LIBRARY BOROUGH OF WOOD GREEN ANNUAL REPORT of the Medical Officer of Health for the Year 1951 MALCOLM MANSON, m.c, g.m., m.a., m.d., d.p.h. Medical Officer of Health. WOOD 33 Borough of Wood Green. With the Compliments of the Medical Officer of Health. Public Health Department, White Hart Lane(dd) School, Wood Green,N.22. BOROUGH OF WOOD GREEN PUBLIC HEALTH COMMITTEE Alderman E. J. Anderton, J.P. (Chairman). The Mayor, Councillor J. S. Bamberger. Alderman A. R. Harrison, Councillor G. Cathles. Councillor J. W. Eunson. The Deputy Mayor, Councillor Mrs. H. S. Harrison. Councillor W. H. Evans. Councillor R. V. Page. Alderman H. Barnes. Councillor E. A. Smeed. Alderman F. Corbett, J.P. Councillor J. J. Wren. STAFF during 1951 *Medical Officer of Health—Malcolm Manson, M.C., G.M., M.A., M.D., D.P.H. Deputy Medical Officer of Health—Effie Scott Stephen, M.B., Ch.B., D.P.H. *Senior Sanitary Inspector—G. C. Billing, Cert. R. San. Inst., Cert. Meat and Food Inspection. (Retired 31.12.51.) *Sanitary Inspectors—W. McCauley, Cert. R. San. Inst, and San. Insp. Joint Board, Cert. Meat and Food Inspection; F. James, Cert. R. San. Inst, and San. Insp. Joint Board, Cert. Meat and Food Inspection; G. Penberthy, Cert. R. San. Inst, and San. Insp. Joint Board. Chief Clerk—W. T. Gloster. General Clerks—H. B. Parker (Cert. R. San. Inst, and San. Insp. Joint Board, July); Miss B. W. Bass; Miss P. Plant (appointed temporary 25.7.51, resigned 22.9.51); P. V. Ingram (appointed temporary 24.9.51). Rodent Operator—J. Harris. Disinfectors—H. Carlan, W. Woodcock. *Half the salaries of these Officers are paid by the Middlesex County Council under Section 109 of the Local Government Act 1933. 4 Public Health Department, White Hart Lane (old) School, Wood Green, N.22. 5th May, 1952. To the Mayor, Aldermen and Councillors, of the Borough of Wood Green. Mr. Mayor, Ladies and Gentlemen, I beg to present to you my Annual Report as Medical Officer of Health for the year 1951. This is the twenty-fourth report of the kind which I have written during my official service in Wood Green. It is also my last, and by the time it reaches your hands, I shall have ceased to be your Medical Officer of Health. In taking official leave of the Council, I wish to express my gratitude for all the kindness, courtesy and support which have been extended to me during my years of service. These have very greatly contributed to the pleasure I have had in my work, coming as they have done, not only from the members of the Public Health Committee and its Chairman, Alderman Anderton, with whom I have been closely associated in that office during 21 of the 24 years I have been in Wood Green, and on whose support I have always been able to rely, but from the members of the Council generally. I have been fortunate in serving Wood Green during a period in which preventive medicine has been held in high esteem throughout the country for what it has achieved and many tributes have been paid to these achievements. Recently, however, it has been pushed into the background, and the emphasis today is all on the curative services. This phase will, I am confident, pass and preventive medicine come into its own again. I have been fortunate also in Wood Green, in the colleagues with whom I have worked, and I wish to express my gratitude to all the members of my staff, both those who are still in the service of the Council and those transferred in 1948 to the service of the Middlesex County Council. The most senior member of my staff, Mr. G. C. Billing, Senior Sanitary Inspector, retired at the end of 1951 after more than 40 years spent in the service of the Council on the staff of the Public Health Department. At all times a hard-working, capable and conscientious official, he has been much missed by his colleagues, not least myself. To all for whom and with whom I have worked during my years in Wood Green, both Council and staff, I tender my thanks for much kindness, consideration and help. Your obedient servant, MALCOLM MANSON, Medical Officer of Health. 5 STATISTICS AND SOCIAL CONDITIONS FOR THE AREA Area (acres) 1,607 Population—estimate supplied by the Registrar-General 52,400 Number of inhabited houses (end of 1951) according to the Rate Books 13,930 Rateable Value, 1951 £542,851 Sum represented by a penny rate £2,227 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Live Births: Total M. F. Legitimate 638 317 321 Birth Rate 12.4 Illegitimate 15 7 8 per 1,000 Still Births 12 6 6 Rate per 1,000 births 18.3 Deaths 715 348 367 Death Rate 13.6 per 1,000 Deaths from PuerRate per 1.000 births 1.5 peral Causes 1 Deaths of Infants under 1 year of age: All Infants 21 Rate per 1,000 live births 32.0 Legitimate 20 Rate per 1,000 legitimate live births 31.3 Illegitimate 1 Rate per 1,000 illegitimate live births 66.6 Deaths from: Cancer (all ages) 120 Measles (all ages) - Whooping Cough (all ages) 1 Diarrhoea (under 2 years of age) 3 Number of Births notified 659 Number of Births registered in the Borough 162 6 POPULATION The mid-year estimate of the population supplied by the Registrar-General is 52,400, a decrease of 310 from that of the previous year. The figure given by the Census in April, 1951. was 52,224. BIRTHS The number of live births registered during the year was 653 which corresponds to a Birth Rate of 12.4 per 1,000 of population. This is slightly lower than in 1950 when the number of births registered was 677 and the Birth Rate 12.8. The number of stillbirths was 12 and the Still-Birth Rate 18.3 per 1,000 births. Tn 1950 the Still-Birth Rate was 18.8. DEATHS The number of deaths credited to Wood Green after the necessary adjustments had been made for inward and outward transfers was 715, giving a Death Rate of 13.6 per 1,000 of population. This is an increase of 85 over the previous year, when the Death Rate was 11.9. Of the total of 715 deaths, no fewer than 487 or 68 per cent, occurred at ages over 65. 