[DPC - LE 1] 07 - Higher Units of Care_ Occupational Health and School Health.pdf

DISEASE PREVENTION AND CONTROL: LE 1 | TRANS 7 Higher Units of Care: Occupational Health and School Health CHRISTIAN PROTACIO G BETITA, MD | (08/22/2024) OUTLINE...

DISEASE PREVENTION AND CONTROL: LE 1 | TRANS 7 Higher Units of Care: Occupational Health and School Health CHRISTIAN PROTACIO G BETITA, MD | (08/22/2024) OUTLINE Prevent ill health, injury or illness already suffered or aggravated by the work environment I. Occupational Health III. Hazards Ensure that workers are able to sufficiently work and Safety A. Definition Detect a health condition of a worker that increases the A. Occupational B. Types of Hazards risk of injury or accident Health and Safety C. Control of in the Philippines Workplace Hazards C. TYPES OF HEALTH EXAMINATIONS IN THE B. Health IV. School Health WORKPLACE Examination in the A. Three Critical Pre-employment physical exam Workplace Areas Periodic annual medical examination C. Types of Health B. Models of School Transfer Examinations in Health Special the Workplace V. Philippine Situation Return to work II. Disability A. One Health Week Separation from work/employment A. Compensation for B. DepEd Programs Disability C. Future PRE-EMPLOYMENT PHYSICAL EXAM B. Types of Developments Condition of an applicant at the time of hiring Disabilities VI. Review Questions Physical abilities required to perform a job C. Medical Services VII. References Prevents placement where a worker may be a danger A general clinical examination, including special laboratory SUMMARY OF ABBREVIATIONS OSH Occupational Safety and Health of the worker’s prospective employment 📖 examinations when necessary, due to the peculiar nature 📖 DepEd Department of Education Include chest x-ray examinations, which under special DOH Department of Health circumstances, shall be rendered free of charge WASH Water Sanitation and Hygiene Table 1. Classifications Of Pre-Employment Physical Exam [Dr. Betita’s WinS WASH in schools Lecture Slides, 2024] WIFA Weekly Iron Folic Acid Classification Definition Class A Physically fit for any work ❗️ Must know 📣 Lecturer 📖 Book 📋 Previous Trans Class B Physically underdeveloped or with correctible defects (e.g., errors of LEARNING OBJECTIVES refraction, dental caries, defective ✔ Identify hazards hearing, and other similar defects) but ✔ Institute measures to control hazards otherwise fit to work; Physically fit but ✔ Apply school health principles or models to deliver with minor ailment/s or condition/s health services to schools/ school age children curable within a short period of time that will not adversely affect the worker’s I. OCCUPATIONAL HEALTH AND SAFETY Aims of Occupational Safety and Health (OSH) → Promoting and maintaining the highest degree of 📖 Class C efficiency Employable but due to certain physical, mental, and social well-being of workers in impairments / conditions (e.g., heart all occupations; disease, hypertension, anatomical → Preventing workers from experiencing departures defects) requires special placement or from health caused by their working conditions; limited duty in a specified or selected → Protecting workers in their employment from risks assignment requiring follow-up resulting from factors adverse to health; treatment / periodic evaluation → Placing and maintaining workers in an occupational Class D Unfit or unsafe for any type of environment adapted to his physiological and employment (e.g., active pulmonary psychological ability; and; tuberculosis, advanced heart disease → Allowing the adaptation of work to man and of each with threatened failure, malignant man to his job hypertension, and other similar defects) A. OCCUPATIONAL HEALTH AND SAFETY IN THE PERIODIC ANNUAL MEDICAL EXAMINATION PHILIPPINES Focuses on health risks of employees As of 2024, non-fatal occupational injuries occur at a rate Follows up on previous findings of approximately 417 per 100,000. Early detection of disease Occupational fatalities occur at a rate of 9.6 per 100,000. B. HEALTH EXAMINATION IN THE WORKPLACE Shall include the following examinations: → General clinical examinations 📖 Determines effect of exposure to health hazards Detect early signs of illness, injury, ill health in workers LE 1 TRANS 7 TG-B22: A. Miranda, A. Mirasol, J. Monfero, M. Monteras, K. TE: J. Monfero, K. Monzon AVPAA: K. Gacutan Page 1 of 9 Monzon, M. Mora, A. Morales*  → Special