AC 4367 acr. 29.7.58 STE 31 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 1957 Together with the Report of the Public Analyst T3T ' ' 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 1957. 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 12 III. Sanitary Circumstances 22 IV. Housing 30 V. Food - Inspection and Supervision 32 VI. Infectious and other Diseases 39 Public Analyst's Report 46 Appendix 49 Index 71 2 PUBLIC HEALTH COMMITTEE at 31st December 1957 Ex-officio - His Worship The Mayor (Councillor J. Reardon, 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, F.C.C.S., J.P. „ C.W.J. Bird „ (Mrs.) M.K. Bryan „ J.H. Coram „ H.S, Darlow „ B, Donovan „ (Miss) M, Downey „ E. Goodwin „ E.W. Hill „ ' R.R. Howell „ (Mrs.) A.P. King „ M.S. Levitas „ D. Milrood „ 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 Slipper Baths, Swimming 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 METROPOLITAN BOROUGH OF STEPNEY" Telephone: STEpney Green 2484 PUBLIC HEALTH DEPARTMENT, 43, White Horse Road, Stepney, LONDON, E.l. To: The Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies and Gentlemen, I have the honour to present my report on the state of the public health in Stepney for the year 1957. The population of the Borough according to the Registrar-General's estimate is 97,810, a decrease of 350 since last year. The population in the Census year, 1951, was 98,581. The live birth-rate is 18.94 (19.44)+, the death rate 12.41 (12.08), the marriage rate 18.5 (19.9), the maternal mortality rate 0.53 (Nil), the infant mortality rate 24.28 (22.52), the neo-natal mortality rate 15.65 (17.81). There were 35 stillbirths, giving a rate of 18.53 (21.53), the lowest rate yet recorded. Notifications of infectious diseases increased from 1,324 to 1,917 chiefly due to the increase in measles which tends to recur in biennial periods. The incidence of influenza was high owing to a widespread epidemic which occurred in the Autumn. The epidemic, often referred to in the press as "Asian flu" had spread to Europe from China in the course of six months. The disease was mild in character and caused comparatively few deaths. Influenza is only notifiable in the form of "influenzal pneumonia", of which 52 cases were notified, all in the last quarter of the year. There were 12 deaths from influenza or influenzal pneumonia. Concurrent with the epidemic of influenza there was an increase in deaths from respiratory causes, which throughout London in the December quarter were 2,000 more than usual. The number of respiratory deaths in *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 stillbirths. 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 parentheses refer to the previous year, 1956. 4 London was also influenced by a short period of dense fog - "smog", which occurred from 2nd to 6th December and which is estimated to have caused some 300 deaths. Incidentally, a serious rail disaster which occurred at Lewisham during the fog added 90 deaths to the London figure. Ten confirmed cases of poliomyelitis were notified in 1957, compared with 3 in 1956 and 44 in 1955. Warm, dry summers, such as we experienced in 1955, appear to increase the incidence of this disease. The total number of cancer deaths, viz. 249, was higher this year, but deaths from lung cancer decreased by 16 to 54. Deaths from pulmonary tuberculosis numbered 20, or three more than last year, and notifications of new cases also increased slightly from 116 to 120. No cases of smallpox occurred in the Borough. No deaths occurred from scarlet fever, whooping-cough, diphtheria, poliomyelitis or nonpulmonary tuberculosis. There was one death from measles, the second in 8 years. Food poisoning notifications decreased from 22 to 8. Some important legislation was passed during the year, including the Rent Act, 1957, and the Housing Act, 1957, the latter being a consolidating Act. An interesting decision was obtained in the Magistrates Court, establishing that separate water closets must be provided for families ant for workers in premises used jointly for residential purposes and for factories (see page 23). The work of the department continues to be seriously hampered by the dearth of district health inspectors, the number being now five short of the required establishment of eleven. The urgent work of operating the new Rent Act was successfully accomplished in spite of the shortage, but to some extent at the expense of the other public health work of the department. In concluding my report on a year, which has been a difficult one for the staff, I would like to thank them for the good work they have done, and to the Chairman and the Committee I accord my deep appreciation of their ever helpful interest and support. I have the honour to be, Your Worship, Ladies and Gentlemen, Your obedient Servant, FRANK R. 0'SHIEL, July, 1958. Medical Officer of Health. 5 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December 1957 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 Disinfestation Inspector Clerical Staff W.Cue (1) E.J.Edwards (1, 2) D.J.Berry R.W.G.Day (1) W.E.Driscoll S.Firsht (1, 2) S.W.Embleton W.H.Hart (l! 2) Housing Inspector W.T.Gardiner W.H.Haworth (1) C.F.Guy (1) H.A..Giddinas J.J.Keniry (1) S.S.Harris L.J.Windsor (1, 2, 3) E.F.Holt Assistant Rodent Officer Miss R.Levey Food Inspectors J.McMullon A.C.Brown (1, 2) G.D. Freeland Mrs.M.Munday (T) H.J.Green (1, 2) (1, 2, 3) S.S. Lowther (1, 2) M.J.O'Connor S.Vogler (X, 2) Hygiene Officer W.A.O'Sullivan Miss M. Guest Caretaker & Messenger (4, 5, 6) Foreman Disinfector: A.N.Cook W. Sexton Hygiene Assistant Relief Caretaker &Messenger Miss A.J.Ballam (T) Rodent Investigators E.H.Vaughan S.C.Ludlow (T) Cleansing Station Disinfecting Staff Attendants Rodent Operatives 8 Males 2 Females, 1 Male 3 Males (1) Public Health Inspectors' Certificate. (2) Meat & Other Foods Inspectors' Certificate. (3) Smoke Inspectors' Certificate. (4) Health Visitors' Certificate. (T) Temporary. (5) State Certified Midwife, (6) State Registered Nurse. Note; For staff changes during the year see Page 20. 6 SUMMARY OF STATISTICS, 1957 Area of Borough 1902,7 Acres Population (Registrar-General's mid-year Estimate of Home Population) 97,810 Number of inhabited dwellings according to Rate Books 25,503 Rateable Value £2,286,956 Sum represented bypenny rate £9,528 Density of population (persons per acre) 55.38 BIRTHS Total Male Female All Births 1888 970 918 Live Births: Legitimate Illegitimate 1689 I64 881 78 808 86 Total: 1853 959 894 Stillbirths: Legitimate 29 9 20 Illegitimate 6 2 4 Total: 35 11 24 DEATHS Al1 Causes 1214 679 535 Maternal 1 - 1 Infants under 1 year: Legitimate 35 20 15 Illegitimate 10 3 7 Total: 45 23 22 RATES* Live Birth Rate per 1,000 population 18.94 Death Rate per 1,000 population 12.41 Stillbirth Rate per 1,000 total births 18.53 Maternal Death Rate per 1,000 total births 0.53 Infant Death Rate (under 1 year) per 1,000 live births 24.28 Illegitimate Infant Death Rate per 1,000 illegitimate live births 60.97 Neo-Natal Death Rate (under 4 weeks) per 1,000 live births 15.65 (*) See footnotes to Page 4. 7 I. 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, end it is estimated that one-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 Rothschild's Mint, and bell casting at the Whitechapel Bell Foundry. In 1957 over 507 million coins were struck at the Royal Mint, approximately 59 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 & Lemons" fame) and St.Mary-leBow (the renowned "Bow Bells), which were 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 Fifty Years Ago. The Annual Report of the Medical Officer of Health for the year 1907 contains the following information: The estimated population was 308,923, but the Medical Officer of Health was of the opinion that the population was, in fact, somewhat higher. The birth-rate was reported to be 33.1, the lowest then on record but still the highest in London. The death rate was also stated to be the lowest on record, and the infant mortality rate was 119 per thousand births. Among the causes of death reported were Scarlet Fever 83, Measles 155, Diphtheria 93, Whooping Cough 102, Diarrhoea 139, Enteritis 129, Pulmonary Tuberculosis 482, Premature Birth 156, Alcoholism 48, Appendicitis 11. Notifications of infectious diseases included Scarlet Fever 2,847, Diphtheria 568, Enteric Fever 107, Typhus 1. The Medical Officer of Health reported that 69 homeless persons died, and in the annual report of the Clerk to the Whitechapel Guardians it was stated that seven persons died from starvation in the Whitechapel district. They were wanderers who made no application to the guardians for relief, and were unknown until they were brought in by the police in a collapsed condition. In the East End 10,000 people slept every night in common lodging houses and shelters. The report of the Council's Borough Engineer and Surveyor included the information that the whole of the Public Health Department office building was thoroughly cleansed, redecorated and repaired both internally and externally at a cost of £124.8s.7d. Population. The Registrar-General's mid-year estimate for 1957 is 97,810. Last year's estimate was 98,160. 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 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 55.38 persons per acre. During the year there was a natural increase in population of 639, i.e., there were 639 more births than deaths. Open Spaces. There is in the Borough a little over half-an-acre of parks and open spaces per thousand population. A list of the sites is given on Page 69. 9 Births. The total number of live births registered in the Borough during the year was 3,870, and of this number 2,219 belonged to other areas. In addition, 202 births belonging to Stepney occurred outside the Borough, making a total of 1,853 births (959 male and 894 female) to Stepney residents. The live birth-rate is 18.94 per 1,000 of the population. The rate when adjusted by the comparability factor is 16.66, compared with the rate for England and Wales of 16.1. The preliminary report of the London County Council's Medical Officer of Health reveals that the County birthrate of 16.2 is the highest since 1949. Illegitimate live births numbered 164, representing 8,8 per cent of the total live births. Still-births numbered 35, representing a rate of 18.53 per 1,000 total births, the lowest rate ever recorded in the Borough. Marriages. The number of marriages registered during the year was 905, being 71 less than last year. The rate of marriages per 1,000 population is 18.5, compared with 19.9 in 1956. Deaths. The net number of deaths registered during the year was 1,214 (679 male and 535 female), compared with 1,186 last year. The rate of 12.41 compares with 12.08 for 1956, The principal causes of death were heart disease, which accounted for 28 percent of the total deaths, cancer 20 percent, and diseases of the respiratory system 18 per cent. Deaths of persons over the age of sixty-five accounted for 65 per cent of the total deaths. Details of deaths by cause and age are given in Table 1 of the Appendix on Pages 50 and 51. 