INTRODUCTION TO ENVIRONMENTAL MEDICINE (2) By Dr. Khalid El Tohami

OBJECTIVES At the end of the session the student should be able to:  Explain hazards of waste, excreta and management in community and hospital  Describe public health, medical entomology and control

SOLID WASTE  It includes:  Garbage (food waste)  Rubbish (paper, plastic, wood, metal, glass,)  Demolition products ( bricks, pipes)  Dead animals, manure  Solid products of sewage ( not night soil)

HAZARDS OF SOLID WASTE  It decomposes and favours fly breeding  Attract rodents  Transmit pathogen back to man through flies or dust  Pollution of soil and water  Unsightly appearance and bad odours

MANAGEMENT OF SOLID WASTE 1. Storage 2. Collection 3. Disposal a. Dumping b. Controlled tipping c. Incineration d. Composting e. Manure pits f. burial

EXCRETA  Hazards of improper excreta disposal:  Soil pollution  water pollution  Food contamination  Propagation of flies  (eg of diseases: typhoid and paratyphoid, dysenteries, diarrheas, cholera, hookworms, ascariasis, viral hepatitis,

METHODS OF EXCRETA DISPOSAL  Unsewered areas:  Bore hole latrine  Pit latrine  Water seal latrines  Septic tank  Aqua privy  Sewered areas:  Water carriage system and sewage treatment  Sea, river outfall

HOSPITAL WASTE  It is a waste that generated during the diagnosis, treatment or immunization of human beings or in research activity

CLASSIFICATION OF HOSPITAL WASTE  Infectious waste  Pathological waste  Pharmaceutical waste  Genotoxic waste  Chemical waste  Waste with heavy metals  Pressurized containers  Radioactive waste

HAZARDS OF HOSPITAL WASTE  It contains infectious agents  It contains toxic chemicals and pharmaceutical  It contains sharps  It is genotoxic  It is radioactive

DISPOSAL OF HOSPITAL WASTE  Incineration  Chemical disinfection  Wet and dry thermal treatment  Microwave irradiation  Land disposal  inertization

MEDICAL ENTOMOLOGY  It is the study of arthropods of medical importance  Arthropods are the most numerous and varied living thing around man  Some of them are allies helping in fertilization of flowers  Others are of no use  Some are the most dangerous enemies destroying corps, food reserves and causing disease

ARTHROPODS OF MEDICAL IMPORTANCE Class insectaClass arachnidaClass crustacea 1.Mosquitoes: Anophelines Culicines 1.Ticks: Hard ticks Soft ticks 1.Cyclops 2.Flies: Houseflies Sandflies Tsetse flies Blackflies 2.Mites: leptotrombidium Mites Itch mite 3.Human Lice: Head & body lice 4.Fleas: Rat fleas Sand fleas 5.Bugs

ARTHROPODS BORNE DISEASE  Mosquito: 1. anopheles  Malaria, filaria, viral encephalitis, viral hemorrhagic fever ( eg yellow fever, dengue fever)

2. Culex  West Nile fever, bancroftian filariasis, viral artheritis

3. Ades  Yellow fever, dengue fever, rift valley fever

 Housefly (Musca domestica)  Typhoid and paratyphoid, dysentery, diarrhea, cholera, trachoma, helminthic infestation

 Sandfly (phlebotomus argentipes)  Kala-azar, oriental sore, sandfly fever

 Tsetse fly (glossinae)  Sleeping sickness

 Blackfly (Simulum)  Onchocerciasis

 Lice (Pediculus capitis / corporis)  Epidemic typhus, relapsing fever, pediculosis

 Rat flea (Xenopsylla, Nosopsylla)  Plaque, endemic typhus

 Bugs  Chagas disease

 Hard tick (Ixodidae)  Tick typhus, viral hemorrhagic fever, tick paralysis

 Soft tick (Orgasidae)  Q fever, relapsing fever

 Mite (chiggers)  Scrub typhus

 Itch mite  Scabies

 Cyclops (Mesocuclops)  Guinea- worm

 Cockroaches  Enteric pathogens

PRINCIPLES OF ARTHROPOD CONTROL  Environmental control  Chemical control  Biological control  Genetic control