LIBRARY BOROUGH OF WOOD GREEN ANNUAL REPORT of the Medical Officer of Health for the Year 1960 WM. CLUNIE HARVEY, M.D.D.P.H. Medical Officer of Health. BOROUGH OF WOOD GREEN ANNUAL REPORT of the Medical Officer of Health for the Year 1960 WM. CLUNIE HARVEY, m.d.,d.p.h. Medical Officer of Health. Public Health Department, Town Hall, Wood Green, N. 22. July, 1961. To THE MAYOR, ALDERMEN and COUNCILLORS Of the BOROUGH OP WOOD GREEN. Mr. Mayor, Ladies and Gentlemen, I beg to present my Annual Report for 1960. The year 1960 was a placid year with few, if any, highlights so far as infectious diseases were concerned. The total number of cases notified during the year again fell - from 360 in 1959 to 229 in 1960 - one of the lowest totals yet recorded in the Borough. This, of course, was mainly due to the lowest number of measles cases known to have been recorded, there being only 21 cases notified compared with 169 during the previous year. It is most satisfactory to be able to record a year in which infectious diseases played such a minor part in the life of the community. These matters will be referred to in greater detail in the body of the report. As I have commented before, however, epidemiology is no longer concerned merely with infectious diseases but embraces any condition or number of conditions prejudicial to health or, to put this in another way, conditions which are capable of causing impaired health or actual disease. Generally speaking,Wood Green is extremely fortunate in its character and amenities It is still our duty nevertheless to make a careful search for any conditions hidden or disclosed,which are detrimental to the health and wellbeing of the community. I need scarcely emphasise, however, that it is infinitely easier to prevent the setting up of such conditions than to remove them once they have become established. For this reason I have pursued a policy of bringing before the Health and Cleansing Committee all matters affecting the health of the Borough. In this connection I count myself extremely fortunate that the Health Committee has always studied my statements or reports with the care which one has come to expect from the Wood Green Borough Council. I think it is true to say that, unless the Health and Cleansing Committee can be supplied with the fullest information, the Medical Officer of Health cannot expect that constant support without which success can never be attained. The vital statistics for the year are also satisfactory. The birth rate of 15.2 again showed an increase over the rate of 1959 (14.2), 724 live births being registered as compared with 676 in 1959. This represents the highest number of live births since 1949. The rate for the County (15.7) is the highest since 1949 but is still lower than that for the country as a whole (17.1). The death rate has again fallen, from 12.4 in 1959 to 11.5. The 3 infantile mortality rate i.e. the death of infants under the age of one year, rose from 20 71 to 30.4. I would however again stress that the totals involved are much too small to provide us with yearly variations which can be accorded any real significance. I would once more emphasize that every infant death is carefully investigated in an effort to discover the cause and, if possible. suggest the appropriate remedy. The vital statistics for 1960 as I have said, indicate a placid year with no major occurrences. Taking a long-term view and considering every relating aspect of health, 1960 can, I suggest, be regarded as a satisfactory year. The significance of health education in the vast field of public health is now an established fact. In the latter part of 1960 a 16mm. film projector was purchased by the Council for health education This is proving of immense value as a positive method of health propaganda, since it is already a proven fact that local organisations will invite a speaker if they know that his talk will be supported by the showing of a film more readily than if the speaker intended to give a talk only. The public generally speaking is still to a great extent oblivious of the work being carried out in the sphere of public health on its behalf. That is why health education has such a vital role to play. The fruits of this work are shown by the very large numbers of the public who have taken advantage of poliomyelitis immunisation. Every method of bringing to the public factors of topical interest must be pursued; and every endeavour, by all means available, must be made to stress the fundamental principles upon which the healthy individual and community are based. Health education is as far as possible projected at those age groups and sections of the community which are most in need of it, without making the cardinal mistake of always speaking to the converted and so neglecting those groups which are most difficult to reach. Our programme of health education in Wood Green is, I venture to say reasonably comprehensive. During the year, at the Wood Green Horticultural Show, a Mass X-ray Unit and Mobile Polio Clinic was sited in the Show grounds. This, so far as we are aware had never been tried anywhere before, and proved an immense success I would take this opportunity of thanking the Health and Cleansing Committee and the Council for their sustained help and encouragement, without which our programme of health education could never have been carried out. I am satisfied that we are working along the right lines, although I am not convinced that we have yet fully explored all available avenues. We will continue our policy of exploration until we can be reasonably sure that the public is fully informed on all matters concerning their health and well-being- the terms are not synonymous - and that no section of the community has been overlooked. As Medical Officer of Health, I was extremely glad when I 4 learnt that the Chief Clerk of the Public Health Department had been appointed as Secretary to the newly constituted Home Safety Committee. Home Safety is something in which the Public Health Department must