BOROUGH OF WOOD GREEN ANNUAL REPORT of the Medical Officer of Health for the Year 1955 WM. CLUNIE HARVEY, md.,d.p.h Medical Officer of Health. BOROUGH OF WOOD GREEN ANNUAL REPORT of the Medical Officer of Health for the Year 1955 WM. CLUNIE HARVEY, m.d., d.p.h. Medical Officer of Health. Public Health Department, White Hart Lane (Old) School Wood Green, N.22. June, 1956. To The MAYOR ALDERMEN and COUNCILLORS, of the BOROUGH OF WOOD GREEN. Mr. Mayor, Ladies and Gentlemen, I beg to present the Annual Report of the Medical Officer of Health for the year 1955. 1955 was once again a placid year, indeed, I did not find it necessary to report any untoward occurrences, epidemics or even outbreaks to the Public Health Committee during the period under review. The vital statistics for the year are satisfactory. The birth rate rose very slightly from 11.03 to 11.7. The death rate fell to an equally slight degree from 10.43 to 10.3. The infant death rate, that is the number of deaths of infants under one year of age per thousand live births, fell from 26.6 to 23.6. This drop, although pleasing, has very little significance, bearing in mind the comparatively small totals involved No death took place from puerperal causes during the year, indeed, no mothers died during or after childbirth. The last maternal death in Wood Green took place in 1953. Since then 1,156 births have taken place in the Borough Altogether, as I have just remarked, the vital statistics for the Borough are satisfactory. I feel I must once again point out, however, that vital statistics can be extremely misleading Indeed, as has so often been said, statistics can be used to prove almost anything. The bald figures set out in the above paragraph by no means tell the whole story. This, the fact that no maternal deaths have taken place in Wood Green since 1953 is in startling contrast to what used to take place not so many years ago. In those days maternal deaths particularly deaths from puerperal sepsis, were all too common Within the past few years, very strict ante-natal supervision great advances in midwifery and the introduction of the new antibiotics have completely revolutionised the situation, Nowadays, a maternal death is considered to be a prime tragedy. Every case is very fully investigated, as we now appreciate that, in a properly organised society,maternal deaths should be regarded as a most disturbing phenomenon. In the same way, the great and steady reduction in infant mortality which has taken place over the past few decades is most pleasing. I have already stated that the totals relating to Wood Green are too small to have any lasting significance. On the other hand, the fact that the rate has fallen over a substantial period and is low compared with pre-war or even post-war years is perhaps, a happy augury for the future. 3 In regard to infectious diseases, 1955 was again a quiet year, apart from the number of measles cases recorded (635 as against 29 during 1954). This was, of course, due to the fact that 1955 was an epidemic year so far as measles was concerned. The infectious diseases pattern will be dealt with in more detail in the section of the Report which deals with this subject, but it can once again be stated that the year was quiet, with an absence of any outbreaks other than the prevalence of measles,to which reference has already been made During 1955, preparations were made to deal with two important aspects of Public Health The first related to housing. As the Council will be aware, the passing of the Housing Repairs and Rents Act 1954 envisaged the survey of all houses in the district, with a view to their classification. Although this more properly comes into the Report for 1956, the survey was duly carried out in 1955, in readiness for action to be taken this year. The second point relates to food hygiene. The Pood & Drugs (1955) Act came into force on 1st January 1956, although certain regulations will not be effective until 1st July 1956. Here again, much preparative work has had to be done, so that we can be in a position to enforce the provisions of the new Act and the important regulations accompanying the Act The work entailed under this Act and its accompanying regulations has placed considerable responsibility on the shoulders of the Sanitary Inspectors. I duly reported the position to the Staff Committee and am glad to be able to record that the Committee appreciated the position to the full, generously acceding to my request that a further Sanitary Inspector should be appointed to the Public Health staff. This was done, the new Sanitary Inspector taking up his duties on 27th October, 1955. Although Wood Green is almost fully built up, there is much in the district for which the inhabitants should be grateful and of which they should feel extremely proud. It is quite obvious to anyone who knows or even passes through Wood Green that maximum use has been made of open spaces, the real lungs of any urban area. Although Wood Green has its share of factories, it is still predominantly a dormitory of the metropolis. Further- and this is a really important point-it is a place to which city workers can return with pleasure in the evening and in which they can enjoy their weekend's leisure. As time passes, this aspect of public health will become more and more apparent: For this reason, the character and standard of the district must be jealously maintained, so that the heritage at present enjoyed by Wood Green citizens can be passed on, unimpaired or even improved,to future generations. It cannot be said that there is any particular health hazard to which the citizens of Wood Green are subject. Pollution of the atmosphere per se does not, so far as one can ascertain, exercise 4 a serious influence on life and well-being, although it must be admitted that impurities in the atmosphere and emissions from the innumerable vehicles using the roads do have an effect,as is the case with every comparable district. This, however, is more a national than a local problem, a problem which will obviously have to be tackled if conditions are to be improved. I would make mention, however, of one set of circumstances which, theoretically at least, do constitute a health hazard. These are the conditions under which so many Wood Green citizens have to travel to and from work in London every day. If one travels on a tube, train or bus during the rush hour, one cannot help wondering how it is that the seething mass of humanity, who are subjected to this peculiar form of modern torture, do not succumb in large numbers to infectious diseases, or even to nervous disorders One can only assume that they become immune, in the same way that we protect ourselves naturally against so many infections. This again is a problem which does not allow of easy solution, certainly not local solution although it is a hazard which we would do well to remember. The work of health education has been carried on in Wood Green during the year along the lines set out in previous reports. A number of talks have been given to local organisations, articles have been accepted by the local press, the magazine BETTER HEALTH continues to circulate, while, during 1955, we arranged a clean food exhibition specially designed to appeal both to food traders and to citizens generally I am more than ever satisfied that, in health education, we have a weapon which is both economical and effective. I would take this opportunity of thanking local editors for their unfailing courtesy and assistance. Without the help of our local press, the work of health education would be materially stultified I ask a good deal of the press, but am more than pleased to be able to record my grateful thanks for all the help forthcoming I would conclude by thanking the Public Health Committee and the Borough Council for their continued support and encouragement. This means a great deal to a Medical Officer of Health and to the Public Health Department as a whole I would also express my sincere thanks to the staff of the Public Health Department. I would make particular reference,once again to the able assistance and devotion to duty rendered by my Deputy Dr J R. Campbell, Mr. W. McCauley, Chief Sanitary Inspector, and Mr W. T. Gloster. Chief Clerk. The fact that one has a first-rate team at one's disposal is now more than ever important bearing in mind the fact that the modern Medical Officer of Health can seldom devote his entire time to the environmental health of any one district I am satisfied that I have the privilege of leading such a team. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, W. C. HARVEY, Medical Officer of Health. 5 BOROUGH OF WOOD GREEN PUBLIC HEALTH COMMITTEE The Deputy Mayor, Alderman J. W. BARNETT. (Chairman) Councillor C. W. BUCKBY (Vice-Chairman) The Mayor Alderman A. VITORIA, J. P. Councillor E. HARRISON Alderman R.V. PAGE. Councillor Miss D.E.M HISCOCK Alderman J. J. WREN. Councillor F.T. SKUDDER. Councillor G. CATHLES. Councillor L. A. VITORIA. STAFF *Medical Officer of Health-william clunie Harvey, m.d. , d.p.H. Deputy Medical Officer of Health-janet russell campbell, m.b., CH.B., D. P.H. *Chief Sanitary Inspector-W.McCAULEY, Cert. R. San. Inst. and San. Insp. Joint Board, Cert. Meat and Food Inspection. *Sanitary Inspectors-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, Cert. Meat and Food Inspection (resigned 3.9.55); H.B. PARKER, Cert. R. San. Inst. and San. Insp. Joint Board, Cert. Meat and Food Inspection (resigned 2.7.55); W E. GOODFELLOW, Cert Royal San. Assoc. of Scotland, Cert Meat and Food Inspection (Permanent 1.7.55): K.M. BELL (resigned 30.4.55); H.J. BAILEY, Cert. R. San. Inst., Cert. Meat and Food Inspection (appointed 12.9.55); D.G. OLIVER, Cert. R. San. Inst. and San Insp. Joint Board, Cert. Meat and Food Inspection (appointed 27.10.55). Chief Clerk-W.T. GLOSTER. General Clerks -P.V. INGRAM; Mrs. C.M.A. MOSS, Shorthand Typist (resigned 30.4.55); Mrs. L. BROOKS (Appointed temporary 25.1.55) (resigned 13 8.55); Miss J. W. POPE, Shorthand Typist (Appointed 29 8.55). Rodent Operator-J. HARRIS. Disinfector-W. WOODCOCK. *Half the salaries of these Officers are paid by the Middlesex County Council under Section 109 of the Local Government Act, 1933. 6 STATISTICS AND SOCIAL CONDITIONS FOR THE AREA Area (acres) 1,606 Population-estimate supplied by the Registrar General 50,610 Number of inhabited houses (end of 1955) according to Rate Books 14,348 Rateable Value (31.3.56) £547,903 (1.4.56) £870,379 Sum represented by a penny rate £2,210 I can add little to the remarks made in this section in preceding Reports,or to what I have already said in the introduction to this Annual Report Our aim must be to eliminate conditions which prejudice the health and well-being of those who live or work in Wood Green As any district becomes older, this task becomes more difficult, more imperative. I am fully aware that the Borough Council has this point well in mind, and that everything possible is being done to maintain and to improve standards in Wood Green so that conditions will not be allowed to deteriorate. EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Live Births: Total M F Legitimate 575 287 288) Birth Rate per 8) 1,000 11.7 Illegitimate 17 9 Still Births 13 7 6 Rate per 1,000 Births 21.9 Deaths 519 255 264 Death Rate per 1,000 10.3 Deaths from Puerperal causes _ Rate per 1,000 Births _ Deaths of infants under 1 year of age- All infants 14 Rate per 1,000 live births 23.6 Legitimate 13 Rate per 1,000 legitimate live births 24.3 Illegitimate 1 Rate per 1,000 illegitimate live births 58.8 Deaths from:- Cancer (all ages) 105 Measles (all ages) _ Whooping Cough (all ages) 1 Diarrhoea (under 2 years of age) _ Number of Births notified 591 Number of Births registered in the Borough 117 POPULATION The mid-year estimate of the population supplied by the Registrar General is 50,610, a decrease of 480 from that of the previous year. 7 BIRTHS The number of live births registered during the year was 592 which gives a crude birth rate of 11.7 per 1,000 of population and a corrected birth rate of 11.5 The rate for 1954 was 1103. There were 13 still-births giving a still birth rate of 21.9 per 1,000 births In 1954 the still-birth rate was 17.4. DEATHS The number of deaths credited to Wood Green after the necessary adjustments had been made for inward and outward transfers was 519 giving a crude death rate of 10.3 per 1,000 of population and a corrected death rate of 9.5. The total number of deaths for the previous year was 533, when the death rate was 10.43, Of the total of 519 deaths no fewer than 316 occurred at ages over 65 and 109 deaths occurred at ages over 80 and 13 at ages over 90. INQUESTS Twenty inquests were held following the deaths of Wood Green residents during 1955. A further 131 post-mortem examinations were carried out without an inquest 47 of these in the Prince of Wales Hospital which by arrangement with the Wood Green Borough Council, provides mortuary services MATERNAL MORTALITY No deaths occurred during the year as a result of childbirth, compared with none during the previous year. INFANT MORTALITY There were 14 deaths of infants under one year of age, giving an infant mortality rate of 23.6 per 1,000 live births This compares with a total of 15 deaths and an infant mortality rate of 26.6 in 1954. Of the 14 infant deaths, 4 occurred within twenty-four hours of birth, 4 during the first week and 2 during the first four weeks of life This gives a neo-natal mortality rate of 16.9. The corresponding figure for 1954 was 17.7. The following table shows the causes of death at various ages under one year. Under 1 week 1 to 2 weeks 2 to 3 weeks 3 to 4 weeks Total under 4 weeks 4 weeks and under 3 mths. 3 mths. and under 6 mths. 6 mths. and under 9 mths. 9 mths. and under 12 mths. Total deaths under one yr. Prematurity 2 — — — 2 — — — — 2 Congenital Defects — — — — — — — — — — Atelectasis 3 — — — 3 — — — — 3 Gastro-enteritis — — — — — — — — — — Intra cranial Haemorrhage — — — — — — — — — — Capillary Bronchitis — — — — — — — — — — Asphyxia — — — — — — — — — — Broncho pneumonia 1 1 — — 2 2 1 —_ — 5 Other Causes 1 — 1 1 3 — — 1 — 4 Total 7 1 1 1 10 2 1 1 — 14 8 GENERAL PROVISION OF HEALTH SERVICES Hospitals The position regarding the availability of hospital beds has altered very little within the past twelve months. On numerous occasions and in various quarters I have stressed the obvious and urgent need for more geriatric beds to be made available for the elderly folk of Wood Green. One must admit that the position is still unsatisfactory, but one can at least say that the matter has been thoroughly ventilated and that the position has been very clearly made known to those concerned. One can only hope that sympathy, which is always expressed, will shortly be translated into practical help Until that comes about,general practitioners will still experience the greatest difficulty in getting their elderly chronic sick into hospital, even when this presents the only solution to a tragic difficulty. The Council can rest assured that I will continue to press this point wherever and whenever possible, until conditions improve Meantime. I feel I must express my thanks to the hospital authorities who are doing their very best to cope with an almost insoluble problem. So far as hospital provision for other types of cases is concerned-infectious diseases, maternity cases and acute illnesses-the position is much more satisfactory Coppetts Wood Hospital, to which cases of infectious diseases occurring in Wood Green are admitted, is most co-operative So far as I can ascertain from general practitioners there is seldom, if ever, difficulty in securing the prompt admission of a case of infectious disease to hospital if and when this is required It is still not possible to secure admission to hospital in the case of all women who would like to be confined in hospital Staffing difficulties still limit maternity beds to a certain degree although there has been considerable betterment since the very difficult days immediately following the war Broadly speaking, cases are only accepted for Confinement in hospital where a difficult labour can reasonably be anticipated or where home conditions are such that it would not be safe,or at least desirable, for the confinement to take place at home Primipara, i.e women expecting their first baby, are given preference over women who