SANITA' PUBBLICA E SCIENZE MEDICO LEGALI - channel 2

12 CFU - 1° Semester

Teaching Staff

MARGHERITA FERRANTE - Module Public Health and forensic sciences, channel 2: Hygiene and Community Medicine - MED/42 - 7 CFU
NUNZIATA GIUSEPPA ELISABETTA BARBERA - Module Legal Medicine - MED/43 - 3 CFU
CATERINA LEDDA - Module Occupational Medicine - MED/44 - 2 CFU

Learning Objectives

Public Health and forensic sciences, channel 2: Hygiene and Community Medicine
- To have strong knowledge regarding: sources and methods of health data collection, epidemiological methods for their analysis and interpretation, causes of invalidity and death, health determinants and risk factors in lifestyle, health determinants and environmental risk factors, methods for the prevention of chronic diseases, mode of occurrence and spread of infections, interventions on individuals and communities for their prevention, principles and application of preventive medicine in the communities, communication principles and methodologies applied to 'health information and health education.

- To present themselves as valid interlocutors on issues affecting the health promotion and disease prevention, in dealing with individuals with health administrators and the community as a whole.

- Assess the epidemiological data and know the use for the purposes of health promotion and disease prevention in the individual and in the community, work together with the health services of the area in the epidemiological surveillance and health promotion programs and disease prevention, recognize the health problems of the community and work together to solve, identify and help remove the causes and factors of diseases present in the behavior and in the living environment, making accurate information on determinants of health and disease, with reference also to lifestyle and to factors in the physical and social environment, educate, in their professional activities, to behaviors in order to promote health and prevent disease and disability due to microbial causes, from physical and chemical agents, as incidents. Knowing the health organization to international, European and national level.
Legal Medicine
Legal medicine is aimed to the study and application of scientific and medical knowledge to legal problems. It is directed to the acquisition of information significant to the exercise of medical profession in terms of legal and ethical issues, with respect to criminal, civil and social insurance. The teaching is focused in particular on the study of the forensic pathology with particular reference to thanatology, forensic traumatology, forensic psychopathology, forensic asphyxiology, forensic toxicology, forensic gynaecology, forensic human identiﬁcation, crime scene processing and investigation.
Occupational Medicine
The aim of the course is to provide information and knowledge about workplace-related pathologies (accidents and illnesses) as well as to become familiar with prevention principles, with particular reference to risk assessment and preventive measure adoption.

Students will have to learn methods and techniques to collect work history, identify environmental and occupational risks and possible relationships with genetic, demographic, socio-economic, psychological and cultural factors, related to health or illness statuses, as well as to look into the possible non-specific effects of occupational risk factors, especially for degenerative chronic diseases.

The main etiologically diagnostic aspects of occupational medicine will be dealt with, and so will the epidemiology of con-causally work-related diseases. Also, the most frequent professional diseases and work accidents will be classified. The main analysis method and work risk assessment instruments will be provided, that is limit exposure levels, environmental/biological monitoring and healthcare surveillance. Also, occupational risk in/formation, safety and health law guidelines in work places, primary and secondary prevention of occupational diseases, role and duties of the competent physician will be discussed.

Course Structure

Public Health and forensic sciences, channel 2: Hygiene and Community Medicine
Interactive didactic with case-study presentation.

Should teaching be carried out in mixed mode or remotely, it may be necessary to introduce changes with respect to previous statements, in line with the programme planned and outlined in the syllabus.

Learning assessment may also be carried out on line, should the conditions require it.
Legal Medicine
The course consists of a series of lectures
Occupational Medicine
Frontal lesson, experiential exercise.

Should teaching be carried out in mixed mode or remotely, it may be necessary to introduce changes with respect to previous statements, in line with the programme planned and outlined in the syllabus.

Detailed Course Content

Public Health and forensic sciences, channel 2: Hygiene and Community Medicine
Principles of demography and health statistics. Sources of demographic and health data. demographic indicators. mortality and morbidity indicators. Indicators of quality of life.
Principles of epidemiological methodology. The measures in epidemiology .The epidemiological studies: descriptive epidemiology; analytical epidemiology; Experimental epidemiology. The causal relationship in epidemiology. The risk assessment. systematic reviews and meta-analysis. The medicine based on evidence of effectiveness.
Epidemiology of of infectious diseases. Mode of infection transmission. The contagion chains. The natural course of infection.

General principles of epidemiology of chronic degenerative diseases and disabilities. The necessary causes and the sufficient causes. Risk factors and protective factors. Causes and factors in the physical and social environment. Lifestyle and health. Frequency of chronic degenerative diseases and other damaging events in the population.

Methodology for prevention and health promotion. Objectives and methods of prevention (primary, secondary and tertiary).
Prevention of infectious diseases. primary prevention of infection Interruption of transmission chains. Interventions for the discovery and inactivation of infection sources. Active and passive immunoprophylaxis. Chemoprophylaxis. Secondary prevention of infections.
Prevention of chronic degenerative diseases and disabilities, primary, secondary and tertiary.
Principles of health education. Health and health promotion. Methods and models of communication. Strategies for health promotion. Health promotion in the Ottawa paper.
Epidemiology and prevention of infectious diseases.
Europe-wide surveillance systems. The networks and activities of ECDC (European Center for Disease Prevention and Control).
- Respiratory tract infections: influenza, tuberculosis, legionellosis.
- Infections transmitted by parenteral or sexual: acquired immune deficiency syndrome (AIDS), viral hepatitis B and C, gonorrhea, syphilis,
infection with human papilloma virus.
- Food-borne infections and zoonoses: cholera, hepatitis A and E, typhoid fever, gastroenteritis.