examinations and/or investigations deemed → Notorious negligence necessary for the diagnosis of these diseases which will → Not work-related be free of charge in case the workers are exposed to II. DISABILITY occupational health hazards → Whenever feasible, a chest x-ray examination at least A. COMPENSATION FOR DISABILITY once a year which shall be rendered free of charge to Injuries, deaths are work-related and compensable if they the workers happened: → Regular biochemical monitoring which shall be → At the workplace conducted free of charge for workers exposed to toxic → While the worker is performing his official function substances / pesticides classified under toxicity → Outside the workplace but while the worker is categories I and II of the WHO toxicity classification performing an order of his/her employer standards → While going to or coming from the place of work Further explanation: → While ministering to personal comfort (hunger, thirst, When occupational diseases have been detected in bathroom breaks) workers and continued employment might jeopardize B. TYPES OF DISABILITIES their health, their employment shall be discontinued until after their complete or satisfactory recovery. If TOTAL DISABILITY circumstances permit, such workers shall meanwhile be A condition where an individual is unable to work due to given some other job consistent with their state of injuries or illnesses that are expected to last indefinitely recovery. 📖 health and which shall not impede or retard their PARTIAL DISABILITY An individual is unable to perform some, but not all, of the TRANSFER significant duties of their occupation due to an illness or An employee shall not be transferred to another work or injury job until they have been examined and certified that TEMPORARY DISABILITY transfer is medically sound 1 – 120 days SPECIAL Daily income benefit 90% of the average daily salary as May be required where there is undue exposure to health determined by SSS/GSIS hazards PERMANENT TOTAL DISABILITY → Health hazards such as lead, mercury, hydrogen More than 120 days (continuously) substances 📖 sulfide, sulfur dioxide, nitroglycol, and other similar → For example, employees who are chronically exposed Any of the following: → Complete loss of sight to organophosphates may undergo special periodic → Loss of limbs at or above the ankle/wrist examination either quarterly or monthly to determine if → Permanent or complete paralysis of 2 limbs → Brain injury resulting in incurable imbecility/insanity exposure 📣 there is an increased illness due to the increased → Miners who are also chronically exposed to lead and PERMANENT PARTIAL DISABILITY Any injury or illness that results in the loss of use of any they are still healthy 📣 mercury need to be regularly examined to determine if 📣 part of the body despite any pre existing condition → You may or you may not return to work RETURN TO WORK Table 2. Loss of body part and their equivalent months of leave with To determine whether or not a worker is fit to return to work pay [Dr. Betita’s Lecture Slides, 2024] To prevent spread of contagious diseases No. of No. of Loss of Loss of To reassess if a worker may continue if with injuries and Months Months disabilities One thumb 10 One arm 50 Conducted after prolonged absence for health reasons, for One index finger 8 One foot 31 causes 📖 the purpose of determining its possible occupational One middle finger 6 One leg 46 SEPARATION FROM EMPLOYMENT One ring finger 5 One ear 10 An employee leaving the employment of the company One little finger 3 Both ears 20 📖 shall, if necessary, be examined by the occupational health One big toe 6 Hearing of one 10 physician: ear → to determine if the employee is suffering from any Any other toe 3 Hearing of both 50 occupational disease; ears → to determine whether he is suffering from any injury or One hand 39 Sight of one 25 illness which has not completely healed; and eye → to determine whether he has sustained an injury Death is compensable when it results from a work-related C. MEDICAL SERVICES injury or sickness Reimbursement of the cost of medicines for the illness or Beneficiaries are entitled to benefits injury, payment to providers of medical care, hospital care, Status of beneficiaries is determined at the time of an surgical expenses, and the costs of rehabilitation employee’s death appliances and supplies Where death/disability is non-compensable: Limited