 Christmas Crackers &c. 3 Cardboard Boxes 10 Feather Sorting 4 Stuffed Toys 6 Artificial Flowers 1 Lampshades 1 Paper Bags 1 Linen 1 There were 32 notifications of infectious disease relating to Outworkers premises. 27 No. of Firms in the Borough employing Outworkers 89 " " Outworkers residing in and employed by firms in the Borough 246 " " Outworkers residing outside the Borough employed by firms in the Borough 581 " " Outworkers residing in the Borough employed by firms outside the Borough 441 An occupier of a factory where wearing apparel is manufactured, summoned for failing to send to the Council a list of Outworkers employed by him, was discharged conditionally on payment of £3.3.0d costs. Rag Dealers. Legal proceedings were taken against a rag dealer for contravening the provisions of the London County Council (General Powers) Act, 1952, by exchanging toys for rags and clothing with children under the age of 15 years. He was fined £1.0.Od and ordered to pay £1.0.Od costs. Rag Flock and Other Filling Materials net. 1951. A bedding manufacturer, summoned for carrying on business in unregistered premises, was given an absolute discharge on payment of £2.2.0d costs. Refuse DisDosal. The Public Cleansing Officer has kindly supplied the following information on refuse and salvage disposed of during the year:- House and Trade Refuse 32,568 tons Street and Market Refuse 7,702 " Salvage - Waste Paper 14 " 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 l¼ 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, then automatically raised, emptied into the vehicle, and returned to the trolley, and thence to the dust chamber. Approximately 400 such containers have been installed in the Borough. 28 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 were submitted to the Ministry covering the period 1st April 1956 to 31st March 1957. During this period, 12,734 dwellings and business premises were inspected, and 2,381 were found to be infested either with mice or rats. Treatments were carried out by the Department's rodent control staff to 2,073 properties which were found to be infested, the charges for servicing business premises amounting to £781. 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 63. Shops. The number of premises in the Borough covered by the provisions of the Shops Act is 2,785. No applications were received during the year for exemption from complying with the sanitary accommodation requirements. Water Certificates. Water certificates as to new dwellings having a proper and sufficient supply of water were issued in respect of 304 flats and 25 houses, under the provisions of the Public Health (London) Act, 1936. 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 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. The number of instances where water supply to premises in the Borough was repaired or reinstated totalled 309, and the Metropolitan Water Board was notified on 13 occasions where wastage of water was taking place. During the year 7 notices were received from the Metropolitan Water Board of withdrawal of the water supply, in three premises for non-payment of rates and in four because of defects in the service. 29 Wells. Bacteriological and chemical analyses of water from the seven deep wells in industrial use in the Borough are made periodically and the results reported to this Department. All were reported as being satisfactory. Workplaces. There are known to be 484 workplaces in the area (other than those premises covered by the Factories Act, 1937). Work Executed bv Council in Default of Owners . Work was carried out by the Council at the following premises in default of the owners, from whom the stated costs incurred are recoverable: - 18/20, Frimley Street. Defective drain. (Sec.40, Public Health (London) Act, 1936) £154.15.10d 93, Eric Street. Do. do. £41. 7.10d 12, Hunton Street. Stopped drain. (Sec.25, London County Council (General Powers) Act, 1955) £8.16. Id Statistics. Summaries of inspections and visits made by the District Public Health Inspectors and of insanitary conditions remedied are given on pages 64, 65 and 66. 30 IV. HOUSING Clearance Areas. During'the year an official representation was made by the Borough Council in respect of a clearance area of 131 houses. In addition, nine areas, involving 290 houses, were declared by the London County Council. One hundred and thirty-three properties were demolished under the Housing Act, 1936, during the year - 122 by the London County Council under Part III of the Act, and U by the Borough Council. One of the houses demolished was No.100, Sidney Street where, on the 3rd January, 1911, the incident which became known as the "Siege of Sidney Street" took place, when two armed men were besieged by police and Scots Guards, in the presence of Sir Winston Churchill who at that time was Home Secretary. Overcrowding. During the year 87 cases of alleged overcrowding were investigated, 56 of which were confirmed and referred to the London County Council. Fourteen overcrowded families were rehoused by the London County Council, and the number of known overcrowded families on the register decreased from 1,040 to 621, a review of the register accounting for the removal of 461 cases. Underground Rooms. There are approximately 2,850 underground rooms in the Borough used for living or sleeping purposes, about 2,730 of which are unfit. During the year 67 rooms were closed and the modified occupation of 11 rooms approved. The number of underground rooms closed since 1936 amounts to date to 408. Progress on closure generally is held up for lack of suitable alternative accommodation. An interesting case which culminated in an important ruling relating to underground rooms was heard at Shoreditch County Court and the Court of Appeal. (The Stepney Borough Council was indirectly concerned in the case by virtue of the fact that the tenant had applied to the Council and . had obtained a disrepair certificate under the Housing Repairs and Rents Act, but on completion of the work the certificate was revoked on the application of the landlord. The tenant considered that the certificate should not have been revoked). The tenant had been served with a notice of increase of rent under the Housing Repairs and Rents Act, 1954, and had failed to pay the increase because he alleged the house was in a state of disrepair. The Judge found for the landlord because the tenant held no "Certificate of Disrepair" from the Borough Council. 31 The tenant took the case to the Court of Appeal where the Judges held that it was not necessary for the tenant to obtain a certificate of disrepair in order to challenge the landlord's declaration under Section 25 of the Act that the house was in a state of repair. The case was remitted back to the County Court for it to determine whether or not the house was in good order. The County Court found in favour of the landlord that the house was in a state of good repair. Eventually in 1957 the tenant again appealed to the Court of Appeal on new grounds, namely, that the basement rooms of the premises were unfit for habitation under the Hpusing Repairs and Rents Act, 1954, by virtue of the fact that these rooms did not comply with the standard in the Underground Rooms Regulations made under Section 12 of the Housing Act, 1936. The Court of Appeal dismissed the appeal, with costs against the appellant, holding that the County Court Judge was correct in maintaining that the requirements of Sections 9 and 49 of the Housing Repairs and Rents Act were satisfied, namely that the house was fit for habitation. In giving this judgment the Court of Appeal Judges stated that in their view the County Court Judge would have been right if he had held that Section 9 of the 1954 Act amended Section 12(2) of the Housing Act, 1936; that Section 9 had the effect of relaxing the rigour of Section 12(2), and that the regulations made under the latter could no longer be held to constitute the standard for judging an underground room. This ruling of the Court of Appeal was quoted in a recent appeal case brought by a Metropolitan borough and had an important influence on its decision. 