152 deaths occurred at ages over 80 and 16 at ages over 90. The individual causes of death are given in Tables III and Ilia in the Appendix, the latter of which gives also the age group at which death occurred. The slight discrepancy in the numbers in the two tables is due to the fact that the former table was supplied by the Registrar-General, while the latter was prepared in my office. The principal causes of death for 1951 and the previous year are shown below. Cause of death. 1951 1950 Heart Disease 224 210 Other Diseases of the Circulatory System 22 16 Vascular Lesions of Nervous System 91 75 Cancer—all sites 120 124 Tuberculosis—all forms 15 12 INQUESTS Twenty-two inquests were held on deaths occurring in Wood Green, one of these without post-mortem examination. A further 125 post-mortem examinations were done without an inquest, 66 of these in the Prince of Wales's Hospital which by arrangement with the Wood Green Council has provided mortuary services since the Wood Green Mortuary was closed a few years ago. 7 INFANTILE MORTALITY The number of deaths of infants under one year was 21 and the Infantile Mortality Rate, 32 per 1,000 live births. This Rate is unfortunately appreciably higher than that for each of the two previous years which was 25, and is the highest since 1946 when it was 34. The rate has been falling steadily for the past few years, and although it is too much to expect that the fall should be uninterrupted, it is none the less regrettable to have to record this temporary set-back. Of the 21 infantile deaths, 8 occurred within 24 hours of birth, 13 during the first week, and 15 during the first four weeks of life. This gives a Neo-natal Mortality Rate of 23. The corresponding figure for 1950 was 19. Of the eight deaths occurring in the first 24 hours, three were those of premature infants, two were cases of rhesus incompatibility, and three were cases of birth injury or serious congenital defect. The following table shows the causes of death at the various ages under one year. Cause of Death Under 1 week. 1 to 2 weeks. 2 to 3 weeks. 3 to 4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under One Year Prematurity 4 1 - - 5 - - - - 5 Congenital Defects — - - - — 2 - - - 2 Atelectasis 1 - - - 1 — - - - 1 Gastro-enteritis - - - - - - 1 - - 1 Intra-cranial Haemorrhage 4 - - - 4 — - - - 4 Capillary Bronchitis — - - - — 1 - - - 1 Asphyxia Neonatorum 1 - - - 1 — - — - 1 Icterus Gravis Neonatorum 2 — — — 2 — - - - 2 Volvulus - 1 - - 1 — - — - 1 Whooping Cough - - - - - 1 - - - 1 Broncho-pneumonia 1 - - - 1 - 1 - - 2 Total 13 2 — — 15 4 2 — — 21 MATERNAL MORTALITY Only one death occurred during the year which was attributable to childbirth—a case of ruptured ectopic pregnancy complicated by necrosis of the kidneys. The Maternal Mortality Rate was 1.5 per 1,000 births. 8 INFECTIOUS DISEASE Table IV in the Appendix gives details of all the cases of infectious disease notified during the year. The total of 916 is not so high as that for 1950 which was 1,010, and measles with 434 notifications and whooping cough with 127 accounted for more than half of all the notifications received. There were no deaths from measles and only one from whooping cough. There were 196 cases of scarlet fever notified as compared with 96 in the previous year. The cases were all of a mild type and no deaths occurred. For the fourth year in succession, there were no cases of diphtheria in Wood Green, and for the twelfth year in succession there were no deaths from this disease. This brief account of the prevalence of the more common infectious diseases during the year, will serve to show what a small part these diseases now play in our mortality figures. The table given below which shows the notifications and deaths, year by year, from diphtheria, scarlet fever, enteric fever, measles, whooping cough and tuberculosis during the 24 years, 1928-1951, indicates that during that period, the fall which has taken place in the mortality for some of these diseases is quite remarkable. So far as diphtheria is concerned, the steady fall in incidence of this disease, with no deaths at all since 1939, and no cases since 1947. is due in very large part at least to the practice of immunisation. This factor does not, however, enter into the case of any of the other diseases, with the possible exception of whooping cough, and here immunisation against this disease has not yet reached sulficient volume to be expected to have any noticeable effect on the incidence of the disease generally. Scarlet fever over the past thirty or forty years has completely changed its character, so that it is no longer the serious and dangerous disease it used to be. and it is doubtful whether there is any necessity to continue to treat it as seriously from the preventive point of view, as we have always done. This disease, however, has changed its character more than once during its history, and there is no guarantee that the present mild type of the disease will always persist. Measles and whooping cough continue to occur in epidemic waves year by year, but the mortality from both diseases has fallen markedly during recent years. This is in large part due to the fact that they are now taken much more seriously than used to be the case, with the result that the complications, which formerly were so dangerous, are less likely to occur. 