to ward services of government hospitals → Intoxication Not included: → Willful intent to injure self or others → Extra charges (e.g., private room, appliances) → Duty nurses DISEASE PREVENTION AND CONTROL Higher Units of Care: Occupational Health and School Health Page 2 of 9  III. HAZARDS A. DEFINITION → When pressure in the lungs is greater than atmospheric pressure, air moves from the lungs to the outside → Decompression sickness 📖 Health hazards are environmental factors, agents or → Dysbarism: has two types, barotrauma and dissolved situations that may create potential harm or injury to one's gas dysbarism physical well-being ▪ Barotrauma Risk is the probability that a person exposed to a factor will − Trauma due to gas-containing tissues in the body actually experience a specific hazard − Involves rapid ascent or descent → With increased exposure comes increased risk − As one enters lower-pressure areas, gas-filled ❗️ Basis for determining hazards and how to control them: → Occupational Safety and Health Standards (Department areas (eg. the lungs) may expand or contract depending on change of pressure − Rapid ascent results in pulmonary of Labor and Employment, 1989) overpressurization, gas embolism; barotrauma → Labor Code of the Philippines may be localized → Employees' Compensation Commission manual − Usually seen in divers, can also be seen in mountain climbers B. TYPES OF HAZARDS ▪ Dissolved gas dysbarism − Increase of pressure leads to nitrogen being 📖 PHYSICAL HAZARDS dissolved inside of the blood This involves contact with various forms of energy − Decrease of pressure with ascent leads to Vibration Syndromes nitrogen bubbles trying to leave the blood, from oscillating sources 📖 → Vibration refers to transmission of mechanical energy → Vibration induced white finger disease (hand-arm resulting in decompression sickness, oxygen toxicity, and nitrogen narcosis − Is also seen in divers vibration syndrome) Heat etc. 📣 ▪ Usually seen in workers using jackhammers, drills, → Increased temperature, humidity, air movement, and lack of shade 📣 → Heat stroke is fatal and must be arrested as soon as possible Figure 1. (Left) White Finger Disease. (Right) Hand-Arm Vibration Frequencies [Dr. Betita’s Lecture Slides, 2024] → Whole body vibration → The vibration energy from the vehicle is transferred to the operator through the feet, seat, or backrest ▪ Health effects − Speech interference Figure 3. Heat Exhaustion vs. Heat Stroke [Dr. Betita’s Lecture Slides, 📖 2024] − Increased heart rate and blood pressure − Muscle fatigue and cramping Lighting (Defective Illumination ) − Increased breathing rate → Low or direct sunlight − Disruption of balance and perception → Poor lighting can be a safety hazard: i.e., 📖 − Low back pain and damage to the spine misjudgement of the position, shape or speed of an object can lead to incidents and injury → Poor lighting can be a health hazard: i.e., too much or 📖 too little light strains eyes and may cause eye discomfort (i.e., burning, etc.) and headaches → Poor lighting can affect the quality of work, specifically productivity 📖 in situation where precision is required, and overall ▪ The amount of light needed in the work area varies and depends on: (1) type of task being done (i.e., Figure 2. Injuries caused by vibrations [Dr. Betita’s Lecture Slides, 2024] such as demands for speed and accuracy); (2) type Altitude (Extremes of Atmospheric Pressure ) 📖 of surfaces (i.e., does it reflect or absorb light); (3) general work area or space; and (4) a person’s gradient or difference in pressure 📖 → Air moves in and out of the lungs due to a pressure → When atmospheric pressure is greater than pressure visual acuity ▪ The amount of light falling on a surface is measured in units called lux. Depending on the factors noted 📖 within the lungs, air flows from the outside into the lungs above, adequate general lighting in a workplace is DISEASE PREVENTION AND CONTROL Higher Units of Care: Occupational Health and School Health Page 3 of 9  usually between 500 and 1,000 lux when measured Heavy equipment 110 in 76 cm (30 inches) above the floor Flight line 120 ERGONOMICS/MECHANICAL HAZARDS Mechanical Ergonomics → Repetitive mechanical forces → Excess loads, poor ergonomics → Includes occupational musculoskeletal injuries such as carpal tunnel syndrome, De Quervain tendinitis, low back pain ▪ Carpal Tunnel Syndrome − Impingement of the median nerve due