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. Deaths of infants under 1 year numbered 45, giving a rate of 24.28 per 1,000 live births, compared with 22,52 last year. The rate for England and Wales for the year is 23.0. Of the infant deaths 29 were under 4 weeks old, representing a rate of 15.65 per 1,000 live births. Last year there were 34 neo-natal deaths, and the rate was 17.81 per 1,000 live births. The neo-natal mortality rate for England and Wales is 16.5. The "peri-natal" mortality rate of infants (viz., still-births plus deaths occurring in the first week of life) was 33.36, compared with 29.21 last year. 10 The tables on Page 52 show deaths from stated causes at various ages under 1 year, together with comparative figures over the last five years Maternal Mortality. There was one maternal death during the year, that of a woman of 42 years, the cause of death being certified as "shock-due to forceps deliver It was her fourth pregnancy and she underwent a difficult and protracted labour chiefly due to the size of the baby, which was eventually delivered stillborn by forceps and weighed 9 lbs.12 ozs. The mother had, in addition a mild toxæmia.which was not thought to have had much influence on the outcome. Accidental Deaths. There was a reduction in the number of deaths from accidents from 49 last year to 33 this year. These included 6 duo to motor vehicles (3 less than in the previous year), 13 at home, 4 at work, 4 due to drowning, and 6 due to various other causes (see table on Page 51 relating to road accidents). The London County Council (General Powers) Act, 1957, contains a provision in Section 82 enabling Borough Councils to make arrangements for the dissemination of information and advice relating to the promotion of safety in the home and taking of proper precautions for avoiding the occurrence of accidents there in. The Council delegated the powers and duties of this section to the Public Health Committee. In 1956, nearly 7,000 persons throughout the country died as a result of fatal domestic accidents, over half of these being 75 years or more. In Stepney during 1957, as stated above, 13 people died from this cause which was three less than in the previous year. Unemployment. The Ministry of Labour has kindly supplied me with the following information as to the estimated, number of persons residing in the Borough registered as unemployed at the end of the year:- Men Boys Women Girls TOTAL 1,354 20 307 19 1,700 The total number of unemployed at the end of 1956 was 1,401. Comparative Statistics. A table showing vital statistics for the Borough at various years from 1901 is on Page 53. 11 II. GENERAL PROVISION OF HEALTH SERVICES WELFARE OF AGED PERSONS. The Council is empowered by Section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendment) Act, 1951, to make application to the Court for an Order for the removal to hospital or an institution of aged, inflra 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 three Removal Orders for the following persons who were aged, infirm and living in insanitary conditions and unable to devote to themselves, and not receiving from other persons, proper care and attention:- Person Age Removed to Remarks Miss M.L. 85 Institution, Emergency Order for 3 weeks. Still away. Mrs. M.O. 76 Institution. Emergency Order for 3 weeks. Still away. Mrs, E.B, 76 Institution. Order for 6 weeks. Still away. In addition to those persons removed under a Magistrate's Order, admission to hospital or institution was gained for 19 other persons. 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 2,732 visits were made by these officers during the year. A register of all old persons visited is kept in the Department. Amendments in the register made during the year were as follows:- Number on Register at 1st January, 1957 1,681 Additions during the year 170 Removals during the year 279 Number on Register at 31st December, 1957 1,572 The Council provides a service for disinfesting and cleansing bedlinen and personal clothing under Section 122 of the Public Health (London) Act, 1936, some 357 parcels being dealt with during the year. 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. 780 baths were given to 60 old people during the year by the Borough Council's Home Bathing Service. 12 Grants may be made under Section 31 of the National Assistance Act,1948 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 £2,675. A list of the Clubs and facilities will be found on Page 70. 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 342 meals was delivered to homebound old people. Five of the clubs, which include luncheon clubs among their facilities, provided an average of 234 meals each week. A Chiropody Service is provided and a wholetime chiropodist employed 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 on an average 238 treatments were 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. Folkestone (April) Aid. J. Sambrook and Medical Officer of Health. Public Health Inspectors' Association Annual Conference. Eastbourne (September) Vice-Chairman, Counc.(Mrs.) E.B. Bolton and Public Health Inspector, Mr. S. Vogler. (Contd...) (*) Hon.Secretary, The Stepney Old People's Welfare Association, St.Katharine's, Butcher Row, Cable Street, E.14. (Telephone: STEpney Green 3659). Voluntary visitors are urgently required, and should apply to the Secretary. 13 Conference Held At Attended By National Smoke Abatement Society Annual Conference. Hastings (October) Counc. H. Walvisch and Public Health Inspector, Mr. S. Firsht. Mechanical Engineers' Contribution to Clean Air. London (February) Public Health Inspector, Mr. G. D. Freeland. Cancer Education. - Central Council for Health Education. London (January) Vice-Chairman, Counc. (Mrs.) E. B. Bolton and Medical Officer of Health. Symposium on Cancer of the Lung. - National Association for the Prevention of Tuberculosis. London (November) Medical Officer of Health. Central Consultative Committee on Welfare of Old People. London (April) Vice-Chairman, Counc. (Mrs.) E. B. Bolton and Medical Officer of Health. DECEASED PERSONS. Inquests. Inquests were held on 49 residents of the Borough; 16 deaths were due to suicide, 21 were accidental and 12 were due to other causes (2 natural, 5 misadventure, 5 open verdicts). 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-nine such burials (21 adults, 2 children under 10 years, 3 under one month and 3 stillborn babies) took place during the year at a cost of £270, of which sum £68 was recovered by the end of the year from the estates of the deceased persons, from liable relatives, or by way of grants made under the National Insurance Act, 1946. Requests for burials came from the following sources:- H.M. Coroner's Officer 15 Relatives of Deceased 11 Friends of Deceased 3 Where persons living alone die in the Borough, it is often necessary to dispose of the contents of their homes. This is done in conjunction with relatives of the deceased, or with the Treasury Solicitor where there are no known relatives, and has the effect of releasing the accommodation for housing purposes as soon as possible. Eight bodies recovered from the river were received into the Mortuary during the year. 14 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 77,000 free washes were taken during the year. HEALTH EDUCATION. In this year's London County Council (General Powers) Act, Section 82 empowers Borough Councils to make arrangements for the dissemination of information and advice for the purpose of promoting safety in the home and encouraging the taking of proper precautions for avoiding occurrences of accidents therein. Publicity campaigns carried out during the year included Mass X-ray, Poliomyelitis Vaccination, and Road Safety. Posters on the large poster frames situated in the Wo main roads in the Borough were changed each month, and nine types of posters 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, and on the Council's vehicles and in public conveniences, and leaflets were made available at many of these establishments. 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". Over 2,000 posters were displayed in the Borough during the year. 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 15 STEPNEY BOROUGH COUNCIL INFORMATION SERVICE. The Council operates an Information Service for the public at the Municipal Offices, 227-233, Commercial Road. 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 136 specimens were carried out during the year, 15 being submitted by the Public Health Department in connection with epidemiological investigations, and 121 by medical practitioners in the Borough. The specimens comprised 63 faeces, 65 throat swabs, 6 rectal swabs and 2 nasal swabs. LEGISLATION. The following Acts, Orders and Regulations affecting the Department were made during the year:- Operative The Housing Act, 1957. 1.9.57 London County Council (General Powers) Act, 1957. 31.7.57 The Rent Act, 1957. 6.7.57 The Clean Air Council Order, 1957. The Smoke Control Areas (Exempted Fireplaces) Order, 1957. 8.5.57 8.4.57 Colouring Matter in Food Regulations, 1957. 30.6.57 Food Hygiene (Amendment) Regulations, 1957. 31.12.57 The Motor Cycle (Protective Helmets) Regulations, 1957. 1.4.57 The Public Analyst Regulations, 1957. 21.5.57 Rent Restrictions Regulations, 1957. 6.7.57 Rent Restriction Rules, 1957. 6.7.57 The Poisons Rules, 1957. 1.4.57 Circulars. Other subjects dealt with by means of Circulars were as follows:- Ministry of Health. Diphtheria Immunisation Publicity Campaign; Food Hygiene (Amendment) Regulations; Services for the Chronic Sick and Infirm; Manual of the International Statistical Classification of Diseases, Injuries and Cause of Death. Ministry of Food. Official certificates under the Public Health (Imported Food) Regulations in respect of Hungary and Sind; Approved Oxydising and Preservative Agents; Recommended Minimum Standards for Slaughterhouses; Exchequer Grants towards the Cost of Meat Inspection; Amendments to Memo, 3/Meat; Public Analyst Regulations; Colouring Matter in Food Regulations. Ministry of Housing & Local Government. Temporary Houses; Accidents in the Home - Fireguards; Charges for Dustbins; Housing of Old People; Clean Air Act 1956; Rent Act 1957; Housing Accommodation for Old People. 16 MATERNITY AND CHILD WELFARE. I am indebted to Dr.G.O.Mitchell, Divisional Medical Officer of the London County Council, for the following information relating to the personal health services administered 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 1,468 1 to 5 years of age 145 Total number of children who attended - Children born in 1957 1,329 „ 1956 887 „ „ 1952/1955 889 Total attendances by children - Under 1 year of age 18,442 1 to 5 years of age 4,397 Ante-Natal and Post-Natal Clinics (exclusive of Hospital Ante-Natal Clinics) Ante-Natal consultations - No. of women who attended 118 No. of new cases included in above 118 Total attendances 872 Post-Natal consultations - No. of women who attended 39 Health Visitors. No. of children visited 6,803 No. of infants under 1 year of age visited for first time 1,874 Total visits to children under 1 year of age 8,464 Total visits to children aged 1 year but under 2 years 5,691 Total visits to children 2 to 5 years of age 11,486 No. of expectant mothers visited 573 Total visits to expectant mothers 1,198 17 Infant Life Protection. No. of Foster Mothers on register at end of year 15 No. of Foster Children on register at end of year 19 Child Minders (daily guardians). No. of child minders - Voluntary 11 Statutory 1 No. of children minded - Voluntary 11 Statutory 4 Care of Premature Infants. No. of premature live births during the year 150 No. who died under one month 26 Immunisation and Vaccination. For details of immunisation and vaccination see Pages 40 and 42, 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), is as follows:- Maternity (including expectant mothers) 12 Tuberculosis 16 Aged and infirm cases 842 Other Cases 142 18 2. Services Provided. Infant Consultation. Afternoons 673, Commercial Road, Tuesday and Thursday (and Friday morning). 17. Rhondda Grove. Monday and Thursday. Mary Hughes Centre, Underwood Road. Monday, Wednesday and Thursday. St.George's Centre, Library Place. Tuesday, Wednesday and Friday. 5, Pier Head, Wapping. Wednesday. Duckett Street Centre. Tuesday and Wednesday (morning). Ante-Natal. 673, Commercial Road. Wednesday, Vaccination against Smallpox. 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 Clinics St,George's Centre, Library Place. First and third Tuesday mornings each month. Mary Hughes Centre, Underwood Road. Tuesday afternoons. 