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 22 such applications were carried out during the year. Applications for Rehousing. At the end of the year there were 4,500 applications for rehousing on the Housing Manager's register, including licensees of 256 requisitioned premises who had applied for transfers. In addition, there were 481 tenants of Council dwellings who applied for transfers to larger or smaller accommodation. Preferential Housing on Health Grounds. Of the 25 cases investigated, twelve were recommended to the Borough Council for rehousing. 32 Temporary Hutments. One hundred and six hutments owned by the Borough Council remained at the end of the year. Thirteen hutments were recommended for demolition because of structural deterioration. Requisitioned Premises. The number of dwellings under requisition by the Borough Council at the end of the year was 799, involving 1,198 lettings. Eight basement rooms in requisitioned dwellings which did not comply with the regulations were recommended for closure. New Housing. During the year 329 new dwellings were completed in the Borough 127 by the Borough Council, 193 by the County Council, and 9 by private enterprise. (See Appendix, page 67 ). A total of 5,317 view permanent dwellings has been constructed in the Borough since the war - 3,258 by the London County Council, 1,983 by the Borough Council, and 76 by private enterprise. Continuing its work of comprehensive reconstruction in Stepney and Poplar, the County Council has been engaged for some time, in active co-operation with the Borough Council, in the development of a new neighbourhood unit to be known as "St.Anne's". Situated in Limehouse to the west of the Lansbury neighbourhood, St.Anne's covers 42 acres and provides for a planned population of 2,220 persons. It lies generally within the area bounded by the railway, Burdett Road, The Cut and Commercial Road and, when completed, will include 441 flats and 150 maisonettes and houses as well as a shopping centre. Provision has also been made in the reconstruction scheme for church and school sites, licensed premises, a new road and an extensive open space. From a town planning and housing point of view, the new neighbourhood is likely to have, like Lansbury, considerable interest and significance. The County Council held a naming ceremony on the site on 28th February, when the Worshipful the Mayor of Stepney (Alderman J. Sambrook, J.P.) unveiled a commemorative tablet. Statistics. A summary of inspections made by the Housing Inspector is given in Table 17 on page 71, and further housing statistics will be found on pages 68 and 69. 33 V. INSPECTION AND SUPERVISION OF FOOD The Food and Drugs act, 1955, together with part of the Food Hygiene Regulations, 1955, which were made under the Act, came into operation on 1st January, 1956. The Act consolidates the Food and Drugs Act, 1938, 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 was 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 determining whether an article of food is injurious to health, regard should also be had to the probable cumulative 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 two 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 relating to sampling and analysis. 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. 34 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, and "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 Regulatijns. 1955. Most of the Regulations came into operation on 1st January, 1956, except certain provisions involving alterations to premises or equipment, which were deferred until 1st July, 1956. The Regulations modify and 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 business, which includes canteens, clubs, and schools, as well as undertakings carried on by public and local authorities. 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) Provision of a constant supply of hot water for sinks, washbasins, 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. 35 (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. 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. In general the occupiers of food premises are co-operating in complying with the requirements of the Food Hygiene Regulations. During the year the Inspectors continued the survey of food premises on 'house-to-house' lines, and 562 premises were inspected and details of construction, hygienic conditions and facilities etc. recorded. A summary of the visits made by the Public Health Inspectors (Food) will be found on pages 70 and 71. Bakehouses and Bakers' Shoos. The proprietor of a baker's shop, summoned for selling a loaf of bread containing a button, was fined £5.0.0d and £6.6.0d costs. Fines totalling £135.0.0d and £9.9.0d costs were imposed on the occupier of a bakehouse following the service of six summonses relating to dirty conditions found at the premises. Butchers' Shops and Stalls. Legal proceedings_were instituted on two occasions against butchers for selling minced meat containing preservative, and on another occasion for the defective condition of the premises. Fines totalling £17.10,0d with costs of £11.6.0d were imposed. Twenty-five samples of beef and pork sausages submitted for analysis were found to have an average meat content of 57.1% and 65.6% respectively. 36 Bacteriological Examination of Foodstuffs. Samples of food submitted for bacteriological examination numbered 150, details of which are as follows:- No.of Samples No.unsatisfactory Observations Egg Albumen Powder 48 3 Two showed presence of Salmonella Senftenberg and 1 Salmonella Aberdeen. (Parcels affected were re-exported). Egg Yolk 21 2 Salmonella Typhi-murium (affected cases re-exported). Pressed Beef 15 1 Staphylococcus Aureus Pyogenes isolated. Proprietor and staff instructed and advised on methods of production, and a code agreed with the proprietor. Subsequent samples (8) proved satisfactory. Ice Cream 13 2 Grade III - manufactured outside the Borough. No adverse reports were received on the following samples examined:13 Egg Albumen Crystals, 7 Pasteurised Milk, 4 Frozen Liquid Whole Egg, 3 Dried Whole Egg, 3 Dressed Crab, 3 School Dinners, 2 Frozen Egg White, 2 Synthetic Cream, 1 Canned Tripe, 1 Gelatine Powder, 1 Sausage Pink, 1 Gelatine Water Colouring. The following samples were examined in connection with cases of suspected food poisoning and all proved satisfactory:- 1 Cake Mix, 1 Home Made Cake, 1 Liver and Bacon Paste, 1 Steak Pie, 1 Steak and Kidney Paste, 1 Corned Beef, 1 Synthetic Cream Doughnut, 1 Pork Pie, 1 Sage and Onion Stuffing, 1 Sausage (uncooked), 1 Confectionery (containing egg albumen), 1 Canned Peas. Export Certificates. Thirty certificates were issued in respect of the examination of foodstuffs for export to South America, Sweden, Canada and the United States of America. Grocers' and Miscellaneous Food Premises. The magistrates discharged absolutely, on payment of £3.0.0d costs, the proprietor of a grocer's shop on whom 4 summonses were served for failing to cleanse the premises and to provide a constant supply of hot water. Legal proceedings were taken against four other shopkeepers, 3 summonses being in respect of minced meat containing preservative and one of ground ginger which contained an excessive quantity of lead. In these cases fines amounting to £32.0.0d and £13.10.0d costs were imposed. 