Immunization

1. Immunization

2. Immunization ScheduleKSA ( most resent) Birth BCG HepBV1 2 mo Rota DTaP1 HibV1 IPV1 HepBV2 PCV1 4 mo Rota DTaP2 HibV2 IPV2 HepBV3 PCV2 6 mo DTaP3 HibV3 HepBV4 PCV3 IPV/OPV3 9 mo Measles1(mono) MCV4 12 mo M2MR1 OPV4 PCVB MCV4 18 mo DTaPB1 HibVB HepAV1 Varicella1 OPVB1 M3MR2 24 mo HepAV2 School Varicella2 DTaPB2 OPVB2 M4MR3 /Td entry vaccineinformation.org

3. Route:IM: deep into muscle to avoid tissue damage from adjuvant usually with a 22-23G needle (2cm) in length. • SC: into a pinched skin fold with a 25 G (2cm) in length • Simultaneous administration: • Routine childhood vaccines are safe and effective when administered simultaneously at different sites ,generally • 1 – 2 inches apart , live viral vaccine (e.g. MMR and varicella) can be administered simultaneously at different sites otherwise the interval between administration should be >1month • Anaphylactic reaction to a vaccine or a vaccine constituent Moderate to severe illness regardless of fever • Special hosts

4. Occupational Health

5. Occupational Health Occupational health hazards WORKPLACE HAZARDS PHYSICAL HAZARDS EXTREME TEMPERATURE Health Effects of Heat Stress

6. Prickly heat is a skin condition that appears as discrete, extremely pruritic, erythematouspapulovesicles accompanied by a sensation of burning, or tingling. It can appear after taking a hot shower. Heat cramps are muscle spasms that result from loss of large amount of salt and water through exercise. It can be caused by inadequate consumption of fluids or electrolytes. Usually they occur later, especially at night or when relaxing. Although heat cramps can be quite painful, they usually don't result in permanent damage. Heat exhaustion: This condition often occurs when people exercise (work or play) in a hot, humid place and body fluids are lost through sweating, causing dehydration and overheating of the body. The person's temperature may be elevated, but not above 104 F (40 C). Heat stroke: is a life-threatening medical condition. The person's cooling system, stops working and the internal body temperature rises to the point at which brain damage or damage to other internal organs may result (temperature may reach 105 F or greater [40.5 C or greater]).

7. Occupational health hazards WORKPLACE HAZARDS PHYSICAL HAZARDS RADIATION

8. WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects Pneumoconiosis: Fibrosis and scarring of the lungs secondary to repeated inhalation of dust associated with some occupation(Silicosis, anthracosis, asbestosis, byssinosis, bagassosis, and farmer’s lung).

9. WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects

10. Phosphene;(PH3): Hydrogen phosphide; Phosphorus trihydride; Phosphorus hydride. Used in semiconductor industries and as a pesticide. It can be absorbed into the body by inhalation. Overexposure to phosphine gas causes nausea, vomiting, abdominal pain, diarrhea; thirst; chest tightness, dyspnea (breathing difficulty); muscle pain, chills; stupor or syncope; pulmonary edema. Arsine is the chemical compound with the formula AsH3. This flammable and highly toxic gas is one of the simplest compounds of arsenic. Despite its lethality, it finds applications in the semiconductor industry and for the synthesis of organoarsenic compounds. Stibine is the chemical compound with the formula SbH3. This colourless gas is the principal covalent hydride of antimony. This gas has an offensive smell like hydrogen sulfide (rotten eggs). SbH3 is an unstable flammable gas. It is highly toxic. The toxicity of stibine is similar to that of arsine. It binds to the haemoglobin of red blood cells, causing them to be destroyed by the body.

11. WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects Mfg: manufacturing

12. WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects

13. WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects

14. WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects

15. Occupational Health Occupational health hazards WORKPLACE HAZARDS BIOLOGICAL HAZARDS Selected Infectious Diseases and Occupations

16. TETANUS:A neurological disorder characterized by increased muscle tone and spasms, that is caused by tetanospasmin, a toxin released by the organism Clostridium tetani. It arises from the contamination of wounds with Clostridium spores. Clinical Manifestations: Increased tone in the masseter muscle (lockjaw), Sustained contraction of the facial muscles (risussardonicus) and back muscles (opisthotonus). Prevention: Active immunization with tetanus toxoid, and careful wound management TUBERCULOSIS: caused by the bacteria, Mycobacterium tuberculosis , caused by droplet nuclei released when sneezing and coughing . Symptoms: weight loss, low grade afternoon fever, persistent cough and sometimes, blood-streaked expectoration or hemoptysis. Directly Observed Therapy Short Course (DOTS) Strategy…the Solution!

