Sunday 11 January 2015

Family Health Notes

INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI)
  • Integrated childhood management which focus on preventive and curative which involves family and community
  • Aim to reduce mortality, illness and disability among under-five years old
Domains of IMCI (Continuum of Care)
  1. Home
    • Growth Promotion & Development
      • Breastfeeding, micronutrient, mental and psychosocial development
    • Home Management
      • Feeding, water, prevent injury, home treatment
    • Disease Prevention
      • Prevent HIV, insecticide treated net, proper sanitation
    • Care Seeking & Compliance 
      • Responsible fatherhood, immunization, seek medical care
  2. Health Facilities
    • Improve skills and equipment as well as facilities
  3. Community
    • Vaccination outreach delivery
    • ORS for diarrhea
    • Insecticide net
    • Routine postnatal care
    • Promotion of breastfeeding and complimentary feeding
Strategies

  • Policies, Strategy, Planning, and Partnership
  • Health support system and management
  • Focus on continuum of care
  • Monitoring and evaluation
TOTAL FERTILITY RATE
Definition: The average number of children per women that would be born to the group of women given the ASFR if she survives until 50 years old

Expressed per women
Single measure that is independent of age

Period

  • Synthetic, measuring a synthetic cohort of women

Cohort

  • Actual TFR, must be followed till 50 years old

(Sum of ASFR / 1000) x 5

ASFR = (no of child birth at age X / mid-year pop. of women age X) x 1000

MATERNAL DEPLETION CYCLE

  • Cycle that explains the effects of maternal malnutrition, infection and other risk factor on women
  • Start when a pregnant mother were exposed to malnutrition, anemia, smoking, and frequent infection (lifestyle, environment and individual factor)
  • Leads to increase number of low birth weight babies (10% less than 2.5 kg)
  • Due to that, the newborn infant were vulnerable to more infection and death up till four years old
  • Those who manage to survive will continue to be under nutrition thus creating more backward female children
  • This children later show poor growth and later on being a stunted adult female
  • Which in the end produce more stunted female
AGE OF MARRIAGE AND ITS EFFECT ON FERTILITY

  • Fertility is the actual reproductive performance, the opposite of childless
  • Marriage is a legal / religious union between men and women
How age of marriage affects fertility

  1. Low fertility
    • Marriage at later age
    • Later age & loss in time of fertility, more risk
    • Less child
  2. High fertility
    • Marriage at early age
    • More time for fertility
    • Thus more child
SAFE MOTHERHOOD

Definition: The ability of women to have safe and healthy pregnancy and childbirth

  • Safe motherhood initiative launched in 1987 targeted to achieve reduction of maternal death by half before year 2000
  • Aim to reduce death, illness among women and children
5 Pillars (Mnemonics – CAREF)

  1. Clean and Safe Delivery
    • TBA, clean and sterile equipment
  2. ANC
    • Proper nutrition, monitoring of mother and child, detect problems early -> plan intervention
  3. Responsible Parenthood
    • Focus on father, supportive during pregnancy and birth as well as looking after child
  4. Emergency Obstetric Care
    • Transportation, specialized care, obstetric emergency – PE, PPH, etc
  5. Family Planning
    • Prevent maternal depletion, reduce risk - LSCS
IMPORTANCE OF POST-NATAL CARE


  1. Post-natal Period


    • Start from birth till 42 days post partum
    • Period where the changes that occur during pregnancy revert to non-pregnant state
    1.      Physiological changes
o    Cardiovascular revert to normal
o    Reduction in size of uterus
o    Reduce swollen of anal and vaginal wall
o    Lochia
-        Problems
o    PPH (first 24h)
o    Post-natal Psychosis
o    Puerperal Pyrexia (first 14 days)

Post-natal Care
-        Aim to promote safety and health of mother and child
-        To provide parents information about sign and symptoms of potential life threatening condition of mother and child
-        Encourage breastfeeding
-        Provide and encourage parents to know when too seek medical care and


GENDER INEQUITY ON HEALTH
Equal: Equal distribution to all level
Equity: Distribution based on the need / performance