37 Ice Cream. Of thirteen samples of ice cream submitted for bacteriological examination, 10 were subjected to the Methylene Blue reduction test with the following results:- Manufactured Total In Borough. Outside Borough. Grade I 1 (-) 6 (3) 7 (3) " II 1 (2) - (5) 1 (7) " III - (-) 2 (-) 2 (-) " IV - (-) - (4) - (4) The figures in parenthesis show the totals for 1955. The respective Local Authorities were notified of the two unsatisfactory samples (Grade III) manufactured outside the Borough. Three samples were examined in connection with cases of suspected food poisoning and were found to be satisfactory. Although there are 29 premises in the Borough registered for the manufacture of ice cream, only two premises were used for this purpose during the year. These were inspected from time to time under the Ice Cream (Heat Treatment) Regulations, 1947-1952, and the thermometer readings checked. No contravention of the regulations was found. Imported Egg Products. Quantities of Chinese dried and crystalline egg albumen, whole-egg powder and frozen liquid whole-egg are imported into this country. Frozen liquid egg is also imported from Australia, New Zealand and South Africa. Reports show that some of these egg products are found to be infected with Salmonella or other food poisoning organisms; for example Salmonella strain was isolated from 27% of 128 cases of Chinese frozen egg mixtures examined in 1955 by the Central Public Health Laboratories at Colindale. Outbreaks of paratyphoid fever were found to be due to Salmonella paratyphoid-B, type 3A, in cakes filled with imitation cream prepared in two bakeries in which unopened tins of Chinese frozen whole-egg were found to be contaminated with the same type 3A Salmonella paratyphoid-B. These outbreaks and the sampling concerned took place outside Stepney. All such products are examined at the ports of importation and the Ministry of Health has held meetings with the medical officers of health of the ports and riparian authorities concerned, including Stepney. The Ministry has also conferred with representatives of the trade concerned in the importation of these products. These egg products have been extensively used for many years by the bakery trade. The process of making fillings for cakes and meringues 38 does not involve sufficient heat treatment to bring about sterilisation and if the egg product is infected with Salmonella or paratyphoid-B, outbreaks of food poisoning due to these organisms may occur, and some recent outbreaks may have been attributable to this cause. As a result of discussions with the Ministry of Health the following procedure was agreed upon:- (i) All Chinese dried and crystalline albumen shall be suitably heat treated at a number of centres which are being set up by the trade. All Chinese albumen will go from the ports to these centres. Heat treated albumen would be adequately sampled; and (ii) there will be suitable sampling of powdered whole egg and yolk and frozen liquid egg at the place of entry, from whatever source, and batches of the products, or individual cases or tins giving positive results will be detained. In Stepney, the Food Inspectors have taken samples of these egg products since May, 1955, and all imports have been detained as a routine pending bacteriological examination. Details of the samples of these various egg products, with results, are given in the table relating to the bacteriological examination of foodstuffs. As an example, 896 cases of Chinese dried whole-egg powder were detained at a wharf in December, 1955. Samples from 784 cases were found to be negative and these were released. Samples from the remaining 112 cases were found to contain Salmonella and these were subsequently re-exported to China. Leeal Proceedings. Summonses taken out during the year by the Public Health Inspectors (Food) were as follows:- No.of Summonses Fines Costs £. s. d. £. s. d. Food and Drugs Act, 1955 7 47. 0. 0. 26. 10. 0. Food Hygiene Regulations, 1955 12 142. 10. 0. 17. 1. 0. 19 £189. 10. 0. £43. 11. 0. Cautionary Letters. On the instructions of the Public Health Committee, cautionary letters were sent in respect of the following contraventions: - Sale of buttered rolls, the fat of which consisted of margarine 3 cautions Sale of peas contaminated with a dye 1 caution Smoking a cigarette by a food handler in a food room where poultry was exposed for sale 1 caution 39 Public Health (Imported Food) Regulations. 1937-1948. Detention and Release Notices, numbering 54 and 64 respectively, were served under these regulations. The notices affected a varjety of foodstuffs including cocoa, dried egg powder, dried fruits, nuts, frozen mutton, dried egg albumen, hog and sheep casings and assorted canned goods. Consignments of sheep and hog casings which arrived unaccompanied by the official certificates, were subsequently released on production of the necessary certificates. 553 carcases of mutton, representing a 5 per cent examination, were examined for caseous lymphadenitis by the cutting of the lymphatic glands. All the carcases were found to be free from the disease. Zeebrugge-Harwich Train Ferry. 305 midnight or early morning visits, and 101 other visits, were made to Bishopsgate Goods Station for the purpose of examining 6,812 trucks of foodstuffs arriving from the following countries:- Austria 5 trucks Belgium 209 " Bulgaria 187 " Canary Islands 11 " Czechoslovakia 8 " Denmark 14 " England (returned exports) 2 '' Germany 15 " Greece 30 trucks Hungary 517 " Italy 5,376 " Spain 5 " Switzerland 5 '' South Africa 1 " Turkey 4 " Yugoslavia 423 " The weight of the foodstuffs examined was 64,368 tons, comprising fresh fruit and vegetables 53,450 tons, preserved fruits and vegetables 357 tons, cheese 36 tons, fish 17 tons, preserved meats, sausages, etc. 4,671 tons, butter 1,478 tons, eggs 2,156 tons, biscuits, cakes and confectionery 56 tons, canned soups 6 tons, bacon 2,034 tons, honey 33 tons and miscellaneous foods 74 tons. The foodstuffs found to be unsound, and which were stopped and destroyed, amounted to 12 tons 16 cwts. Samples taken for analysis included baking powder, blancmange powder and gelatine from Germany and canned tripe and sausages from Yugoslavia. A sample of canned tripe was also submitted for bacteriological examination. All the samples proved satisfactory. Two trucks of Italian walnuts, weighing 21 tons, detained because a considerable percentage of the nuts were bad, were subsequently re-exported. Two of the trucks from Belgium contained horseflesh for human consumption, exported from Britain, but were refused by the Belgian consignees and returned to this country via the train ferry. On examination the 40 horsemeat was found to be unfit for human consumption and was condemned and released under supervision for use as fertiliser. One truck of Italian apples was detained as several of the boxes were not marked in accordance with the Merchandise Marks Act. The apples were subsequently released on an undertaking given by the importer to take the matter up with the Italian authorities to ensure that all future consignments were correctly marked. Unsound Food. The following quantities of unsound foodstuffs were disposed of during the year under the Public Health (Imported Food) Regulations, 1937-1948, and the Public Health (London) Act, 1936:- Premises Tons Cwta Qrs Lbs Wharves 151 5 0 19 London Fruit Exchange and Spitalfields Market 92 14 2 15 Railway Depots 13 9 0 6 . Zeebrugge-Harwich Train Ferry (at Bishopsgate Goods Station) 12 16 2 15 Other Premises 33 15 3 24 304 1 1 23 Approximately 20 tons of unsound food were allowed to be used for animal feeding purposes, or for manufacturing purposes other than for human consumption, the remainder being delivered to, or collected by the Public Cleansing Department, at whose riverside depot it was mixed with household refuse under the supervision of the Public Cleansing Officer, and removed by barge to a controlled tipping site in Essex. Over 2,200 Condemnation Certificates in respect of unsound food were issued in 1956. Improvements effected at Food Establishments. No. Lavatory basins installed 222 Premises where hot and cold water supply installed 352 Premises where washing facilities for staff have been improved 327 Sinks provided 86 Food storage accommodation provided 47 Refrigerators installed or repaired 20 Premises where walls, ceilings, floors, windows cleansed 904 Floors renewed or repaired 69 Shop-fronts improved 17 Premises where ventilation provided or improved 35 Premises where natural lighting improved 12 Protective covers provided for displayed food 41 Refuse bins provided 93 Miscellaneous improvements 1,219 41 VI. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES Weather Conditions. On the whole 1956 was a year of dull weather and low temperature in Summer but, with the exception of February, the Winter was not a very cold one. Dense fog occurred in London during 4th-6th January, and is stated to have caused over 400 additional deaths in the County and almost 1,000 in Greater London. This is the third major fog mortality incident in London since 1948. Age groups predominantly affected were babies in their first year and persons over 65. Deaths, occurring in Stepney during the ten day period, 4th-13th January, 1956, showed an increase of 56 per cent over the previous ten days, 25th December, 1955, to 3rd January, 1956. January was wet and changeable with much fog in the first week, February was exceptionally cold with some snow and sleet, March was dry and sunny, April was rather cold, whilst May, being very dry and sunny, was one of the best months of the year. June was cold and dull with little sun and some thunderstorms, July was cool, dull and wet - the night of 8th-9th, with 2.38 inches of rain at Kew, being the wettest since 1871. The month ended with gales. August was the coldest at Kew since 1922; there was heavy rainfall and thunder on several days and sunshine was below normal. September was the fourth successive dull month and commenced with much rainfall. Thus ended a very bad Summer. October opened with very heavy rainfall on the first day, being otherwise fairly dry though cold; there was considerable fog from the 9th-l6th. November was very dry but cold towards the end, and December, changeable and exceptionally dull, was the gloomiest December for 66 years. The Easter holiday week-end, 30th March to 2nd April, was dry and mostly dull but Monday was very pleasant; Whitsun, 19th-21st May, was dry and sunny but cool, and August 4th-6th cool and thundery. Notifications. A total of'1,324 notifications of cases of infectious diseases were received during the year, as compared with 2,677 in 1955; the difference being largely accounted for by the high number of notifications of measles last year. Table 18 on page 72 shows details of notifications received, together with age groups.The diagnosis was not confirmed in six of the abovementioned notifications. A list of the diseases notifiable in the County of London is shown in Table 19 on page 73. 42 By virtue of Section 61 of the London County Council (General Powers) Act, 1956, Continued Fever was removed from the list of notifiable infectious diseases. Cancer. The number of deaths from cancer of all sites occurring in residents of the Borough during the year was 234, being 13 less than last year. Deaths from lung cancer numbered 70, one more than in 1955. The association between cancer of the lung and smoking leaves little doubt that smoking is a direct cause of lung cancer. Diphtheria. Although 4 notifications of diphtheria were received, in only one case was the diagnosis confirmed. The confirmed case was a boy of 5½ years and was unusual, inasmuch as he was one of the rare cases where a fully inoculated child develops severe diphtheria with extensive membrane, toxaemia, myocarditis and albuminuria. However he made a complete recovery It must be remembered that whilst "diphtheria immunisation" in a rare number of cases does not confer complete immunity it almost always prevents death from the disease. The child was inoculated in 1952 with two doses of A.P.T., with an interval of 4 weeks between the doses. The case has been well written up in the "Lancet" of 29th September, 1956, by Dr.B.Winokur, lately of St.Ann's General Hospital, London, to whom I am much indebted for his great interest in the case. The number of children immunised at London County Council clinics during the last 3 years was as follows: - 1956 1955 1954 Completed primary course:- Children under 5 1761 601 1386 Children 5 to 15 439 84 472 Children given secondary injection 1563 893 1239 Owing to the policy of deferring immunisation whilst poliomyelitis is occurring in the district, the number of children immunised in 1955 was considerably less than this year. Notifications and deaths in England and Wales fell from 18,596 and 722, respectively, in 1945, to 161 and 11 in 1955. Seventy-seven swabs were forwarded by general practitioners to the Mile End Group Laboratory, where bacteriological examinations are carried out on behalf of the Borough Council. 43 Dysentery. There was a decrease in the incidence of Sonne dysentery, 116 cases being notified, as compared with 147 cases last year. The Ministry of Health points out that notifications in 1955 reached the highest total ever recorded, but that due to more laboratory investigations in recent years, symptomless excreters of the organisms have come to the fore, and this may to some extent explain the increase in notifications. Erysipelas. During the year eight notifications were received. Food Poisoning - Delay in Notification. Of 8,961 cases of food poisoning in England and Wales recorded in the 1955 Report of the Chief Medical Officer of the Ministry of Health, 5,269 were found or presumed to be caused by Salmonella organisms. In 3,447 cases it was not possible to identify either the food eaten or the food poison germ infecting it. Early notification to the medical officer of health by doctors and hospitals is essential if the causal agent is to be discovered. Unfortunately many cases of food poisoning are not notified and others are notified too late to trace the cause. Rather than wait until the diagnosis is confirmed it is better to notify at once as "suspected food poisoning". It is seldom possible to trace the cause without bacteriological examination of the meal partaken, and to secure the remains of the meal before it is destroyed it is necessary for the health inspector to visit within a few hours. During the year there were 40 known cases of suspected food poisoning in the Borough, of which 22 were officially notified. There were no deaths. In nine cases a Salmonella was isolated from the patient's stool but in no case was the source of infection traced to any article of food. One group of cases related to four hospital nurses infected with Salmonella typhimurium. It was considered that the suspected food might have been homemade pastries made from egg products, either Australian liquid whole egg, Chinese hen-egg albumen or English liquid whole egg; but when these egg products were bacteriologically examined Salmonella typhi-murium was not found. An outbreak not officially notified occurred among some cadets who breakfasted at a hostel outside Stepney and lunched at a school dinner centre in Stepney. Seventeen cadets were affected with stomach pains and diarrhoea. Only seventeen of the 54 cadets at risk were affected, and none of the teachers or children of the school, and it is therefore unlikely that the school meal was the source of the trouble. The cause of the outbreak was not ascertained. Examination of the excreta of the cadets and the kitchen staff gave negative results. 44 Apart from the above two outbreaks, the other cases of food poisoning which occurred in the Borough related to single individuals, and three small family outbreaks involving 3, 2, and 2, persons respectively. Influenza. Of the various forms of pneumonia only acute primary and acute influenzal are notifiable, and 79 cases were notified. In the Ministry's annual report for 1955 it is stated that influenza has been showing signs of biennial epidemicity in recent years. Malaria. There were no cases of malaria notified during the year. Measles. Notifications of meales in the Borough numbered 574, compared with 1,834 last year, but there were no deaths from the disease. Epidemics tend to recur at intervals of just under 2 years, the peak month last year being April, with the seasonal rise commencing again in November of this year. The incidence of measles continues to be high. So far, no way has been found to immunise children against the disease. In the past, most deaths were caused by pneumonia as a complication, but due to better nursing facilities and the use of antibiotics and sulphonamides deaths from the disease have greatly decreased. Between 1901 and 1910 no less than 1,728 deaths from the disease occurred in the Borough, equivalent to an annual mortality 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, 1947-1956, there were five deaths, the rate being 0.05 per 10,000 population. Meningococcal Infection. There were 5 notifications and 2 deaths during the year, compared with 5 notifications and one death last year. Ophthalmia Neonatorum. There were three cases notified this year. Poliomyelitis. This year saw a decrease in the number of cases of poliomyelitis, 3 cases being confirmed compared with 44 last year. The incidence of the disease tends to be greater in hot summers. 