AC 4367 liw Copy STE 35 Metropolitan Borough of Stepneg Annual Report of the Medical Officer of Health R. W. WATTON, M.B., B.S., D.P.H., D.C.H. for the year 1961 Together with the Report of the Public Analyst - Metropolitan Borough of Stepneg. ANNHUL REPORT of the MEDICAL OFFICER OF H3ALTH for the year 1961 together with the Report of the Public Analyst CONTENTS PAGE Sketch Map of Borough Frontispiece Public Health and Physical Training & Recreation Committees 2 Introductory 3 Staff 5 Summary of Statistics 6 I. Statistics and Social Conditions of the Area 7 II. General Provision of Health Services 13 III. Sanitary Circumstances 24- IV. Housing 32 V. Food - Inspection and Supervision 34- VI, Infectious and other Diseases 4-0 Public Analyst's Report 4-6 Appendix 49 Index 74 PUBLIC HEALTH COrMITTEE at 31st December. 1961 Ex-officio - Her Worship THE MAYOR (Councillor Mrs. K. O'Connor, J.P.) CHAIRMAN: Councillor E.W. Hill. VICE-CHAIRMAN: Councillor G.H. Wall ALDERMAN: T.Aylward. COUNCILLORS: Alfred D. Bermel, J.P. C. Dines J. Milrood B. Borman M.J. Durell J. Olley G.W. Butcher (Mrs.) C. Edwards J. Sambrook (Mrs.) I.B. Calnan (Mrs.) A. Elboa H. Walvisch M. Collins PHYSICAL TRAINING AND RECREATION COMMITTEE at 31st December. 1961 Ex-officio - Her Worship THE MAYOR (Councillor Mrs'.K.O'Connor, J.F.) CHAIRMAN: Councillor H.Walvisch. VICE-CHAIRMAN: Alderman Mrs. C.F. Woollon. ALDERMEN: J.C. Lawder, O.B.E., J.P. J. O'Connor, J.P. A.E. Sealey, COUNCILLORS: g.w. Butcher (Mrs.) C. Edwards A.D. Kirby, l.C.C. (Mrs.) I.B. Calnan (Mrs.) A. Elboz J.T. Reilly H«S. Darlow M. King P. Sullivan 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 AMD WA3HIICU3ES 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. 2 METROPOLITAN BOROUGH OF STEPNEY Tel: No. PUBLIC HEALTH DEPARTMENT, STEpney Green 24-84 43> White Horse Road, Stepney, E.l. To The Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies 2c. Gentlemen, I have the honour to present the report on the state of the public health in Stepney for the year 1961. Compiled this year, the report appertains to the last year of office of my predecessor, Dr.F.R.O'Shiel, who retired earlier in the year after 26 years' service as Medical Officer of Health to the borough. He gave, in the report for I960., a survey of the changes and progress made during his term of office; it seems opportune to consider developing fields of work in the public health sphere. Housing still presents problems. Without adequate provision of good housing accommodation, wholesome family life, in which the foundations are laid for physical, mental and social wellbeing, can seldom be achieved. Along with the provision of new houses runs a need to provide amenities in the many sub-standard tenement blocks which will remain with us for some years to come. Many of these lack such basic amenities as running water within each dwelling. Whilst much of the borough is undergoing redevelopment, derelict sites will be with us. Their incorporation into temporary use as open spaces for which there is a great need in this part of London would be beneficial. Tuberculosis remains a challenge, as does cancer of the lung, to the preventive medical services. About one-fifth of the lung tuberculosis notifications in 1961 consisted of occupants of common lodging houses, seamen's hostels and other accommodation provided for persons having no fixed place of residence in the metropolis. Tuberculosis has now become a preventable disease by use of the new forms of therapy combined with vigorous case and contact finding. Health education receives much lip service, in an era when personal decision increasingly must determine levels of health efficiency. For example, in respect of food hygiene, education of the food handlers (via the large food firms and food shops) can only be effective if the general public is educated to expect and demand proper handling and display of food products. Similarly, community action to reduce atmospheric pollution continues by the provision of Smoke Control Areas (the fourth is now being surveyed), but personal pollution by cigarette smoking (with its concomitant risk of increased liability to cancer of the lung) can only be reduced by individual decision. The 'will of the people is the highest law' in the sense that legislation, to be effective, must carry with it the force of public opinion. 3 An increasingly ageing population creates the need to provide suitable accommodation for the fit, the frail, and the sick in need of constant care. Liaison will be necessary between hospital boards, local authorities and voluntary agencies to bridge the gap between life in the community and 'living-in care', by the provision of graduated accommodation house - halfway house - hospital. The greater number reaching pensionable age, and the deferment of senility, requires schemes of work for the elderly who often can contribute to the economic wealth of the community as well as maintain their own wellbeing by undertaking work adjusted to their capabilities. An interesting project, discussed in the report, was begun during the year at St.Clement's Hospital to provide for the needs of aged persons with psychiatric infirmities. This forms part of a new approach to 'Mental Health' problems which are being tackled by less institutional and more community care. However, if this emphasis on the desirability of community care for all persons, whatever their disability, is to flourish,proper planning to utilise the services of the existing small number of socio-medical workers is required. In this respect, the services of the two visitors of the Council are fully utilised. If community care expands, as is forecast, most of us will be able to live out our lives with greater happiness in the community at less cost to the nation than for institutional care. Stepney is a microcosm of society in that despite increasing affluence, the moral and social hygiene of a small part of the community shows no improvement. Juvenile delinquency in the borough continues to increase. Vice and undesirable practices exist in certain areas to which undue national publicity has been given and from which no positive measures to ameliorate the conditions have arisen. Moral welfare agencies, Church groups and statutory bodies endeavour to combat ignorance, apathy and the alien cultural values of some immigrant sections of the community. Knowledge of the causes of the decline in certain "twilight" areas in the borough might aid in a reasoned approach to plan their restoration. Planned area development, and studies of social needs will be required to knit a cosmopolitan community into an integrated society. In conclusion, I record my gratitude to the Chairmen and members of Committees for their support. The help and co-operation of the Town Clerk and other Chief Officers of the Council and their staff are greatly appreciated. To all the staff of the Public Health Department I extend thanks for their continued interest in the efficient running of the Department during a time of change. I have the honour to be, Your Worship, Ladies & Gentlemen, Your obedient servant, R. W. WATTON, Miedical Officer of Health. April, 1962. 4 STAFF OF PUBLIC HEALTH DEPARTMENT at 31st December 1961 MEDICAL OFFICER OF HEALTH F. Roantree O'Shiel, L.R.C.P.I., L.M., D.P.H. Assistant Administrative Officer E.P.Webber (l,2) Senior Administrative Assistant M. Pliskin. District Public Disinfestation Administrative & Health Inspectors . Inspector Clerical Staff W. Cue (l) E.J.Edwards (l,2) D.J.Berry R.W.G.Day (l) Miss D.Calnan W.T.Gardiner (l,2) Housing Inspector C.H.Coveley A-biddings (1) W.H.Haworth' (1) ' W.16.tel«oU W.E.Hart (1,2) b.W.Embleton J.J.Keniry (l) B.Goldston B.L.Nunn (1) Smoke & Factories S.S.Harris L.Rajigah (1) (T) Inspector E.F.Holt (3 vacancies) G.D.Freeland (1,2,3) D.A.Hunnibal A.Jacques J.H. King Food Inspectors Technical Assistant (Smoke Control) A.C.Brown (1, 2) v Miss R.Levey H.J.Green (l, 2) A.B.Keniry (T) J.W.Meakin S.S.Lowther (1. 2) Mrs .M.Munday (T) S.Vogler (1, 2) Hygiene Officers Miss A.Sayers Caretaker & Messenger Miss A.J.Ballam Pupil Public Miss M. Guest (4,5,6) Health Inspectors A.N.Cook Foreman Disinfector R.W.Scanes Relief Caretaker and N. Gray Messenger W. Sexton Rodent E.H.Vaughan Investigator Cleansing Station S.G.Ludlow Disinfecting Staff Attendants Rodent Operatives 8 Males 2 Females, 1 Male 3 Males Holiday Centre Staff: Resident Steward - R. Willis Other Resident Cook - Mrs, N.Willis Staff - 7 Resident Assistant - Mrs. N.Fromling (1) Public Health Inspector's Certificate. (2), Meat and Other Food Inspector's Certificate. (3). Smoke Inspector's Certificate. (4) Health Visitor's Certificate. (5) State Certified Midwife (T) Temporary (6) State Registered Nurse. (NOTE; For staff changes during the year see page 23.) SUMMARY OF STATISTICS. 1961. Area of Borough 1902.7 acres. Rateable Value 0-st April) £2,390,868 Population raid-year Estimate 91,710 Sum represented by Census 91,94-0 penny rate (1961/62) £9,962 Density of population (personsper acre) 52.06 General Rate (1961/62) 19/4-d in £ Number of inhabited dwellings according to Rate Books 26,157 Number of structurally separate dwellings - Census 1961 27,257 Number of private households - Census 1961 29,333 BIRTHS TOTAL Male Female All Births 1903 977 926 Live Births - Legitimate 1583 811 772 - Illegitimate 280 151 129 Total - 1863 962 901 Still-births- Legitimate 35 13 22 - Illegitimate 5 2 3 Total - 40 15 25 DEATHS All Causes 1208 664 544 Maternal 1 - 1 Infants under 1 year - Legitimate 30 18 12 - Illegitimate 11 7 4 Total 41 25 16 RATES * Live birth rate per 1000 population 20.26 Death rate per 1000 population 13.13 Still-birth rate per 1000 total births 21.02 Maternal death rate per 1000 total births 0.52 Infant death rate (under 1 year) per 1000 live births 22.00 Legitimate infant death rate per 1000 legitimate live births 18.95 Illegitimate infant death rate per 1000 illegitimate live births39.28 Neo-natal death rate (under 4 weeks) per 1000 live births 17.17 Early neo-natal death rate (under 1 week) per 1000 live births 16.10 Perinatal death rate (still-births + deaths under 1 week per 1000 total births) 36.78 Illegitimate live births per cent of total live births 15.02 (*) Based on Census Population. 6 1. STATISTICS AND SOCIAL CONDITIONS OF THE AREA General Information. The Metropolitan' Borough of Stepney is bounded on the west side by the City of London, on the east by the Borough of Poplar, on the north by the Boroughs of Shoreditch and Bethnal Green and on the south by the River Thames, the river boundary being some 2.39 miles in length. The Borough is roughly rectangular in shape, the length being 2.3 miles and the breadth varying from 1 to 1½ miles, and contains approximately ninety miles of streets. The area of the Borough is 1,902 acres, and of this the river accounts for 136 acres, and inland water consisting of docks and canals covers 75 acres. Dark blue London Clay is found under the whole Borough at a depth of between 20 to 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 there 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, and 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. Notable landmarks in the Borough include the Tower of London and the Royal Mint. Fifty Years Ago. The Annual Report of the Medical Officer of Health for the year 1911 contains the following information: The Census population was 280,024, and the birth rate was reported to be 30.2. The death rate (uncorrected) was 17.3 per 1,000 population, and the infant mortality rate was 149 per 1,000 births. Among the causes of deaths reported were: Tuberculosis 647, Diarrhoea and Enteritis 506, Measles 291, Cancer 236, Premature Births 166, Whooping Cough 44> Alcoholism 34> Diphtheria 34> Scarlet Fever 9, Smallpov 8. Deaths of children under one year included 382 from Diarrhoea and Enteritis, 70 from Measles, 17 from Whooping Cough. There were 197 inquests on children under five years of age, 48 deaths being attributed to convulsions, 26 deaths to overlying in bed by parents and 11 to burns and scalds. 7 Notifications of infectious disease included 1,819 cases of Measles, 440 of Diphtheria, 387 of Scarlet Fever, 78 of Enteric Fever and 38 of Smallpox. Of the 1,257 samples of food analysed, 139 (11.1%) were found to be adulterated, as a result of which 73 prosecutions were taken. 109 samples of milk and 15 samples of butter were found to be adulterated. 96 samples of milk were taken on Sundays, 14.6% of these being adulterated. Legal proceedings were taken in 145 instances under the Public Health Act, Food & Drugs Acts and other Acts and Byelaws and included nine summonses issued for refusal to sell samples of food for analysis. The principal building3 of the Council were illuminated on 22nd June, 1911, in celebration of tne Coronation of Their Majesties King George V and Queen Mary at cost of £337. 1. 0. On 9th May, 1911, Her Highness Princess Marie Louise of SchleswigHolstein, opened the extension of the Out Patients Department and an Open Air Shelter at the East London Hospital for Children, Shadwell (now known as Queen Elizabeth Hospital). 10 beds were reserved in Sanatoria at Hastings and Reading for consumptive patients of the Borough at a cost of £312 per annum. The carcases of 3 plague infected rats were found on a wharf within the 3orough. Measles, Poliomyelitis and Polioencephalitis were made notifiable and Underground Room Regulations were also made. Thirty-eight prosecutions were taken against persons for depositing rubbish on the carriageway. The bodies of 521 cats were burnt in the Council's incinerator for Our Dumb Friends League, the charge being 2d for cats and Id for kittens. 43,240 tons street refuse was collected during the year. The number of Public Conveyances in London was 16,476, inclusive of 3,347 horse drawn cabs, 876 horse drawn buses and trams, 12,253 motor buses, caba and electric trams. 15,797 loads of hay and straw were bought into Whitechapel Hay and Straw Market. A Dispensary for the Prevention of Consumption was opened by the Council at Arbour Square. Population. The Registrar-General's mid-year estimate for 1961 is 91,710. Last year's estimate was 93,850. The Registrar-General's Report on the 1951 Census revealed that the Borough's day-time population was 141,400 compared with 98,858 night-time population, an increase of over 44 p2r cent. 8 The density of population is now 52.06 persons per acre. In 1935 it was 120 per acre. During the year there was a natural increase in population of 655, that is, there were 655 more births than deaths. The Registrar-General estimates the population to be 2,140 less than last year, the indication being that 2,795 persons have moved out of the Borough. Census. 