to inflammation at the flexor retinaculum − Tested either through Phalen’s Test or Tinel’s Test (hand motions and sensory input) ▪ De Quervain Tendinitis Figure 4. Consequences of Poor Lighting [Dr. Betita’s Lecture Slides, − Due to inflammation of the two tendons that 2024] control the thumb Radiation − Can be diagnosed using Finkelstein’s Maneuver → Ionizing radiation with enough energy to break chemical 📖 bonds non-thermally (eg. X-rays, gamma rays) → Types of radiation: ▪ Non-ionizing: ultraviolet, microwave, infrared, laser ▪ Ionizing: radiation capable of producing ions, directly or indirectly, when it interacts with matter − Particulate type (i.e., alpha particles, beta particles, neutrons) − Electromagnetic type (i.e., x-ray, gamma rays) Figure 6. Diagnosing De Quervain Tendinitis [Dr. Betita’s Lecture Slides, 2024] Figure 5. Dangers of Radiation Damage [Dr. Betita’s Lecture Slides, 2024] Further explanation: Noise Ergonomics was coined from two Greek words: ergon → Permissible exposure to noise is around 90 dBA for 8 hours → Exposure to an intensity of 85-90 dB will probably lead defined as: 📖 (work or strength) and nomos law or rule. It has been → With application of human biological and engineering working lifetime 📖 to permanent hearing loss if continued through a → Types of occupational hearing loss: 📖 sciences, and measured in terms of human efficiency and well-being (International Labor Organization) → Concerned with the understanding of interactions ▪ Noise-induced hearing loss: cumulative among the human and other elements of a system; permanent loss of hearing that develops gradually to optimize human well being and overall system after months or years of exposure to high levels of performance (International Ergonomics noise; always sensorineural hearing loss Association Council, 2000) ▪ Acoustic traumatic injury: loss of hearing arising → The study of the design of requirements of work in out of traumatic injury such as explosions or a blow relation to the physical and psychological capabilities to the head and limitations of people (Occupational Safety and Table 3. Comparison of Noise Levels (in dBA) [Dr. Betita’s Lecture Slides, 2024] Health Standards, USA) Noise levels dBA CHEMICAL HAZARDS Normal conversation 50-60 Include solid, liquid, gaseous substances Truck transportation 90 → Particulate Matter: any solid particle or liquid droplets Farm equipment 100 dispersed in the air Lumber and woodworking 100 DISEASE PREVENTION AND CONTROL Higher Units of Care: Occupational Health and School Health Page 4 of 9  ▪ Dust: solid particles capable of being suspended in − Usually affects agricultural workers the air ▪ Fumes: suspended solid particles which are generated by condensation from gaseous state, generally after volatilization from molten metals ▪ Smoke: visible product of imperfect combustion, comprising carbon in particulate form ▪ Mist: suspended liquid droplets generated by condensation or by atomizing, foaming or splashing → Gases: aeroform fluids which have neither shape nor volume, eg. benzene, toluene → Vapors: gaseous forms of substances which are normally liquid or solid states Threshold Limit Value is the maximum airborne concentration under which all workers may be repeatedly [Dr. Betita’s Lecture Slides, 2024] exposed without adverse effects Figure 8. The Anthrax Bacterium → Examples of chemical injuries: irritative contact ▪ HIV/AIDS dermatitis, allergy and atopy, occupational asthma, − Typically transmitted through contact with infected silicosis, amyloidosis, chemical burns bodily fluids Nice to know: Information about a chemical agent can be obtained 📖 from the manufacturers or distributors of specific chemicals 📖 Each chemical is documented through a Material Safety Data Sheet (MSDS) [Dr. Betita’s Lecture Slides, 2024] Figure 9. The Anthrax Bacterium SAFETY HAZARDS Unsafe working conditions → Spills → Obstacles → Heights → Machines Figure 7. Mercury Exposure [Dr. Betita’s Lecture Slides, 2024] → Electricity ▪ Primarily prevented through early warning signs and BIOLOGICAL HAZARDS through the mitigation of spills by cleaning, etc. Biological hazards involve infectious diseases as well as Zero accident program the pathogens that cause them Drug free workplace → Among these hazards are TB, hepatitis, HIV → One way of transmission is via exposure to human and animal fluids ▪ Hepatitis B − Primarily transmitted through sexual transmission − Can