45 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 63 notifications during the year, compared with 134 in 1955. Of the 63 cases notified, 27 were residents of the Borough. Scabies. Scabies is still notifiable under the County of London (Scabies) Regulations, 1943. The number of cases formally notified was 43, compared with 39 last year. Ninety-three scabies patients and contacts were treated by medicinal baths at Branch Road Treatment Centre and their clothing disinfested, viz: - Males Females Children 48 25 20 The number of baths given totalled 144 during the year. Scarlet Fever. There were 34 cases notified and 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 re-vaccinated at London County Council clinics during the year was 910. Tuberculosis. The number of primary notifications of pulmonary tuberculosis received was 116, compared with 149 last year, and the number of nonpulmonary cases notified was 11, as compared with 23 last year. The mortality rate for the year for pulmonary tuberculosis was 17, and of non-pulmonary nil per 100,000 population, as compared with 17 and 3, respectively, in 1955. (For details of register and notifications see page 74). 46 In view of the interest always taken in tuberculosis, it is pleasing to be able to refer to a comment in the Ministry of Health's Annual Report for 1955,wherein it is stated that a striking decline in the number of cases and deaths has taken place within the past six years, which justifies a hope that continued efforts should see the end of tuberculosis as an important health problem in the not too distant future. The figures for Stepney show that deaths have steadily declined from 50 in 1952 to 17 in 1956, and although the decline in notifications of pulmonary tuberculosis has not been so regular the numbers have fallen from 173 in 1951 to 116 this year. 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 during the year to take action under the regulations. Tuberculosis Care Committee. The Tuberculosis Care Committee, on which are represented voluntary and official bodies, and whose meetings are attended by the Medical Officer of Health, continues to supply help to tuberculous persons and to 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. Although tuberculosis is slowly but surely being conquered, the public should realise that much help is still needed to be given to persons suffering from the disease. Extra nourishment was given to 205 patients in the year through the London County Council Extra Nourishment Scheme, and 48 patients went for recuperative convalescent holidays. Help was also given during the year to 118 persons by way of clothing, extra nourishment, bedding, holiday expenses, fuel, wireless licences and fares to relatives visiting patients in sanatoria. The annual Christmas Seal Sale Fund amounted to £244, 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 last year 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. 47 Whooping Cough. Two hundred and thirty-five cases were notified during the year, the figure for 1955 being 147. There were no deaths from the disease. Infectious Disease Contacts. Where a person is precluded from continuing at work by reason of being a carrier, or having been in contact with an 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 two such certificates during the year. Authentication of International Certificates of Vaccination and Inoculation. A person proceeding abroad is required in certain countries to produce a certificate of recent successful vaccination and inoculation, and, in addition, the signature of the vaccinating doctor must be verified by the Medical Officer of Health of the district. The signature on 671 such certificates were verified by me during the year as those of medical practitioners practising in Stepney, and the certificates were endorsed accordingly. Disinfection. Eighty premises were disinfected because of infectious disease, of which 7 were for pulmonary tuberculosis. 22,585 articles of clothing and bedding were steam disinfected, including 13,525 articles for export, for which 60 certificates were issued. Formaldehyde disinfection of 117,000 articles of clothing, 220 tons of boots and 186 tons of waste paper for export was also carried out during the year, for which 53 certificates were issued. The charges for export and other disinfections carried out amounted to £182. Disinfestation (bed bugs and other insect pests). The following is a summary of work carried out by the specialist inspectors engaged on disinfestation duties:- 48 General inspections for vermin 917 Attempted visits 179 No. of premises found verminous 250 No. of revisits 287 No. of miscellaneous visits 565 No. of premises sprayed 643 No. of rooms sprayed 1,484 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, E.14. The furniture and effects of 183 such families were treated during the year. In addition, disinfestation by steam and formaldehyde was carried out on 10 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 392 28 13 .. 433 The number of baths and treatments given amounted to 464. SUMMARY OF PUBLIC ANALYST'S QUARTERLY REPORTS For the Year 1956 During the year 347 samples were submitted for analysis, 155 being purchased or taken formally and 192 informally. The samples are classified as follows:- 15 Alcoholic Spirits 1 Jelly (Table) 2 Arrowroot 1 " (Turtle) 4 Baking Powder 1 Kangaroo Tail Soup 2 Blancmange Powder 1 Luncheon Sausage 1 Bread 6 Margarine 12 Buttered Rolls and Slices 3 Meat (canned) 1 Cake 32 " (minced) 6 Cake Mixtures 1 Meat Paste 4 Cheese 2 Meat Pies 3 Chewing Gum 95 Milk 1 Chicken and Lentils (canned) 1 Mint Sauce 1 Chilli Powder 1 Mustard (prepared) 1 Chocolates 1 Non-brewed Condiment 5 Condensed Milk 1 Oranges 2 Cucumbers in Brine 1 Peas (canned) 1 Curry Powder 3 Pickles 6 Dripping 2 Ravioli (canned) 5 Fish (canned) 36 Sausages & Cooked Sausages 4 Fish (bottled) 2 Spices and Herbs 2 Fish Paste 3 Soft Drinks 1 Fruit (canned) 1 Soft Drink Tablets 2 Fruit Squashes 9 Soups (bottled and canned) 4 Frying Oil 2 Soup Tablets 1 Gelatine 1 Split Peas in Stew 2 Gravy Powder 1 Sweets 5 Ground Ginger 10 Tea 1 Ice Cream 1 Tomato Ketchup 2 Ice Lollies 1 Tripe (canned) 3 Jam 2 Vinegar 3 Boracic Ointment 2 Cascara Tablets 1 Cough Mixture 2 Epsom Salts 2 Glauber Salts 2 Glycerine 1 Halibut Oil Capsules 1 Olive Oil 1 Sedative Tablets 3 Throat Lozenges 2 Vitamin Preparations 2 Wintergreen Oil & Liniment 4 Zinc Ointment and Cream. 50 Of the 347 samples analysed 9 formal and 9 informal were found to be unsatisfactory, as follows:- Article Formal or Informal Nature of Irregularity Remarks Milk. Informal 2.3% added Water. Formal sample satisfactory. Minced Meat. Informal Contained Sulphur Dioxide (410 parts per million). Formal sample satisfactory. Do. Informal Contained Sulphur Dioxide (4000 parts per million). See following formal samples. Do. Formal Contained Sulphur Dioxide) (650 parts per million). ) Fine £5:0:0. Do. Formal Contained Sulphur Dioxide (450 parts per million). Costs £3:7:0. Do. Formal Contained Sulphur Dioxide (100 parts per million). Fine £10:0:0. Costs £6;l6;0. Do. Formal Gontained Sulphur Dioxide (2500 parts per million). Fine £5:0:0. Costs £3:7:0. Do. Formal Contained Sulphur Dioxide (1100 parts per million). Fine £2:0:0. Costs £3:7:0. Buttered Rolls. Formal Fat consisted of Margarine Cautionary letter sent. Buttered Buns. Formal Do. Do. Buttered Slices. Formal Do. Do. Cake Mixture. Informal "Soapy" taste, due to acidity. Stock withdrawr from sale. Margarine. Informal Excess of Vitamin A. Manufacturers advised. Ground Ginger. Informal Contained Lead (50 parts per million). See following sample. Do. Formal Contained Lead (60 parts per million). Fine £20:0:0. Costs £3:7:0. Pork Sausages. Informal Contained 46% Meat. Formal sample satisfactory. Rollmops. Informal Bottle not properly labelled. Formal sample unobtainable. Split Peas in Stew. Informal Contained red dye. Cautionary letter sent. 51 Milk. 95 samples of milk were examined during the year, 3 being of the super-fatted variety (e.g. "Channel Islands" or "South Devon" milk) for which a higher minimum percentage (4%) of milk fat content is provided for by arrangement between the producers and the Ministry of Agriculture, Fisheries and Food. The average composition of the ordinary milk samples (excluding "Channel Islands, etc." milk) was 3.52 per cent fat and 8.53 per cent solids other than fat, and of the "Channel Islands" milk 4.32 per cent fat and 8.85 per cent solids other than fat. Average composition of ordinary milk samples (excluding "Channel Islands,etc." milk) taken over the past 10 years, is as follows:- Year No. Samples Examined Fat, Per Cent. Solids-not-Fat, Per Cent. 