Vital Statistics Lesson 3

LESSON 3: VITAL STATISTICS CRUDE BIRTH RATE (CBR) Vital Statistics which is also known as biostatistics or simply the A measure of one characteristic of the natural growth or vital health indices. Morbidity statistics and mort...

LESSON 3: VITAL STATISTICS CRUDE BIRTH RATE (CBR) Vital Statistics which is also known as biostatistics or simply the A measure of one characteristic of the natural growth or vital health indices. Morbidity statistics and mortality statistics increase of a population. Measures how fast people are added which are concerned with death and the causes of death, to the population through births. indicate more or less clearly the healthfulness of a community and the success and failure of health work. Complete studies of CRUDE DEATH RATE (CDR) vital statistics include many other items such as marriage and A measure of one mortality from all causes which may result in divorce rates and characteristics of population of the country a decrease of population. Gives the speed with which mortality as to age, race, etc. occurs in a given population. VITAL STATISTICS/BIOSTATISTICS CRUDE or GENERAL RATES Pertains to BIRTH and DEATH records in general, VITAL pertains These rates are referred to the total living population. It must to life or concerning BIRTHS, MARRIAGES, DEATHS, and be presumed that the total population was exposed to the risk ILLNESSES. The Science and Analysis of Vital on Population with of the occurrence of the event. particular reference to Birth, Marriage, Morbidity and Mortality. Vital statistics are the information maintained by a DEATH government, recording the birth and death of individuals Is the permanent disappearance of all evidence of life at any within that government's jurisdiction. These data are used by time after live birth has taken place (postnatal cessation of vital public health programs to evaluate how effective their functions without capability of programs are. They are the cornerstone of public health resuscitation). systems today. Useful by-products of birth and death registration are official certificates of those events. These DEATH CERTIFICATES certificates serve as primary evidence of that event. Death certificates are required by the Law. They include as to name, usual residence, age, race, nativity, conjugal condition, STATISTICS occupation and date of death of the deceased. It is the study of the collection, organization, analysis, and interpretation of data. It deals with all aspects of this, including FETAL DEATH the planning of data collection in terms of the design of surveys The death prior to the complete expulsion or extraction of a and experiments. product of conception from its mother, irrespective of the duration of pregnancy; the death is indicated by the fact that STATISTICIAN after such separation the fetus does not breathe Someone who is particularly well versed in the ways of thinking or show any other evidence of life, such as beating of the necessary for the successful application of statistical analysis heart, pulsation of the umbilical cord, or definite movement of and working in any of a wide number of voluntary muscles. fields. BIRTH CERTIFICATES The certificate contains the date and place of birth, the name FETAL DEATH RATE (FDR) and sex of the child; the name, age, race, birthplace and Measures pregnancy wastage. Death of the product of residence of the parents; and the occupation of the conception prior to its complete expulsion, irrespective of father. duration of pregnancy. CASE FATALITY RATE (CFR) INCIDENCE RATE (IR) The proportion of cases which end up fatality. Measures the frequency of occurrence of the phenomenon during a given period of time. Deals only with new cases. CAUSE-OF-DEATH RATE OR MORTALITY RATE FROM SPECIFIC Measures the development of disease in a group exposed to DISEASES OR CONDITIONS the risk of the disease in a period of time. Gives the rate of dying secondary to specific causes. INFANT MORTALITY/DEATH CENSUS The death of an infant under one year of age. An official count of a population; the information is obtained through questions may be classified under the following INFANT MORTALITY RATE (IMR) headings: place of abode, tenure of home, personal Measures the risk of dying during the 1st year of life. It is a good description, citizenship, nativity, and occupation. index of the general health condition of a community since it reflects the changes in the environmental and medical conditions of a community. Defined as the number of deaths PREVALENCE RATE (PR) among infants under one year of age in a calendar year per one Measures the proportion of the population which exhibits a thousand live births in the same period. particular disease at a particular time. This can only be determined following a survey of the population concerned. GENERAL FERTILITY RATE (GFR) Deals with total (old and new) number of cases. More specific rate than the crude birth rate since births are related to the segment of the population deemed to be PREVALENCE RATE (PR) capable of giving birth. Measures the proportion of existing cases of a disease in the population. The term “existing” refers to old and new cases of LATE FETAL DEATH the diseases. The death of fetus with 28 or more completed weeks of gestation. PROPORTIONATE MORTALITY (PM) Shows the numerical relationship between deaths from a cause LIVE BIRTH (or groups of causes), age (or groups of age) etc. and the total The complete expulsion or extraction from its mother of a number of deaths from all causes in all ages taken together. product of conception, irrespective of the duration of the Not a measure of risk of dying. pregnancy, which after such separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of RATE the umbilical cord, or definite movement of voluntary muscles, In Vital Statistics, a rate shows the relationship between a vital whether or not the umbilical cord has been cut or the placenta event and those persons exposed to the occurrence of said is attached; each product of such birth is considered liveborn. event, within a given area and during a specified unit of time. It is evident that the persons experiencing the event (the MATERNAL MORTALITY/DEATH numerator) must come from the total population exposed to The death of a woman while pregnant or within 42 days of the risk of same event (the denominator). termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. RATIO It is used to describe the relationship between two (2) MATERNAL MORTALITY RATE (MMR) numerical quantities or measures of events without taking It measures the risk of dying from causes related to pregnancy, particular considerations to the time or place. These quantities childbirth and puerperium. It is an index of the obstetrical care need not necessarily represent the same entities, although the needed and unit of measure must be the same for both numerator and received by the women in a community. denominator of the ratio. MORBIDITY STATISTICS The statistics of disease SPECIFIC DEATH RATE/ SPECIFIC MORTALITY RATES Describes more accurately the risk of exposure of certain MORTALITY STATISTICS classes or groups to particular diseases. To understand the Concerned with death and the causes of death, indicate more forces of mortality, the rates should be made specific provided or less clearly the healthfulness of a community and the the data are available for both the population and the event in success and failure of health work. their specifications. Specific rates render more comparable results and thus, reveal the problems of public health. Show NEONATAL DEATH rates of dying in specific population groups. The death among live births during the first 28 completed days of life. SPECIFIC RATE The relationship is for a specific population class or group. NEONATAL DEATH RATE (NDR) It limits the occurrence of the event to that portion of the Measures the risk of dying during the 1st month of life. May population definitely exposed to it. serve as index of the effects of prenatal care and obstetrical management on the newborn. TOTAL FERTILITY RATE (TFR) Refers to the number of children a woman would have by the PLACE OF OCCURRENCE time she reaches age 50 under a given fixed fertility schedule. It Refers to the place where the vital event is sometimes referred to as completed family size. It is the took place. average number of births per 100 females aged 15-49 years.  