Definition
-        Gender is a social perception on how male or female should behave
-        In health
o    Women known to be more vulnerable than men
o    Women has more risk to develop CVD
o    More risk to develop HIV/AIDS
o    Women receive treatment later than men (women seek late treatment)


GENDER BIAS

-        Unequal relation between men and women in family, workplace and society
-        Usually referred to women as men were placed in higher position compared to women
-        Example
o    Family
§  Men as a leader, strong, women weak, need to obey
o    Community
§  Man made decision, women need to adhere, all facilities based on men, men as the benchmark
o    Workplace
§   
o    Health




PERINATAL MORTALITY
Perinatal Period: A period start from 22 weeks of gestation till the 1st week of life

Mortality: The extreme outcome of health, also known as death.

Perinatal Mortality
1.      Any death occurring between the periods of 22 weeks of life till the 1st week of life.


GROWTH MONITORING
Growth: The increase in size of organism that includes increase in cell size and cell number

Monitoring of Growth
-        Aim to measure the current and past nutritional status of child
-        Regular weight and height measurements and plotting aim to monitor child growth
-        Method -> Growth Chart
o    Tool for monitoring growth and development
o    Used to detect early growth deviation
o    Assist in diagnosis of childhood diseases
o    For prevention and curative care
o    Age at X-Axis
o    Consists of reference line -> to compare between normal and acceptable growth

Weight to Height - Indicator for current nutrition status
Height to Age – Indicator for previous nutrition status


UNIVERSAL CHILDHOOD IMMUNIZATION

Expanded Program on Immunization
-        Created by WHO 1974 due to low number of immunized children (less than 5%)
-        Objective to reduce morbidity and mortality from immunization preventable disease such as diphtheria, pertussis, tuberculosis and measles
-        Making immunization available by 1990


SCREENING OF CONGENITAL ABNORMALITIES
Congenital Anomalies: Any fetal abnormalities that arises during antenatal period

Screening: A method for early detection of abnormalities / diseases

Aim:
To detect congenital abnormalities of fetal at earlier stage so that decision can be made whether to continue pregnancy / to prepare for the care of the babies

How (e.g. down syndrome)
1.      Ultrasound Scan during 1st trimester to detect down syndrome
2.      Amnion synthesis
3.      Maternal Serum Screening


CONTRACEPTIVE PREVALANCE RATE
-        (No of women with contraceptive / no of women in age group 15 – 49) x 100
-        Percentage of women that use contraceptive in a particular time


EARLY CHILDHOOD DEVELOPMENT
Development: A biological, psychosocial, and emotional changes that occur between birth and end adolescence

IQ: Score derived from one of several test to assess human intelligence

-        The process of development of a child which covers developmental changes start from birth till end of adolescence
-        Disorder
o    Dyslexia – difficult to read and write
o    ADHD
o    Autism – Spectrum of psychological condition characterized by abnormalities in social interaction and communications



VIOLENCE AGAINST WOMEN

-        Intentional use of force or power to threatened that may cause harm to the other parties physically, psychologically, and sexually
-        Violence against women can be divided into;
o    Physical
§  Hitting, kicking, use of intentional force
o    Sexual
§  Forced sex, unconsented oral sex, ass grabbing, unwanted sexual talk
o    Psychological
§  No right to talk, give opinion, mental torture
-        Why
o    Because women socially accepted as the lowest hierarchy, lack of power, have no right, men more superior
o    Cultural belief
-        How to prevent
o    Call center
o    Community support group
o    Education to women about their rights


HARMFULL TRADITIONAL PRACTICE DURING ANC

ANC: Care received during the pregnancy period

What
-        Consumption of traditional herbs which may contain toxic, steroid that may cause harm to mother and child
-        Antenatal massage, which may cause abortion / bleeding due to pressure at abdomen
-        Salt bathing of mother, can introduce infection to baby

How To Control
-        Proper antenatal care at professional health care / antenatal clinic
-        Health education to future mothers as well as mothers


