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September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 1 Preventing disease (7y900) (incidence, prevalence, building determinants, DALY)

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Presentation on theme: "September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 1 Preventing disease (7y900) (incidence, prevalence, building determinants, DALY)"— Presentation transcript:

1 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 1 Preventing disease (7y900) (incidence, prevalence, building determinants, DALY)

2 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 2 Indicators for Public Health 1. Incidence of disease or infliction = number of cases diagnosed in a certain year 2. Prevalence of disease or infliction = number of cases known to be present in a certain year 3. Prevalence of increased risk = number of persons with increased risk in a certain year 4. Lost Years of Life = extra years of life that could have been expected, had the deadly condition not occurred 5. Disability Adjusted Life Years (DALY’s) = healthy years in a life span

3 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 3 Top-10 Diseases The Netherlands 1994 Cause(s) in built environment characteristics Built environment may compensate / support

4 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 4 Top-10 Diseases The Netherlands 1994 Cause(s) in built environment characteristics Built environment may compensate / support

5 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 5 Indoor Air Suitability (NL) After MCL Snijders. PhD Thesis, TU/e, September 5, 2001 User Group With Chronic Lung Disease Children, Elderly, Non- sensitized Atopics Healthy, non-atopic Adults None CO 2 in ppm <= 680680 < CO 2 =< 865865 < CO 2 =< 1085> 1085 Moisture: % of time in Humidity Class I or II 95 < 95 Room Ventilation Rate (RVR) in l s -1 m - 2 >= 2.42.4 > RVR >= 1.51.5 > RVR >= 1.05< 1.05 Suitable Living Rooms in Heating Season 00432

6 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 6 Atopy Inherited constitution ( 40% of the population )Inherited constitution ( 40% of the population ) Disease process is IgE mediatedDisease process is IgE mediated 1 st phase: Sensitization ( skin- and laboratory tests )1 st phase: Sensitization ( skin- and laboratory tests ) 2 nd phase: Disease symptoms2 nd phase: Disease symptoms 85% of symptoms building related85% of symptoms building related Affected organs: eyes, nose, lungs, skin, alimentary canalAffected organs: eyes, nose, lungs, skin, alimentary canal

7 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 7

8 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 8

9 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 9 House Dust Mites

10 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 10 The 6 Global Risk Areas for mite growth and survival in carpeting of well ventilated and heated rooms 1. No survival 2. Survival on poorly insulated ground floors 3. Survival on all floors 4. Growth on poorly insulated ground floors 5. Growth on most floors 6. Growth on all floors 1. 2. 3. 4. 5. 6.

11 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 11 Temperature and House Dust Mites in Carpeting Source: JEMH van Bronswijk, G Pauli (eds) 1996. An update on long-lasting mite avoidance. GuT, Aachen. ISBN 3-00-000896-9

12 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 12 The 6 Global Risk Areas for mite growth and survival in carpeting of well ventilated and heated rooms 1. No survival 2. Survival on poorly insulated ground floors 3. Survival on all floors 4. Growth on poorly insulated ground floors 5. Growth on most floors 6. Growth on all floors 1. 2. 3. 4. 5. 6.

13 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 13 Prevalence of Sensitisation to mite allergen in atopic patients Source: JEMH van Bronswijk, G Pauli (eds) 1996. An update on long-lasting mite avoidance. GuT, Aachen. ISBN 3-00-000896-9

14 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 14 Top-10 Diseases The Netherlands 1994 Cause(s) in built environment characteristics Built environment may compensate / support

15 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 15 Important Infections in Architecture, Building & Planning Infection Transmitted through AirWaterSurfacesOutdoor Influenza A xxx(x) Lyme disease ---x SARSxxx(x) Tuberculosisx--- Veteran’s disease -x-- Weil’s disease ---x In green: diseases associated with pneumonia In red: zoonoses

16 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 16

17 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 17 Pneumonia: Influenza A: bird flu Virus particles are spherical (diameter of 80-120 nm) or filamentous (length 1 mu m) Source: http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/I/Influenza.html

18 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 18 Pneumonia: SARS

19 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 19 SARS - Severe Acute Respiratory Syndrome - Coronavirus, person to person transmission - 2003: 908 dead among 8.422 patients - Survivors: medication caused osteoporosis - Damage to the economy Influenza A -Orthomyxovirus, person to person transmission ? -Some death did occur -Pandemic: after person to person transmission

20 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 20 Zoonosis Definition: Disease of animals that may be transmitted to humansDefinition: Disease of animals that may be transmitted to humans Severity: Expect severe diseaseSeverity: Expect severe disease Use: Some zoonoses are used in biowarUse: Some zoonoses are used in biowar Currently abundant in NL: Diseases of Lyme and WeilCurrently abundant in NL: Diseases of Lyme and Weil

21 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 21 Technology to enlarge vitality? 93% of NL-elderly (2.2 mil of 65+) live independently 33% of the elderly with a severe physical disorder live in an unsuitable dwelling (not fully accessible, limited support) Source: Lectoraat Vraaggestuurde Zorg (dr. H.S.M. Kort), Utrecht 2005

22 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 22 A Smart Home Environment (2 nd semester 7y910) is a home environment that adapts itself to the dweller. A SHE forms an invisible, intelligent, self-learning part of our daily life, combining functions pertaining to demand-driven comfort, domestic tasks, personal care, quality of life, and professional care Source: Bronswijk et al. 2005: De Intelligente Thuisomgeving. In: Handboek Zorg Thuis. Amsterdam: Elsevier

23 September 5, 2007JEMH van Bronswijk www.phe.bwk.tue.nl 23 Next class September 12: No class, consultation on request September 19: The DALY construct (Disability Adjusted Life Years) to evaluate building services

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