673, Commercial Road, Second and fourth Monday afternoons each month. 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), 19 The Dame Colet Voluntary Infant Welfare Centre., and Dame Colet House. On 1st April the Dame Colet Voluntary Infant Welfare Centre, Duckett Street, was taken over by the London County Council. This voluntary infant welfare centre was commenced in 1916 in Emmott Street by the St.Paul's Girls' School Union for Social Work, Mrs.Carew Robinson being the Hon,Secretary until her death last year. The centre was transferred to new premises in Duckett Street in 1926. Prior to the war there were nine voluntary infant welfare centres in Stepney and with the closure of the Dame Colet centre none now remains. The first voluntary centre. the "Stepney School for Mothers and Babies", started in Stepney before the commencement of this century. The successful pioneer work of the Voluntary Centres brought about legislation which enabled Local Authorities to open municipal centres following the Maternity and Child Welfare Act of 1918. Since the war the activities of the Dame Colet Centre were mainly concerned with infant welfare work and health visiting, but prior to the war numerous other services were provided including an artificial sunlight clinic, a father's club, sewing and keep fit classes. On 26th June,Her Royal Highness, Princess Margaret, opened the newly built Dame Colet House in Ben Jonson Road, which includes a large Communal Hall (The Frances Gray Memorial Hall). A club is provided for girls, and a luncheon club for old persons including up-to-date catering facilities; but the infant welfare work is now carried on by the London County Council at the premises in Duckett Street, which will eventually be transferred to 35, Stepney Green. SPECIAL REPORTS. A special report was made to the Physical Training and Recreation Committee of the Council by the Medical Officer of Health during the year, concerning The Manor House Holiday Centre, Sandgate, Kent, proposed to be established under the Physical Training and Recreation Act, 1941. STAFF CHANGES. The following staff changes took place during the year:Ceased Duty: Clark, W. Mortuary Keeper. 13th April (deceased). Dixon, W.J. Orders & Requisitions Clerk. l6th June (deceased). Walker, T,T. Rodent Investigator. 7th October (retired). Commenced Duty: Giddings, H.A. General Clerk. 15th Hay. Nunn, B.L. General Clerk. 15th May. 20 SWIMMING AND SLIPPER BATHS. The three Swimming Baths in the Borough are provided by the Council. During the year the number of swims amounted to 186,230, comprising 51,036 adults and 135,194 children. The water is subjected to continuous chlorination end filtration, and 36 samples were taken during the year for bacteriological analysis, five of which were found to be unsatisfactory. The number of Slipper Baths taken during the year at the four Council establishments was 274,801, which included 6,920 attendances of old age pensioners and 70 unemployed persons, who were admitted free of charge. The total number of persons admitted to all sections of the Baths Department, including the Laundry, was 506,728. 21 III. SANITARf ClflCUMST/iNCES The District Public Health Inspectors served 2,923 notices during the year, and in 20 cases legal proceedings were employed to enforce compliance. The department still has only seven district inspectors, which is four below the establishment. Legislation passed during the year included the Rent Act, 1957, which receives further mention below. Another duty to fall upon the Public Health Inspectors during the year was the exercise of the functions of the Motor Cycles (Protective Helmets) Regulations, 1957, made by the Minister of Transport and Civil Aviation and which came into force on the 1st April. Certificates of Disrepair (Rent Act. 1957). The Rent Act, 1957, received the Royal Assent on 6th June, 1957, and came into operation on 6th July. The main effects of the Act are to free from rent control dwellings which are above certain rateable values and to allow limited increases in the rents of dxvellings remaining under control, such increases being subject to abatement in the event of dwellings being in disrepair. Procedure to be followed by landlords and tenants with respect to applications for, and cancellation of, certificates of disrepair is detailed in the Act, replacing similar provisions which were contained in the Housing Repairs and Rent Act, 1954, and the Rent and Mortgage Interest (Restrictions) Acts, 1920-193Q. By the end of the year 490 applications for Certificates of Disrepair had been received from tenants. Detailed information will be found in the table on Page 55. Clean Air. Certain provisions of the Clean Air Act, 1956, came into operation on 31st December, 1956, namely those relating to the installation of new furnaces, smoke control areas, height of chimneys, and research and publicity. The remaining provisions of the Act will come into force next year. The Minister of Housing and Local Government made regulations during the year relating to the constitution and procedure of the Clean Air Council, which he was required to appoint under Section 23 of the Act, and to the exemption of certain fireplaces which are specially designed or adapted for combustion of liquid fuel from some of the requirements relating to Smoke Control Areas. Occupiers of all the larger industrial and commercial premises in the area were circularised as to the provisions, generally, of the Act. Prior approval was given during the year to plans and specifications submitted under Section 3 of the Act of furnaces proposed to be installed in a County Council housing scheme. 22 Complaints received of smoke nuisances numbered 28, and ninety-two observations were made on chimneys. Measurements of air pollution are regularly toicen 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 9 and 10 on Pages 58 and 59. Drainage and Sanitary Conveniences. A landlord appealed against a notice served on him under Section 40 of the Public Health (London) Act, 1936, in respect of a defective drain, the grounds for the Appeal being that the notice required the execution of works which would be for the common benefit of two premises and that the owner of the adjoining premises ought to have contributed towards the expense. When the matter came before the Court, the Appeal was withdrawn as the two parties had reached an agreement. Another landlord appealed against a notice served on him under Section 105, Public Health (London) Act, 1936, requiring the provision of proper and sufficient water closet accommodation at a premises used for both residential and factory purposes. The grounds for the Appeal were that the notice was bad inasmuch as there were two water closets in the premises. The Appeal was dismissed, the Magistrate holding the view that where premises consist of a dwelling and a factory, the dwelling must have at least one separate water closet for the exclusive use of the residents. Byelaws made by the London County Council in 1930 included one which required the provision of one water closet for every 12 inmates of a house occupied by members of more than one family. Having regard to the provisions of Section 11 of the Housing Repairs and Rent Act, 1954, re-enacted in Section 36 of the Housing Act, 1957, which empowers local authorities to require the execution of works in, or the reduction of the number of occupants of, houses-let-in-lodgings, the above-mentioned London County Council byelaw could no longer apply. In its stead, a standard has been adopted by this Council, in common with other Metropolitan Councils, namely, that one water closet for each household be provided where practicable, and where premises are let in lodgings, at least one water closet be provided for every 8 persons or for every 4 rooms, whichever standard is the higher. Factories. A copy of the annual return furnished to the Ministry of Labour and National Service will be found in Table 18 on Page 67. Hairdressers and Barbers. On the instructions of the Public Health Committee, the occupier of a hairdresser's establishment was cautioned for carrying on a business as a hairdresser without registration. 23 Legal Proceedings. Legal proceedings instituted by the District Public Health Inspectors during the year, showing penalties imposed, were as follows:- Number of Summonses Fines Costs £. s. d. £. s. d. Public Health (London) Act, 1936: Nuisance Orders 13 47. 9. 0. Non-compliance with Nuisance Orders 1 (Conditionally discharged) (Adjourned sine die) Defective Drains (Section 40) 1 London County Council (General Powers) Act, 1954 (Section 12) 1 3. 7. 0. London County Council (General Powers) Act, 1952 (Section 26) 1 1. 0. 0. 1. 1. 0. Factories Act, 1937 - Section 7 1 10. 0. 0. 5. 0. 0. do. - Section 110 2 10. 0. 0. 6. 6. 0. 20 £21. 0. 0. £63. 3. 0. Two owners appealed against notices served upon them. One in respect of a notice under Section 105 of the Public Health (London) Act, 1936, being dismissed and the other in respect of a notice under Section 40 of the same Act being withdrawn. The Magistrates made a Closing Order on a dwelling-house in the Borough under the Public Health (London) Act, 1936, a summons being issued for non-compliance with a Statutory Notice, and at the Herring the defendant requested the Magistrates to make a Closing Order. 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 10-23, Johnson Street. 258 men 177, Whitechapel Road. 407 men Hostel for Women, Hopetown Street.228 women. The premises at 10/22, Johnson Street have been temporarily closed since 1st June, 1957, for structural alterations. 24 Lodging Houses - Seamen's. There are five such premises in the Borough, providing accommodation for 496 seamen, as follows The Sailors' Home & Red Ensign Club, Ensign Street and Dock Street. 243 seamen. The Empire Memorial Hostel, 747, Commercial Road. 190 " 5, North East Passage. 11 " 220, Cable Street. 30 " 9, Ensign Street. 22 11 Lodging Houses - Other. In addition to the licensed Common and Seamen1s Lodging Houses, there are two other premises in the Borough which are not subject to licensing or registration, namely Rowton House and Providence Row Night Refuge. Rowton House in Fieldgate Street, Whitechapel, which was opened in 1902, provides accommodation for 796 men, and Providence Row Night Refuge provides for 135 men, women and children. Notices Served. Notices served under the various Acts and Byelaws during the year were as follows:- aas follow served Public Health (London) Act, 1936:- Intimation Not ice _s Statutory Notices Section 82 (Nuisances) 2,077 426 Section j[fO 28 24 Section 108 2 1 Section 109 33 10 Factories Acts, 1937 & 1948 88 - Shops Act, 1950 1 - London County Council (General Powers) Act, 1955:Stopped-up Drains, etc. - 122 London County Council (General Powers) Act, 1954:Dustbins 75 2 Prevention of Damage by Pests Act, 1949, Section - 21 London County Council (Seamen's Lodging Houses) Byelaws 1 _ London County Council (Poultry Slaughterhouses) Byelaws 12 - • 2,317 606 Offensive Businesses. There are 19 offensive businesses in the Borough. The premises of a fur skin dresser at 29, Spelman Street and of a poultry slaughterhouse at 42, Hessel Street were removed from the register during the year. 25 The register comprises the following premises: - Pressors of Furskin. (2) 34/38, Brodlove Lane. *48, 50, 50a, 54 & 56, Old Church Road. Kosher Poultry Slaughterhouses. (17) *19, Bell Lane. 28, Burslem Street. l6l. Cannon Street Road. 16/18, Cobb Street. 49, Globe Road. *14, Hessel Street. *21/22, Hessel Street. 36, Hessel Street. 75, Hessel Street. *7, Leyden Street. 13, Leyden Street. 15, Leyden Street. *7, Lower Hessel Street. *4, Monthope Street. *6, Monthope Street. 10a, Monthope Street. 