TEENAGE PREGNANCY

Definition: Pregnancy under the age of 20 at the time of pregnancy ends

Why
-        Increase and early sexual exposure from friends, mass media, internet
-        Lack of knowledge about contraceptive, sexual relationship
-        Lack of monitoring from parents

What Problems
-        Maternal death
-        Low birth weight baby
-        Unsafe abortion
-        Disposal of babies

How To Control
-        Sexual education
-        Parental control
-        Contraceptive knowledge
-        Supportive community (rumah pengasih)


FEMALE GENITAL MUTILATION

Definition: Known as female genital cutting / female circumcision which was done traditionally to remove some part of the female genital

What Type
1.      Normal
2.      Type 1 – Prepuce removal / prepuce + part of clitoris removal
3.      Type 2 – Clitoris removal plus part of labia minora
4.      Type 3 – Removal all labia minora and labia majora opposed leaving only the urethra and small hole for menses

Complication
- Painful period, urinary retention, infertility, pain during intercourse, infection






INDICES OF INFANT MORTALITY

Infant Mortality = No of infant death (age less than 1 year) x 100
                                 No of life birth in a same year

Infant                         = Age less than 1 year (indices life birth)
Neonatal                    = Age under 28 days (indices life birth)
Post-Neonatal          = Age 28 days to 1 year (indices life birth)
Perinatal                                     = 22 weeks of gestation till 1st week of life (indices stillbirth n life birth)
Still Birth                                    = Death at 22 weeks of gestation or more (indices stillbirth n life birth)
Toddler                     = Age 1 to 4 years (indices bahagi mid-year population)
Under-5                     = Age less than 5 years old indices bahagi mid-year pop)

BABY FRIENDLY HOSPITAL INITIATIVE
WELL-BABY CLINIC
BIRTH WEIGHT / LOW BIRTH WEIGHT
EARLY INVESTIGATION PROGRAM FOR DISABLED CHILDREN


CHID ABUSE AND NEGLECT

-        Type of violence towards child
-        Divided into
o    Physical
o    Sexual
o    Psychological
-        Neglect

POPULATION DYNAMIC

Total Dependency Ratio


Kalau Aged ambil >65 over pop 15-64
Kalau Child ambil 0-14 over pop 15-64

Doubling time = No of years needed for a population to double its size



Occupational And Environmental Health Notes !!~!!

STABILIZATION POND (Mnemonics – FAM)

-        Known as oxidation pond or sewage lagoon
-        Used in most housing project with more than 100 unit of houses
-        Sewage purified by natural process

Operation
1.      Facultative Lagoon
a.      Sewage -> Discharge Pond -> Undergo natural process by microorganism -> CO2 -> Algae convert CO2 to O2 -> O2 used to convert and stabilized sewage into harmless product and deodorized.

2.      Maturation Lagoon
a.      Further process known as polishing lagoon
b.      Further reduce BOD, bacteria

3.      Anaerobic Lagoon
a.      Used to decompose settled solid before transfer to facultative lagoon or maturation lagoon

BIOCHEMICAL OXYGEN DEMAND (BOD)

-        Chemical procedure used in water quality management and assessment, ecology and environmental science
-        Used to determine how fast microorganism in water use up dissolve oxygen
-        BOD were measured by DO5-DO0

Use
-        To determine the oxygen demand of waste water
-        To determine the quality of water
-        Evaluate efficiency of water treatment system
-        Evaluate effectiveness of water treatment plan

Test
1.      Sample of water were taken
2.      Sample were then labeled and measured for initial DO (DO0)
3.      Sample diluted with de-ionized oxygenated water
4.      An aliquot seed were inserted in sample
5.      Sample were incubated in dark room with temperature of 20OC to prevent photosynthesis
6.      On day 5, the DO (DO5) were measured
7.      BOD is the difference between DO5 and DO0

Interpretation
-        High DO – Oxygen uptake is low
-        Low DO – High uptake of oxygen, possible source of contamination
-        BOD Level (in ppm)
o    1 – 2 = Very Good
o    3 – 5 = Moderate Clean
o    6 – 9 = Somewhat Polluted
o    10+ = Very Polluted