have already borne children, for the obvious reason that first pregnancies are notoriously unpredictable. Care of the Aged The problem of the aged continues to increase. The fact that a special committee has been set up in Wood Green to deal with problems associated with old age is a sure indication that the Borough Council is fully alive to the magnitude of this problem and to the need for very definite action. It seems now clear that what is required more than anything else is co-ordination. There are many organisations, many individuals, in Wood Green, helping old people in very many ways. These 9 activities should be properly co-ordinated, overlapping should be avoided and existing gaps adequately filled. This, together with some focal point to which old people in need of any kind of assistance can apply for help, should go far towards a proper understanding of the problem and a fuller knowledge of the various ways in which it can be solved. No one can deny that this is one of the most urgent pressing problems facing us today Nor can one deny that the solution is by no means easy Indeed when one dwells on what is happening and thinks of the inexpressible misery and distress to which so many old folk are subjected.it sometimes appears that a national approach must soon be made. In the meantime, we must do what we can for the old folk in Wood Green. As I have already indicated, much is already being done If we can determine what more is required and how best out efforts can be expended we will have at least made a substantial contribution to this quite critical situation. Laboratory Facilities Once again, we did not have to call upon the Laboratory to any extent during 1955, owing to the absence of major outbreaks of infectious disease or any other untoward happenings. None the less, I would place on record my personal appreciation of the great help extended to the Public Health Department by the Director and staff of the Central Public Health Laboratory at Colindale and also by Mr. G. McGimpsey,the Bacteriologist in charge of the Branch Laboratory at Coppetts Wood Hospital This help has invariably been forthcoming in generous measure It has not only been of practical' assistance, but remains a safeguard upon which we know we can always rely Summary of work carried out at Central Public Health Laboratories for the year 1955:— Positive Negative Swabs for diphtheria bacilli — — Sputa for tubercle bacilli — 14 Throat and nose swabs 21 Faeces 246 Urine 4 Blood 6 Others 69 Ice Cream 29 Milk 14 Water (Swimming Pool) 5 10 NATIONAL ASSISTANCE ACT, 1948 (National Assistance Amendment Act, 1951) SECTION 47.- Removal to suitable premises of persons in need of care and attention. No action was taken by the Council in 1955 under this Section. NATIONAL ASSISTANCE ACT, 1948 SECTION 50,- Burial or Cremation of the Dead No burials were carried out by the Council during 1955. Two burials were carried out during the previous year. 11 SANITARY SERVICES Inspections Public Health Act, 1936 624 Housing Act, 1936 574 Rag Flock and Other Filling Material Act, 1951 2 Pet Animals Act, 1951 16 Factories and Outworkers 100 Food Preparing Premises 127 General Food Premises 532 Shops Act, 1950 206 Smoke Observations 34 Unsound Food 112 Complaints investigated 517 Interviews with owners, etc. 206 Re visits to property under notice 1,666 Infectious Disease cases 100 Food Poisoning 46 Special enquiries in connection with infectious disease cases 151 Aged and infirm persons 45 Miscellaneous 383 Pests Act 196 5,637 Housing Repairs and Rents Act, 1954 Certificates of Disrepair:- Granted 31 Rejected 3 Revocation of Certificates of Disrepair- Revoked 35 Rejected 5 Number of visits made in connection with above 80 Informal Notices served:- Shops Act 13 Complied with — Food & Drugs Act 16 ,, ,, 9 Public Health Act 289 ,, ,, 288 Housing Act 27 ,, ,, 31 Factories Act 8 ,, ,, 5 Pests Act 2 ,, ,, 1 Statutory Notices served:- Public Health Act 46 ,, ,, 29 Housing Act 5 ,, ,, 9 Factories Act — ,, ,, — Food & Drugs Act — ,, ,, 2 Housing Statistics 1. Inspection of dwelling-houses during the year:- (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 316 (b) Number of inspections made for the purpose 1,198 12 (2) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation. 1 (3) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head)found not to be in all respects reasonably fit for human habitation. 40 2. Remedy of defects during the year without service of formal Notices:- Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers. 319 3. Action under Statutory Powers during the year:— (l) Proceedings under Section 9,10 and 16 of the Housing Act, 1936:- (a) Number of dwelling-houses in respect of which notices were served requiring repairs 5 (b) Number of dwelling-houses which were rendered fit after service of formal notices:— (i) By Owners 5 (ii) By Local Authority in default of owners 4 (2) Proceedings under Public Health Acts:— (a) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied. 46 (b) Number of dwelling houses in which defects were remedied after service of formal notices: (i) By Owners 29 (ii) By Local Authority in default of owners — (3) Proceedings under Sections 11 and 13 of the Housing Act 1936:— (a) Number of dwelling-houses in respect of which demolition orders were made 1 (b) Number of dwelling-houses demolished in pursuance of demolition orders — (4) Proceedings under Section 12 of the Housing Act 1936:— (a) Number of separate tenements or underground rooms in respect of which closing orders were made — (b) Number of separate tenements or underground rooms in respect of which closing orders were determined the tenement or room having been rendered fit. — In no instance was it found necessary for legal proceedings to be taken. 13 Housing Applications The task of visiting housing applicants and the preparation of reports on their living conditions has been discontinued with the exception of certain cases where information is required by the Council's Housing Officer or by Housing Departments of outside districts, when a Wood Green resident is an applicant on their Housing List Several such visits were made by the Sanitary Inspectors during the year. I am happy to be able to report that the closest liaison exists between the Housing Section and the Public Health Department Scarcely a week passes but consultation takes place between both Departments in regard to housing applications. This particularly applies; of course, to cases in which there is a medical background especially cases of tuberculosis. It is very right that this co-operation should exist and it gives me great satisfaction to know that the weight of medical evidence invariably receives sympathetic and careful consideration. Housing Survey The preliminary survey of the Council's proposed clearance area was commenced during the latter part of the year. A full report on this will be included in a subsequent report. The Moselle Brook The investigation of the Moselle Brook, which was started in February 1954,, was concluded in June of this year. Mr. Bell, one of the two Sanitary Inspectors employed for this purpose resigned from the Council's employ on 30th April as the work was by that time nearing completion, it was not deemed necessary to replace him. The work was then pursued to its conclusion by Mr Goodfellow being assisted by two workmen from the Borough Engineer and Surveyor's Department. The method of procedure was identical to that carried out during 1954. I submit below a final summary of the work carried out. Besides the notices served to remedy defective drainage,advice was given to owners or their representatives at interviews. The necessary work was required to be done in accordance with the notices served. Re-inspections were made in all cases in order to ensure complete compliance with the notices. In this respect it was found necessary in a number of instances to make several calls. Letters have been sent by the Town Clerk to the owners of properties where notices are still outstanding. Houses tested Business premises tested Defective Rain Water to soil Prelim inary Notices Statutory Notices Re inspec tion ted W. Cs. Sinks Baths Wash hand basins 5,184 