9 INFECTIOUS DISEASES 1928 to 1951 Year Diphtheria Scarlet Fever Enteric Fever Pulmonary Tuberculosis Non-pulmonary Tuberculosis Measles Whooping Cough †N *D †N *D †N *D †N *D †N *D †N *D †N D* 1928 42 - 142 - 4 - 39 33 8 2 4 2 1929 128 2 187 1 1 2 57 38 7 5 - 10 1930 97 4 234 - 2 — 55 42 14 3 4 1 1931 39 1 97 1 1 — 58 35 9 8 1 3 1932 33 1 110 - 3 — 41 37 15 4 3 3 1933 24 1 192 - — — 57 26 9 6 - 1 1934 31 3 292 - 1 — 56 32 12 3 1 2 1935 39 4 201 1 4 — 47 23 5 1 - - 1936 99 12 98 - 5 — 51 46 8 5 2 2 1937 46 3 72 1 2 — 49 24 8 2 1 5 1938 63 2 92 - 1 — 59 21 10 7 3 - 1939 24 1 63 - — — 45 26 6 2 - 1 1940 26 — 61 - 7 - 55 22 10 4 89 - 24 2 1941 42 — 51 - 2 — 57 26 7 4 401 2 192 1 1942 22 — 87 - — — 69 30 4 4 361 2 95 1 1943 26 — 155 - — — 43 22 3 3 356 - 106 1 1944 9 — 51 - — — 44 20 5 4 232 - 134 1 1945 2 — 62 - 2 — 56 27 7 4 172 — 117 - 1946 7 — 73 - 1 — 76 22 10 3 346 — 89 - 1947 10 — 46 - — — 52 17 10 5 410 2 171 - 1948 - — 69 - — — 65 21 9 5 408 - 174 - 1949 - — 71 - 2 — 68 19 9 — 678 — 46 - 1950 - — 99 - 1 — 57 10 6 2 421 — 376 1 1951 - - 196 - 1 — 50 13 5 2 434 — 127 1 †N = Notifications. *D = Deaths. 10 DIPHTHERIA IMMUNISATION During the year, 738 children were immunised for the first time, 315 of these against diphtheria alone, 343 against diphtheria and whooping cough, and 80 against whooping cough only. Of the total of 738, 144 were immunised by private doctors, and 594 at local clinics and schools. During the same time, 808 children received reinforcing injections, 30 of them from private doctors, and 778 at schools or clinics. Immunisation against diphtheria has been carried out regularly in Wood Green since 1929. and the state of immunisation of the child population must be regarded as fairly satisfactory. TUBERCULOSIS The number of new cases of tuberculosis which came to the knowledge of the Health Department during the year was 69, 64 pulmonary and 5 non-pulmonary. This figure is rather better than those for the years 1950 and 1949 which were, respectively, 83 and 95. Of the 69 new cases. 14 were transfers from other districts, and 55 new notifications. The Table given above shows that while there has not been any appreciable fall in the number of new cases of tuberculosis occurring year by year over the 24 years, there has been a definite fall in the number of deaths, more especially during the past few years. This has occurred at a time when admission to hospital or sanitorium has often been very difficult, and when many patients have had to wait a long period at home before being admitted. The fall in the death rate has not been confined to Wood Green, but has been general throughout the country, and many experts in tuberculosis have expressed the view that the decreased mortality is related in part, at least, to the use of the new antibiotic drugs which have been introduced in recent years. As one effect of the use of these new drugs is usually to reduce the infectiousness of the individual patient, their more widespread use should in time have the result also of reducing the spread of the disease among the immediate contacts of the infected person. All this, however, should not make us forget that the first line of attack against the prevalence and spread of this disease, which remains one of the most serious problems of a health authority, is the improvement of the conditions under which people live, the houses in which they live and sleep, the factories and workshops in which they work, and the provision of adequate food. With housing conditions as they are at present, the prevention of the spread of the disease in infected households is often extremely difficult, and in some cases, almost, if not quite impossible. In Wood Green, it has been found possible in spite of the long waiting list of applicants for houses, for the Housing Committee to give special consideration 11 to applicants whose families include cases of tuberculosis, and several such cases have been satisfactorily rehoused. The number of families so benefited is, however, only a very small fraction of all the tuberculous families in Wood Green. B.C.G. Vaccination of Selected School-leavers In several continental countries, vaccination against tuberculosis by the Bacillus Calmette Guerin has been practised for many years, but it has not been used to anything like the same extent in this country. Recently, however, the Medical Research Council has been carrying out a scheme whereby selected school-leavers are vaccinated with