finance, prices and marketing information, income, and USUAL RESIDENCE expenditure, education, health, culture, and social situations of Refers to the place where the person/deceased habitually or the government and the public; permanently resides. Carry out, enforce and administer civil registration functions in the country as provided for in Act 3753, the Law on Registry of SOURCES OF VITAL STATISTICAL DATA Civil Status; Vital events refer to marriages, births, deaths, fetal deaths, and Collaborate with the department of national government all such events that have something to do with an individual's including GOCCs and their subsidiaries in the collection, entrance and departure from life, together with the changes in compilation, maintenance and publication of statistical civil status that may have occurred during the lifetime of a information, including special statistical data derived from the person. Recording of these events in the civil register is known activities of those departments, corporations and their as vital or civil registration. The following are the sources of subsidiaries; Vital Statistical Data: Promote and develop integrated social and economic statistics and coordinate plans for the integration of those statistics, WORLD HEALTH ORGANIZATION (WHO) including the national accounts; The health statistics and information systems of the World Develop and maintain appropriate frameworks and standards Health Organization provides the comprehensive, timely, and for the collection, processing, analysis and dissemination of reliable health and health – related statistics which are data; fundamental for assessing the state of a population’s health Coordinate with government departments and local and how it is changing. The WHO established a Reference government units (LGUs) on the promotion of statistical Group on Health Statistics in 2013 to provide advice on standards involving techniques, methodologies, concepts, population health statistics to WHO with a focus on definitions and classifications and on the avoidance of methodological and data issues related to the measurement of duplication in the collection of statistical information; mortality and cause – of – death patterns. Recent Conduct continuing methodological, analytical and developments in global health and an increased focus on development activities, in coordination with the PSRTI, to monitoring and accountability suggest that the role, improve the conduct of censuses, surveys and other data responsibilities, scope and membership of the Reference Group collection activities; must be renewed to ensure that WHO and its Member States Recommend executive and legislative measures to enhance the continue to benefit from the best possible scientific and development of the statistical activities and programs of the strategic advice and support in the generation, use, government; interpretation, and dissemination of global health statistics. Prepare, in consultation with the PSA Board, a Philippine Statistical Development Program (PSDP); PHILIPPINE STATISTICS AUTHORITY (PSA) Implement policies on statistical matters and coordination, s The Philippine Statistics Authority (PSA) shall primarily be directed by the PSA Board, and; responsible for the implementation of the objectives of R.A. Perform other functions as may be assigned by the PSA Board 10625. It shall plan, develop, prescribe, disseminate and and as may be necessary to carry out the purposes of R.A. enforce policies, rules and regulations and coordinate 10625. government – wide programs governing the production of official statistics, general – purpose statistics, and civil In local level, it is the City or Municipal Civil Registry Office has registration services. It shall primarily be responsible for all the the duty and responsibility on the collection, analysis and national census and surveys, sectoral statistics, consolidation of dissemination of different vital health data. selected administrative recording systems and compilation of national accounts. DEPARTMENT OF HEALTH (DOH) The PSA shall: The EPIDEMIOLOGY BUREAU of the Department of Health Serve as the central statistical authority of the Philippine provides stakeholders with surveillance and epidemiologic government on primary data collection; information to prevent and control outbreaks and to improve Prepare and conduct periodic censuses on population, housing, health policies, programs and systems and also develop agriculture, fisheries, business, industry, and other sectors of competent health personnel to detect and respond to public the economy; health threats. Collect, compile, analyze, abstract and publish statistical The Epidemiology Bureau of DOH has the following functions: information relating to the country’s economic, social, Develop and evaluate surveillance systems and other health demographic and general activities and condition of the information systems; people; Collect, analyze and disseminate reliable and timely Prepare and conduct statistical sample surveys on all aspects of information on the health status; socioeconomic life including agriculture, industry, trade, Investigate disease outbreaks and other threats to public health; Network public health laboratories in support of epidemiological and surveillance activities The Epidemiology Bureau has three divisions which include: Applied Epidemiology Health Management Division Public Health Surveillance Division Survey, Monitoring and Evaluation Division Registration of vital events is the responsibility of the Local Government Units (LGU) through the LCRs who are under the technical supervision of the Civil Registrar General of the NSO by virtue of the provisions of Act 3753. However, pursuant to the Philippine Statistical Act of 2013, the PSA took over the civil registration function of NSO with the National Statistician as the Civil Registrar General who provides overall directions in the implementation of the Civil Registry Law and related issuances and exercises technical supervision over the LCR. POPULATION PROJECTION/ESTIMATION To be able to estimate the population for any date in the future, one should have the population count for an earlier date. It is upon the population of any particular geographical subdivision that its vital statistics are based and this information is obtained from census reports. For vital statistics purposes, population during non - censal years are generally estimated by the arithmetic increase, the geometric increase, or other suitable methods. ARITHMETIC METHOD – it is assumed that the actual increase in population per year is constant. ; Pf = Pp + nk where: Pf – future population Pp – present population n – number of days k – constant annual increase GEOMETRIC METHOD – it is assumed that the rate of increase in population per year as a percent of the previous population is constant. ; Pf = Pp (1 + k)n where: Pf – future population Pp – present population n – number of days k – constant annual increase FORMULA OF