607 19 150 60 48 440 198 — 256 170 14 The Muswel1 Stream Investigation of this Stream was commenced in October of this year. The procedure used was identical to that of the Moselle Brook Survey with one exception, that is that the work was shared among all the Inspectors, as Mr. Goodfellow is now a District Inspector. Due to the depth of sewers in the area under survey, it was found necessary to postpone this work in early December until the Spring of next year since by 3 p.m. it was too dark to see the colour trace in the water. The Town Clerk wrote to the Lee Conservancy Board informing them of this and of our proposal to resume this most important work at the end of February 1956. Houses tested Business premises tested Defective Rain Water to soil Prelim inary Notices Statutory Notices Reins pection Com pleted W. Cs Sinks Baths Wash hand basins 864 24 — 34 8 9 — 38 — 15 10 Rodent Control Out of a total of 2,225 premises inspected throughout the year, it was found necessary to carry out treatment at 152 of them: 123 dwelling houses and 17 other premises were treated for rat infestation; a further 29 dwelling houses and 17 other premises were treated for the presence of mice. During the year 15 to 20 baiting points have been maintained on the Council's tip at White Hart Lane. The poison used in every case was "Warfarin". Where there is suspicion or evidence that the rats are coming from defective drains, the Sanitary Inspector is informed, a test with the smoke testing machine applied, and any necessary action taken. 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. In the second treatment the bait used was sausage rusk and the poison arsenic. Of the manholes baited, 434 showed pre-bait take, and 417 part-take of poison. There were no complete takes of poison, whilst the complete takes of pre-bait were 206. The sewer treatment was carried out in co-operation with the Borough Engineer and surveyor's Department. The Public Health Department employs a whole-time rodent operator who made 3,182 visits to premises during the year. Ponds and Rubbish Dumps These are regularly inspected with the object of preventing the breeding of insect pests. The pond in White Hart Lane is emptied and cleansed periodically by the Borough Engineer and Surveyor's Department, whilst that of Alexandra Palace is supervised by the Alexandra Palace Trustees. 15 Public Conveniences Fifteen public conveniences are available in the Borough, situated as follows:— Lordship Lane Station Road Albert Road Town Hall Park Chapman's Green Recreation Ground White Hart Lane Recreation Ground Albert Road Recreation Ground "Kings Arms" Hotel, N 22. "Prince of Wales" Hotel, N. 22 "Alexandra Tavern", N. 22 "Duke of Edinburgh", N, 22. "Springfield" Hotel, N. 11. "Ranelagh" Hotel, N. 11. "Seven Oaks", N.22. "Jolly Butchers" Hotel, N. 22. Conveniences provided by the London Transport Executive are also available to the public at Bounds Green Underground Station Regular inspections of all public conveniences are made by members of the Public Health Department staff These inspections include conveniences in our parks and open spaces and those provided for the use of the public in hotels and public houses. Defects are reported to the Borough Engineer and Surveyor's Department or are brought to the notice of the proprietors of the premises in which the public convenience in question is situated. 16 INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply The following licences for the sale of milk under special designations have been granted:- Tuberculin Tested 15 Pasteurised 21 Sterilised 39 Supplementary licences to sell milk from premises which are outside the area of the Licensing Authority:- Tuberculin Tested 11 Pasteurised 12 Sterilised 13 Fourteen 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 110 premises registered for retailing Ice Cream During the year, 92 visits were paid to these premises and 29 samples were submitted for bacteriological examination. Of these samples:- 25 were Grade I 2 were Grade II 2 were Grade III (c) Meat and Other Foods The undermentioned foodstuffs were certified as unfit for human consumption during the year:- lbs. lbs. Tomato Paste 560 Meat 60 Meat l,398¼ Fish 4 Fish 281 Vegetables 37 Nuts 249 Fruit 63 Sweets 15 Evaporated Milk 23 Jam 6 Soup 1 Cheese — Cream — 2,503¼ 194 Miscellaneous Items Eggs 1,718 Chocolate Bars 1,592 Meat and Fish Paste 2 Cakes, etc. 20 Cake Mixture 2 Fruit and Vegetables 1 Cheese 109 Condiments 1 17 (d) Inspection of Food Premises The following visits were made to food premises during the year and where defects were found the requisite steps were taken to have them remedied:- Butchers' Shops 102 Dairies and Milk Shops 54 Ice Cream Premises 92 Fried Fish Shops 6 Stalls 40 Other Food Premises 365 (e) Food and Drugs Act, 1955 As I mentioned earlier in this Report, the Food and Drugs Act 1955 came into operation on 1st January 1956 This Act is a consolidating measure It repeals the Food and Drugs Amendment Act, 1954 and consolidates it together with the Food and Drugs Act 1938,the Food and Drugs(Milk, Dairies and Artificial Cream) Act 1950 and certain other enactments amending and supplementing Part V of the 1938 Act. The Minister of Agriculture Fisheries and Food has used his powers to make Regulations under this Act. These are more sweeping than anything we have had before In consequence more work has divulged on the Public Health Department especially on the Sanitary Inspectors whose duty it is to ensure that these Regulations together with the parent Act are fully complied with. In the latter part of last year the preparatory work was already well under way, in readiness for the coming into operation of this Act. Middlesex County Council Act, 1950. Section IIRegistration of Hawkers of Food. Sixty-three hawkers of food in the Borough are registered. FACTORIES AND HOMEWORK 1. Inspections Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted FACTORIES WITHOUT mechanical power 40 36 — — FACTORIES WITH mechanical power 181 64 8 — OTHER PREMISES in which Section 7 is enforced by the local authority 2 2 — — Total 223 102 8 — 18 2. Defects Found Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. tor By H.M. tor Want of cleanliness 3 — — — — Overcrowding — — — — -— Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary conveniences (a) insufficient 1 1 — — — (b) unsuitable or defective — — — — — (c) not separate for sexes 1 1 — — -— Other offences against the Act (not including offences relating tQ outwork) 3 3 — 3 — Total 8 5 — 3 — 3. Outwork 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 Prosecu tions Wearing apparel: Making etc. 11 — — — — — Household linen 5 — — — — — Lace, Lace curtains and nets — — — — — — Curtains and furniture hangings 1 — — — — — Brass and Brass articles — — — — — — Artificial Flowers 7 — — — — — Feather sorting 12 — — — — — Cosaques, Christmas crackers and stockings 41 — — — — — Total 77 — — — — — 19 Water Supply The whole Borough is in the area supplied by the Metropolitan Water Board and every house has a constant supply. Rag Flock and Other Filling Materials Act, 1951 Three premises in the Borough are registered under the above Act, The premises are periodically visited and during the year four samples were taken and sent for analysis. The results were satisfactory. Pet Animals Act, 1951 Under the Act nine licences were renewed during the year after the premises had been inspected and found to be satisfactory. Establishments for Massage or Special Treatment Five existing licences under the Middlesex County Council Act, 1950 were renewed during the year. 