1961. The preliminary report of the Registrar-General on the 1961 Census reveals that the Borough's population is 91,940, comprising 46,303 males and 45,637 females. Stepney appears to be the only Metropolitan Borough with a preponderance of males. The population has decreased since the last census by 6,918, equivalent to a reduction of 7.0%. As the number of live births exceeded the number of deaths of residents of the Borough during the intercensal period by 6,366, there is an indication that 13,284 persons have moved out of the Borough during the last ten years. The number of private households is 29,333, being 962 less than in 1951, or a reduction of 3.2%, whereas the number of private dwellings has risen by 2,362 to 27,257, an increase of 9.5%. Births. The total number of live births registered in the Borough, during the year, was 4,235 and of this number 2,610 belonged to other areas. In addition, 238 births belonging to Stepney occurred outside the Borough, making a total of 1,863 births (962 malesj 901 females) to Stepney residents. The live birth rate is 20.26 per 1,000 population, the highest since 1948. The rate when adjusted by the comparability factor is 18.43, compared with the rate for England and Wales of 17.4. Illegitimate live births numbered 280, representing 15.02 per cent of the total live births, the increase following the metropolitan trend. Still-births numbered 40, representing a rate of 21.02 per 1,000 total births. Marriages. The number of marriages in the Borough during the year was 787, being 10 less than last year. The marriage rate per 1,000 population is 17.1 compared with 17.0 in I960. Deaths. The net number of deaths registered during the year was 1,208, compared with 1,037 last year. The death rate of 13.13 compares with 11.05 for I960. The rate of 13.13 when adjusted by the comparability 9 factor is 13.39 as compared with 12.0 for England and Wales. The principal causes of death were heart disease, which accounted for 30 per cent of the total deaths, cancer 20 per cent and diseases of the respiratory system 20 per cent. Deaths of persons over the age of 65 years amounted to 66.3 per cent of the total deaths. Details of deaths by cause and age are given in Table I of the Appendix, on pages 50 & 51. Infant Mortality. Deaths of infants under one year numbered 41, giving a rate of 22.00 per 1,000 live births compared with 18.66 last year. The rate for England and Wales is 21.4, the lowest ever recorded. The tables on page 52 show the deaths from stated causes at various ages under one year, together with comparative figures over the last five years. Perinatal Mortality. The perinatal mortality rate of infants (viz., stillbirths plus deaths occurring in the first week of life) was 36.78 as compared with 27.46 last year. The principal causes of perinatal mortality are as followsi- (a) Ante-partum death with maceration and ante-partum asphyxia are both associated with toxaemia of pregnancy, hypertension, multiple pregnancy and high maternal age. (b) Intra-partum asphyxia and birth trauma are associated with long labour, complicated delivery, multiple pregnancy, prematurity and high maternal age. (c) Congenital malformations form a heterogenous group including hydro-cephalus, meningocele, and congenital heart lesions. (d) Erythroblastosis foetalis and intra-ventricular haemorrhage; the former is associated with blood group incompatability, the latter with prematurity. In (a), (b) and (d), the associated factors are those for which higher standards of ante-natal care, a better selection of patients at risk for hospital delivery, and adequate paediatric care (particularly of the premature infant) will lead to further reduction in mortality. The policy of encouraging special obstetric list general practitioners, and the recent abortive attempt to lay down minimum standards of attendance by general practitioners undertaking obstetric care, under the aegis of Executive Councils, are measures to ensure such necessary care. In (c), congenital malformations, research proceeds. There has been a dual genetic approach; on the one hand, at the cellular level 10 (chromosome studies); on the other, by population genetical studies. Much wider knowledge is required before valid genetic counselling can be given to couples seeking advice on possible genetic malformations in their offspring. Ironically, whilst such work continues, the testing of powerful atomic, hydrogen and fcobalt bombs proceeds with a concomitant pollution of the atmosphere by radioactive substances which are known to have an adverse effect on mutation in cells, and so potentially can lead to malformations of genetic origin. Such activities would appear to be incomprehensible, an example of man creating his own deleterious environment for himself and for future generations. Prevention, here, is our own direct responsibility and duty. Neonatal Mortality. Whilst the Infant Mortality Rate (defined as the number of deaths of infants under one year per 1,000 registered live births) has shown a consistent fall over the years, the figures for Neonatal Mortality (defined as the deaths among live-born infants under four weeks of age per 1,000 live births) have not shown such a decrease.(See graphs facing this page). This year there were 32 deaths of infants under 4 weeks old, representing a neonatal mortality rate of 17.17. Last year there were 19 neonatal deaths and the rate was 11.08. Further analysis of the Neonatal Mortality Rate reveals that many deaths occur in the first seven days of life, which combined with the still-births (defined as a child that has been issued forth from its mother after the 28th week of pregnancy and which did not at any time after being completely expelled, breathe or show any other sign of life), are an indication of factors operating in utero, during and immediately after birth, and are defined as the Perinatal Mortality. Maternal Mortality. There was one maternal death during the year. Some days after a caesarian section and delivery of a living child, the mother died of pulmonary embolism, which is a natural risk of the post-natal period. This maternal death therefore can be classified as non-preventable. Accidental Deaths. The number of deaths due to accidents was 40, or 7 less than last year. These included 8 due to motor vehicles (13 less than in the previous year); 14 in the home; 2 at work; 2 from drowning, and 14 due to various other causes. (See Table 2 on page 51 relating to Road Accidents). 11 Accidents in the Home. Many more deaths throughout the country occur, now, from accidents in the home than from road accidents, or from lung tuberculosis, and the public cannot be urged too strongly to see that all possible precautions are taken in the home to minimise them. The powers and duties of the Council under the Home Safety Act, 1961, relating to the dissemination of information and advice for promoting safety in the home and encouraging proper precautions against accidents,are exercisable by the Public Health Committee and the means taken to educate the public in this respect are referred to elsewhere in this report. The County Medical Officer of Health supplies me with information which he obtains from the London Ambulance Service,relating to the removal to hospital of home accident cases occurring in London and in the London County Council Health Division 5, of which Stepney forms a part. A table summarising these figures over the past four years is given on page 53* Whilst the figures may not be fully comprehensive they give a reasonably accurate picture. During the year, the London Ambulance Service removed to hospital 218 Stepney home -accident cases as compared with 178 last year. Old people are prone to home accidents and the Department's women Hygiene Officers pay great attention to this during their visitsj for example, where accidents from gas appliances have occurred, or are likely to occur, they have been instrumental in obtaining for the old persons concerned a special safety-type gas cooker. Attention is also given in the homes of old people to oil heaters, particularly those of the drip-feed type. Advice and assistance is given to enable the old people to have these converted so as to conform with safety standards. Unemployment. The Ministry of Labour has kindly supplied me with the following information as to the estimated number of persons residing in the Borough who were registered as unemployed at the end of the year:- Men Boys Women Girls 1,308 20 161 8 = Total: 1,497 The total number of unemployed at the end of I960 was 1,265. Open Spaces. There is in the Borough 0.73 of an acre of Parks and Open Spaces per 1,000 population. A list of the sites is given on page 72. Comparative Statistics. A table showing vital statistics for the Borough at various years from 1901, is on page 54. 12 II. GENERAL PROVISION. OF HEALTH SERVICES AGED PERSONS WELFARE. 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 a Court of Summary Jurisdiction for an Order for the removal to a hospital or institution of any aged, infirm or physically incapacitated person living in insanitary conditions and who is in need of care and attention. During the year, it was necessary to apply for three Removal Orders and one Extension Order under this enactment in respect of the following persons:- Age Removed to Remarks Miss M.H. 74 Hospital Order for 3 weeks, (Died). Miss B.B. 72 Institution Order for 3 months (Extension Order)for transfer from Hospital to Institution. (Died). Mrs. M.C. 76 Hospital Order for 3 weeks. (Died). Mrs. R.S. 80 Hospital Order for 3 weeks. (Still away). In addition to those persons removed under Magistrate's Orders, admission to hospital or institution was obtained for 23 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 3,748 visits were made by these officers during the year. A register of all old persons visited is kept in the Department. Amendments made to the register during the year are as follows:- Number on register at 1st January, 1961 1,850 Additions during the year 547 Removals during the year 266 Number on register at 31st December, 1961 2,131 The Department continued operating its Laundry Service (begun in 1951) for the chronic sick who are unable by reason of ill-health, senility, etc. to keep their personal laundry and bed-linen in a clean condition. During the year, 455 parcels of laundry were dealt with. The facilities of the laundry were augmented during the year by the installation of a hydro-extractor. 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 bathing. 801 baths were given to 87 old people during the year by the Council's Home Bathing Service, which was inaugurated in 1950. 13 Grants may be made under section 31 of the National Assistance Act, 1943, to voluntary associations whose activities include the provision of recreation and meals for old people. Hitherto the Council had made grants to individual old peoples Clubs and organisations. The Council resolved this year to make an all embracing contribution to the Stepney Old Peoples Welfare Association, for allocation as appropriate to the various organisations in the Borough catering for the welfare of old people. The contribution for the year 1961/62 amounted to over £7000. There are 20 old people's clubs in the Borough, 17 being affiliated to The Stepney Old People's Welfare Association.* The Council is represented on the Association by the Chairman of the Public Health Committee and other members of the Council and by the Medical Officer of Health, A list of clubs and the facilities thereat will be found on page 73. A grant of £550 was also made to the Workrooms for the Elderly, a voluntary organisation. This is an employment scheme for elderly persons which commenced in the Borough in 1953. The Mental Welfare Day Hospital, opened last year at St. Clement's Hospital, Poplar, has been of assistance to our old people and early cases of mental deterioration have been referred there. The scheme is in its early experimental stage but is undoubtedly of benefit to those cases which in the past have been difficult to deal with. The Mobile Meals Service operated by the Stepney Old People's Welfare Association, the Women's Voluntary Service and the Beaumont Hall Settlement stepped up its deliveries to a weekly average of 806 meals to homebound old people. Facing this page is a photograph showing meals being loaded in to vans, from the Womens Voluntary Sorvices' Kitchen at Blakesley Street for delivery to homebound old people. Seven of the Old Peoples Clubs, which include a luncheon club among their facilities, provided an average of 633 meals each week. A Chiropody Service with a whole-time chiropodist is provided by the Stepney Old People's Welfare Association at clinics situated in six of the old people's clubs in the Borough, and on an average 600 treatments were given each month, including domiciliary treatments. On 22nd September an old people's home was opened by the London County Council in Stepney Way, The home, called 'Braybrooke' after the first Bishop of Stepney who died in 1404, accommodates 84 persons, mainly in single and double rooms with a few rooms containing 4 beds. * Hon, Secretary, The Stepney Old People's Welfare Association, St. Katharine's, Butcher Row, Cable Street, E.14. Voluntary visitors are urgently needed and should apply to the Secretary. 14 aibulance facilities. The London County Council is responsible under Section 27 of the National Health Service Act, 194-6, 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 Blackpool Cr.E.W.Hill and Medical Officer (April) of Health. Central Consultative London Cr.E.W.Hill and Medical Officer Committee for Old People (July) . of Health. Public Health Inspectors Bournemouth Aid.Mrs.C.F.Woollon and Public Association (September) Health Inspector Mr.H.J.Green. National Society for Brighton Cr.Mrs.C.Edwards and Public Clean Air (October) Health Inspector Mr.G.D.Freeland. DECEASED PERSONS. Inquests. Inquests were held on 54 residents of the Borough, the verdicts being 8 deaths due to road accidents; 25 other accidents; 13 suicides; 2 acute alcoholism; 2 misadventure; 1 natural causes and 3 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. Eighteen such burials took place during the year, all adults, at a cost of £205, of which sum £152 was recovered by the end of the year from the estates of the deceased persons or from liable relatives or by way of grants made under the National Insurance Act, 1946. Fourteen requests for burial came from H.M. Coroner's Officer and four from relatives of the deceased. In 1948, the first year that this service was undertaken by the Council, 65 burials took place. It is often necessary where persons living alone have died in the Borough, 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. FREE WASHING FACILITIES. The Council provides free washing facilities in sixteen of the twenty-two public conveniences in the Borough, with the aim of promoting iood hygiene and cleanliness. Some 129,000 free washes were taken during the year. HEALTH EDUCATION. Health education is becoming an increasingly important activity of local authorities. Every effort is made to reach as broad a section of the public as possible in the dissemination of publicity relating to general health matters, whilst educational material relative to particular subjects is distributed to selected sections of the public as applicable in each case. The operation of the Council's second Smoke Control Order required, and was given, intensive publicity in the part of the Borough covered by the Order. The Council co-operated with the London County Council in the National Fire Prevention Week Campaign in November, with emphasis being placed on the prevention of burns and scalds. Following the issue of a statement by