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 1956 92 3.52 8.53 APPENDIX of STATISTICAL TABLES 53 54 Table 1. TOTAL DEATHS BY CAUSE AND AGE OF STEPNEY RESIDENTS - 1956 (Registrar-General's Return) CAUSES OF DEATH ALL AGES Age Groups Total M F -1 1- 5- 5- 25- 45- 65- 75- 1. Tuberculosis - Respiratory 17 12 5 – – – – 4 6 5 2 2. " - Other – – – – – – – — – – – 3. Syphilitic Disease 9 7 2 – – – – 1 2 – 6 4. Diphtheria – – – – – – – – – – – 5. Whooping Cough – – – – – – – – – – – 6. Meningococcal Infection 2 – 2 – – – – – 1 1 – 7. Acute Poliomyelitis – – – — – – – – – – – 8. Measles – – – – – – – – – – – 9. Other Infective and Parasitic Diseases 2 – 2 – 1 – – – 1 – – 10. Malignant Neoplasm - Stomach 26 18 8 – – – – 3 10 6 7 11. " - Lung, Bronchus 70 60 10 – – – – 4 31 24 11 12. " - Breast 22 1 21 – – – – 2 15 3 2 13. " - Uterus 11 – 11 – — — – — 6 1 4 14. " - Other 100 54 46 1 — 1 l 10 28 26 33 15. Leukaemia, Aleukaemia 5 3 2 — 1 – 1 – – 1 2 16. Diabetes 11 5 6 — – – – – 2 8 1 17. Vascular Lesions of Nervous System 107 48 59 – – 1 1 2 16 35 52 18. Coronary Disease, Angina 201 136 65 – – – – 7 58 73 63 19. Hypertension with Heart Disease 38 19 19 — — — – 1 6 15 16 20. Other Heart Disease 104 45 59 – – – – 4 32 16 52 21. Other Circulatory Diseases 56 23 33 – – – 1 2 7 17 29 22. Influenza 2 2 — – – – – – 1 – 1 23. Pneumonia 77 44 33 7 1 – 1 2 9 20 37 24. Bronchitis 119 83 36 – 3 – – 1 22 31 62 25. Other Diseases of Respiratory System 10 7 3 – 1 1 – – 1 4 3 26. Ulcer of Stomach and Duodenum 15 10 5 – – — — 1 3 7 4 55 Table 1 (contd.) CAUSES OF DEATH ALL AGES Age Groups Total M F -1 1- 5- 15- 45- 65- 75- 27. Gastritis, Enteritis and Diarrhoea 8 3 5 2 – – – 1 1 3 1 28. Nephritis and Nephrosis 10 6 4 – – — 3 — 2 3 2 29. Hyperplasia of Prostate 6 6 – – – – – – – 2 4 30. Pregnancy, childbirth, abortion – – – – – – – – – – — 31. Congenital Malformations 14 9 5 6 1 1 – 2 1 2 1 32. Other defined and ill-defined diseases 88 42 46 24 1 – 1 10 19 13 20 33. Motor Vehicle Accidents 9 6 3 – – – 1 3 – 3 2 34. All other accidents 40 26 14 3 – 4 3 3 8 7 12 35. Suicide 6 3 3 – – – 1 – 3 2 – 36. Homicide and operations of war 1 – 1 — — — — — 1 — — Males 678 – 25 5 7 9 33 186 192 221 Females _ 508 18 4 1 5 30 106 136 208 GRAND TOTAL: 1186 43 9 8 14 63 292 328 429 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 Injured 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 1956 – 58 — 60 4 742 4 860 1956 Pedestrians Motor Cyclists Pedal Cyclists Drivers Other Road Users TOTAL killed 3 — 1 – — 4 Injured 316 91 136 97 220 860 56 Table 3. INFANT MORTALITY, 1956. 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 under 4 wks. Months 1- 2- 3- 1- 4- 7- 10- Cancer (Mcdullo blastona) — — — 1 — 1 — – — — 1 (-) 2.33 Pneumonia — — — – 1 1 2 2 – – 5 (3) 11.63 Gastritis,Enteritis, &c. – — — – – – — 1 – 1 2 (1) 4.65 Congenital Malformations 2 2 — — 2 6 1 1 – – 8 (5) 18.60 Premature Birth 5 9 1 — 1 16 — — – – 16(19) 37.20 Atelectasis 2 3 – – – 5 – – – – 5 (6) 11.63 Haemolytic Disease of the New Born 1 1 – – – 2 – – – – 2 (1) 4.65 Unascertainable (found dead) 1 – – – _ 1 – – – – 1 (-) 2.33 Accidental smothering by pillow – – – – – – 1 – 1 – 2 (-) 4.65 Inhalation of Vomit 1 – – – – 1 – – – – 1 (-) 2.33 TOTALS 12 15 1 1 4 33 4 4 1 1 43(41) 100.00 Figures in parenthesis denote corresponding deaths in 1955. * Includes deaths from other causes. 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 1952 6 16 2 24 11 35 68 1953 18 11 7 36 38 74 49 1954 17 11 4 3.2 9 41 78 1955 18 11 4 33 8 41 78 1956 12 15 6 33 10 43 77 Table 5. LOSS OF EXPECTED YEARS OF LIFE In years 1953-55. 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 1955 1954 1953 1955 1955 1954 1953 1955 1955 1954 1953 1955 All Causes M 144 139 148 125 759 900 998 763 2902 2884 3066 2430 F 95 88 92 109 537 518 734 489 1725 1752 2011 1634 Pulmonary Tuberculosis M 2 5 6 2 15 36 47 19 53 129 141 51 F 1 1 1 1 3 3 31 12 28 13 63 25 Cancer (all sites) M 30 31 29 23 130 170 133 113 562 619 549 423 F 20 21 18 19 133 145 129 96 . 429 487 397 329 Cancer (lung & bronchus) M 12 9 9 7 74 39 55 38 275 172 209 144 Coronary Disease M 22 19 19 21 99 80 48 74 437 367 281 342 F 7 10 11 11 15 39 23 18 91 177 155 120 Other Cardiac Disease M 14 13 11 19 24 31 30 35 186 192 161 235 F 16 14 12 24 36 30 46 33 201 186 189 230 Bronchitis & Pneumonia M 30 22 27 14 105 61 87 82 506 333 416 270 F 13 7 12 9 35 15 67 43 164 93 214 133 57 Table 6. 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 2.63 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 99,730 1845 18.5 1255 12.5 49 26 2 1.0 244 2.4 56 0.5 1951 98,581 1846 18.7 1364 13.8 39 21 0 0.0 232 2.3 49 0.4 1952 99,000 1894 19.1 1371 13.8 35 18 6 3.0 241 2.4 50 0.5 1953 98,570 1919 19.5 1187 12.0 75 39 1 0.5 237 2.4 43 0.4 1954 97,900 1851 18.9 1126 11.5 41 22 1 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 1956 98,160 1909 19.4 1186 12.1 43 22 0 0.0 234 2.4 17 0.2 58 Table 7. List of Social Clubs. Lunch Clubs and Chiropody Clinics affiliated to The Stepney Old People's Welfare Association B.E.T.A. Club for Pensioners, meets at St.Peter's Hall, Cephas Street, E.l. Fridays, 7.30-10 p.m. *Beaumont Hall Old Age Pensioners' Club, Beaumont Hall, 2 Beaumont Grove, E.l. Thursdays, 1.30-3.30 p.m. Berner Friendship Club for Jewish Pensioners, meets at the Bernhard Baron Settlement, Berner Street, E.l. Tuesdays, 2-4 p.m. Brady Fellowship Club for Jewish Pensioners, meets at the Brady Settlement, Hanbury Street, E.l. Wednesdays, 2-4.30 p.m. "Golden Age" Club, meets at the Labour Party Hall, Stepney Green, E.l. Mondays, 7-9 p.m. Jewish Blind Society, East End Club, 241 Mile End Road, E.l. Wednesdays, 2-4.30 p.m. Lycett Central Hall, Mile End Road, E.l, (for men only). Mondays, 2 p.m. S.A.L.O.P. Club, meets at St.Anne's Institute, Three Colt Street, E.14. Tuesdays, 7-9 p.m. +Saint Dunstan's Club, Haileybury Boys' Club Hall, Ben Jonson Road, E.l. Wednesdays, 2-4 p.m. *Saint George's Club for Pensioners, St.George's Mission Hall, 181 The Highway, E.l. Fridays, 2-4.30 p.m. *Saint Katharine's Club for Pensioners, Royal Foundation of St.Katharine, Butcher Row, Ratcliffe, E.14. Mondays, 2-4.30 p.m. and Thursdays, 7-9 p.m. Stepney Central Hall, Commercial Road, E.l. (for men only), Tuesdays, 7.30-9 p.m. Stepney Friendship Club, East London Synagogue Hall, Rectory Square, E.l, Tuesdays, 7-9.30 p.m. Stepney Senior Club, Ratcliff Settlement, Ratcliffe Lane, E.14. Tuesdays,.2 p.m. Stepney Old Age Pensioners' Club, Holy Trinity Hall, Maplin. Street, E.3. Fridays, 1.30-4.30 p.m. +Toynbee Veterans' Club, Toynbee Hall, Commercial Street, E.l. Alternate Tuesdays, 2-4.30 p.m. +W.V.S. Darby and Joan Club, Ebenezer Congregational Church Hall, Watney Street, E.l. Fridays, 2-4 p.m. *(451, Commercial Road, E.l. - Chiropody Clinic). *Zekeinim Club for Jewish Pensioners, Jewish Institute, Adler House, Adler Street, E.l. Mondays to Thursdays, 2-5 p.m. + Also Lunch Club. * Also Chiropody Clinic. 59 Table 8. AIR POLLUTION Amounts of deposited matter recorded by deposit gauges and of sulphur trioxide collected by lead peroxide method at St.George's Town Hall (Station 1) and London Jewish Hospital (Station 2). Station Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. INSOLUBLE MATTER DEPOSITED (Tons per square mile) Sta-)1956 10.4 6.1 14.0 9.9 12.5 7.5 8.6 10.2 11.7 9.4 9.1 12.9 tion)1955 17.8 6.7 12.0 6.7 13.7 12.5 13.0 9.3 10.5 9.9 9.7 9.7 No.1)1954 13.5 14.0 11.9 8.1 13.5 7.6 15.7 9.1 9.9 * 12.4 9.4 Sta-)1956 11.5 6.5 13.3 10.5 3.9 7.6 9.3 9.7 10.1 8.2 10.8 14.9 tion)l955 14.9 8.3 12.1 9.9 10.8 11.3 10.3 7.7 9.8 8.5 11.1 7.6 No.2)1954 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) Sta-)1956 16.2 8.0 8.6 8.1 4.0 9.6 8.4 13.1 6.4 8.2 5.3 7.2 tion)l955 14.3 7.8 7.5 4.9 ll.l 7.9 7.4 11.8 5.8 6.6 4.6 8.7 No.1)1954 7.4 12.3 7.7 4.4 10.7 10.7 6.6 10.7 9.7 * 13.7 7.0 Sta-)1956 10.4 5.9 7.4 7.8 1.4 10.6 10.2 7.5 6.2 7.7 3.9 9.5 tion)1955 12.2 7.2 9.0 6 .1 8.1 6.1 6.4 5.1 6.3 9.8 6.7 9.3 No.2)1954 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 COLLECTED (Ms. per day per 100 sq. cm. of lead peroxide) Sta-)1956 4.6 4.9 3.8 3.9 1.9 1.3 1.5 1.5 2.3 3.0 4.3 3.8 tion)1955 4.3 4.6 4.0 1.5 1.3 1.8 1.7 1.8 1.8 3.6 4.2 3.9 No.1)1954 4.3 3.9 2.2 2.8 2.2 1.4 1.5 1.6 1.7 1.8 3.4 4.3 Sta-)1956 5.5 5.6 4.2 3.3 2.2 1.6 1.7 1.7 2.4 3.5 4.9 4.6 tion)1955 5.5 5.2 4.5 1.6 1.5 2.0 1.8 1.9 2.0 4.4 5.5 5.0 No.2)1954 4.8 5.3 3.2 2.9 2.6 1.5 1.8 2.0 2.0 2.8 5.3 5.0 * No reading. 