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 Properties completed:— 38 dwellings at Bounds Green Road 21 flats at Eldon Road Council properties in course of construction at end of year:- 9 flats at Grosvenor Road 2 flats at Crescent Rise 18 flats at Granville Road 2 flats at Grainger Road 6 flats at Ellenborough Road 3 flats at New Road 1 house at Lordship Lane Private enterprise-completed or in course of construction at end of year:- 2 new houses at Alexandra Park Road 2 new houses at Cecil Road 2 new flats at Palmerston Road 2 new flats at Darwin Road 14 new flats at Westbeech/Bury Roads All on bomb damaged sites Swimming Baths The figures of attendances at Western Road and Durnsford Road Baths for the past two years are as follows:— 20 Western Road Baths 1955 1954 Swimming Bath 58,046 60,976 do. Children (Special sessions) 725 276 Children from Schools 24,797 25,130 Spectators 6,227 6,741 Slipper Baths 41,826 42,804 do. Old Age Pensioners (free) 2,089 1,282 Durnsford Road Open Air Baths Swimmers-Adults 29,356 6,257 Swimmers-Children 52,726 17,222 Children from Schools 1,321 2,993 Season Ticket Holders 31,155 14,762 Spectators-Adults 10,409 3,799 Spectators-Children 993 552 Samples of water were taken from both baths at regular intervals during the year The results of the tests were uniformly satisfactory. I would once again emphasise the great value of our Swimming Baths as health amenities of the very first order, I am quite certain that the large attendances particularly at our Open Air Swimming Bath during the summer of 1955 will have a most beneficial effect on health for some time to come. It is sometimes doubtful whether the true value of a swimming bath as an insurance policy for health is fully realized I am happy to think however that this fact is realized in Wood Green and that the many benefits to be derived from regular visits to our Swimming Baths needs no further recommendation in this Report. Collection and Disposal of Refuse The Borough Engineer and Surveyor, who is responsible for this service, reports as follows:- (a) Household refuse is collected weekly by vehicles operated on the relay system. (b) Trade and Special refuse is collected as and when required. Nine 12 cubic yard capacity Scammell Containers and two Mechanical Horses are used for collection of household refuse, and one Bedford Lorry for trade and special refuse. During the year 1954/55 the total tonnage of refuse collected was 13,472 tons: from this,material salvaged was sold for £1,788. The quantities or salvage were:- Tons Cwts. Qtrs Paper 212 3 2 Mixed Scrap Iron 12 13 2 Rags 1 0 0 The steam raised by the incineration of the refuse is used for space and water heating at Western Road Baths. 21 PREVALENCE AND CONTROL OF INFECTIOUS DISEASES From the table of infectious diseases set out on page 40 it will be observed that 852 cases were reported during the year as against 365 in 1954 The infectious sickness rate for the district was therefore 16 83 as compared with 7.14 for last year As I have mentioned on several occasions in the past, it is virtually useless to compare either the yearly totals of infectious diseases or the infectious sickness rate. Nowadays, apart from any spasmodic epidemics or outbreaks which may occur the infectious sickness rate is more or less governed by the number of measles cases reported in any twelve months During 1955, for instance, the total of 852 cases of infectious diseases notified during the year contained no less than 635 cases of measles i.e. 74.5% of the total The fact that measles occurs in epidemic proportions every second year, and the effect which this has on the infectious sick • ness rate, will be further seen when it is remembered that the total number of infectious diseases notified during 1954 was 365 and in 1953, which was an epidemic year so far as measles was concerned, 1,232. This is one of the ways in which the Annual Report of the Medical Officer of Health has materially changed since before the war Then neither measles nor whooping cough was notifiable so that it was quite possible to draw fair and accurate comparisons between the infectious sickness rate produced each year That has now gone by the board, although of course, it is still possible and sometimes very illuminating, to compare the individual totals of the various notifiable infectious diseases as they occur year by year This is especially valuable if one compares these totals over a period of 10 15 or 20 years when the trend can be very clearly seen. The Council will also remember that on more than one occas ion I have remarked that the general significance of infectious diseases has completely altered in the last few decades In 1930 the word fever- was dreaded by all mothers who knew only too well the type of illness which might result and which might be followed by quite disastrous consequences Nowadays, although an infectious disease can visit a child or an adult with considerable severity and although some infectious diseases, especially the new virus diseases and particularly poliomyelitis are still frought with considerable peril, the whole pattern has been re assembled Infectious diseases have ceased to bring wholesale dread to a family: indeed there is now the contradictory fear that parents are sometimes apt to treat them much too lightly Although it is certainly a fact that today, and at least in Wood Green , infectious diseases have ceased to be a killing or even an incapacitating factor in more than a minute proportion of the population, they should still be treated with due respect. We do not know when virulence may change, we cannot say how long we will remain immune from serious illness or harmful after-effects. For that reason, although it sometimes appears as though we were spending an unnecessary amount of time on precautionary measures and on investigating contacts and "carriers", this is not really the case. We have been able to modify our standard procedure to 22 a certain degree, especially in the matter of intestinal infections such as Sonne Dysentery, but the basic principles upon which our control of infectious diseases has its foundation cannot, indeed should not, yet be altered There is also the known fact that the terra "epidemiology" which, broadly speaking covers the incidence and spread of disease, is no longer concerned solely with the infectious element. We want to know-and how desperate our need for knowledge isthe reason behind the comparatively sudden increase in the incid ence of cardiac illness and lung cancer and the even more tragic increase in deaths from the same types of diseases. We also lack information on the types of illness which are more particularly prevalent among the population in different age groups in both sexes, and in different occupations At present, our information is availaele only from general practitioners, from death certificates and in part at least, from the Ministry of Employment and National Insurance On paper this may sound very well.Actually, the information we receive can only be fragmentary and is often out of date before it comes to hand When and only when this problem is tackled as it deserves to be tackled, as it must be tackled, can it be truly said that we are covering the field of epidemiology in an adequate manner, I have already remarked that so far as Wood Green is concerned, it does appear at least on the surface, that there are no specific conditions within the Borough which encourage special diseases. This however is not enough A health programme which is to be successful can only be planned and brought to fruition if the fullest possible informa tion is in the hands of those whose duty it is to perform this quite substantial task Need I say that this problem has not es caped notice, that only the gigantic nature of the problem itself, and the obvious difficulties in surmounting the known obstacles have so far prevented ready solution. It is to be hoped however, that,the .part which the epidemiologist of the future can play in regulating health and preventing disease will soon be even more fully and readily appreciated by all who have a part to play in this great, this fundamental task. Diphtheria For the eighth year in succession no case of diphtheria was notified in the Borough The last death took place in 1939 The immunisation programme carried out in Wood Green by the Middlesex County Council has only been altered in minor respects to ensure that maximum use is being made of scientific advances Although it is difficult to obtain precise figures as to the percentage of children protected against diphtheria by immunisation in Wood Green,-it is clear that this figure must be well over 60% so far as children up to the age of two are concerned. Indeed, the latest figures available showed the percentage to be