this organism and kept under observation for a subsequent period of three years. Among other districts in the Home Counties, Wood Green has been participating in this scheme. With the full consent of the parents and the approval of the Divisional Executive Education Committee, all children in their last year at the Secondary Modern Schools have been given the opportunity to be X-rayed and tuberculin-tested during their penultimate term at school. Of those found to be quite free of any evidence of tuberculosis and tuberculin-negative, one-half are given a dose of B.C.G. Vaccine and the other half act as controls. They are again X-rayed and retested during the last term at school, and thereafter X-rayed and tuberculin-tested at yearly intervals for at least three years. The scheme has been in operation now since the beginning of 1951 and although the numbers dealt with in Wood Green are small, the aggregate for all the districts throughout the country which are participating, should be sufficient to provide valuable information as to the actual value of this form of vaccination as a preventive agent in tuberculosis, and help to decide whether it should be widely adopted throughout the country. POLIOMYELITIS Only one case of poliomyelitis occurred during the year as compared with four in the previous year. The patient was a girl of 16 years and the attack was fortunately not a very severe one. There is still—five months afterwards—some slight resulting weakness in the affected limb, but every prospect of this clearing up completely. DYSENTERY During the year, 27 cases of Sonne Dysentery were notified. In two instances, three cases occurred in one household, and in three instances there were two cases in one household. All the others were single cases. This disease is not in itself very serious. 12 but it is very troublesome and is very easily spread by the handto-mouth transfer of contaminated material. The causative organism of the disease, the Shigella Sonnei, is present in the faeces of the infected person, and before the patient can be said to be likely to be free from infection, it is in practice necessary to obtain three consecutive negative specimens. This means that the infected school child is often kept from school for several weeks, and similarly, if the adult patient is a food handler, it may be necessary for him to stay off work for quite a considerable time. FOOD POISONING Fifteen cases of food poisoning were notified during the year. In most of these cases the resulting illness was not very severe and of very short duration, and the evidence pointing to any particular article of food as the cause of illness was usually very indefinite. In eleven cases, only one member of a household was affected, and in none of these cases did bacteriological investigation show any bacterial contamination of food. In one case, four members of a household were affected, and although the history of the illness seemed to point to one article of food as the cause, no confirmation of this was obtained by the bacteriological investigation. The attention which the question of food poisoning has received in the public press has served to make people more aware of the possibility of such poisoning, with the result that many cases of digestive upset which formerly attracted little or no attention, are apt now to be notified as possible cases of food poisoning. DISINFECTION AND DISINFESTATION The number of articles dealt with at the Disinfecting Station was as follows: Articles disinfected 680 Articles destroyed 195 229 rooms were disinfected on account of infectious disease, and 70 disinfested on account of the presence of vermin. 179 library books were brought to the Department during the year for disinfection. Frequent requests are received from the Fire and Ambulance Service for the disinfection of blankets and clothing. The process used for the disinfection of bedding at the Disinfecting Station is high pressure steam. Formalin is used for the disinfection of rooms and library books, and D.D.T. liquid insecticide for vermin, and also fly and wasp infestations. In addition, disinfection of premises is carried out at various times for infestations of beetles, cockroaches and ants and this is done with D.D.T. general purpose dusting powder. 13 BACTERIOLOGICAL WORK The majority of all the bacteriological work required for the Borough was carried out at the Public Health Sub-Laboratory situated at the Connetts Wood Isolation Hospital. The specimens examined during the year were as follows: Positive Negative Total Diphtheria - 166 210 Haemolytic Streptococci 44 Vincent's Angina - Faeces 55 243 298 Sputum (for tubercle bacilli) 6 10 16 In addition, 59 ice-cream samples were examined, and 23 milk samples. NATIONAL ASSISTANCE ACT 1948 National Assistance (Amendment) Act 1951 Certain provisions of these Acts give a local authority power to take action when certain very definite conditions are complied with, for the purpose of securing the necessary care and attention for persons who: a. Are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions, and b. Are unable to devote to themselves, and are not receiving from other persons, proper care and attention. The action to be taken is usually the removal