60 Table 9. AIR POLLUTION Concentration of smoke and sulphur dioxide recorded by the Volumetric Method at two Stations in the Borough during 1956. Station Jan. Feb. Mar. Apr. May June July Aug. Sep. Oct. Nov. Dec. SMOKE (Milligrams per 100 cubic metres) Public Health Office Monthly average * 61 41 39 16 * 12 16 21 48 60 56 Highest daily average * 99 78 63 27 * 21 28 31 111 140 123 Mile End Library Monthly average 60 48 36 32 15 11 10 16 15 34 41 43 Highest daily average 195 186 61 61 25 21 14 54 24 61 86 104 SULPHUR DIOXIDE (Parts per 100 million parts of air) Public Health Office Monthly average * 13 12 13 7 * 4 4 7 11 12 15 Highest daily average * 26 20 25 13 * 8 9 19 23 28 42 Mile End Library Monthly average 14 15 16 13 7 5 5 8 11 13 12 17 Highest daily average 33 64 33 32 15 9 16 11 24 23 15 38 * No readings. 61 Table 10. FACTORIES ACTS. 1937 & 1948. 1. Inspections for purposes of provisions as to health. Type of Factory No. on Register Inspections Written Notices Factories without mechanical power 178 3 1 Factories with mechanical power 2122 296 63 Other premises under the Acts (building operations and works of engineering and construction) 122 2 - TOTAL 2422 301 64 2. Cases in which defects were found. Particulars Found Remedied Referred - to H.M. Inspector by H.M. Inspector Want of cleanliness — - — 3 Overcrowding — — — — Unreasonable temperature 2 2 — 2 Inadequate ventilation — — — — Ineffective drainage of floors — — — — Sanitary Conveniences- (a) Insufficient 5 5 — 9 Co) Unsuitable or defective 73 73 — 38 (c) Not separate for sexes 20 20 — 3 Other offences against the Acts (not including those relating to Outwork) 1 — 1 — TOTAL 101 100 1 55 3. Prosecutions. An occupier of a factory, summoned for failing to supply a list of outworkers employed by him, was discharged conditionally on payment of £3.3.0d costs. 62 Table 11 RODENT CONTROL (Period 1st April 1956 - 31st March 1957) Council Property Dwelling Houses Other Premises TOTAL Total Properties in Area 41 25,800 7,599 33,440 No. Properties inspected as result of - (a) Notification 5 936 289 1,230 (b) Survey under the Act — 8,431 3,073 11,504 No. Properties inspected which were found to be infested by- (a) Rats - Major — 1 3 4 Minor 1 780 250 1,031 (b) Mice - Major 3 203 124 330 Minor 1 809 306 1,116 No. infested properties treated by Local Authority 5 1,760 308 2,073 No, Sec.4 Notices served (i) Treatment — — — — (ii) Structural works — — 17 17 No. cases where default action taken following Sec.4 Notice — — — — Legal Proceedings — — — — No. of "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 28th May to 14th August and from 26th November, 1956, to 14th February, 1957. 1,471 manholes were treated in each period. 63 Table 12. SUMMARY OF WORK OF DISTRICT PUBLIC HEALTH INSPECTORS No. of Premises Inspections Notices Served Legal Proceedings Taken Registered and Licensed Premises Hairdressers and Barbers 134 96 8 — Rag Flock Premises 23 31 — 1 Pet Shops 10 4 — — Offensive Businesses 21 271 — — Pharmacy and Poisons Premises 89 125 — — Common Lodging Houses 5 31 1 — Seamen's Lodging Houses 5 49 1 — Factories. Shoos &c. Mechanical Factories 2122 296 63 — Non-mechanical " 178 3 1 — Other " 122 2 — — Outworkers 687 40 — 1 Shops 2785 69 2 — Other Visits and Inspections Complaints and Nuisances 6279 House-to-House 1068 2919 50 Drainage 4657 71 2 Infectious Disease and Contacts 218 — — Markets (weekend inspections) 33 — — Heating Appliances (Fireguards) Act 20 — 1 Disrepair Certificates 283 — — Smoke Observations 66 — — Miscellaneous visits and inspections 1752 — — Re-visits 4092 656 — Attempted visits 1933 — — Rag and Bone Dealers — — 1 21,418 3,722 56 (Contd.) 64 Summary of Work of District Public Health Inspectors (Contd.) Certificates of Disrepair: Housing Repairs and Rents Act - Applications for Certificates received 52 Applications withdrawn — Certificates-issued 47 Certificates, refused 5 Applications for Revocation Certificates 71 Revocation Certificates issued 62 Revocation Certificates refused 9 Rent and Mortgage Interest (Restrictions) Acts - Applications for Certificates received 33 Applications, withdrawn 2 Certificates issued 30 Certificates refused 1 Applications for Revocation Certificates 19 Revocation Certificates issued 14 Revocation Certificates refused 5 Complaints: total received at Office 3331 of Smoke Nuisance received 49 of Noise Nuisance received 11 Dangerous Structures: No. premises notified to District Surveyor 119 Drains: No. tested with smoke 1016 No. found defective 153 No. plans on which observations submitted 175 Fireguards tested: Oil heaters 14 Electric heaters 7 Land Charges: No. premises reported upon 1466 Public Houses: No. premises reported on to Licensing Justices 67 Rag Flock and Other Filling Materials. Act: No. of Samples taken 18 Wastage of Water: No. premises notified to Metropolitan Water Board 13 65 Table 13 SUMMARY OF REPAIRS Etc. CARRIED OUT UNDER THE SUPERVISION OF DISTRICT PUBLIC HEALTH INSPECTORS DURING THE YEAR Dampness in rooms remedied 1,664 Premises where - New drains constructed 175 Drains reconstructed — Existing drains repaired 145 Drain obstructions cleared 201 Dustbins provided 120 Dwelling-rooms, passages and staircase walls and ceilings cleansed or repaired 1,154 Factories - New W.Cs. provided 1 Sanitary accommodation repaired 99 Other defects remedied — Floors repaired 302 Fireplaces and coppers repaired or renewed 265 Gullies, manholes, provided or repaired 122 Light and ventilation improved or provided to rooms and staircases 3 Roofs, gutters, rainwater pipes, renewed or repaired 1,130 Rubbish accumulations removed 98 Sinks, baths and lavatory basins fitted 508 Soil and vent pipes provided or repaired 93 Staircases - Treads, etc., repaired 63 Ventilation (under-floor) provided to rooms 2 Waste pipes provided or repaired 255 Water Closets and Urinals- New provided 264 Compartments cleansed, repaired 298 Obstructions cleared 48 Flush apparatus repaired 283 Pans and traps fixed 187 Water Supply - Cisterns cleansed, repaired 1 Defective supply or fittings remedied 308 Windows repaired 748 Yards and areas, cleansed or paving repaired 55 Miscellaneous repairs 357 66 Table 14. DWELLINGS ERECTED DURING 1956 Address No. of Dwellings ( a) By Borough Council Arthur Deakin House 40 Bethlehem House 30 Kerry House 41 Vollasky House 15 Settles Street, No. 57 1 127 (b) By London County Council Broadford House 18 Cambridge Heath Road, Nos. 104/110 & 128/134 (consec.) 8 Caspian House 24 Dora Street, Nos. 1/24 & 49/60 (consec.) 36 Drewett House 18 Silvester House 22 Stifford House 20 Tylney House 25 Vawdrey Close 7 Wyllen Close 15 193 (c) Other Cannon Street Road, No.63 1 Nelson Street, Nos, 42/52 (even) 1 Sidney Street, Nos.61 b & c, 63 b, c, d, e. 6 Stainsby Road, No.11. 1 9 TOTAL: 329 67 Table l5. HOUSING STATISTICS I. Inspection of dwelling-houses during the years:- (l)(a) Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 5,322 (b) Inspections made for the purpose 14,513 (2)(a) Dwelling-houses inspected and recorded under Housing Consolidated Regulations, 1925 1,071 (b) Inspections made for the purpose 1,092 (3) Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 148 (4) Dwelling-houses found not to be in all respects reasonably fit for habitation 2,557 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 2,019 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 538 (2) Dwelling-houses in which defects were remedied after service of Formal Notices:- (i) By Owners 534 (ii) By Local Authority in default of owners 4 68 Table. . 