SECTION “HOSPITAL HYGIENE”.

THEME № 16. HYGIENIC REQUIREMENTS TO TREATMENT-AND-

PROPHYLACTIC ESTABLISHMENTS.
The treatment establishments (hospitals) is build for creation treatment-guarding mode.
The treatment-guarding mode and it main components.
The treatment-guarding mode is the complex of treatment - diagnostic, hygienic,
administrative and economic actions, directed on the fastest restoration of work capacity or
health of the person.
Treatment-diagnostic actions:
- Diagnostical and medical procedures. It is the main factor, but without performance
other measures of treatment-guarding mode it efficiency is reduced.
Hygienic actions:
- Optimum choice site of hospital, observance requirements to hospital site and its
functional zones;
- Creation sanitary - antyepidemic mode in hospitals, prevention intra hospital
infections (II);
- Creation optimum hygienic conditions of accommodation, lay-out, isolation and
functional connection premises in hospital;
- Maintenance hygienic requirements to microclimate, bacterial impurity of the hospital
environment, illumination, ventilation, water supply, heating of hospital premises;
- Maintenance rational and dietetic nutrition patients, prevention food poisonings;
- Observance personal hygiene by patients and the personnel;
- Creation optimum working conditions for medical staff and prevention occupational
diseases in personnel.
Administrative actions:
- Establishment the schedule and mode of operation of hospital and polyclinic;
- Management states of the personnel;
- Analysis effectiveness work of the personnel etc.
Economic actions:
Supply with medicines, linen and the equipment, foodstuffs; transport supply of
hospital.

HYGIENIC REQUIREMENTS TO THE HOSPITAL SITE

At choice place for site of hospital of the common structure (central region hospital,
city hospital with polyclinic etc.) 2 basic requirements are showed:
1) Creation optimum hygienic conditions in the place of location - is better behind city.
2) Availability to the served population (radius service of polyclinic in city 3-5 kms) –
hospital must be in city center, where it is bad hygienic conditions
It is difficult enough to combine both these requirements since it is inconsistent. Now
the problem is solved by construction hospital on surburb, and polyclinics - in city center.
For the specialized hospitals (phtysiatric, oncological, psycho-neurologic, infectious,
venerologic) the first requirement is priority, second is not need.
The area of hospital site.
The sizes of the ground areas for hospitals of all types are regulated by Sanitary norms
and depend on capacity of hospital:
at capacity hospital up to 50 cots (beds) - 300 m2 for 1 cot, up to 100 cots - 200 m2,
from 200 up to 400 cots - 140-100 m2, from 400 up to 800 cots - 100 - 80 m2, from 800 up
to 1000 cots - 80 - 60 m2.
For the specialized hospitals in suburb the area is increased: for infectious and
oncological hospitals on 15 %, for phtysiatric and psychiatric - on 25 %, for pediatric on 40
%. The area site of maternity hospital makes 0,7 from norms for usual hospital.
 HYGIENIC REQUIREMENTS FOR THE LAY-OUT OF THE HOSPITAL SITE.
The hospital site should be the rectangular form with a ratio of the sides as 1: 2 or
3 : 4 for convenience functional zones.
The density building of site of hospital should not exceed 15 %. Green plantings
should occupy not less than 60 % of the area of a site. On perimeter the protective green
strip not less than 15 meters is arranged.
Functional zones on hospital site:
1. Zone of medical buildings (infectious and not infectious). Infectious branch place
in depth of a site.
2. The gardening zone - includes green plantings on perimeter of a site, between
buildings.
3. The zone of pathological anatomical branch should settle down outside of it
visibility from windows of medical cases.
4. Zone of polyclinic. The polyclinic should be placed on distance 30-50 m from
medical cases and have a separate entrance on a hospital site, or to be closer to a main
entrance on a hospital site (prevention intrahospital infections from visitors of the
polyclinic).
5.The economic zone settles on distance 30-40 meters from other zones. Here
place the central boiler-house, laundry with desinfection chamber, warehouse premises,
garage, kitchen.
THE SYSTEMS OF HOSPITAL CONSTRUCTION.
Historical types construction hospitals:
In 17-18 centuries - barracks type (one big room for all patients), then - corridor-
barracks type - the big wards left in a corridor - conditions for patients and the personnel
were very bad.
The hutment type. For the first time in the world was applied by N.I.Pirogov in
Crimea in 1855-1856 during Russia-Gngland-France-Turkey war. Patients after operations
were short time in one wooden barrack, then them translated in other barrack, and old
barrack burnt. It made possible to lower amount of postoperative infectious complications.
Pavilion type - in 19 century - the beginning 20 century. It is construction separate
premises for wards in park, with good airing, illumination.
Modern types construction hospitals (in 20 century):
1. Decentralized system is characterized by presence several, usually one - two
floor buildings, each of which is used for branch of one type (surgical, therapeutic etc.). In
separate buildings of hospital placed diagnostic, economic and auxiliary services,
management of hospital, polyclinic.
Positive sides of it system – good conditions for prevention intrahospital infections
(isolation each branch of hospital in separate building), it is easy for the patients to use
hospital garden, to be at open air at good weather, to have daily doze of UV irradiation.
Lacks of it system – it is need very big area of hospital site, very expensive building
many 1-floor buildings, it is difficulties for the personnel and patients at transportation to
different diagnostic departments (especially at bad weather), to supply branches by
medicaments, food, etc.
This system is now applied at construction sanatoriums and for building hospitals in
mountain districts.
2. Centralized system is characterized accommodation all medical branches,
polyclinics, administrative premises, pathological anatomical and economic branches in
one multi-storey building. For example, for 900 - cot hospital needs 15-floor building. The
advantages and lacks of it system – on the contrary as at desentralized system (for
example, in such hospitals it is high level of intrahospital infections and it is very difficult to
struggle with it in this system of hospital building)
3. The mixed system building is characterized by the tendency to reduction amount
of medical cases up to 2-4, centralization hospital treatment-diagnostic and auxiliary
services. Infectious, children's, radiological branches and polyclinic are placed in separate
buildings. So, at hospital site there are some small-floor and multi-floor buildings.
4. The centralized - block system in modern conditions is the most appropriate for
large hospitals. Basic sign of centralized - block system is division all premises of hospital
complex into two groups for best maintenance treatment-quarding mode in hospital:
1) The first group of premises - for long-term, stable operation – treatment buildings
with ward sections of any structure.
1) The second group of premises which functional purpose demands regular updating of
the equipment, reconstruction or repair (which realization should not stop work of
hospital complex as a whole) – operational block, premises for functional diagnostics,
diagnostic laboratories, physiotherapeutic branches, polyclinic, etc.

HYGIENIC REQUIREMENTS TO WARD SECTION.

The basic functional element of any branch of hospital is ward section for 25 – 30
cots, in some profile branches (reanimation branch) it is less. If branch is calculated for 30
cots it is equal one ward section.
The basic premises of ward section: wards, room of the doctor, viewing, buffet,
bathroom, hall - dining room, material. There should be two 1-cot wards (for infectious
patients - isolator and for agonise patients).

HYGIENIC REQUIREMENTS TO HOSPITAL WARD.

Capacity of ward for adults and children is more senior than 1 year in hospitals
should not be more than 4 cots. This parameter is optimum both in technological, and in
hygienic relations.
The area of ward should be 7 m 2 on 1 cot, the area in ward of intensive therapy - 13
2
m on 1 cot.
The microclimate: temperature 18-22 C, relative humidity 40-60 %, speed
movement of air 0,2-0,4 m/s.
Ventilation: contents СО2 - 0,1 %, frequency rate of ventilation 2-3, volume of
ventilation 20-80 m3 in hour at 1 cot.
Natural illumination: Light factor (LF) 1 : 5 – 1 : 6, factor natural illumination (FNI) -1%.
Artificial illumination: common illumination in ward not less than 50 lux, local -100 lux,
on duty (at night at an exit) - 3 lux.
The distance between beds not less than 0,8 - 1m, and between beds and external
walls is not closer than 0,9 - 1 m.
Maximal permissible level of noise in ward is 25 deciBell.

HYGIENIC REQUIREMENTS TO OPERATIONAL BLOCK.

At designing modern large hospitals rationally association several operational in a
uniform complex, which should have two branches: septic and aseptic with operational,
auxiliary and office accommodations.
In the structure of operational block is enter: operational, predoperative, sterilizing,
narcotic, premises for storage blood and the portable equipment, a premise for surgeons
and operational sisters.
Operational block shares on 4 zones on a degree of sterility:
1) Sterile (operational);
2) Strictly mode (sanitary processing for the personnel, sterilizing);
3) The limited mode (washing, rooms for the personnel);
4) Common hospital mode (cabinet chief of block, etc.).

HYGIENIC REQUIREMENTS TO THE OPERATIONAL

 Operational is designing on 1 operational table. The area operational should be not
less 36 m2, for difficult operations with participation the big operational brigade - 45-50 m2.
Common amount operational tables accept at the rate of 1 table on everyone 30 cots in
branches of a surgical structure. Walls operational should be good washing, their coloring
in greenish tone is preferable.
Natural illumination. Light factor - 1:2 - 1:4, factor natural illumination - 2-2,5 %.
General artificial light exposure - 300-500 lux, local - (on operational field) - 3-10
thousand lux.
Ventilation. Operational air ventilation inflow 6-multiple, extract - 5 with creation
surplus of air so that microbes in air from other premises of operational block can not enter
in operational. A ventilating aperture must be: inflow - at a ceiling, exhaust - at a floor as
pair of narcotics it is heavier than air.
Temperature of air in operational 22-25 0C (the patient is in a narcosis - the centers
thermoregulation are switched - off), humidity up to 55 % (the prevention explosion pairs
narcotics in view of high electric conductivity damp air), speed movement of air - 0,1 m /
sec.
HYGIENIC REQUIREMENTS to the RECEPTION BRANCH OF HOSPITAL.
The reception is intended for registration, physical examination, statement or
specification of the diagnosis, sanitary processing patients and in case of need - rendering
emergency medical aid. At reception wards patients with the obscure diagnosis are
placed.
The structure of reception includes the following premises: lobby (for expectation),
registry and help, viewing, sanitary processing (locker room, a bath, for dressing),
procedural, laboratory for urgent analyses, roentgen cabinet, wards on 1-2 cot, study of
the doctor on duty, toilet for the personnel.

HYGIENIC REQUIREMENTS to INFECTIOUS BRANCH

Infectious patients act in the infectious branches not only for treatment, but also for
isolation. Therefore, internal planning and sanitary mode of this branch makes for the
purpose of prevention intra hospital infections.
Kinds of wards. Isolation patients are carried out in boxings, half-boxings and
boxing wards.
Boxing - a premise of the general area 22 m 2 (on 1 cot) or 27 m2 (on 2 cots) in which
there is a ward, external entrance and tambour for receipt the patient, bathroom, internal
entrance, which is connected to a hospital corridor. In boxing place patients with the
obscure diagnosis and particulary danderous infections (cholera, ets.).
Half-boxing - differs from boxing only absence external entrance with tambour.
Patients act in it through a hospital corridor.
Boxing wards - usual ward, cots in which are divided by partitions of height 2 - 2,5
m for the prevention contact between infectious patients. It is impossible to place here
patients with air - drop infections - the general air exchange in this ward.
The Infectious branch should have two entrances: one for patients, the second - for
the personnel, for delivery medicines, food etc.
Sewage from infectious branch before dump in the city water drain are disinfected
(norm of residual chlorine in it - 3 mg / l).

