Preventive Medicine Overview

Health and Safety

• Health and safety is about preventing or mitigating accidents and incidents at the workplace, protecting employees and others from injury.
• Key aspects include: procedures, regulations, training, insurance, protection, and audits.

Focus on Safety and Health

• Identify workers, occupations, and sectors at higher risk of contagion.
• Implement control and prevention measures based on risk assessments.
• Disseminate information and preventive measures to reduce the spread of infectious diseases, collaborating with public health authorities.

Responsibilities

• Employer: Overall responsibility for health and safety.
• Chief Executive: Implementing and managing health and safety strategy and policy.
• Line Managers: Day-to-day responsibility for themselves, employees, and others (including members of the public).
• Employees: Responsibility for themselves and others.

OSH Rights and Responsibilities

• Employers' roles and responsibilities:
  • Workplace, machinery, equipment, and processes must be safe and without risk to health.
  • Chemical, physical, and biological substances must be safe when appropriate protection measures are taken.
  • Adequate protective clothing & equipment must be provided (free of charge to workers).
  • Measures must be in place for emergencies and accidents, including adequate first-aid arrangements.
  • Worker consultation, information, and proper training on OSH is essential. (per Occupational Safety and Health Convention, No. 155, and Recommendation, No. 164)

Risk of Contagion

• Probability of exposure to contagion, considering disease characteristics and potential exposure to contaminated environments and materials.
• Severity of resulting health outcomes, considering individual factors (age, underlying conditions) and available control measures.

Emergency Response Workers

• Health care workers.
• Laboratory personnel.
• Death care workers.
• Emergency transport workers.
• Cleaners and waste management workers in healthcare facilities.
• Other emergency responders (police, civil protection, military, fire).

Stress, Psychosocial Risks, and Violence

• Common psychosocial factors during pandemics include fear for personal or family well-being, lack of safety equipment, isolation, and lack of social support.
• Tension between safety protocols and the need to support individuals and difficulty maintaining self-care (like exercise, nutrition, and rest) can create additional stress.
• Common responses include stress, low mood, low motivation, anxiety, and depression.
• These factors impact mental health and well-being.

Working from Home

• Management commitment and supervisor support.
• Clear expectations (tasks, results).
• Flexibility in work schedules.
• Dedicated workspace and appropriate equipment (e.g., laptops, apps, adequate IT support).
• Training.
• Comprehensive communication systems.
• Employee assistance programs are vital.

Ergonomics

• Manual handling of loads, awkward postures (associated with longer hours, higher work load and high-pressure environments), musculoskeletal injuries, diminished work capacity, and adherence to strict work practices issues are all important.
• Increased absenteeism and higher risk of accidents may also occur.

Heavy PPE Risks

• Health care workers may experience added risks from prolonged use of heavy PPE.
• These can include heat stress & dehydration, dizziness, physical markings on faces.
• PPE: Personal protective Equipment.

Social Dialogue

• Employers & their organizations must collaborate to shape policies conducive to business resilience and sustainability, observe guidance from public authorities, and proactively communicate critical information to workers.
• Employers should also review or draw up business continuity plans, identify and mitigate risks of contagion to workers, and actively promote proper hygiene and a responsible workplace culture.
• Workers themselves must participate in decision-making and policy responses, actively cooperate with employers, strictly adhere to workplace hygiene practices, and exhibit responsible behaviors.

OSH Practitioners

• Facilitate access to reliable information.
• Increase understanding of disease and symptoms.
• Provide support in risk assessment and management processes (identifying hazards, assessing risks, adopting preventive measures, monitoring, reviewing efforts).
• Contribute in developing & updating prevention, containment, mitigation, & recovery plans.

Write Assessment (IPC)

• Write an article about Infection Prevention and Control (IPC) that doesn't exceed three sheets and avoids intellectual exaggeration.
• Include the article's objectives and examples, supported by pictures. The research must include a reference.

Moral and Medical Ethics

• Ethics: signifies moral values.
• Medical ethics: moral principles for medical practitioners in dealings with colleagues, patients, and the state.
• Medical etiquette: conventional laws, customs, and codes of conduct for doctors among colleagues.