15_ _ (contd.) (c) Proceedings under Sections 11 and 13 of Housing Act, 1936:- (i) Dwelling-houses in respect of which Demolition Orders were made 3 (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 68 (ii) Closing Orders determined, the tenements or rooms having been rendered fit Nil (e) Proceedings under Section 25 of Housing Act, 1936:- (i) No. of houses included by representation by Medical Officer of Health 131 (ii) No. of houses demolished in pursuance of representations 11 (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 1,040 (ii) No. of new cases encountered during year 56 (iii) No. of cases relieved during the year 14 (iv) No. of cases removed from register following review of lists 461 (v) No, of overcrowded families on register at end of year 621 69 Table 16 SUMMARY OF WORK OF PUBLIC HEALTH INSPECTORS (FOOD) No. Visits or Inspections Notices Legal Proceedings Registered Premises 346 11 — Milk Distributors - Dairies 17 Itinerant Vendors 31 Other 218 Licences issued to persons to sell designated milk 510 Ice Cream Premises - Sale 262 156 12 — Manufacture 29 Storage 3 Prepared Food Premises - Meat 89 314 78 — Fish 53 Other Premises Bakehouses - basement 7 454 44 2 level 42 Baker Shops 65 Butcher Shops and Stalls 102 373 58 3 Catering Establishments 905 1300 168 — Fish Premises 165 305 55 — Greengrocers and Fruiterers 653 570 83 — Grocers (Wholesale and Retail) 400 974 80 5 Public Houses and Off Licences 280 225 26 — Poultry Dealers (excluding Butchers) 85 212 36 — Railway Depots 4 413 — — Wharves 42 797 — — Miscellaneous Food Premises 334 844 21 — Meat Vehicles — 99 — — Revisits — 1435 — — 8817 672 10 There are 2,973 food premises in the Borough. Some of the premises listed above are included under more than one trade category. Contd... 70 Summary of Work of Public Health Inspectors (Food). Table 16 (Contd.) Reason for Visit Food Hygiene Regulations, 1955 4255 Surrender of Unsound Food 581 Merchandise Marks Acts 593 Public Health Meat Regulations 394 Food Standards Orders 111 Labelling of Food Orders 105 Byelaws: Fish Curer and Fish Vendor 81 Agriculture Produce Grading and Marking Acts 25 Pharmacy and Medicines Act, 1941 6 Sampling 372 Complaints 184 Samples of food taken during the year for chemical and bacteriological examination numbered 498. Summonses taken out relating to foodstuffs numbered 7 and to conditions at food premises 12 (three premises involved). Table 17 SUMMARY OF INSPECTIONS MADE BY THE HOUSING INSPECTOR Caravans 112 Complaints 57 Housing Act, 1936 (Section 11) 3 " " (Section 12) 67 Housing Accommodation Direction, 1952 59 Immigrant Enquiries - for Malta Government 9 for Cyprus Government 4 Improvement Grants 5 Miscellaneous Inspections 252 Overcrowding 103 "Permitted Numbers" under Housing Act, 1936 24 Premises situated in Clearance Areas 341 Requisitioned Premises 85 Temporary Hutments 40 Underground Rooms 672 71 Table 18. NOTIFIABLE DISEASES NOTIFIED DURING THE YEAR 1956. 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. EncephalitisInfective — — — — — — — 1 — — — — 1 1 1 Ac .PoliomyelitisParalytic — 1 — 1 — — — — — — — — 2 2 2 Non-paralytic — — — — — 2 1 — — — — — 3 1 3 Diphtheria — — — — 1 2 - - — — 1 — 4 1 4 Dysentery 12 21 12 9 7 28 8 2 12 — 4 1 116 115 28 Enteric Fever — 1 — 1 — 1 — 1 1 — — — 5 5 5 Erysipelas — — — — — — — — — 1 7 — 8 8 2 Food Poisoning 1 2 1 — — 3 3 — 8 1 2 1 22 22 8 Measles 23 74 78 75 94 217 6 2 4 1 — — 574 574 45 Mening .Infection 1 3 1 — — — — — — — — — 5 5 5 Ophth .Neonatorum 3 — — — — — — — — — — — 3 3 1 Pneumonia — — 2 1 1 4 1 1 14 7 22 26 79 79 24 Puerperal Pyrexia — — — — — — — 5 51 7 — — 63 63 58 Scabies — 1 — — — 5 4 3 16 10 4 — 43 43 2 Scarlet Fever — — 1 2 8 18 3 2 — — — — 34 34 2 Tuberculosis Pulmonary 1 2 — — — 1 2 7 42 17 30 14 116 116 — Non-Pulmonary — — — — — 1 — — 5 2 2 3 11 11 — Whooping Cough 28 37 32 26 27 72 8 — 4 1 — — 235 235 17 TOTALS: 69 142 127 115 138 354 36 24 157 47 72 43 1324 1318 207 There were no notifications of Smallpox, Membranous Croup, Malaria or Acute Encephalitis (Post Infectious). 72 Table 19 DISEASES NOTIFIABLE IN LONDON Disease Authority for Notification Acute Encephalitis P.H. Act, 1936 (S.143), SI.1949/2259. Ac. Influenzal Pneumonia Do. SI.1953/299. Ac. Primary Preumonia Do. SI.1953/299. Ac. Poliomyelitis Do. SI.1949/2259. Anthrax L.C.C. Order, 1909; P.H.(L) Act, 1936. (S.192 and 304). Chicken Pox (Notifiable in Port of London only). Cholera P.H.(L) Act, 1936 (S.192 & 305). Diphtheria Do. Dysentery P.H. Act, 1936 (S.143), SI.1953/299. Enteric Fever (incl. Typhoid and Paratyphoid) P.H.(L) Act, 1936 (S.192 & 304), SI.1953/299 Erysipelas Do. (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 and 305). Hydrophobia Do. Do. Leprosy P.H. Act, 1936 (S.143), SI.1951/1036. Malaria Do. SI.1953/299. Measles Do. 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 & 1937/35 Plague P.H. Act, 1936 (S.143); LGB.Reg.1900. Puerperal Pyrexia Do. SI.1951/1081 and 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 Do. Tuberculosis P.H. Act, 1936 (S.143), SI.1952/704. Typhus Fever P.H.(L) Act, 1936 (S.192 & 304). Whooping Cough P.H. Act, 1936 (S.143), SRO.1938/1100, 1940/205 & SI.1948/420 Yellow Fever (Notifiable in Port of London only). Zymotic Enteritis or Summer Diarrhoea (Notifiable in 9 Metropolitan Boroughs only not notifiable in Stepney). 73 Table 20, TUBERCULOSIS - New Gases and Deaths New Cases, 146 Pulmonary cases were notified, including 116 primary notifications, 26 from death returns and 4 posthumous notifications. 12 Non-Pulmonary cases were notified, including 11 primary notifications and 1 from death returns. Deaths. (* ) 16 persons died from Pulmonary Tuberculosis. 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 — — — — 1 3 8 17 13 24 15 21 4 106 F 1 2 — 1 1 4 6 13 9 2 — 1 — 40 Non-Pulmonary M — — — 1 — — 1 1 — 1 1 1 — 6 F — — — — — — 1 2 2 1 — — — 6 (b) Deaths (* ) Pulmonary M — — — — — — — 1 — 1 3 4 2 11 F — — — — — — — — 3 1 — 1 — 5 Non-Pulmonary M — — — — — — — — — — — — — — F — — — — — — — — — — — — — — (*) Compiled from local death returns, (Registrar-General's return shows 17 Pulmonary and no Non-Pulmonary deaths.) Table 21. TUBERCULOSIS - Variations in Register Pulmonary NonPulmonary Total Cases M F M F (a) Cases on Register at 1/1/56 659 386 91 82 1218 (b) New Cases notified 78 38 6 7 129 (c) " " (corrected) 73 34 6 7 120 (d) Cases restored to Register 17 4 — — 21 (e) Other cases added 25 17 — 4 46 (f) Removals 130 70 16 11 227 (g) Cases remaining on Register at 31/12/56 644 371 81 82 1178 74 INDEX . ~ Page No. Accidents - Home 11 — Road 11,55 Aged Persons 13 Analyst's Report 50 Area of Borough 7 Air Pollution 23, 60, 61 Bacteriological Examination of Foodstuffs 37 Bakehouses 36, 70 Births 7,9 Cancer 10, 43 Catering Establishments 70 Chiropody Clinics 15, 59 Clearance Areas 31 Common Lodging Houses 25, 64 Complaints of Nuisances 64, 65 Conferences 15 Deaths 7, 10, 54 Diphtheria 43 Disinfection and Disinfestation 48 Disrepair Certificates 64, 65 Drainage 24, 64, 65 Dysentery 44 Factories 24, 62, 64 Food Inspection and Supervision 34, 70 Food Poisoning - Delays in Notification 44 Food - Unsound 41 Free Washing Facilities 16 General Information 8 Hairdressers & Barbers Premises 64 Health Education 16 Health Services, General Provision of 13 Heating Appliances (Fireguards) Act, 1952 24, 64, 65 Home Bathing 14 Hospital Facilities 17 House-to-House Inspections 64 Houses - Number in Borough 7 Housing 31 Housing Repairs and Rents Act, 1954 64, 65 Housing Statistics 68, 69, 71 Ice Cream 37, 38, 70 Illegitimate- Births 7,9 Imported Egg Products 38 Infant Mortality 7, 10, 56 Infectious Disease 42, 72, 73 Information Service 17 Inquests 15 Laboratory Facilities 18 75 Legal Proceedings 24, 39 Legislation 13 Licensed Premises 65, 70 Loss of Expected Years of Life 11, 57 Marriages 9 Maternal Mortality 7, 11 Maternity and Child Welfare 19 Meals-on-Wheels 14 Measles 45 Milk Supply 52, 70 National Assistance Act, 1948 13, 14, 16 Noise Nuisances 65 Notices Served 26 Offensive Businesses 26, 64 Old People's Welfare Association 14, 59 Open Spaces 9 Outworkers 27, 64 Overcrowding 31 Pet Animals 64 Pharmacy & Poisons Act 64 Poliomyelitis 45 Population 7, 9 Poultry Slaughterhouses 26 Prepared Food Premises 70 Public Health Inspectors - Summary of Inspections 64, 65 - Return of Sanitary Work 66 Rag Flock and Other Filling Materials' Act, 1951 28 , 64 , 65 Rateable Value 7 Refuse Disposal 28 Removal of Persons in need of Care and Attention 13 Rent and Mortgage Interest (Restrictions) Acts 64, 65 Rodent Control 29, 63 Sanitary Circumstances 23 Scarlet Fever 46 Seamen's Lodging Houses 25, 64 Shops 29, 64 Smallpox 46 Social Conditions of Area 9 Special Reports to Public Health Committee 22 Staff 6, 22 Statistics, Summary of 7 Stillbirths 7,9 Swimming Baths 22 Tuberculosis 46, 74 Underground Rooms 31 Unemployment 12 Vaccination 46 Vital Statistics 7, 58 Water Supply 29 Weather Conditions 42 Whooping Cough 48 76