THE REASONS AND PROPHYLACTIC INTRA HOSPITAL INFECTIONS.

Intra hospital infection (II) by the definition of the WHO:
It is any clinically expressed disease microbe aetyology, amazing the patient during
hospitalization or visiting medical establishments, and also medical staff during his
professional work, irrespective, are shown or are not shown symptoms of this disease
during presence of the given persons in medical establishment or after 3 days after leaving
of the hospital.
The spreading of II is now registrated in all countries of the world, it is very actual
problem for the health servise, so at WHO it is the special Committee for investigation and
struggle with II.
Structure activators of II in 20 century:
1) Till 50th years the leading position in structure II was occupied the sharp
infectious diseases caused by pathogenic microorganisms (scarlet fever, diphtheria,
chicken pox, gas gangrene, tetanus etc.).
2) The main place and original "plague" of many hospitals in 50-60-е years became
a staphylococcal infection.
3) Thanks to wide use of antybiotic therapy since 70-th years at first place become
the gramm - negative flora – proteus, esherixia coli, enterobacter, etc. (are very stable to
antybiotics and it is very difficult to deliver from it by the help of antybiotics).
Danger of appearance of II for the patient:
- Current of the basic disease is made heavier;
- Morbidity patients at generalized form II is up to 60 %;
- There can be new illnesses during treatment in hospital.
Danger of II for public health services:
- Violation work of a hospital, down to time closing hospital or it department for
desinfection;
- Increase time of stay of the patient in a hospital (on the average one case of II
extends term of stay of the patient in hospital for 13-17 days);
- Additional economic charges for treatment patients, work of the personnel.
Basic sources of II:
- Initial sourses: it is patients, medical staff, visitors (less often)
- Secondary sourses (objects of the intra hospital environment): tools; linen, furniture;
air, food.
Categories of intra hospital subjects on danger of transfer II:
1) Critical (are most dangerous, the most strict requirements to it disinfection) - surgical
toolkit, needles, endoscopes, cateters;
2) Half-critical (the equipment for inhalations and anesthesia, utensils);
3) Not critical (linen, furniture).
The Basic ways of transfer II:
- Inhalation way (air - drop and air - dust);
- Contact (through tools, linen, furniture);
- Injection (at introduction of medicines);
- Fecal-oral (intestital infections throwing by dirty hands);
- Alimentary (through food).
Structure of II (frequency rate in different departments of hospital):
- Infections of renal ways - 15-40 %;
- Surgical and dentist infection - 10-30 %;
- Infections of respiratory ways - 15-20 %;
- Intestinal infections - 10-20 %
The Reasons of growing II now in any countries:
- Growth among hospitalized patients amount of persons from groups of the
increased risk - patients with various chronic diseases (cardiovascular, oncological,
illnesses of blood, a diabetes), immunodepressive conditions; old patients,
- Easing of natural immunity and allergization the population owing to an adverse
ecological situation;
- "Urbanization" of the intra hospital environment, concentration a plenty of patients
and the personnel in multi-storey buildings;
- Complication operative interventions, increase it duration and traumatic, wide
application endoscope equipment which are badly giving in to sterilization;
- Excessive, sometimes insufficiently proved application antibiotics, formation intra
hospital kinds activators II, polyresistant to antibiotics, used in a hospital;
- Insufficiently careful disinfecting injection and other toolkit;
- Increase duration stay of the patient in a hospital, connected to many functional -
diagnostic researches;
- Easing attention to strict observance of the hygienic and sanitary - antyepidemical
modes in hospitals.
System prevention II in hospital:
1) Strict observance sanitary - antyepidemical mode:
- Good ventilation, sanitation air of premises, optimum microclimate;
- Realization medical control personnel;
- Qualitative disinfection and sterilization the equipment, linen etc.;
- Regular bacteriological control tools, linen, air, food, hands;
- Revealing and isolation infectious patients;
- Observance rules of personal hygiene by the personnel and patients.
2) Architectural actions:
- Rational accommodation and zoning hospital site;
- Interposition branches and divisions on buildings and floors for isolation ward
sections, branches, operational, studies, wards;
- Observance hygienic norms of the area, volume of hospital premises.
3)Increase resistancy patients and the personnel:
- optimum mode of work and rest;
- rational balanced diet;
- sufficient stay on fresh air;
- scheduled and emergency immunization of the patients.

HYGIENE OF THE WORK OF MEDICAL PERSONNEL.

Between other professions, sick rate of medical personnel is rather high, especially
in surgeons, anesthesiologists, infectionists, phtysiatrists (doctors, treat for tuberculosis),
roentgenologists, radiologists, etc.
HYGIENE of WORK SURGEONS and ANESTHESIOLOGISTS.
During professional work surgeons and anesthesiologists have a number of harmful
factors:
- Action chemical substances (means for a narcosis) – professional poisonings;
- Adverse microclimate (hot temperature) - overheating;
- Increase concentration СО2 and decrease contents О2 (sterile mask on the face) –
hyroxia and hypercapnia;
- Psycho-emotional and physical overloads with a long pressure on visual, acoustical,
tactile analyzers – cardiac diseases;
- Compelled position of a body (long stay in vertical position) – radiculitis, osteochondrosis;
- Contact to infectious agents (includes AIDS);
- Often violations of a mode of work and rest.
For prevention professional pathology will carry out a number of preventive actions:
- Creation good artificial microclimate (air-conditioning);
- Centralized submission О2 in operational;
- Forced-air and exhaust ventilation with prevalence of inflow;
- Observance mode of work and rest (duration of a working day in operational day no
more than 5 hours, alternation of one operational and two not operational days, after
realization of operation - gymnastic exercises and reception soul);
- High-grade nutrition;
- After realization operation it is not recommended to carry out outpatient reception
hours.
- Making surgeons and anesthesiologists dressing from the materials providing good
ventilation;
- Change dressing after four hours, mask - in 2 hours after the beginning of operation
(since through this time interval sterility is lost).

INSTRUCTION FOR PRACTICAL LESSON ON THE THEME

LESSON N 1. HOSPITAL HYGIENE.

The educational questions:

1. Treatment-quarding mode in hospital and its components
2. Hygienic requirements to a site and structural divisions of hospital.
3. The hygienic requirements to functional zones of a hospital site.
4. Hygienic requirements to ward section and hospital ward.
5. Hygienic requirements to operational block and operational.
6. Hygienic requirements to infectious branch
7. Reason of growth, sources, ways of transmission and prevention intrahospital infections
8. Hygiene of work of the surgeons and anaesthesiologists and doctors of other specialities

The educational tasks and concrete definition of the tasks

1. To give the answers to the tests of the control of an initial level of knowledge.
2.To learn the rules of accommodation of a site of hospital, systems of hospital construction under
the offered tables and instruction.
3.To sketch in notebook the general plan of hospital.
4.Schematically to sketch in notebook the lay-out of:
а) typical ward section;
b) operational
c) boxing, half-boxing in infection branche
5. Substantiation necessary measures for struggle with intrahospital infections (II). The decision
situational tasks with estimation necessary measures for prevention or struggle with II.
6.To answer the tests of a final level of knowledge on this theme.

Tests for the control level of knowledge

1.The one of methods of specific prevention intrahospital infections is:
1. isolation operational blocks
2. rational accommodation of branches on floors
3. emergency immunization patients
4. zonning of a hospital site
5. sanitary - antyepidemic measures
2. At sanitary examination of the project of infectious hospital was established, that the basic
premises (rooms) are boxing and half-boxing. What absence of an element distinguishes half-
boxing from boxing?
1. an entrance from a street
2. chambers
3. sanitary unit
4. a sluice
5. an entrance from branch
3. At sanitary inspection pulmonary branch for the adult was established, that the ward on 4 cots
have the area 28m2. What should be the minimal area of ward in branch
1. 40m2
2. 24m2
 3. 28m2
4. 30 m2
5. 52m2

Situational tasks
1. The pregnancy branch is located in 3-floor building. The first floor occupies observation branch,
second - branch of physiology of pregnancy, third branch of a pathology of pregnancy. All floors
incorporate by channels exaust ventilation. What does not correspond to hygienic norms in branch
and demands re-planning?.
2. The general area of ward is 28 m2. For what amount of the patients the given ward is designed?
3. In regional hospital of a premise for reception and extract of the patients of children's branch is
common with other branches. Similar accommodation of premises for reception of children's branch
is allowed, and in what cases?
The standards of the answers:
1. Observational branch should be located on the third floor, for what it is necessary to change
branches of pathology of pregnancy and observation.
2. For 4 patients, norm is 7m2 on one patient.
3. According to the hygienic specifications a premise for reception in children's branch always
should be separate. Overlapping premises for an extract of the patients is allowed.

Sources of the information.

The basic literature
1.Никберг И.И. Гигиена больниц. – Киев, 1993.- 235с.
2. Румянцев Г.И. Общая гигиена. – Москва, 1998. – С. 253-328
3. I.I.Даценко, Р.Д.Габович. Профiлактична медицина. -Київ, Здоров'я, 1999.- 694с.
4.Е.И.Гончарук, В.Г.Бардов Г.И.Румянцев. Общая гигиена. Київ, " Вища школа", 2000
652с.
5. Е.И.Гончарук. Руководство к практическим занятиям по коммунальной гигиене.- Москва,
1990.- 236с.
6. Р.Д.Габович. Гигиена. – Киев, 1983.- 320с.
7. S.Shibanov. Lectures on common hygiene and ecology. Simferopol. 2003, 150p.
8. Park’s textbook of Preventive and Social medicine. India, 2000.- 16-th edition. – 660p.
9. Руководство к практическим занятиям по общей гигиене и медицинской экологии. / Под
ред. Проф. С.Э.Шибанова. – Симферополь, 2003. – 260с.
The additional literature:
1. В.Войффен. Больничная гигиена. Минск, 1984
2. Р.П.Венцель. Внутрибольничные инфекции. – Москва, 1970
3. Д.Лошинци. Внутрибольничные инфекции. – Москва, 1978
4. Маненко А.К., Сахновская Н.И. Гигиена медицинских учреждений. –Киев, 1982
5. В.К. Овчарова. Работа и здоровье медицинских работников. – Москва, 1985

LESSON N 2.
Sanitary - hygienic inspection of hospitals (Independent work).
The student should be able:
1. To carry out sanitary inspection hospital.
2. To make the act of sanitary inspection of hospital.

Purpose of independent work.

To take possession of skills of an estimation of accommodation of a site of hospital, system
of building of a hospital complex, lay-out and equipment: receptions, therapeutical, surgical,
pregnancy, infectious, children's branches (children's hospitals), ward sections, polyclinics.
To take possession of a technique of an estimation and realization of sanitary examination
of the projects construction of hospitals and branches of a various structure and hygienic estimation
of conditions of work of the medical personnel, prove necessary measures for struggle with
intrahospital infections.