somewhere in the region of 68%, When it is remembered that every child in Wood Green attending a private or maintained school is offered a reinforcing or a boosting" dose of immunising material when he or she enters school, and that the invitation is repeated when the child reaches the age of ten,and when it is further remembered that the percentage of parents taking advantage of these offers 23 is very high indeed, it can, I think be claimed that the possibility of a diphtheria epidemic or even a limited outbreak among Wood Green children is definitely low. Scarlet Fever Twenty-six cases of scarlet fever were notified during the year, as against 61 in 1954. The totals for the past four years have been 93, 66, 61 and 26 respectively. Acute Anterior Poliomyelitis Five cases of acute anterior poliomyelitis were notified in 1955 as against one case during the previous year. Of these four cases, three were paralytic and one non paralytic, The number of cases notified during each of the previous 5 years was 1, 3, 6, 1 and 4. It will now be common knowledge that a scheme for inoculating certain age groups against poliomyelitis has been drawn up,using the British type vaccine which is said to be in advance of any vaccine yet used in other parts of the world At the time of writing this report 116 Wood Green children have already been inoculated with no untoward effects of any kind Inoculations are, of course being carried out by Area Health staff, but I know that the Council will await with interest the results of the first batch of inoculations when these are available. Measles As noted elsewhere,635 cases of measles were notified during the year as against 29 cases in 1954 Admission to hospital was not required in any case, again an indication of the mild character of the disease Pertussis (Whooping Cough) Twenty eight cases of pertussis were notified during the year as against 80 in 1954 The fall in the incidence of this disease will be shown when the figures appertaining to the past five years are considered. These were 127 89 202 80 and 28 respectively. It may be that the widespread adoption by parents of the com bined method of immunisation for their children is having an effect, This combined method, whereby children can be inoculated against diphtheria and pertussis at the same time has been more or less accepted by parents attending County Council clinics as standard procedure I understand from general practitioners that they are finding the same thing It would certainly be dangerous to draw any lasting conclusion from the figures set out above but they are at least heartening and would seem to show that pres ent policy can be justified. Food Poisoning (including Sonne Dysentery) Twenty-seven cases of food poisoning and 34 cases of dysentery were reported in 1955, as against totals of 24 and 41 respectively during the previous year. I would, however, repeat the warning which I have sounded on several occasions previously, that these totals may be highly deceptive. We can be sure of only one thing, 24 that they do not represent the total number of cases of food poisoning and dysentery which have occurred during the period under review, On the other hand, they are useful for comparative purposes,and should at least show the average incidence of these diseases within the Borough. The scheme set out in my annual report for 1954 relating to the exclusion of cases of diarrhoea, with or without sickness from school has worked very well indeed. I am now satisfied that it does allow us to control the spread of such diseases as dysentery and winter vomiting without in any way dislocating the timetable of a school. Minor difficulties were encountered from time to time but on the whole the present system seems to be a great improvement on older methods, which took up a great deal of the time of Sanitary Inspectors and resulted in most instances, in what was sometimes an alarming degree of absences from school. I have therefore had no hesitation in continuing our present procedure, at least for the time being. Para-typhoid Fever Two cases of para-typhoid fever were notified during 1955 So far as we can ascertain, these cases were associated with Chinese Egg products. The Council will remember that I reported these cases fully to the Public Health Committee and that the necessary investiga tions, including the supervision of contacts, threw a considerable additional burden on the Public Health staff, especially the Sanitary Inspectors. The matter was also taken up with the Ministry of Health and with the Central Public Health Laboratory, from whom we received the greatest assistance in typing the responsible organisms. Although this does not strictly fall under the heading of Para typhoid Fever", it may be mentioned here that other batches of Chinese Egg products were encountered which contained Salmonella organisms (among which the organism responsible for para-typhoid fever is included). This was to say the least, disturbing Since the first cases were reported,we have made a strict point of investigating all batches of Chinese Egg products which we were informed had been sent into the district. In several instances, we asked that the products, which after examination were found to contain Salmonella organisms, be sent back to the point of distribution. I am glad to say that in every case,we received the full co-operation of the local firms which were using the products. I further understand that steps are now being taken to ensure that all Chinese Egg products will be treated, if there is reason to believe that they contain disease-producing organisms. No further cases of para typhoid fever or of any other type of food poisoning, traceable to Chinese Egg products have been reported in Wood Green, It cannot yet be said, however, that the last has been heard of this matter. Puerperal Pyrexia No case of puerperal pyrexia was notified during the year, as was the case in 1954.This is a sure indication of the tremendous improvement which has taken place within recent years in antenatal supervision, midwifery and the timely and effective use of antibiotics, 25 Smal1 pox No case of smallpox occurred In Wood Green during 1955.Indeed, for the first time in many years no doubtful cases were reported Once again. I am happy to report that the number of mothers seeking vaccination for their infants at Child Welfare Centres in Wood Green shows a very welcome increase. The latest figures which I have produced for submission to the County Council show that the number of children under the age of one, who have been protected against smallpox, is now more than 50%. This figure is very much higher than could have been claimed only a few years ago nd shows, I feel, the value of true health education It also points to the fact that in Wood Green, we are extremely fortunate in having the type of mother who appreciates the value of such scientific measures as vaccination, Tuberculos is Sixty seven cases of tuberculosis (61 pulmonary 6 non pulmon ary) were notified during the year, as against 94 cases in 1954 Of the 67 cases, 11 were transferred from other districts, 56 being new cases. A broad classification of the new notifications during the past three years in relation to employment was: 1953 1954 1955 Clerical 12 16 12 Manual Labour 23 14 17 Housewives 11 20 8 Factory Workers 4 7 - Children 4 5 5 Professional classes 4 1 2 Domestic Service - - 2 Nurses - - 1 Shop.Assistants 2 8 4 Armed Forces - - 2 Retired Persons 3 2 2 Unclassified 8 8 1 71 81 56 The number of cases on the register at the end of the year was as follows:- Pulmonary 287 males Non-pulmonary: 10 males 252 females 39 females Total 539 Total 49 It will be seen that the number of new tuberculosis cases notified dropped from 81 in 1954 to 56 in 1955.1 would again emphasise, however, that these totals are much too small to allow of any significant conclusions being drawn We still continue to work in very close harmony with the Tottenham Chest Clinic.All families in which a case of tuberculosis or suspected tuberculosis has occurred, and where the Chest Clinic consider that adequate housing is essential, both from a 26 point of prevention and cure are brought to ray notice, I place