the Packaging Films Manufacturers Association concerning thin Polythene Film, a poster was prepared and exhibited, warning mothers not to allow their children to play with bags made of this substance. Another poster drawn up in the department warned the public to exercise care in the use of oil heaters and to have them modified in accordance .with the manufacturers' advice. The former Empire Marketing Boards were used to display various posters during the year, as were also the Council's official notice boards and those affixed to lamp columns in street markets in the Borough. The occupiers of several large factories in the Borough and of -some chemists' shops accept posters for display and leaflets for distribution. With the co-operation of the Borough Librarian bookmarks and leaflets on various health subjects were distributed from the lending section of the Borough Libraries. Enamelled panels giving details of hospitals and the times of attendances where advice on, or treatment of, venereal diseases can be obtained were renewed, as necessary, in the Council's public conveniences. Vacant sites in the Borough were kept posted with notices warning the public against depositing rubbish and also against the use of land as caravan sites. Publicity was given to other subjects including diphtheria immunisation, vaccination against poliomyelitis, food hygiene, influenza, the care of the elderly,and to the Council's Holiday Centre. In all over 2,600 posters were displayed throughout the Borough during the year, and 21,000 leaflets distributed. HOLIDAY CENTRE. During the year 1,136 Stepney residents spent a holiday at the Council's Holiday Centre, The Manor House, Sandgate, near Folkestone, Kent. This number included 704 aged persons and 147 children. The total number of weekly bookings was 1,274, the highest since the Centre was opened in 1958. The Holiday Centre is open all the year round and is available for holidays to any resident of the Borough, young and old. Half the total 16 accommodation Is allotted to the latter each week. Coach transport is provided to and from the Public Health Department and the Manor House, The management and control of the Holiday Centre are vested in the Council's Physical Training & Recreation Committee, and the day-to-day administration is the responsibility of the Medical Officer of Health* HOSPITAL FACILITIES. The undermentioned Hospitals are situated in the Borough; No.of Beds London Hospital, Whitechapel Road. 686 Mile End Hospital, Bancroft Road. 476 London Jewish Hospital, Stepney Green. 129 Queen Elizabeth Hospital for Children, Glamis Road. 44 East End Maternity Hospital, Commercial Road. 58 INFORMATION CENTRE. The Council operates an Information Service for the public at the Municipal Offices, 227/233, Commercial Road, E.l, (Telephone; STEpney Green 1818). LABORATORY FACILITIES. Bacteriological investigations for infectious diseases are carried out on behalf of the Public Health Department by the Regional Hospital Board's Group Laboratory at Mile End Hospital. (See also page 35 regarding Food Samples). Investigations were carried out on 254 specimens submitted by the Medical Officer of Health and by medical practitioners in the Borough during the year. The specimens comprised 176 faeces, 58 throat swabs, 13 rectal swabs and 7 nasal swabs. LEGISLATION. The following Acts, Orders and Regulations affecting the Department were made during the year:- Date Operative Factories Act, 1961 1/4/62. Home Safety Act, 1961 18/5/61. Housing Act, 1961 24/11/61. Licensing Act, 1961 l/ll/6l & 1/3/62. London County Council (General Powers) Act, 1961 3/8/61. Public Health Act, 1961 3/10/61. Rivers (Prevention of Pollution) Act, 1961 27/9/61. Anthrax (Disinfection Fee) Amendment Rules, 1961 1/4/61. Authorised Officers (Meat Inspection) Regulations, 1961 1O/3/61. Labelling of Food (Amendment) Regulations, 1961 20/3/61. Lead in Food Regulations, 1961 16/4/62. Motor Cycles (Protective Helmets)(Amendment) Regulations,1961 l/8/6l. Public Health (Aircraft)(Amendment) Regulations, 1961 17/l/6l. Public Health (Ships)(Amendment) Regulations, 1961 17/1/61. Rag Flock & Other Filling Materials Regulations, 1961 l/8/6l. Rent Restrictions (Amendment) Regulations, 1961 24/11/61, 17 Other subjects dealt with in Circulars issued by Government Departments included the following: Ministry of Health. Annual Reoorts of Medical Officers of Health; Food Hygiene Code of Practice (Poultry Dressing and Packing); Poliomyelitis and Services for Old People (Co-operation between housing, local health and welfare authorities and voluntary organisations). Ministry of Agriculture, Fisheries & Food. Official certificates under the Public Health (imported Food) Regulations in respect of Bulgaria & Iceland; Approved Chemical Agents. Ministry of Housing & Local Government. The Clean Air Act, 1956; The Economic Situation; Turnstiles in Public Conveniences. Home Office. Pharmacy and Poisons Act, 1933. General Register Office. Infectious and Other Notifiable Diseases (weekly and quarterly returns); Transfer of Births, Deaths and Still-births; Vital Statistics Annual Reports of Medical Officeis of Health. PROVISION OF PSYCHO-GERIATRIC SERVICES - ST. CLEMENT'S HOSPITAL. (a) DUNDEE WARD. For a long time, the needfor making provision for the elderly psychiatric patient has been recognised in this area, as in many others. In September, 1961, such a unit was inaugurated at St. Clement's Hospital, Bow Road, to serve the boroughs of Bethnal Green, Poplar and Stepney. Under the energetic influence of a consultant psychiatrist, Dr. W. Ford Robertson, from Long Grove, Epsom, and his colleague, Dr. J. Sawle Thomas, a ward for the admission of 12 female patients was opened. Provision has since been made for 10 male patients. The intention from the outset was stressed, viz. by careful selection of patients those amenable to treatment would be admitted, with the hope that they would be able to return to their family and/or community care in a short period- i.e. a maximum of 6 weeks. Obviously, were this criteria not laid down, these 22 beds would rapidly be filled with chronically sick and disturbed patients for whom, unfortunately, other provisions are inadequate at present. Hence, admission has been controlled by doctors attached to the unit, who either visit patients in their own homes or see them in the out-patients department at St. Clement's at the request of family doctors. From inception the following admissions and discharges occurred during the remainder of 1961:- Admissions: Male - 24 Female - 43 Discharges: Male - 14 Female - 34 18 (b) Lay hospital Associated with the unit described above, a Day Hospital accommodating 24 persons commenced on 5th December, 1960. This has proved useful in providing a 'stepping-stone' back to the community after inpatient stay in Dundee Ward- and vice-versa. Day Hospital Attendances in 1961. Admissions 88 Persons Discharges 65 Persons Average daily attendance 21 Persons Average age 67 Years As is only to be expected many patients have to be transferred to other care or are found unsuitable to continue attendance. However of those that stay nearly all benefit greatly, and are happy. But for these- attendances many of them would be in hospital care. To be convinced of this a visit to the unit to see and understand what occupational and social rehabilitation can do for the depressed, lonely and anxious and even paranoid person should be made. Visitors will be made welcome, between the hours of 10 a.m. and 3 p.m. Old persons are collected by hospital bus from their homes and taken to the Day Hospital. A midday meal is provided and return by bus arranged in the afternoon. During the day activities are planned such as knitting, rug and basket-making, weaving and embroidery. On the social side, one afternoon each week is devoted to games, and another to music, partly provided by the patients' own percussion band, in which they all take part and enjoy to the full. Some persons, after persuasion to attend, have defaulted or refused to continue attendance even when it would obviously be in their own interest to make and maintain social contacts available at the Day Centre. Partly, the reluctance is due to the prejudice, still existing, toward any centre associated with a psychiatric unit. Also, in old people, seclusive habits are difficult to overcome. Attempts have been made by the Stepney Borough Council to encourage attendance, by arranging for visitors to be present when the hospital bus calls for the old person, particularly at the initial visit. Such activity by staff is, however, limited whilst there are so many other demands on their time in the care of old people in the Borough. SPECIAL REPORTS- OF MEDICAL OFFICER OF HEALTH. Special reports were made to the Public Health Committee during the year on the following subjects:- (1) Fish oaring premises in Stepney. (2) Hydrocyanide Disinfestation Station. (3) Registration of Ice Cream Premises. (A) Stepney Smoke Control Order No. 3. (5) Storage facilities for solid smokeless fuel in Council dwellings. 19 MATERNIIT AMD CHILD WELFARE. I am indebted to Dr. G.O. Mitchell, Divisional Medical Officer, London County Council, for the following information relating to the personal health services administered in the Borough by the 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 1,469 Total number of children who attended - Children born in 1961 1,355 " " 1960 1,072 " " " 1956-9 1,066 Total attendances by children - Under 1 year of age 17,700 1 to 5 years of age 5,458 Ante-Natal and Post-Natal Clinics (exclusive of Hospital Ante-natal Clinics). Ante-Natal Consultations - Number of women who attended 156 Number of New Cases (included in above) 125 Total attendances 1,017 Post-Natal Consultations - Number of women who attended 46 20 Health Visitors. Number of children (up to 4 years) visited 6,256 Number of infants under 1 year of age visited for first time 1,658 Total visits to children under 1 year of age 6,659 Total visits to children aged 1 year but under 2 years 4,058 Total visits to children 2 to 5 years of age 8,660 Number of expectant mothers visited 600 Total visits to expectant mothers 1,183 Child Minders (daily guardians). Number of child minders - Voluntary 14 Statutory 5 Number of children minded- Voluntary 9 Statutory 9 Immunisation and Vaccination. For details of immunisation and vaccination see pages 41 and 43. 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), are as follows Maternity (including expectant mothers) 7 Tuberculosis 14 Aged and infirm cases 860 Other cases 82 21 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. 35, Stepney Green. Tuesday (morning), Wednesday 69, East India Dock Road. Thursday (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). Inoculation against Poliomyelitis. 35, Stepney Green. Tuesday. Toddlers Clinics. 35, Stepney Green, First Thursday (morning) in month. St. George's Centre, Library Place. First and third Tuesday (mornings) in month, Mary Hughes Centre, Underwood Road, Tuesday. 673, Commercial Road Monday. Day Nurseries. Christian Street, Underwood Road. The day nursery at Old Church Road closed on 15th December and is to revert to its original use, namely, as a Nursery School in September 196^• Voluntary Day Nursery. Beaumont Grove (Alice Model Day Nursery.) Nursery School. Thirza Street (Sisters of Mercy). 22 SITTING AND SLIPPER BATHS. Four Swimming Baths are provided by the Council in the Borough. The Open Air Swimming Bath at Goulston Street was closed throughout the year for modernisation. During the year the number of swims taken amounted to 153,102, comprising 25,914 adults and 127,188 children and juveniles. The water is subjected to a continuous chlorination and filtration process, passing through the filters once every 3l½-hours. Five samples were taken during the year for bacteriological and chemical analysis. Three were found to be unsatisfactory; two by reason of high pH value and one revealing a low free chlorine content. The number of Slipper Baths taken during the year at the four Council establishments was 186,922, which included 5,976 by old age pensioners and 31 by unemployed persons, who were admitted free of charge. The total number of persons admitted to all sections of the Baths and Washhouses Department, including the Laundry, was 380,021. STAFF CHANGES. The following staff changes took place during the year;Conmenced Duty Calnan, D.A. Miss General Clerk Nov. 27 Gray, N. Pupil Public Health Inspector Oct. 17 Hunnibal, D.A. General Clerk May 23 Sayers, A. Miss General Clerk Oct. 23 Scanes, R.W. Pupil Public Health Inspector June 26 Ceased Duty Aylward, T. Clerical Assistant III Aug. 20 Guy, C.F. Public Health Inspector (Housing) Aug. 2 O'Connor, M.J. General Clerk (Died) Feb. 22 Saunders, B.J. Public Health Inspector (District) June 25 23 III. SANITARY CIRCUMSTANCES The District Public Health Inspectors served 2,070 Notices during the year, and in 61 cases legal proceedings were employed to enforce compliance therewith. At the end of the year, the Department was still three below the establishment of district Inspectors. Aspects of the work of the Inspectors not covered in the following paragraphs will be found in the statistical appendix, pages 55 to 61. From 1st March, the service of intimation notices for nuisances under the Public Health (London) Act and informal notices generally under other Acts and Byelaws was discontinued. Certificates of Disrepair (Rent Act. 1957). During the year, 21 applications were received from tenants for Certificates of Disrepair under the Rent Act, 1957. The Council exercised its right under Paragraph 5 of the First Schedule of the Act in refusing to accept undertakings from landlords in respect of three premises. It is interesting to note that during the first six months of operation of the Act in 1957, no less than 490 applications were received for certificates of disrepair. Clean Air. The Borough's second Smoke Control Order made under the Clean Air Act, 1956, was confirmed by the Minister of Housing & Local Government in June and com®into operation on 22nd January, 1962. At the end of the year the Minister 1s confirmation of Area No.3 was awaited. Area No.2 is one of 81 acres and comprises 1,734 dwellings and 191 commercial, industrial and other premises. A survey of the area revealed that the number of appliances in dwellings which were in regular use, and which required replacement or adaptation, was 980. Once again it is regretted that at the date of coming into operation of the Order, applications for grant towards conversions received and approved amounted to less than 20 per cent of the total number of appliances requiring conversion. The owners and occupiers of dwellings were apathetic in spite of the pains taken by the Department's officers to ensure that they had ample notice of the Council's intention to include their premises in a smoke control area and to make them fully aware of their duties and responsibilities. However, the delay in having conversions carried out is not entirely due to owners and tenants, who have difficulty in getting builders and gas fitters to give estimates and carry out the work within a reasonable time. When a Smoke Control Order is made posters are