WATER QUALITY TEST

Dissolve Oxygen – BOD, COD
Total Suspended Solid – TSS capture by filter
Bacteriological – Total Coliform, Chlorine Residual

Test
1.      Total coliform
2.      Pseudomonas
3.      Naegleria Fowleri
4.      BOD
5.      MPN
6.      COD


WASTE WATER TREATMENT

Municipal
-        Domestic, pretreated industrial, run-off, sewage system

Industrial
-        Industrial used water need to be treated before discharge to environment





DRINKING WATER QUALITY  (Mnemonic – PCRV3B)

Quality
a.      Physical
a.      Color, Smell, Solid, Turbidity, Taste
b.      Chemical
a.      Any substance that alter potability (e.g. fluoride, arsenic)
c.      Biological
a.      Any organism such as algae, protozoa
d.      Bacteriological
a.      Any contamination by bacteria such as e-coli, coliform, streptococcal faecalis must not be detectable
e.      Viral
a.      Any contamination by viral source
f.       Radiological
a.      To detect the alpha and beta activity
g.      Biochemical
a.      BOD and COD


WATER INFECTIONS

- Infection of water source that can be transmitted to living organism such as humans and animals
- Coliform – Infected form fecal material, Pseudomonas, Naegleria Fowleri – Brain eating organism, Streptococcus Faecalis

Source
1.      Water Treatment Plan
2.      Water Delivery System
3.      Water Collection System
4.      Water Preparation

Transmission
a.      Water-Borne
a.      Pathogen in water, drunk by humans and get infected
b.      Water-Washed
a.      Water that is contaminated by usage of water
b.      Can be used by increase the volume of water used for hygienic purpose
c.      Water-Based
a.      Disease which the pathogen spend part of lice in a water (e.g. parasite, helminthes)
d.      Insect-Vector
a.      Disease that is spread by organism breeding or bite near water


REFUSE DISPOSAL (MIB-CRIL)

Onsite (MIB)
-        Manure pit (lubang sampah biasa and kambus hari-hari)
-        Burial – Suitable for camp
-        Incineration – High temperature burning (toxic, infectious)

Offsite (CRIL)
-        Landfill – Dispose at open land and cover with soil every day
-        Incineration – Burn high temperature
-        Recycle
-        Compositing

Final Disposal
1.      Open Dumping – Dumped in low-lying areas (water, air pollution)
2.      Dumping at Sea – Can use for claiming land
3.      Controlled Tipping – Same as dumping but put in trench, compacted and covered with soil (less pollution except for leachate)
4.      Sanitary Landfill
a.      Modern landfill
b.      Proper fencing, grading, stockpiling material, leachate collection and extraction system, treatment and monitoring system
c.      Advantage
                                                i.     Can generate electricity
                                               ii.     Reclaim Land
                                              iii.     No Pollution of ground water

d.      Disadvantage
                                                i.     Required land for long period
                                               ii.     Fire hazard, pollution if not maintained properly


INCINERATION

-        A method of onsite and off site disposal of refuse
-        High infectious, toxic, flammable refuse were collected with proper collection system
-        Burned with high temperature
-        Suitable when there is limited land

Advantage
-        Can generate energy
-        Safe space / land
-        Efficient
-        No air pollution if temperature in more than 10000C

Disadvantage
-        Need proper control of dioxin
-        Can and bottle still available
-        Cost to maintain is high


HEALTH HAZARD OF SOLID WASTE

Solid Waste Source (Mnemonics - DICAH)
-        Domestic – Plastic, Cans, Paper, Leftover
-        Industrial – Chemical, Raw Material
-        Community – Same as domestic but in large scale
-        Agricultural
-        Healthcare – Toxic waste, Human Parts, Sharps, Pharmaceutical, Drugs