the facts before the Housing Section, and am particularly happy to be able to report that in every instance, my statements have been carefully and most generously considered Although I know how difficult the housing situation is in Wood Green I feel that I must always bring the need of these families to the notice of the Housing Committee. It must be remembered that not only is it so very obviously humane to treat a case of tuberculosis with special consideration there is the remaining and most important desideratum, the possible spread of infection from a case of tuberculosis living in unsatisfactory and over-crowded conditions. As I have stated so often this is the most important way in which a Borough Council can be of practical assistance to the Chest Clinic, and to the Borough itself in limiting the spread of infection, apart, that is, from the well-ordering of the Borough and the provision of sufficient open spaces As I say, I have brought this matter to the notice of the Housing Committee on many occasions and am sincerely glad to say that I have always been given a most sympathetic hearing The Borough of Wood Green has an excellent reputation in the matter of helping tuberculous families having regard to the limited housing accommodation at the disposal of the Council, I have already mentioned this fact in several previous Reports I make no apology for paying a further tribute to the efforts made in Wood Green to assist in checking this serious disease. Mass Radiography Unit 6A did not visit Wood Green during 1955, I have however, a firm promise from the Unit that Wood Green will be visited during 1956 Indeed as I write this Report, arrangements are in hand to select a suitable site and to institute the necessary publicity, DISINFECTION AND DISINFESTATION The number of articles dealt with at the Disinfection Station was as follows;- Articles disinfected 128 Articles destroyed 64 39 rooms were disinfected on account of infectious disease 63 rooms were disinfested on account of the presence of vermin, 60 premises were treated for infestations of cockroaches,wasps, ants, flies, fleas beetles and moths. 98 library books were brought to the Department during the year for disinfection. 27 28 INFECTIOUS DISEASES FOR THE PAST 25 YEARS Year Diphtheria Scarlet Fever Enteric Fever Pulmonary Tuberculosis Non pulmonary Tuberculosis Measles Pertussis Poliomyelitis /N *D /N *D /N *D /N *D /N *D /N *D /N *D /N •D 1931 39 1 97 1 1 - 58 35 9 8 1 3 - - 1932 33 1 110 - 3 - 41 37 15 4 3 3 2 - 1933 24 1 192 - - - 57 26 9 6 1 1 - 1934 31 3 292 - 1 - 56 32 12 3 1 2 1 - 1935 39 4 201 1 4 - 47 23 5 1 - - 1 - 1936 99 12 98 - 5 - 51 46 8 5 2 2 2 - 1937 46 3 72 1 2 - 49 24 8 2 1 5 2 - 1938 63 2 92 - 1 - 59 21 10 7 3 - 1 - 1939 24 1 63 - - - 45 26 6 2 - 1 2 - 1940 26 - 61 - 7 - 55 22 10 4 89 - 24 2 - - 1941 42 - 51 - 2 - 57 26 7 4 401 2 192 1 1 - 1942 22 - 87 - - - 69 30 4 4 361 2 95 1 1 - 1943 26 - 155 - - - 43 22 3 3 356 - 106 1 - - 1944 9 - 51 - - - 44 20 5 4 232 - 134 1 1 - 1945 2 - 62 - 2 - 56 27 7 4 172 - 117 - 2 - 1946 7 - 73 - 1 - 76 22 10 3 346 - 89 - - 1 1947 10 - 46 - - - 52 17 10 5 410 2 171 - 2 - 1948 - - 69 - - - 65 21 9 5 408 - 174 - 5 1 1949 - - 71 - 2 - 68 19 9 - 678 - 46 - 6 1 1950 - - 99 - 1 - 57 10 6 2 421 - 376 1 4 - 1951 - - 196 - 1 - 50 13 5 2 434 - 127 1 1 - 1952 - - 93 - - - 36 5 4 1 449 - 89 - 3 - 1953 - - 66 - - - 64 5 7 2 778 - 202 - 6 2 1954 - - 61 - - - 73 6 8 1 29 - 80 - 1 - 1955 - - 26 - - - 51 6 5 1 635 - 28 1 5 ~ / - Notifications *D - Deaths APPENDIX I CLEAN FOOD CAMPAIGN Specia1 Report to Pub1ic Health Committee dated 29th September, 1955 Set out below is a list of the expenses incurred in running the Clean Food Campaign held in August last.As the Committee will note, the total expenses were well under the £125 originally allocated for this effort - Item • Firm or Authority concerned Cost £ s d Posters (1) Floyd Studios 8. 15. 0 (2) Mercy Signs 13 0. 0 Press Advertising (1) Wood Green Herald 2. 16. 0 (2) North London Observer 2. 16 0 (3) Muswell Hill Record 3. 0. 0 3 000 Leaflets ) Town Hall 9, 18 0 5,000 Bookmarks ) 5. 10. 10 Timber paint, etc Tripp 6. 12 2 Pares and Sundries 1. 7. 2 Corrugated Cardboard Abbotts 5. 14 0 Gummed Labels Barnard & Crannis 3. 0. 0 Lantern Slides Morgans Slides Ltd. 9. 6 Insurance Municipal Mutual Insurance 1. 17. 2 Hire of Films Central Film Library 7. 15. 0 Electrical Work Eastern Electricity Board 9. 16 6 Wages of Projectionist Southgate Borough Council 32 9. 0 Topic Central Council for Health Education 2. 0. 0 Direct Labour Work Wages £2 15 10 plus (25% on cost) 14s . 3. 9. 10 Materials 4. 0 Haulage 4. 4. 0 124 14. 2 Less Cable sold to Surveyor's Department (75%) 5. 0. 0 £119. 14. 2 29 As the Committee will be aware, our Clean Pood Campaign was officially held from 8th 26th August apart from visits to local organisations since that time Set out below is a brief resume of the activities included in this Campaign: - Publicity Full publicity was given to the Campaign by way of street banners, signposts posters advertisements and articles in the local press cinema slides letters and leaflets to all food shops the distribution of book marks through the libraries, leaflets distributed from the Town Hall. Libraries, Public Health Department Area Health Office Welfare Centres and Clinics to gether with labels on all envelopes leaving the Town Hall Libraries and White Hart Lane (Old) School In addition to the measures set out above, the Sanitary Inspectors paid personal visits to all food shops and premises throughout the Borough Clean Food Exhibition The Clean Pood Exhibition was arranged in two rooms at White Hart Lane (Old) School from the 8th 26th August, being open from 10 00 a.m. to 9.00 pm daily with the exception of Sundays The Exhibition was open to the general public The attendance during the three weeks at the Exhibition was approximately 3 075 an average of 181 a day. The first three days were most gratify ing with an average attendance of over 310 After that there was a steady decline though the numbers improved again towards the latter end of the third week. Film Shows and Talks A Film Show and Talk was given each afternoon and evening Attendances at these shows were good some people attending more than one talk. Throughout the period approximately 780 people attended these informal talks, an average of 23 at every show Thirteen different films were shown during the Campaign The Exhibition was visited by the Mayor and Members of the Council Mr Morley Parry. Food Hygiene Advispry Officer to the Ministry of Health Mr. Capstick, a Director of tne United Dairies members of the staffs of other Public Health Departments and representatives of various interested parties Comments were favourable, Mr. Capstick,who makes a point of visiting all such exhibitions, commented to members of the press that it was one of the best and most comprehensive exhibitions of its kind he had seen. I am satisfied that the Clean Food Campaign was justified and that the results warranted the very modest expenditure incurred The attention of the burgesses and food handlers alike was drawn to the principles of food hygiene All those who helped in any way have already been thanked, but I should like to take this opportunity of expressing my personal appreciation to the editors of our local press and to the other Committees and departments of the Borough Council who helped our effort. I would particularly like to thank the Sanitary In spectors, and Mr. P. V. Ingram, who, under the very capable leadership of Mr McCauley, organised and manned the Exhibition It 32 will be obvious that a great deal of thought and time had to be spent, not only in preparing the Campaign and Exhibition, but also in giving the talks and demonstrations The Sanitary Inspectors and Mr, Ingram all undertook a substantial amount of evening duty, this time being willingly and cheerfully made available. 33 34 APPENDIX ? TABLE 1 Vital Statistics of Wood Green, 1935-55 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) 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 52,700 624 11.8 25 21 34 2 83 594 11.7 and 50,700 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 1952 52, 080 654 12 5 33 14 21 2 60 602 11.5 1953 51, 470 600 11.6 23 17 28 3 130 517 10. 