displayed throughout the area and an explanatory letter and booklets sent to all the occupiers of dwellings in the area, who are also visited by the Smoke Inspector 24 No.l. Order made Nov. 1959 No. 2. Order made Dec. I960 No.3. Order made Dec. 1961 Nos. Orders proposed to be 4-5. made 1962-3 and/or Technical Assistant. Forms are sent to each occupier to facilitate the submission of estimates and claims for grants. In order to ease the burden of expense on persons who are having conversions executed, the Council accepts the assignment of grants direct to the contractor. By this means, instead of the person having to pay the whole cost of the work and obtaining reimbursement from the Council, he pays only his own portion of the cost, the remainder being paid by the Council direct to the contractor. There is in the Public Health Offices a Smoke Control Exhibition which is always open to the public and in which are displayed various types of approved space heating and cooking appliances and authorised fuels. Arrangements were also made with the Solid Smokeless Fuel Federation for their Demonstration Van to tour the Smoke Control Area for a week. Facing page 24 is a map showing the first programme of Smoke Control Areas established and proposed to be established in the Borough. Under the provisions of lection 3(3) of the Clean Air Act, 1956, furnaces may not be installed in buildings unless notice of proposal to install has been given to the Council. Notices were given to the Council of proposal to install furnaces in 11 premises. Persons who installed furnaces in two premises without giving the requisite notice were oautioned. Measurements of air pollution are taken regularly in the Borough by means of deposit gauges and lead peroxide instruments, which give monthly records of deposited matter and of the 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 will be found in Tables 12 and 13 on pages 62 and 63, and details of visits and inspections made by the Smoke & Factories Inspector are given on page 59. Drainage and Sanitary Conveniences. Considerable use is being made of Section 25(l) of the London County Council (General Powers) Act, 1955, whereby a Public Health Inspector can serve a notice on a person requiring him to clear an obstructed drain within 4.8 hours, and if the notice is not complied with during that time the Council may themselves execute the work and recover the cost from the person responsible. Notices under this section served during the year numbered 177, the Council executing the work in 27 instances. Factories. Under Section 128 of the Factories Act, 1937, the Medical Officer of Health is required among other things to report to the Council in his annual report specifically on the administration of, and furnish the prescribed particulars vrith respect to, matters under the Act administered by the Council. The prescribed particulars referred to will be found in the Appendix, pages 60 and 61. 25 Fireguards. Of the 4 fireguards examined under the Heating Appliances (Fireguards) Regulations, 1953, three fireguards to electric fires were found to be unsatisfactory. The heaters were withdrawn from sale. Hairdressers. Hairdressers and barbers premises registered by the Council under Section 18 of the London County Council (General Powers) Act, 1954., number 131. During the year the Public Health Committee instructed that the occupiers of two such establishments be cautioned for carrying on business whilst they and their premises were unregistered. Legal Proceedings. Legal proceedings instituted during the year (other than those relating to food premises), showing penalties imposed, were as follows No. of Summonses Fines Costs £ s. d. £ s. d. Public Health (London) Act, 1936: Nuisance Orders 46 - 160. 13. 0 Non-compliance with Nuifcance Orders 5 49. 10. 0 14. 2. 0 Defective drain (Section 4-0) 1 — 3. 13. 0 Insufficient W.C. accommodation (Section 105) 1 5. 0. 0 3. 13. 0 Establishing without consent business of slaughterer of Poultry (Section 140) 1 15. 0. 0 3. 7. 0 London County Council (Drainage) Byelaws 1 2. 0. 0 2. 0. 0 London County Council (General Powers)Act, 1951 - Section 22 (using unlicensed land for siting caravans) 4 7. 0. 0 2. 2. 0 Prevention of Damage by Pests Act 1949 Section 4 (rat harbourage) 1 - - Factories Act, 1937 - Section 110 (failure to submit list of outworkers) 1 3. 0. 0 3. 3. 0 Total 61 £81. 10. 0 £192. 13. 0 (Details of other legal proceedings taken will be found on pages 33 and 36.) An appeal was brought by an owner of a house against an Order made by the Court for the abatement of a nuisance. The Council defended the appeal, which was disallowed, £7. 7. 0 costs being awarded to the Council. An appeal was taken to the Divisional Court by the Council against the decision of a magistrate in dismissing a case brought before him under 26 Section 4 of the Prevention of Damage by Pests Act, 1949. The appeal was allowed, with costs and the case remitted to the itagistrate with a direction to convict. At hearings of summonses for abatement orders under the Public Health (London) Act, 1936, the Magistrates made Closing Orders on three dwellings following representations by the owners. Lodging Houses - Common. There are three Common Lodging Houses.in the Borough, providing accommodation for 703 persons, as follows 10-22, Johnson Street (Church Army) 175 men 177, Whitechapel Road (Salvation Army) 300 " Hostel for Women, Hopetown Street (Salvation Army) 228 Women The use of the premises 86, Cable Street as a common lodging house was given up during the year. Lodging Houses - Seamen. There are two such premises in the Borough, providing accommodation for 34-5 seamen, as follows The Sailers' Home & Red Ensign Club, Ensign Street & Dock Street 243 Seamen The Empire Memorial Hostel, 747, Commercial Road 102 " Lodging Houses - Other. In addition to the licensed Common and Seamen's Lodging Houses, there are two other premises in the Borough which provide lodgings but which are not subject to licensing or registration: viz., Tower House and the Providence Row Night Refuge. Tower Hnuse (formerly known as "Rowton House"), which was opened in 1902, provides accommodation for 694 men. and the Providence Row Night Refuge for 77 men, women and children. Outworkers. There are 596 premises on the register, 14 more than last year No.of Firms in the Bor»ugh employing outworkers 88 " Outworkers residing in, and employed by firms in the Borough 269 11 Outworkers residing outside the Borough employed by firms in the borough 902 " Outworkers residing in the Borough employed by firms outside the Borough 327 Legal proceedings instituted against the occupier of a clothing factory for failing to submit a list of outworkers resulted in a fine of £3. 0. 0 and costs of £3. 3. 0 being imposed. 27 Notices Served. Notices served during the year under the various Acts and Byelaws, were as follows Intimation Notices Statutory Notices Public Health (London) Act, 1936 Section 82 382 1,156 " 40 - 111 "105 - 11 " 109 — 10 Factories Acts, 1937 & 1948 35 — Prevention of Damage by Pests Act, 1949: Section 4 - 35 London County Council (General Powers) Act, 1955 Stopped-up Drains, etc. - 177 London County Council (General Powers) Act, 1954 Dustbins - 65 London County Council (Water Closet) Byelaws - 2 London County Council (Poultry Slaughterhouses) Byelaws - 13 London County Council (Drainage) Byelaws - 35 Stepney Council (Staircase Lighting) Byelaws - 13 Stepney Council (Yard Paving) Byelaws - 2 Stepney Council (Storage Cisterns) Byelaws - 3 Stepney Council (Hairdressers) Byelaws 20 - 437 1,633 Refuse Disposal. The Public Cleansing Officer has kindly supplied the following information on refuse disposed of during the years- House and Trade refuse - 37,190 Tons Street and Market refuse - 9.262 " Where possible refuse collection is cajjried out by means of "Paladin" containers, mainly from blocks of flats throughout the Borough. - This method was adopted in 1955, since when over 600 of these containers have been installed. The Cleansing Department carried out 22,935 cleansings of 5,192 street gullies by means of mechanical gully emptiers. 28 Offensive Businesses. There are 19 offensive businesses in the Borough. The register comprises the following premises Dresser of Furskins (l). 34/38, Brodlove Lane. Poultry Slaughterhouses (18). 19, Bell Lane * 28, Burslem Street 161, Cannon Street Road 163, " " * 16/18, Cobb Street 14, Hessel Street * 21/22, " * 36, " 75, " 7, Leyden Street * 10b, " * 13, " 15, " 7, Lower Hessel Street * 4, Monthope Street * 6, " * 10a, " 82, Stepney Way. Establishment Orders of those premises marked (*) are subject to renewal from time to time by the Council. Legal proceedings were instituted against a person for establishing at 10b, Leyden Street, without the consent of the Council, the business of a slaughterer of poultry, in contravention of Section 1^0 of the Public Health (London) Act, 1936. A fine of £15.0.0d was imposed, with costs of £3.7.Od. Subsequently the Council granted, on application, an establishment order for the premises. 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 during the year were submitted to the Ministry. During this period 3,203 dwellings and other premises were inspected, and 1,330 were found to be infested with mice or rats. Treatments were carried out by the Department's Rodent Control staff to 1,088 properties found to be infested, the charges made for servicing business premises amounting to £515. By the implementation of Section 4 of the Prevention of Damage by Pests Act, 1949, it has been found possible to clear bombed sites of refuse which would otherwise act as possible harbourage for rats and other vermin. 29 Moreover, under the same section, which permits specified works to be carried out, it has been possible to require sites to be fenced in by the owners. Action in default was taken by the Council regarding one site (comprising U premises); the cost of removing the refuse and fencing the site was charged to the owners. Proceedings were taken before a Stipendiary Magistrates Court against the owner of another site for failing to comply with a notice served under Section A of the Prevention of Damage by Pests Act requiring the removal from the site of rat harbourage and the prevention of deposition of further harbourage by the erection of a closed fence or wall around the site. The summons was dismissed, on the grounds that there was no evidence of rats or mice being on the site. The Council prosecuted an appeal against the Magistrate's decision to the Divisional Court, the appeal being allowed. A copy of the Return furnished to the Ministry is on page 55. The Council carries out, on behalf of the Stepney Group Hospital Management Committee, any necessary treatments for rodent infestation at hospitals and other premises in the Borough which come under the control of that Committee. Shops. The number of premises in the Borough covered by the provisions of the Shops Act, is 3,092. No applications were received during the year for exemption from compliance with sanitary accommodation requirements. Water Certificates Water certificates as to new dwellings having a proper and sufficient supply of water were issued in respect of 496 dwellings, 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 the water supply to premises in the Borough was repaired or reinstated following action taken by the Department totalled 88, and the Metropolitan Water Board was notified on 31 occasions where wastage of water was taking place. During the year, 30 notices were received from the Metropolitan Water Board of withdrawal of water supply: in 13 premises for nonpayment of rates and in 17 because of defects in the service. 30 Wells. Bacteriological and chemical analyses of water from U 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 530 workplaces in the area (other than those premises covered by the Factories Act, 1937). Work executed by the 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 were recoverable: - Rat harbourage removed and preventive measures taken; (Section A. Prevention of Damage by Pasts Act. 19A9). Site - 11, Casson Street £10£. 5. k " 13 " 137. 5. 3 " 29, Hopetown Street 33. 5. 0 » 31,' " 72. 13. 0 Defective Drains repaired or re-laid: (Section AO. Public Health (London) Act. 1936). 29, Bigland Street £232. 17. 5 Dustbins supplied- (Section 12, London County C+unci-1 (General Powers) Act. 195A) 6 Premises £21. 0. 1 Non-compliance with Nuisanee Order; (Public Health (London) Act. 1936). 62, pLhodeswell Road £131. 5. 8 Stopped-up Drains cleared - (Section 25(l), London County Council (General Powers) Act. 1955). 27 Premises £100. 10. 1 31 IV. HOUSING Clearance Areas. During the year one area, involving 28 houses, was declared as a clearance area by the Borough Council. Demolition Orders. Demolition Orders on 5 houses and Closing Orders in lieu of Demolition Orders on 2 houses were made by the Council during the year. Overcrowding. During the year 29 cases of alleged overcrowding were investigated, ten of which were confirmed and referred to the London County Council. Twelve overcrowded families were rehoused by the London County Council and 6 by the Borough Council. The number of known overcrowded families on the register decreased from 363 to 355. Underground Rooms. There are approximately 1,650 underground rooms in the Borough used for living or sleeping purposes, 1,600 of which are unfit. During the year two rooms were closed and Closing Orders on 6 rooms were determined. Appeals brought by the owner of two premises against Closing Orders made' on underground rooms were allowed. The number of underground fooms closed since 1936 is 453. Progress on closures generally is held up for lack of suitable alternative accommodation. Town "c Country Planning (Housing Accommodation) Direction. 1952. Under this Order the Borough Council is consulted by the London County Council (the Planning Authority) before applications are determined for planning permission for development involving change of user of premises from use as a dwelling. Investigations'of 46 such applications were carried out during the year. Application for Rehousing. At the end of the year, there were 3,889 applications for rehousing on the Housing Manager's register. These included the tenants of 323 Council dwellings who desired larger or smaller accommodation. Preferential Housing on health grounds. Ten of the 15 cases investigated were found to come within the Council's Points Scheme. 