obviously be interested, very keenly interested, Mr. Ingram's appointment means that the work of home safety can be closely integrated with the general work of the Public Health Department. This will undoubtedly be of benefit, and should ensure that an important phase of modem life comes more closely within the ambit of public health Although this does not come strictly within the province of my Annual Report for 1960 I feel that I should make mention here of the very sad loss which was sustained by the death of Dr. Malcolm Manson in June 1961. Dr, Manson took up his duties as Medical Officer of Health of Wood Green in 1928 and continued these duties until his retirement in 1952. It would be a truism to say that Dr. Manson was a first-class Medical Officer of Health, conscientious, progressive, always willing to receive and adapt new ideas, ever watchful for the health of the community and of the individuals who resided or worked in Wood Green. Dr. Manson's magnificent contributions during World War II will need no reminder from me. Altogether, I can think of no other Medical Officer of Health who served his district more ably for so many years. I have already thanked the Aldermen of the Council, including most especially the members of the Health and Cleansing Committee, for their continued support and encouragement. I would be failing in my duty if I did not do so once again. Nothing is of greater importance to the work of a Medical Officer of Health Indeed, the efforts of any Medical Officer of Health can be made or marred by the help he receives from his Council and Health Commi ttee. I would again express my sincere thanks to the staff of the Public Health Department for their continued loyalty and support. I would make particular reference in this connection to the able assistance rendered by Mr McCauley, Chief Public Health Inspector, and Mr. P. V. Ingram, Chief Clerk in the Public Health Department. I would also thank my Deputy Dr. Campbell, for her unfailing loyalty and assistance at all times, I have particularly mentioned Dr. Campbell, Mr. McCauley and Mr, Ingram, but my thanks are due to all members of the staff, a staff which can be regarded as a team in the truest sense of the word. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, W. C. HARVEY, Medical Officer of Health. 5 BOROUGH OF WOOD GREEN HEALTH AND CLEANSING COMMITTEE Councillor C.D. MOSS (Chairman) Councillor Mrs. L. A. ANGELL (Vice-chairman) The Mayor, Councillor C. W. BUCKBY J, P. Councillor J. A. CATON Alderman R G. KENDALL Councillor E. C. HALE Councillor G. CATHLES Councillor E. E. NICE Councillor J. D. REED 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 Public Health Inspector - W. McCAULEY, Cert. R. San, Inst. and San. Insp. Joint Board, Cert, Meat and Food Inspection. Public Health Inspectors - F. JAMES, Cert R San. Inst., and San, Insp. Joint Board, Cert. Meat and Food Inspection, Cert. R. Soc. of Health, Smoke Inspector W. E, GOOD FELLOW. Cert. R, San, Assoc. of Scotland, Cert. Meat and Food Inspection and Cert. R. Soc. of Health, Smoke Inspector H. J. BAILEY, Cert. R San. Inst, and San. Insp. Joint Board, Cert. Meat and Food Inspection: J, E JONES Cert. R. San. Inst. and Cert. Meat and Food Inspection. Chief Clerk, - P. V. INGRAM General Clerks. - Miss J. W, POPE, Shorthand-Typist. R. W SHADBOLT Rodent Operator. - J, HARRIS Disinfector. - F. WORKMAN 6 STATISTICS AND SOCIAL CONDITIONS FOR THE AREA Area (acres) 1,606 Population - estimate supplied by the Registrar General 48,160 Number of inhabited houses (end of 1957) according to Rate Books 14,601 Rateable Value (1959) £873,039 Sum represented by a penny rate (estimated) £3,516 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Total M. F. Live Births - Legitimate 678 345 333 Birth Rate per Illegitimate 46 30 16 1,000 15.0 Still Births 11 6 5 Rate per 1,000 Births 15,2 Deaths 555 298 257 Death Rate per 1,000 11.5 Deaths from Puerperal causes - Rate per 1,000 Births Deaths of infants under one year of age:- All infants 22 Rate per 1,000 live births 30.4 Legitimate 22 Rate per 1,000 legitimate live births 32,45 Illegitimate - Rate per 1.000 illegitimate live births . . Deaths from:- Tuberculosis 1 Cancer (all ages) 129 Measles (all ages) - Whooping Cough (all ages) - Diarrhoea (under 2 years of age) - Number of Births notified 724 Number of Births registered in the Borough 178 POPULATION The mid-year estimate of the population supplied by the Registrar General is 48,160 a decrease of 360 from that of the previous year. BIRTHS The number of live births registered during the year was 724, which gives a crude birth rate of 15.0 per 1,000 of population, the corrected birth rate being 15.2. The rate for 1959 was 14.7. There were 11 still-births, giving a still-birth rate of 15.2 per 1,000 births. In 1959 the still-birth rate was 22.19. 7 DEATHS The net number of deaths accredited to the district for the year 1960 was 555, 49 less than in 1959. This gives a crude death rate of 11.5 per 1,000 of the population and a corrected death rate of 11.0. From the table which sets out the causes of death for 1960 (Page 30), it will once again be seen that diseases of the heart and circulation made up by far the greatest single cause of death in the Borough (118, or 2.5 per 1,000 of population, died of coronary disease, angina). Deaths from cancer made up the second largest cause (113 cases or 2.3 per 1,000), the most alarming feature being, of course, the continued increase in cancer of the lung and cancer of the bronchus. This bears out what I have already said that modem epidemiology must take into account all the factors which affect health or which produce death. These matters are, I need scarcely say, of national rather than local importance. So far as can be ascertained, there are no conditions existing in Wood Green which encourage either coronary thrombosis or lung cancer. Health education must still remain our most powerful weapon in the fight against these two very serious diseases. I myself have written on coronary