be also transmitted through exposure to 📣 infected blood and bodily fluids − 100 times more infectious than HIV ▪ Anthrax − Can enter the body through cutaneous spread, ingestion, or inhalation of the anthrax spores which typically come from farm animals Figure 10. Early Warning Signs [Dr. Betita’s Lecture Slides, 2024] − May exist in the soil, in the droppings of infected PSYCHOSOCIAL HAZARDS farm animals, and also in their fur DISEASE PREVENTION AND CONTROL Higher Units of Care: Occupational Health and School Health Page 5 of 9  This includes: IV. SCHOOL HEALTH → Sexual harassment Integration of wellness, safety, growth, learning and → Victimization development in the lives of school aged children and → Stress adolescents in the context of their school and with the → Workplace violence coordinated alliance of the family and the medical home C. CONTROL OF WORKPLACE HAZARDS BASIC PRINCIPLES IN THE CONTROL OF WORKPLACE (AAP, 1993) School health programs 📖 → Developed to ensure and promote health among school HAZARDS children, under the premise that a child who is healthy Isolation is also capable of learning → You are placing a distance between the hazard and the → The combination of good health and good education in susceptible host a child assures him/her the chance to reach his/her full → Ex. Transporting waste at night which would decrease exposure to waste among the general population → Ex. Placing a barrier between the hazard and the potential “Education for All” 📖 → All children have access to basic education of good people/workers quality Substitution → Creates an environment that is → Substituting a harmful product or harmful substance for ▪ Friendly and welcoming to children a less harmful one ▪ Healthy for children → Ex. Substituting normal gasoline, which is high in lead, ▪ Effective with children with unleaded gasoline ▪ Protective of children Shielding Table 4. Students with higher grades → You are placing a barrier MORE LIKELY TO LESS LIKELY TO → Ex. Lead aprons will prevent x-rays from hitting the Eat breakfast on all 7 Watch television for 3 or body days more hours a day Treatment Eat fruit or drink 100% Play video games or use → You are effectively eliminating the hazard fruit juice one or more a computer 3 or more → Ex. Sewerage treatment times per day hours a day ▪ Sewerage will contain a lot of biological hazards, so Eat vegetables one or Have had their first drink when you treat it, you eliminate the biological hazard more times per day of alcohol before the age Prevention Not drink soda of 13 → Through the use of preventive interventions Engage in physical Currently drink alcohol → Ex. Prophylaxis and immunization activity at least 60 Currently binge drink EFFECTIVENESS OF CONTROLS minutes per day on all 7 Vape or use an electronic days cigarette Play on at least one Smoke cigars sports team Smoke cigarettes More likely to have 8 Use smokeless tobacco hours of sleep Less likely to have never seen a dentist A. THREE CRITICAL AREAS 1. School health services 2. School health education 3. School health environment No matter what model of school health that we use, these 📣 three critical areas are always present in those three models. Figure 11. Control of Workplace Hazards [Dr. Betita’s Lecture Slides, 2024] B. MODELS OF SCHOOL HEALTH Personal Protective Equipment 📣 → At the bottom, least effective CHILD FRIENDLY SCHOOLS (UNICEF, 2009) Administrative and Work Practice controls A model adopted by UNICEF → Policies Started by the DepEd as the School Health and Nutrition Engineering Controls Center → Measures put in place in the workplace Focused on the school aged child → Might have to do with the manufacturing process itself Covers safety, security, nutritional status, and Elimination and Substitution psychological well-being of the child → Eliminating the exposure before it even occurs or Includes appropriateness of the teaching methods and substituting the harmful hazard for something else learning resources → Or completely eliminating the hazard Intersectoral approach → involves the wider community Child friendly schools focuses on: → Improving water supply → Promoting good hygiene practices → Addressing nutritional needs DISEASE PREVENTION AND CONTROL Higher Units of Care: Occupational Health and School Health Page 6 of 9  → Increasing access to energy V. PHILIPPINE SITUATION → Addresses challenges posed by climate change Medical and dental services