32 Standard Grants and Improvement Grants. In conjunction with officers of the Borough Engineer & Surveyor's Department, the Housing Inspector inspected 19 premises regarding which applications had been made to the Council for standard or improvement grants. New Housing. During the year, 4.96 new dwellings were completed in the Borough: 93 hy the Borough Council, 330 by the County Council and 73 by private enterprise. (See Appendix, page 71). A total of 7,658 new permanent dwellings have been constructed in the Borough since the war: 5,026 by the London County Council, 2,359 by the Borough Council, 69 by the Corporation of London and 204 by private enterprise. At the end of the year, units of accommodation owned by the Council numbered 4,147, comprising 3,717 erected by the Council and 430 formerly requisitioned and other premises purchased by the Council. Caravans. Several times during the year residential caravans were reported to have arrived in the Borough and parked on bombed sites. These were visited by the Housing Inspector immediately the information was received, and in some cases the occupiers were persuaded to vacate the sites. In other cases, legal proceedings had to be employed to enforce vacation of sites by caravanners who contravened Section 22 of the London County Council (General Powers) Act, 1959, by stationing their caravans on land which was not licensed for the purpose. Four summonses were heard, resulting in fines of £7.0.0d with costs £2.2.0d. Many more summonses were issued, but not served, the persons having left the. sites in respect of which the summonses were made out. Statistics. A Summary of inspections made by the Housing Inspector is given on page 67, and further housing statistics will be found on pages 64 and 65. 33 V. INSPECTION AND SUPERVISION OF FOOD. There have been increased imports of beef and pork from Yugoslavia arriving at Bishopsgate Goods Station via the Zeebrugge-Harwich Train Ferry, The beef arrives as chilled quarters (fores & hinds) and generally speaking, is in good condition. The meat is inspected for condition and for the presence of the official veterinary certificate on each quarter, (required under the Public Health (imported Food) Regulations). The latter signifies that the animals have received ante- and post-mortem veterinary inspection, and are free from disease. A small percentage of the trucks arrives with meat out of condition and requiring trimming. The beef concerned is allowed to go only to the Central Meat Market, Smithfield, for trimming under the supervision of the City Corporation Meat Inspectors. As will be noted on page 35 the year has seen a very large increase in bacteriological sampling of desiccated coconut, imported dried whole egg and egg albumen at the wharves in the Borough, It is gratifying to report a substantial decrease in the number of samples of desiccated coconut which were found to contain salmonella organisms; only 2 out of 841 samples examined being unsatisfactory. There is little doubt that the stringent sampling procedures and, where necessary, detention and re-export or destruction of the affected consignments, which operate in the United Kingdom, have resulted in a distinct improvement in the methods of handling and preparation of the product in Ceylon. These measures also apply to imports of processed egg. The percentage of positive samples is higher here than in the case of desiccated coconut. Affected consignments of dried egg powder or dried egg albumen are detained at the wharves for re-export, or, in the case of albumen, for suitable heat-treatment to sterilise the product, Compared with 1960, there has been a sharp decrease in the number of samples of Formosan black tea containing excess of lead. The permitted maximum is 10 parts of lead, per million parts of tea. Where consignments are found, on analysis of samples, to contain lead in excess of this maximum, they are released only for blending with other teas to reduce the amount of lead to the permitted limit. The local authorities into whose areas the tea is sent are notified. Under the Lead in Food Regulations, 1961, which comes into operation on 16th April, 1962, the import of tea, which contains lead in excess of 10 parts per million will be prohibited. A Code of Practice was issued during the year jointly by the Ministry of Health and the Ministry of Agriculture, Fisheries & Food covering Poultry Dressing and Packing. In June and July, there were several cases of food poisoning attributable to cream confectionery which included frozen whole egg as an ingredient, One of the suppliers of this egg was a Stepney firm. In consultation with Dr. Galbraith of the Central Public Health Laboratory, Colindale, and Dr, Toalinson of the Public Health Laboratory, County Hall, samples were taken at this firm. Also included were some samples originating from eggs 34 supplied by a certain egg packing station in East.Anglia, The laboratory at County Hall reported that in none of the samples had they been able to isolate organisms of the Salmonella group. Added attention was given during the year to milk supplied from milk vending machines on private forecourts. These machines are now a commonplace. From the 5 machines in Stepney 36 samples were submitted for chemical analysis and bacteriological examination. All were satisfactory. It was noticeable that whereas the fat content of samples of milk obtained from other sources was subject to occasional marked fluctuations, that of samples from machines was fairly uniform and never less than 3.3%. (The legal presumed standard is 3.0% minimum fat content). A summary of the visits made by the Public Health Inspectors (Food) to food premises will be found on pages 66 and 67. Bacteriological Examination of Foodstuffs. Samples of foods submitted for bacteriological examination numbered 1,268, as compared with 4-00 last year, and comprised 84I samples of desiccated coconut, 315 dried whole hen egg powder (Chinese, Mexican, American & Australian),21 dried hen egg albumen (Chinese, American and Argentinian), 8 liquid whole egg (English), 2 dried egg yolk (American),1 liquid hen egg yolk (English),22 Ice Cream,16 Tuberculin Tested (Pasteurised) milk, 13 Pasteurised milk, 12 sterilised milk, 9 quick frozen prawns (Japanese),3 cheddar cheese, 2 chillies, 1 cooked minced beef, 1 cooked chicken, 1 curried chicken. 24 egg powder and 7 egg albumen samples were found to contain various salmonellae organisms and the packages were detained under the Public Health (imported Food) Regulations for re-export or heat treatment. In some cases whole consignments of albumen were dealt with in this manner. Two samples of desiccated coconut contained salmonellae, one case being destroyed, the other released for sterilisation under supervision, A consignment of chillies, polluted by river water, was found to contain E.coli and was destroyed. Basement Bakehouses. The fourth quinquennial examination of basement bakehouses took place in 1959, and as a result notice was given to the occupiers of the remaining five basement bakehouses in the Borough that the Certificates of Suitability issued with respect to the premises under the Factory & Workshop Act, 1901, would cease to have effect after 31st July, I960. By that date all the bakehouses were closed with the exception of Nos. 3/5, Dock Street. The proprietors were summoned in December I960, and again in March this year for using the bakehouse when the Certificate of Suitability had been withdrawn. On the latter occasion, they were fined £15 and ordered to pay £7. costs in respect of the two dates concerned. The premises then ceased to be used as a bakehouse. Bakehouses and Bakers Shops. Two summonses were issued against the proprietors of Bakers' shops for selling cake containing foreign bodies. Fines of £25. with costs of £8. 13. 0d.were imposed. 35 Chemical Sampling of Foodstuffs. Samples submitted for analysis to the Public Analyst numbered 387 for the year. The Report of the Public Analyst appears on pages 46 to 48. Sxoort Certificates. Eighty certificates were issued in respect of the examination of a variety of foodstuffs exported to the United States, South America, Canada, Sweden, Italy, Norway and Malta. The issue of these certificates necessitates inspection of the foodstuffs to be exported, and, on occasion, samples are taken for analysis before a certificate is issued. Where necessary, investigation is made into the method of production. Ice Cream. Although there are 23 premises in the Borough registered for the manufacture of ice cream, only three were used for this purpose during the year. These were inspected from time to time under the Ice Cream (Heat Treatment, &c.) Regulations, 1959, and no contravention of the Regulations was found. Three samples of ice cream submitted for chemical analysis showed fat content exceeding 10.5 per cent. Twenty-two samples of ice cream were subjected to the Methylene Blue reduction test, with the following results Manufactured Total in Borough: outside Borough Grade I 3(-) 12 (14) 15 (14) " II 1(1) 2 (-) 3 (1) " III 3(1) - (-) 3 (1) " IV 1 (6) - (-) 1 (6) (The figures in parenthesis are those for I960). The four unsatisfactory (grade III & IV) samples were all taken from the same manufacturers who have themselves been submitting samples for examination in order to trace the cause of the low standards. This department has been kept informed of the results of their investigations. An intensive study of all the likely sources of contamination is at present continuing in order to overcome the problem. Legal Proceedings. Summonses dealt with by the Public Health Inspectors (Food) during the year, were as follows;- No. of Summonses Fines Costs Food and Drugs Act, 1955. 2 £25. 0. 0. £8.13. 0. Factories Act, 1937. 2 15. 0. 0. 7. 0. 0. 4 £40. 0. 0. £15.13. 0. 36 Cautionary Letters. On the instructions of the Public Health Committee, a cautionary letter was sent in respect of the sale of milk containing added water (less than 1 per cent). Milk Samples. Milk samples taken and submitted for chemical analysis during the year numbered 100, including 9 taken at hospitals, schools and day nurseries in the Borough. The average fat and solids-not-fat content of milk samples analysed were 3.67 and 8,55 per cent respectively. Public Health (Imported Food) Regulations. 1937-48. 267 Detention Notices and 4.56 Release Notices were served under the Regulations. These affected a variety of foodstuffs including bacon, barbasco root, capsicums, cinnamon, coconut, coffee, dried fruit, egg powder, fruit pulp, frozen prawns, gelatine, ginger, gram-dahl, ground nuts, gum arabic, mace, assorted meats, nutmegs, offals, pepper, sago, sugar, tea and turmeric. Consignments of meat and meat products which arrived unaccompanied by the official certificates, were either re-exported or subsequently released on production of the certificates. 72 carcases of mutton, representing a 5 per cent examination, were examined for caseous lymphadenitis by the cutting of the lymphatic nodes. All the carcases examined were found to be free from the disease. Twelve cases of minced frozen pork which arrived via- the Continental Train Ferry were destroyed under supervision, the importation of such (scrap) meat being prohibited under the Regulations, Sausages (Meat Content). Analysis of 13 samples of pork sausages and 2 samples of beef sausages showed the average meat content to be 66 per cent and 56.5 per cent respectively. A formal sample taken of pork sausages was found to contain 57 per cent, a deficiency of 12 per cent meat content. Legal proceedings were taken, the offender being conditionally discharged on payment of £7. 7. 0. costs. Unsound Fond. The following quantities of unsound foodstuffs were disposed of during the year under the Public Health (imported Food) Regulations, 1937-48, and the Public Health (London) Act, 1936:- Tons Wharves 56 London Fruit Exchange & Spitalfields Market 117 Bishopsgate Goods Station 2 Other Premises 37 Total: 212 Tons 37 Approximately 27 tons of unsound food was allowed to be used for chemical or 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, Approximately 2,250 condemnation certificates in respect of unsound food' were issued in 1961. Zeebrugge-Harwich Train Ferry. 292 midnight or early morning visits and 151 other visits were.made to Bishopsgate Goods Station for the purpose of examining 8,805 trucks of foodstuffs arriving from the following countries Argentine 2 Trucks Greece 6 Trucks Belgium 541 " Hungary 432 " Bulgaria 25 " Italy 3877 " Canary Islands 10 " Holland 10 " Congo 65 " Poland 19 " Denmark 77 " Roumania 78 " Ecuador 2 " Switzerland 35 " England (Returned Goods) 1 " Yugoslavia 3593 " Germany 32 " The weight of the foodstuffs examined was 80,165 tons, comprising 4-5,103 tons of fresh fruit and vegetables, 15,036 tons chilled and frozen meat and offals, 8,003 tons canned meats and sausages, etc. 7,783 tons bacon, 2,718 tons butter, 138 tons confectionery, 40 tons canned fruits and vegetables, 806 tons soup, 270 tons shell eggs, 158 tons horsemeat, 53 tons cheese and 57 tons of miscellaneous foodstuffs. Foodstuffs found to be unsound, and which were stopped and destroyed, amounted to 27 hundred-weights. Unsound Food. &c.- Complaints. Complaints made by members of the public as to the alleged unsound condition, etc. of food, and which were investigated during the year, numbered 36. The complaints referred to the following Alleged unsound condition: Bread lj Butter 1; Canned Crab lj Chicken 1; Chocolate Cakes 1; Dates 1; Figs l; Meat Pie l; Melon l; Milk 1; Pastry 2; Peaches 1; Smoked Fish 2; Spaghetti 1. Alleged dirty condition and/or foreign body or deposit; Baked Beans 1; Beer 1; Bread 3; Cakes 2; Cereal 1; Cheese Roll 1; Cooking Fat 1; Milk 1; Minced Beef 1; Pork Pie 1; Rollmops 1; Soft drink 1; Sweets 2. Alleged dirty Utensils etc. Cooking Utensils 1; Milk bottles 2. 38 Improvements effected and work done at Food Establishments. Lavatory basins installed 50 Premises where hot and cold water supply installed 81 " " washing facilities for staff improved 78 " " walls, ceilings, floors and windows cleansed 333 " " ventilation provided or improved 19 " " natural lighting improved 8 Sinks provided 17 Food storage accommodation provided 9 Refrigerators installed or repaired 19 Floors renewed or repaired 23 Shop-fronts improved 9 Protective covers provided for displayed food 30 Refuse bins provided 30 Miscellaneous 416 39 VI. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES Weather Conditions. January was mainly wet but sunny and had sleet or snow on four days. February was wet but the mildest February since records began in 1871. March was dry and sunny and also the mildest for many years. April had less sunshine than average, hay was very dry and rather sunny, as also was June. A temperature of 92°F. recorded in London on July 1, 1961, equalled the record high of July 1947. August was rather wet and dull but September warm. October was sunny and rather mild and November was very sunny. December was cold and wet and 1961 went out with three-inches of snow falling in central London, the heaviest since 1947. The year was not a fine one but the winter was mild. Notifications. The number of notified cases of infectious diseases (corrected for revised diagnosis and duplicate notifications) during the year was 2,434; the number last year was 835, the lowest ever recorded. Table 17 on page 68 shows cases notified, together with comparative figures over the last ten years. A list of diseases notifiable in the County of London is shown in Table 20, on page 70. Glanders and Hydrophobia were this year removed from the list of notifiable diseases. Cancer. The number of deaths from cancer during the year was 236 (23 more than last year). Deaths from lung cancer numbered 79, which is 26 more than in 1960. The comparative vital statistics for the Metropolitan Borough of Stepney show a rate, per 1,000 population, of 2.8 in respect of deaths from Tuberculosis (all forms) in 1901. Thereafter a consistent fall occurs over the years to a rate of 0.1 in 1961. For deaths attributable to Cancer, the equivalent rates are 0.7 in 1901 with a progressive increase to an average of 2.4 por 1,000 population in the last three years. This is partly due to the greater numbers in the population reaching old age (concomitant with the increase in life expectancy over the last 60 years) and so becoming "at risk" to cancerous diseases whose incidence is, generally speaking, greater with age. However, whereas the largest rate of deaths from cancer, in the male, used to be in respect of the gastro-intestinal tract, the cancer of lung and bronchus rate now forms the greatest percentage, that is, nearly one-third of all such deaths. For the female, deaths from cancer of the breast and genital organs still provide the bulk of deaths attributable to cancer; 40 there is also a definite trend towards an increase from deaths due to cancer of the lung and bronchus (shown better in the national figures). Many of the male deaths occur in the age group 45-65 years and so are a personal and economic loss to the community. It is relevant to ask what causative factors can be traced to account for this rapid increase in cancer of the lung. To date the evidence points to the increased indulgence in tobacco smoking, and particularly of cigarettes. A further factor, namely that of atmospheric pollution, is obvious from comparative studies between urban and rural populations. Atmospheric pollution is beginning to be reduced by use of the powers in the Clean Air Act - i.e. at a community level. Smoking lies in the domain of personal choice and responsibility which presents a more complex problem of persuasion by health education and publicity. On the present evidence, the public should know that if they do not stop excessive smoking (particularly of cigarettes) they run a greatly increased risk of premature death from carcinoma of bronchus (lung). At the time of compilation of this report, this message has been reinforced by the publication of a report from the Royal College of Physicians (London) on the dangers of smoking. Diphtheria. One notification of Diphtheria was received during the year, but was not confirmed. The number of Stepney children immunised at London County Council clinics during the last five years, was as follows:- 1961 1960 1959 1958 1957 Completed primary course- Children under 5 years 1424 1302 1330 1106 1147 " 5 to 15 years 489 437 318 420 415 Children given a secondary injection 2858 1389 940 1372 1437 Although only 7 cases of Diphtheria have been notified in the Borough during the last twelve years, the necessity for immunisation is as pressing as ever. Fifty-eight 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, cases being notified compared with 140 cases last year. 41 Enteric Fever. One case of Enteric Fever was notified during the year. Erysipelas. During the year 13 notifications were received (compared with 119 in 1936). Food Poisoning. There were 24 cases of food poisoning notified in the Borough during the year. Salmonella organisms were isolated in 7 cases. Malaria. No cases of Malaria were notified. Measles. Notifications of Measles in the Borough numbered 1906 compared with 55 last year. There were no deaths from the disease. Epidemics tend to recur at intervals of just under two years. Meningococcal Infection. There were two notifications confirmed during the year, the same number as last year. Ophthalmia Neonatorum. One case, in a resident of the Borough, was notified during the year. Poliomyelitis. One notification of Poliomyelitis was received, the diagnosis not being confirmed. Vaccination against Poliomyelitis is carried out by the Divisional Health Department of the London County Council and is available to all persons up to the age of 40 years. Puerperal Pyrexia. There were 87 notifications during the year compared with 106 in 1960. Of these, 33 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 50 compared with 61 last year. 42 Eighty-eight scabies patients and contacts were treated bymedicinal baths at Branch Road Treatment Centre and their clothing disinfested, viz; Males Females Children 26 38 24 The number of baths given totalled 129. Scarlet Fever. There were 53 cases notified and no deaths from the disease. Smallpox. No cases of Smallpox were notified during the year and it was not necessary to take action under the Public Health (Smallpox) Regulations, 1917. Frequent notifications are received from Port and Airport authorities of persons coming into the Borough who may have been in contact with smallpox. Observation for the necessary period is kept on such persons by officers of the Public Health Department. The number of children successfully vaccinated or re-vaccinated against smallpox at London County Council clinics during the year was 975. Tuberculosis. The number of primary notifications of pulmonary tuberculosis received was 99 compared with 110 last year, and the number of nonpulmonary cases notified was 9 compared with 14 the previous year. The mortality rate for the year for pulmonary tuberculosis was 12 and for non-pulmonary nil per 100,000 population, compared with 8 and nil respectively for 1960. (For details of register and notifications see page 69). 113 visits were paid by the Public Health Inspectors to the homes of persons suffering from tuberculosis and appropriate action taken where public health nuisances were found to exist. Public Health (Prevention of Tuberculosis) Regulations. 1925. These Regulations provide that persons suffering from tuberculosis of the respiratory tract shall not be employed in the handling of milk or milk receptacles. Power is given to the Council to cause such persons to discontinue their employment. It was not found necessary during the year to take action under the Regulations. 43 Tuberculosis Care Committee. The Tuberculosis Care Committee on which voluntary and official bodies are represented, and whose meetings are attended by the Medical Officer of Health, continues to supply help to tuberculous persons and to relatives who require assistance which cannot be obtained from official sources or where urgency or special circumstances indicate that the voluntary sources of the Care Committee are preferable. Although tuberculosis is slowly but surely being conquered, the public should realise that much help is still needed to be given to persons suffering from the disease. During the year assistance was given to needy persons by way of grants towards clothing, fuel, removal expenses, holidays and fares for relatives visiting patients in hospital. The Care Committee again provided a day's coach outing to the seaside in the summer and Christmas gifts to 50 patients. The Annual Christmas Seal Sale Fund amounted to £176 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. Help was also obtained from appropriate sources for patients who were attending the Chest Clinic suffering from chronic bronchitis or lung cancer. The number of these patients is increasing and many are in need of help and advice. Whooping Cough. Confirmed cases notified during the year numbered 31, the figure for 1960 being 223. There were no deaths from the disease. Infections Disease Contacts. Where a person is precluded from continuing at work by reason of being a carrier or having been in contact with an infectious disease, benefits under the National Insurance Act, 1946, are paid only on production of a certificate from the Medical Officer of Health. It was not found necessary to issue any certificates during the year. Authentication of International Certificates of Vaccination and Inoculation. A person proceeding abroad is required in certain countries to produce a certificate of recent successful vaccination and inoculation, and, in addition, the signature of the vaccinating doctor must be verified by the Medical Officer of Health of the district. During the year, the signatures on 720 certificates were verified as those of medical practitioners practising in Stepney and the certificates endorsed accordingly. 44 Disinfection. Premises disinfected because of infectious disease numbered 37, which included 5 for pulmonary tuberculosis. 4,059 articles of clothing and bedding were steam disinfected, including 1,260 articles for export for which three certificates were issued. Formaldehyde disinfection of 273,776 articles of clothing, 120 tons of paper and 43 tons of rags all for export was also carried out during the year, for which 196 certificates were issued. The charges for export and other disinfections carried out amounted to £193. A new Washington-Lyon Steam Disinfecting Machine was installed during the year (see photograph). This machine has semi-automatic controls and is also capable of disinfecting by formaldehyde vapour. Disinfestation (bed bugs and other insect pests). The following is a summary of insect disinfestation work carried out by the Public Health Inspector (Disinfestation) General inspections for vermin 1,272 Attempted visits 159 No. of premises found verminous 502 " re-visits 83 " miscellaneous visits 220 " rooms sprayed 1,774 " premises sprayed 588 In addition, disinfestation was carried out on 38 occasions of the furniture and effects of families rehoused by the London County Council. Treatments were also carried out for infestations of cockroaches, beetles, ants, silverfish, and the like. The Council continues to carry out, on behalf of the Stepney Group Hospital Management Committee, any necessary work of disinfestation at hospitals and other premises in the Borough coming within the control of that Committee. Verminous Persons. The number of lice-infested persons bathed and whose clothing was disinfested at the Council's Cleansing Station, was as followss:- Males Females Children 158 19 1 Total: 178 The number of baths and treatments given amounted to 188. 45 SUMMARY OF PUBLIC ANALYST'S QUARTERLY REPORTS for the year 1961. The following is a summary of the reports submitted each quarter of the year, in compliance with Section 99 of the Food and. Drugs Act, 1955, by the Council's Public Analyst, Mr. D. F. H. Button, A. R. C. S., F. R. I. C., of Southwark Health Services Department, Walworth Road, S. E.17. A copy of each quarterly report is submitted to the Minister of Agriculture, Fisheries, and Food, in accordance with the same section of the Act. During the year, 387 samples were submitted for analysis, 64. of which were purchased or taken formally and 323 informally. The samples are classified as follows:- 9 Alcoholic Spirits 1 Flan Mixture 2 Medicated Pastilles 1 Antacid Powder 1 Flour 100 Milk 1 Aspirin Tablets 2 Flour Confectionery 1 Mint (dried) 1 Baby Food 2 Fruit 1 Nasal Spray 1 Bacon Rind 63 Fruit (dried) 3 Non-brewed Condiment 1 Bicarbonate of Soda 1 Fruit Pie 1 Pepper 2 Bismuth Carbonate 2 Fruit Pulp (canned) 3 Pickles 2 Boracic Ointment U Fruit Squashes 3 Sauces 1 Boracic Powder 1 Glauber Salts 15 Sausages 20 Butter 1 Gravy Powder 1 Seidlitz Powder 1 Camphorated Oil 1 Ground Almonds 2 Skin Cream 1 Capers in Vinegar 1 Ground Ginger 5 Soft Drinks 4- Cheese 1 Honey 1 Soup 1 Chicken Croquette 3 Ice Cream 12 Soup (canned) 1 Chicken (minced) 1 Indigestion Mixture 2 Soup Tablets 1 Chocolate Mould 1 Indigestion Tablets 1 Strawberry flavoured 3 Coffee & Coffee Beans 1 Jelly Powder Syrup 1 Condensed Milk 1 Kangaroo Steaks 1 Stimulant Tablets 1 Cornflour 2 Laxative Tablets 5 Sugar Confectionery 2 Cough Mixtures 2 Marrons in Syrup 2 Sulphur Ointment 2 Gream 5 Meat (canned) 2 Table Jelly 2 Fish (canned) 4 Meat Minced 58 Tea 1 Fish Paste 2 Meat Pies 1 Tonic Mixture 1 Fish (potted) 1 Meat Pudding (canned) 46 Of the samples analysed, 5 formal and 21 informal were found to be unsatisfactory, as follows:- Article Formal or Informal Nature of Irregularity Remarks Dried Apricots (12 Samples) Informal Contained sulphur dioxide in amounts varying from 2100 to 3300 parts per million. Released for reexport or for use in dried salad mix. Chocolate Laxative Informal Incorrectly labelled. Old Stock. New Stock properly labelled. Bacon Rind Informal Green stain-contained 100 parts per million copper. Bacon trimmed - Stained parts destroyed. Milk (2 Samples) Formal Contained 1.0 per cent. extraneous water. Taken in course of delivery from farm Cautionary letter sent. Milk (2 Samples) Formal 3.3 per cent. deficient in fat. Taken in course of delivery from farm. Bulk satisfactory. Pork Sausages Informal 18 per cent. deficient in meat. (See formal sample below). Pork Sausages Formal 12 per cent. deficient in meat. Legal Proceedings. Conditional discharge £7.7.0. costs. Pork Sausages Informal 7.5 per cent. deficient in meat. Formal sample satisfactory. Tea Informal Contained lead-25 parts per million Released for blending. Chopped Meat Informal Contained sulphur dioxide-220 parts per million. Formal sample to be taken. Chopped Meat Informal Contained sulphur dioxide-44 parts per million. Formal sample satisfactory. Boracic Ointment Informal Contained 9.4 per cent. boric acid. Tin rusty and ointment contaminated. Old stock-supply now exhausted. Soft Drink Informal Contained a growth of moulds. No action. 47 Milk. 100 samples of milk were examined during the year, their average composition being 3.67 per cent. fat and 8,55 per cent. non-fat solids. The average composition of samples taken over the past 10 years is as follows:- Year No. Samples Examined Milk Fat, per cent (Legal minimum standard-3.0) Non-Fat Solids, per cent. (Legal minimum standard-8.50) 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 1958 93 3.73 8.56 1959 102 3.67 8.58 I960 70 3.60 8.59 1961 100 3.67 8.55 48 APPENDIX of STATISTICAL TABLES 49 Table 1. TOTAL DEATHS BY CAUSE AND AGE OF STEPNEY RESIDENTS-1961. (Registrar-General's Return) CAUSE OF DEATH ALL AGES Age Groups Total M F -1 1- 5- 15- 25- 45- 65- 75- 1 Tuberculosis-Respiratory 11 8 3 - - - - 4 4 2 1 2 -Other - - - - - - - - - - - 3 Syphilitic Disease 3 3 - - - - - 1 - 2 - 4 Diphtheria - - - - - - - - - - - 5 Whooping Cough - - - - - - - - - - - 6 Meningococcal Infection 1 - 1 - - 1 - - - - - 7 Acute Poliomyelitis - - - - - - - - - - - 8 Measles - - - - - - - - - - - 9 Other Infective and Parasitic Diseases 3 1 2 - - - - - 3 - - 10 Malignant Neoplasm-Stomach. 