VITAL HEALTH INDICATORS LESSON 4: CONTROL OF COMMUNICABLE DISEASES (2019) and Leptospirosis (2018) were also considered as an PART 1 epidemic disease in some areas in the Philippines. Study of Disease Pandemic Diseases - Disease that is OCCURRING IN EPIDEMIC EPIDEMIOLOGY and PATHOLOGY can be loosely defined as the PROPORTIONS IN MANY COUNTRIES SIMULTANEOUSLY – study of disease. sometimes worldwide. Affects large number of people at the same time and TRANSCENDS COMMUNITY BOUNDARIES. This Epidemiology - Is the study of FACTORS that determine the includes HIV/AIDS, Tuberculosis and Malaria. frequency, distribution, and determinants of diseases in human populations, and ways to prevent, control, or eradicate Causation of Communicable Disease - Communicable disease diseases in populations. is a result of the interaction of the AGENT, HOST and the ENVIRONMENT. Pathology - Is the study of the STRUCTURAL AND FUNCTIONAL MANIFESTATIONS OF DISEASE and involves diagnosing of Agent/Infectious Agent - Microorganisms capable of producing diseases in individuals. It is the study of the ESSENTIAL NATURE infectious disease under circumstances of host and OF DISEASES and especially of the structural and functional environment favoring transmission. Infectious pathogens vary changes produced by them. in size and biological makeup from protein particles (prions) and ultramicroscopic viruses to multicellular tapeworms many Infectious Disease - (Infection) is a disease that is CAUSED BY A meters long. They are spread by direct contact; person-to- PATHOGENIC MICROORGANISMS, such as bacteria, viruses, person contact; droplet spread; through personal articles, parasites or fungi. clothing, utensils, and other belongings (known collectively as fomite); by way of a common vehicle such as water, food, milk, Communicable Disease - An infectious disease that is or contaminated air; by insect and other vectors; from animals TRANSMISSIBLE FROM ONE PERSON TO ANOTHER. that are their natural hosts, and from the inanimate environment. Contagious Disease - A communicable disease that is EASILY TRANSMITTED FROM ONE PERSON TO ANOTHER HOST A person or other living organisms that can be infected by an Zoonotic Disease/Zoonoses - Infectious disease that human infectious agent under natural conditions. ACQUIRES FROM ANIMAL SOURCES ENVIRONMENT Classification of Diseases According to Occurrence Refers to the ecological conditions that favor the interaction of Sporadic Diseases - Disease that OCCURS ONLY OCCASIONALLY host and agent. (sporadically) within the population of a particular geographic area. In USA, sporadic diseases includes botulism, cholera, gas gangrene, plague, tetanus and typhoid fever. In the Philippines, sporadic diseases includes Pellegra, Elephantiasis and Myelitis. Endemic Diseases - Disease that are ALWAYS PRESENT within the population of a particular geographic area. The number of cases may fluctuate over time, but the disease never dies out completely. Endemic diseases in USA includes TB, STDs such as gonorrhea and syphilis, common colds, influenza, chickenpox AGENT/PATHOGENS and mumps. In the Philippines, this includes Chronic Diarrhea, Typhoid and Dysentery Disease – causing microorganisms Epidemic Diseases - Diseases that OCCUR IN A GREATER THAN microbes USUAL NUMBER OF CASES IN A PARTICULAR REGION, and usually occur within a relatively short period of time. It is the incidence of a communicable disease among a number of cellular acellular people to an extent that is recognized statistically as being well (microorganisms) (infectious particles) beyond the normal expectancy for the disease in a community in a different period of time. In the Philippines, this includes all bacteria, all archaea, viruses Dengue Fever, German Measles, and Cholera. Recently Measles some algae, all protozoa, some fungi prions  Viruses are not alive. To replicate, viruses must invade a live host cells. No type of organism is safe from viral infections: viruses infect microbes humans, animals, plants, fungi, protozoa, algae and bacterial cells. Many human diseases are caused by viruses. PATHOGENS NON PATHOGENS (disease-causing (do not cause disease) VIRIONS - Complete virus particles that are very small and microorganisms) simple in structure. microbes microbial allies microbial enemies microbes indigeneous opportunistic decomposers microflora pathogens or saprophytes microbes that lives do not cause disease under involved in the ordinary conditions, but on and in the have potential to cause decomposition of human body. disease should the dead organisms and opportunity present itself. the waste products estimated to be colonizes or inhabits our 500 - 1000 species body. of living organisms. ACELLULAR MICROBES: VIRUSES BACTERIOPHAGES Microbiology – The study of microbes Viruses that infect bacteria. They are obligate intracellular Bacteriology – The study of structure, functions and activities pathogens; in that they must enter a bacterial cell to replicate. of Bacteria ▪Icosahedron Bacteriophages: Almost spherical in shape, w/ 20 Phycology - The study of Algae triangular facets; the smallest are about 25nm. Protozoology – The study of Protozoa and their activities ▪ Filamentous Bacteriophages: Long Tube formed by capsid Mycology – The study of Fungi proteins assembled into a helical structure; they can be up to Virology – The study of Viruses and their effects on living cells about 900nm long of all types ▪ Complex Bacteriophages: Icosahedral heads attached to Archaea or Cyanobacteria – First microbes on Earth helical tails; may also possess base plates and tail fibers Bacteria and Protozoa – The First microbes to be observed by humans VIRULENT BACTERIOPHAGES Anton van Leeuwenhoek – Father or Microbiology; Father of Always cause lytic cycle which ends with the destruction (lysis) Bacteriology; Father of Protozoology; First to see live bacteria of the bacterial cell. and protozoa ACELLULAR MICROBES: VIRUSES - Acellular microbes that are smaller than bacteria; Obligate intracellular parasites; Referred to as Infectious particles rather than microbes. They are not composed of cells. ACELLULAR MICROBES: VIRUSES BACILLI (BACILLUS) ANIMAL VIRUS - Viruses that collectively infect humans and RECTANGULAR OR ROD shaped. May be short or long, thick or animals thin, and pointed or w/ curved or blunt ends ONCOGENIC VIRUS - Viruses that cause cancer diplobacilli – pairs of bacilli MIMI VIRUS - An extremely large double – stranded DNA virus streptobacilli – chains of bacilli that has been recovered from amoeba. It mimics the bacteria coccobacilli – short and resembling elongated cocci (Ex. Listeria VIROIDS & PRIONS - Viroids are infectious RNA molecules that monocytogenes and Haemophilus influenzae) cause variety of plant diseases. Prions are infectious molecules Example of Medically important cocci: that cause variety of animal and human diseases. Enterobacter, Escherichia, Klebsiella, Proteus, Salmonella, Shigella spp., Pseudomonas aeruginosa, Bacillus spp., and Clostridium spp. SPIRILLA CURVED and SPIRAL in shape Example of Medically important cocci: Vibrio cholerae Vibrio parahaemolyticus Pleomorphic – Bacteria that exist in a variety of shapes Pleomorphism – The ability to exist in a variety of shapes. Mycoplasma – bacteria that do not have cell wall and are resistant to antibiotics that inhibit cell wall synthesis. CELLULAR MICROBES: BACTERIA These are prokaryotic microscopic single celled organisms. The domain bacteria contains 23 phyla, 32 classes, 5 sub classes, 77 orders, 14 sub orders, 182 families, 871 genera and 5,007 species. Divided into three phenotypic categories: Gram – negative and have a cell wall, Gram o positive and have a cell wall, and those that lack a cell wall. Bacteria reproduce by binary fission There are three basic shapes of bacteria COCCI (COCCUS) ROUND OR SPHERICAL in shape. diplococci – pairs of cocci streptococci – chains of cocci staphylococci – clusters of cocci Example of Medically important cocci: Enterococcus spp. Neisseria spp. Staphylococcus spp. Streptococcus spp.  