82, Stepney Way. The Establishment Orders of those premises marked (*) are subject to renewal from time to-time by the Council. An application to establish anew an offensive business (a poultry slaughterhouse) was refused. 26 Outworkers. Forty-two inspections were ma.de of Outworkers' premises. There arc 731 premises on the register, an increase of 44 over last year, the trades concerned being as follows Artificial Flowers 1 Brusheo Lampshades 1 1 Cardboard Boxes 8 Stuffed Toys 3 Carding &c. of Buttons 3 Umbrella 4 Christmas Crackers &c. 2 Wearing Apparel 653 There were 19 notifications of infectious disease relating to Outworkers' premises. Number of firms in the Borough employing Outworkers 94 " " Outworkers residing in and employed by firms in the Borough 291 11 " Outworkers residing outside the Borough employed by firms in the Borough 619 " " Outworkers residing in the Borough employed by firms outside the Borough 440 The occupiers of two factories where wearing apparel is manufactured, summoned for failing to send lists of Outworkers employed by them to the Council, were each fined £5 and ordered to pay £3. 3s. 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 and ordered to pay £1. Is. costs. Refuse Disposal. The Public Cleansing Officer has kindly supplied the following information on refuse and salvage disposed of during the year House and Trade Refuse ... 35,442 Tons Street and Market Refuse ... 8,094 Tons 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 1^—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, x^ich 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, 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. Rodent Control. In accordance with the requirements 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 1957 to 31st March 1958. During this period, 9,444 dwellings and business premises were inspected, and 1,749 were found to be infested either with mice or rats. Treatments were carried out by the department's rodent control staff to 1,500 properties which were found to be infested, the charges made for servicing business premises amounting to £742. 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 27 which 'would otherwise act as a 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 57. Shops. The number of premises in the Borough covered by the provisions of the Shops Act is 2,855. 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 598 Flats and 28 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. The 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 a w-.ter supply to premises in the Borough was repaired or reinstated totalled 62, and the Metropolitan Water Board was notified on ten occasions where wastage of water was taking place. During the year 10 notices were received from the Metropolitan Water Board of withdrawal of the water supply, in 4 premises for non-payment of rates and in 6 because of defects in the service. Wells. Bacteriological and chemical analyses of water from the 7 deep wells in industrial use in the Borough are made periodically and the results reported to this Department. All were reported as being satisfactory. Workplaces. There are known to be 304 workplaces in the area (other than those premises covered by the Factories Act, 1937). 28 Work Executed by 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 :- Stopped-up Drain (Section 25, London County Council (General Powers) Act, 1955). £ s d 48, Alie Street. 3. 13. 5 126, Brick Lane, 2. 0. 10 Site of 197, Burdett Road. 7. 2 19, Casson Street 1. 18. 2 Eileen Mansions. 6. 17. 1 13, Ensign Street. 4/5, Fleur de Lis Buildings. 4. 2. 0 12. 4. 2 17, Fleur de Lis Buildings. 2. 6. 11 5, Heneage Street. 2. 0. 7 5, I loss' 3 Buildings 1. 4. 8 5, Moss's Buildings 12. 8 40, Princelet Street. 2. 18. 10 1, Tailworth Street. 5. 4. 1 8, Tailworth Street. 1. 0. 1 Defective Drain (Section 40, Public Health (London) Act, 1936). 309/315, Whitechapel Road. 442. 18. 1 £489, 8, 9 UUc.OlJOlQQ • Summaries of inspections and visits made by the District Public Health Inspectors and of insanitary conditions remedied are given on Pages 54, 55 and 56. 29 IV. HOUSING Clearance Areas. The Housing Act, 1957, came into operation on 1st September, 1957. The Act repeals and re-enacts in consolidated form the provisions of the earlier Housing Acts, with the exception of financial provisions which are to be consolidated in a separate Act. During the year six areas, involving 156 houses, were declared by the London County Council as clearance areas and 110 properties were demolished by that authority under the Housing Act, 1936. Overcrowding. During the year 58 cases of alleged overcrowding were investigated, 16 of which were confirmed and referred to the London County Council. Nineteen overcrowded families were rehoused by the London County Council, and the number of known overcrowded families on the register decreased from 621 to 443, a review of the register accounting for the removal of 168 cases. Underground Rooms. There are approximately 2,500 underground rooms in the Borough used for living or sleeping purposes, about 2,380 of which are unfit. During the year 14 rooms were closed. The number of underground rooms closed since 1936 to date is 422. Progress on closure generally is held up for lack of suitable alternative accommodation. Town & 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. Investigation of 25 such applications was carried out during the year. Applications for Rehousing. At the end of the year, there were 4,346 applications for rehousing on the Housing Manager's Register, In addition licensees of 251 requisitioned premises are on the register for transfer of accommodation, as also are the tenants of 417 Council dwellings. Preferential Housing on Health Grounds. Of the 32 cases investigated, fourteen were found to come within the Council's Points Scheme. 30 Temporary Hutments. Ninety hutments owned by the Borough Council remained at the end of the year. Ten hutments were recommended for demolition because of structural deterioration. Requisitioned Premises. The number of dwellings under requisition by the Borough Council is 716, involving 1,029 lettings. Five basement rooms in requisitioned dwellings did not comply with the regulations and were recommended for closure. New Housing. During the year 626 new dwellings were completed in the Borough; 100 by the Borough Council, 1$ 1 by the County Council, 30 by the Corporation of London and 15 by private enterprise (see Appendix, Page 68). A total of 5,943 new permanent dwellings has been constructed in the Borough since the war; 3,739 by the London County Council, 2,083 by the Borough Council, 30 by the Corporation of London, and 91 by private enterprise. Statistics. A summary of inspections made by the Housing Inspector is given in Table 12 on Page 61, and further housing statistics will be found on Pages 62 and 63. 31 V. INSPECTION AND SUPERVISION OF POOD During the year, the Public Health Food Inspectors continued to visit food premises with a view to the implementation of the provisions of the Food Hygiene Regulations, 1955, and, as will be seen from the Table on Page 38, many premises which lacked adequate washing facilities, sinks, etc. were required to provide them. Attention has also been given to all the other requirements of the Regulations. The Inspectors continued also to survey food premises on 'house-tohouse' lines, and 574 premises were inspected and details of construction, hygienic conditions and facilities etc. recorded. A summary of the visits made by the Public Health Food Inspectors will be found on Pages 60 and 6l. Bakehouses and Bakers' Shops. The proprietors of premises comprising a baker's shop and bakehouse were summoned for selling bread not of the substance demanded (in that it contained a piece of glass), and also in respect of the dirtjr condition of the bakehouse and equipment. Fines totalling £225 with £10 costs were imposed. A summons was issued against the proprietor of another baker1s shop for selling to the prejudice of the purchaser, 'cream doughnuts' the filling of which consisted of artificial cream. The summons was dismissed. Basement bakehouses in the area now number six, the bakehouse at 20, Cable Street,having been removed from the register during the year as it hod not been in use for a period exceeding 12 months. Butchers' Shops. Proceedings were instituted against the proprietor of a butcher's shop for failing to provide suitable and sufficient washhand basins, sinks, and an adequate supply of hot and cold water. Fines totalling £2 with £2,. 2s. costs were imposed. Proceedings were also taken in respect of another premises regarding the sale of minced meat containing sulphur dioxide preservative. The proprietor was fined £10 with £3. 9s. costs. Thirty-three samples of beef and pork sausages submitted for analysis were found to have an average meat content of 59.9$ and 66.{&> respectively. 32 Bacteriological Examination of Foodstuffs. Samples of food submitted for bacteriological examination numbered 79, details of which are as follows:- Number of Samples Number Unsatisfactory. Observations Dried Whole Hen Egg Albumen 37 k Two showed presence of SalmonpH 1 a. ".berdeen and 2 Salmonella thompson. Consignment reexported . + Egg Albumen 1 1 Salmonella Aberdeen isolated. Synthetic Cream 5 2 One showed Dresence of Faecal coli, the other Staphylococcus aureus pyogenes. Manufactured in another area; local authority notified. Pasteurised Milk 9 1 Subsequent samples satisfactory. * Cooked Prrwns 2 2 Staphylococci (including Staph, aureus) found. No adverse reports were received on the following samples examined:- Ice Cream 11 Boned Veal 6 Roast Pork 1 Sausages 1 Sterilised Milk 1 Frozen Whole Egg 3 Norwegian Pickled Shrimps 2 (+) The albumen was used in accordance with the recommendations of the Albumen Advisory Committee of the Bakery- and Allied Trades Association. (*) Food Poisoning c.used by; Norwegian Cooked Prawns, In June, 1957, information was received from the Medical Officer of Health of a metropolitan borough of a case of food poisoning alleged to have been caused by the consumption of Norwegian cooked prawns. The prawns were consumed during a meal in a restaurant and formed part of a 1 shrimp cocktail',and had been supplied to the restaurant by a firm in Stepney. Whilst investigations were proceeding, a further case of food poisoning occurred, the cause being the consumption, at the same restaurant, of a 'shrimp cocktail' containing Norwegian cooked prawns from the same source of supply, 33 Bacteriological examination of samples of the prawns procured from the Stepney firm showed the presence of Staphylococcus aureus and other Staphylococci. Investigation showed that the prawns were cooked and packed in Norway in 1-lb. and J-lb. waxed cartons and refrigerated. The frozen prawns were sent from Norway by refrigerated ship and train, and were kept in efficient refrigerators by the Stepney importers and sent to their customers in insulated refrigerated containers. At no time after refrigeration in Norway were the prawns unfrozen or handled until unpacked at the restaurant. The danger from the prawns arises after delivery to the restaurant where they may be kept in conditions suitable for the growth of food poisoning toxins. No Staphylococcal infection of the prawns is likely to become dangerous unless given temperature and time to produce toxins. The matter was reported to the Ministry of Health, who approached the Norwegian authorities with a view to improving the hygiene at the packing station at Stavangar. The Stepney importers agreed that in future the cartons should carry a printed note to the effect that, until used, the prawns should be kept continuously at a temperature below 40 F. Export Certificates. Twenty-seven certificates were issued in respect of the examination of a variety of foodstuffs for export to the United States, South America, Canada, Sweden, Italy and France. Such certificates necessitate the inspection of the foodstuffs to be exported, and, on occasions, samples are taken for analysis before a certificate is issued. Food Stalls. Legal proceedings were instituted on two occasions; one for the depositing of foodstuffs (groceries) within 18 inches of the ground, which resulted in a fine of £2 with £3. 