of such persons to a hospital or other institution but these powers, useful as they are bound to be in certain cases, are not usually invoked until all other means of relieving the situation have been tried. During the past year it has not been necessary to make use of them. Several cases occurred in which these powers might have been used, but in every case, sometimes with considerable difficulty, it was found possible to persuade the aged or infirm person to enter a hospital or other institution of his own free will. With the gradual ageing of the population which is taking place, the number of old people calling for care and attention is steadily increasing, and at the same time it has become more difficult in the past few years to obtain the admission of these people into hospital. The situation in this district seems, however, to be improving recently, and most of the hospitals serving this part of the County are setting up or have set up geriatric units for the care of old people. Along with this more is being done by voluntary bodies to help the older members of the community, and in this connection the intention of the Wood Green Charity Trustees to provide a holiday for a number of old people during the summer months is very much to be commended. 14 NATIONAL ASSISTANCE ACT 1948 Burial or Cremation of the Dead Under Section 50 of this Act, it is the duty of a local authority to arrange for the burial or cremation of any person who has died in the district where no suitable arrangements for the disposal of the body have been or are being made otherwise than by the authority. No cases occurred during 1951 in which it was necessary to exercise this duty. During the previous year there were three such cases. HOUSING The Borough Surveyor has kindly supplied me with the following figures, showing the number of houses which have been erected or rebuilt during the year. Council Flats completed: 30 at Bounds Green Court. 18 at "The Hollies" and "Woodfield House," Bounds Green Road. 18 at Vincent Square. Council Flats in course of construction at end of year: 10 at Bounds Green Court. 6 at Marlborough House, Marlborough Road. Private Enterprise Six flats and two houses were built by private enterprise and six flats and four houses were in course of construction at the end of the year. There were no war-destroyed houses rebuilt during the year, but two unoccupied houses were repaired and brought into use, making three units of accommodation, and one under repair at the end of the year which will provide one unit of living accommodation. ESTABLISHMENTS FOR MASSAGE OR SPECIAL TREATMENT Four existing licences under the Middlesex County Council Act 1950 were renewed during the year. MEDICAL EXAMINATIONS During the year, 19 medical examinations were carried out in respect of entrants to the Council's employ, for acceptance into the Superannuation Scheme. In addition, 52 Council employees were examined owing to absence from duty through sickness. 15 WORK OF THE SANITARY INSPECTORS The information given in the tables set out below supplies a brief summary of the routine work carried out by the Sanitary Inspectors during the year. A very large part of the inspectors' time is given to the inspection of dwelling houses, with a view to the carrying out of such repairs as are found to be necessary, and it will be seen that a very large number of these repairs has been carried out. Much of the house property in Wood Green is old and shows evidence of the neglect and damage incidental to the war years. The remedy of these defects is very often a slow process, particularly when repair materials are in short supply, but in most cases the work is carried out after the service of informal notice, and in only a minority of cases is it necessary to ask the Council's authority to serve Statutory Notice requiring the work to be done. In most of these cases the Statutory Notice is complied with within a reasonable period, and it is seldom necessary to take legal proceedings to enforce compliance. Only one such case occurred in 1951, and in this case a conviction was obtained, the defendant being ordered to execute the work asked for within 14 days. Costs of £5 5s. were authorised. As in former years the Sanitary Inspectors have also devoted a considerable part of their time to the inspection of food premises, with a view to improving the conditions generally, under which food is prepared and served to the public. As I have stated elsewhere in this report, the greatly increased attention paid in the public press during recent years to the question of food poisoning and the handling of food, has made the public generally much more interested than formerly in the conditions under which food is provided in public restaurants and this, combined with the regular periodic inspection of food premises, has resulted in very marked improvement in these conditions. Great, however, as the improvement which has already taken place is, there is still room for further improvement, but there is ample evidence that not only the food handler, but also the food buyer is now very much alive to the importance of a high standard of cleanliness in the matter of food. During the past few years, for instance, there has been an