40 15 25 - - - - 2 11 12 15 11 " " - Dung, Bronchus 79 65 14 - - - - 3 35 27 14 12 " " - Breast 21 1 20 - - - - 2 13 - 6 13 " " - Uterus 8 - 8 - - - - 2 4 2 - 14 " " - Other 78 48 30 - - - - 2 25 26 25 15 Leukaemia, Aleukaemia 10 6 4 - 1 1 1 3 3 1 16 Diabetes 6 2 4 - - - - - 2 1 3 17 Vascular Lesions of Nervous System 97 a 56 - - - - - 23 30 44 18 Coronary Disease, Angina 233 141 92 - - - - 5 72 75 81 19 Hypertension with Heart Disease 35 12 23 - - - - - 5 11 19 20 Other Heart Disease 100 34 66 - - - - 4 12 23 61 21 Other Circulatory Diseases 52 31 21 - - - - 4 6 18 24 22 Influenza 27 10 17 - - - - 1 3 4 19 23 Pneumonia 97 62 35 7 2 2 1 1 5 21 58 24 Bronchitis 101 71 30 - 2 - - - 19 32 48 25 Other Diseases of Respiratory System 15 8 7 1 - - - 1 4 5 4 26 Ulcer of Stomach and Duodenum 13 9 4 - - - - - 5 3 5 27 Gastritis, Enteritis and Diarrhoea 7 2 5 2 - - - - 1 2 2 28 Nephritis and Nephrosis 9 4 5 - - - - - 3 3 3 50 Table 4 (Contd.) CAUSE OF DEATH ALL AGES Age Groups Total M F -1 1- 5- 15- 25- 45- 65- 75- 29 Hyperplasia of Prostate 2 2 - - - - - - - 1 1 30 Pregnancy, childbirth, abortion 1 - 1 - - - - 1 - - - 31 Congenital Malformations 8 7 1 - 2 - - 1 - 1 - 32 Other defined and ill-defined diseases 96 49 47 27 - 1 2 7 15 20 24 33 Motor Vehicle Accidents 8 5 3 - - - 1 2 3 1 1 34 All other accidents 32 20 12 - 3 1 1 10 4 6 7 35 Suicide 14 6 8 - - - 1 5 3 4 1 36 Homicide and operations of war 1 1 - - - - - 1 - - - Males 664 25 4 4 4 36 184 193 212 Females 544 16 6 2 2 22 99 142 255 GRAND TOTAL: 1208 41 10 6 6 60 283 335 467 Table 2. COMPARATIVE TABLE OF ROAD ACCIDENTS OCCURRING IN THE BOROUGH YEAR Children under 7 years Children 7-14 years Adults TOTALS Killed Injured Killed Injured Killed Injured Killed Injured 1957 - 49 - 54 2 667 2 770 1958 - 70 - 75 14 896 14 1041 1959 - 59 - 68 8 930 8 1057 1960 - 69 2 62 11 894 13 1025 1961 - 88 - 73 8 919 8 1080 1961 |Pedestrians Motor Cyclists Pedal Cyclists Drivers Other Road Users TOTAL Killed 6 - 1 - 1 8 Injured 384 174 104 141 277 1080 51 Table 3 INFANT MORTALITY. 1961 Deaths from stated causes at various ages under 1 year (Compiled from Local Death Returns) CAUSE OF DEATH AGE PERIODS Total Deaths under 1 Year Per Cent of Total Under 24 hours 1-6 days Total under 1 wk. Weeks Total under a wks. Months 1- 2- 3- 1- 4- 7- 10- Pneumonia - 2 2 - - - 2 2 2 1 - 7 (5) 17.5 Gastro-Enteritis - - - - - - - 1 - - - 1 (-) 2.5 Congenital Malformations - - - - 1 - 1 2 - - - 3 (6) 7.5 Premature Birth 19 1 20 - - 1 21 - - - - 21 (8) 52.5 Asphyxia, Atelectasis 4 - 4 - - - 4 - - - - 4 (3) 10.0 Birth Injuries 1 1 2 - - - 2 - - - - 2 (1) 5.0 Polycystic Disease - - - - - - - 1 - - - 1 (-) 2.5 Rhesus Incompatability 1 - 1 - - - 1 - - - - 1 (-) 2.5 TOTALS: 25 a 29 - 1 1 31 6 2 1 - 40 (32)* 100.00 ≠Figures in parenthesis denote corresponding deaths in i960. *Includes deaths from other causes. Table 4 Comparative Table showing Deaths of Infants at Various Ages under 1 Year YEAR Under 24 hours 1-6 days 1-4 weeks Total under a weeks 1-12 months Total under 1 Year Percentage Deaths under 4 weeks of Total Infant Deaths 1957 19 9 2 30 15 45 67 1958 13 7 1 21 15 36 58 1959 17 11 4 32 13 a5 71 1960 8 6 5 19 13 32 57 1961 25 4 2 31 9 40 77 52 Table 5 HOME ACCIDENT CASES REPORTED BY THE LONDON AMBULANCE SERVICE Accidents due to Falls. 1961 1960 1959 1958 London Divn. 5 London Divn. 5 London Divn. 5 London Divn. 5 On stairs 1119 65 1221 69 1175 42 1235 76 From Ladder 111 4 113 1 134 2 119 5 From chair 174 15 199 7 237 15 233 20 Outside (i.e. windows, balconies, roofs, etc.) 217 12 234 4 300 21 210 10 In garden 227 11 251 8 305 4 294 8 In bath 15 2 18 1 27 1 19 1 From one level to another (i.e. tables, boxes, beds, etc.) 412 15 348 19 386 28 385 28 On same level (i.e. in room, over objects) 920 40 888 32 1004 47 972 51 Unspecified 3261 170 2868 162 2369 124 2096 107 TOTAL DUE TO FALLS: 6456 334 6140 303 5937 284 5563 306 Other Accidents. Hit by object 202 5 184 8 172 13 127 11 Scalding from objects on cooking stove (saucepans, water, fats, etc.) 123 4 108 1 125 3 95 5 Scalding from teapot 45 1 53 4 55 4 56 1 Other boiling water 151 6 129 l 134 6 158 8 Electric Shock 39 3 26 3 26 2 17 3 Poisoning (including foreign objects) 338 12 318 15 255 11 241 16 Gassing 165 14 137 12 188 23 130 12 Knife-like wounds (including spikes and cuts from glass) 337 24 321 11 327 11 315 13 Fires 178 16 141 11 128 15 163 9 Windows (trapping) 42 - 47 2 34 1 48 3 Suffocation 18 2 17 1 21 3 20 3 Unspecified 337 19 326 25 412 22 411 25 TOTAL OTHER ACCIDENTS; 1975 106 1807 94 1877 114 1781 109 TOTAL-ALL ACCIDENTS 8431 440 7947 397 7814 398 7344 415 53 Table 6 COMPARATIVE VITAL STATISTICS YEAR Population Live Births Deaths Deaths under 1 Year Maternal Deaths Cancer Deaths Tuberculosis Deaths (all forms) No. Rate* No. Rate* No. Rate≠ No. Rate≠ No. Rate* No. Rate* 1901 298,600 11052 37.0 6217 20.8 1817 165 17 1.5 211 0.7 865 2.8 1911 279,560 8464 30.2 4854 17.3 1261 148 24 2.8 236 0.8 647 2.3 1921 249,657 6169 24.7 3244 12.9 550 89 10 1.6 263 1.0 346 1.3 1931 225,238 4010 17.8 2958 13.1 313 78 9 2.1 342 1.5 254 1.1 1941 74,780 1164 15.5 1883 25.1 64 79 3 3.5 203 2.7 145 1.9 1942 71,980 1271 17.6 1243 17.2 66 52 5 3.7 171 2.3 85 1.8 1943 72,920 1371 18.8 1368 18.7 73 53 3 2.1 188 2.5 107 1.4 1944 73,030 1306 17.8 1425 19.5 77 56 0 0.0 185 2.5 96 1.3 1945 77,610 1442 18.5 1469 18.9 81 56 4 2.6 201 2.5 110 1.4 1946 94,800 2147 22.6 1399 14.7 110 51 4 1.8 198 2.1 81 0.8 1947 100,020 2184 21.8 1419 14.1 82 37 2 0.8 229 2.2 99 0.9 1948 99,470 2077 20.2 1228 12.3 59 28 0 0.0 239 2.3 75 0.7 1949 100,550 1830 18.1 1339 13.3 59 32 1 0.5 255 2.5 71 0.7 1950 99,730 1845 18.5 1255 12.5 49 26 2 1.0 244 2.4 56 0.5 1951 98,858 1846 18.7 1364 13.8 39 21 0 0.0 232 2.3 49 0.4 1952 99,000 1894 19.1 1371 13.8 35 18 6 3.0 241 2.4 50 0.5 1953 98,570 1919 19.5 1187 12.0 75 39 1 0.5 237 2.4 43 0.4 1954 97,900 1851 18.9 1126 11.5 41 22 1 0.5 261 2.6 36 0.3 1955 98,180 1826 18.5 1183 12.0 42 23 2 1.0 247 2.5 20 0.2 1956 98,160 1909 19.4 1186 12.1 43 22 0 0.0 234 2.4 17 0.2 1957 97,810 1853 18.9 1214 12.4 45 24 1 0.5 249 2.5 20 0.2 1958 96,360 1818 18.9 1161 12.0 36 20 2 1.0 221 2.3 16 0.2 1959 94,900 1811 19.1 1246 13.1 45 24 0 0.0 242 2.5 17 0.2 I960 93,850 1714 18.3 1037 11.0 32 18 2 1.1 213 2.3 8 0.1 1961 91,940 1863 20.3 1208 13.1 41 22 1 0.5 236 2.5 11 0.1 | *Per 1000 population. ≠Per 1000 total births. 54 Table 7 RODENT CONTROL Council Property Dwelling Houses Other Premises TOTAL Total Properties in Area 41 26,551 7,502 34,094 No. Properties inspected as result of- (a) Notification 5 860 257 1,122 (b) Survey under Act - 1,462 624 2,086 (c) Otherwise - 85 10 95 Total inspections carried out 5 2,407 891 3,303 No, Properties inspected which were found to be infested by (a) Rats-Major 2 11 10 23 -Minor - 558 115 673 (b) Mice-Major 3 54 81 138 -Minor - 375 121 496 No. Infested properties treated by Council 5 935 148 1,088 Total treatments carried out 5 979 326 1,310 No. Section 4 Notices served:- (i) Treatment - 1 - 1 (ii) Structural works - - 35 35 No. Cases where default action taken following Section 4 Notice - - 4 4 Legal Proceedings - - 1 1 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 10th April to 30th June, and from 9th October to 27th November. 1,471 manholes were treated in each period. 55 Table 8 SUMMARY OF WORK OF DISTRICT PUBLIC HEALTH INSPECTORS No. of Premises Inspections Notices Served Legal Proceedings Taken Registered and Licensed Premises. Hairdressers and Barbers 131 118 20 - Rag Flock Premises 19 3 - - Pet Shops 6 2 - - Offensive Businesses 19 103 13 1 Pharmacy and Poisons Premises 68 82 - - Common Lodging Houses 3 14 - _ Seamen's Lodging Houses 2 7 - - Factories. Shoos, &c. Mechanical Factories 2,068 138 35 - Non-mechanical Factories 147 2 - - Other Factories 91 10 - - Outworkers 596 4 - 1 Shops 3,092 42 - - Workplaces 530 1 - - Other Visits and Inspections. Complaints and Nuisances 5,392 1,677 56 House-to-House 698 Disrepair Certificates 224 - - Drainage 4,972 325 3 Heating Appliances (Fireguards) Act 4 - - Infectious Disease and Contacts 213 - - Markets (Week-end inspections) 24 - - Miscellaneous Visits and Inspections 2,428 - - Re-visits 4,166 - - Attempted visits 1,196 - - TOTALS: 19,843 2,070 61 (Contd.) 56 Table 8 (contd.) Rent Act, 1957-Certificates of Disrepair. 1, Applications for Disrepair Certificates 21 Notices of Proposal to issue Certificates 19 Undertakings accepted 8 Undertakings refused 3 Certificates issued 10 2. Applications for cancellation of Disrepair Certificates 24 Cancellations issued 13 Cancellations refused 12 Tenants Landlords 3. Applications for Certificates as to remedying of defects 3 29 Certificates issued-all defects remedied 0 18 Certificates issued-some defects remedied 4 13 Complaints; Number received at Office 3,221 Dangerous Structures: No. premises notified to District Surveyor 69 Drains; No. tested with smoke 1,143 No. found defective 138 No. of plans on which observations submitted 155 Fireguards Tested; (Electric heaters) 4 Land Charges: No. of premises reported upon 2,769 Pharmacy & Poisons: No. of samoles taken 3 Public Houses: No. of premises reported on to Licensing Justices 35 Pag Flock and Other Filling Materials Act: No. of samples taken 1 Wastage of Water: No. of premises notified to Metropolitan Water Board 31 57 Table 9 SUMMARY OF REPAIRS &c. CARRIED OUT UNDER THE SUPERVISION OF DISTRICT PUBLIC HEALTH INSPECTORS DURING THE YEAR Dampness in rooms remedied 761 Premises where-New drains constructed 349 - Drains reconstructed 141 - Existing drains repaired 239 - Drain obstructions cleared 272 Dustbins provided 103 Dwelling-rooms, passages and staircases walls and ceilings repaired 438 Factories-New W.C.s provided 6 - Sanitary accommodation repaired 69 - Other defects remedied 9 Floors repaired 262 Fireplaces and coppers repaired or renewed 87 Gullies, manholes, provided or repaired 381 Light and ventilation improved or provided to rooms and staircases 27 Roofs, gutters, rainwater pipes, renewed or repaired 746 Rubbish accumulations removed 169 Sinks, baths and lavatory basins fitted 1,801 Soil and vent pipes provided or repaired 213 Staircases-Treads, etc., repaired 77 Ventilation (under-floor) provided to rooms 13 Waste pipes provided or repaired 357 Water closets and Urinals-New provided 642 - Compartments cleansed, repaired .. 165 - Obstructions cleared 45 - Flush apparatus repaired 202 - Pans and traps fixed 323 Water Supply-Cisterns cleansed, repaired 32 - Defective supply or fittings remedied 88 - Extra supply provided 2 Windows repaired 444 Yards and areas, cleansed or paving repaired 107 Miscellaneous repairs 250 58 Table 10 Summary of Work of the Public Health Inspector (Smoke & Factories) and Technical Assistant Clean Air Act. 1956. No. of Visits to premises re Smoke Control Areas 1582 No. of Premises visited on complaint of Smoke Nuisance 100 No. of Notices served re Smoke Nuisances (Sec.16) 2 No. of Smoke Observations reports 125 No. of Applications for prior approval (Sec.3(2)) received - No. of Notices of proposal to install (Sec.3(3)) received 11 No. of contraventions of Sec.3 (3) ascertained 4 No. of Notices served under Sec.12 (2) (Adaptations) 523 Factories Acts. 1937-59. No. of Visits to Mechanical Factories 67 No. of Visits to Non-mechanical Factories 18 No. of Miscellaneous Visits 103 No. of Notices served 14 No. of matters referred to H.M. Inspector of Factories 6 59 Table 11 PRESCRIBED PARTICULARS ON THE ADMINISTRATION OF THE FACTORIES ACTS„ 1937-1959. 1. Inspections for purposes of provisions as to health. Type of Factory No. on Register Inspections Written Notices Factories without mechanical power 147 20 1 Factories with mechanical power 2,068 205 48 Other premises under the Acts (Electrical Stations, Institutions, and sites of building operations and works of engineering and construction) 91 10 - TOTALS: 2,306 235 49 2. Cases in which defects were found. Particulars Found Remedied Referred- to H.M. Inspector by H.M. Inspector Want of Cleanliness 2 2 - 1 Overcrowding - - - - Unreasonable temperature - - - - Inadequate ventilation - - - - Ineffective drainage of floors - - - - Sanitary conveniences- (a) Insufficient 7 7 - 1 (b) Unsuitable or defective 52 52 - 20 (c) Not separate for sexes 10 10 - 5 Other offences against the Acts (not including those relating to outwork) 7 - 7 - TOTALS: 78 71 7 27 3. Prosecutions. The occupier of a factory, summoned under Section 110 of the Act, for failing to submit a list of outworkers was conditionally discharged for 12 months and ordered to pay £3. 3. 0d. costs. A summons issued against the occupier of a basement bakehouse for using the bakehouse after the certificate of suitability had been withdrawn under Section 54 of the Act resulted in fines and costs totalling £22 being imposed. 60 Table 11 (contd.) Part VIII of the Act Outwork Section 110. Nature of Work No. outworkers in August list No. cases of default in sending lists to the Council No. Prosecutions for failure to supply lists. Wearing apparel-Making, etc. 562 1 1 - Cleaning and Washing - - - Household linen 1 - - Lace, lace curtains and nets - - - Curtains and furniture hangings - - - Furniture and upholstery - - - Electro-plate - - - File making - - - Brass and brass articles - - - Pur pulling - - - Iron and steel cables and chains - - - Iron and steel anchors arid grapnels - - - Cart gear - - - Locks, latches and keys - - - Umbrellas, etc. 3 — - Artificial flowers 1 - - Nets, other than wire nets — - — Tents - - - Sacks - - - Racquets and tennis balls - - - Paper bags 1 - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 23 - - Brush making - - - Pea picking - - - Feather sorting - - - Carding, etc., of buttons, etc. 1 - - Stuffed toys 1 - - Basket making - - - Chocolate and sweetmeats - - - Cosaques, Christmas stockings, etc. 1 — — Textile weaving — — - Lampshades 2 — - TOTALS: 5 596 1 1 Section 111. There were no instances found of work in unwholesome premises. 61 62 Table 12 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) during 1959-1961 Station Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. INSOLUBLE MATTER DEPOSITED (Tons per square mile) Station No.1. 1961 8.4 9.1 8.5 12.1 3.8 7.9 6.5 8.0 7.1 6.2 8.3 9.5 1960 9.0 8.3 10.8 6.8 15.7 9.3 6.1 6.5 8.1 17.0 7.7 9.2 1959 12.0 10.4 13.4 10.9 10.3 9.1 6.8 13.1 9.4 13.5 10.8 7.6 Station No.2. 1961 10.6 11.8 9.5 12.0 4.8 8.2 7.2 7.7 6.4 6.4 10.1 15.7 1960 8.1 11.0 9.3 6.6 * * 7.0 6.3 5.7 17.3 8.4 10.6 1959 15.0 9.0 11.7 10.6 8.7 8.4 6.7 9.9 9.0 10.5 10.7 7.7 SOLUBLE MATTER DEPOSITED (Tons per square mile) Station No.1. 1961 7.3 8.6 4.5 6.2 1.7 3.7 3.1 3.4 3.8 13.1 9.5 9.5 1960 5.9 4.0 7.4 3.5 6.6 5.4 6.1 9.1 15.0 12.0 7.5 6.0 1959 8.1 6.5 6.4 5.6 4.5 4.8 4.0 6.4 3.0 5.7 13.6 6.3 Station No.2. 1961 6.9 13.4 3.6 7.5 1.4 3.8 3.7 5.1 6.5 10.1 8.2 9.8 1960 5.8 8.6 12.6 7.1 * * 5.3 8.1 19.5 12.3 7.9 9.2 1959 9.7 4.3 6.0 7.1 3.8 5.7 5.7 6.4 7.8 7.9 15.0 11.0 SULPHUR TRIOXIDE COLLECTED (Mg. per day per 100 sq.cm. of lead peroxide) Station No.1. 1961 3.2 3.1 3.5 2.3 1.9 1.5 1.2 1.3 2.0 2.1 3.8 5.0 1960 3.8 3.4 3.6 2.1 2.6 1.9 1.1 1.3 2.0 2.9 2.7 3.5 1959 6.0 5.1 2.8 2.8 2.4 1.9 1.5 2.2 2.4 3.3 3.5 3.2 Station No.2. 1961 4.6 3.4 3.9 2.8 2.0 1.7 1.3 1.5 2.3 2.8 4.7 4.2 1960 4.5 4.2 4.0 2.6 2.7 1.6 1.2 1.1 2.2 3.6 3.4 3.9 1959 6.7 6.9 3.5 3.4 2.4 2.0 1.4 2.1 2.4 3.4 4.3 3.8 * Figures not available. 