Health Hazards
1.      Air Pollution
a.      From open burning causes pollution to air, effect the respiratory system
2.      Water Pollution
a.      May cause pollution in ground water, contaminated, thus higher chance of infection
3.      Soil Pollution
a.      Leachate pollute soil
4.      Infection
a.      Waste provides optimal food for rodents, vector of other communicable disease.
5.      Fire Hazard
a.      Burn, spontaneous fire at disposal site
6.      Physical Injury
a.      Physical trauma or injury from landslide due to solid waste disposal


RECYCLING

-        A method of solid waste disposal
-        Solid waste were sorted according to groups at household, commercial, industrial, as well as agricultural level
-        Based on a concept of 3 R, Reduce, Reuse, Recycle
-        Advantage
o    Did not require usage of large land – selected and sorted at source, only unrecyclable were disposed
o    Reduce cost of waste disposal
o    Save energy
o    Reduce air and water pollution
-        Disadvantage
o    Expensive to recycle some material
o    Need proper set up and participation of community
o    Limited to certain waste only
-        Steps
o    Collection and Separation
o    Manufacturing – reuse recyclable material (e.g. tissue paper)
o    Purchasing recycle product – complete the recycle loop


FOOD ADDITIVES

-        Any substance that is added into food during food processes
-        Aim to improve quality of food, shelf life, added color, taste, and odor
-        Anti-oxidants, preservatives, coloring, artificial flavor, food conditioner




HAZARD ANALYSIS CRITICAL CONTROL POINT (HACCP) IN FOOD QUALITY CONTROL

-        Food quality control system
-        Ensure food is properly prepared, transported, stored and delivered
-        Ensure food free from contamination
-        Use critical controlling point
-        IDENTIFY & PREVENT

Hazard Analysis – identification of food items and preparation process that might cause contamination or illness

Critical Control Point – steps where contamination is likely to occur and control measures is used to prevent, eliminate, minimize hazard

Principles (Mnemonics – HaCLiMCoVD)
1.      HAZARD - Conduct hazard analysis
2.      CRITICAL POINTS - Identify critical points
3.      LIMITS - Set standard / limit for critical points
4.      MONITOR - Set monitoring requirements of critical points
5.      CORRECTIVE - Corrective action
6.      VERIFICATION - HACCP working procedure verification
7.      DOCUMENTATION - Record keeping

Advantage (Mnemonic - PESEO)
-        Prompt
-        Efficient
-        Systematic
-        Economical
-        On the spot


FOOD QUALTIY CONTROL

Aim:
-        To ensure consumption of safe and wholesome food
-        To prevent distribution of unwholesome food
-        To reduce spoilage

1.      Control at source
2.      Control at processing
3.      Control at transportation
4.      Control at storage
5.      Control at retail / distribution point
6.      Control at preparation

Control Measures
-        Heat – Pasteurization of milk
-        Dehydration – Dried fruits, fish
-        Cold – Meat, Fish
-        Acidification – Vinegar and pickles
-        Chemical – Chlorine in water
-        Antibiotic – Nissin in cheese
-        Irradiation – Water with UV
-        Gases – Vegetables with carbon dioxide


AIR POLLUTION (API)

-        Occurs when the air contains gasses, fume, dust, particulate matter, odor in harmful amounts
-        Monitored by DOE, ASMA
-        API
o    Air pollution index
o    Tell us how bad is the pollution associated to health
o    It’s an index which capture major pollutants which can cause potential harm to health
o    Type of pollutant
§  Ozone, PM10, carbon monoxide, sulfur dioxide, nitrogen dioxide
o    The Index
§  0 – 50            = Good = No ill effects
§  51 – 100        = Moderate = No ill effects
§  101 – 150      = Unhealthy = Mild, high-risk
§  151 – 200      = Very Unhealthy = Significant risk, all
§  300 - 500       = Hazardous = Severe, danger
§  > 500             = Emergency