7s. costs being imposed, and one for selling ground almonds which were not of the substance demanded. In the latter case the proprietor was fined £10 with £3. 7s. costs. Food Hygiene Regulations. 1955. Applications were made by the occupiers of two food premises for exemption from compliance with certain requirements of the Regulations. In one case the application was acceded to, and in the other refused. 34 Grocers' and Miscellaneous Food Premises. Legal proceedings taken with regard to the sale of non-brewed condiment which was 17.5$ deficient in acetic acid resulted in the defendant being granted an absolute discharge on payment of £2. 2s. costs. Ice Cream. Eleven samples of ice cream were subjected to the Methylene Blue reduction test with the following results:- Manufactured TOTAL In Borough. Outside Borough. Grade I 2 (1) 7 (6) 9 (7) " II 1 (1) 1 (-) 2 (1) " HI - (-) - (2) - (2) " IV - (-) - (-) - (-) The figures in parenthesis are those for 1956. Ten samples were submitted for chemical analysis and showed an average fat content of 11.35%. Although there are 29 premises registered in the Borough for the manufacture of ice cream, only three 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. Of the 20 applications received for the registration of premises under Section 16 of the Food and Drugs Act, 1955, for the sale and storage of ice cream, one application was refused. Imported Egg Products. As referred to in my Annual Report of last year, following discussions which took place with the Ministry of Health, a procedure was agreed upon whereby all imports of Chinese dried hen egg albumen would be suitably heat-treated at centres to be set up by the trade. A number of these centres are now operating in London and imports are released only for heat treatment at one of the centres. The procedure is working smoothly. Imports of powdered whole egg, of yolk and of frozen liquid egg are detained at the wharves and sampled for bacteriological examination. 35 Legal Proceedings. Summonses dealt with during the year by the Public Health Food Inspectors were as follows:- Number of Summonses Fines Costs £ s d £ s d Food and Drugs Act, 1955 6 25. 0. 0 18. 18. 0 Food Hygiene Regulations, 1955 17 224. 0. 0 5. 9. 0 23 £249. 0. 0 £24. 7. 0 In addition to the above, six summonses taken out were not heard owing to the death of the defendant. Cautionary Letters. On the instructions of the Public Health Committee, cautionaryletters were sent in respect of each of the following contraventions:- Sale of buttered slices, the fat of which consisted of margarine. Sale of a bun containing a piece of wall tile. Sale of beef sausage containing undeclared preservative. Sale of 'chocolate cream eclairs1 containing artificial cream. Inadequate supply of hot water in a grocery shop. Fish stall not screened. Milk Samples. Milk samples taken and submitted for analysis during the year numbered 114, including 11 taken at hospitals and at a day nursery in the Borough. All proved satisfactory. The average fat and solids-not-fat contents of milk samples analysed wbx'u as xoiiows;- Fat Content Solids-not-Fat Contsnt. Jersey, Channel Islands Milk 4.31$ 8.8C$ Others 3.58$ 8.54$ It is interesting to recall that 50 years ago, 19.3$ of the milk samples taken were adulterated. 36 Public Health (Imported Food) Regulations. 1937-1948. Eighty-five Detention Notices and 80 Release Notices were served under the Regulations. These affected a variety of foodstuffs, including cocoa, coconut, egg powder, dried fruits, nuts, egg albumen, assorted meats, sugar, tea, coffee, lard, casings, etc. Consignments of lard and casings which arrived unaccompanied by the official certificates, were subsequently released on production of the necessary certificates. 259 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. 308 midnight or early morning visits and 101 other visits were made to Bishopsgate Goods Station for the purpose of examining 6,137 trucks of foodstuffs arriving from the following countries:- Belgian Congo 22 trucks. Greece 14 trucks Belgium 391 " Holland 13 " Bulgaria 11 " Hungary 262 " Czechoslovakia 6 " Italy 4838 " Denmark 3 " South Africa 3 " Germany 22 " Yugoslovia 562 " The weight of the foodstuffs examined was 58,946 tons, comprising fresh fruit and vegetables - 48,762 tons; preserved fruits and vegetables 206 tons; cheese - 9 tons; fish - 42 tons; canned meats and sausages etc. 7,045 tons; butter - 291 tons; eggs - 103 tons; confectionery - 19 tons; bacon - 2,281 tons; honey - 43 tons; wheat gluten - 6l tons; offals - 56 tons; casein - 15 tons; sauerkraut - 10 tons and honey cakes - 3 tons. Foodstuffs found to be unsound and which were stopped and destroyed amounted to 4 tons 14 cwts. Samples taken for analysis for metallic contamination included canned ox tongues, beef goulash, pigs tongues and jellied veal, and samples of spinach, strawberries and apricot pulp were examined for preservatives. Six samples of Australian boneless veal were taken at wharf cold stores for bacteriological examination for Salmonella organisms. All were found to be free. Six samples' of Argentine sugar, procured at a wharf, were submitted for analysis for the presence of arsenic and were found to be arsenic free. In addition,' samples of Yugoslavian sausages were examined for the presence of horseflesh and preservatives. All were satisfactory. 37 Hungarian deep frozen strawberries and vegetables began to arrive in March and deep frozen fresh offals in April. All were in sound condition. 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 Tons Cwts. Qrs. Lbs. Wharves 78 9 1 8 London Fruit Exchange & Spitafields Market 84 4 1 8 Bishopsgate Goods Station: ex Zeebrugge-Harwich Train Ferry 4 14 0 14 non-Ferry Goods 18 I 1 Other premises 46 3 1 24 Total: 214 9 1 27 Approximately 66 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 2,400 Condemnation Certificates in respect of unsound food were issued in 1957. Improvements effected at Food Establishments. Number Lavatory basins installed 140 Premises where hot and cold water supply installed 203 Premises where washing facilities for staff have been improved 192 Sinks provided 48 Food storage accommodation provided 25 Refrigerators installed or repaired 12 Premises where walls, ceilings, floors, windows cleansed. 662 Floors renewed or repaired 44 Shop-fronts improved 6 Premises where ventilation provided or improved 34 Premises where natural lighting improved 12 Protective covers provided for displayed food 19 Refuse bins provided 54 Miscellaneous 946 38 VI. PflEVALENCE OF ;JMD CONTROL OVER INFECTIOUS AND OTHER DISEASES. Weather Conditions. Although the weather in London in 1957 was milder than average the Summer was disappointing, with June the only hot month, January and February were mild with practically no frost, followed by a dry March, April and May. March was exceptionally mild and April sunny but a little cooler than March. The Summer arrived with the warmest and sunniest June for 75 years. July brought. heavy rain and much thunder. August, except for the first few days, wa.s cool, cloudy and very wet, and September also was very wet, cool and dull. October was fairly dry and mild. November although stormy at first was mainly dry and without fog. During the first week of December there was hard frost and persistent fog. The second week was stormy with very heavy rain especially on the 12-13th. The remainder of the month, including Christmas, was dry, mild and sunny. The Easter Holiday vjeekend, 19th-22nd April, began fine and sunny but by Monday was cloudy and cool, with some rain. Whitsun, 8-10th Juno, also began well on Saturday but was cloudy and wet on Sunday evening, improving somewhat by Monday evening. The August holiday from 3rd-5th was pleasantly warn and dry with light sunshine and high temperatures. Notifications. A total of 1,914 notifications of cases of infectious diseases were received during the year, compared with 1,324 in 1956, the difference being, in the main, measles notifications. The diagnosis was not confirmed in five of the notifications. Table 14 on Page 64 shows details of notifications received, together with age groups. A list of diseases notifiable in the County of London is shown in Table 17 on Page 06. Cancer. The number of deaths from cancer of all sites occurring in residents of the Borough during the year was 249, being 15 more than last year. Deaths from lung cancer numbered 54, which is 16 loss than in 1956. The association between cancer of the lung and smoking leaves little doubt that smoking is a direct cause of lung cancer. 39 Diphtheria. No notifications of Diphtheria were received during the year. The number of children immunised at London County Council clinics during the last four years was as follows Completed primary course:- 1957 1956 1955 1954 Children under 5 1147 1761 601 1386 Children 5 to 15 415 439 84 472 Children given secondary injection 1437 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 in other years. Notifications and deaths in England and Wales fell from 18,596 and 722 respectively in 1945, to 53 and 8 in 1956, Sixty-five swabs were forwarded by general practitioners to the Mile End Group Laboratory, where bacteriological examinations are carried out on behalf of the Borough Council, Dysentery. There was a decrease in the incidence of Sonne dysentery, 34 cases being notified, compared with 116 cases last year. Erysipelas. During the year thirteen notifications were received. Food Poisoning. Eight cases of suspected food poisoning were notified during the year. There were no deaths. In 5 cases a Salmonella organism was isolated from the patient's stool, but in no c\case was the source of infection traced to any article of food. Hookworm Disease. A Pakistani who came to this country two years ago was reported to be suffering from hookworm disease (ankylostomiasis). Influenza. Deaths from respiratory diseases in the last quarter of the year were higher than normal, totalling 117 as against 229 for the year. In 1956, deaths from respiratory diseases during the December quarter numbered 29 out of a total of 208, Throughout London,deaths in the last quarter of the year from the same cause were twice the seasonal average, according to the County Medical Officer of Health, and this period corresponds with that during which the epidemic known as "Asian '£Lu" was active in London. 40 The actual number of deaths attributed to influenza was eleven during the last quarter of 1957, and none in the corresponding period of 1956. This epidemic, though not a severe type 01 lnlluenza, was very widespread involving a large number of cases and affecting the mortality from respiratory causes, as will be seen from details set out below:- Deaths from Respiratory Diseases: Influenz a. Pneumonia. Bronchitis. Other Respiratory diseases. TOTAL lst-3rd Quarter, f! II 1956. 1957. 2 1 64 48 106 56 7 7 179 112 4th Quarter, it 1956. 1957. 11 13 49 13 53 3 4 29 117 Malaria. There were two cases of malaria notified during the year. Measles. Notifications of measles in the Borough numbered 1,399, compared with 574 last year. There was one death from the disease. Epidemics tend to recur at intervals' of just under two years. Meningococcal Infection. There were 6 notifications and one death during the year, compared with 5 notifications and two deaths last year. Ophthalmia Neonatorum. There were seven cases notified this year. Poliomyelitis. Out of fourteen cases notified, 7 paralytic and 7 non-paralytic , ten were confirmed. Puerperal Pyrexia. There were 44 notifications during the year, compared with 63 in 195^ Of these, 23 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 51, compare with 43 last year. 41 One-hundred end thirty-five scabies patients and contacts were treated by medicinal baths at the Branch Road Treatment Centre and their clothing disinfested, viz.:- MaLes Females Children 60 38 37 The number of baths given during the year totalled 275. Scarlet Fever. There were forty-five 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 rr. vnceinatod at London County Council clinics during the year was 1,205. Tuberculosis. The number of primary notifications of pulmonary tuberculosis received was 117, compared with 116 last year, and the number of nonpulmonary cases notified was 18 as compared with 11 last year. The mortality rate for the year for pulmonary tuberculosis was 20 and of non-pulmonary nil per 100,000 population, compared with 17 and nil respectively in 1956. (For details of register and notifications see Page 65). Tuberculosis - Mass X-ray Survey. A mass X-ray mobile unit of the North East Metropolitan Regional Hospital Board visited the Borough during the year. Besides being static at the Public Health Department for part of the period, the unit visited some large factories in the area, as well as a London County Council institution, ond undertook a new venture by visiting large housing estates in the Borough. The unit vjsl'3 also set up for a few days at "Speakers' Corner" on Tower Hill. The totcJ. number of persons X-rayed was 12,120, of whom 335 were recalled for large films. The numbers X-rayed at the various sites in 42 the Borough were as follows: SITE MALES FEMALES TOTALS Miniatures. Large Films Miniar tures. Large Films Miniatures. Large Films Housing Estates 1925 78 2046 43 3971 121 Public Health Department 1398 72 904 20 2302 92 Tower Hill 806 25 201 2 1007 27 St.George's Hostel 290 6 220 7 510 13 Southern Grove Lodge 127 7 88 3 215 10 Factories 2940 53 1175 19 4115 72 Totals: 7486 241 4634 94 1 PI ?0 335 Approximately 0.38 per cent of those persons X-rayed were found to be suffering from pulmonary tuberculosis. Other abnormalities discovered included four cases of cancer of the bronchus. In 1956, the number of persons X-rayed in the Borough by the unit was 3,260, of whom 112 were recalled for large films. The Minister of Health states that Mass Radiography continues to display its value as a diagnostic technique. Over 7,000 cases of tuberculosis which would otherwise have been undiagnosed were revealed by this means. This is nearly a fifth of the total number of cases notified. Its value is not confined to the diagnosis of tuberculosis, for it is an important discoverer of a number of abnormal chest conditions of which cancer of the lung is the outstanding example. Public Health (Prevention of Tuberculosis) Regulations. 1925. These egulations 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 43 should realise that much help is still needed to be given to persons suffering from the disease, Extra nourishment was given during the year to 117 patients through the London County Council Extra Nourishment Scheme, and 41 patients went for recuperative convalescent holidays. Help was also given to 86 persons by way of clothing, extra nourishment, bedding, holiday expenses, radio licences, and fares to relatives visiting patients in sanatoria. The Care Committee again provided r day's coach outing to the sea for 23 patients and Christmas gifts for 53 patients. The Annuel Christmas Seal Sale Fund amounted to £194, 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, but where these could not be obtained, the funds of the Committee were used. The London County Council two years ago 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. Whooping Cough. Seventy-seven cases were notified during the year, the figure, for 1956 being 235. There were no deaths from the disease. ♦ • • • Infectious Disea.se 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 one such certificate 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 signatures on 1,013 such certificates were verified by me during the year as those of medical practitioners practising in Stepney, and the certificates were endorsed accordingly, 44 Disinfection. Promises disinfected because of infectious disease numbered 69, which included 12 for pulmonary tuberculosis. 12,208 articles of clothing and bedding were steam disinfected, including 1,984 articles for export, for which 32 certificates were issued. Formaldehyde disinfection of 339,405 articles of clothing and 210 tons of waste-paper for export was also carried out during the year, for which 176 certificates were issued. • The charges for export and other disinfections carried out amounted to £99. Disinfestation (bed bucs and other insect pests). The following is a summary of work carried out by the specialist Inspector engaged on disinfestation duties:- General inspection for vermin 1,143 Attempted visits 193 No. of premises found verminous 359 11 re-visits 460 " miscellaneous 880 " premises sprayed 543 " rooms sprayed 1,282 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, Harrow Street, E.14. The furniture and effects of 400 such families were treated during the year. In addition, disinfestation by steam and formaldehyde was carried out on 22 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 244 33 21 298 The number of baths and treatments given amounted to 322. 45 SUMMARY OF PUBLIC AI'IALYST1 S Quarterly Reports for the year 1957 Daring the year 402 samples were submitted for analysis, 178 being purchased or taken formally and 224 informally. The samples are classified as follows:- 1 Faggot 2 Fish (canned) 1 Flour 1 Fruit (canned) 7 Fruit (dried) 1 Gravy Powder 2 Ground Ginger 10 Ice Cream 2 Jellied Eels 2 Jelly (Guava) 3 Jelly (Table) 1 Jelly (Turtle) 3 Lard 3 Lemon Juice 12 Margarine 7 Meat (canned) 17 Meat (minced) 1 Meat Pudding (canned) 114 Milk 1 Mint (dried) 3 Mint Sauce 6 Non-brewed Condiment 25 Alcoholic Spirits 3 Almonds (ground) 2 Apricot Pulp 1 Bacon 16 Butter 2 Buttered Slices 1 Cake 5 Cake Mixtures 1 Carraway Seeds 5 Cheese and Cheese Spread 1 Cochineal 2 Cocoa 2 Coffee 1 Coffee & Chicory Essence 1 Condensed Milk 6 Cream 4 Cream Pastries 6 Custard Powder 1 Oil (cooking) 2 Oil (ground nut) 1 Pepper 1 Salad Cream 1 Sausage Meat 38 Sausages and Cooked Sausages 1 Smoked Salmon 21 Soft Drinks, Squashes and Cordials 10 Soups (bottled and canned) 1 Soup Tablets 2 Stuffing 6 Sugar 5 Sweets 1 Tea 1 Tomato Ketchup 3 Vegetables 1 Vinegar 1 Antacid Tablets 2 Boracic Powder 1 Borax 1 Castor Oil 5 Chemical Foods 2 Cold Capsules 2 Glycerine 1 Gregory Powder 2 Iodine'- Tincture 1 Liquid Paraffin 1 Medicated Tablets 1 Olive Oil 1 Soda Mints 1 Zinc Ointment and Cream 46 Of the 402 samples analysed, 7 formal end 9 informal were found to be unsatisfactory, as follows:- Article Formal or Informal Nature of Irregularity Remarks Olive Oil. Informal Contained 30 per cent Arachis Oil. Vendor advised on correct labelling. Non-brewed Condiment. Informal 40 per cent deficient in Acetic Acid. Taken up with Manufacturer. do. Formal 17.5 per cent deficient in Acetic Acid. Absolute discharge on payment of £2. 2s. costs. Chocolate Cream Eclairs. Formal Contained imitation cream. Cautionary letter sent. Double Cream. Informal 28 per cent Fat. Incorrectly labelled. Formal sample satisfactory. Minced Meat. Formal Contained Sulphur Dioxide (1050 parts per million). Fine £10. Os. Costs £3. 9s. Buttered Slices. Formal Fat consisted of Margarine. Cautionary letter sent. Ground Almonds. Informal Contained 50 per cent Arachis Nuts and 10 per cent Soya Flour, (See following sample). do. Formal Contained 50 per cent Arachis Nuts and 10 per cent Soya Flour. Fine £10. 0s. Costs £3. 7s. Pork Sausages. Informal 15 per cent deficient in meat. Formal sample satisfactory. Beef Sausages. Formal Contained undeclared Sulphur Dioxide (250 parts per million). 1 Cautionary letter sent to vendor. (Contd.) 47 (Contd.) Article Formal or Informal Nature of Irregularity Remarks Bleached Sultanas. Informal Contained 920 parts per million Sulphur Dioxide. ImDorters warned. (Sampled under Public Health (Imported Food) Regulations). do. Informal Contained 970 parts per million Sulphur Dioxide. Cream Doughnuts. Informal Contained imitation cream. "Artificial Cream" Notice displayed in shop on subsequent visits. dc. Informal Contained imitation cream. do. Formal. Contained imitation cream. Summons dismissed. Milk. 114 samples of milk were examined during the year, 4 being of the super-fatted variety (e.g. "Channel Islands" or "South Devon" milk) for which a higher minimum percentage (4 per cent) 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 3.58 per cent fat and 8.54 per cent solids other than fat, and of the "Channel Islands" milk 4.31 per cent fat and 8.80 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 other thar Fat, per cent 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 1957 110 3.58 8.54 48 APPENDIX of STATISTICAL TABLES 49 OS Table 1. TOTAL DEATHS BY CAUSE AND AGE OF STEPNEY RESIDENTS- 1957 (Registrar-General's Return) CAUSE OF DEATH ALL AGES Age Groups Total M F -1 -l 5- 15- 25- 45- 65- 75- 1. Tuberculosis - Respiratory 20 15 5 - — _ 2 - 10 6 2 2. ''- Other - - - — - - - - - - - 3. Syphilitic Disease 7 6 l - - - "" - 2 4 1 4. Diphtheria - — - - — — - — — — — 5. Whooping Cough - - - - - - - - - 6. Meningococcal Infection 1 1 - - - l - — — — — 7. Acute Poliomyelitis - - - - - - - — — — — 8. Measles 1 1 - - 1 - - - — - - 9. Other Infective and Parasitic Diseases 3 2 l - - - - - 2 ~ 1 10. Malignant Neoplasm - Stomach 34 21 13 - - - - 2 8 14 10 11. '' - Lung, Bronchus 54 50 4 - — - - 1 29 17 7 12. " - Breast 13 _ 13 — - - - 2 7 3 l 13. " - Uterus 5 — 5 — — - - - 2 2 1 l4. '' - Other 135 81 54 1 - l 1 9 40 53 30 15. Leukaemia, Aleukaemia 8 7 1 - l - - 1 2 1 3 16. Diabetes l4 4 10 - - - - 1 1 8 4 17. Vascular Lesions of Nervous System 109 41 68 - - - _ 3 18 35 53 18. Coronary Disease, Angina 199 115 84 - - - - 7 63 68 61 19. Hypertension with Heart Disease 27 12 15 - - - - - 2 l4 11 20. Other Heart Disease 116 49 67 - - - — 5 21 22 68 21. Other Circulatory Diseases 60 30 30 - - - - 3 11 19 27 22. Influenza 12 8 4 - - 1 - 1 3 1 6 23. Pneumonia 97 59 38 8 — - - 1 19 29 40 24. Bronchitis 109 77 32 5 - 1 - 1 21 26 55 25. Other Diseases of Respiratory System 11 8 3 1 - - - - 1 3 6 26. Ulcer of Stomach and Duodenum l4 8 6 - - - - - 4 3 7 T£ Table 1 (contd.) CAUSE OF DEATH ALL AGES Age Groups Total M F -1 l- 5- 15- 25- 65- 65-1 75- 27. Gastritis, Enteritis and Diarrhoea 8 4 4 - l - l _ 1 3 2 28. Nephritis and Nephrosis 4 1 3 — - - - _ 2 l 1 29. Hyperplasia of Prostate l4 14 - ' — - - - - - 3 11 30. Pregnancy, childbirth, abortion 1 - 1 — - - - 1 - - - I 31. Congenital Malformations 10 5 5 6 - 1 - - 3 - - I 32. Other defined and ill-defined diseases 79 33 46 23 5 - 2 3 l4 11 21 33. Motor Vehicle Accidents 6 5 1 — — — 3 1 1 - 1 3 if. All other accidents 27 15 12 1 l - - 3 6 4 12 35. Suicide 16 7 9 - - - - 3 7 3 3 36. Homicide and operations of war - — - - - - - - - - - Males 679 ! 23 5 2 6 28 198 210 207 Females 535 22 4 3 3 20 102 l43 238 GRAND TOTAL: i 1214 45 9 5 9 4 300 353 445 Table 2. COMPARATIVE TABLE OF ROAD ACCIDENTS IN THE BOROUGH YEAR Children Under 7 years Children 7 - l4years Adults TOTALS | Killed Injured Killed Injured Killed Injured Killed[/##] Injured 1952 1 4 1 54 7 521 9 620 1953 1 4 53 5 563 6 663 1954 No statistics available 1955 - 70 - 56 7 726 7 852 1956 - 58 - 60 4 742 4 860 1957 — 49 - 54 2 667 2 770 1957 Pedestrians Motor Cyclists 3;Pedal Cyclists Drivers Other Road Users TOTAL Killed - - 1 1 - 2 In.iured 309 102 79 91 189 770 2S Table 3. INFANT MORTALITY, 1957. Deaths from stated causes at various ages under 1 year. (Compiled from Local Death Returns) CAUSES OF DEATH AGS PERIODS TOTAL DEATHS UNDER 1 YEAR PER CENT. OF TOTAL Under 2b hours 1-6 days. Weeks Total under i wks. Months 1- 2- 3- 1- 4- 7- 10- Pneumonia - 3 _ _ - 3 3 1 1 . 