- Emerging and vector-borne infections: arbovirus infections, leishmaniasis, malaria, rickettsial.

- Infections preventable by vaccination: diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, bacterial meningitis, chickenpox infections, invasive bacterial, rotavirus infections.
- Infections acquired in healthcare sector (HAI, hospital acquired infections): the surveillance programs and national and European networks.

- Epidemiologia and prevention of major chronic diseases. cardiovascular diseases, malignant tumors, diabetes, chronic obstructive pulmonary disease.

- Health promotion and disease prevention in the different phases of life. Pre conceptional prevention, prenatal and neonatal. Health needs in children. Health needs in adulthood. Defense and promotion of health in the elderly.

Food hygiene and nutrition

-Food hygiene. Food and related health issues. microbial contamination. Restoration and preservation of foods. Food safety

Environment and health.

- Environmental factors such as certain health and disease. The pollution of the environment and its effects on health and. The water and its characteristics. Water intended for human consumption, treatment and distribution. Mineral waters. Use of water for recreational purposes. The municipal wastewater, agricultural and industrial. Air pollution; the effects on health and environment of air pollutants. The medical waste and municipal solid waste. Electromagnetic pollution. Risk factors and prevention in living and working environments.

Health organization: Health organization at international and European level. The national health service in Italy: the central, regional and local levels. The health planning. The national health plan and regional health plans. The Health Management.
Legal Medicine
Introduction to Penal Law (crime, classifications, objective and subjective elements). Civil capacity (legal capacity and capacity to act, interdiction, disqualification, natural incapacity). Material causation and law regulations. Chain of material causation. Imputability (under age, full or partial infirmity of the mind, intoxications, deaf-mutism). Diagnosis of death. Report of the causes of death. Regulations of mortuary Police. Time of death and thanatological changes of corpse. Medical Deontology. Informed consent. Notes on pathology: injuries from blunt instruments; stab injuries; injuries from fire-arm; electrical injuries; asphyxia (suffocation, hanging, strangulation, constriction, drowning). Forensic Toxicology: diagnosis of poisoning; CO poisoning; alcoholism and drug addiction; legislation on drugs. Degrees of murder. Crimes of beating and personal injury. Crime of sexual violence. Abortion. The professional medical liability. Medical Report to Public Prosecutor’s Office. Professional secrecy. Medical record; medical certification. Legal advice to the Office of Public Prosecutions. Compulsory medical treatments. Social system of assistance and welfare services.
Occupational Medicine
History and evolution of Occupational Medicine: prevention service legislation and organization; work accidents and professional diseases insurance practices. Risk assessment procedure; exposure times and limit levels/values.

Primary and secondary prevention principles. Healthcare surveillance and duties of competent physician. Biological monitoring procedures. General and individual preventive practices and first aid action organization. Biological risk and vaccinations. Physical risks: noise, vibrations, ionizing-non-ionizing radiations, microclimate and compressed atmosphere. Ergonomy principles: postures and work. Workstation, shift and night work risks. Assessment of risks in manual loads handling and in repetitive movements of upper limbs with associated pathologies. Organizational wellness and its associated work stress. Health promotion in working places.

Main dust/fibre and professional allergene exposure–related pathologies; indoor and outdoor pollutants. Exposure risks to chemical, mutagen and carcenogenic agents.

Principles of Industrial Hygiene and hints of Statistics. Risks in the main working cycles. Guidelines on safety and health in working places.

Textbook Information

Public Health and forensic sciences, channel 2: Hygiene and Community Medicine
1) Maria Triassi, Gabriella Aggazzotti, Margherita Ferrante, Igiene Medicina Preventiva e del Territorio, II edizione, Sorbona, Idelson Gnocchi, Napoli 2015.

2) Buffoli M, Capolongo S., Odone A, Signorelli C. Salute e Ambienter, EDISES, Napoli 2016.

3) Gilli G. Professione igienista Manuale dell'igiene ambientale e territoriale. Casa Editrice Ambrosiana, Milano 2010.
Legal Medicine
1. L. Macchiarelli, P. Arbarello, G. Cave Bondi, N. M. Di Luca, T. Feola - Compendio di Medicina Legale. Editore: Minerva Medica
2. G.A. Norelli, C. Buccelli, V. Fineschi - Medicina legale e delle assicurazioni. Editore: Piccin
3. Zagra M., Argo A., Madea B., Procaccianti P. Medicina legale orientata per problemi. Editore: Elsevier Srl, 2011.
Occupational Medicine
- David Koh, Ken Takahashi. Textbook of Occupational Medicine Practice. 3rd Edition ISBN: 978-981-4329-57-6

Open in PDF format Versione in italiano