thrombosis on anumber of occasions while the Chief Health Education Officer is paying particular attention to schools in an attempt to persuade children to resist the temptation to start smoking. This would seem to be the most profitable line of approach, and it is sincerely to be hoped that efforts made in this direction will have their effect on future generations, INQUESTS Twenty-eight inquests were held following the deaths of Wood Green residents during 1960 A further 145 post mortem examinations were carried out without an inquest, 70 of these in the Prince of Wales Hospital which, by arrangement with the Wood Green Borough Council, provides mortuary services, MATERNAL MORTALITY No cases of maternal mortality were reported. INFANT MORTALITY There were 22 deaths of infants under one year of age, which gives an infant death rate of 3.4 per 1,000 live births, as compared with 14 deaths and a rate of 20.5 in the preceding year. Among the 22 infants who died in Wood Green during 1960 before they had reached the age of twelve months, 18 were under the age of one month. Of these, 16 failed to survive one week, in fact 15 died in the first day. Every infant death is carefully scrutinised. Although the infant mortality figures for the last few years are very much 8 better than was the case not so many years ago, it is obvious that we must continue our struggle to eliminate all cases of infant death, whether the deaths occur in the first week in the first month, or in the first year. STILL-BIRTHS Eleven still-births, 10 legitimate and 1 illegitimate were accredited to the Borough for 1960. This is equal to a death rate of 15.2 per 1,000 births, the corresponding figures for 1959 being 15 still-births with a rate of 22.19. The following table shows 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 8 - - - 8 - - - - 8 Congenital Defects 4 - 1 - 5 - 1 1 - 7 Atelectasis 1 - - - 1 - - - - 1 Gastro-enteritis - - - - - - • - - - Intra-cranial Haemorrhage 1 - - - 1 - - - - 1 Capillary Bronchitis . - - - - - - - - - Asphyxia - - - - - - - - - - Broncho-pneumonia - - - - - - 1 - - 1 Other Causes 2 - - - 2 - 1 - 1 4 Total 16 - 1 - 17 - 3 1 1 22 9 GENERAL PROVISION OF HEALTH SERVICES Hospitals I can add little to the remarks which I have made in the last few Annual Reports relating to the hospital services available to the Burgesses of Wood Green, particularly the comments I made in the Annual Report for 1959. The situation has altered very little, and it is still particularly difficult to obtain admission to hospital of aged persons who are not acutely ill. I invariably try to assist any general practitioner who asks for my help, and am happy to say that the support which I have been able to give general practitioners has, in many instances, proved successful. Care of the Aged It is extremely pleasing to be able to report that the Old People s Centre is proving of the greatest value to old people, and that in many ways it is adding considerably to their comfort and well-being. As the Council is aware, l am hoping, as Area Medical Officer, to institute a clinic for old persons at the Old People's Centre. Up to the present, however, the project has had to be held up, as I am extremely anxious to ensure the full co-operation of all general practitioners before any further steps are taken. I have done my best to make it clear that this Old People's Clinic will be much more social than medical. Although simple medical examinations may be undertaken by the Medical Officer in charge, i.e. urine testing, sight testing, blood pressure examination, etc., no attempt will be made to carry out any more elaborate examinations, On the other hand, we will try to help the old people by suggestions as to future employment, hobbies, diet and the like. In shorty our aim will be to try to keep old people healthy and to obviate the need for a visit to their general practitioner. As will be seen we should not in any way be encroaching on general practitioners' preserves, but should actually help them in their work. I have every hope that the problems which exist at present will be resolved within the near future, and am quite sure that we will have the goodwill of all the general practitioners within the Borough. As I have mentioned in previous reports, our Health Visitors, Home Nurses and Home Helps continue to assist the aged in every possible way. Laboratory Facilities As in past years, the Central Public Health Laboratory Service has been of the greatest assistance to us, not only the Central Laboratory atColindale, but also theLaboratory housed in Coppetts Wood Hospital, where Mr. McGimpsey is the Bacteriologist. I gratefully acknowledge the assistance afforded throughout the 10 year, and the close co-operation which has continued for so many years between the Public Health Department and the Laboratory Service. Summary of the work carried out at the Central Public Health Laboratory for the year as follows:- Positive Negative Swabs for diphtheria bacilli - 7 Sputa for tubercle bacilli - 5 Throat and nose swabs 117 Faeces 298 Urine - Blood 2 Others 6 Ice Cream 6 Milk 6 Water (Swimming Pool) 6 NATIONAL ASSISTANCE ACT, 1918 (National Assistance Amendment Act, 1951) SECTION 47:- Removal to suitable premises of persons in need of care and attention. It was not found necessary for the Council to take any action under this Section during 1960. NATIONAL ASSISTANCE ACT, 1948 SECTION 50:- Burial or Cremation of the Dead. There were no burials carried out under this Section during 1960. 