Medical Council

• Recognition of medical qualifications.
• Supervision of undergraduate medical education.
• Supervision of post-graduate medical education.
• Recognition of foreign medical education.
• Derecognition.
• Medical register maintenance.
• Warning notices for disciplinary actions.
• Appeals process for disciplinary actions.

Duties of Medical Practitioners towards Patients

• Implied treatment contract.
• Duty to sick patients.
• Duty to continue treatment.
• Duty to earn patient's confidence.
• Duty to children/infirm.
• Charge for service.
• Right to choose a patient.
• The duty to give proper directions.
• Duty to offer proper treatment regime.
• Duty to notify communicable diseases.
• Examination and consent procedures.
• Duty related to treatment results.

Professional Secrecy

• Privileged Communication: A bonafide statement by a registered medical professional on a matter of public interest to a concerned authority, to protect community concerns.
• Rules and criteria for privileged communication.

Duties of Medical Practitioners toward the State

• Notification of infectious diseases.
• Notice to police.
• Notification of births and deaths.
• Issuing of certificates.
• Responding to emergencies (military services).

Duties of Medical Practitioners towards One Another

• Extend same honour, respect, and good behavior as expected from one another.
• Avoid actions that diminish reputation of colleagues.
• Should not entice patients away from colleagues.
• Free medical service among colleagues.

Professional Misconduct

• Conduct considered dishonorable by professional peers, including issuing false medical certificates, covering up unqualified individuals, helping quacks, prescribing habit-forming drugs, disclosing patient secrets, failing to notify, treating patients under the influence of drugs, and fee splitting.

Professional Negligence (Malpractice)

• Negligence: Acting or failing to act in a manner not expected.
• Professional Negligence: Absence of reasonable care and skill, leading to patient injury or death.

Misadventure

• Dangerous, unforeseeable effects following the use of a procedure, measure, or drug are categorized as misadventure.
  • Therapeutic: procedures with potentially bad outcomes
  • Diagnostic:
  • Experimental

Informed Consent

• Agreement or permission given voluntarily (without compulsion).
• Express (verbal or written) or implied.
• Nature of ailment, proposed treatment, alternative treatments.
• Risks & benefits, potential burdens & failure possibilities; Freedom of choice.

Consent for Medico-Legal Examinations

• Consent in writing is always needed for medico-legal examinations.
• Written and express consent is required prior to procedures beyond routine medical examinations.
• Minors (under 12 yrs) cannot provide valid consent, but parents and legal guardians can.

Euthanasia

• Mercy killing—not permitted in most of the world, including many Islamic and Arab countries.

Scientific Journal Article

• Research article on medical misadventure/professional negligence must not exceed 3 pages.
• It must contain the (objective), supporting pictures, and a reference.

Preventive Medicine and Health Care

• Basic Concept: The practice of promoting preventive health care to improve well-being. Aims to prevent, or minimize, disease, disability, and early death, studying the external environment’s effect on human health (environmental and occupational health, nutrition, community medicine, statistics, and epidemiology).

Importance of Preventive Medicine

• Cost savings.
• Improved health outcomes.
• Empowerment and personal responsibility.
• Population health.
• Long-term sustainability.

Modern Medicine

• Involves the correct use of drugs, devices, procedures, and supportive systems for healthcare, to cure, treat, diagnose, and rehabilitate. Encompasses diagnostic, preventive, therapeutic, and rehabilitative technologies within the context of computer science.

Preventive Medicine vs. Clinical Professionals

• Preventive medicine aims at preventing diseases and problems from occurring or recurring through implementation of educational programs, policies, and research.
• Clinical professionals focus on treating individuals who become sick or injured, after the disease has developed. But the two fields work hand-in-hand; sometimes treating a disease helps prevent from recurring in others.

Preventive Care/Preventive Medicine Examples

• Routine blood pressure tests.
• Diabetes screening.
• Cholesterol tests.
• Routine vaccines.
• Cancer screenings
• STD screenings.
• Occupational Health Medicine
• Environmental Health
• Nutrition and Food Hygiene
• Community medicine

Methodology of Preventive Medicine

• Epidemiology: surveillance, investigation, analysis, evaluation.
• Biostatistics: descriptive and inferential statistics.