Algorithm practical independent work of the students.

The first stage. Independent sanitary inspection of hospital, branch and ward of hospital of
Simferopol according to the scheme (see appendix)
The second stage. Representation of the project of the act of sanitary inspection to the teacher.
The third stage. Preparation of the act of sanitary inspection.
The fourth stage. Delivery of the act of sanitary inspection TPE of Simferopol to the teacher

The appendix
The scheme of sanitary inspection of hospital:
1. Name, capacity, address, medical structure of establishment.
2. Hygienic estimation of accommodation of a hospital site.
3. Functional zonning of a hospital site, hygienic estimation.
4. Area of a hospital site (on 1 cot).
5. Presence of polyclinic, radius of it service.
6. Kind of building of hospital.
7. Estimation of measures on maintenance treatment-quarding mode.
8. Structure of premises of a reception, equipment, sanitary condition.
9. Description of one of the basic branches:
- Name, amount ward sections;
- Structure of premises of ward section;
- Sanitary condition of branch.
10. Description of ward in branch:
- № ward;
- amount cots, area on 1 cot;
- Microclimate, ventilation, illumination, colouring of walls;
- Sanitary condition;
- Interrogation of the patients in ward about a sanitary condition of hospital, convenience of its
arrangement;
- Estimation of measures on maintenance treatment-quarding mode (administrative, hygienic,
economic measures).
11. The basic lacks revealed at inspection of hospital as a whole, and also branch and ward.
12. The offers to it elimination.
13. The general conclusion about opportunity of maintenance treatment-quarding mode in
hospital.
Date of inspection _____________________
Signature (group, family.)_______________________________________

The note: inspection and drawing up of the act of sanitary inspection is made under the scheme:
One hospital on 1 group, 3-5 students on one branch, one student on one ward.

SECTION " HYGIENE OF WORK"

THEME 17. THE SUBJECT AND TASKS HYGIENE OF WORK.

PHYSIOLOGY OF WORK.
PROFESSIONAL HARMFUL FACTORS AND OCCUPATIONAL
DISEASES. PREVENTION PROFESSIONAL PATHOLOGY.
PROFESSIONAL DUST PATHOLOGY AND ITS PREVENTION
 Hygiene of work - the section of hygiene studying influence process of work and
harmful professional factors on an organism of the working person and developing
preventive actions for decrease and prevention occupational diseases.
The basic sections hygiene of work:
- Physiology of work - studying influence on an organism various kinds of work,
estimation its weight and intensity, prevention exhaustion.
- Hygiene of work with adverse physical professional factors - studying influence on
an organism noise, vibration, electromagnetic fields, laser irradiation, etc.
- Radiation hygiene - studying influence radiation on an organism, development actions
of antiradiation protection
- Hygiene of work with industrial poisons - industrial toxicology – studying parameters
toxity of industrial poisonings, reasons and clinic of professional poisonings, prevention it
- Hygiene of work in agriculture with agrochemicals - agricultural toxicology - studying
parameters toxity of agrochemicals, reasons and clinic of professional poisonings,
prevention it
- Hygiene of work in conditions dust pollution of air – studing action on the person
different dust, prevention professional dust pathology (phneumoconiosis)
There is also division hygiene of work on industries (chemical, mining, metallurgical,
building etc.) and in agriculture.

PHYSIOLOGY of WORK
Physiology of work - boundary section of hygiene and the physiology, studying
influence process of work on an organism of the person and developing actions for
increase serviceability and the prevention development of early exhaustion.
Classification kinds of work.
Work shares on intellectual and physical, however science and technical progress
erases clear borders between these kinds of work.
The basic kinds of work:
1. Physical work - demands the big physical activity and energy expenses (work of the
loader etc.)
2.The mechanized work - needs significant muscular activity, but energy expenses are
less (work of the turner, etc.)
3.Automated work - demands smaller energy expenses, but is characterized by
monotony (the serviceman, the weaver etc.)
4.Work on the conveyor - the monotony, the imposed rhythm of work
5.Intellectual kinds of work:
а) In sphere material production - engineers, operators
b) Outside material production - doctors, teachers, artists etc.
On size energy expenses work shares on the following groups:
1) Work with significant muscular activity (energy expenses 4000-6000 Kcal)
2) Work on the conveyor, mechanized work (3000-4000 Kcal)
3) The automated work, intellectual kinds of work (2000-2400 Kcal).
Physical work divide on:
Static – the constant strain of one group muscles and systems – quickly develops
exaustion (works only one group of muscles, blood supply is worsened),
Dynamic - work different muscles with it rest - work more favorably.

CLASSIFICATION WORK BY A DEGREE of GRAVITY AND INTENSITY

THE GRAVITY of work is connected to physical gravity of work and is
characterized:
- by amount of work (in kilogram-meters)
- by capacity of work (amount of work for a time unit)
 On physical gravity work is divided on:
1. Mild
2. Medium gravity
3. Serious
4. Very serious
THE INTENSITY of work (at mental, operator work) is characterized:
- by the demands to attention
- by an emotional strain
- by a strain of audition and vision
- by monotony
On intensity work is divided on:
1. Unintensive
2. Small intensive
3. Middle intensive
4. Very much intensive

Concepts "exhaustion" and "tiredness".

Tiredness is subjective feeling, as a rule, accompanying development exhaustion.
Depends from psychological conditions of working, its degree of interest in work.
Exhaustion – complex objective changes in an organism as a result of the work,
shown in decrease of serviceability.
If the exhaustion does not pass before the beginning of the following cycle of work,
it gradually collects and gives overexhaustion - proof decrease of serviceability,
pathology CNS, cardiac system, immunodepression, growth of a traumatism.

Concept “serviceability”.
Serviceability – it is ability of the person to long work without decrease qualitative
and quantity indicators (with high efficiency of work).
Serviceability depends on such reasons: state of health, hygienic conditions of
work, organization of work process, psycho-physiological factors.
Early decrease of serviceability – indicator of influence of these factors, therefore
studying its dynamics is important for estimation health of working and working conditions.

Dynamics of the serviceability during work process.

During work allocate 3 stages of serviceability:
1) In-work period - gradual increase of serviceability
2) Working excitation - maximal level of serviceability
3) Beginning of the exhaustion - gradual decrease of serviceability
Dynamics serviceability after work:
1) After working excitation - after very heavy or hard work
2) After working braking - sharp decrease of serviceability
3) Restoration of the serviceability. At sufficient duration of this stage the level of
serviceability comes back to initial and there is no over-exaustion.

Methods studying serviceability.

It is a lot methods of the research serviceability or exhaustion, it are psycho-
physiological or only physiological tests.
For brainwork (intellectual work):
1) Corrector test – crossing out concrete letters or figures in special tables during
60 seconds. Estimation results of the test fulfilled under formula Hartridg - by amount of
the processed information in bits / sec.
2) Verbal - associative experiment - estimation speed and degree of association
between setting words.
3) Definition stability of attention (for schoolboys)
4) Definition time of hearing - motor and visual - motor reaction (latent period of
reflex) with the help of chronoreflexometr (for operator work)
For any work – chronometric (timing) researches:
 Selective timing work elements
 Fixing distraction of the attention (at school)
 Phototiming
For physical work:
 Definition physical force with the help of a dynamometer
 Studying a tremor (trembling) hands (with the help of tremometr) – for exact
works

EXHAUSTION, theories of the mechanism of its development.

Among many theories (more than 20) development exhaustion till now is not
present universal. Now is most recognized central - nervous theory by Sechenov,
Uchtomski, Vvedenski. The basic role in exhaustion is played decrease serviceability cells
of a brain, so balance of excitation and braking in CNS are broken. Thus in CNS formed
proof centers of excitation or braking - the theory of disbalance. This theory last years is
added with the theory reticulary formation - frustration communications between
supreme and lowest departments CNS.
Earlier were recognized humoral local theories:
- The theory of exhaustion - exhaustion in muscles power stocks (ATF, glycogen)
- The theory of poisoning - accumulation in muscles not-oxidazed products (milk,
pyro-grape acid and even poison - "kenotoxine" – it was not founded in
experiments).
The inaccuracy of these theories is proved experimentally, besides they do not
explain development of exhaustion at brainwork. However these processes play some role
in development exhaustion.

MAIN REASONS DEVELOPMENT PREMATURE EXHAUSTION DURING WORK

1. ENDOGEN:
- diseases and prepathological states
- defects development bodies and systems
- poor or non-optimum feeding (food)
- the negative attitude to work
2. EXOGEN:
1) INFRINGEMENT HYGIENIC WORKING CONDITIONS:
- non-optimum microclimate
- non-optimum irradiating
- stimulated position of a body
- overstrain bodies and systems
- high level of the professional harmful factors (chemical, physical, biological) – more,
than MPC, MPL
2) NON-OPTIMUM ORGANIZATION OF WORK PROCESS:
- very long work
- the very serious and intensive work
- monotony of work
- non-observance regimen of work and rest
3) NON-OPTIMUM PSYCHOLOGICAL - EMOTIONAL WORKING CONDITIONS:
- a poor moral climate in collective (conflicts)
- the negative attitude to work
 The basic directions of prevention exhaustion:
1. SCIENTIFIC SUBSTANTIATION And KEEPING HYGIENIC DEMANDS To WORKING
CONDITIONS
(Demands to a microclimate, irradiating, areas of workstation, absence exceeding MPC of
the harmful professional factors)
2. SCIENTIFIC (RATIONAL) ORGANIZATION OF LABOUR PROCESS
(Keeping regimen of work and rest, restriction duration, gravity and intensity of work,
translation static physical work in dynamic etc.)
3.TECHNICAL MEASURES ON ENRICHING WORKING CONDITIONS ON
WORKSTATION
(Usage ERGONOMICS - science about relation of the man and devices, industrial art)
3. PSYCHOLOGIC MEASURES
(Psychology of work - industrial psychohygiene, psychologic selection on particular
occupations, optimization psychologic climate in collective)

Changes in an organism during work. Changes in CNS.

The first system reacting to work - CNS - is marked stimulation. At adequate work
favorable changes of nervous processes are observed, latent time of reactions is reduced,
at very hard work time improvement of parameters CNS is replaced by their deterioration -
easing reflexes, premature exhaustion.
Changes of breath.
At work breath of fabrics of organism increased. Increasing delivery of oxygen to
fabrics and removal СО2 is reached by increase frequency and deepening of breath (in
rest frequency of breath 7 - 22 times in minute, at work - 50 and more times, the volume
lung’s ventilation raises in 5 - 10 times).
Maximal receipt О 2 with breath - 3-4 l/min – it is oxygen ceiling. Receipt of
oxygen in an organism increased gradually and in the beginning of work the oxygen duty
(debts) is created, during which collect non- oxidazed products of exchange. At heavy
inadequate work the oxygen duty very big and need some days for full oxidation
metabolites formed in fabrics.
Phenomenon Lingard. German physiologist Lingard has established, that at heavy
static physical work after the ending of work the need for oxygen again raises due to exit
non-oxidazed products of exchange from fabrics in blood that causes stimulation gas
exchange.
Changes of cardiovascular system.
The increased metabolism in working fabrics demands strengthening blood
circulation. At work increase frequency of cardiac contractions, systolic volume of heart,
therefore the minute volume of blood is increased. At trained people it is increased due to
increase systolic volume, at untrained - due to increase of a pulse rate. Arterial pressure,
especially maximal, raises, that conducts to growth pulse pressure. After adequate work
the arterial pressure through 5-10 minutes comes back to norm.