63 Table 13 AIR POLLUTION Concentration of Smoke and Sulphur Dioxide recorded by the Volumetric Method at two Stations in the Borough during 1961. Measured in milligrams per 1000 cubic metres. Station Jan. Feb. Mar. Apr. May June July Aug. Sep. Oct. Nov. Dec. SMOKE Public Health Office Average value * 130 18O * * 36 32 32 65 103 177 259 Highest value * 250 380 * * 70 50 70 110 320 432 612 Lowest value * 50 60 * * 17 10 20 40 30 44 88 Mile End Librarv Average value 140 90 120 50 26 * * * * 84 150 247 Highest value 410 150 270 70 40 * * * * 220 400 472 Lowest:value 50 50 30 20 10 * * * * 30 52 40 SULPHUR DIOXIDE Public Health Office Average value * 92 237 * * 115 91 98 * 254 374 499 Highest value * 126 540 * * 226 192 235 * 915 781 925 Lowest value * 40 74 * * 52 40 43 * 83 88 217 Mile End Library Average value 60 72 86 86 100 * * * * 182 271 285 Highest value 109 94 194 114 206 * * * * 875 875 545 Lowest value ... — — 23 54 29 51 49 * * * * 77 51 92 * Figures not available Table 14 HOUSING STATISTICS I. Inspection of dwelling-houses during the year:- (1)(a) Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 4,472 (b) Inspections made for the purpose 14,424 (2)(a) Dwelling-houses inspected and recorded under Housing Consolidated Regulations, 1925 698 (b) Inspections made for the purpose 755 (3) Dwelling'-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 8 (4) Dwelling-houses found not to be in all respects reasonably fit for habitation 1,700 II. Remedy of defects during the year without service of formal notices:- Dwelling-houses rendered fit in consequence of informal action by the local authority or their officers 335 III. Action under statutory powers during the year:- (a) Proceedings under Sections 9, 10 and 12 of Housing Act, 1957- Dwelling-houses in respect of which notices were served requiring repairs Nil (b) Proceedings under Public Health Acts- (1) Dwelling-houses in respect of which notices were served requiring defects to be remedied 1,365 (2) Dwelling-houses in which defects were remedied after service of formal notices- (i) By owners 1,325 (ii) By local authority in default of owners 40 (Contd.) 64 Table 14 (Contd.) (c) Proceedings under Section 17 of Housing Act, 1957- (i) Dwelling-houses in respect of which Demolition Orders were made 5 (ii) Dwelling-houses demolished in pursuance of Demolition Orders 1 (iii) Closing Orders made 2 (d) Proceedings under Section 18 of Housing Act, 1957- (i) Separate tenements or underground rooms in respect of which Closing Orders were made 2 (ii) Closing Orders determined, the tenements or rooms having been rendered fit (Section 27) 7 (e) Proceedings under Section 28 of Housing Act, 1957- Demolition Orders substituted for Closing Orders Nil (f) Proceedings under Section 42 of Housing Act, 1957- (i) No. of houses included by representation by Medical Officer of Health 28 (ii) No. of houses demolished in pursuance of representations Nil IV. Housing Act, 1957, Part IV- Overcrowding:- (i) No. of overcrowded families on register at beginning of year 363 (ii) No. of new cases encountered during year 10 (iii) No. of cases relieved during the year 18 (iv) No. of overcrowded families on register at end of year 355 65 Table 15 SUMMARY OF WORK OF PUBLIC HEALTH INSPECTORS (FOOD) No. Visits or Inspections Notices Legal Proceedings Registered Premises. Milk Distributors- Dairies 9 255 7 - - Other 221 Licences issued to persons under the Milk (Special Designations) Regulations, 1960 231 Ice Cream Premises- Sale 300 255 6 - - Manufacture 23 - Storage only 1 Prepared Food Premises- Meat 74 243 37 - - Fish 41 - Onion Peeling 2 Other Premises. Bakehouses 38 332 13 2 Bakers shops 62 2 Butchers shops and stalls 103 313 38 - Catering establishments 1035 1886 115 - Fish shops and stalls 122 139 22 - Greengrocers and fruiterers 631 675 52 - Grocers (wholesale and retail) 357 1021 27 - Public Houses and Off Licences 252 232 5 - Poultry Dealers (excluding butchers) 74 107 16 - Railway Depots 4 449 - - Wharves 45 811 3 - Miscellaneous Food Premises 334 850 18 - Meat Vehicles - 91 1 - Revisits - 741 - - 8400 360 4 There are 3,011 food premises, including stalls, in the Borough. Some of the premises listed above are included under more than one trade category. (Contd.) 66 Summary of Work of Public Health Inspectors (Food). (Table 15 contd.) Reason for Visit. Food Hygiene (General) Regulations, 1960 5,010 Surrender of Unsound Food 545 Merchandise Marks Act 201 Public Health (Meat) Regulations 342 Food Standards Orders 30 Labelling of Food Orders 38 Byelaws: Fish Curing and Fish Frying 86 Agricultural Produce Grading and Marking Acts 35 Pharmacy and Medicines Act, 1941 33 Sampling 293 Complaints 163 Shops Act 141 Samples of food taken during the year for chemical and bacteriological examination numbered 1,663. Summonses taken out numbered 4 and related to 3 premises in the Borough. Two summonses related to foreign bodies found in cake, and two to the continued use of a basement bakehouse after the Certificate of Suitability had been withdrawn. Table 16 SUMMARY OF INSPECTIONS MADE BY THE HOUSING INSPECTOR Caravan Sites 266 Housing Act, 1957- Section 16 39 Housing Act, 1957- Section 17 54 Town Planning 52 Immigrant Enquiries for Malta Government 26 Improvement Grants and Standard Grants 19 Miscellaneous Inspections 311 Overcrowding 50 "Permitted Numbers" under the Housing Act 203 Premises situated in Clearance Areas 69 Premises inspected- Compulsory Purchase Orders 432 Underground Rooms 439 Vacant sites 12 67 68 Table 17 NOTIFICATION OF INFECTIOUS DISEASES DISEASE 1961 1951-1960 CORRECTED NOTIFICATIONS Notifications Admitted to Hospital Corrected Total 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 Ac.Encephalitis- Infective - - - - - - 1 1 3 2 1 - - Post-Infectious 1 - 1 1 - - - - - - - 1 - Ac.Poliomyelitis- , Paralytic 1 1 - 1 6 3 7 2 27 3 5 6 1 Non-paralytic - - - - 1 - 3 1 17 - 2 3 - Diphtheria 1 1 - 1 2 1 - 1 - 1 1 - - Dysentery 48 10 48 140 87 145 34 115 147 117 67 71 216 Enteric Fever 1 - 1 1 2 1 1 5 1 1 1 2 9 Erysipelas 13 2 13 5 13 6 13 8 11 11 9 24 17 Food Poisoning 24 11 24 19 8 69 8 22 18 23 12 14 7 Malaria - - - - - 2 2 - 1 2 2 1 1 Measles 1906 105 1898 55 1344 199 1398 574 1834 144 655 1284 1459 Membranous Croup - - - - - - - - - - - - - Mening. Infection 3 3 2 2 2 3 6 5 5 6 8 3 9 Oph. Neonatorum 1 - 1 2 1 5 7 3 20 10 24 24 9 Pneumonia 117 4 117 81 131 90 77 79 54 65 78 63 97 Puerperal Pyrexia 86 86 87 100 58 26 44 63 134 163 98 96 34 Scabies 50 - 50 61 49 53 51 43 39 29 22 28 28 Scarlet Fever 53 10 53 24 59 97 46 34 26 60 75 208 135 Smallpox - - - - - - - - - - - - - Tuberculosis- 1 Pulmonary 112 - 99 110 135 136 120 116 149 160 167 137 173 Non-pulmonary 9 - 9 9 14 9 18 11 23 23 13 12 16 Whooping Cough 33 6 31 223 76 36 76 235 147 125 249 156 223 TOTALS: 2459 239 2434 835 1988 881 1912 1318 2656 945 1489 2133 2434 Table 18 TUBERCULOSIS - NEW CASES AND DEATHS New Cases. 103 pulmonary cases were notified, being 99 primary notifications and 4 from death returns. 10 non-pulmonary cases were notified, 9 being primary notifications and 1 from death returns. Deaths. 11 persons died from pulmonary tuberculosis. There were no deaths from non-pulmonary tuberculosis. Ape Distribution of new cases and deaths is as follows:- -1 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total (all ages) (a) New Cases (Primary Notifications) Pulmonary M 1 1 3 2 1 1 2 9 13 23 6 11 2 75 F - - 2 3 1 3 2 5 1 2 3 2 _ 24 Non-Pulmonary M - - - 1 - - - 1 - 1 - 1 - 4 F - - - - 1 1 - 1 - 2 - - - 5 (b) Deaths Pulmonary M - - - - - - - - 2 - 3 2 1 8 F - - - - - - - 1 1 1 - - - 3 Non-Pulmonary M - - - - - - - - - - - - - - F - - - - - - - - - - - - - - Table 19 TUBERCULOSIS - VARIATIONS IN REGISTER Pulmonary NonPulmonary Total Cases M F M F (a) Cases on Register at 1/1/61 742 368 77 84 1,271 (b) New cases 73 26 5 4 108 (c) Cases restored to Register 10 5 1 2 18 (d) Other cases added 61 13 6 1 81 (e) Removals 110 63 5 5 183 (f) Cases remaining on Register at 31/12/61 776 349 84 86 1,295 69 Table 20 DISEASES NOTIFIABLE IN LONDON Disease Authority for Notification Acute Encephalitis - P.H.Act, 1936 (S.143); SI.1949/2259. " Influenzal Pneumonia - P.H.Act, 1936 (S.143); SI.1953/299. " Primary Pneumonia - P.H.Act, 1936 (S.143); SI.1953/299. " Poliomyelitis - P.H.Act, 1936 (S.143); SI.1949/2259. Anthrax - P.H.(L)Act, 1936 (S.305); SI.1960/1989. Chicken Pox - (Notifiable in Port of London only.) Cholera - P.H.(L)Act, 1936 (S.192 & 304). Diphtheria - P.H.(L)Act, 1936 (S.192 & 304). Dysentery - P.H.Act, 1936 (S.143); SI.1953/299. Enteric Fever (including Typhoid and Paratyphoid) - P.H.(L)Act, 1936 (S.192 & 304); SI.1953/299. Erysipelas - P.H.(L)Act, 1936 (S.192 & 304). Food Poisoning - F.SD. Act, 1955 (S.26). German Measles - (Notifiable in Port of London only.) *Leprosy - P.H.Act, 1936 (S.143); SI.1951/1036. Malaria - P.H.Act. 1936 (S.143); SI.1953/299. Measles - P.H.(L)Act, 1936 (S.192); SRO.1938/1100; SRO.1940/205 and SI.1948/420. Membranous Croup - P.H.(L)Act, 1936 (S.192 & 304). Meningococcal Infection - P.H.Act, 1936 (S.143); SI.1949/2259. Ophthalmia Neonatorum - L.C.C. Order, 1910; P.H.(L)Act, 1936 (S.192 & 305); SRO.1926/971 & 1937/35; SRO.1928/419. Plague - P.H.Act, 1936 (S.143); LGB. Reg., 1900. Puerperal Pyrexia - P.H.Act, 1936 (S.143); SI.1951/1081 and SI.1954/1691. Relapsing Fever - P.H.(L)Act, 1936 (S.192 & 304). Scabies - P.H.Act, 1936 (S.143); SRO.1943/1016. Scarlet Fever - P.H.(L)Act, 1936 (S.192 & 304). Smallpox - P.H.(L)Act, 1936 (S.192 & 304). Tuberculosis - P.H.Act, 1936 (S.143); SI.1952/704. Typhus Fever - P.H.(L)Act, 1936 (S.192 & 304). Whooping Cough - P.H.(L)Act, 1936 (3.192); SRO.1938/1100 & 1940/205; SI.1948/420. Yellow Fever - (Notifiable in Port of London only). Zymotic Enteritis, or Summer Diarrhoea - (Notifiable in 9 Metropolitan Boroughs only - not notifiable in Stepney.) * Notifiable to the Ministry of Health. ≠ " " County Medical Officer of Health for London. 70 Table 21 DWELLINGS ERECTED DURING 1961 Address No. of Dwellings (a) By BOROUGH COUNCIL John Pritchard House 31 McGlashon House 42 Ratcliffe House 20 93 (b) By LONDON COUNTY COUNCIL Mountmorres Road 32 Westport Street 20 Bradmore House 97 Ewhurst House 97 Norton House 48 Nicholas Road 16 Stayners Road 16 Dwellings converted from drying rooms in various estates 4 330 (c) OTHER Knutsford House, East Mount Street 36 33, Lyal Road 1 Flats 1-6 30 Myrdle Street 12 Flats 1-6 48 Flats 1-2 28 Parfett Street 8 Flats 55/60 Simons Court, Flower & Dean Street 16 73 TOTAL: 496 71 Table 22 OPEN SPACES WITHIN THE BOROUGH Location Acreage MAINTAINED BY BOROUGH COUNCIL Albert Square Gardens 0.66 Arbour Square Gardens 0.66 Beaumont Square Gardens 1.00 Carlton Square Gardens 0.75 Christchurch Gardens, Spitalfields 1.25 Ford Square Gardens 0.40 Kingward Street Playground 0.13 Mallon Gardens, Commercial Street 0.19 Mile End Gardens 0.50 St.George-in-the-East Churchyard 2.25 St,George's Gardens 0.75 St.James's Gardens, Ratcliffe 2.00 Sidney Square Gardens 0.33 Stepney Green Gardens, including Clock Tower space 1.50 Swedenborg Square Playground 0.67 Trafalgar Gardens 0.60 Tredegar Square Playground 1.24 Trinity Square Gardens 1.22 Vallance Road Recreation Ground 1.19 Wakefield Gardens 0.06 York Square Gardens 0.20 17.55 MAINTAINED BY LONDON COUNTY COUNCIL Allen Gardens 1.26 Bethnal Green Gardens Extension 1.60 Brickfield Gardens 5.73 Diggon Street Playground 0.13 King Edward VII Memorial Park 8.50 King George's Playing Fields (part) 13.52 Limehouse Churchyard 2.00 Rope Walk Gardens, Christian Street 1.51 Shandy Park 3.18 Stepney Churchyard 6.75 Wapping Gardens 3.45 Waterside Gardens 1.92 49.55 TOTAL (Acres) 67.10 These Open Spaces represent 3.97% of the area of the Borough, which is 1,691 acres, exclusive of the area covered by the river, docks and canals. 72 Table 23 Social Clubs. Lunch Clubs and Chiropodv Clinics affiliated to the Stepney Old People's Welfare Association. B.E.T.A. Club for Pensioners, meets at St.Peter's Hall, Cephas Street, E.1. Tuesdays, 7.30-10 p.m. ‡*Beaumont Hall Old Age Pensioners' Club, Beaumont Hall, 2 Beaumont Grove, E.1. Thursdays, 1.30-3.30 p.m. Berner Friendship Club for Jewish Pensioners, meets at the Bernhard Baron Settlement, Berner Street, E.1. Tuesdays, 2-4. p.m. ‡ Brady Friendship Club for Jewish Pensioners, meets at the Brady Settlement, Hanbury Street, E.1, Wednesdays, 2-4.30 p.m. Commercial Road Companionship Club, 351/3 Commercial Road, E.1. Tuesdays, Wednesdays & Thursdays, 6-9 p.m. "Golden Age" Club, meets at the Labour Party Hall, Stepney Green, E.1. Mondays, 7-9 p.m. Jewish Blind Society, East End Club, 24-1 Mile End Road, E.1. Wednesdays, 2-4.30 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.1, Wednesdays, 2-4 p.m. * Saint George's Club for Pensioners, St.George's Mission Hall, 181 The Highway, E.1. Fridays, 2-4.30 p.m. * Saint Katharine's Club for Pensioners, The Royal Foundation of St.Katharine, Butcher Row, Ratcliffe, E.14. Mondays, 2-4 p.m. & Thursdays, 7-9 p.m. Stepney Friendship Club, East London Synagogue Hall, Rectory Square, E.1. Tuesdays, 7-9.30 p.m. ‡*Toynbee Veterans' Club, Toynbee Hall, 28 Commercial Street, E.1. Tuesdays, 2-4.30 p.m. Thursdays, 2-4.30 p.m. ‡*W.V.S. Darby and Joan All-day Club, Blakesley Street, E.1. Monday to Friday, 11 a.m.- 4.30 p.m. ‡W.V.S. Darby and Joan Club, Burdett Estate, St.Paul's Way, E.3. Tuesdays, 11 a.m.- 1 p.m. Fridays, Noon- 4 p.m. ‡Dame Colet House, 29 Ben Jonson Road, E.1. Tuesdays & Fridays, Noon- 2 p.m. * 'Zekeinim Club for Jewish Pensioners, Jewish Institute, Adler House, Adler Street, E.1. Monday to Thursday, 2-5 p.m. Clubs not affiliated to the Stepney Old People's Welfare Association. Lycett Central Hall, Mile End Road, E.1. (for Men only) Mondays, 2 p.m. The Vaughan Pensioners' Club, Johnson Street, E.1. Thursdays, 2-4 p.m. Our Lady Immaculate Pensioners' Club, Commercial Road, E.14 Wednesday, 2-4 p.m. ‡ Also Lunch Club. *Also Chiropody Clinic. 73 INDEX Page No. Accidents- Home 11, 12, 53 - Road 11, 51 Aged Persons 13, 73 Analyst's Report 46 Area of Borough 6 Bacteriological Examinations of Foodstuffs 35 Bakehouses 35, 60 Births 6, 9 Cancer 40 Catering Establishments 66 Census 1961 9 Chiropody Clinics 14, 73 Clean Air 24, 59, 62, 63 Clearance Areas 32 Common Lodging Houses 27, 56 Complaints of Nuisances 56, 57 Conferences 15 Deaths 6, 9, 50 Diphtheria 41, 68 Disinfection and Disinfestation 45 Drainage 25, 56, 57 Dysentery 41, 68 Factories 25, 56, 59, 60 Fifty Years Ago 7 Food- Unsound 37 - Inspection and Supervision 34, 66 - Poisoning 42 Free Washing Facilities 15 General Information 7 Hairdressers and Barbers Premises 26, 56 Health Education 3, 16 Health Services, General Provision of 13 Heating Appliances (Fireguards) Act, 1952 26, 56 Holiday Centre 16 Home Bathing 13 Hospital Facilities 17 House-to-House Inspections 56 Houses - Number in Borough 6 Housing 3, 32 Housing Statistics 64, 65, 67, 71 Ice Cream 36, 66 Illegitimate Births 6,9 Infant Mortality 6, 10, 52 Infectious Diseases 40, 68, 70 Information Centre 17 Inquests 15 Laboratory Facilities 17 74 Legal Proceedings 26, 33, 36 Legislation 17 Marriages 9 Maternal Mortality 6, 11 Maternity and Child Welfare 20 Measles 42, 68 Mental Health 4, 14, 18 Milk Supply 37, 48 Mobile Meals Service 14 National Assistance Act, 1948 14, 15 Neonatal Mortality 11 Notices Served 28 Offensive Businesses 29, 56 Old People's Welfare Association 14 Open Spaces 12, 72 Outworkers 27, 56, 61 Overcrowding 32 Perinatal Mortality 10 Pet Animals Act, 1951 56 Pharmacy & Poisons Act, 1933 56, 57 Physical Training & Recreation Committee 2 Poliomyelitis 42, 68 Population 6, 8 Poultry Slaughterhouses 29 Public Health Committee 2 Public Health Inspectors (District)- Summary of Inspections 56 - Return of Sanitary Work 58 Rag Flock & Other Filling Materials Act, 1951 56 Refuse Disposal 28 Rent Act, 1957 24, 57 Rodent Control 29, 55 Sanitary Circumstances 24 Scarlet Fever 43, 68 Seamen's Lodging Houses 27, 56 Shops 30, 56, 66 Smoke Control Areas 24 Smallpox 43, 68 Social Conditions of Area 7 Staff 5, 23 Statistics, Summary of 6, 54 Still-births 6 Swimming Baths 23 Tuberculosis 3, 43, 69 Underground Rooms 32 Unemployment 12 Vital Statistics 6, 54 Water Supply 30 Weather Conditions 40 Workrooms for the Elderly 14 75