04 1954 51,090 564 11. 03 25 15 26 0 - 533 10. 4 1955 50,610 592 11.7 17 14 23.6 1 58.8 519 10.3 TABLE 11 Causes of death during the year 1955 Causes of Death Male Female Tuberculosis respiratory 4 2 Tuberculosis, other 1 - Syphilitic disease - - Diphtheria - - Whooping Cough - 1 Meningococcal infections - - Acute Poliomyelitis - - Measles - - Other infective and parasitic diseases - - Malignant neoplasm, stomach 5 5 Malignant neoplasm, lung bronchus 26 1 Malignant neoplasm, uterus - 3 Malignant Neoplasm, breast - 9 Other malignant and lymphatic neoplasms 23 33 Leukaemia, aleukaemia 1 1 Diabetes 1 - Vascular lesions of nervous system 32 48 Coronary disease, angina 59 46 Hypertension with heart disease 3 5 Other Heart diseases 20 32 Other circulatory disease 7 12 Influenza - - Pneumonia 9 12 Bronchitis 36 12 Other diseases of respiratory system 1 3 Ulcer of stomach and duodenum 2 Gastritis, enteritis and diarrhoea - - Nephritis and nephrosis 2 1 Hyperplasia of prostate 2 - Pregnancy childbirth abortion - - Congenital malformations 1 3 Other defined and ill defined diseases 12 24 Motor vehicle accidents 2 4 All other accidents 3 3 Suicide 3 - Homicide and operations of war - 4 Totals 255 264 35 TABLE 11A 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 4 - - - - - 1 1 1 1 - _ Tuberculosis other 1 - - - - - 1 - - - - Syphilitic disease - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - Measles - - - - - - - - - - - - Other infective and parasitic diseases - - - - - - - - - - - - Malignant neoplasm stomach 5 - - - - - 1 - 2 1 1 - Malignant neoplasm. lung bronchus 26 - - - - - 1 3 10 5 4 3 Malignant neoplasm, breast - - - - - - - - - - - - Malignant neoplasm uterus - - - - - - - - - - - - Other malignant and lymphatic neoplasms 23 - - - - 1 - 2 4 5 6 5 Leukaemia, aleukaemia 1 - - - - - - 1 - - - - Diabetes 1 - - - - - - - - - 1 - Vascular lesions of nervous system 32 - - - - - 1 3 2 7 8 11 Coronary disease, angina 59 - - - - - - 2 6 10 27 14 Hypertension with heart disease 3 - - - - - - - - - 1 2 Other heart diseases 20 - - - - - - - 1 4 9 6 Other circulatory disease 7 - - - - - - - 3 2 2 - Influenza - - - - - - - - - - - - Pneumonia 9 3 - - - - 1 - - 3 1 1 Bronchitis 36 1 - - - - - - 2 8 16 9 Other disease of respiratory system 1 _ - _ _ _ _ _ _ 1 - - Ulcer of stomach and duodenum 2 - - _ _ _ _ _ 1 _ 1 _ Gastritis, Enteritis and Diarrhoea - - - - - - - - - - - - Nephritis & nephrosis 2 - - - " " 1 - - - 1 - Hyperplasia of prostate 2 - - - - - - - - - 1 1 Totals carried forward 234 4 - - - 1 6 13 32 47 79 52 36 TABLE 11A (Cont'd) 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 brought forward 234 4 - - - 1 6 13 32 47 79 52 Pregnancy childbirth abortion - - - - - - - - - - - - Congenital malformations 1 1 - - - - - - - - - _ Other defined and illdefined diseases 12 3 2 1 _ _ _ 1 1 4 _ _ Motor vehicle accidents 2 - - - 1 - - - 1 - - - All other accidents 3 - - - - - - - 1 - 2 " Suicide 3 - - - - - - - 1 1 1 - Homicide and operations of war - - - - - - - - - - - - Totals 255 8 2 1 1 1 6 14 36 52 82 52 37 TABLE 11B 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 2 - - - - 2 - - - - - - Tuberculosis, other - - - - - - - - - - - - Syphilitic disease - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - Whooping Cough 1 1 - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - Measles - - - - - - - - - - - - Other infective and parasitic diseases - - - - - - - - - - - - Malignant neoplasm stomach 5 - - - - - - - 2 1 2 _ Malignant neoplasm lung bronchus 1 - - - - - - 1 _ _ - - Malignant neoplasm breast 9 - - - - - - 1 3 - 3 2 Malignant neoplasm, uterus 3 - - - - - - - 1 1 1 - Other malignant and lymphatic neoplasms 33 - - - - - - 1 3 6 16 7 Leukaemia aleukaemia 1 - - - - - - - 1 - - - Diabetes - - - - - - - - - - - - Vascular lesions of nervous system 48 - - - - - - 3 7 10 16 12 Coronary disease angina 46 - - - - - - 1 1 4 13 27 Hypertension with heart disease 5 - - - - - - - - 3 1 1 Other heartdiseases 32 - - - - - - - 1 3 9 19 Other circulatory disease 12 - - - - - - - - 3 5 4 Influenza - - - - - - - - - - - - Pneumonia 12 - - - - - - - 1 1 3 7 Bronchitis 12 - - - - - - - 2 1 3 6 Other disease of respiratory system 3 - - - - - - - - - 2 1 Ulcer of stomach and duodenum - - - - - - - - - - - - Gastritis, Enteritis and Diarrhoea - - - - - - - - - - - - Nephritis and nephrosis 1 - - - - - - - 1 - - - Hyperplasia of prostate - - - - - - - - - - - - Totals carried forward 226 1 - - - 2 - 7 23 33 74 86 38 TABLE 11B (Cont'd.) 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 brought forward 226 1 - - - 2 - 7 23 33 74 86 Pregnancy Childbirth. Abortion - - - - - - - - - - - - Congenital malformations 3 3 - - - - - - - - - - Other defined and illdefined diseases 24 2 1 _ - 1 2 1 - - 9 8 Motor vehicle accidents 4 - - - - - - - 2 1 1 - All other accidents 3 - - - - - - - - - 2 1 Suicide - - - - - - - - - - - - Homicide and operations of war 4 - 1 1 - - 1 - - - 1 - Totals 264 6 2 1 - 3 3 8 25 34 87 95 39 40 TABLE III Infectious Diseases Notified during the year 1955 Notifiable Disease Cases Notified in Whole Borough Total Cases Notified in each Ward Total Cases removed to Hospital or Sanatorium Total Deaths All Ages At Ages - Years 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 35 to 45 years 45 to 55 years 55 to 65 years 65 and upwards Alexandra Bowes Town Hall Noel Park Scarlet Fever 26 1 10 10 5 - - - - - - - 11 8 7 15 - Diphtheria - - - - - - - - - - - - - - - - - Cerebro-Spinal Fever 1 1 - - - - - - - - - - 1 - - 1 - Enteric Fever - - - - - - - - - - - - - - - - - Para-typhoid Fever 2 - - 2 - - - - - - - - 2 - - 2 - Erysipelas 2 - - - - - - - - - 1 1 - 1 1 - - Pneumonia 36 1 - 2 1 - 3 1 9 4 7 8 11 9 16 2 21 Acute Poliomyelitis 4 1 1 1 - 1 - - - - - - 2 - 2 4 - Polio encephalitis 1 - - 1 - - - - - - ~ - - 1 - 1 - Puerperal Pyrexia - - - - - - - - - - - - - - - - - Pulm. Tuberculosis 51 - 1 1 3 5 12 7 10 4 6 2 16 20 15 25 6 Non Pulm Tuberculosis 5 - - - - - 2 1 1 1 - - 2 1 2 2 1 Malaria - - - - - - - - - - - - - - ~ - - Measles 635 10 244 370 5 1 3 1 1 - - - 205 191 239 18 - Whooping Cough 28 3 16 9 - - - - - - - - 6 10 12 3 1 Ophthalmia Neonatorum - - - - - - - - - - - ~ - - - - - Dysentery . 34 - 8 5 4 1 3 4 2 3 1 3 12 10 12 6 - Food Poisoning 27 1 1 2 1 2 1 7 6 2 1 3 5 15 7 2 - Totals 852 18 281 403 19 10 24 21 29 14 16 17 273 266 313 81 29 TABLE IV TUBERCULOSIS Tuberculosis Register Pulmonary NonPulmonary Total M F M. F. No of cases on Register at end of 1954 269 242 11 35 557 New cases notified during 1955 29 21 1 5 56 Transfers from other Districts 8 3 - - 11 No of cases removed from Register 19 14 2 1 36 No of cases on Register at end of 1955 287 252 10 39 588 New Cases and Mortality during 1955 Age Periods New Cases Deaths Respiratory Non • Respiratory Respiratory NonRespiratory M F M. F. M F. M. F 0 - - - - - - - - 1 - 1 - - - - - - 5 2 3 - - - - - - 15 9 11 - 3 - - - - 25 7 3 - 1 - - - - 35 6 3 1 - - - - - 45 4 2 - 1 - - 1 - 55 7 1 - - 2 1 - - 65 and upwards 2 - - - 2 1 ~ - Totals 37 24 1 5 4 2 1 - Above includes transfers (11) from other districts. 41 APPENDIX 3 Mi seel 1aneous (a) Letters to Doctors The following letters were sent to practitioners during 1955:- January Influenza, Influenzal meningitis and meningismus February Puerperal Pyrexia (Amendment) tions 1954 July Notification of Infectious Diseases August 2 letters notifying cases of elitis September Paratyphoid "B" Fever. October Mass Radiography Notification of case of Poliomyelitis December Thanks for co-operation through-out the year and Annual Report 1954 Notification of case of Poliomyelitis Exclusion from work - Infectious Diseases, (b) Medical Examinations During the year 58 medical examinations were carried out Twenty of these were in respect of entrants to the Council s employ for acceptance into the Superannuation Scheme 15 in respect of workmen in the Council's employ for acceptance into the Superannuation Scheme and 23 in respect of workmen for acceptance into the Sickness Pay Scheme, In addition, 28 medical reports were issued relating to employees absent from duty through sickness 42 Printed and Published by Wood Green Borough Council Torn Hall, :: :: N. 22.