Presentation on theme: "Primary Health Care Systems"— Presentation transcript:
1 Primary Health Care Systems NUR 473Lecture 6+7ENIVRONMENTAL HEALTH
2 Outline Definition of terms Importance of environmental health Components of environmental healthTown planningHousing, pure air and ventilationLightingSafe water supplyRefuse disposableSewage disposableFood safetyVector controlIndustrial sanitation
3 Objectives: After reading this lecture, the students should be able to understand the following: Define termsList for importance of environmental healthExplain components of environmental healthTown planningHousing, pure air and ventilationLightingSafe water supplyRefuse disposableSewage disposableFood safetyVector controlIndustrial sanitation
4 IntroductionOur environment—the conditions within which we live and work, including the quality of our air, water, food, and working conditions—strongly influences our health status.Environmental health is concerned with assessing, controlling, and improving the impact people make on their environment and the impact of the environment on them.Different environments pose different health problems and benefits. Consider the effects of acid rain, soil erosion, and insect invasions on a rural community or the effects of industrial toxic wastes, auto emissions, and airport noise on urban residents.
5 Concept of Environmental health and other related terms:Sanitation is a way of life and the quality of living that is expressed in a clean home , clean farm, clean business , clean neighbourhood and clean the communityAccording to the WHO Environmental sanitation as "the control of all those factors in man's physical environment which may or may not exercise a deleterious effect of the development, health and survival" man has manipulated the environment for his comfort and health by causing social and environmental changes, hence environmental health is becoming more complex.The term environmental sanitation is thus, now replaced by environmental health.Proper environmental health requires an inter-sectoral effort in a community
6 Importance of environmental health Preventive: a sanitary clean environment is free of vectors of diseases, rodents which may be reservoirs of infection, pathogenic agents of communicable diseases (infectious and parasitic)General welfare and health promotion of the populationComfort and increased productivity and quality of workEthics: a clean environment is essential for human dignity
7 Remember:Most of the ill health is due to poor environmental health i.e. unsafe drinking water, polluted soil, unhygienic disposal of human excreta and refuse, poor housing , insects and rodents, air pollution in cities etc, cause a major problem to health of the people .The high death rate, infant mortality rate, morbidity rate and poor standards of living are due to defective environmental sanitationGrowing industrialization and automobiles on the road pose air pollution and diseases of respiratory system, discharging industrial waste indiscriminately can cause soil and water pollution causing problems to human and aquatic life,Increasing growth of population is factor rendering environmental pollutionUrbanization and over-crowding due to industrialization is yet another major concern
8 Components of Environmental Health Components of Environmental HealthTown planningHousing, pure air and ventilationLightingSafe water supplyRefuse disposableSewage disposableFood safetyVector controlIndustrial sanitation
9 Town planningTown planning is the policy of putting a scheme for the establishment of cities, towns and districts, taken into consideration future development and extension.The principles of town planning:Division of town districts: industrial , commercial, and residentialSufficient wide street, parks, and play groundsSufficient spacing and open areas between building for good ventilationGeneral public services
10 2. Housing, Pure Air and Ventilation 2. Housing, Pure Air and VentilationA healthful housing environment should meet the following criteria:Sanitary site and specifications of buildingSuitable number of rooms according to family sizeAdequate ventilation and lightingHeating and cooling system is necessarySanitary water supply and waste disposalCleanliness and insect controlSafety measures for prevention of home accidentsDamp-proofing of the foundations and plumbing system to prevent dampness of the building walls
11 Hazards of bad/poor housing: Hazards of bad/poor housing:A higher incidence of general morbidity and mortality specially of infectious disease e.g. TB, diarrhea, common cold, influenzaIncrease risk of human accidentsSocial problems
12 Air pollution People have known that air quality affects human health Air pollutionPeople have known that air quality affects human healthAir pollution is now recognized as one of the most hazardous sources of chemical contamination. And considered as a global problemIt is especially prevalent in highly industrialized and urbanized areas where concentrations of motor vehicles and industry produce large volumes of gaseous pollutantsThe list of diseases and symptoms of ill health associated with specific air pollutants is lengthy, ranging from minor nose and throat irritations, respiratory infections, and bronchial asthma to emphysema, cardiovascular disease, lung cancer, and genetic mutationsCertain geographic areas are more susceptible to the ill effects of air pollution because of weather conditions or physical terrain.