11 SANITARY SERVICES Inspections Public Health Act, 1936 560 Housing Act, 1957 286 Rag Flock and Other Filling Material Act, 1951 2 Pet Animals Act, 1951 12 Factories and Outworkers 319 Food Preparing Premises 233 General Food Premises 810 Shops Act, 1950 153 Smoke Observations 106 Unsound Food 137 Complaints Investigated 419 Interviews with Owners, etc. 143 Revisits to property under notice 823 Infectious Diseases Cases 97 Special enquiries in connection with infectious disease cases 20 Aged and infirm persons 6 Pests Act 326 Clean Air Act 2,484 Miscellaneous 205 Informal Notices Served Shops Act 7 Complied with 2 Food and Drugs Act 16 " " 15 Public Health Act 217 " " 177 Housing Act1 " " - Factories Act 4 " " 5 Pests Act - n n - Statutory Notices Served Public Health Act 53 Complied with 73 Housing Act 4 " " - Factories Act " " - Food and Drugs Act " " - Rent Act, 1957 The number of applications for Certificates of Disrepair has shown no appreciable change this year Set out below is a table showing the number of applications received as compared with the previous year:- 1959 1960 Number of Applications for Certificates of Disrepair (Form I) 23 21 Number of Proposals to Issue Certificates of Disrepair (Form J) 21 20 Number of Certificates of Disrepair issued (Form L) 6 6 12 1959 1960 Number of Applications for Certificates of Disrepair rejected - 2 Number of Certificates of Disrepair cancelled 11 5 Number of Applications for Cancellation rejected 3 1 Number of visits made in connection with above 97 44 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) 277 ( b) Number of inspections made for the purpose 823 (2) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation (3) Number of dwelling houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 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 177 3. Action under Statutory Powers during the year:- (1) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1957:- (a) Number of dwelling houses in respect of which notices were served requiring repairs 4 (b) Number of dwelling-houses which were rendered fit after service of formal notices:- (i) By owners (ii) By Local Authority in default of owners - (2) Proceedings under Public Health Acts:- (a) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 53 (b) Number of dwelling-houses in which defects were remedied after service of formal notices (i) By owners 73 (ii) By Local Authority in default of owners - 13 (3) Proceedings under Sections 11 and 13 of the Housing Act, 1957:- (a) Number of dwelling-houses in respect of which demolition orders were made (b) Number of dwelling-houses demolished in pursuance of demolitipn orders (4) Proceedings under Section 12 of the Housing Act, 1957:- (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. 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 Public Health Inspectors during the year. In many cases I receive letters from private doctors pressing the urgency of the need for rehousing a patient on medical grounds. On these occasions I discuss the matter with the Housing Officer and award extra points when I consider the case warrants some priority. Unfortunately the housing situation in Wood Green is so critical that at the moment all new housing accommodation is needed to rehouse people from the clearance areas Housing Surveys WOOD GREEN (COMMERCE ROAD AREA NO. 1) DECLARATION OF UNFITNESS ORDER, 1959. A Public Enquiry was ordered by the Minister of Housing and Local Government into the above Order. This took place on the 8th November 1960 at the Town Hall and was conducted by Mr. E. W. Riley, A, R.I. B. A., M.P.T. I., A. I.L.A., the Inspector appointed by the Minister. After the Enquiry, the Inspector visited all of the houses in the Area. We have since learned that the Order was confirmed with minor modifications. Smoke Control Areas Work in the formation of smoke control areas under the Clean Air Act 1956 continues. The Council's Smoke Control Order No. 2 came into operation on 1st October 1960, This Order relates to an area of 250 acres in extent and comprises 1,215 dwellings in the area bounded by The Avenue part of Albert Road Dagmar Road 14 part of Alexandra Park Road and thence by Vallance Road to The Avenue. At the close of the year, the Council submitted for approval by the Minister of Housing and Local Government Smoke Control Order No. 3 relating to an area embracing 1,389 dwellings in the Bounds Green area. It is proposed that the Order come into operation on the 1st October 1961 Rodent Control During the year, 184 dwellings in the Borough were treated for rat infestation, entailing 1,366 visits. In addition 17 business premises were treated for the presence of rats, A further 54 dwellings and 14 other premises were treated for mice and a total of 512 visits were made. The Council's refuse tip at White Hart Lane was constantly baited with an anti-coagulant bait and several supervisory visits were made to the adjoining Council allotments for evidence of the presence of rats. The sewers were treated on two occasions for the control of rats during the year and 672 manholes were baited. The baiting consisted of two unpoisoned baits on alternate days, followed by a poisoned bait. For the purpose of sewer treatment the Borough is divided into ten small areas and two gangs of two men each occupy just over three weeks in carrying out the treatment. Cooperation is sought from the Borough Engineer's and Surveyor s Department in this connection. Record sheets are kept of each visit and a return made to the Ministry of Agriculture, Fisheries and Food after each treatment. The following is a copy of the results of both treatments:- RODENT OPERATION (l) Twenty-sixth Maintenance Treatment May 1960 and (2) Twenty-seventh Maintenance Treatment October/November 1960 Number of Manholes Manholes Showing Pre-bait take Complete Pre-bait take Complete Poison take Part Poison take 2nd May/ 27th May 672 391 126 0 372 17th Oct/ 11th Nov. 672 398 121 0 339 15 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 at Alexandra Palace is supervised by the Alexandra Palace Trustees. 