8 (5) 17.78 Bronchitis - — - — 1 1 3 1 — . 5 (-) 11.12 Congenital Malformations 1 1 — — - 2 3 . 1 . 6 (8) 13.34 Premature Birth 13 4 - _ — 17 . . — . 17(16) 37.78 Broncho-pneumonia due to umbilical sepsis - - - - 1 1 . . . . 1 (-) 2.22 Birth Injuries 1 1 — — — 2 — . . . 2 (-) 4.44 Intracranial Tumour 1 — - - - 1 - — — - . l(-) 2.22 Toxaemia due to multiple infection of skin - - - - - - 1 . . . 1 (-) 2.22 Tracheo-laryngitis — — — — — — 1 — — — 1 (-) 2.22 Asphyxia 1 — — — — 1 — — — . 1 (-) 2.22 Ilaemolytic and Haemorrhagic Disease of Newborn 2 - - - - 2 _ . . . 2 (2) 4.44 TOTALS: 19 9 - _ 2 30 11 2 2 - 45(43) 100.00 ≠Figures in parentheses denote corre qp onding deaths in 1956. * Includes deaths from other causes. Table b. Comparative Table showing Deaths of Infants at Various Ages under 1 year. YEAR Under 2b Hours 1-6 Days 1-if Weeks Total under *+ weeks 1-12 Months Total under 1 year Percentage Deaths under weeks of Total Infant Deaths 1953 18 11 7 36 38 74 49 195V 17 11 4 32 9 41 78 1955 18 11 4 33 8 41 78 1956 12 15 6 33 10 43 77 1957 19 9 2 30 15 45 73 Table 5. COMPARATIVE VITAL STATISTICS YEAR Population Live Births Deaths Deaths under 1 Year Maternal Deaths Cancer Deaths Tuberculosis Deaths (all forms) No. Rate Wo. 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 8^ , , 30.2 J+85!+ 17.3 1261 1^8 2b 2.8 236 0.8 6if7 2.3 1921 2^9,657 6169 2^.7 12.9 550 89 10 1.6 263 1.0 $£ 1.3 1931 225,238 if 010 17.8 2958 13.1 313 78 9 2.1 3*f2 1.5 25b 1.1 1939 197,200 2^-66 12.5 2213 12.0 12 7 53 8 3.3 319 1.6 lif8 0.7 19*fO 136,030 2l¥f 15.7 2729 20.0 86 ^3 5 2.3 292 2.1 lif7 1.0 19^1 7^,780 ll6if 15.5 1883 25.1 6*f 79 3 3.5 203 2.7 lif5 1.9 19^2 71,980 1271 17.6 12*f3 17.2 66 52 5 3.7 171 2.3 85 1.8 19[+3 72,920 1371 18.8 1368 18.7 73 53 3 2.1 188 2.5 107 _ / l.if 19^ 73,030 1306 17.8 1425 19.5 77 56 0 0.0 185 2.5 96 19^5 77,610 lMf2 18.5 1^69 18.9 81 56 2.6 201 2.5 110 i.b 19^6 9^,800 2lb7 22.6 1399 ib.7 110 51 if 1.8 198 2.1 81 0.8 19^7 100,020 ' 2l8if 21.8 1^19 l^f.i 82 37 2 0.8 229 2.2 99 0.9 19)+8 99,^70 2077 20.2 1228 12.3 59 28 0 0.0 239 2.3 75 0.7 19^9 100,550 1830 18.1 1339 13.3 59 32 1 0.5 255 2.5 71 0.7 1950 99,730 18^5 18.5 1255 12.5 *+9 26 2 1.0 2¥f 2.if 56 0.5 1951 98,581 18^6 18.7 13#f 13.8 39 2i 0 0.0 232 2.3 *+9 oA 1952 99,000 189^ 19.1 1371 13.8 35 18 6 3.0 2*fl 2.if ?° 0.5 1953 98,570 1919 19.5 1187 12.0 75 39 1 0.5 237 2.if b3 o.b 195^ 97,900 1851 18.9 1126 11.5 bl 22 1 o.5 261 2.6 36 0.3 1955 98,180 1826 18.5 1183 12.0 b2 23 2 1.0 2if7 2.5 20 0.2 1956 98,160 1909 19 A 1186 12.1 22 0 0.0 2^b 2.if 17 0.2 1957 97,810 1853 18.9 1211+ 12A ^5 2b 1 o.5 2b9 2.5 20 0.2 Table 6. SUMMARY OF WORK OF DISTRICT PUBLIC.HEALTH INSPECTORS No, of Premises Inspections Notices Served Legal ings Taken Registered and Licensed Premises Hairdressers and Barbers 130 48 — _ Rag Flock Premises 23 4 — - Pet Shops 6 23 - - Offensive Businesses 19 123 12 — Pharmacy and Poisons Premises 87 112 - - Common Lodging Houses 5 38 - - Seamen1s Lodging Houses 5 27 1 — Factories. Shops. &c. Mechanical Factories 2162 383 88 1 Non-mechanical Factories 206 12 — - Other 53 1 — - Outworkers 731 42 — 2 Shops 2855 47 1 — Other Visits and Inspections. Complaints and Nuisances 4862 2152 15 House-to-House 805 Drainage 3389 63 1 Infectious Disease and Gontacts 172 — — Markets (week-end inspections) 28 — — Heating Appliances (Fireguards) Act 21 -- - Disrepair Certificates 1360 - - Smoke Observations 92 — - Miscellaneous Visits and Inspections 1255 - . - Revisits 3004 606 — Attempted Visits 1901 - - Motor Cycles (Protective Helmets) - - - Regulations, 1957 26 - - Rag and Bone Dealers . - - 1 Totals: 17,775 2923 20 (Contd,) 54 Table 6. (contd.) Certificates of Disrepair: 1920 Act 1954 Act 1957 Act 1. Applications for Disrepair Certificates 16 56 490 Notices of Proposal to issue Certificate - - 450 Applications withdrawn - - 7 Undertakings acccptod - - 150 Undertakings refused - - 53 Certificates issued 15 52 212 Certificates refused 1 4 160 2. Applications for cancellation of Disrepair Certificates 16 55 42 Cancellations issued 11 40 33 Cancellations refused 5 15 5 3. Applications by landlords for Certificates as to remedying of defects, as undertaken - - 6 Certificates issued certifying all defects remedied - - 5 Certificates issued certifying some defects remedied - - 1 Complaints: Total received at Office 2595 - of Smoke Nuisance received • • 28 - of Noise Nuisance received m • 5 Dangerous Structures: No. premises notified to District Surveyour 77 Drains: No. tested with smoke 1149 No. found defective 133 No. of plans on which observations submitted 99 Fireguards Tested: Oil heaters 3 Electric heaters 13 Land Charges: No. of premises reported upon 2012 Public Houses: No. of premises reported on to Licensing Justices 36 Rag Flock and Other Filling Materials Act: No. of samples taker 5 Wastage of Water: No. of premises notified to Metropolitan Water Board 10 Table 7. SUMMARY OF REPAIRS &c. CARRIED OUT UN HIS TIG SUPERVISION 0F DISTRICT PUBLIC H.--ALTH INSPECTORS DURING THE YEAR. Dampness in rooms remedied 1,507 Premises where - New drains constructed 818 - Drains reconstructed 172 - Existing drains repaired 90 - Drain obstructions cleared 71 Dustbins provided 117 Dwelling-rooms, passages and staircase walls and ceilings cleansed or repaired 1,377 Factories - New W.Cs. provided 5 - Sanitary accommodation'repaired 225 - Other defects remedied - Floors repaired 450 Fireplaces and coppers repaired or renewed 368 Gullies, manholes, provided or repaired 543 Light and ventilation improved or provided to rooms and staircases - Roofs, gutters, rainwater pipes, renewed or repaired 1,238 Rubbish accumulations removed 82 Sinks, baths and lavatory basins fitted 1,257 Soil and vent pipes provided or repaired 532 Staircases - Treads, etc. repaired 81 Ventilation (under-floor) provided, to rooms 1 Waste pipes provided or repaired 1,013 Water Closets and Urinals - New provided 702 - Compartments cleansed, repaired 338 - Obstructions cleared 27 - Flush apparatus repaired 223 - Fans ajid traps fixed 731 Water Supply - Cisterns cleansed, repaired 2 - Defective supply or fittings remedied 62 Windows repaired 1,231 Yards and areas, cleansed or paving repaired 153 Miscellaneous repairs 382 56 Table 8. RODENT CONTROL (Period 1st April 1957 - 31st March 1958) Council Property Dwelling Houses Other Premises 1 TOTAL Total Properties in Are 41 26,020 7,624 33,685 No. Properties inspected as result of - (a) Notification 6 800 239 1,045 (b) Survey under the Act — 6,350 2,049 6,399 No. Properties inspected which were found to be infested bv - (a) Rate - Major - - 1 1 Minor 1 567 190 758 (b) Mice - Major 2 124 89 215 Minor 3 606 166 775 No. Infested properties treated by Local Authority" 6 1,272 222 1,500 No. Section 4 Notices served: (i) Treatment — _ — — (ii) Structural works - - 21 21 No. Cases where default action taken following Section 4 Notice - - - - Legal'Proceedings - - - - No.' "Block" control schemes carried out — Nil Sewers - "Maintenance Treatments." I am informed by the Borough Engineer and Surveyor that two treatments for the destruction of rats in sewers were carried out during the year, viz., from 1st April to 12th July and 7th October to 23rd December. 1,469 manholes were treated in each period. 57 Table 9. 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-)1957 7.5 9.0 13.9 9.4 8.7 8.4 9.2 9.8 10.3 12.7 10.9 11.0 tion)1956 10.4 6.1 l4.0 9.9 12.5 7.5 8.6 10.2 11.7 9.4 9.1 12.9 No.1)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 Sta-)1957 8.8 9.8 12.5 8.6 9.5 10.1 10.6 8.9 11.0 13.4 8.8 14.3 tion)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 No.2)1955 l4.9 8.3 12.1 9.9 10.8 11.3 10.3 7.7 9.8 8.5 11.1 7.6 SOLUBLE MATTER DEPOSITED (Tons per.square mile) Sta-)1957 5.4 7.7 7.6 4.6 3.6 3.8 6.6 5.6 8.8 7.5 7.0 10.0 tion)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 No.1)1955 14.3 7.8 7.5 4.9 ll.l 7.9 7.4 11.8 5.8 6.6 . 4.6 8.7 Sta-)1957 6.8 6.8 8.2 4.9 3.6 6.2 8.5 6.2 8.1 9.2 7.9 9.1 tion)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 No.2)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 SULPHUR TRIOXIDE COLLECTED (Mr. per day per 100 sq. cm. of lead peroxide) Sta-)1957 3.0 4.O 3.3 2.7 1.7 l.4 1.6 1.7 1.9 3.3 4.3 4.8 tion)l956 4.6 4.9 3.8 3.9 1.9 1.3 1.5 1.5 2.3 3.0 4.3 3.8 No.1)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 Sta-)1957 3.8 4.9 3.8 2.9 2.1 1.7 l.4 2.0 2.0 3.7 4.8 6.4 tion)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 No.2)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 6S Table 10. AIR POLLUTION Concentration of Smoke and Sulphur Dioxide recorded by the Volumetric Method at two Stations in the Borough during 1957. Station Jan. Feb. Mar. Apr. May June. July Aug. Sep. Oct. Nov. Dec. SMOKE (Milligrams per 100 cubic metres) Public Health Office Monthly average 41 47 37 25 16 12 10 13 17 43 52 86 Highest daily average 86 92 83 51 30 21 17 38 32 104 110 365 Mile End Library Monthly average 40 50 31 18 12 12 10 11 11 31 31 48 Highest daily average 93 108 54 35 26 23 24 24 21 56 55 181 SULPHUR DIOXIDE (Parts per 100 million parts of air) Public Health Office Monthly average 11 l4 12 9 6 7 5 5 6 11 14 27 Highest daily average 25 29 25 24 12 15 12 12 9 28 33 87 Mile End Library Monthly average 10 13 11 8 If 5 5 5 6 12 12 18 Highest daily average 22 23 24 17 12 11 11 13 12 23 23 75 i Table 11. SUMMARY OF WORK OF PUBLIC HEALTH INSPECTORS (FOOD) No. Visits or Inspections . Notices Legal Proceedings. Registered Premises Milk Distributors Dairies 16 333 6 - Itinerant Vendors 31 Other 219 Licences issued to persons under the Milk (Special Designations)(Pasteurised & Sterilised Milk) & (Raw Milk) Regulations, 1949-34 558 - - - Ice Cream Premises Sale 269 150 6 - Manufacture 29 - Storage only. 2 Prepared Food Prem ises - Meat 87 318 32 - - Fish 49 ) Other Premises Bakehouses - basement 6 _ ground level 44 476 32 3 Bakers shops 63 Butchers shops and stalls 112 432 74 2 Catering establishments 903 1492 177 — Fish shops and stalls 162 170 50 — Greengrocers and fruiterers 680 541 75 1 Grocers (wholesale and retail) 414 995 70 2 Public Houses and Off Licences 278 197 18 - Poultry Dealers (excluding butchers) 86 166 28 _ Railway Depots 4 419 _ - Wharves 42 764 - - Miscellaneous Food Premises 338 716 25 — Meat Vehicles - 96 — _ Revisits - 1646 - - i ' 8911 593 8 There are 2,863 food premises, including stalls, in the Borough. Some of the premises listed above are included under more than one trade category. (Contd.) 60 Summary of Work of Public Health Inspectors (Food). (Table 11 contd.) Reason for Visit. Food Hygiene Regulations, 1955 4455 Surrender of Unsound Food 505 Merchandise Marks Acts 342 Public Health(Meat)Regulations 258 Food Standards Orders 101 Labelling of Food Orders 70 Byelaws: Fish Curer and Fish Vendor 82 Agriculture Produce Grading and Marking Acts 78 Pharmacy and Medicines Act, 1941 35 Sampling 337 Complaints 129 Samples of food taken during the year for chemical and bacteriological examination numbered 481. Summonses talc en out relating to foodstuffs numbered 5 and to conditions at food premises 23 (four premises involved). Table 12. SUMMARY OF INSPECTIONS MADE BY THE HOUSING INSPECTOR Caravans 86 Complaints 31 Housing Act, 1936 - Section 11 30 " " - Section 12 32 Housing Accommodation Direction, 1952 32 Immigrant Enquiries for Malta Government 31 Improvement Grants 6 Miscellaneous Inspections 229 Overcrowding 87 "Permitted Numbers" under the Housing Act, 1936 197 Premises situated in Clearance Areas 257 Requisitioned Premises 243 Temporary Hutments 26 Underground Rooms 660 61 Table 13. HOUSING STATISTICS 1. Inspection of dwelling-houses during the year:- (1) (a) Dwelling-houses inspected for housing defects ("under Public Health or Housing Acts) 4,342 (b) Inspections made for the purpose 11,312 (2) (a) Dwelling-houses inspected and recorded under Housing Consolidated Regulations, 1925. 