PROFESSIONAL HARMFUL FACTORS AND OCCUPATIONAL DISEASES.

PREVENTION PROFESSIONAL PATHOLOGY.
Professional harmful factors (PHF) - the factors influencing on working people
and capable to cause violations of health - occupational diseases.
Primary tasks of hygiene of work in the relation PHF:
1. Studying sources, conditions of occurrence and parameters PHF on manufacture.
2. Studying action PHF on organism and its systems in experiment with laboratory
animals.
3. Investigation cases occupational diseases on manufacture.
4. Development prevention measures occupational diseases.
Classification PHF.
In hygiene of work allocate the following groups PHF:
1) Connected to violations hygienic conditions on manufacture (not optimum microclimate,
action harmful professional factors etc.)
2) Connected to the wrong organization of work (excessively intensive, heavy, long work,
monotony of work etc.)
3) Connected to lacks of working conditions (the small area of the workplace, the
compelled position of a body etc.)
According to State Standart "Dangerous and harmful professional factors.
Classification" all PHF is divided on:
Dangerous professional factor - can cause sharp violation of health or death of
the person
Harmful professional factor - can cause chronic violation of health - occupational
disease.
Classification PHF in State Standart:
1. Psycho-physiologic and physical factors in the organization of work, the lacks of a
workplace and the equipment (the psychological and physical overloads, the compelled
position of body, overstrain of separate bodies and systems)
2. Physical professional factors (not optimum microclimate, illumination, increased noise
level, vibrations, radiation, electromagnetic fields)
3. Chemical professional factors (industrial poisons) – chemical substances, used on
manufacture.
4. Biological professional factors (microbes, substances protein nature, allergens)
5. Industrial traumatism (mechanical, thermal, electric trauma).
Diagnostics and prevention professional pathology
In the basis of diagnostics and prevention professional pathology there is order of
Ministry of Health of Ukraine № 45, which contain:
1) The list of manufactures and trades for which preliminary and periodic physical
examinations working are obligatory.
2) The order of realization such surveys, structure medical commission for surveys.
3) The list of medical contra-indications for reception at various kinds of manufactures.
4) The list of diagnoses of occupational diseases and poisonings.
Purpose, kinds and the organization physical examinations working.
Preliminary physical examinations - for again acting for work with harmful and
dangerous working conditions with the purpose:
а) To admit to work only those which state of health completely meets the requirements of
a given trade,
b) To not admit to work the persons having deviations in health which can amplify under
influence of working conditions, and also those who can be a source of infectious or
parasitic illnesses.
Periodic physical examinations – it is regular medical inspection working in
harmful or dangerous conditions. Periodicity of it is determined by the order № 45. Tasks
of these physical examinations:
а) To reveal early attributes of occupational diseases
b) To reveal the general diseases interfering the further work
c) To appoint individual treatment-and-prophylactic actions.
Concept and classification occupational diseases.
The occupational disease (poisoning) - disease for which is proved connection with
action professional factors.
In the order № 45 is given:
1) Names of occupational diseases - 27 diagnoses (phneymoconiosis, noise illness,
vibrating illness etc., sharp and chronic poisonings)
2) Dangerous and harmful production factors, which action can result in occurrence
of occupational diseases
3) The list of works and trades at which the given occupational disease meets mainly
or as exception.
The basic directions prevention occupational diseases.
1. Law-legislative measures. CLW (the code of laws on work), State Standarts,
Sanitary rules, etc.
2. Hygienic measures: preventive and current sanitary inspection.
3. Medical-preventive measures: preliminary and periodic physical examinations,
prophylactic nutrition.
4. Sanitary education workers about harmful and dangerous professional factors
and professional diseases.
5. Technological measures on decrease or elimination PHF.
6. Individual means of protection.

PROFESSIONAL DUST PATHOLOGY AND ITS PREVENTION

Dust as professional harmfull factor.
Influence of a dust is observed on working in mining and coal industry, in the
building industry (cement etc.), at metal working, in agriculture etc.
CLASSIFICATIONS INDUSTRIAL DUST
1. By origin: inorganic (mineral, metal), organic (vegetative, animal, polymeric),
mixed.
2. On formation: aerosoles desintegration (at crushing firm bodies), aerosols
condensation pairs metals.
3. On dispersion:
 visible (the size of particles > 10 microns)
 microscopic (2,5 - 10 microns)
 ultra microscopic (< 0,25 microns)
The sizes of dust particles determine danger of dust and depth of their penetration
in lungs and the area of defeat.
4. On action on organism: toxic (manganese, lead, arsenic etc.), irritating (limy,
alkaline etc.), infectious (microbes, disputes etc.), allergic (woolen, synthetic etc.),
cancerogenic (asbest etc.), fibrinogenic (phneumoconiotic) - contain silicium.
5. ON TOXICITY:
Nontoxical dust (soil, wood) - maximum permissible concentration 10 mg/m3
Toxic dust - silicate (contains silicon - maximum permissible concentration 1 mg/m3),
dust of lead (maximum permissible concentration - 0,01мг/m3).
At hygienic characteristic dust it is taken into account: chemical compound,
dispersiveness, solubility in blood, hardness, absorbtion properties.

ACTION of the DUST ON the ORGANISM

Ways of receipt dust in organism: at inhalation, at swallowing with a saliva and
slime, through skin.
Nonspecific action: action of the dust may give diseases bodies of breath, mucous
of eyes, skin. Promotes tuberculosis, allergic diseases.
Specific action: formation phneumoconiosis, cancerogenic action.
Phneumoconiosis – most widely spread dust occupational diseases. To it concerns
silicosis (action dioxide of silicon), silicatosis (dust of salts silicon acid), asbestosis,
antracosis (coal dust). Can develop at action dust of metals.
 Silicosis - the most often kind phneumoconiosis. Pathogenesis: dust particles in
lungs tissue are absorbed by hystiocytes - are formed fibroblastes - formation collagenic
fibres (connecting tissue) - reduction lungs surfaces.
Clinic: respiratory insufficiency different degree of weight, bronchitis, pneumonia,
emphysema.
CLASSIFICATION PHNEUMOCONIOSIS
1. Phneumoconiosis at influence high and middle fibrinogen dust (the contents
free dioxide of silicon SiO2 > 10 %):
silicosis, antracosilicosis, silicosiderosis, silicosis with complication by tuberculosis -
silicotuberculosis
2. Phneumoconiosis at influence low fibrinogen dust (SiO2 < 10 %):
silicatosis (asbestosis etc.), carboconiosis (antracosis etc.), bisinosis (vegetative dust).
3. Phneumoconiosis from aerosols of toxic-allergenic action:
berilliosis, aluminosis, farmer’s lungs, chronic phneumonia with allergenic component.
DIAGNOSTICS PHNEUMOCONIOSIS
Morfologic forms: 1) Nodular, 2) Intersticial, 3) Mixed.
Forms on current: 1) slowly progressing, 2) quickly progressing silicosis
RADIOLOGICAL DIAGNOSTICS PHNEUMOCONIOSIS
1 stage - intersticial fibrosis of lungs, formation small knots 1 mm in diameter along
bronchial tubes, bilaterial strengthening lungs figure.
2 stage - strengthening intersticial and nodular lungs fibrosis and formation
numerous knots 2 - 4 mm in diameter on background of sites аtelectasis (symptom of
"snow storm"), the deformation lungs figure.
3 stage - massive fibrosis lungs, big units of connecting tissue, expressed
deformation of bronchial tree, infringement of bronchial penetration.
For мetalloconiosis - in addition – increased roentgen contrast dust of metals in
lungs.
CLINIC-FUNCTIONAL DIAGNOSTICS PHNEUMOCONIOSIS
Symptoms of bronchitis, emphysema lungs, respiratory insufficiency, infringement
of blood circulation in a small circle of blood circulation - a hypertrophy left cardiac
ventriculus, changes on ECG - " lungs heart ".
At asbestosis - in phlegm - asbestine bodies, at antracosis - phlegm black color.
Complications phneumoconiosis: cancer of lungs, tuberculosis, pneumonia,
bronchial asthma, revmatoid arthritis etc.
Prevention dust diseases.
1. The labour legislation, preliminary and current physical examinations, it is
impossible to work in mines more than 20 years etc.
2. Preventive and current sanitary control work conditions with dust.
3. Struggle against formation and spreading dust.
4. Biological methods - increase resistibility of organism - UVR, alkaline inhalations,
respiratory gymnastics, treatment-and-prophylactic feed (proteins and vitamins).
5. Individual means of protection.

INSTRUCTION FOR PRACTICAL LESSON ON THE THEME

Educational questions:
1. Basic laws of functioning of various systems of organism.
2. Physiology of work. Classification of kinds of work.
3. Dynamics of serviceability during work and after its termination.
4. Methods of study of serviceability
5. Change of bodies and systems during work
6. Concept about professional harm factors and occupational diseases. Classifications.
7. Order of the account, registration and investigation occupational diseases.
8. Purpose, kinds, organization of realization of physical examinations working.
9. Classification of a dust, pathogenesis and kinds pneumoconiosis, their diagnostics and
prevention.