increase in the number of complaints received at the Public Health Department, of food found after purchase to be contaminated in one way or another. During 1951 nine complaints were received of foreign matter found in various articles of food. All these complaints were considered by the Public Health Committee and in most cases an official letter was sent to the offending party, drawing attention to the serious nature of the complaint, and the necessity to take proper steps to prevent its recurrence. In one case, legal proceedings were taken against a large milk purveying 16 firm, under the Food and Drugs Act 1938. The firm pleaded guilty to the charge of delivering a bottle of milk to a customer which contained a piece of paper. A fine of £5 was imposed, together with costs of £2 2s. SANITARY INSPECTION OF THE AREA Inspections and Reinspections of dwelling houses:— Total 3,263 Enquiries in connection with Infectious Diseases:— Total 312 Inspections of registered premises:— Total 1,677 Miscellaneous Inspections:— Total 462 Work Carried Out:— Drains reconstructed 4 Drains repaired 143 New water closets 5 Water closets repaired 105 Premises cleansed, etc. 8 Rooms disinfested 70 Accumulation of refuse removed 14 Keeping of animals discontinued 1 Dampness to premises remedied 430 Houses repaired 456 Miscellaneous 140 Total 1,376 Investigations in connection with Housing Applications:- Total 2 Rent Restrictions Acts Certificates granted under the above heading during 1951:— Total 1 FACTORIES AND HOMEWORK 1. Inspections Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted Factories without mechanical power 40 53 — — Factories with mechanical power 183 148 8 — Other premises in which Section 7 is enforced by the local authority 2 2 - - Total 225 203 8 - 17 2. Defects Found Particulars Number of cases in which defects where found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness — - — — — Overcrowding — — — — — Unreasonable temperature - — — — — Inadequate ventilation - - — — — Ineffective drainage of floors - - - — — Sanitary conveniences: (a) insufficient — - — — — (b) unsuitable or defective 8 8 — — — (p) not separate for sexes — — — — — Other offences against the Act (not including offences relating to outwork) - - - - - Total 8 8 — — — 3. Outwork Nature of Work No. of outworkers in August list No. of cases of default in sending lists to Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing apparel: Making, etc. 14 - — — — — Household linen 1 - — - — — Lace, lace curtains and nets 1 - - - - - Curtains and furniture hangings 2 - - - - - Brass and brass articles 1 - - - - - Artificial flowers 8 - — - - — Feather sorting 29 - - - - — Cosaques, Christmas crackers and stockings 38 - - - - - Total 94 — — — - — WATER SUPPLY The whole borough is in the area supplied by the Metropolitan Water Board and every house has a constant supply. 18 INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply The following licences for the sale of milk under special designations have been granted. Tuberculin Tested Accredited Pasteurised Sterilised 14 1 19 31 Supplementary Licences to sell milk from premises which are outside the area of the Licensing Authority. Tuberculin Tested Accredited Pasteurised Sterilised 11 - 12 13 23 samples of milk were submitted for examination during the year and all of these conformed to the standards under the Milk (Special Designations) Regulations. 1949. (b) Ice Cream There are 11 premises registered for the manufacture of ice cream in the district, and 93 premises registered for retailing ice cream. During the year 211 visits were paid to these premises, and 59 samples were submitted for bacteriological examination. Of these samples: 51 were Grade 1. 2 were Grade 11. 6 were Grade 111. None were Grade IV. (c) Meat and Other Foods The undermentioned foodstuffs were certified as unfit for human consumption during the year: lbs. Tinned Food tins Meat 399¾ Meat 835 Fish 861¼ Fish 45 Fruit 102 Vegetables 185 Cheese 18¾ Fruit 310 Cooking Fats 5½ Evaporated Milk 153 Cereals 109½ Jam 106 Nuts 1,026½ Soup 1 Cakes, etc. 159½ 1,635 Sweets 250 2,932¾ 19 Miscellaneous Items Eggs 1,618 Cereals 6 pkts. Meat & Fish Paste 9 Fruit & Vegetables 12 jars Fish Cakes 36 Jam 1 jar Cakes, etc. 3 Cheese 17 pkts. Cake Mixture, etc. 85 pkts. Beverages 4 pkts. Biscuits, etc. 1 pkt. Condiments 1 bott. Meat Pies 3 Miscellaneous packets 122 pkts. (d) Inspection of Food Premises The following visits have been made to food premises during the year, and where defects were found the requisite steps have been taken to have them remedied. Butchers' Shops 278 Dairies and Milk Shops 73 Ice Cream Premises 231 Fried Fish Shops 58 Stalls 85 Other Food Premises 432 RODENT CONTROL During the year 1,696 premises were inspected, and it was found necessary to carry out treatment in 150 of these. One hundred and two dwelling houses and 14 premises other than dwelling houses were treated for infestation by rats; also 24 dwelling houses and 10 other premises were treated for mice. A total of 2,764 visits was made by the Rodent Operator. Two maintenance treatments of the soil sewers were carried out, the first in June and the second in November and December: on both occasions 672 manholes were baited. At the