Mycelium - A mass of intertwined fungi. YEASTS - Microscopic, single – celled organisms that usually reproduce by budding. Examples are Candida albicans, Candida neoformans. MOULDS - Microscopic, multicellular organisms. FLESHY FUNGI - Mushrooms, toadstool and bracket of fungi, collectively. These are fungi that are not microorganisms. CELLULAR MICROBES: PROTOZOAL PARASITES PROTOZOA - Single – celled free-living microorganisms. Paramecium and Vorticella spp. are examples of free – living pond protozoa. A typical protozoan life cycle consists of two stages: a motile TROPHOZOITE STAGE and nonmotile CYST STAGE. RESERVOIRS OF INFECTION - A reservoir is any site or the TROPHOZOITE - The motile, feeding, dividing stage in a habitat where pathogen can multiply or merely survive until it protozoan’s life cycle. is transferred to a host. It may be Living Reservoir (Human and CYST - The nonmotile, dormant, survival stage. Cysts are like animal) or Environmental Reservoir - (materials and inanimate bacterial spores. objects) LIVING RESERVOIRS - Includes humans, household pets, farm animals, wild animals, certain insects and certain arachnids (ticks and mites). HUMAN AS RESERVOIR/HUMAN CARRIER - The most important reservoirs of human infectious diseases CARRIER - A person who is colonized with a particular pathogen, but the pathogen is not currently causing disease in that person. A person without apparent disease who harbors a CELLULAR MICROBES: PROTOZOAL PARASITES specific infectious agent and is capable of transmitting the PARASITES - Organism that lived on or in other living agent to others. organisms, at whose expense they gain some advantage. ECTOPARASITES - Parasites that live outside host’s body. ENDOPARASITES - Parasites that live inside host’s body. FACULTATIVE PARASITES - Can be parasitic but are also capable of free-living existence. OBLIGATE PARASITES - To survive, they must be parasites (needs a host). PARASITOLOGY - The study of parasites. It can be divided into the study of parasitic protozoa, helminths and arthropods. ANIMALS AS RESERVOIR HELMINTHS - Means parasitic worms. The helminths that infect Zoonotic Disease or Zoonoses are infectious diseases that humans are always endoparasites. Helminths are multi cellular, humans acquire from animal source. There are over 200 known eukaryotic organisms. zoonoses that can be transmitted from animals to human. This may include dog, cats, bats, birds, monkey, wild rodents, roundworms (nematodes) arthropods and others. helminths tapeworms (cestodes) RESERVOIRS OF INFECTION flat worms flukes (trematodes) CELLULAR MICROBES: FUNGI Eukaryotic, non-photosynthetic microorganism. That can be either saprophytic or parasitic. It includes yeast, moulds and mushrooms. Considered as “Garbage Disposers” of Nature – the “vultures” of microbial world, the “original recyclers” Hyphae - Fungi that grows as filaments.  MODE OF TRANSMISSION There are five principal modes by which transmission of pathogens occur are: Contact Transmission Droplet Transmission Airborne Transmission Vehicular Transmission Vector Transmission MODE OF TRANSMISSION Contact Transmission Direct Transmission –The immediate transfer of an agent from a reservoir to a susceptible host by direct physical contact. Indirect Transmission –The transmission of an agent carried from a reservoir to a susceptible host by fomites. Droplet Transmission Involves the transfer of pathogens via infectious droplets. Droplets may be generated by coughing, sneezing and even talking. Vehicular Transmission - Involves contaminated inanimate objects (“vehicles”) such as food, water, dust, and fomites. Vector Transmission - Involves the various types of biting insects and arachnids Biological Vector – such as mosquitoes and ticks may carry pathogens that can multiply within their bodies and be delivered to new hosts, usually by biting. Examples are Ticks, Flea, Louse, Mite. Mechanical Vector – such as flies can pick up infectious agents NON-LIVING RESERVOIR - Also known as inanimate reservoirs on the outside of their bodies and transmit them through of infection that includes air, soil, dust, food, milk, water and physical contact. fomites PORTAL OF ENTRY FOMITES - Are inanimate objects capable of transmitting The manner of entry is similar with the mode of exit from the pathogens. Fomites found within healthcare settings include reservoir. The most important portals of entry are: patients’ gowns, beddings, towels, eating and drinking utensils Skin and hospital equipment such as bedpans, stethoscope, latex Mucous Membrane gloves, electronic thermometers and electrocardiographic Respiratory Tract electrodes. Gastrointestinal Tract Urinary Tract PORTAL OF EXIT - Before the infectious agent can attack a new Reproductive System host, it must have a way of escape from the reservoir of Conjunctiva infection, like man, animals, plants, soils and others. Placenta The most frequent portals of exit in man are: ▪ Skin through open lesions or w/ the aid of insects or Channels of Infection – Means through which the body hypodermic needles becomes infected by disease producing agents. This may be the Respiratory Tract Respiratory Tract, Digestive Tract and Exterior Surfaces of the Gastrointestinal Tract Body. Eyes/Ears Susceptible Host - A person or animal not possessing sufficient resistance against a particular pathogenic agent and for that person liable to contact a disease if or when expose.  permanent damage may be caused destruction of tissues in the affected areas. TYPE of INFECTION DESCRIPTION EXAMPLE Localized Infection Remain Localized Pimples, Boils, Abscesses Systemic Infection Spread throughout the Miliary /Generalized Infections body Tuberculosis Acute Disease Has a rapid onset Measles, Mumps, usually followed by a Influenza relatively rapid recovery Chronic Diseases Has an insidious (slow) Tuberculosis, onset and lasts a long Leprosy, Syphilis time Sub-acute Diseases Come on more Sub-acute suddenly than chronic Bacterial disease, but less Endocarditis suddenly than an acute disease TYPE of INFECTION DESCRIPTION EXAMPLE Symptomatic A disease in w/c the patient Gonorrhea Disease/Clinical Disease is experiencing symptoms Asymptomatic A disease that the patient is Trichomoniasis Disease/Sub Clinical unaware of because he/she Disease is not experiencing any LESSON 5: CONTROL OF COMMUNICABLE DISEASES symptoms Part II Latent Infection An infectious disease may Cold Sores, go from being symptomatic Genital Herpes to asymptomatic and then, Infections, PATHOGENESIS OF INFECTIOUS DISEASE go back being symptomatic. Shingles The prefix path comes from the Greek word “pathos” meaning Lying dormant and not disease. currently manifesting itself. Primary Infections Pathogen– Microbe capable of causing disease. Secondary Infections Pathology–The study of the structural and functional manifestations of disease. TYPE of DISEASES DESCRIPTION Pathologist–A physician who has specialized in pathology. Congenital Present at Birth Pathogenic–The ability to cause disease. Degenerative From Aging Pathogenesis–The steps or mechanisms involved in the Hereditary Errors in Genetic Code received from parents development of a disease. Hormonal Excess or Deficiency of Hormone Iatrogenic Caused by Medical Treatment/Procedure Idiopathic Unknown Cause FOUR PERIODS OR PHASES IN THE COURSE OF AN INFECTIOUS Immunological Hyperactive or Hypoactive