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Quarantine, isolation, vaccination and therapeutic advances have enabled us to
exclude many of the agents of infection from the environment and to render many others
impotent. Environmental hygiene has virtually eliminated enteric fevers from these islands.
The sewage effluent discharged into the rivers from which our water supply is derived is
highly purified but constant vigilance is still needed especially when, as happened during the
municipal workers strike crude sewage was discharged untreated into the river Lea. During
the year 1,699 notices were issued for contraventions, in food premises, of requirements under
the various Clean Food Regulations and 57 individuals or firms had to be referred to the Legal
Department in respect of 94 offences. The Council are winning the battle against the need
for Waltham Forest residents to live in unfit or sub-standard dwellings; purity of the water
supply and clean air are taken for granted, as well as protection from exposure to infectious
disease.
But the figures I have quoted make it plain that those concerned with the health of
Waltham Forest cannot afford the time to reflect on past achievements when we are faced with
an epidemic increase in smokers' cancer and of ischaemic heart disease (coronary and angina)
where nicotine addiction and the current stress of the working environment combine to cause
almost one third of all the deaths occurring in the Borough. So often these deaths occur in
comparatively young men and women at a time when they have great family responsibilities
and often, in their work, are making their greatest contribution to the community. No girl
should marry a man who smokes unless he agrees to pay a weekly life assurance premium
equal to the amount he is spending on cigarettes.
Aiready powerful support is coming in to help our campaign against the tobacco habit,
especially in schoolchildren but there is little a Medical Officer of Health can do about the
almost equally dangerous environmental stress except to point to the figures and ask employers
to consider whether, in the long run, stress inducing high-pressure productivity schemes are
really worth while. The human animal lives a pretty unnatural life as it is and if driven
beyond his capacity inevitably breaks down. Higher productivity may mean more pay for
shorter hours but it may be for a shorter life as well. Executive stress in the "rat race" is
becoming very common these days, about as common as death from coronary thrombosis.
Over 2,000 visits were made by the Deputy Medical Officer of Health and/or the
Infectious Diseases Nurse for Infectious Disease control during the year and 800 specimens
taken for laboratory examination. Our thanks are due to our colleagues in general medical
practice and in the hospital service for their ready co-operation and prompt notification of all
cases where a public health risk is present; also to Dr.B.T.Thorn and his colleagues at the
Whipps Cross Public Health Laboratory for much help and valued advice.
With regard to venereal disease, the following table shows the numbers of new cases
notified to hospitals in the London area from this borough during 1970:-
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