Final Control on Hygiene and Ecology

1. Key questions

2. Samles of Tests

3. Situational tasks

 

LITERATURE

 

Attachment 1 Students’ Independent Work. Evaluation of adequacy of an individual nutrition

 

Attachment 2 Symptoms of poisoning by Lead and Mercury

 

Introduction

Goals and Objectives of Studying General Hygiene and Medical Ecology at medical faculties

The purpose of studying hygiene and ecology at medical faculties is the formation in a future doctor of hygienic thinking, i.e. understanding the interrelation between health and quality (degree of the pollution level) of the environment that is a necessary condition of scientifically proved systems of health protection, healthy lifestyle, effective public and individual prevention of various diseases.

While studying hygiene and medical ecology, the students should acquire the knowledge of:

· methodology, basic laws of a hygienic science and common laws of relation of health with factors and conditions of the environment.

· origin, characteristics and laws of influence of the basic natural and technogenic factors of the environment and social conditions on the ecological situation and health of the population.

· methodology of studying the influence of the environmental factors and conditions on health of various groups of population; qualitative and quantitative parameters of hygienic estimation of the environment condition and its influence on health of the population.

· methodology and principles of hygienic regulation of harmful factors in the environment, organization and contents of preventive and current sanitary supervision over medical-preventive establishments, inhabited and other objects of sanitary-municipal purpose, establishments of nutrition, children's and educational establishments, enterprises of industrial and agricultural manufacture.

· bases of a healthy lifestyle, personal hygiene and balanced diet, to be able to prove recommendations for prevention of various diseases.

In the future professional activity the hygienic knowledge and practical skills are necessary for the doctor in the following situations:

· At differential diagnostics of diseases, administration of treatment, medical-preventive conditions and medical-labour examination.

· In the work on professional orientation, professional training and employment of persons with a different level of health.

· At estimation and maintenance of sanitary-hygienic and antiepidemic conditions of medical-preventive establishments, institutions of preschool, school and professional training, establishments of public catering and others.

· For optimization of conditions of life, education, training, work, prevention of intrahospital and other infections, substantiation of recommendations on personal hygiene, balanced diet.

· At development and realization of complex programs of prevention of various diseases.

· In the work on propaganda of medical knowledge and hygienic education of various groups of population.

 

 

Theme No 1.

Subject and Tasks of Hygiene and Ecology

Hygiene as a Medical Science

In medicine it is possible to distinguish 2 areas: medical and preventive. They are interrelated and supplement each other, but are separate scientific disciplines. The object of studying clinical medicine is a sick person (patient); its aim is diagnosis and treatment of diseases.

The preventive medicine or "hygiene" (from Greek — "bringing health") studies a healthy person (individual health) or health of the population of a region or country (population health) with the purpose of maintaining or improvement of health. Specialists in this area are referred to as doctors-hygienists or sanitary inspectors (abroad — doctors of public health).

The task of studying hygiene in medical university is to inculcate hygienic thinking in a future doctor, which means:

· to be able to connect the occurrence of disease in a separate person or certain population of people with the influence of factors of the environmental, industrial or household surroundings, with sanitary conditions of life

· to be able to develop the appropriate measures for prevention of negative influence of adverse environment factors on human health.

The Concept of Hygiene

Hygiene is a medical science studying the influence of environmental factors on a human organism and on public health in order to prove hygienic measures, sanitary rules and measures for maintenance and improvement of a human health and prevention of diseases.

Factors Influencing the Health of Population

According to the data of the World Health Organization (WHO), the health of population of any country of the world depends on the following factors:

· in 48-53% — on socio-economic conditions in the country or region and a lifestyle of a person (physical training, smoking, etc.)

· in 18-20 % — on the genetic factor (spread of hereditary illnesses in population)

· in 17-20 % — on quality (degree of pollution) of the environment

· in 8-10 % — on level of development and quality of medical aid.

Thus, the improvement of quality of the environment can theoretically produce a positive effect two times greater than that of the development of the clinical medicine. It shows the significance of preventive medicine or hygiene for improvement of health of population.

 

The Origin and Development of Hygiene

A centuries-old history of hygiene can be conditionally divided into 2 periods:

Empirical hygiene (experimental hygiene) is a gradual accumulation of hygienic knowledge by people from the time of primitive society on the basis of own experience or experience of the previous generations (the use and preservation of various food, water from different water sources, arrangement of habitation in different districts, etc.). The further development of empirical hygiene took place in the slave-owning system, to a great extent under the influence of religious instructions of Ancient East, Babylon, Greece, Rome. In the Middle Ages the centers of medical science shifted from Europe, suppressed by inquisition, to the East (the works by Avicenna or Ibn-Sina).

The period of empirical hygiene had been completed by the epoch of Renaissance in Europe (15th century), by discovery of microscope and nature of infectious diseases (16-17th centuries).

The period of scientific-experimental hygiene is a period of studying the harmful factors influencing the health of a person in natural and experimental conditions (on laboratory anivals) and development of scientifically grounded preventive recommendations.

The first known scientific work on hygiene was "Reflections on Illnesses of Handicraftsmen" by Italian doctor B. Ramazzini in which the conditions of work of 52 trades were described (17th century). In Russia the president of Petersburg medicosurgical academy A. Frank (18th century) issued the multivolume book "A Complete System of Medical Police".