CLIMATE CHANGE

Climate: The atmosphere condition over long period

-        Climate Change
o    Increased Precipitation
o    Increased Humidity
o    Increased Global Temperature
-        Causes
o    Mainly Pollution (Air) – Ozone depletion, UV rays
o    Deforestation – Haze, Increase temperature
o    Technological Advancement – Green house effects
o    Development – Green house effects
o    Loss of Biodiversity – Disharmony of environment
-        Effects
o    Increase global temperature
o    Increase water level
o    Vector breed
o    Flood
o    Extreme weather – cold / hot
o    Draught
-        Health Effects
o    Skin diseases / cancer
o    Infection
o    Heat Related Illness
o    CVD / Stroke
-        Measures
o    Adaptation – adapting to the change, anticipate, change and prepare
o    Mitigation – effect to slow, stabilize or reverse climate change by reducing green house gasses (green house gas create low level ozone, block uv, heat to be disperse to space, retain heat -> green house effects)


DENGUE VECTOR CONTROL

Dengue – Mosquito borne infection by Aedes species

Control Measures
(Elimination, Substitution, Engineering, Administrative, PPE)

Steps
1.      Identify Hazard – Dengue Outbreak
2.      Risk Assessment – Dengue high morbidity and rising mortality
3.      Control
a.      Elimination – Source reduction, eliminate breeding site, larvacidal, fish (gambusia affinis)
b.      Substitution – None
c.      Engineering – Genetic modification (male only mosquito), Insecticide net, larva trap
d.      Administrative – Surveillance, law enforcement
e.      PPE – Avoid going out at dusk and dawn, mosquito repellent cream


HEIRARCHY OF CONTROL

Elimination
Substitution
Engineering
Administrative
PPE


PRE-EMPLOYMENY EXAMINATION

-        Medical examination conducted before job employment
-        Look at general health
-        Benefits
o    Cost effective
o    Reduce absenteeism
o    Legal obligation
Objectives
-        Measure medical fitness
-        Ability to perform work without hazard to others
-        Baseline record of employee health status
Content
1.      General Examination
2.      Chest X-Ray
3.      Urine Analysis
4.      Blood Analysis (Upon request)

HEALTH SURVEILLENCE LEAD

Lead
-        Listed in USECHH regulation 2008
-        Exposure = lead battery manufacture, PVC compound, ship-breaker welders, soldering
-        Effects
o    Developmental delay
o    Anemia
o    GI symptoms
o    Abortion
o    CNS and PNS (Paresis, Encephalopathy)

Medical Surveillance
-        Any worker exposed to level of airborne lead 10% from PEL
-        Blood and urine, routine and follow up

-        Levels
o    PEL = 50 ug/m3
o    Biological Exposure Indices = 30 ug/100ml blood

-        Removal (FMA 1984)
o    Blood sampling >80 ug/100ml blood
o    Average 3x blood sampling of 75 ug/100 ml blood
o    Female childbearing >40 ug/100 ml blood
o    Pregnant and breast feeding

-        Prevention
o    Elimination, Substitution, Engineering, Administrative, PPE


RISK ASSESSMENT

Risk: Likelihood of harm to occur (Risk = Hazard x Exposure)

Hazard: Source of potential harm

Exposure: Time contact with substance

Risk Assessment (DGDIECCIRR): Process to estimate the magnitude of risk, and control measures taken

1.      Decide Assessor
2.      Gather Information
3.      Divide into groups
4.      Identify Hazard
5.      Evaluate Exposure
6.      Control Measures
7.      Conclude Risk
8.      Identify Action
9.      Report Writing
10.    Review

Hazard Rating
1.      No injury / not affecting work performance
2.      Minor injury / affecting work performance
3.      Major injury / affecting work performance
4.      Permanent total disability
5.      Death

Exposure Rating
1.      Exposure less than once a year
2.      Exposure more than once per year
3.      Exposure more than once per month
4.      Exposure more than once per week
5.      Exposure more than once per day / shift

Risk Rating - Conclusion from risk matrix to grade risk
-        1 and 2 = Not Significant
-        3 and 4 = Significant but lower priority
-        5 = Significant and Intolerable

Conclusion
1.      C1 = Risk not significant / likely not increase
2.      C2 = Risk significant / adequate control
3.      C3 = Risk significant / inadequate control
4.      C4 = Uncertain about risk / insufficient information
5.      C5 = Uncertain about risk / degree ad extend of exposure




PERMISSIBLE EXPOSURE LIMIT

-        Is a legal limit for exposure of an employee to a substance
-        Expressed in PPM
-        Usually given as time weighted average (TWA)
-        TWA = average exposure over a specific time (8 Hours)

Noise
-        Unwanted sound
-        Sound = Vibration that can be heard by human ear
-        PEL
o    TWA = continuous 90dB for 8 hours
o    Short Term Exposure Limit = not more than 15 min exposure to 115 dB
o    Ceiling Limit = continuous, impulsive or intermittent more than 140 dB at any time
-        Side effects
o    Auditory (NIHL)
§  Short term hearing loss
§  Long term hearing loss (Permanent Threshold Shift)
o    Non-auditory
§  Headache, sleep disturbance

WALK THROUGH SURVEY

-        Process to identify hazard and exposure by going through the work process on the ground
-        Steps
o    Meet the management
o    Discuss about the purpose
o    Review health complains
o    Process work flow diagram in hand
o    Walk through survey form
o    Perform work through survey
§  Get briefing regarding work process
§  Assess worker and workplace
§  Check materials
§  Listen to workers, observe, interview
§  Attention to non-routine work
§  Note down
§  Assess effectiveness of control measures
§  Attention to hazards


OCCUPATIONAL HEALTH HAZARD

Physical
Chemical
Biological
Mechanical
Psychosocial


CONTACT ALLERGIC DERMATITIS

Definition: Inflammation of the skin due to prolong contact with allergenic substance

Symptoms: Red, dry, itchiness, scaly

-        Occur due to frequent contact of skin with chemical, material
-        The degree of allergic depends on the individuals immune system reaction as well as the strength of the materials / substance

Detection
-        Victims consult doctor
-        Get more history (time started, how long, aggravating factor)
-        Get occupational history (workplace, material used or exposed, PPE)
-        Skin test
-        Confirm diagnosis
-        Treatment, Control (Hierarchy of control) and Prevention










PNEUMOCONIOSIS

Definition: Group of condition resulting from mineral dust deposition in lung leading to lung tissue reaction

Silicosis
-        Parenchymal lung disease due to inhalation of silica dust
-        Common in miners, sandblasters, silica production
-        Patterns
o    Chronic Simple Silicosis
§  Exposure >10 years
§  Characteristic
·       Silicotic nodule at lung parenchymal and hilar nodes
·       Rare sign and symptoms in simple, (complicated = dyspnea)
o    Sub-acute Silicosis
§  Similar with chronic but shorter exposure duration and heavier exposure (2-3 years)
o    Acute Silicosis
§  Rare but fatal
§  Intense exposure within month
§  Occur due to inadequate respiratory protection
§  Characteristic
·       Lung consolidation without silicotic nodule
·       Alveolar space filled with fluid
o    Complicated Chronic Silicosis
§  Reduction in lung volume

Asbestosis
-        Diffuse interstitial pulmonary fibrosis due to inhalation of asbestos fiber
-        Characteristic
o    Bilateral pleural thickening
o    Diaphragmatic calcification
o    Pericardial calcification

Coal Miners Pneumoconiosis
-        Parenchymal disease of lung due to inhalation of coal dust
-        Risk -> underground coal miner, exposure <20 o:p="" years="">


HAND ARM VIBRATION SYNDROME

Definition: Combination of symptoms in fingers, hands and arms caused by prolonged use of vibration equipment

Symptoms: White finger, numbness, ache, and pain

Prevention: Anti vibrating handle, reduce exposure, health education, and medical surveillance


OCCUPATIONAL ASTHMA

Definition: Asthma that occur due to workplace exposure, worker free from asthma before start working

Types
1.      Sensitizer-induced asthma / Allergic Asthma
2.      Without sensitizer / Non-Allergic Asthma


DISASTER MANAGEMENT

Phase
1.      Pre-Emergency
2.      Impact & Flight
3.      Acute Emergency
4.      Post Emergency
5.      Rehabilitation
6.      Reconstruction
7.      Mitigation