16 INSPECTION AND SUPERVISION OF FOOD (a) Food Premises in the Borough Bakers' Shops 23 Batchers' Shops 38 Cafes and Restaurants 52 Chemists' Shops 15 Confectionery and Sweet Shops 69 Dairies and Milk Shops 38 Pried Pish Shops 11 Wet Fish Shops 11 Greengrocers' Shops 49 Grocers' Shops 82 Public Houses and Off- Licences 41 Food Factories 9 (b) Milk Supply The following licences for the sale of milk under special designations have been granted to the 38 premises registered for the sale of milk in the Borough:- Tuberculin Tested Pasteurised Sterilised 17 23 38 Supplementary Licences to sell milk from premises which are outside the area of the Licensing Authority:- Tuberculin Tested Pasteurised Sterilised 9 10 13 Twelve 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. (c) Food and Drugs Act, 1955, Section 16. There are 11 premises registered for the manufacture of Ice Cream in the district and 148 premises registered for retailing Ice Cream. During the year 46 visits were paid to these premises and 12 samples were submitted for bacteriological examination. These 12 samples were all Grade I. Also 45 premises are registered under this Section for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale. Visits to these premises during the year numbered 148. (d) Middlesex County Council Act, 1950. Section II. - Registration of Hawkers of Pood. Twenty-seven hawkers of food in the Borough are registered. 17 (e) Meat and Other Foods Condemned The under-mentioned foodstuffs were certified as unfit for human consumption during the year:- lb. Tins Meat 542 1/2 Meat 585 Fish 166 Fish 68 Salt 61 Fruit 670 Cheese 164 Vegetables 549 933 1/2 Tomatoes 120 Evaporated Milk 234 MISCELLANEOUS ITEMS Sterilised Milk 64 Soup 30 Edam Cheeses 4 Rice Pudding 36 Ketchup & Sauce 30 Spaghetti 9 Jam & Marmalade 4 Fruit Juice 6 Packets of Cheese 9 Apple Dumpling 5 Others 9 2, 376 After examination by the Public Health Inspector condemned food is collected by this Department's van, it is then removed to the Council's Refuse Disposal Plant where it is destroyed by incineration. In some instances food is brought to the Department' s offices for examination and the same method of disposal applies. (f) Food and Drugs Act, 1955 - Food Hygiene Regulations, 1955. Throughout the year, as in previous years, much attention has been paid to food hygiene. The Public Health Inspectors make frequent visits to food premises within the Borough, primarily to ensure the enforcement of the Food Hygiene Regulations, and secondly to advise and educate food handlers in the paramount importance of food hygiene. In all 1053 visits were made to food premises, as set out below:- Dairies and Milk Shops (Registered) 74 Butchers 228 Ice Cream Premises (Registered) 46 Fried Fish Shops 18 Stalls (Registered) 77 Other Food Premises 610 Full use has again been made of the propaganda material available, including posters from the Ministry of Health, Ministry of Agriculture, Fisheries and Food, the Central Office of Information and the Central Council for Health Education. 18 FACTORIES AND HOMEWORK 1. Inspections Premises No. on Register Number of Inspections Written Notices Occupiers prosecuted FACTORIES WITHOUT mechanical power 30 47 - - FACTORIES WITH mechanical power 181 184 - - OTHER PREMISES in which Section 7 is enforced tav the local authority 4 4 _ - Total 215 235 - - 2. Defects Found Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Pound 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 1 1 _ 1 _ (b) unsuitable or defective " 1 " - (c) not separate for sexes - ° ' - Other offences against the Act (not including offences relating to outwork} 3 3 3 Total 4 5 4 3. Outwork Particulars 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 74 - - - - - Umbrellas 2 - - - - - Artificial flowers 1 - - - - - Paper bags 1 - - - - - Brushes 2 - - - - - Christmas crackers 12 - - - - - Lampshades 1 - - - - - Leather goods 1 - - - - - Toy painting 15 - - - - - Greeting cards 8 - - - - - Total 117 - - - - - 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. Three samples of feathers were submitted for laboratory examination and were found to be satisfactory. Pet Animals Act 1951 Under the Act, seven 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 dwellings which have been erected or rebuilt during the year. Council dwellings completed:- 4 maisonettes Trinity Road 6 houses Devonshire Hill Lane 18 flats Winkfield Road Council properties in course of construction at end of year:- 15 flats Alexandra Park Road 36 maisonettes Winkfield and Acacia Roads 2 flats New Road Private enterprise properties completed or in course of construction - 26 flats - 1 house rebuilt. Swimming Baths The figures of attendances at Western Road and Durnsford Road Baths for the past two years are as follows:- Western Road Baths 1959 1960 Swimming Bath 93,417 93,270 -do- Children (Special sessions) 643 439 Children from Schools 26,099 32, 296 Spectators 9,057 9,353 Slipper Baths 36,939 33,418 -do- Old Age Pensioners (free) 3,263 3,051 20 Durnsford Road Open Air Baths 1959 1960 Adults 45,742 18,046 Children 81,930 41,349 Children from Schools 1,742 600 Season Ticket Holders 46,131 26,576 Spectators - Adults 11,227 6,232 Children 895 836 Samples of water were taken from both baths. The results of the tests were uniformly satisfactory. There is nothing I can add to the remarks which I have made in previous Annual Reports relating to our Swimming Baths being a means of providing health-giving exercise in the open air. The incidence of plantar warts (verrucas) among schoolchildren continues to be a matter of concern. Although it is quite obvious that swimming baths are by no means the only way in which verrucas can be spread, it is equally obvious that the wet surrounds of swimming baths provide a means of allowing the virus which causes verrucas to pass from one child to another. I am doing all I can to get the co-operation of teachers and parents in obviating the spread of this infection and the Baths Superintendent and I have the situation constantly under review. 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. Six 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 1959/60 the total tonnage of refuse collected was 11,587 tons: from this, material salvaged was sold for £1,691. The quantities of salvage were:- Tons Cwts. Qtrs. Paper 59 11 2 Mixed Scrap Iron 32 1 2 Rags 3 18 0 Non- Ferrous Metals - - - Scrap Tyres - 18 2 Flock Mattresses 6 7 2 Tins 236 8 0 Bottles 13 13 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 29, it will be seen that 229 cases of infectious diseases were notified during the year as against 360 in 1959. This is again a very low figure, partly due to the fact that 1960 was not a "measles year". The following table sets out the notifiable infectious diseases for the two years 1959 and 1960:- 1960 1959 Scarlet Fever 38 28 Diptheria - - Cerebro-Spinal Fever - - Enteric or Typhoid Fever - - Paratyphoid Fever - 3 Erysipelas 3 1 Pneumonia 28 46 Acute Poliomyelitis - 7 Acute Encephalitis - 1 Puerperal Pyrexia - - Pulmonary Tuberculosis 27 42 Non-pulmonary Tuberculosis 3 3 Malaria - - Measles 21 169 Whooping Cough 72 16 Ophthalmia Neonatorum - - Dysentery 34 35 Food Poisoning 3 9 Smallpox - - 229 360 Scarlet fever notifications rose from 28 in 1959 to 38 in 1960. Once again, the type of scarlet fever met with in the majority of cases was extremely mild. For the thirteenth year in succession no case of diphtheria occurred in the Borough. The last death took place approximately 21 years ago. The fact that small outbreaks of diphtheria are still occurring throughout the country, however, means that we cannot relax our precautions in any way. This particularly applies to immunisation, which is now normally carried out by the triple method, i.e. diphtheria, pertussis and tetanus combined. The addition of tetanus vaccination is a welcome addition to our armamentarium. Measles notifications dropped from 169 in 1959 to 21 the lowest figure yet recorded. This was to be expected, as 1960 was not a "measles year". Severity was extremely low, and none of the cases was removed to hospital. 22 Pertussis notifications rose from 16 to 72. This was in some ways surprising, since the incidence of measles and pertussis usually run together. Of the 72 cases of pertussis notified during the year only 7 had been vaccinated. In this connection it must be remembered that vaccination against pertussis does not guarantee complete protection against the disease. What we hope and what indeed we have found, is that, when a vaccinated child develops pertussis, the illness is usually particularly mild. The incidence of food poisoning and dysentery fell slightly during the year from a combined total of 44 during 1959 to a total of 37 during 1960. Sonne dysentery is now endemic in this country and control measures must be rigidly applied. These include an adequate provision of hot water, soap and towels in schools this is a matter we are constantly taking up - the teaching of all children to wash their hands after using the toilet and before eating food, the supply of disinfectants to schools when the incidence either of food poisoning or dysentery increases, and the use of letters excluding children who have suffered or are suffering from diarrhoea from school for one week, when more than a few cases have been reported from that particular school. These precautions are very necessary because although neither food poisoning nor sonne dysentery can be said to be a particularly dangerous illness in school children, we know only too well that such diseases as poliomyelitis may be spread in precisely the same way. No cases of poliomyelitis were notified during 1960. Our immunisation campaign against poliomyelitis has continued without abatement. Our present figures show that more than 90% of Wood Green children have been protected against poliomyelitis by vaccination, a figure of which we are particularly proud. There were 30 cases of tuberculosis notified during 1960 as compared with 43 in 1959. For your further information I set out below a broad classification of the cases of tuberculosis notified during the past five years in relation to employment:- 1956 1957 1958 1959 1960 Clerical 5 4 5 4 5 Manual Labour 7 3 2 10 2 Housewives 3 3 9 3 3 Factory Workers 5 3 2 8 11 Children 5 1 - 3 3 Professional classes 3 3 2 3 1 Domestic Service - 1 1 1 - Nurses - - - - 1 Shop Assistants 1 2 3 3 1 Armed Forces - - 1 - - Retired Persons 2 - - 3 1 Unclassified 6 5 8 5 2 37 25 33 43 30 23 The number of cases on the register at the end of the year was 600 as set out in the table on page 35. Our scheme for the B.C.G vaccination of school children continues and is working extremely well. This work is undertaken by the School Health Service. As I have already stated, the infectious diseases picture in Wood Green for 1960 makes very pleasant reading. The fact that more than 90% of our children have been vaccinated or immunised, either against poliomyelitis or by the triple antigen (diphtheria, pertussis and tetanus) must have made a considerable contribution towards this excellent result. This, as I have pointed out on numerous occasions is an excellent example of the value of cooperation between the Borough of Wood Green, the local authority, and the Middlesex County Council, the local health authority. The Middlesex County Council is responsible for vaccination and immunisation,as an integral part of the personal health services. On the other hand, the Borough has made a particularly valuable contribution in helping the County Council to display posters, distribute literature, etc. As the Council will be aware, the articles which I contribute to the local papers are written as Medical Officer of Health, since I have always felt that my approach as Medical Officer of Health should be much more potent than any approach I can make as Area Medical Officer. In addition - and here I believe we are in many ways unique - a letter is addressed to every parent at least once a year, on the value of immunisation and vaccination, so that no parent can remain unaware of the advantages which vaccination and immunisation confer upon their children. We consider this personal approach particularly valuable, and are of opinion that, very largely by this means, we can claim the results achieved. Mass Radiography During September Mass Radiography Unit 6A again visited Wood Green after an interval of two years. Although the number of public sessions had to be reduced, the total