The first department of hygiene in the territory of the Russian empire was opened in 1863 at Kiev University, in 1865 — in St. Petersburg. The prominent hygienists in Russia before the revolution were N. A. Dobroslavin and F. F. Erisman. In the Soviet period the outstanding scientists-hygienists were academicians A. N. Sysin, A. N. Marzeev, L. I. Medved.

In USSR such eminent scientists as academician J. I. Kundiev (director of scientific research institute of occupational hygiene), academician E. I. Goncharuk (rector of Kiev medical university), academician A. M. Serdyuk (director of Ukrainian scientific hygienic centre), A.N.Sysin (director of Moscow scientific research institute of general and municipal hygiene was worked.

Subject of Hygiene

The subject of studying hygiene is health of a person and environment in their complex interaction.

The environment in a wide sense is everything that surrounds person and influences him.

In hygiene the environment is considered as 4 objects, which primarily influence the organism of a person. They are:

· Atmospheric air and air of a working zone;

· Water of reservoirs and drinking water;

· Soil;

· Foodstuffs.                  

Table 1

Structure of Environment and Biosphere          

Environment	Biosphere
1. Atmosphere air (Air in premises)	1. A troposphere — a low surface layer of atmosphere (10-18km)
2. Water of reservoirs and drinking water	2. Hydrosphere — up to 11km
3. Soil	3. A lithosphere — up to 12 km
4. Foodstuffs

 

 

Primary Tasks of Hygiene

They include:

v Studying natural and anthropogenic factors of the environment (table 2) influencing a human being — their sources, reasons of occurrence, ways of influence on a person, basic quantitative and qualitative characteristics. In hygiene all the variety of the environment factors influencing a person are subdivided into:

Ø Physical factors (noise, vibration, radiation);

Ø Chemical factors (various chemical substances);

Ø Biological factors (microbes, viruses, biological agents, etc.);

Ø Psychogenic factors (informational — a high level of negative information can cause illness or even death of a person);

Ø Social factors (level of life, conditions of rest, etc.)

 

Table 2

Classification of Environmental Factors

Hygienic	Ecological
1. Physical (noise, vibration, EMF, radiation, etc.)	1. Abiotic (nonliving nature)
2. Chemical (various materials, steams, gases)	2. Biotic (alive nature)
3. Biological (macro- and microorganisms, bioactive materials)	3. Anthropogenic (man-caused)
4. Psychogenic (psychophysiological)

 

v Studying the influence of the environment factors on the organism (in natural or laboratory experiments).

v Scientific substantiation and elaboration of hygienic standards, rules and recommendations to decrease or eliminate the influence of harmful factors and strengthen the effect of positive factors.

v Implementation of hygienic recommendations in practice, check of its efficiency and further perfection.

v A scientifically grounded prognosis of sanitary situation in certain region or country for the nearest and remote period on the basis of multifactorial mathematical modelling.

The Basic Sections of Hygiene

The contents of hygiene as a science is determined by the list of its basic sections:

· General hygiene (propaedeutics of hygiene)

· Hygiene of nutrition

· Municipal hygiene

· Hygiene of environment

· Occupational hygiene

· Hygiene of children and teenagers

· Hygiene of medical-prophylactic establishments

· Hygiene of extreme conditions

· Military hygiene

· Hygiene of hot climate

· Radiative hygiene

· Other sections — transport, sports hygiene, etc.

Methods of Hygienic Researches

Alongside with methods used in other medical sciences — physical, biochemical, physiological, morphological, hygiene has a number of specific methods of research:

v Epidemiological method — studying health of population according to basic quantity indicators as an integrated criterion of quality of the environment. The basic quantity indicators of population health are:

Ø Demographic — death rate, birth rate, natality, average life expectancy, etc.;

Ø Parameters of morbidity (common sickness rate, morbidity, etc.);

Ø Physical development — (weight, height) — is especially important in children and teenagers;

Ø Disablement (invalidity) of population (amount of invalids in population, reasons (diseases) of invalidity, etc).

v Method of sanitary inspection.The very first method in hygiene is a sanitary inspection of an object (for example, a canteen with drawing up the act of sanitary inspection).

v Method of sanitary examination — examination of civil-engineering designs of objects from the point of view of hygienic requirements, examination of foodstuffs (comparison of product parameters to requirements of the state standards and making the decision on possibility of food product realization).

v Method of hygienic experiment — studying the effect of a harmful factor on the organism of animals in laboratory experiment with modelling conditions of real influence on a person with revealing the affected organs and systems, the threshold and noneffective levels of effect — is the basis of hygienic regulation of harmful factors.

The State Sanitary Inspection and Its Structure

Hygieneis a scientific part of preventive medicine.

Sanitaryis a practical part of hygiene; its aim is application of hygienic requirements to practice and the control of their fulfilment.

To fulfill this task, each country has a special public service supervising the observance of the sanitary legislation. In Russia and Ukraine such special public service was called a sanitary-epidemiological service (SES), which is a part of Ministry of Public Health of the country.

From 2004 in Russia was formed Federal Service for Supervision of Consumer Rights Protection and Human Welfare (Rospotrebnadzor RF), which includes Territorial Administrations and Centers of Hygiene and Epideviology.