Immunity DISEASE Mental Emotional/Psychosomatic Incubation Period- The time that elapses between arrival of Neoplastic Abnormal Cell Growth the pathogen and the onset of symptoms. The length of the Nutritional Lack of Essential Nutrients in Diet incubation period is influenced by many factors, including the overall health and nutritional status of the host, the immune STEPS IN THE PATHOGENESIS OF INFECTIOUS DISEASES status of the host, the virulence of the pathogen, and the Entry number of pathogens that enter the body. Attachment Prodromal Period- The time during which the patient feels “out Multiplication of sorts’ but is not yet experiencing actual symptoms of the Invasion or Spread of Pathogen disease. The patients may feel like they are “coming down with Evasion of Host Defenses something” but are not yet sure what it is. Damage to Host Tissue(s) Period Of Illness- The time during which the patient experiences the typical symptoms associated with that particular disease. Communicable diseases are most easily transmitted during this third period. Convalescent Period- The time during which the patient recovers. For certain infectious diseases, especially viral respiratory diseases, the convalescent period can be quite long. Although the patient may recover from the illness itself, OVERVIEW OF HUMAN INFECTIOUS DISEASE LESSON 6: OCCUPATIONAL DISEASES BAGASSOSIS Source: Moldy Sugarcane Fiber Causative Agent: Thermoactinomyces sacchari, Thermophilic actinomycetes BYSSINOSIS (Brown Lung Disease/Monday Fever) Source: Textile, Yarn, Fabric Manufacturing Causative Agent/ Major Antigen: Textile Fiber Dust, Cotton Dust BIRD’S FANCIER LUNG (Bird Breeder’s Lung) Source: Pigeons, Parakeets, Fowl, Rodents Causative Agent: Avian or Animal Protein Remarks: A type of hypersensitivity pneumonitis caused by birds droppings. CHEESEWORKER”S LUNG Source: Cheese Mold Causative Agent/ Major Antigen: Penicillium casei, Penicellium roqueforti ESPARTO GRASS HYPERSENSITIVITY PNEUMONITIS Source: Moldy esparto used to produced ropes, canvas, sandals, mats, baskets and paper paste Causative Agent: Fungus (Aspergillus fumigatus) FARMER”S LUNG DISEASE BERYLLIOSIS Source: Moldy Hay Source: Aerosspace Manufacturing, Beryllium Mining or Causative Agent/Major Antigen: Saccharopolyspora manufacturing of fluorescent light bulbs rectivirgula, Thermoactinomyces vulgaris, Thermoactinomyces Causative Agent/ Major Antigen: Beryllium Dust viridis and Thermoactinomyces sacchari BAUXITE (Shaver’s Disease) GRAIN HANDLER’S LUNG Source: Alumina abrasive manufacturing Source: Moldy Grain Causative Agent: Bauxite Fumes Causative Agent: S. Rectivirgula, T. Vulgaris CALCICOSIS HUMIDIFIER/AIRCONDITIONER LUNG Source: Source: Contaminated Forced air systems, heated water Causative Agent/ Major Antigen: Limestone Dust reservoir Causative Agent/Major Antigen: Rectivirgula, T. Vulgaris CHALICOSIS (Flint Disease) Source: Stonecutting/ Masonry Works JAPANESE SUMMER TYPE HYPERSENSITIVITY PNEUMONITIS Causative Agent: Fine Particles of Stone Source: Damp wood and mats Causative Agent: Fungus (Trichosporon cutaneum) COAL WORKERS’ PNEUMOCONIOSIS (Black Lung Disease) Source: MALT WORKER’S LUNG Causative Agent/ Major Antigen: Dust from coal, graphite Source: Moldy Malt Causative Agent/ Major Antigen: Aspergillus clavatus, SIDEROSIS Aspergillus fumigatus Source: Metal Grinding Works Causative Agent: Iron Particles MUSHOOM PICKER’S LUNG Source: Mushroom SILICOSIS Causative Agent: Trichophyton vulgaris Source: Silica exposure Causative Agent/ Major Antigen: Silica Dust SEQUOIOSIS Source: Moldy Redwood bark Causative Agent/ Major Antigen: Spores of Pullularia pullulans MAPPLE BARK DISEASE Source: Moldy Mapple Bark/Mapple Bark Strippers Causative Agent: Aspergillus clavatus, Aspergillus fumigatus MOLLUSK SHELL HYPERSENSITIVITY Source: Shell Dust Causative Agent/ Major Antigen: Sea snail shell SUBEROSIS Source: Moldy Cork Dust Causative Agent: Fungus (Penicillum frequentas) ASBESTOSIS (White Lung Disease) Source: Causative Agent/ Major Antigen: Asbestos Fibers BARITOSIS Source: Barium Handling Industry Causative Agent: Barium Dust LESSON 6.1: INSECTS AND VERMIN CONTROL Control of these pests may be done, in general, through one or more integrated control program of the following basic INSECTS methods of control: Six-legged animal PHYSICAL AND MECHANICAL Air breathing invertebrate animal arthropod with a body that CHEMICAL has well-defined segments, including a head, thorax, abdomen, BIOLOGICAL two antennae, three pair of legs, and usually two sets of wings. ENVIRONMENTAL HEALTH EDUCATION CAMPAIGN BASIC METHODS IN THE CONTROL OF INSECTS AND RODENTS PHYSICAL AND MECHANICAL Use of mechanical devices or physical forces CHEMICAL Chemical applications are rapid and effective means to reduce THERE ARE MORE THAN A MILLION OF INSECTS SPECIES vector population density. INCLUDING: FLIES, BEETLES, CRICKETS, BEES, & GNAT. Constraints: - Behavioral resistance VERMIN - Insecticide persistence A group of insects or small animals which are vectors of diseases BIOLOGICAL e.i. flies, mosquitoes, cockroaches, lice, bedbugs, mice and Considering of limiting factors that affect their growth and rats reproduction. VECTORS ENVIRONMENTAL Arthropods or other invertebrates which transmit infection by Removal of breeding places and attractants. innoculation or through the skin or mucuos membrane by biting, or by deposit of infective materials on the skin or on HEALTH AND EDUCATION CAMPAIGN food or other objects. Understand and appreciate the importance of control measures and therefore motivate them to change their habits, DISEASES ARE TRANSMITTED BY VECTORS EITHER: practices, and attitudes, which promote the survival and MECHANICALLY-The causative organism is carried in or on the multiplication of pests. body of the insect. The insect plays no part in the metabolism, or physiological changes in the nature of organism. HOUSEFLY (musca domestica) BIOLOGICALLY- The body of the insect furnishes an essential link in the series of biological changes which occur in the development of the organism BASIC REQUIREMENTS IN THE CONTROL OF VECTORS The control of insects requires a understanding of their way of life. It is necessary to understand the anatomy of the insect, its method of growth, the time it takes for the insect to grow from egg to adult, its habits, the stage of its life history in which it causes damage, its food, and its common living places. In order to obtain the best control it is especially important to be able to identify correctly the specific insect involved because without this knowledge, it is impossible to prescribe a proper Adult look like: treatment. Large eyes 2 wings BASIC METHODS IN THE CONTROL OF INSECTS AND RODENTS Small antennae (feelers) At the outset it must be understood that it is a biological 3 pairs of legs and fat body impossibility to exterminate or eradicate completely these 6 to 9 mm long (1/4 inch) vectors. The most that can be expected is to minimized their No biting mouthparts number and/or eliminate them from household premises.  