figure was, I am pleased to say, almost as high - 3,603 as compared with 3,684 in 1958. Leaflets were prepared by the Unit giving details of the public sessions. These were distributed through the usual channels. The utmost publicity was given by the display of banners, newspaper advertisements, posters and leaflets. Facilities were again offered by the Wood Green Horticultural Society at their Annual Show. The Unit was sited in the Show Grounds for two days where 347 people took advantage of this opportunity. Several hundreds of inflated balloons bearing an appropriate slogan were distributed to children. This year, for the first time, the Unit spent two days in the car park at Durnsford Road Swimming Pool where a further 479 people came for an X-ray. 24 The Secretary, Mrs. Waters, informed me that the Unit was very pleased with the response they enjoyed in Wood Green and with the assistance they received from this Department. We now look forward to their next visit in the early Autumn of 1962. I attach on the following page in the form of a table the Mass Radiography Unit's analysis of their survey showing the number of cases of tuberculosis found and the number of other abnormalities discovered. Abnormalities Other than Tuberculosis Discovered Includes:- Male Female Total Bronchial Carcinoma 1 - 1 Congenital abnormalities of heart and vessels - 2 2 Acquired abnormalities of heart and vessels - 1 1 Sarcoidosis - 1 1 Pneumonia 2 - 2 Abnormalities of the diaphragm - 2 2 Pneumoconiosis 1 - 1 Pulmonary Fibrosis- non-tuberculous 1 1 2 Acquired abnormalities of bony thorax 1 1 2 Congenital abnormality of bony thorax - 1 1 6 9 15 DISINFECTION AND DISINFESTATION The number of articles dealt with at the Disinfection Station was as follows:- Articles disinfected 43 Articles destroyed 58 and 2 dogs 6 rooms were disinfected on account of infectious disease, 10 premises were disinfested on account of the presence of vermin, which involved the disinfestation of 25 rooms. 64 premises were treated for infestations of cockroaches, wasps, ants, flies, bluebottles, fleas, beetles, and maggots. 67 library books were brought to the Department during the year for disinfection on account of being in contact with cases of infectious disease. 25 ANALYSIS OF MASS RADIOGRAPHY SURVEY GROUP Number Examined Recalled for further Investigation Did not Attend for further Investigation Pulmonary Tuberculosis Discovered Other Abnormalities Discovered Presumed Healed Occasional Clinic Supervision Requiring Immediate Treatment PUBLIC SESSIONS Male 1,015 18 1 7 2 1 6 Female 1,308 15 1 9 3 - 9 ORGANISED GROUPS Male 467 2 - - - - - Female 813 9 - - - - - TOTAL Male 1,482 20 1 7 2 1 6 Female 2,121 24 1 9 3 - 9 TOTAL 3,603 44 2 16 5 1 15 26 APPENDIX 1 TABLE 1 Vital Statistics of Wood Green 1940-60 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) 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 1956 50,100 578 11.5 20 10 17.3 1 50.0 537 10.7 1957 49,500 655 13.2 28 11 16.8 1 35.7 585 9.6 1958 49,100 635 12.9 37 13 26.62 1 27.09 573 11.3 1959 48,520 640 14.1 36 14 20.71 2 55.56 604 12.4 1960 48,160 724 15.0 46 22 30.4 - - 555 11.5 27 TABLE II INFECTIOUS DISEASES FOR THE PAST 25 YEARS Year Diphtheria Scarlet Fever Enteric or Typhoid fever Pulmonary Tuberculosis Nonpulmonary Tuberculosis Measles Pertussis Poliomyelitis †N *D †N *D †N *D †N *D †N *D †N *D †N *D †N *D 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 4 - 1956 - - 17 - - - 30 1 7 1 27 - 37 - 5 - 1957 - - 22 - - - 26 6 5 1 876 - 95 - 6 — 1958 - - 77 - 1 - 29 5 3 - 421 - 40 - 2 1 1959 - - 28 - - - 30 1 3 - 169 - 16 - 7 1 1960 - - 38 - - - 27 1 3 - 21 - 72 - - - †- Notifications *D - Deaths 28 TABLE III Infectious Diseases Notified during the year I960 Cases Notified in Whole Borough Total Cases Notified in each Ward Total Cases removed to Hospital or Sanatorium Total Deaths Notifiable Disease 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 35 to 45 years 45 to 55 years 55 to 65 years 65 and upwards AlexandraBowes Town Hall Noel Park Scarlet Fever 38 - 11 21 6 - - - - - - - 6 16 16 12 - Diphtheria - - - - - - - - - - - - - - - - - Cerebro-Spinal Fever - - - - - - - - - - - - - - - - - Enteric Fever - - - - - - - - - - - - - - - - - Para-typhoid Fever - - - - - - - - - - - - - - - - - Erysipelas 3 - - - - - - - 1 - 1 1 - 1 2 - - Pneumonia 28 1 2 1 1 1 - 1 3 5 3 10 7 11 10 19 19 Acute Poliomyelitis - - - - - - - - - - - - - - - - - Polio-Encephalitis - - - - - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - - - - - - - - - - - Pulm. Tuberculosis 27 - 1 2 - - 4 6 3 3 4 4 6 12 9 12 1 Non-Pulm. Tuberculosis 3 - - - - - 1 - 2 - - - 1 2 - - - Malaria - - - - - - - - - - - - - - - - - Smallpox - - - - - - - - - - - - - - - - - Measles 21 2 13 5 - - 1 - - - - - 7 8 6 - - Whooping Cough 72 5 33 25 7 2 - - - - - - 24 31 17 8 - Ophthalmia Neonatorum - - - - - - - - - - - - - - - - - Dysentery 34 1 7 7 5 - 1 7 4 - 1 1 9 11 14 3 - Food Poisoning 3 - 1 - - 1 1 - - - - - 2 1 - 3 - Totals 229 9 68 61 19 4 8 14 13 8 9 16 62 93 74 57 20 29 TABLE IV Causes of death during the year I960 Causes of Death Male Female Tuberculosis, respiratory - 1 Tuberculosis, other - - Syphilitic disease 1 - Diphtheria - - Whooping Cough - - Meningococcal infections - - Acute Poliomyelitis - - Measles - - Other infective and parasitic diseases 1 1 Malignant neoplasm, stomach 13 7 Malignant neoplasm, lung, bronchus 29 11 Malignant neoplasm, uterus - 3 Malignant neoplasm, breast 1 5 Other Malignant and lymphatic neoplasms 25 19 Leukaemia, aleukaemia 3 1 Diabetes 1 - Vascular lesions of nervous system 15 24 Coronary disease, angina 69 49 Hypertension with heart disease 6 7 Other heart diseases 31 53 Other circulatory disease 15 9 Influenza - - Pneumonia 10 9 Bronchitis 30 9 Other diseases of respiratory system 3 2 Ulcer of stomach and duodenum - 2 Gastritis, enteritis and diarrhoea - 4 Nephritis and nephrosis 2 1 Hyperplasia of prostate 2 2 Pregnancy, childbirth, abortion - - Congenital malformations 5 2 Other defined and ill-defined diseases 24 19 