in the DepEd were (disaster risk reduction, preparedness, response) nationalized in 1960 School health and nutrition center of the then, Department 📣 HEALTH-PROMOTING SCHOOLS (WHO, 2003) of Education, Culture and Sports (DECS) in 1977 A model that's advanced by the WHO in 2003 Integrated school health and nutrition program of the DOH A more holistic definition of health in 1997 Six key features: All schools of the Philippines are required to have a school 1. Engages health and education officials, teachers, clinical and dental unit parents, students, community leaders Societies advancing school health in the Philippines: 2. Safe and healthy environment → Private School Health Officers Association 3. Skills based health education → Philippine Academy of Physicians in School Health Inc. 4. Access to health services 📣 5. Health promoting policies and practices A. ONE HEALTH WEEK 6. Improves the health of the community Program of the DOH ENGAGES HEALTH AND EDUCATION OFFICIALS, First done in September 6-11, 2021 TEACHERS, PARENTS, COMMUNITY LEADERS Nationwide simultaneous inauguration of medical and dental clinics Families and community groups are involved in the school Launch of: Community services, businesses and organizations are 1. Dental health program linked to the school 2. School based feeding program School/community projects and outreach 3. Comprehensive sexuality education and adolescent Health promotion for the school staff members health convergence This focuses on engaging the community at large, including the teachers, parents, education officials, etc. 📣 Webinars on: → School mental health initiatives/ national suicide SAFE AND HEALTHY ENVIRONMENT prevention day Sufficient sanitation and water → National drug education program Freedom from abuse and violence Adolescent health convergence – the entire gamut of A climate of care, trust and respect adolescent health Social support and mental health promotion Safe school grounds Opportunities of physical education and recreation abuse prevention, alcohol abuse prevention 📣 → Includes risky behavior prevention, sex education, drug → Includes menstrual education services for girls, SKILL-BASED HEALTH EDUCATION transexual education, and also specific concerns for Involves a curricula that: LGBTQI → Improves student understanding of factors that B. DEPED PROGRAMS influence health Water Sanitation and Hygiene (WASH) in School → Include critical health and life skills (WinS) 📣 Training and education for teacher and parents → Covers everything from handwashing to basic hygiene ACCESS TO HEALTH SERVICES Services (screening, diagnosis, monitoring growth and development, vaccinations, selected treatment and → Primarily nutrition📣 School-based Feeding Programs Adolescent Reproductive Health procedures) Partnership with local health agencies Nutrition and food safety programs adolescents 📣 → Primarily aimed at reducing risky behaviors in National Drug Education Programs 📖 HEALTH PROMOTING POLICIES AND PRACTICES → Aims to prevent drug abuse through the development of An overall policy supported by school administration and desirable values, attitudes and practices management as well as teaching practices that help create COVID-19 Response a healthy psychosocial environment Tobacco Control Program 📣 Policies on equal treatment for all Early Childhood Development and Pediatrics Policies on drug and alcohol use, first aid, violence and → Primarily concerned with growth and development reduce or prevent physical, emotional, and social problems Integrated School Nutrition Model IMPROVES THE HEALTH OF THE COMMUNITY OK sa DepEd – Oplan Kalusugan Focusing on community health concerns HEALTH SERVICES UNDER OK SA DEPED Participates in community health programs Height and weight COORDINATED SCHOOL HEALTH (LEAR, ISAACS Vision screening AND KNICKMAN, 2006) → For kindergarten, grades 1, 4, 7, and 10 students Eight components: Auditory screening → For grade 10 students 1. Health education Consultation and treatment 2. Physical education Oral health examination and dental treatment 3. Health services → Dental treatment involves non-traumatic treatment of 4. Nutritional services dental caries such as filling and pasta 5. Counseling, psychological and social services Referrals 6. Health promotion for staff Other health services as needed 7. Family and community involvement Immunization 8. Healthy environment DISEASE PREVENTION AND CONTROL Higher