BIOLOGICAL CONTROL -Release of sterile flies– when female fly mate with sterile male whose pupa which expose to gamma rays from radioactive cobalt, large number of sterile eggs are produced. Released of sterile flies continued until the population falls to an extremely low level. - The sterile males compete with wild males to mate with the females. Females that mate with a sterile male produce no offspring, thus reducing the next generation's population. The life cycle of a fly has four stages: egg, larva, pupa, and CHEMICAL CONTROL adult. – Residual spray– for long lasting control. When applied, the -An egg hatches in 6 t0 8 hours chlorinated hydrocarbons and organic phosphorous insecticide -A larva comes out will leave a film of crystals that will kill some insects for weeks -The larva grows and molts 3 times in 3 days or more or months thereafter. -It becomes pupa for 3 days or more. – Space spraying– ultra low volume and thermal fog -The adult hatches and can mate after 15 hours. application– economical and fast. Putting a very fine mist or -The adult hatches and can mate after 15 hours aerosol into areas where flies are abundant, for killing a large number of adults. To control fly quickly from distance away. Why are housefly harmful? – Larvicidal Treatment– for control of maggots. It is directed Acts as mechanical vector of many human disease towards the elimination of breeding media of larval habitats. The most important breeding places of the housefly are: - human excreta HEALTH EDUCATION CAMPAIGN - Fresh horse manure - Manure of other animals COACKROACH (Blattella germanica) - garbage Flies live in filth: in feces, garbage, and dead animals. Germs are carried on fly’s feet Flies land on food and dishes Flies eat organisms in feces, garbage and meat Flies leave droppings on their food. Droppings contain organisms that cause disease. It may then transmit pathogenic bacteria to human food from its mouth parts, by vomitus, and from its sticky foot pads and body and legs hairs. Adult are strong: Disease known to have been so transmitted are typhoid fever, They can live 2 weeks w/o water. cholera, bacillary and amoebic dysentery, etc. They can live 3 weeks w/o food. They eat almost anything: food, leather, glue, hair, paper, How do we control Housefly? wallpaper, paste, and each other. ENVIRONMENTAL CONTROL - Elimination of Food Sources - Elimination of Breeding Places Cleaning and removal of decaying vegetables, animal matter, garbage, manure piles, etc. Such materials shall never be allowed to remain for more than 4 days. - proper refuse storage and disposal. - proper food storage. - proper excreta disposal. The life cycle of a fly has three stages: egg, nymph and adult. MECHANICAL AND PHYSICAL CONTROL -A female lays about 30-40 eggs in an egg case. - Screens o Electric Fans -She carries the egg case under her body within a day or two. - Other Physical Control Measures Such as Swatting Use of Fly -The nymph comes from the egg in 2 or 3 days Sticker, Flame Throwers, Flooding Of Breeding Grounds. -The nymph grows and shred skin 5 to 7 times in 30 to 60 days -Adults mate 7 to 10 days after they are fully grown -The life cycle takes 2 to 3 months - It is pupa for 1-2 days - It becomes an adult on day 11 WHY ARE COCKROACH HARMFUL? - An egg can live for a year or more w/0 water. They can carry organisms that cause disease. They can make skin itch and eyelids swell. Why are Mosquitoes harmful? They can spoil food. - They cause annoyance and discomfort to people. - They bite and make skin itch HABITS OF COCKROACH - They carry organism that cause disease. They Are Active At Night They Hide During The Day In The Kitchen And Furniture And Habits of Mosquitoes Almost Everywhere They Fit Narrow Spaces They Live In Group They Prefer Starchy Materials Such As Bakery Good, Cereals And Book Bindings But Will Also Feed Upon Leather, Wallpaper, CULEX PIPIENS QUINQUEFASCIATUS And Dead Animals. ADULT MOSQUITOES ARE ACTIVE AT NIGHT THEY REST DURING THE DAY IN AND AROUND THE HOUSE HOW DO WE CONTROL COCKROACHES? THEY BITE ANYWHERE ON PEOPLE AND ANIMALS ENVIRONMENTAL CONTROL THEY LAY EGGS IN WATERS -All areas must be kept clean -Frequent cleaning of the building will help remove the eggs AEDES AEGYPTI -The building should always be in good repair. BITES ONLY IN THE DAYTIME OR BY ARTIFICIAL LIGHT AND ITS -All windows and doors should be tight-fitting. FAVORITE POINT OF ATTACK IS THE ANKLES THE BITE AND SUCK BLOOD CHEMICAL CONTROL A FEMALE BITES PEOPLE ON ANKLES, NECK, AND UNDER -Use of insecticides CLOTHING THEY HIDE IN HOLES IN TREES AND IN DRAINAGE PIPES HEALTH EDUCATION CAMPAIGN THEY CARRY ORGANISMS THAT CAUSE DISEASES LIVE NEAR WATER MOSQUITOES (Culex pipiens Quinquefasciatus) HOW DO WE CONTROL MOSQUITOES? (Aedes Aegypti) ENVIRONMENTAL CONTROL - Source elimination CHEMICAL CONTROL - Space spraying - Oils - Repellants BIOLOGICAL CONTROL - Iarvivorous fish eat mosquito larvae - Dragonfly eat mosquito eggs, wriggles and tumblers - Toads and frogs eat adult mosquitoes Life Cycle of Culex Pipiens Quinquefasciatus - Lizard eat adult mosquitoes - A female lays about 100 – 300 eggs. - Eggs form a raft which floats on water. MECHANICAL/PHYSICAL CONTROL - Eggs hatch in 1 to 2 days. - Use netting or screens over windows, beds and especially - Larva and pupa stages take 8-10 days cribs - It takes 9-13 days to change from egg to adult - An adult lives for 10-12 days HEALTH EDUCATION CAMPAIGN - Females need blood to lay eggs Life Cycle of Aedes Aegypti - An egg hatches in 10-20 minutes - A larva lives in water for 7-9 days RATS AND MOUSE PUBLIC HEALTH SIGNIFICANCE OF DOMESTIC RATS RESERVOIR OF HUMAN DISEASES MOUSE Murine Typhus Fever Have 20 chromosome Plague Small feces Rat Bite Fever Small, triangular head Weil’s Disease or leptospirosis Narrow with sharp muzzle Salmonellosis Ears are large Ricketsialpox RAT HOST FOR ECTOPARASITE Have 21 chromosome pairs FLEAS: Plague, Murine typhus Larger feces Life span is 1.5-2.5 years ECONOMIC LOSS AND DAMAGE Has a small and skinny tail Contaminating foodstuff Can dig about 1 foot Destroying properties Slightly bigger eyes Head is short, stubby, broad, large relative to body LOST OF MANPOWER EFFICIENCY Large blunt with wide muzzle Loss of sleep Ears are small relative to head Inconvenience Life span average to 2-3 years Has a big and thick tail WHAT ARE THEIR HABITS? Can dig deep and long burrows -REACTION TO STRANGE OBJECTS Small eyes -CLIMBING -JUMPING NORWAY RATS (Rattus norvegicus) -SWIMMING Most common and largest of the domestic rats -NESTING AND HARBORAGE Called brown rat or sewer rat -GNAWING Burrowing animal -FEEDING HABITS LIFE CYCLE: Attained its sexual maturity 3-5 months and the average SENSES gestation period is 22 days -TOUCH Frequent range of travel is 100-150 ft. from their harborage -VISION Length of life is about one year -SMELL -TASTE ROOF RAT (Rattus rattus) -HEARING Also known as black rat, climbing rat, ship rat, house rat, -BALANCE Alexandrine rat, old English rat. -COMPETITION Prefers hollow spaces in walls, or rubbish boxes, barrels, and other containers, attics, or upper stories and trees. HOW DO WE CONTROL RATS AND MICE? Can climb pipes, ropes, wires, wooded uprights. ENVIRONMENTAL CONTROL Less prolific than the brown rat, producing fewer rats per - Rodent Starvation litter. CHEMICAL CONTROL HOUSE MOUSE (Mus musculus) - Fumigation The smallest of the domestic rodents - Stomach Poisons Small and slender and is covered with dusky gray - Ectoparasites Control Has a long tail Ears is moderately large and prominent BIOLOGICAL CONTROL Lives in any convenient place such as walls, cabinets, and - Predatory animals furniture. - Use of sterile males LIFE CYCLE: Attained its sexual maturity 1 ½ months or 45 days and the MECHANICAL/PHYSICAL CONTROL average gestation period is 90 days - Rodent Stoppage Frequent range of travel is 100-150 ft. from their harborage - Use traps Length of life is about one year - Shooting with bullets - Catching with bare hand · Magnitude of exposure - electrocution *An immediate response may be produced due to intense exposure to the hazard or the response may result from longer HEALTH EDUCATION CAMPAIGN exposure at a lower intensity. REGULATORY –QUARANTINE LAWS III. CHEMICAL HAZARDS Chemical Agents May Occur As: LESSON 7: OCCUPATIONAL HAZARDS AND EFFECTS · Gas – e.g. carbon monoxide, hydrogen sulfide, carbon