Motor vehicle accidents 3 4 All other accidents 4 9 Suicide 5 5 Homicide and operations of war - 1 Total 298 257 30 TABLE IVA 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 - - - - - - - - - - - - Tuberculosis, other - - - - - - - - - - - - Syphilitic disease 1 - - - - - - - - - - 1 Diphtheria - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - Measles - - - - - - - - - - - - Other infective and parasitic diseases 1 - - - - - - - - - - 1 Malignant neoplasm stomach 13 - - - - - - - 1 2 5 5 Malignant neoplasm lung, bronchus 29 - - - - - - 1 2 11 7 8 Malignant neoplasm breast 1 - - - - - - - - - - 1 Other malignant and lymphatic neoplasms 25 - - - - - - - 4 1 7 13 Leukaemia, aleukaeraia 3 - - 1 - - - - - 1 - 1 Diabetes 1 - - - - - - - - 1 - - Vascular lesions of nervous system 15 - - - - - 1 1 3 6 2 2 Coronary disease, angina 69 - - - - - 1 1 5 15 19 28 Hypertension with heart disease 6 - - - - - - 1 - 3 1 1 Other heart diseases 31 - - - - - - - 1 5 12 13 Other circulatory diseases 15 - - - - - - - 2 3 5 5 Influenza - - - - - - - - - - - - Pneumonia 10 - - - - 2 - 1 1 2 2 2 Bronchitis 30 - - - - - - - - 3 18 9 Other diseases of respiratory system 3 - - - - - - - - - 2 1 Ulcer of stomach and duodenum - - - - - - - - - - - - Gastritis, Enteritis and Diarrhoea - - - - - - - - - - - - Nephritis and nephrosis 2 - - - - - - - 1 - 1 - Hyperplasia of prostate 2 - - - - - - - - - - 2 Totals carried forward 257 - - 1 - 2 2 5 20 53 81 93 31 TABLE IVA (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 257 - - 1 - 2 2 5 20 53 81 93 Congenital malformations 5 5 - - - - - - - - - - Other defined and illdefined diseases 24 9 - - - 1 1 1 - 3 5 4 Motor vehicle accidents 3 - - - - - 1 - - 1 1 - All other accidents 4 1 - - - - - - - 1 1 1 Suicide 5 - - - - - - - 3 - - 2 Homicide and operations of war - - - - - - - - - - - - Totals 298 15 - 1 - 3 4 6 23 58 88 100 32 TABLE IVB 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 1 - - - - - - - 1 - - - Tuberculosis, other - - - - - - - - - - - - Syphilitic disease - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - Measles - - - - - - - - - - - - Other infective and parasitic diseases 1 - - - - - - - - - - 1 Malignant neoplasm, stomach 7 - - - - - - - 1 3 2 1 Malignant neoplasm, lung, bronchus 11 - - - - - - - 2 3 4 2 Malignant neoplasm, breast 5 - - - - - - - - - 3 2 Malignant neoplasm, uterus 3 - - - - - - - - 1 - 2 Other malignant and lymphatic neoplasms 19 - - - - - - 1 1 1 3 13 Leukaemia, aleukaemia 1 - - - - - - - - 1 - - Diabetes - - - - - - - - - - - - Vascular lesions of nervous system 24 - - - - - 1 - 1 1 8 13 Coronary disease, angina 49 - - - - - - - 2 5 15 27 Hypertension with heart disease 7 - - - - - - - - 2 1 4 Other heart diseases 53 - - - - - - - 1 3 17 32 Other circulatory diseases 9 - - - - - - - 1 - 1 7 Influenza - - - - - - - - - - - - Pneumonia 9 1 - - - - - - 1 - 6 1 Bronchitis 9 - - - - - - - - 1 1 7 Other diseases of respiratory system 2 - - - - - - - 1 - 1 - Ulcer of stomach and duodenum 2 - - - - - - - - - 1 1 Gastritis, Enteritis and Diarrhoea 4 - - - - - - - - - - 4 Nephritis and nephrosis 1 - - - 1 - - - - - - - Totals carried forward 217 1 - - 1 - 1 1 12 21 63 117 33 TABLE 1VB (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 217 1 - - 1 - 1 1 12 21 63 117 Pregnancy, Childbirth Abortion - - - - - - - - - - - - Congenital Malformations 2 2 - - - - - - - - - - Other defined and illdefined diseases 19 4 - - - - 1 - 4 1 5 4 Motor vehicle accidents 4 - - 1 1 - - - - - 1 1 All other accidents 9 - - - - - 1 - - 2 - 6 Suicide 5 - - - - - - - 1 2 2 - Homicide and operations of war 1 - - - - - - 1 - - - - Totals 257 7 - 1 2 - 3 2 17 26 71 128 34 TABLE V TUBERCULOSIS Tuberculosis Register Pulmonary NonPulmonary Total M. F. M. F. No. of cases on Register at end of 1959 342 272 15 48 677 New cases notified during 1960 20 7 1 2 30 Transfers from other Districts 11 1 2 - 14 No. of cases removed from Register 64 49 4 4 121 No. of cases on Register at end of 1960 309 231 14 46 600 New Cases and Mortality during I960 Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. 0 - - - - - - - - 1 1 - - - - - - - 5 2 - - - - - - - 15 5 2 - 2 - - - - 25 8 - 1 1 - - - - 35 4 3 1 1 - - - - 45 3 1 - - - 1 - - 55 5 1 - - - - - - 65 and upwards 4 - - - - - - - Totals 32 7 2 4 - 1 - - Above includes transfers (14) from other districts. 35 APPENDIX 2 Miscel1aneous (a) Medical Examinations During the year 70 medical examinations were carried out: 14 of these were in respect of entrants to the Council's employ for acceptance into the Superannuation Scheme, 22 in respect of workmen already in the Council's employ for acceptance into the Superannuation Scheme and 34 in respect of workmen for acceptance into the Sickness Pay Scheme. In addition, 35 medical reports were issued relating to employees absent from duty for more than a short period through sickness. These reports were obtained from the family doctor with whom we have the most happy relations. (b) Additional Reports to Health Committee January - Measurement of Air Pollution. March - Proposed Smoke Control Area No. 3 Provisional Plan. May - Coal Handling Plant - Palace Gates Sidings. - Health Congress at Torquay. June - Travelling Facilities for Inspectors in Smoke Control Areas. August - Quotations - 16 mm. Sound Projection Equipment. September - Conference of Association of Public Health Injectors. October - Health Services Handbook. November - Proposed Smoke Control Area No. 3. - National Society for Clean Air - Conference. December - Additional Monitoring Points for Measurement of Air Pollution. 36 APPENDIX 3 Legal Proceedings during 1960 Food & Drugs Act 1955, S.2 - Fine £20 - £3.3.0. costs Selling food not of the substance demanded. Food & Drugs Act 1955, S.2 - Fine £5 £2.2.0. costs. Selling food not of the substance demanded. Food Hygiene Regulations - Fine £60 - £18 18,0. costs,, 6 offences at cafe in High Road. Public Health Act 1936, S. 93 - Order for abatement of Statutory Nuisance - Lordship Lane, nuisance within 28 days - £3.3.0. costs. 37