17. WORKPLACE HAZARDS BIOLOGICAL HAZARDS Selected Infectious Diseases and Occupations Anthrax is an acute disease caused by the bacterium Bacillus anthracis. Most forms of the disease are lethal, and it affects both humans and other animals. There are effective vaccines against anthrax, and some forms of the disease respond well to antibiotic treatment. Anthrax spores can be produced in vitro and used as a biological weapon.

18. WORKPLACE HAZARDS BIOLOGICAL HAZARDS Selected Infectious Diseases and Occupations

19. Environmental Health

20. MAJOR GLOBAL ENVIRONMENTAL PROBLEMS 1- Overpopulation 2- Air pollution: 3- Ozone depletion and global warming: 4- Water pollution:

21. 1- Overpopulation • Pollution • Air • Water • Soil • Resource depletion • Forests • Fossil fuel • Extinction(52 species) • Mammals • Birds • Amphibians Fossil fuels: contain high percentages of carbon and include coal, petroleum, and natural gas. They range from volatile materials with low carbon:hydrogen ratios like methane, to liquid petroleum to nonvolatile materials composed of almost pure carbon, like anthracite coal. *ESTIMATE

22. 2- Air pollution: • industrialized and urbanized areas • 75% of children suffer respiratory disease • London fog (1952) killed 4000-8000 (mostly elderly). • The six major air pollutants: • Carbon monoxide (CO) • Nitrogen Oxides (NO, NO2) • particulate matter • sulfur dioxide (SO2) • Hydrocarbons • lead

23. Particulate matter: is a complex mixture of extremely small particles and liquid droplets. Particle pollution is made up of a number of components, including acids (such as nitrates and sulfates), organic chemicals, metals, and soil or dust particles. The sources are modern farming, burning oil and coal, dust storms and volcanic eruptions. Once inhaled, the small size of particles can affect the heart and lungs and cause serious health effects.

24. 3- Ozone depletion and global warming: plant/ animal ultraviolet rays (skin cancer, cataracts, etc) • Refrigerants :chlorofluorocarbons (CFCs), • 1930: introduced(Freon) • 1976: 750 million lb./year • 1980s: $28 billions/year • CO2 from fossil fuel Keeling Curve Without pollution control, the waste products from consumption, heating, agriculture, mining, manufacturing, transportation and other human activities, whether they accumulate or disperse, will degrade the environment.

26. 3- Ozone depletion and global warming: several thousand x the greenhouse potential CO2 CFCs CFCs cooling of the stratosphere accelerates ozone depletion accelerates ozone depletion • What can we do? • Reduce home energy usage • Buy cars that are fuel-smart • Transportation alternatives : • mass transit,, bicycling • Insulate your home to save • money and energy • Plant trees • Educate others

27. 4- Water pollution: • Causes of water pollution • Population growth. • Outputs (Industrial, agricultural and urban) • Control of water pollution: • Domestic sewage • wastewater • Industrial • Agricultural • stormwater • Construction site • Urban runoff

28. MAJOR GLOBAL ENVIRONMENTAL PROBLEMS Pollutioncontrol: PREVENT most favoured REDUCE option REUSE RECYCLE MITIGATE COMPOST DISPOSE least favoured option

29. Pollution control :Prevention: Pollution prevention describes activities that reduce the amount of pollution generated by a process. In contrast to most pollution control strategies, which seek to manage a pollutant after it is formed, the pollution prevention approach seeks to increase the efficiency of a process, thereby reducing the amount of pollution generated at its source. Some professionals also use the term pollution prevention to include recycling or reuse. Reduce: reducing the amount of waste produced by a person or a society. Waste minimization involves efforts to minimize resource and energy use during manufacture. Reuse is to use an item more than once. Reuse help save time, money, energy, and resources. Recycling is processing waste into new products to prevent waste of potentially useful materials, reduce the consumption of fresh raw materials, reduce energy usage ….reduce air, water and soil pollution by reducing the need for "conventional" waste disposal.

30. Mitigation: The implementation of measures designed to reduce the undesirable effects of a proposed action on the environment. Fully or partially prevent an impact/reduce a risk by: changing means or technique, changing the site of a project and specifying operating practices to decrease waste. Compost: is organic matter that has been decomposed and recycled as a fertilizer and soil amendment. Composting simply requires making a heap of wetted organic matter (leaves, food waste) and waiting for the materials to break down into humus after a period of weeks or months. Worms and fungi further break up the material. Aerobic bacteria manage the chemical process by converting the inputs into heat, carbon dioxide and ammonium cpds. The ammonium cpds are further converted by bacteria into plant-nourishing nitrites and nitrates through the process of nitrification.