13 The sources of air pollution The sources of air pollutionAir pollution comes from many different sources.Natural processes that affect air quality include volcanoes, which produce sulfur, chlorine, and ash. Wildfires produce smoke and carbon monoxide. Cattle and other animals emit methane as part of their digestive process.Many forms of air pollution are human-made. Industrial plants, power plants and vehicles with internal combustion engines produce nitrogen oxides, carbon monoxide, carbon dioxide, sulfur dioxide. Example: cars in megacities and farmers burning their crop waste
14 Prevention and control of air pollution: Prevention and control of air pollution:Containment: Control at the every point of its origins in industriesReplacement: Replacement of coal and gas by electricityDilution : Growing vegetation and plants between industrialand residential areas |(Green Belts)Legislation : Air pollution can be controlled in many countries bysuitable legislation as (no smoking)Nursing role / Air pollution: Primary / community health nurses can influence air quality through detection, community education, and lobbying for appropriate legislation
15 Ventilation:Ventilation implies replacement of vitiated air and supply of fresh out door air, and control of quality of air with regard to temperature, humidity, and purity with a view to provide thermal environment that is comfortable and free from infectionFunction: gas exchange, cooling power, feeling of comfort and better performance of workVentilation can be achieved by:Natural Ventilation: is brought about through doors and windows facing each other to allow cross ventilationMechanical Ventilation: include exhaust ventilation and air conditioningCommunity laws and regulation for ventilation:All building should have cross ventilation : 10 % for windows from the floor area or residential building, 20% for schools and public places
16 3. LightingTypes of lighting: is natural or sunlight, or artificial e.g. electricity, oil lamps and candlesEffect of poor lightingStrong and concentrated light produce eye fatigue and strainPoor light leads to accidentsIn factories strong shadows over a job can be dangerousCommunity laws and regulations for good lighting:The lighting level must be small objects, are visible , uniform and not patchy , cause no dazzle, and avoid dark spots
17 4. Safe water supply: Water has many uses: 4. Safe water supply:Water has many uses:Domestic uses as drinking, cooking , washing , bathingPublic uses: It serves as a means of transportation, forms of recreation and sports, such as swimming and boatingIndustrial uses: It cleans and cools the body or other objects. and it provides a vehicle for disposing of human and industrial wastes and controlling fires.Agricultural uses, water also acts as a medium for sustaining other living organisms, as a home to plant and animal life.
18 Sources of Water: Basic sources: Surface water: lakes, rivers, ponds Sources of Water:Basic sources:Surface water: lakes, rivers, pondsUnderground water: shallow wells, deep wells and springsMinor Sources:RainwaterDistilled sea water
19 Water purification:Is the process of removing undesirable chemicals, biological contaminants, suspended solids and gases from contaminated water.Examination of water: after disinfection , water samples are sent to laboratories for physical , chemical and bacteriological examination
20 Characteristics of potable water: Characteristics of potable water:Physical : odourless, colourless, clear and agreeable tasteChemical: neutral or slightly alkalineBacteriological: allowable total bacterial count is 100 organism per millilitre
21 Sources of Water Pollution: Sources of Water Pollution:Water may be infected with bacteria or parasites that cause disease.A parasite that enters the water supply through contamination from human or wild animal feces. (sewage )Toxic substances such as pesticides are introduced by humans into water systems.(industrial and agricultural)Heat, radioactive substancesWater borne diseases:Viral e.g. viral hepatitisBacterial e.g. cholera, typhoid, diarrheaProtozoa e.g. amoebiasisParasites
22 Activities to provide safe water supply: Activities to provide safe water supply:The main water sources in every place must be sampled to study the bacteriological contamination, once in every three monthsIdentify the private wells which are being used to supply through tankers in houses must be inspected and disinfected frequentlyConstruct good drainage system around the wellCommunity must be educated to practice household method of purification of water for drinking purposesEducate the community , the hygienic methods of collection, storage and use of water to prevent water borne diseases
23 5. Refuse Disposal: Refuse is the solid waste matter of the community. 5. Refuse Disposal:Refuse is the solid waste matter of the community.Types of refuse:Building refuse: garbage (food waste) and rubbish (tins, paper, glass)Street refuse: refuse of public placesHospital refuse : building refuse and dressing refuseIndustrial refuse : building refuse and toxic refuseAgriculture operation refuse
24 Methods of waste (refuse) disposal Methods of waste (refuse) disposalA. Incineration / burning:Refuse can be disposal of hygienically by burning or incineration.Hospital wastes which is dangerous with large quantities and variety of pathogens be dust disposed by incineration.Refuse containing sand dust and other inorganic materials like the glass and tins etc, which create problem in burning must be removed.It is good method for cities where suitable land is not adequateBurning, although it reduces the volume of garbage, produced noxious odors and pollutes the air.
25 Methods of waste (refuse) disposal Methods of waste (refuse) disposalB. Dumping:Bumping is a simple method. Low lying areas are selected to dump the wastesDumping is problematic, because garbage dumps provide perfect conditions for the breeding of rats, flies, and other disease-carrying organisms and may potentially be a source of water contamination from runoff.C. Fermentation/ composting :It is a method of combined disposal of refuse and excreta.It is a process whereby organic matter breaks down under bacterial action resulting in the formation of a relatively stable humus-like material called compost which is a good manure
26 Disposal of Hazardous Waste Disposal of Hazardous WasteDisposal of toxic chemical and radioactive wastes produced by industry is another grave concern.The threat is serious. Many of these wastes escape containment or accidentally leak into water systems and into the soil to contaminate drinking water and food.Community laws and regulations for refuse:Collection of refuse adequatelyAdequate refuse disposal to prevent health hazards
27 Nurse’s RoleCommunity health nurses can encourage the positive actions described by educating the public and lobbying for enabling legislation.Nurses can promote greater sensitivity among citizens to the problems of accumulating waste with its potential health hazards,Encourage clients to buy products that can be recycledDiscourage use of aerosol spray containers, plastics, and other non-recyclable items.