Achievements

Improved quality of life. Increased life expectancy. Worldwide reduction in infant and child mortality. Elimination or reduction of many communicable diseases.

Notable Public Health Achievements (20th Century)

• Vaccination (immunization).
• Motor-vehicle safety.
• Safer workplaces.
• Control of infectious diseases.
• Reduced deaths from coronary heart disease and stroke.
• Safer, healthier food.
• Healthier mothers and babies.
• Family planning.
• Fluoridation of drinking water.
• Recognition of tobacco use as a health hazard.

Public Health Challenges

• New infections (e.g., SARS, COVID-19).
• Chronic diseases (obesity and diabetes).
• Cancers.
• Bioterrorism.
• Behavioral factors (smoking, diet).
• Access to health care.
• Other

Actual Causes of Death (1990, U.S.)

• Tobacco.
• Poor diet/lack of exercise.
• Alcohol
• Infectious agents.
• Pollutants/toxins.
• Firearms.
• Sexual behavior.
• Motor vehicles.
• Illicit drug use.

Spread of Infectious Disease

• Environmental Conditions: Globalization of food supply, development projects altering disease-carrying insect habitats, increased human contact with wilderness areas, and increased use of antimicrobial agents.

• Demographic Conditions: Size and dynamics of populations, human migration patterns, and high-risk behaviors.

Levels of Prevention

• Primordial Prevention: Preventing risk factors before they appear in a population group (e.g., lifestyle-related diseases).
  • Health education.
• Primary Prevention: Taken before disease onset (e.g., immunization, promoting healthy behaviors), aiming to eliminate or modify risk factors.
  • Population-wide (mass public health interventions).
  • High-risk strategy.
• Secondary Prevention: Stopping the disease at an early stage (e.g., screening for pre-symptomatic conditions), providing early diagnosis and treatment
  • Drawbacks include mental anguish(pain), loss of productivity, and high cost.
  • Examples include regular exams & screenings.
• Tertiary Prevention: Reducing disability and suffering from an already established disease (e.g., cardiac rehabilitation).

Primary Health Care (PHC)

• Definition: The first level of contact between patients and health services. Provides essential care, and a majority of prevailing health problems dealt with effectively.
• Elements of PHC: Promotive (health education, food, nutrition, maternal/child care), Preventive (immunizations, diseases control, safe water/sanitation), Curative (treatment, provision of essential drugs). Added elements can include dental care, school health, and home health care, and community participation.

Essential Elements of PHC (WHO)

1. Education
2. Water and sanitation.
3. Nutrition.
4. Maternal and child health.
5. Immunization/vaccination.
6. Prevention of endemic diseases .
7. Treatment and drug availability

Primary Health Care (PHC) Principles

• Equity in distribution: services to all and prioritize those in need.
• Appropriate technology: technology that is accessible and can be afforded.
• Multi-sectoral approach: involves multiple health care departments to ensure collaborative efforts.
• Community participation: people take part in the health system.
• Support from higher levels: Hospitals/government support primary health care initiatives and share the social goal of improving health.

WHO Strategies of PHC

• Reducing excess mortality in poor marginalized populations: ensuring these populations have access to health services and addressing the root causes of death, morbidity, and disability.
• Reducing leading risk factors: Identifying and reducing the factors that most affect health outcomes.
• Developing sustainable health systems: Developing sustainable and financially sound systems.
• Developing an enabling policy and institutional environment: integrating PHC initiatives into national/governmental policies and systems

Basic Requirements for Sound PHC

• Appropriateness.
• Adequacy.
• Affordability.
• Accessibility.
• Acceptability.
• Availability.
• Assessability.
• Accountability.
• Completeness.
• Comprehensiveness.
• Continuity.

Nutrition in Health and Disease

• Background: Nutrition is the science of food and its role in health. It is important to promote healthy eating habits.
• Modern Nutrition : identifying micronutrients (vitamins, minerals) crucial for growth, health, and preventing disease—as well as the relationships between nutrition and diseases like obesity.

Test your knowledge on the various levels and types of preventive medicine, including primordial, primary, secondary, and tertiary prevention. This quiz covers key concepts such as health care levels, demographics influencing disease spread, and the roles of different healthcare specialists. Enhance your understanding of how preventive strategies aim to improve public health.