31. Demographic Issues (more people) • Growth in number • Increase in Consumption • Consumption Patterns: • More wastes • Growth of cities (More • large cities and slums)

32. CHALLENGES and OBSTACLES to IMPROVED SANITATION • Macro Economic Policies • More use and degradation of resources • Poverty: > 1 billion live below poverty line( $ 1.25/day) • Behavioural and perception barriers: • – low environmental concern • – benefits of improved sanitation not widelyunderstood

33. Pollution affects every organ Cardiac Cardiac

34. The basic requirements for healthy environment • Clean Air • Safe and Sufficient Water • Adequate and Safe Food • Safe and Peaceful Settlements • Stable Global Environment

35. Summary Environmental health is the broadest scope of health problem definition Environmental health studies the impact of the environment on populations It is a population based science that can be scaled to study individuals within populations Problem definition and potential resolution is possible through the implementation of a systematic approach

36. School health

37. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Objectives of school health program: zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz • health promotion of school children, • prevention and control of health hazards, • rehabilitation of the handicapped. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

38. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Importance of school health program: zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz The school child is the subject of special consideration for many reasons:- • This group is of vital importance to the community( future generations). zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz • They constitute a sizeable segment of the population( 35 – 39%). • They are subject to the risk of communicable • diseases( immunity, exposure and outcome). • They undergo the stresses and strains of • growth and development. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

39. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Importance of school health program: zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz The school child is the subject of special consideration for many reasons:- • The physical, mental and emotional stresses should always be considered. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz • Unsanitary environment is gaining lots of attention due to its impact on health. • Health and education are closely related: • “Education is fundamental to health and • health is vital for efficient education”. (Learning in the classroom ) i zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

40. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Target (Aims) zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz • Provide an environment for healthy development • ( Physical, Mental and Emotional) • Obtain information of health status using various types of medical inspection and evaluation zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz • Early diagnosis and prompt treatment • Institution of healthy habits (health education) • Care of special groups: Handicapped, Maladjusted and Crippled. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

41. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH School Health Program : zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz 1. Health Promotion. 2. Prevention of health hazards. 3. Medical Care . 4. Health Education. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

42. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Coordinated School Health zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

43. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Health Promotion: zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz • Adequate nutrition, • Sanitary school environment, • Meeting the needs for mental development (emotional & behavioral adjustment ) zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz • Physical fitness and activities, • Social activities and recreation. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

44. Health Benefits of : Health benefits of regular physical activity should be accessible for children and adolescents, young and middle-aged adults and older adults. There are also benefits for people who have disabilities.Both aerobic (endurance) and muscle-strengthening (resistance) physical activities are beneficial. Bone strengthening activities are also important for children and adolescents.There is strong evidence of significant health benefits with regular physical activity. • Some of these health benefits include the following: • 1- Improved cardiorespiratory and muscular fitness. • 2-Improved bone health. • 3- Improved cardiovascular and metabolic health biomarkers. • 4-Weight loss and/or prevention of weight gain • Regular physical activity may reduce the risk of many adverse health outcomes, including the following: • 1- Lower risk of early death. • 2- Lower risk of coronary heart disease, stroke, and high blood pressure. • 3- Lower risk of type 2 diabetes and metabolic syndrome. • 4- Low risk of colon and breast cancer

45. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Health Appraisal zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz Objectives Case-finding, specially of unapparent disease , Assessment of health status of school children, Baseline for follow-up of health status. Health education and guidance of students, zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

46. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Health Appraisal zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz Components 1- comprehensive medical examination 2- Screening tests, zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz 3- Clinical (curative) service 4- Survey studies. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

47. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Health Appraisal zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz Components 1- comprehensive medical examination zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz • Beginning of each level • Entry • Intermediate • Secondary zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

48. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Health Appraisal zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz Components 2. Screening Tests: They are simple tests which can be carried out frequently : - obesity (BMI) - visual acuity, - acuity of hearing, - IQ testing, and - dental examination. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

49. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Health Appraisal zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz Components 3. Clinical Service: School health units, referrals to specialized clinics, referrals to hospitals for diagnosis and treatment . some cases may need specialized diagnosis or/and management. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

50. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz SCHOOL HEALTH Health Appraisal zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz Components 4. Survey Studies: Occasionally required, specially when precise data are not available zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz • nutritional deficiency • parasitic diseases • handicapping conditions zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz