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

2. 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

3. 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)

4. 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

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

6. 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,

7. 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

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

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

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

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

12. 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

13. 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

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

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

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

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

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

19.  Tsetse fly (glossinae)  Sleeping sickness

20.  Blackfly (Simulum)  Onchocerciasis

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

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

23.  Bugs  Chagas disease

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

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

26.  Mite (chiggers)  Scrub typhus

27.  Itch mite  Scabies

28.  Cyclops (Mesocuclops)  Guinea- worm

29.  Cockroaches  Enteric pathogens

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