Units of Care: Occupational Health and School Health Page 7 of 9  → Measles, Rubella, Tetanus, Diphtheria 9. Child Friendly Schools was started by the DepEd as ▪ For grades 1 and 7 students ___. → HPV immunization a. School Health and Nutrition Center ▪ For girls, grade 4 b. OK sa DepEd Weekly Iron Folic Acid (WIFA) supplementation for female learners c. One Health Week d. Early Childhood Development and Pediatrics C. FUTURE DEVELOPMENTS PhilHealth coverage for outpatient health needs ANSWER KEY A separate commission on school health 1. B Class A: Fit for any work In the organizational chart of school system, school Class B: Physically underdeveloped or with health officials are under the head of the school correctible defects Standardization of the school healthcare system Class C: Employable but due to certain Certification system for specialization impairments/ conditions requires special School health offers a certification system📣 → Currently, the Philippine Academy of Physicians in ▪ Offers a course for doctors who wish to practice placement or limited duty, requires follow-up treatment / periodic evaluation Class D: Unfit for any type of employment school health 2. C Pre-employment physical exams: Done to VI. REVIEW QUESTIONS check the condition of an applicant at time of hiring. 1. In a pre-employment physical exam, what is the Transfer: Done to certify if a worker is medically classification if the worker is physically sound to be transferred to another work or job underdeveloped or with correctible defects? Special: Required where there is undue a. Class A exposure to health hazards b. Class B Return to work: Performed to determine c. Class C whether or not a worker is fit to return to work d. Class D 2. What type of health examination is required for 3. A White finger disease, also known as hand-arm miners who are chronically exposed to lead and vibration syndrome, is a vibration-induced mercury? injury. a. Pre-employment physical exam 4. A True. Barotrauma is due to differences in b. Transfer pressure between gas spaces inside the body c. Special and the surrounding gas outside. Dissolved gas d. Return to work dysbarism is due primarily to nitrogen-related 3. White finger disease is caused by what type of dissolution and bubbling inside of the body. physical hazard? a. Vibration 5. B 90 dbA is equivalent to the loudness of truck b. Altitude transportation. c. Heat 6. C Agricultural settings typically contain the d. Radiation environments in which anthrax may propagate 4. T/F. Dysbarism has 2 types: barotrauma and ie. soil, animal droppings, and animal fur. dissolved gas dysbarism. a. True Sewage settings are more likely to contain b. False 5. Permissible exposure to noise is around ___ dBA for waterborne pathogens and are not commonly 8 hours. associated with anthrax. Quarries and industrial a. 50 factory settings are more likely to expose b. 90 workers to physical, chemical, and c. 130 machinery-related hazards than anthrax. d. 150 7. D Elimination/Substitution is the most effective 6. Anthrax typically affects ___ workers. way of controlling workspace hazards as it a. Quarry eliminates the hazards before it can occur. b. Industrial factory 8. B False. It is given to grade 10 students. c. Agricultural 9. A Child Friendly Schools was started by the d. Sewage DepEd as the School Health and Nutrition 7. ___ is the most effective way of controlling workplace Center before being adopted by UNICEF in hazards. 2009 a. PPE VII. REFERENCES b. Administrative and Work Practice Controls Betita, C. P. (2024). Higher Units of Care: Occupational Health c. Engineering Controls and School Health [Lecture Video] d. Elimination / Substitution Department of Preventive and Community Medicine. (2023). 8. T/F. Auditory screening is done at the age of 10. Occupational Safety and Health. In Review Notes and Manual in Disease Prevention and Control in the Family and Community (pp. a. True 160-171) b. False Department of Preventive and Community Medicine. (2023). School Health. In Review Notes and Manual in Disease DISEASE PREVENTION AND CONTROL Higher Units of Care: Occupational Health and School Health Page 8 of 9  Prevention and Control in the Family and Community (pp. 150-159) Asynchronous Lecture: Video Lecture on Higher Units of Care, School Health, Occupational Safety and Health DISEASE PREVENTION AND CONTROL Higher Units of Care: Occupational Health and School Health Page 9 of 9