dioxide · Vapors – e.g. solvents, acids WORKPLACE HAZARDS AND THEIR ILL EFFECTS · Aerosols – dusts, fumes, smoke, mist, fog I. INTRODUCTION: Examples of the Patterns of Effects from Exposure to Chemical Goals of Occupational Health (Joint ILO/WHO Committee on Hazards Occupational Health) · Acute – immediate effect from high dose exposure the promotion and maintenance of the highest degree of - e.g. pesticide poisoning physical, mental and social well-being of workers in all · Chronic – effects from low dose long term exposure occupations; - e.g. lead poisoning, cancer from benzene the prevention among its workers of departures from health · Carcinogenic effect caused by their working conditions; the protection of workers · Allergic reaction/ effects, etc in their employment from risks usually from factors adverse to health; Routes of Entry of Chemical Hazards into the Human Body the placing and maintenance of the worker in an · Through the skin (absorption) occupational environment adapted to his/her physiological and · Through the gastrointestinal tract (ingestion) psychological ability; and · Through the respiratory tract/ lungs (inhalation) the adaptation of work to the worker and each worker to *In the occupational setting, the most frequent and most his/her job. important route of absorption is through the lungs or inhalation II. CLASSIFICATION OF HAZARDS Occupational hazards - factors found in the workplace that can Routes by Which the Body Excretes the Chemical Hazards cause diseases, injuries or deviations from health and may be · Gastrointestinal tract – through the feces classified as physical, chemical, biological and ergonomic · Kidneys – through the urine hazards. · Lungs – as one exhales 1. Physical agents include excessive levels of noise, vibration, · Secretory structures – through the sweat glands, breast milk, extremes of temperature and pressure and ionizing and non- etc. ionizing radiation. 2. Biologic agents cause diseases through infection or by Factors which affect absorption of chemical hazards affecting the immune mechanism. · Water solubility 3. Chemical hazards are caused by gases, vapors or aerosols · Particle size workers come in contact with through the performance of their · Defense mechanisms of the host/ human body tasks. 4. Ergonomic stressors include improperly designed tools or Table 1. Renal Diseases That May Arise From Chemical Exposure in work areas, improper lifting or reaching, poor visual conditions the Workplace and other conditions in the workplace that may lead to Causative Agents Industry Diseases accidents and illness or discomfort on the part of the workers. Mercury, Lead, Battery, chemical Chronic Renal Cadmium industries, Battery Failure, Renal manufacturing Stones (cadmium), Factors That Influence Workers’ Response to Hazards Nephrotic · Genetic or Heredity Syndrome (mercury) · Age Chloroform, Carbon Solvents, chemical Acute Renal Failure · Gender tetrachloride industries · Medical History Carbon disulfide Solvents, pesticides Chronic renal failure Variables that Influence Effects of Hazards to the Workers · Physical properties of the hazards · Multiplicity of exposure to the hazards · Duration of exposure to the hazards · Timing of exposure Table 2. Respiratory Diseases That May Arise From Chemical Exposure Table 6. Occupational Cardiovascular Diseases in the Workplace Causative Agent Industry/Process Disease Causative Industry/ Process Diseases Lead, cadmium Battery Hypertension Agents manufacturing/recycling Inorganic Dust Mining, sandblasting, Pneumoconiosis Carbon disulfide Degreasing, dry cleaning Atherosclerosis construction, coal workers (silicosis, asbestosis, Flourocarbons, Refrigeration, solvent Arrythmias coal workers’ trichloroethylene workers pneumoconiosis Nitrates Explosives Angina, Hemp, flax Textile, cotton, Myocardial Byssinosis infarction Molds Agriculture Farmers’ Lung, bagassosis Table 7. Occupational Lead Exposure: Risk Factors Solvents, Chemical processes/ Irritation, INCREASED RISK DECREASED RISK ammonia, industries, pulp & paper inflammation, The High processing Low temperature formaldehyde production, laboratories edema process temperature (esp. 1000oc) (500oc) Diisocyanates, Plastics, platinum Asthma itself Extensive fume, dust or Low dust exposure vanish jewellers, electroplating aerosol formation. Automation Nickel, Pigments, plating Cancer Primitive working methods arsenic, processes, metal refining General Poor housekeeping Efficient local and chromium hygienic Poor personal hygiene general ventilation level of the Ignorance (e.g when Prevention of Table 3. Occupational Hematologic (Blood) Diseases workplace protective equipment is spread of lead dust Causative Agent Industry/Process Disease required but not used) (for example, Lead Battery manufacturing, Anemia Smoking and eating in the moistening the lead smelting workplace floor) Benzene Solvent, soap Aplastic anemia manufacturing Effects of Lead Poisoning: Arsine gas Chemical industries Hemolysis of red · Hypertension blood cells · Decreased hearing acuity · Nephropathy/ Renal failure Table 4. Skin Diseases That May Arise From Chemical Exposure in the · Infertility (men) Workplace · Frank anemia Causative Agent Industry/Process Disease Plastics. Epoxies Plastic, Varnish Allergic Contact · Peripheral Neuropathy Dermatitis · Encephalopathy – seizures Sodium Hydroxide, Chemical industry, Irritant Contact Acids laundering Dermatitis IV. PHYSICAL HAZARDS Cement Construction, Burns, irritation, · Noise Cement contact dermatitis · Extremes of Temperatures (Very warm & very cold) manufacturing · Inadequate Illumination Cutting oils, grease Machine tools Acne · Radiation (Ionizing & Non-ionizing) operations · Vibration Chlorinated Chemical processes Chloracne hydrocarbons A. NOISE Arsenic, tar, polycyclic Petroleum refinery, Skin cancers · Any unwanted or undesirable sound hydrocarbons asphalt workers · Effects of noise depend on Table 5. Occupational Liver Diseases o intensity (loudness) Causative Agent Industry/Process Disease o duration of the sound Carbon Cleaning fluids, dry Acute o frequency of the sound tetrachloride cleaners Hepatotoxicity Arsenic, Chlorinated Smelting, Cirrhosis Approximate Decibel Level Hydrocarbons Insecticides, Decibels (dB) Chemical industry 0 - The quietest sound you can hear Epoxy resins Rubber, synthetic Acute cholestatic 30 - Whisper, quiet library fabrics hepatitis 60 - Normal conversation, sewing machine, typewriter Vinyl chloride, Plastics, vinyl Liver cancer 70-80 - Television aflatoxins chloride monomer 90 - Lawnmower, shop tools, truck traffic, 8 hours per day is the maximum exposure 100 - Chainsaw, pneumatic drill, snowmobile; B. VIBRATION 115 - Sandblasting, loud rock concert, auto horn Definition - physical factor which affects man by transmission 140 - Gun muzzle blast, jet engine of mechanical energy from oscillating sources Permissible Noise Exposure Subdivisions Duration/day (hrs) - Sound Level (dB) · Wholebody vibration 8 - 90 · Segmental vibration 6 - 92 4 - 95 POTENTIAL OCCUPATIONAL EXPOSURES 3 - 97 Whole Body Vibration Segmental Vibration 2 - 100 truck drivers chain sawyers 1 - 1/2 102 bus drivers pneumatic tool operators 1 - 105 (chippers, staple gun 1/2 - 110 operators, construction & road operations) 1/4 or less - 115 heavy equipment operators mining (jack leg & hand tool) farm vehicle and tractor electrical grinder operators (from the Department of Labor & Employment: Occupational operators Safety & Health Standards) foundry workers (mold shakeout, metal extrusion operators forklift trucks, overhead cranes) Harmful Effects of Noise railroads (engineers, conductors, wood products manufacturing · Hearing damage track repair workers) · Interfers