Ministry of Agriculture and Fisheries request the manholes were inspected after the completion of baiting in the first of these treatments, and a record of the poison takes was kept. In 55 manholes a complete take of the poison bait was registered and in 305 a part of the poison bait was taken. Owing to the large number of complete poison takes recorded in the first treatment, the Ministry of Agriculture and Fisheries requested that in the second treatment of the sewers the modified procedure of baiting should be used. This procedure includes a preliminary laying of 4 oz. of prebait in each manhole; where the whole of the 4 oz. of prebait is taken 8 oz. of prebait is then placed in the manhole. In every manhole in which all the 8 oz. is taken, 16 oz. of poison bait is then laid. 20 In only one manhole was a complete take of 16 oz. of poisoned bait recorded. From the statistics obtained during the two treatments carried out this year, it does appear advisble to inspect the record of poison bait takes, and thus ensure the best results from the sewer treatments. As in past years, the Public Health Department and the Borough Engineer's Department co-operated in carrying out the sewer treatments. MIDDLESEX COUNTY COUNCIL ACT, 1950 Section 11. Registration of Hawkers of Food This Act superseded the Middlesex County Council Act 1944. Section 279, on the 1st April. 51 hawkers of food in the Borough are registered. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 Under this Act, which came into operation on the 1st November, three premises in the Borough were registered. PUBLIC CONVENIENCES There are three Public Conveniences in the Borough which are kept under constant supervision by the Public Health Department. 21 APPENDIX Table I. Vital Statistics of Wood Green, 1931-51 Year Population estimated to middle of each year Nett Births belonging to the District Nett Deaths belonging to the District Under 1 year of age At all ages Total No. Rate per 1,000 population Illegitimate No. Total No. Rate per 1,000 live births Illegitimate No. Rate per 1,000 illegitimate births No. Rate per 1,000 population (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) 1931 54,520 719 13.2 30 32 44 2 66 549 10.1 1932 54,500 681 12.5 20 28 41 4 200 556 10.2 1933 54,210 601 11.1 24 32 53 2 83 565 10.4 1934 53,755 564 10.5 16 21 37 2 125 562 10.5 1935 53,470 570 10.7 22 27 47 1 45 529 9.9 1936 53,620 700 13.1 23 38 54 0 — 588 10.9 1937 53,510 659 12.3 21 32 48 2 95 593 11.1 1938 53,190 652 12.3 17 25 38 1 59 540 10.1 1939 52,700 and 50,700 624 11.8 25 21 34 2 83 594 11.7 1940 46,230 605 13.1 42 23 39 3 71 737 15.9 1941 43,870 523 11.9 25 16 31 0 — 589 13.4 1942 44,840 704 15.7 29 25 37 1 34 573 12.7 1943 44,710 756 16.8 37 31 41 0 — 553 12.3 1944 44,060 824 18.7 46 26 31 5 108 564 12.8 1945 44,940 694 15.9 47 19 27 1 21 616 13.7 1946 50,680 986 19.4 48 34 34 2 42 629 12.4 1947 52,290 1,066 20.3 41 30 28 1 24 649 12.4 1948 53,080 805 15.1 21 23 28 2 95 520 9.8 1949 52,780 719 13.6 33 18 25 0 — 631 11.9 1950 52,710 677 12.8 25 17 25 1 40 630 11.9 1951 52,400 653 12.4 15 21 32 1 67 715 13.6 22 Table II. Birth Rate, Death Rate and Analysis of Mortality during 1951 Birth-rate per 1,000 population Annual Death-Rate per 1,000 Population Rate per 1,000 Births All causes Typhoid and Paratyphoid Fevers Smallpox Whooping Cough Diphtheria Influenza Diarrhoea and Enteritis (under 2 years) Total Deaths under 1 year England and Wales 15.5 12.5 0.00 0.00 0.01 0.00 0.38 1.4 29.6 126 County Boroughs and Great Towns (including London) 17.3 13.4 0.00 0.00 0.01 0.00 0.36 1.6 33.9 148 Smaller Towns (population 25,00050,000 at Census 1931) 16.7' 12.5 0.00 0.00 0.01 0.00 0.38 1.0 27.6 London 17.8 13.1 0.00 0.00 0.01 0.00 0.23 0.7 26.4 Wood Green 12.4 13.6 0.00 0.00 0.01 0.00 0.15 4.5 32.0 23 Table III. Causes of Death during the year 1951 Causes of Death Male Female Tuberculosis, respiratory 9 4 Tuberculosis, other 1 1 Syphilitic disease - — Diphtheria - — Whooping Cough 1 — Meningococcal infections - — Acute Poliomyelitis - — Measles - — Other infective and parasitic diseases - — Malignant neoplasm, stomach 9 11 Malignant neoplasm, lung, bronchus 21 4 Malignant neoplasm, breast — 13 Malignant neoplasm, uterus — 5 Other malignant and lymphatic neoplasms 23 34 Leukaemia, aleukaemia — 3 Diabetes 2 5 Vascular lesions of nervous system 36 55 Coronary disease, angina 57 35 Hypertension with heart disease 12 17 Other heart diseases 44 59 Other circulatory disease 8 14 Influenza 3 5 Pneumonia 16 26 Bronchitis 40 24 Other diseases of respiratory system 2 — Ulcer of stomach and duodenum 5 3 Gastritis, enteritis and diarrhoea 2 1 Nephritis and nephrosis 2 2 Hyperplasia of prostate 6 — Pregnancy, childbirth, abortion — 1 Congenital malformations 2 5 Other defined and ill-defined diseases 35 28 Motor vehicle accidents 4 — All other accidents 6 7 Suicide 2 5 Homicide and operations of war - — Totals 348 367 24 Table IIIa. Males Causes of Death All ages Under 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Tuberculosis, respiratory 9 - - - - - 1 — 2 3 2 1 Tuberculosis, other 1 - - - - - - - - 1 - - Syphilitic disease - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - Whooping Cough 1 1 - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - Measles - - - - - - - - - - - - Other infective and parasitic diseases - - - - - - - - - - - - Malignant neoplasm, stomach 9 - - - - - - 1 - 1 4 3 Malignant neoplasm, lung, bronchus 21 - - - - - - 1 4 7 7 2 Malignant neoplasm, breast - - - - - - - - - - - - Malignant neoplasm, uterus - - - - - - - - - - - Other malignant and lymphatic neoplasms 23 - - - - - - 1 2 2 14 4 Leukaemia, aleukaemia - - - - - - - - - - - - Diabetes 2 - - - - - - - - - 2 — Vascular lesions of nervous system 36 - - - - - - - 3 6 11 16 Coronary disease, angina 56 - - - - - - - 8 11 18 19 Hypertension with heart disease 12 - - - - - - - 1 3 6 2 Other heart diseases 44 - — — — — 1 1 4 3 12 23 Other circulatory disease 8 - - - - - - 1 — 1 1 5 Influenza 3 - - - - - - - - - 1 2 Pneumonia 16 - - - - - - - 1 1 5 9 Bronchitis 39 - - - - - - - 5 6 13 15 Other disease of respiratory system 2 - - - - - - - - — 1 1 Ulcer of stomach and duodenum 5 - - - - - - - - 2 2 1 Gastritis, Enteritis and Diarrhoea 2 2 - - - - - - - - - - Nephritis and nephrosis 2 — — — — — 2 — — — — — Hyperplasia of prostate 6 — - - - - - - - - 3 3 Pregnancy, childbirth, abortion - - - - - - - - - - - - Congenital malformations 2 2 - - - - - - - - - - Other defined and illdefined diseases 34 2 2 1 1 1 1 2 3 8 9 4 Motor vehicle accidents 4 — — 1 — 1 1 1 — — — All other accidents 6 — — 1 — — — 1 1 2 — 1 Suicide 2 - - - - - - - - 1 1 — Homicide and operations of war - - - - - - - - - - - - Totals 345 7 2 3 1 2 6 8 35 58 112 111 25 Table IIIa. Females Causes of Death All ages Under 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Tuberculosis, respiratory 4 - - - - - - 2 1 1 - - Tuberculosis, other 1 - - - - - - - - - - 1 Syphilitic disease - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - Acute Poliomyelitis — - - - - - - - - - - - Measles - - - - - - - - - - - - Other infective and parasitic diseases - - - - - - - - - - - - Malignant neoplasm, stomach 11 - - - - - - - 1 2 5 3 Malignant neoplasm, lung, bronchus 4 - - - - - - - - - 2 2 Malignant neoplasm, breast 13 - - - - - - - 1 3 6 3 Malignant neoplasm, uterus 5 - - - - - - - - - 3 2 Other malignant and lymphatic neoplasms 34 - - - - - 1 1 4 2 14 12 Leukaemia, aleukaemia 3 - - - - - - - 2 — 1 — Diabetes 5 - - - - - - - - 2 1 2 Vascular lesions of nervous system 56 - - - - - - - 3 7 12 34 Coronary disease, angina 35 - - - - - - - 1 7 7 20 Hypertension with heart disease 17 - - - - - - - 2 - 5 10 Other heart diseases 58 - - - - - - 1 5 6 10 36 Other circulatory disease 15 - - - - - - - - 4 1 10 Influenza 5 - - - - - - - - 2 2 1 Pneumonia 26 2 — — 1 — — 1 2 3 8 9 Bronchitis 24 — — 1 — — — — — 2 5 16 Other disease of respiratory system - - - - - - - - - - - - Ulcer of stomach and duodenum 3 - - - - - - - - - 1 2 Gastritis, Enteritis and Diarrhoea 1 - - - - - - - - 1 - - Nephritis and nephrosis 2 - - - - - - - 1 - - 1 Hyperplasia of prostate - - - - - - - - - - - - Pregnancy, childbirth, abortion 1 - - - - 1 - - - - - - Congenital malformations 5 5 - - - - - - - - - - Other defined and illdefined diseases 28 4 - 1 1 - 1 - 3 4 4 10 Motor vehicle accidents — — — — — — — — — — — - All other accidents 7 - - - - - - 2 1 — 1 3 Suicide 5 - - - - - - 1 1 — 2 1 Homicide and operations of war - - - - - - - - - - - - Totals 368 11 - 2 2 1 2 8 28 46 90 178 26 Table IV. Infectious Diseases notified during the year 1951 Notifiable Disease Cases Notified in Whole Borough Total Cases Notified in each Ward Total Cases removed to Hospital or Sanatorium Total Deaths At Ages—Years All Ages Under 1 year 1 to 5 years 5 to 10 years 10 to 15 years 15 to 20 years 20 to 25 years 25 to 35 years j 35 to 45 years 45 to 55 years 55 to 65 years J 65 and upwards AlexandraBowes Town Hall Noel Park Scarlet Fever 196 - 51 126 15 3 1 - - - - - 58 56 82 118 - Diphtheria — - — — — — — — - - - — — — - - - Cerebro-Spinal Fever 2 - 2 — — — — - - - - — - 2 - 2 - Enteric Fever 1 - — — — 1 — - - - - - 1 - - 1 - Para-typhoid Fever 1 - - - - - - 1 - - - - 1 - - 1 - Erysipelas 13 - — — 1 1 1 1 2 2 3 2 3 6 4 3 - Pneumonia 41 - 1 2 5 2 2 2 3 5 6 13 16 13 12 11 42 Acute Poliomyelitis 1 - — — - 1 — — - — — — — - 1 1 - Polio-encephalitis - - - - - - - - - - - - - - - - - Puerperal Pyrexia 3 - — — — — — 3 - - — — 1 1 1 3 - Pulm. Tuberculosis 50 - 2 2 — 8 9 14 5 3 3 4 21 15 14 31 13 Non-Pulm. Tuberculosis 5 - — — — 1 - - 1 1 - 2 3 1 1 2 2 Malaria — - — — — - - - - - — - - - - - Measles 434 22 258 142 6 4 2 - - - — - 212 120 102 10 - Whooping Cough 127 9 72 40 3 — — 3 — — — — 37 42 48 7 1 Ophthalmia Neonatorum — — — — — — — — — — — — — - - - - Dysentery 27 — 10 5 4 2 2 2 2 — — — 13 9 5 2 - Food Poisoning 15 — 2 — 1 1 1 1 2 3 3 1 12 2 1 — — Totals 916 31 398 317 35 24 18 27 15 14 15 22 378 267 271 192 58 27 Table V. TUBERCULOSIS New Cases and Mortality during 1951 Age Periods New Cases Deaths Respiratory Nonrespiratory Respiratory Nonrespiratory M. F. M. F. M. F. M. F. 0 — — — — — — — — 1 1 1 — — — — — — 5 2 — — — — — — — 15 9 13 — 1 — — — — 25 9 10 — — 1 — — 35 5 3 — 1 — 2 — — 45 2 2 1 — 2 1 — 55 3 - — — 3 1 1 — 65 and upwards 3 1 — 2 3 - - 1 Totals 34 30 1 4 9 4 1 1 Above includes transfers (14) from other districts. Two non-notified tuberculosis deaths occurred. Printed by Barnard & Crannis Ltd., 103, Myddleton Road, Bowes Park - N.22