28 6. Sewage disposalOne of the oldest environmental health hazards comes from improper disposal of human excreta.Human wastes, particularly feces, provide a perfect environment in which bacteria and disease-causing parasites can live and reproduce.Component of sewage:Sewage is the collected liquid wastes of the communityDomestics waste: excreta of man and waste of kitchen and bathsMunicipal waste: washing streets or rainIndustrial wastes
29 Health hazards from sewage: Health hazards from sewage:Spread of infection from fliesContamination of soilPollution of river and shallow wellsContamination of vegetables by human fertilizersPollution of sea waterDiseases associated with improper excreta disposal is:Typhoid, paratyphoid, cholera, diarrhoea, and dysenteryHelminth infection : hookworm, ascariasisViral hepatitis, poliomyelitis
30 There are several methods of sewage disposal . There are several methods of sewage disposal .Some are applicable to rural areas (Latrines and septic tanks) andSome to cities and towns water carriage system and sewage treatmentsewage posses through a number of steps in special tanks where it is submitted to a series of physical and biological processes of finally separates into liquid part
31 Community laws and regulations for sewage disposal: Community laws and regulations for sewage disposal:Water-closets in school, industry public spaces should fulfil sanitary requirements, cleanness ventilation, no insects and maintenanceEvery building should have a sewage drainage systemDisposal at sea: proper selection of the site of disposal, pipes go sufficiently far from the shore
32 7. Food Safety Food is a potential source of infection. Food is a potential source of infection.It can contaminated by bacteria and other microorganisms and parasites.Food safety implies hygiene in production, handling, distribution and serving of all types of foods.Many communicable diseases can cause by poor personal hygiene and contamination of food.Any untidy household, dirty hands and poor environment create suitable conditions for growth of microorganism.
33 Foodborne infections and diseases Viral e.g. viral hepatitis, poliomyelitisBacterial e.g. typhoid , paratyphoid, and diarrheaProtozoa e.g. Amoebiasis,Parasites e.g. ascariasis , tape wormOther e.g. food poisoning
34 Food Handlers:Food handlers, cooking, serving and distributing food should be periodically examined for any infection especially those who remain as carriers.Types of examinations:Clinical examination for skin diseases, TBLab examination, blood for typhoid and paratyphoid, stool for bacillary dysentery and parasites' and amoebic dysenterySwabbing for throat swab, nose swab to be examined for diphtheria or staphylococciChest x-rayValidity of the food certificatesSanitary precautions during work-Cleanliness of the body clothing-Responsibility of manager to exclude from work until cured any case of common cold, other infection diseases , wounds, ulcers of the skinThe health authority has the right to call any food handlers at any time for examination according to necessity
35 Food Utensils (Containers) Containers or articles used for storage and serving food should be:Made of a safe materials not including toxic metals especially lead and arsenicKept always cleanCopper utensils need be soldered with tin periodically
36 Community laws and regulations for food sanitation Community laws and regulations for food sanitation General measures at home:Keep food refrigeratedCover food to protect it from fliesWash vegetables with clean and safe waterWash hands with clean and soap before preparing and eating foodCook any only sufficient food for one time mealB. Sanitary publicRestaurants, Cafeteria, Canteens, groceries, hotels and food store:Should fulfil sanitary requirements to be licensed by the local municipal or health authorities
37 Insect e.g. mosquitoes, flies, fleas, bed bugs, cockroaches 8. Vector ControlGroup of insects:Insect e.g. mosquitoes, flies, fleas, bed bugs, cockroachesArachnid e.g. ticks , mitesHealth hazards from insects:Directly invade the body e.g. scabiesIrritation, discomfort and hypersensitivity by bitesControl measures of insects:Sanitation and cleanliness of the environmentControl of breeding placesApplication of insecticidesSanitary disposal of wastes
38 Ensure that screens exist on all open windows, and use screen doors. Nurse’s Role Insect and Rodent ControlEnsure that screens exist on all open windows, and use screen doors.Wash dishes, pots, and pans after meals, and clean counter surfaces.Keep foodstuffs that insects may infest, such as cereals, corn meal, and flour, in closed plastic containers.Keep floors swept and vacuumed in rooms where people eat, to eliminate food supply for rodents and insects; preferably, eat only in the kitchen or dining room.Remove trash bags that include food scraps and food packaging from the home daily and place in garbage containers that are kept outside and have tight-fitting lids
39 9. Industrial sanitation 9. Industrial sanitationSanitation of the work environment :Proper design and general cleanliness of industrial plantsAdequate natural and mechanical ventilationLighting : optimum power and distributionSafe water supply for drinking and personal cleanlinessToilet and washing facilities e.g. W.C. bathsWaste disposal for plants and industrial wastes