927 (b) Inspections made for the purpose 1,044 (3) Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 24 (4) Dwelling-houses found not to be in all respects reasonably fit for habitation 2,186 II. Reir tedy 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 1,663 III. Act ion under statutory powers during the year:- (a) Proceedings under Sections 9, 10 and 12 of Housing Act, 1937 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 523 (2 ) Dwelling-houses in which defects were remedied after service of formal notices - (i) By owners 507 (ii) By local authority in default of owners 16 62 Table 13 (contd.) (c) Proceedings -under Sections 16 and 23 of Housing Act, 1957 - (i) Dwelling-houses in respect of which Demolition Orders were made 4 (ii) Dwelling-houses demolished in pursuance of Demolition Orders I (d) Proceedings under Section 18 of Housing Act, 1957- (i) Separate, tenements or underground rooms in respect of which Closing Orders were made 17 (ii) Closing Orders determined, the tenements or rooms having been rendered fit Nil (e) Proceedings under Section 42. of Housing Act, 1957- (i) No. of houses included by representation by Medical Officer,of Health Nil (ii) No. of houses demolished in pursuance of representations 110 (f) Proceedings under Section of Housing Act, 1957 - (i) Closing Orders made 2 (ii) Closing Orders determined Nil IV. Housing Act, 1957, Part IV - Overcrowding:- (i) No. of overcrowded families on register at beginning of year 621 (ii) No. of new cases encountered during year 16 (iii) No. of cases relieved during the year 26 (iv) No. of cases removed from register following review of lists 168 (v) No. of overcrowded families on register at end of year U3 63 4 Table 1^. NOTIFIABLE DISEASES NOTIFIED DURING TH3 YEAR 1957. DISEASE CASES NOTIFIED in Age Groups Notifications Corrected Total Admitted to Hospital -1 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- 65- Ac.Encephalitis Infective - 1 - - - - - - - - - - 1 i 1 Ac. PoliomyelitisParalytic 2 3 _ — - 2 - - - - - - 7 7 7 Non-paralytic - - 2 2 1 2 - - - - - - 7 3 7 Dysentery 4 9 3 6 2 1 l 2 2 - l 3 34 34 20 Enteric Fever _ - - - - — - — 1 — — — 1 1 1 Erysipelas - - - - - - - - 1 1 5 6 13 13 5 Food Poisoning 2 - — 2 1 — — — - 2 1 - 8 8 4 Malaria - - - - - — _ _ — - 2 - 2 2 2 Measles 59 196 203 191 263 42 15 3 5 1 1 - 1399 1398 108 Lening.Infection 4 — — — — — 1 - 1 - - 6 6 6 Ophth.Neonatorum 7 - — - _ - - - - - - - 7 7 7 Pneumonia 2 1 3 1 1 5 2 1 12 6 26 17 77 77 23 Puerperal Pyrexia - - — — - - 7 31 5 1 - 44 44 43 Scabies — 2 - 1 1 8 6 6 l4 5 7 1 51 51 2 Scarlet Fever 1 1 3 9 28 2 1 - - - — 4 4 13 Tuberculosis Pulmonary 1 1 - 1 1 4 2 4 44 25 29 8 120 120 — Non-Pulmonary Whooping Cough - 10 - 10 1 12 1 13 - 10 2 17 - 3 1 - 9 1 - 1 2 — 2 - 18 77 18 76 15 TOTALS: 91 224 225 221 289 531 31 26 120 4 75 37 1917 1912 264 There were no notifications of Smallpox, Membranous Croup, Diphtheria or Acute Encephalitis (Post Infectious). Table 15. TUBERCULOSIS - New Cases' and Deaths New Cases. 129 Pulmonary oases were notified, including 120 primary notifications, 8 from death returns and 1 posthumous notification. 18 Non-Pulmonary cases were notified, all being primary notifications. Deaths. 20 persons died from Pulmonary Tuberculosis. Aee Distribution of new cases and deaths is as follows:- -1 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- 65- Total (all aces) (a) New Cases. Pulmonary M 1 - - 1 1 3 1 2 24 21 23 6 83 F - 1 - - - 1 1 2 20 4 6 2 37 Non-Pulmonary M _- _ 1 _ _ 2 — 1 5 — 2 — 11 F - - - 1 - - - - 4 - - 2 7 (b) Deaths. Pulmonary M - - - - - - - - 1 - 8 6 15 F - - - - - - - 1 - - 2 2 5 Non-Pulmonary M - - - - - - - - - - - - - F - - - - - - - - - - — - - Table 16. TUBERCULOSIS - Variations in Register Pulmonary NonPulmonary Total Cases. M F M F [/##] [a) Cases on Register at 1/1/57 644 371 81 82 1178 (b) New Cases 83 37 11 7 138 (c) Cases restored to Register 16 6 - _ 22 (d) Other cases added 39 13 — 1 53 (e) Removals 109 49 8 6 172 (f) Cases remaining on Register at 31/12/57 673 378 84 84 1219 65 Table 17. DISEASES NOTIFIABLE IN LONDON Disease Authoritv for Notification . Acute Encephalitis. P.H. Act 1936 (S.143); SI. 1949/2259. Ac.Influenzal Pneumonia. " " SI.1953/299. Ac.Primary Pneumonia. " " 1953/299. Ac.Poliomyelitis. " " SI.1949/2259. Anthrax. L.C.C. Order 1909; P.H.(L) Act 1936 (S.305). Chicken Pox. (Notifiable in Port of London only). Cholera. P.H. (L) Act 1936 (S.192 and 304). Diphtheria. " " Dysentery. " (s.143); SI.1953/299. Enteric Fever (including Typhoid and Paratyphoid). " (S.192 and 304);SI.1953/299. Erysipelas. " (S.192 and 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. " " " Leprosy. P.H. Act 1936 (S.143); SI.1951/1036. Malaria. " " SI.1953/299. Measles. " " SRO.1938/1100; SRO.1940/205 and SI.1948/420. Membranous Croup. " (S.192 and 304). Meningococcal Infection. (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.l900« Puerperal Pyrexia. " " SI.1951/1081 and SI.1954/1691. Relapsing Fever. " (S.192 and 304). Scabies. " (S.143); SRO.1943/1016. Scarlet Fever. " (S.192 and 304). Smallpox. " " Tuberculosis. " (S.143); SI.1952/704. Typhus Fever. " (S.192 and 304). Whooping Cough. "(S.143); SRO.1938/1100, 1940/205; SI.1948/420. Yellow Fever. (Notifiable in Port of.London only). Zymotic Enteritis or (Notifiable in 9 Metropolitan Boroughs only - Summer Diarrhoea. not notifiable in Stepney). 66 Table 18. FACTORIES ACTS. 1937 & 1948. T . Inspections for purposes of provisions as to health. Type of Factory No. on Register Inspections Written Notices Factories without mechanical power 206 12 — Factories with mechanical power 2162 383 88 Other premises under the Acts (building operations and works of engineering and construction) 53 1 - Total: 2421 396 88 2. Cases in which defects found. Referred - Particulars Found Remedied to H.M. Inspector by H.M. Inspector Want of cleanliness 3 3 — 3 Overcrowding - - - - Unreasonable temperature - - - - Inadequate ventilation - - - - Ineffective drainage of floors - - - - Sanitary Conveniences - (a) Insufficient 2 2 — 5 (b) Unsuitable or defective 80 80 - 46 (c) Not separate for sexes 36 36 - 12 Other offences against the Acts (not including those relating to Outwork) - - - - Total: 121 121 ; - i 66 3. Prosecutions. The occupiers of two factories, svuxionod for failing to supply lists of outworkers employed by thou, were fined £5 each and ordered to pay £3:3:Od costs. Another was fined £10 and ordered to pay £5 costs for failing to maintain sanitary conveniences in a cleanly condition. 67 Table 19. D.VELLINGS EJECTED DURING 1957 Address No. of Dwellings (a) By Borough Council Athlone House 29 Longford House 37 Zion House 34 100 (b) By London County Council Bahama House 25 Barnardo Gardens 36 Carbis Road 20 Cleveland Way 14 Dora Street 24 Flansham House 40 Formosa House 36 Gatwick House 56 Globe Road 32 Levant House 24 Norbiton Road 26 Redbourne House 56 RhodeSwell Road 7 Salmon Lane 9 Southwater Close 46 Stepney Way 25 Welstead House 5 481 (c) By Corporation of London Dron House, Adelina Grove ?0 30 (d) Other Ben Jonson Road, Dame Colet House, Caretaker's Flat 1 Ben Jonson Road, Haileybury Boys' Club, Caretaker1s Flat 1 Bow Common Lane, Church of Holy Name, Presbytery 1 Grove Dwellings, Adelina Grove 12 1? TOTAL: 626 68 Table 20. OPEN SPACES WITHIN THE EOROUGH Location Acreage Maintained by Borough Council- Albert Square Gardens 0.66 Arbour Square Gardens O.66 Beaumont Square Gardens 1.00 Carlton Square Gardens 0.75 Christchurch Gardens, Spitalfields 1.25 Commercial Street (Toynbec Hall) 0.19 Ford Square Gardens 0.40 Kingward Street Playground 0.13 Mile End Gardens 0.50 St.George's Gardens 0.75 St,James' Gardens, Ratcliff 2.00 Swedenborg Square Playground 0.67 St,George-in-the-East Churchyard 2.25 Shandy Street Recreation Ground 1.50 Sidney Square Gardens 0.33 Stepney Green Gardens, including Clock Tower Space 1.50 Trafalgar Square Gardens 0.60 Tredegar Square Playground 1.24 Trinity Square Gardens 1.13 Vallance Road Recreation Ground 1.19 Wakefield Gardens 0.06 York Square Gardens 0.20 Maintained by London County Council- Diggon Street Playground 0.13 King Edward VII Memorial Park, Shadwell 8.50 King George's Playing Fields (part) 14.65 Limehouse Churchyard 2.00 St.Anne's Neighbourhood Open Space 2.29 Stepney Churchyard 4.00 Wapping Gardens 3.45 Waterside Gardens 0.52 TOTAL: 54.50 Acres These Open Spaces represent 3.2 per cent of the area of the Borough, which is 1,691 acres exclusive of the are? covered by the river, docks and canals.- 69 Table 21. List of Social Clubs. Lunch Clubs and ChiroDodv Clinics affiliated to The Steonev 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 Berrihard 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 Slind 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. V/ednesdays, 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, The Royal Foundation of St.Katherine, Butcher Row, Ratcliffe, E.14. Mondays, 2-4.30 p.m. and Thursdays, 7-9 p.m. Stepney Friendship Club, East London Synagogue Hall, Rectory Square, E.l. Tuesdays, 7-9.30 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). +W.V.S. Darby and Joan Club, Burdett Estate, St.Paul's Way, E.3. Fridays, Noon - 4 p.m. + Dame Colet House, 29 Ben Jonson Road, E.l. Tuesdays & Fridays, Noon - 2 p.m *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. 70 INDEX Page No Accidents - Home 11 — Road 11, 51 Aged Persons 12, 70 Air Pollution 22, 54, 58, 59 Analyst1s Report 46 Area of Borough 7 Asian ' flu 4 Bacteriological Examination of Foodstuffs 33 Bakehouses 32, 60 Births 7, 10 oancer 5, 39 Catering Establishments 60 Chiropody Clinics 13, 70 Clearance Areas - 30 Common Lodging Houses 24, 54 Complaints of Nuisances 54, 55 Conferences 13 Deaths 7, 10, 50 Diphtheria 40 Disinfection and Disinfestation 45 Disrepair Certificates 22, 54, 55 Drainage 23, 29, 55 Dysentery 40 Factories 23, 54, 67 Fifty Years Ago Food - Unsound 38 Food Inspection and Supervision, 32, 60 Food Poisoning 5, 40 Free Washing Facilities 15 General Information 8 Hairdressers & Barbers Premises 23, 54 Health Education 15 Health Services,- General Provision of 12 Heating Appliances (Fireguards). Act, 1952 54 Holiday Centre 20 Home Bathing 12 Hospital Facilities 15 House-to-House-Inspections 54 Houses - Number in Borough 7 Housing 30 Housing Statistics 6l, 62, 63 Ice Cream 35, 60 Illegitimate Births 7, 10 Imported Egg Products 35 Infant Mortality 7, 10, 52 Infectious Disease 39, 54, 64, 60 Influenza 40 Information Service 16 71 Inquests 14 Laboratory Facilities 16 Legal Proceedings 24, 36 Legislation 5, 16 Licensed Premises 55, 60 Marriages 10 Mass X-Ray 42 Maternal Mortality 7, 11 Maternity and Child Welfare 17 Measles 41 Milk Supply 36, 48, 60 Mobile Meals Service 13 National Assistance Act, 1948 13, 14 Notices Served 25 Offensive Businesses 25, 54 Old People's Welfare Association 13, 70 Open Spaces 9, 69 Outworkers 26, 67 Overcrowding 30 Pet Animals 54 Pharmacy & Poisons Act 54 Poliomyelitis 41 Population 7,9 Poultry Slaughterhouses 25 Prepared Food Premises 60 Public Health Inspectors (District) - Summary of Inspections 54, 55 - Return of Sanitary Work 56 Rag Dealers 27 Rag Flock and Other Filling Materials Act, 1951 54, 55 Rateable Value 7 Refuse Disposal 27 Removal of Persons in need of Care and Attention 12 Rent Act, 1957 22, 55 Rodent Control 27, 57 Sanitary Circumstances 22 Sanitary Conveniences 23 Scarlet Fever 42 Seamen's Lodging Houses 25, 54 Shops 28, 54 Smallpox 42 Social Conditions of Area 8 Staff 6, 20 Statistics, Summary of 7 Stillbirths 7, 10 Swimming Baths 21 Tuberculosis 5, 42, 65 Underground Rooms 30 Unemployment 11 Vital Statistics 7, 53 Water Supply 28, 55 Weather Conditions 39 Whooping Cough 44 72