with work performance forklift operators · Disturbs relaxation and sleep · Hypertension HEALTH EFFECTS: VIBRATION · Hyperacidity Whole Body Vibration Segmental Vibration (Hand-Arm) · Palpitations General stressor Localized stressor to the fingers and · Stress-related disorders hand – can cause damage to the bones and joints of the upper Patterns of Hearing Damage From Noise Exposure extremities Acute Effects: From loud/ excessive noise such as blasts (140- Changes in the central Hand-Arm Vibration Syndrome - nervous system Raynaud’s phenomenon or “white 160 dB, damages the eardrums) fingers” – fingers blanch or turn Chronic Effects: Due to long term exposure to hazardous noise white especially when vibration levels exposure is also accompanied by exposure to cold weather Types of Noise Induced hearing Loss Damage in bone structure tenosynovitis 1. Temporary Threshold Shift (Auditory Fatigue) Disturbance in nerve Dupuytren’s contractures · Temporary loss of hearing acuity after exposure to loud noise conduction · Recovery within 16-48 hours Disturbances in vision and 2. Permanent Threshold Shift gastrointestinal function · Irreversible loss of hearing Increase in oxygen · Usually after prolonged unprotected exposure to noise consumption greater than the permissible limit Increase in pulmonary ventilation Early Signs of Hearing Loss Prevention of Vibration injuries: · Difficulty in understanding spoken words in a noisy · Information and training of workers environment · Proper work schedule: rotation of workers, adequate rest · Need to be near or look at the person speaking to help · Proper job and production design understand words · Minimize smoking and use of drugs which affect circulation · Familiar sounds are muffled · Use of personal protection such as vibration dampening · Complaints that people do not speak clearly gloves or shock absorbers · Ringing noises in the ears (tinnitus) Medical Surveillance: Table 8. Summary of Disorders due to heat stress Pre-employment and Periodic Exams Disorder Cause Main Treatment Prognosis > clearances from an otolaryngologist, neuropathologist, Clinical Features therapist, gynecologist, and radiologist Milaria Malfunction of Pruritic rash Symptomatic Good Special Tests Rubra sweat glands > general: blood tests Heat Loss of water Cramps in Rest, fluids Complete > x-ray of the hand bones or spinal column Cramps and electrolytes limbs with added is salt/saline recovery usual C. INADEQUATE ILLUMINATION Heat Physical Dizziness, Rest, cooling Complete Evaluation for illumination shall consider: exhausti exertion. Loss of blurring of in well- recovery 1. Quantity - depends on task (too much too little) on water and vision, ventilated is usual 2. Quality - shadows, silhouettes, overcasts, reflections, glares electrolytes. clammy, surroundings sweaty, cold skin. Recommended Illumination Levels Heat Failure of Convulsions Stripping High Area of Operation =Min Lighting Level (lux) stroke temperature ; muscle down, cooling mortality, Cutting Cloth =2000 control center twitching. with ice- sequelae Fine machining in brain delirium. baths, may Hot dry corticosteroid include Transcribing handwriting =1000 skin, s poor Drafting cyanosis, memory Welding =500 body and First Aid station temperatur concentra Lunch Room =300 e 41.1o C or tion, higher. headache. Rest Room Recommendations For Working In Hot Conditions Recommended Illumination Levels at VDT Workstations 1. Acclimatization is necessary Working Conditions =Illumination Level (lux) 2. Encourage drinking small amount of fluids at frequent Conversational Tasks =300 intervals - well printed source documents 3. The greater the heat and physical load, the more frequent - reduced readability of source documents =300-400 the cooling periods. Data Entry Tasks =500-700 4. Source of drinking water should be made available and if possible near the workers. Usual Complaints of Inadequate Illumination: 5. Proper clothing should be worn, clothing adequate enough Visual Fatigue to shield workers from the heat source. Double Vision Headaches COLD STRESS Painful irritation Occupational Exposures Lacrimation, Conjunctivitis · cooling room workers · dry ice workers Occupational Effects of Visual Fatigue · ice makers · Loss of productivity · out of door workers during cold weather · Increased Accident Rate · cold storage workers · More Mistakes · Lowering of Quality Cold Induced Injuries · Visual Complaints Frostbite · fingers, toes, cheeks, nose, and ears are most susceptible D. HEAT · characterized by reddening of the skin, localized burning pain, -Heat is a form of thermal energy which may come from: and numbness · body metabolism Trench Foot (Immersion Foot) · increase physical activities · results from prolonged exposure of the lower extremities to · radiation from hot surfaces/ objects or from the sun and cold and moisture byproducts of industrial processes. - 32 F to 50 F or O to 10 C · neurovascular damage, and tissue anoxia follows · characterized by numbness, painful paresthesias, followed by leg cramps, vesiculation, ulceration and gangrene General Hypothermia · Lasers – Potential hazards to the skin and eyes · results from being in cold weather or submerged in cold water · Microwave – Current conduction, heat · characterized by dizziness, fatigue · Radiofrequency - Current conduction, heat · can lead to unconsciousness and death · Extremely low frequency – current conduction · Static fields – static electric shock Control Measures Provide adequate clothing including insulated gloves, footwear and headgear V. BIOLOGIC HAZARDS · Build barriers around the worksite to block the wind Biological hazards - caused by living organisms which include · Supply workers with warm beverages insects, molds, fungi, viruses and bacterial contamination; from defects in sanitation and housekeeping procedures, such as in RADIATION the provision of potable water, removal of industrial waste and Ionizing Radiation – any electromagnetic or particulate sewage, food handling and personal cleanliness. radiation capable of producing ion pairs by interaction with matter, particularly important biologically since media can be Common Health Problems From Biologic Hazards: altered Tuberculosis (TB) Ionized atom in DNA molecule may be altered causing: - chronic bacterial infection that is characterized by formation –cell death of granulomas (scarring of tissues) in infected tissues. –change in cell reproduction and division - In 1993, was the 5th leading cause of death in the Philippines –mutation - 60% of deaths occur among the 15-64 years of age (productive age group) Examples of Ionizing Radiation: General Population Exposure - readily transmitted by an infected person through respiratory · Alpha particles Medical secretions during coughing, sneezing, vocalizing · Beta particles Radon - easily treated with antimicrobials, preventable · Neutrons Terrestrial · X and Gamma rays Cosmic Tetanus Fallout - caused by a bacteria, Clostridium tetani, usually from Industrial Internal contaminated wounds - affects the nervous system Acute Effects of Ionizing Radiation (within days,4 weeks to 3 - manifests as muscle spasm, lock jaw, sustained contraction of months) muscles in the face & back, convulsions/ seizures. 1. Skin – erythema - can be prevented through active immunization with tetanus 2. Bone Marrow – depressed white cell count, impaired vaccine and careful wound management immune system 3. Intestines – depletion of intestinal villi, can result in fatal Viral Hepatitis dysentery like syndrome - systemic infection caused by a virus affecting the liver 4. Testes – decreased sperm count, sterility - route of infection 5. Lungs – Pneumonitis, respiratory failure ß Hepatiti