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SANITA' PUBBLICA E SCIENZE MEDICO LEGALI

Teaching Staff

MARINA MARRANZANO - Module Hygene - MED/42 - 7 CFU
DIEGO GERACI - Module MEDICINA LEGALE - MED/43 - 3 CFU
LIDIA PROIETTI - Module Occupational Medicine - MED/44 - 2 CFU

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Learning Objectives

• Hygene
  

  To have depth knowledge regarding: sources and methods for health data

  collection, epidemiological methods for their analysis and interpretation, causes of

  disability and death, health determinants and risk factors in the 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 on communities for their prevention, principles and application of preventive

  medicine in the community, principles and methods of communication applied to

  health information and health education.

  - To present themselves as authoritative interlocutors on health promotion and

  disease prevention issues, in dealing with individuals, with health administrators and

  the community.

  - To evaluate epidemiological data and know the use for the purposes of health

  promotion and disease prevention in individuals and in the community, to

  collaborate with the health services in the epidemiological surveillance and in the

  programs of health promotion and disease prevention, recognizing health problems

  of the community and to collaborate to solve them, to identify and to collaborate to

  remove the causes and factors of diseases present in the behavior and environment,

  making accurate information on the determinants of health and disease regarding

  lifestyle factors and physical and social environment, educate, as part of their

  professional activities, to behaviors that promote health and prevent disease and

  disability due to microbial, chemical and physical agents, accident.

  - to know the health organization at international, European and national level.

  -to know skills and managerial activities.

  - to know the principles and applications of health economics for the purpose of

  choices in health planning

• 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.

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Detailed Course Content

• Hygene
  

  Principles of demography and health statistics. Sources of demographic and

  epidemiological data. Demographic indicators. Indicators of mortality and

  morbidity. 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. Risk

  assessment. Systematic reviews and meta-analysis. The evidence-based medicine.

  Principles of epidemiology of infectious diseases. Mode of transmission of infection.

  The chains of contagion. The natural course of infection.

  General principles of the epidemiology of chronic diseases and disabilities. The

  necessary causes and the sufficient causes. Risk factors and protective factors.

  Causes and factors of the physical environment and of the social environment.

  Lifestyles and health. Frequency of chronic diseases and other harmful events in the

  population.

  Methodology for the prevention and health promotion. Objectives and methods of

  prevention (primary, secondary and tertiary prevention).

  The prevention of infectious diseases. Primary prevention of infection. Breaking the

  chains of transmission. Interventions for the discovery and inactivation of the

  sources of infection. Active and passive immunoprophylaxis. Chemoprophylaxis.

  Secondary prevention of infections.

  Prevention of chronic diseases and of disabilities. Primary, secondary and tertiary

  prevention.

  Principles of health education. Health and health promotion. Methods and models

  of communication. Strategies for health promotion. Health promotion in the Ottawa

  Charter.

  Epidemiology and prevention of major infectious diseases.

  Surveillance systems at European level. The networks and activities of the ECDC

  (European Centre for Disease Prevention and Control).

  - Respiratory tract infections: influenza, tuberculosis, Legionnaires’ disease.

  - Sexually transmitted infections, including HIV and blood-borne viruses:

  HIV/AIDS, Hepatitis B and C virus infections, blenorragia, syphilis, Human

  Papilloma Virus infections infezioni.

  - Food- and waterborne diseases and zoonoses: cholera, Hepatitis A and E

  virus infections, typhoid feve, gastroenteritis.

  - Emerging and vector-borne diseases: arbovirus infections, leishmaniasis,

  malaria, rickettsiosis.

  - Vaccine-preventable diseases: diphtheria, tetanus, pertussis, polio, measles,

  mumps, rubella, bacterial meningitis, varicella, invasive bacterial infections,

  rotavirus infections.

  - Health care associated infections (HAI, hospital acquired infections):

  surveillance programs and national and European networks.

  Epidemiology and prevention of major chronic diseases. Cardiovascular diseases,

  malignant tumors, diabetes, chronic obstructive pulmonary disease.

  Health promotion and disease prevention at different stages of life. Preconception,

  prenatal and neonatal prevention. Health needs in children and adolescents. Health

  needs in adulthood. Promotion of health in the elderly.

  Hygiene of food and of nutrition. Food hygiene. Food and health related issues.

  Microbial contamination. Cleaning and preservation of foods. Food safety.

  Environment and health. Environmental factors as determinants of health and

  disease. The environmental pollution and its effects on health. Water and its

  features. Water intended for human consumption, treatment and distribution of

  water. Mineral waters. Use of water for recreational purposes. The domestic,

  agricultural and industrial wastewater. Air pollution; the effects of air pollutants on

  health and environment. The medical waste and domestic solid wastes.

  Electromagnetic pollution. Risk factors and prevention in the areas of life and work.

  Health organization. The National Health Service in Italy: the central, regional and

  local levels. The health planning. The national health plan and the regional health

  plans. The health management.

• 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.

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Textbook Information

• Hygene
  

  Barbuti S., Fara G.M., Giammanco G. – Igiene, medicina di comunità e sanità pubblica. Edizione EDISES.2014

• Occupational Medicine
  
  1. David Koh, Ken Takahashi. Textbook of Occupational Medicine Practice. 3rd Edition ISBN: 978-981-4329-57-6
  2. Antonio Mutti, Massimo Corradi: "Lezioni di Medicina del Lavoro". Nuova Editrice Berti, 2014 (ISBN 978-88-7364-627-3)
  3. Per Alberto Bertazzi: "Medicina del lavoro". Raffaello Cortina Editore, 2013 (ISBN 978-88-6030-633-3)
  4. Enrico Pira, Canzio Romano, Paolo Carrer: "Manuale di medicina del lavoro". Minerva Medica, 2016 (9788877118431)

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