The educational tasks and concrete definition of the tasks

1.Realization corrector test in the beginning and at the end of the lesson on offered tests to
define speed of the taken information in bit\s under the formula Hartridg:
0,5436xN - 2,807xn
S=
T
Where: S - speed of the studied information (bit\s), N - number of the seen marks in the table, n -
number of the passings and mistakes, Т - time of viewing of the table (60 sec.).
2.Research muscular serviceability. For definition of physical force the examinee twice
with the maximal pressure compresses dynamometer, the greatest meaning accept for initial. At
definition of endurance establish time (in sec), during which the examinee keeps a spring
dynamometer at a level of 0.5 maximal forces, up to complete impossibility to continue effort of
this intensity.
3.The research of serviceability by a method finding of numbers at marked time, for
which researched names and shows all numbers printed in the table, containing 49 numbers (from 1
up to 25 and from 24 to1) represented by different colour.
4.The investigation tremor of hands will be carried out by tremometer. Frequency tremor
movements per one second 8-12 fluctuations - often, 5-8 average, 3-5 slow.
5.Investigation of serviceability by a chronometric method. The increase of time spent
on operation, testifies to exhaustion. In hygiene and the physiologies of work use a photochrono-
metric investigation of a working day and detailed selective chronometric. Use it for study of
influence of labour process on a condition organism and the serviceability reveals: duration of
separate operations, parity of time spent on performance basic and other operations, congestion of a
working day, productivity of work, its change within day. On the basis of the analysis of materials
and comparison them with the data of physiological methods of research grounded the
recommendation for rational construction of a working day, change of a rhythm of work.
6.The verbal - associative experiment. A method more often is applied at an estimation of
intellectual work (lecturers, announcers, teachers). The method allows to estimate a functional
condition of analyzers of the second alarm system (speech, -acoustical, -impellent). The purpose of
research: definition of speed of occurrence in brain associative communications between images of
various subjects and concepts. The speed of these communications depends on a functional
condition CNS and first of all from a degree of exhaustion. The principle of a method consists that
it is offered to the examinee from 10 up to 30 words (names) with an interval 10-20 sec. The
examinee should on each word answer to anyone connected with offered on sense. For example,
table - high, cap – big, etc. The researcher fixes in seconds size of the latent period (time from the
moment, when the word and answer of the examinee was named) and amount of mistakes admitted
in the answer (the answer is not connected on sense). The researches will carry out some times
within a working day, the results compare.
7. The definition stability of attention. Change of attention during work also is connected
to a number of the reasons and, first of all, exhaustions. To the examinee with the help of the special
device demonstrate for the certain time consistently number of figures painted in different colours.
The examinee is offered to count in mind, how many was such figures. At calculation he should not
use a pencil. The researches will be carried out some times within a working day, the results are
analyzed. The increase of amount of mistakes speaks about coming exhaustion.

1. Tests for the control level of knowledge

1. To the methods research of serviceability concerns:
1. corrector test
2. test Eiber
 3. method Duglas
2. To what are connected professional harm factors more often?
1. with production, its technology and equipment
2. with interruption of work (having rummaged, dinner, call to the heads etc.)
3. with labour process, its organization
4. with intensity and duration of labour process
3. In shop of factory was carried out manual having poured of liquid metal in the fine forms. At the
workers repeatedly participating in process having poured, the attributes intoxication by aerosols of
heavy metals have appeared. Offer radical measures of prevention professional poisonings in the
given situation.
1. Regular medical surveys
2. Control aerosols of metal in air of a working zone and comparison with MPC
3. Expansion of ventilation
4. Installation of the automatic transfer line having poured metals with effective ventilation

Situational tasks
1. It is necessary to determine stages of serviceability of the schoolboy on parameters of corrector
test: in the beginning of lessons - 4,2; at 3 lesson - 5,5; at 5 lesson - 5,3. What other methods it is
possible to investigate serviceability of the schoolboy by?
2. After failure on chemical manufacture there was a pollution of an environment
nitrozoconnections. At the people living in this district, the headache, dyspnoe has appeared. In
What is the reason of hypoxia?
3. Give a hygienic estimation of work in shop of furniture combine, where the general dust content
makes 20 mg/m3. What occupational diseases are possible at working, whan principles of their
diagnostics and prevention?.
The standards of the answers:
1. By the data of corrector test, in the beginning of lessons there was stage in-working, and then -
stage of working excitation was observed. It is necessary to carry out similar researches and with
other schoolboys in a class for correct construction of a lesson and prevention of exhaustion of the
pupils, and if at some schoolboys is the premature exhaustion - develops to investigate a condition
of their health. It is possible to apply to study of serviceability methods of definition of stability of
attention, word-associative experiment, chronometric researchs.
2. Formation methaemoglobynaemia
3. MPC of a not toxic (furniture) dust makes 10 mg/m3, in this case general dust content exceeds
the specifications in 2 times, in this connection the development pneumoconiosis at working is
possible. Their diagnostics will be carried out at X-ray and clinical investigations (on a degree of
respiratory insufficiency). Prevention: change of technology, strengthening artificial general and
local ventilation, application dust-gathering equipment, current sanitary control of a dust content of
air, application individual means of protection of bodies of breath (respirators).

The appendix 1
Ministry Health of Ukraine
City registration form №163
Medical establishment

The notice
About a sharp professional poisoning or professional disease
Enterprise _______________________________________
The shop (where, has taken place a poisoning).
Surname, name__________________________
Date disease____________________________
 Diagnosis._____________________________
Date of departure of the notice_____________________
The signature of the doctor

The appendix №2
Ministry Health of Ukraine
City Registration form №165
Medical establishment

The list of the persons, at which for the first time is revealed chronic professional poisoning or
professional disease for __________ month of 200 __ year.
Enterprise ____________________________________
Ministry ____________________________________
Branch of manufacture ____________________________________
____________________________________________________________________________
№ name Concrete Diagnosis
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

The appendix №3
Ministry Health of Ukraine
city registration form №163
Medical establishment

Registration card № ___ of sharp professional poisoning or professional disease

The sharp poisoning has taken place __________ Month 200 __ year.
Enterprise ______________ Address ________________
Branch of manufacture. The shop, department (Where has taken place)
Surname, name ___________
Sex _________ Age _______
Trade ________________
Experience of work in the given shop ___________
Experience of work in the given trade ______
Experience of a previous trade _______ In what manufactures _______,
In what trades ____________ (is filled in case of chronic disease)
Circumstances, at which there was a poisoning ___________________________
а) What poisonous substances is caused professional poisoning or professional disease

THEME № 18. HYGIENE of WORK AT ACTION PHYSICAL

PROFESSIONAL HARMFULL FACTORS (NOISE, VIBRATION, ELECTRO-
MAGNETIC FIELDS).
Concept about harmful physical professional factors.
On working can operate many physical PHF: adverse microclimatic factors; not
optimum illumination or surplus of its components, laser radiation, noise, vibration,
electromagnetic fields (EMF), high or low pressure, radioactive radiation.
NOISE as PHF, its characteristics.
On the data the WHO, noise - universal problem for mankind, one of main physical
factor of pollution of environmental and industrial environment.
 CONCEPT "NOISE":
- In physics noise - the chaotic sound fluctuations, which are not having regularity;
- In hygiene noise - any sounds, preventing recognition useful sound signals, violation the
rest, rendering negative action on organism of the person and lowering his serviceability.
NOISE - inordinate sound oscillations in a frequency range, heard by the man (20 -
20000 Hz), acting at the man in operating time, rest or dream.

CLASSIFICATIONS OF NOISE
ON SOURCES:
- household
- transport
- industrial
- building
- agricultural
ON DURATION:
- stable - fluctuation level of noise no more than 5 dB
- unstable - more than 5 dB
- impulsive - intermittent
ON FREQUENCY:
1) Heard sounds (16 - 20000 Gertz):
- low-frequency - up to 400 Hz
- middle - 400 - 1000 Hz
- high-frequency - more than 1000 Hz
2) Infra sound - frequency up to 20 Gz - the expressed action on internal bodies
since its frequency can coincide with frequency fluctuations of internal bodies - is most
dangerous frequency 8 Gz - violations of alpha - rhythm of a brain; 1-3 Gz - violations of
breath etc.;
3) Ultrasound - more than 20000 Gz - mechanical and chemical action – cavitation
(making cavities in interstitial tissues), destruction molecules, their ionization; thermal
action - heating fabrics (used in physiotherapy, at the big levels - local defeat of peripheral
nervous and blood system, violation CNS etc.).

Level of noise. Units of it measurement.

Action of noise depends not only on frequency, but also from a level. In acoustics
loud of sound is sound pressure in Nuton / m2 (difference between atmospheric and sound
pressure).
Unit level of sound in hygiene is logarithmic unit, show excess of sound pressure
above a sound threshold: 0 - 14 Bell, or 0 - 140 dB:
Available sound pressure
1 dB = 20 lg ---------------------------------------------
Sound threshold
Sound threshold = threshold of recognition - 2 х 10-5 Nuton/m2 = 0 dB
Painful sound threshold 14 Bell = 140 dB.

SON - comparative unity volume different on frequency sounds

Abroad unit of sound it is FON (sound with frequency 1000 Gz at a level 1 dB).

Action of noise on organism.

Distinguish specific and nonspecific action of noise:
SPECIFIC action: Violation function of acoustic analyzer owing to a long angio
(vessel) spasmes, in result - degenerate changes in the nervous terminations and neuritis
acoustical nerve (professional deafness)
 3 STAGES NOISE ILLNESS at audiomethria (estimation level of hearing):
- Acoustical adaptation – at action of noise acoustical threshold grows on 10-15 dB, but
through 1-3 min. comes to norm (physiologic phenomenon);
- Acoustical exhaustion - decrease of hearing on 15-20 dB during hours or days after
finishing noise;
- Progressing deafness - gradual complete hearing loss in connection with organic
changes at the center of audition in CNS (noise at the level more 80 dB quickly causes
decrease of hearing and development deafness at the experience till 5 years).

NONSPECIFIC action of noise: Excitation brain, hypothalamus and a spinal cord,

quickly develops braking of CNS, then - exhaustion nervous cells - irritability, emotional
unstability, decrease attention, memory, serviceability, through vegetative nervous system
change functions different systems and bodies.
As a result of long action intensive noise develops NOISE ILLNESS - the general
disease with defeat of an ear, CNS and other systems.
Struggle against noise on manufacture and in the occupied places.
1. Administrative - legislative measures.
2. Architectural - planning (functional zones in cities, sanitary - protective breaks, transport
highways).
3. Hygienic:
а) preventive sanitary control - normalization noise - establishment MPL:

MAXIMAL PERMISSIBLE LEVELS of NOISE FOR VARIOUS PREMISES

View of premise MPL, dB test of harmful activity
________________________________________________________________________
Inhabited rooms 30 conservation dream at the night
Wards in hospitals 25 support treatment - protective
Regimen in hospital
Educational rooms 50 conservation perception of the
information
Industrial premises 65* - 85 prophylaxis noise illness
________________________________________________________
The note: * - for high-frequency noise

b) Current sanitary control - the control noise levels and restriction it.
4. Medical-preventive - preliminary and current survey workers at noisy manufactures.
5. Technological: decreasing noise linings, coverings of walls, automatization etc.
6. Individual: headphones, are higher 100 dB - flannel helmets.

Hygienic characteristic vibration.

Vibration it is oscillations elastic bodies with frequency more than 1 Hz.
It is characterized by amplitude, frequency, direction.
CLASSIFICATION VIBRATION: COMMON, LOCAL
ON FREQUENCY:
- Low-frequency
- Middle-frequency
- High-frequency
ON DIRECTION:
Horizontal
Vertical
Local vibration of small intensity gives a positive effect (vibrating massage); at the
general vibration of high intensity - changes CNS, through vegetative nervous system -
changes of internal bodies.
Local vibration causes long angiospasmes and mechanical trauma periphery
nerves in hand fingers – violations throfics in fabrics, polyneuritis, arthrosis - VIBRATION
ILLNESS of a various degree of weight.

STAGES VIBRATORY ILLNESS at action common vibration

1. Small pains and parestesia of extremities
2. Expressed parastesia, drop sensitivity of a skin
3. Vascular and trophic infringements of dactyls, changes of CNS
4. Generalized sharp vascular infringements, vasospasms of heart and CNS

DEGREES of VIBRATORY ILLNESS at action local vibration

1. Peripheric angiodystonic syndrome, sensory polyneuropathia dactyls of hand
2. Expressed angiospastic syndrome dactyls of hand
3. Expressed generalized angiospastic syndrome, dystrophic changes of bones,
muscles of arms, deformation joints of dactyls of hand

Hygienic characteristic EMF.

EMF - the special form of a matter, created by moving or motionless electric
charges. Key parameters: length of a wave, frequency of fluctuations. (EMF) consist from
electric (EF) and magnetic fields (MF).
NATURAL EMF:
1) MF of the Earth - 400 А/m - depends on geographical position, season and day, solar
activity ("magnetic storms")
2) EF of the Earth - 130 V/m at surface of the Earth, is reduced with height
ANTHROPOGENIC (TECHNOGENIC) EMF:
1) Electric static fields (ESF) - it is created by motionless electric charges - in the
industry, near energy lines of ultrahigh voltage. Operates on CNS and causes functional
shifts of vegetative nervous system.
2) Stationary magnetic field (SMF)
3) EMF of industrial frequency - 50 Hz
4) Infrared, visual, UV, laser radiation
5) EMF radio frequencies.

CLASSIFICATION EMF RADIO FREQUENCIES

_____________________________________________________
Kind lengh of wave sources, application
Low-frequency 1-10 kms broadcasting, radio communication, Industry
Middle 100м - 1 km -"-
High 1 - 100 m -"-
Ultra-High 10 cms - 1 m radio, TV, medicine
Above high frequencies
(AHF – MICROWAVE) 1 - 10 cms radiolocation, television, industry,
for preparation of food MICROWAVE OVEN
Hyper-high frequencies
(HHF) 1 mm - 1 cm industry

Action EMF on the organism.

DEGREE of biological effect EMP depends from:
- Frequency (than above, the more strongly effect)
- Intensity
- Exposure time
- Character of irradiating (continuous, modulated)
- Regimen of irradiating (constant, intermittent, periodic)
MECHANISMS ACTION EMF
1. HEAT EFFECT (at very high radiation intensity) - destruction bodies and fabrics -
at the big intensity – microvawe oven.
2. NOT THERMAL EFFECT (at small levels of action) - influence on substrata of
organism with formation bioactive substances. At chronic action the cumulative effect is
marked;
CLINIC PATHOLOGICAL ACTION EMF:
- Asthenic syndrome
- Asthenic-vegetative syndrome
- Diencephalic syndrome
- Damage systems: cardiac, hemopoiesis, immune, endocrine etc.
THE FORMS PATHOLOGICAL ACTION EMF:
1) Acute and chronic form
2) Mild, medium and serious degree
MICROWAVE - SYNDROME:
1) violations of CNS (astenic and vegetative syndrome)
2) turbidy of crystalline lens (cataract)
3) damage hair follicules (baldness)
Besides: changes cardiac system, infringement of hemopoiesis, dysfunctions of
immune, endocrine systems, remote effects.

PROPHYLAXIS HARMFUL ACTION EMF for working with sources EMF,

especial MICROWAVE EMF:
4 PRINCIPLES PROTECTION from electromagnetic radiation (including ionizing):
1) Protection by dose or amount (MPD)
2) Protection by distance
3) Protection by time
4) Protection by screening

BASE DIRECTIONS PROPHYLAXIS HARMFUL ACTION EMF:

1) Administrative - statutiry measures on guarding work - cutting operating time
(protection by time)
2) Architectural – planning measures - sanitary - protective zones from sources EMF,
correct placement sources EMF from other objects (protection by distance)
3) Hygienic measures:
а) Preventive sanitary control - substantiation MPL EMF (protection by dose):
- In industry - MPL for a working day - 2 Watt in hour / m2
- For the population - MPL inside inhabited buildings - 0,5 kiloWatt / m,
- In territory of inhabited building - 1 kw / m,
- Outside of inhabited building - 5 kw / m,
- Near lines of electricity - 10 kw / m
b) current sanitary control - check keeping MPL, hygienic prescriptions etc.
4) Medical-preventive measures - physical examinations working and population,
treatment-improving measures
5) Technological measures - change technology for drop level EMF, protection by
screens.

THE HYGIENIC CHARACTERISTIC LASER IRRADIATION

Lasers - optical quantum generators excreting focalized fascicle of electromagnetic
radiation in wawelengh from IR up to UV.
 Laser irradiation on time is divided on:
- Continuous
- Impulsive
On direction:
- Direct
- Reflecting
- Diffusely reflex
- Dissipated

ACTION LASER IRRADIATION ON MEDICAL STAFF

At the reflex radiation it may be organic changes of tissues in a place of irradiating
and nonspecific reflectory changes bodies and systems.
Thermal specific activity - prompt heating tissues and combustions.
Common nonspecific action - changes CNS, cardiac, endocrine system, oppression
chromogenesis.
Local action -
On organs of sight - time loss of sight,
On a skin - hyperemia, combustions, necrosises.

PROPHYLAXIS HARMFUL ACTION OF LASERS

1. Hygienic measures
2. Planning and technical measures
3. Medical-preventive measures
4. Individual means of protection

INSTRUCTION FOR PRACTICAL LESSON ON THE THEME

Educational questions of the theme:
1. Methods of the prevention harmful action of noise.
- What is noise, its classification and unit of measurements;
- Devices for measurement of a level and spectrum of noise;
- Influence of noise on организм of the man, MPL of noise for different premises and criterion of
their development;
2. Methods of the prevention harmful influence of vibration:
- What is vibration, its classification and unit of measurements;
- Devices for measurement of vibration;
- Influence of vibration on the man, norm of vibration;
- Methods prevention harmful influence of vibration.
3. Methods of the prevention harmful action EMF, ultrasound, infrasound, laser irradiation, on the
man.
- Hygienic characteristic EMF, ultrasound, infrasound, laser irradiation,
- action of an electromagnetic field, ultrasound, infrasound, lasers, on organism.
- Devices for measurement ЭМП, ultrasound, infrasound, laser irradiation.
- Methods prevention of harmful influence these factors.

Tests for the control level of knowledge

1. In the shop of a machine-building factory, where the women work, takes place manual periodic
(up to 2 times in one hour) moving of the processed details. What limiting norm of rise and moving
of a cargo by the women should be recommended administrations according to the specifications
authorized Ministry Health of Ukraine?
1. 10 kg
2. 20 kg
3. 15 kg
 4. 7 kg
5. 5 kg
2. What are the basic methods of research influence of vibration on the person?
1. definition temperature of a skin
2. corrector test
3. capillaroscopia
4. research of vibrating sensitivity
5. definition pain sensitivity
3. Give the definition of noise
1. It is chaotic combination of sounds of different frequency and intensity
2. mechanical fluctuations of firm bodies
3. sounds irritating CNS of the man

Situational tasks
1. In the rod branch of foundry shop for sublimation of cores the high-frequency heating is used. In
shop 10 drying chambers simultaneously work. A range of working frequencies: 30-48 megagerz.
What primary pathological changes are possible at work in the given conditions?
2. In one of premises of the chemical enterprise the constant infringement of a microclimate
(temperature mode, ventilation) takes place. What it is necessary to recommend for support of an
industrial microclimate in the given premise at a level, that it would answer the hygienic
requirements?
3. The noise level on a workplace makes 121 dB. What physiological effect is most possible at
working?
The standards of the answers:
1. Asteno-vegetative syndrome
2. Equipment of a premise by the conditioner
3. Risk of reception an acoustic trauma
THEME RADIATION HYGIENE AND ECOLOGY
Radiation as adverse physical professional factor.
Radioactive radiation is widely applied in the atomic power station, the industry, in
medicine for medical and diagnostic procedures, so it can give negative action on many
working. Besides that, in connection with wide radiactive pollution biosphere, especially
after failures on atomic power stations, increased level of radioactivity may have negative
influence on the health of the population.
Feature of the action of this factor on organism is presence pathological changes
even at small levels of influence that demands especially strict observance hygienic
requirements, norms of radiating safety (NRS) and careful survey working.
Concept “Radio-activity”.
Radio-activity – it is ability some substances to spontaneous disintegration
(transformation nucleus of atoms of one elements into others) with allocation energy as
particles or radiation.
In hygiene all sources of radiation share on CLOSED and OPEN:
- CLOSED source - in environment acts only radiation (example - x-ray tube);
- OPEN source - in environment can act both radiation and particles (example -
radioactive isotopes).
The characteristic kinds of ionization radiation:
1. Corpuscular radiation:
- Alpha - radiation – it is a stream of alpha particles (nucleus of helium) - basically from
natural isotopes. Ionization ability - forming 6000 ions in 1 mm 3 of air, penetrating ability –
run in air 11mm, in body 1/6 mm - penetrates only into a superficial layer of skin.
Protection is enough by clothes, by aluminium foil. The basic danger - at internal hit in an
organism with water, food;
- Betta - radiation – it is a stream of betta-particles (electrones or positrons). Ionization
ability - 6 pairs in 1mm3, penetrating ability - up to 1m in air, in body - up to 1sm. For
protection can use any materials, except lead (formation braking x-ray radiation).
- Neutron radiation - a stream of neutrons. Ionization - 400 ions in 1mm 3, run in air -
hundreds meters, in body - up to 10 m. Protection against fast neutrons - substances with
a small serial number (hydrogen) - water, paraffin, polymer materials, slow neutrons are
absorbed by borum, cadmium.
2. Electromagnetic radiation:
X-ray and gamma - radiation. Ionization 0,1 ions in 1mm3, run in air hundred
meters, in body - some meters (depends on rigidity of radiation - from length of a wave).
Gamma – radiation is more rigid. Protection - materials with high density - lead, concrete.

Basic units of radio-activity.

1. Unit of radio-activity of isotope: Bekkerel (System Iternational - SI) - activity of
substance with 1 nuclear disintegration for 1 sec. Old unit - Kuri - 4 х 1010 disintegrations
for 1 sec.
2. Unit of exposition doze. Used for the characteristic doze of ionization in air - for
gamma and x-ray radiation. Kulon / kg (SI) - a doze forming in 1 kg of air ions by a charge
1 kulon. Old unit - Roentgen - a doze forming in 1sm3 of air 3 х 109 pairs of ions.
3. Units of power exposition doze. Unit of a doze referred to a time unit – Roentgen /
hour, milliR/mines, microR/sec
4. Unit of absorbed doze. Grey (Gy) - absorbed doze in 1 Joule of energy on 1 kg of
substance. Old unit - Rad - 100 erg absorbed energy on 1g substance. 1 Gy = 100 Rad.
5. Unit of equivalent doze. Zivert (Zv) - biological effect of the absorbed doze in 1Gy.
BER - the biological effect of the absorbed doze 1 Rad. 1 Zv = 100 BER.

ACTION of RADIATION ON the ORGANISM

The basic stages development radiation injuries:
1. Formation ionized and excited atoms and molecules which cooperate among
themselves and various molecular systems, forming biologically active substances, also it
is possible breaks of intermolecular connections (initial or starting processes);
2. Action formed biologically active substances (free radicals, ions etc.) on biological
structures of a cells in organism - destruction biosubstances and formation new
substances unusual for an organism;
3. Violation by formed biologically active substances metabolism of biological systems with
changes appropriate functions.
The major biological reactions organism at action radiation.
All consequences action of radiation on organism conditionally can be divided on
SOMATIC effects and REMOVAL effects.
Somatic - effects at the irradiated organism, removal effects – appeared after long
time or at future generations.
All radiating effects divide on:
STOCHASTIC (probable) effects – it is no threshold of harmful action, have
probable character - estimated on possible risk - the cancerogenic, mutagen action,
hereditary effects. It is difficult to investigate it in experimental research, it is impossible to
establish threshold of harmful action precisely. These effects basically are shown at action
of small dozes (when the professional and natural irradiation for life does not exceed 100
BER).
NOT STOCHASTIC (threshold) effects - the weight of defeat depends on doze and it
is possible to establish threshold of harmful action and to determine safe levels influence
of radiation. All norms of radiation are based on the prevention of these effects.
To not stochastic effects concern:
1. Sharp beam sickness – it is at dozes of irradiation at once more than 100 BER (100-
200 - easy degree; 200-300 - average; 300-500 - heavy and from above 500 BER - the
heaviest). Dozes 500-600 BER at a unitary irradiation - are absolutely fatal.
2. Chronic beam sickness – it may be at long time irradiation in a doze less than 100
BER.
3. Beam burns on the skin - reaction of 1 degree - at doze up to 500 BER; 2 degree - up
to 800; 3 - up to 1200; 4 - above 1200 BER.
4. Beam cataract - at doze of radiation more than 30 BER per one year.
Researches showed, that somatic effects do not arise at observance established
hygienic specifications, however because there are not threshold of stochastic and
hereditary effects hygienic specifications can not guarantee it absence. The main principle
of norms of radiating safety (NRS) is the decreasing a doze of radiation as more, as
possible.

GROUPS OF CRITICAL BODIES OF ORGANISM ON RADIO-SENSITIVITY.

THE LAW OF BERGANIE.
Law French scientist Berganie is: radio sensitivity of fabrics is directly proportional
to its ability to division and inversely proportional to degree of its differentiation. Thus, than
more intensively in a fabric or body there are processes of duplication of cells and the less
a fabric is differented, the more sensitively it is to radiation.
According to this law all bodies share on 3 groups of critical bodies:
1 - all body, gonades, bodies of blood formation (red bone brain);
2 - all other bodies and fabrics,
3 - skin, bones.
 HYGIENIC NORMATIVES of RADIATION
For protection working and the population from radiation are established the
following norms, on influence on 1 group of critical bodies are established the maximal
permissible doses (MPD) of radiation at external irradiation:
Category A - the persons professionally contacting to radiation –
MPD 2 BER / year (0,2 Zivert / year) or 40 miliBER in week.
Category B - people who are taking place near the sources of radiation –
MPD - 0,2 BER (0,02 Zv / year).
Category C - all other population - MPD - 0,1 BER (0,01 Zv / year).

Principles of radiation safety at work with the closed sources of radiation.

CLOSED SOURCE - allocates in environment only electromagnetic radiation - x-ray
or gamma - radiation. Basis of protective measures – laws of transmission radiation:
а) The doze of external irradiation is proportional to intensity and time of action;
b) Intensity of radiation is inversely proportional to a distance;
c) Intensity of radiation decreases depending on thickness of screens.
From here - 4 principles protection from radiation:
1) protection by amount of doze (MPD),
2) by distance,
3) by time,
4) by screens.
There are 5 kinds of screens for protection from radiation:
- Protective containers for storage radioisotopes;
- Screens for the equipment;
- Mobile screens;
- Screens in building designs (walls, ceilings, doors, floors);
- Screens in individual means of protection - lead gloves, aprons, etc.

Principles of radiating safety at work with open sources of radiation.

OPEN SOURCE - allocates in environment not only x-ray and gamma - radiation,
but also streams of radioactive particles (alpha, betta - particles and neutrons).
Main principles of protection:
- Use principles of protection at work with the closed sources;
- Hermetic sealing, automatization of the equipment, isolating suits, special boxes and
exhaust devices for work with isotopes;
- Special not adsorbing coverings of surfaces, often cleaning surfaces of radioactive
pollution;
- The special equipment of ventilation (exhaust ventilation is equipped with filters), water
drains (in special sediment bowls), sufficient water supply;
- Special lay-out of premises with the protective screens; a lay-out of a site of radiological
department - distance radiological laboratories from residential buildings, other hospital
branches, depending from it class (there is 4 classes of radiological laboratories by annual
amount used radioactive substances);
- Careful radiating and medical control personnel;
- Observance personal hygiene and requirements to overalls.

Problems of radiating ecology.

Natural radiating background (NRB)
Natural radiating background - a natural level of radio-activity in the given district,
basically dependent on natural factors. On the average makes about 100 miliBER / year,
but can test significant fluctuations in view of the natural and anthropogen reasons. In
Crimea it is 6-30 miliRoentgen / hour (it is more - in the mountain part of Crimea -
radioactivity of the granite masses, containing uranium).
Structure of NRB:
- Space radiation (25-40 %) – (2 protection screens from it – EMF of the Earth and ozone
cloud) it varies in connection with fluctuations of solar activity and interplanetary EMF, on
the average the person on the Earth receives by it 28 mBER/year;
- Natural radio-activity of ground (granite - uranium), of air, of water;
- Food stuffs - about 25 % NRB
Thus, in NRB the external irradiation makes 75 %, internal (more dangerous) -25 %.
Additional anthropogen sources of increase NRB for the population:
- Regions of the atomic power station and consequences of it failures and nuclear
explosions;
- Diagnostic x-ray procedures (at roentgenoscopia the patient receives 1 BER at once); (it
is important to reduce unnecessary diagnostic x-ray procedures).
- TV-sets – at see color TV for 4 hours in day person receives 50 mBER per year. (It is
especially important for children).
Dynamics (changes) NRB.
It is investigated since 50th years. Rise of it was in 50th years (reason -mass tests
of the nuclear weapon), than - decrease to 70th years (convention about interdiction
nuclear tests in 3 air, water – now it is permissible only uderground explosions), growth
since 70th years (development atomic power stations).

INSTRUCTION FOR PRACTICAL LESSON ON THE THEME

Educational questions:
1. CONCEPT About a RADIO-ACTIVITY, HYGIENIC CHARACTERISTIC of the BASIC
KINDS of RADIATIONS;
2. BASIC SIZES And UNITS DESCRIBING RADIATIONS.
3. ACTION of RADIATION ON ORGANISM. THRESHOLD And STOCHASTIC (NOT
THRESHOLD) EFFECTS.
4. DEFINITION of DOZES of an EXTERNAL And INTERNAL IRRADIATION.
5. GROUP of CRITICAL BODIES. MPD of RADIATION.
6. PRINCIPLES of PROTECTION AT WORK at the CLOSED And OPEN SOURCES of
RADIATION.
7. NATURAL RADIATING BACKGROUND: COMPONENTS, LEVELS, DYNAMICS.
8. SOURCES of RADIOACTIVE POLLUTION of BIOSPHERE
9. HYGIENIC CONSEQUENCES CHERNOBYL ACCIDENT.
10. METHODS of NEUTRALIZATION RADIOACTIVE WASTE.
11. HYGIENIC REQUIREMENTS FOR X-RAY AND RADIOLOGIC BRANCHES.

The educational tasks.

1. Characteristic kinds of radiations. Ionization ability. Run in air and fabrics. Screens.
2. Biological action of radiations. The basic kinds of beam defeats. Conditions of their occurrence.
3. Concept about the closed and open sources of radiation.. Principles defence, ways of protection.
4. Natural radioactive background: levels, sources, dynamics of changes. Measurement it with the
help of the counter Heiger.
5. Hygienic requirements to hospitals, using sources of radioactive radiation. Structure of x-ray and
radiologic branches.

Tests for the control level of knowledge

1. For creation of radiating safety of the medical personnel of a X-ray study the protective means
such as screens are used: lead glass on the screen, large and small mobile protective screens, veil
and protective clothers with lead rubber. What else means of shielding are necessary?
1. an apron from lead material
2. boots from lead rubber
3. restriction of duration of a working day
4. remote control X-ray devic
5. it is enough of the specified measures
2. In radiologic branch for bream therapy the scale - installation source - isotope cobalt is used
which is in a steel ampoule. What from the listed ways of protection of the personnel from influence
the radiations are necessary for using first of all in view of a type of a source?
1. shielding of a source and workplace
2. hermetic sealing of installation
3. measures lay-out character (zonning of a premise)
4. the equipment of premises by effective ventilation
5. use of means of individual protection and sanitary processing of the personnel
3. At graduation examinations the student has answered to the examiner, that the greatest
penetration in organism of the man has alfa - radiation. The correct answer is:
1. gamma - radiation
2. neutron radiation
3. alfa-radiation
4. proton radiation
5. beta-radiation

Situational tasks
1. At work with radioactive isotopes the doze of an irradiation makes 100 milliBER/hours at 30-
hour working week. Your estimation of working conditions in laboratory.
2. The doze of an irradiation of the doctor - radiologist for one week has made 110 milliBER, for
one year - 6 BER. What protective measures in this case are necessary?
The standards of the answers:
1. The working conditions do not answer the hygienic requirements, since the week doze of an
irradiation makes 100 mBER/hour х 30 hours = 3000 mBER, at MPD – 40 mBER/week. It is
necessary to find out the reasons of excess MPD and to remove them, at impossibility it is to
strengthen all kinds of antyradiation protection at work with open sources of radiation.
2. The doze of an irradiation exceeds MPD of radiation at an external irradiation (40 mBER per one
week and 2 BER for one year), that can result in chronic beam illness and occurrence of the remote
harmful effects (mutagen, cancerogen). The radiologist work with open sources of radiation
(allocateof radiation and flows of radioactive particles). The protection by a doze, time, distance,
screens and complex of measures on prevention of hit radionuclides inside organism is necessary.

THE APPENDIX
Devices of the dosimetrical control
Depending on type of the detector and methods of registration radiations dozimetric devices
are divided on:
- ionizational (with ionization chamber, counters Heiger)
- scincillational
- luminescent (thermoluminescent)
- photographic
- chemical
- semi-conductor
- calorymetrical

The characteristic of dosimetric devices

The name a type registered radiation a range of measurements weight, kg
Dosimeter СРП-68-01 gamma 1-3000 mkR/h 3,6
ДРГ-05 М gamma, roentgen 1-10000 mR/s 2,0
ДКС-04 gamma, beta, neutrons 0,1-1000 mR/h 0,25
ДБГ-06 Т gamma 0,01-99,9 mR/h 0,01-1000 mkZv/h 0,25
ДРГ-01 Т gamma 0,01-99,9 mR/h 0,25
Radiometer-
dosimeter МКС-01Р-01 Alfa, beta, gamma
neutrons 1-30000 particle / min см2
1-100000 particle / min см2
0,01-10000 mkZv/h
mkBER/s 18,0
Individual
dosimeter КДТ-02ДТУ-01КИД-08 C gamma 5-1000000 mR 41,4
Individual
dosimeter КИД-2 gamma, roentgen 0,005-1,0 R 4,0 0,04
Individual.
Dosimeter ИФК-2,3ИФКУ beta, gamma , neutron 0,01-3 Р, BER a film

Sources of the information.

The basic literature
1. Нікберг І. І. Радіаційна гігієна. Підручник для студентів.- Київ, 1999.- 159с.
2. Lectures on common hygiene. Simferopol, 2003.-130p.
3. І.І.Даценко. Загальна гiгiена. Посiбник для практичних занять.- Київ,1992.- 267с.
4. В.Ф.Кириллов и др. Руководство к практическим занятиям по радиационной гигиене.-
Москва, 2001.- 223с.
5.Park’s textbook of Preventive and Social medicine. India, 2000.- 16-th edition. – 660p.
6. Руководство к практическим занятиям по общей гигиене и медицинской экологии. / Под ред. Проф.
С.Э.Шибанова. – Симферополь, 2003. – 260с.
The additional literature:
1 Кириллов В.Ф. и др. Радиационная гигиена. – Москва, 1988.- 237с.
2 Ильин Л.А., Кириллов В.Ф. Радиационная гигиена.- Москва, 1999.- 384с.
3 Ильин Л.А., Кириллов В.Ф. Радиационная безопасность и защита. – Москва, 1996.-
336с.

THEME № 20. INDUSTRIAL TOXICOLOGY.

HYGIENE OF APPLICATION AND TOXICOLOGY OF AGROCHEMICALS.

Toxicology and industrial toxicology.

Toxicology is a science, studying laws of action various toxins (poisons) on an
organism. The toxicology shares on military, household, industrial.
Industrial toxicology - the section of toxicology, studying laws of action on an
organism industrial poisons - chemical substances to which the person contacts on
manufacture and which can cause development of professional poisonings.

Parameters of toxity of the industrial poisons.

For the toxic and hygienic characteristic industrial poisonings it is necessary to
know key parameters of it toxity at investigation on laboratory animals dependences "doze
- effect" (TOXICODYNAMICS) and "time - effect" (TOXICOKYNETICS).
All these parameters are determined in experiments at laboratory animals and then
approximated on the person with account FSS - factor of specific sensitivity - differences in
toxicological parameters for different kinds of warm-blooded animals (white mice, rats,
rabbits).
KEY PARAMETERS of the LEVEL of TOXITY of POISONS
PARAMETERS OF TOXICODYNAMICS:
1. ACUTE TOXICITY (at unitary influence):
1) Lethal (fatal) dozes (concentration) – LD0, LD100, LD50 (amount of animals, died at action
of this doze).
2) The threshold of sharp action - Lim ac. – limit doze on common toxic effects, Lim ac sp.
- on specific effects (for example, irritating action).
3) The zone of sharp action - Z ac. = LD50 / Lim ac. – then it is less, the substance is more
dangerous for sharp poisonings.
2.HALF-ACUTE TOXITY – it is studied at influence on animals in experiment by 30-45
days.
It is determined coefficient cumulation (C. cum.) = LD50 at unitary action / LD50 totally
during 30 days.
3. CHRONIC TOXITY (at long time influence – during months or years) - it is most
important parameter - represents real conditions of influence industrial poisons on the
person:
Lim ch (threshold chronic action by common toxic and specific and remote effects).
Abroad used LOAEL - the bottom level of notice harmful effect (Lim ch),
NOAEL - level of not notice harmful effect (under threshold effect).
The zone of chronic action - Z ch = Lim ac / Lim ch - then it is more - the more opportunity
occurrence chronic poisonings.
SAFE LEVELS INDUSTRIAL POISONS FOR the PERSON
From Lim ch (NOAEL) for animals calculated maximal permissible concentration or
doze for person with using coefficient safety (depends from level toxity poison, cumulation,
etc.)
KEY PARAMETERS TOXICOKYNETICS:
Т50 - the period half-removing poison from an organism (from blood, bodies, biological
liquids);
Т95 - the period of removing 95% poison from an organism.
It is determined in experiments with the help of radioactive labels (isotope C 14).
The less these parameters - the faster poison are deduced from an organism.
TOXICOKINETICS is closely connected with cumulation poisons in organism.

Table
THE BASIC PARAMETERS TOXICOMETRY of CHEMICAL SUBSTANCES
_____________________________________________________________________________
Primary parameter Derivative parameter

PARAMETERS TOXICODYNAMICS
1. SHARP TOXITY
Fatal dozes and concentrations Zone of fatal action
LD0, LD50, LD100 (LC) Z = LD84 / LD16

Factor interkind sensitivity Factor of an opportunity

FIS = LD 50 max/LD 50min inhalation poisoning
FOIP = C / LC 50

THRESHOLD a sharp integrated Zone of sharp action

action Lim ac. Integr. Z ac. = LD 50 / Lim ac. Integr.
THRESHOLD sharp specific Zone of sharp specific action
Actions Lim ac. sp. Z ac.sp. = ЛД 50 / Lim ac. sp.

2. HALF-SHARP TOXITY
Factor cumulation
F cum. = LD 50 sum during 30 days / LD 50 at once
Threshold half-sharp action Lim h.-s. ac.

3. CHRONIC TOXITY
Threshold chronic integrated Zone of chronic action
action Lim ch. Integr. Z ch. = Lim ac. / Lim ch.
(LOAEL) *
Threshold chronic specific Zone biological action
Lim ch.sp. Z ch.sp. = Lim ac.sp./Lim ch.sp.

SAFE LEVELS FOR the MAN

Maximal not action dose (NOAEL) *, MPC

PARAMETERS TOXICOKYNETICS
The period of half-removing substance from organism Т 50
The period of removing substance from organism Т 95
Factor cumulation F cum.
LOAEL - bottom level of observable harmful effect
NOAEL - level of not observable harmful effect

CLASSIFICATION TOXIC SUBSTANCES ON a DEGREE OF CUMULATION

_________________________________________________________________
Level cumulation Coefficient cumulation C cum. Time of response
TR 50, day
Supercumulation <1 < 20
Expressed cumulation 1-3 20 - 60
Middle cumulation 3-5 60 - 100
Weak cumulation >5 > 100

CLASSIFICATION industrial piosons:

CLASSIFICATION CHEMICAL SUBSTANCES ON TOXITY

I class of danger - EXTREMELY DANGEROUS SUBSTANCES (Extremely toxic)
II class of danger - HIGLY DANGEROUS SUBSTANCES (Highly toxic)
III class of danger - MIDDLE DANGEROUS SUBSTANCES (Middle toxic)
IV class of danger - SMALL DANGEROUS SUBSTANCES (Small toxic)
________________________________________________________
Parameter I class II class III class IV class
3
MPC in air, mg / m < 0,1 0,1 - 1,0 1,0 - 10 > 10
DL 50 peroral < 15 15 - 150 150 - 5000 > 5000
DL50 at skin < 100 100 - 500 500 - 2000 > 2000
CL 50 inhalation < 500 500 - 5000 5000-50000 > 50000
FOIP > 300 300 - 30 30 - 3 <3
Zone acute action Z ac. <6 6 - 18 18 - 54 > 54
Zone chronic action Z ch. > 10 10 - 5 5 - 2,5 < 2,5

Classification poisons by primary character of action on organism:

Irritating, neurotropic, cardio- hepatotropic, nephrotropic, gonadotropic, cancerogen,
mutagen, etc.

BASIC REGULARITIES ACTION POISONS ON ORGANISM.

Toxic effect of poisons depend from:
1) THE EXOGEN FACTORS:
- Chemical structure of poison (for example, increase toxicity in gomological line of
hydrocarbons);
- Doze, concentration of poison (dependence "doze - effect" and "time - effect");
- Ability to flying, level of dispersion of poison;
- Way of receipt poison in organism (inhalation or other); character and rate of a
metabolism, path of removing poison from an organism
- Conditions of environment (metheorologic factors);
- Selective sensitivity: Age, Sexual, Specific, Individual
- Selective activity on members and systems:
- Commom toxic poisons
- Hepatotropic
- Nephrotropic
- Cardiotoxic
- Neurotropic
- Character of action:
- Constant or intermittent
- Isolated
- Combined, complex

2) THE ENDOGEN FACTORS - depends from a state of an organism:

- Age
- Sex
- Presence of diseases
- Defects detoxical system (inheritable or acquired)
- Pregnancy, lactation
- Physical and intellectual overfatigue.

KINDS of the ADAPTATION ORGANISM TO ACTION POISONS

ADAPTATION is the true adaptation of an organism to action of poison without
irreversible biological changes and with preservation gomeostasis (constancy) biological
system.
 COMPENSATION (or accustoming) - temporarily latent pathology due to overstrain
of adaptable reserves, at action any adverse factors becomes decompensation -
poisoning.
In experiment on animals difference of adaptation from compensation is checked by
special functional tests.

STAGES OF DEVELOPMENT CHEMICAL INTOXICATION

1 - primary decompensation
2 - physiological adaptation
3 - hidden pathology
4 - decompensated pathology (poisoning)

TYPES CUMULATION POISONS In ORGANISM

1. MATERIAL - accumulation poison or it metabolites in an organism
2. FUNCTIONAL - accumulation only toxic effects poison in an organism
3. MIXED - accumulation in an organism metabolites or poison and pathological
effects

COMBINED action poisons.

As a rule, in real industrial conditions isolated action poisons on an organism
practically does not meet, more often takes place the combined action (action many
substances at the same time), which can change toxic effects in comparison with separate
influence.
Kinds of the combined action:
ANTAGONISM (less, than additive action),
SUMMATION (additive action),
POTENTIATION (more, than additive action).
Hygienic estimation the industrial environment with the account kind of the
combined action poisons.
1) In case antagonism – estimation goes on separate maximum permissible
concentration for every founded poison;
2) At summation - under formula summary toxity Averianov:
C1 C2 Ci
------- + ------- + ... ------ < 1 C – concentration founded substance
MPC1 MPC2 MPC i MPC – maximum permissible concentration
3) At potentiation – under formula:
C1 C2 Ci
------- + ------- + ... ------ < 1/K C – concentration founded substance
MPC1 MPC2 MPC i MPC – maximum permissible concentration
K - Coefficient of potentiation

BASIC WAYS of DETOXICATION INDUSTRIAL POISONS

1. Change chemical structure of poison - hydroxilation (formation OH - groups), oxidation,
restoration, metylization (connection СН3 - groups), connection with glucuronic acid and
amino acids - are formed less toxic metabolites.
2. Deposition in bodies and fabrics (material cumulation) - time decrease concentration of
poison in blood (for example, heavy metals are deposited in bones, liver and kidneys). It is
defective way of neutralization - under adverse conditions may be exit of poisons from
depot and aggravations of chronic poisonings.
3. Removing from an organism - through lungs, kidneys, intestines, skin.
Detoxication system of organism and parameters of its functioning
This complex system can be presented as 5 parts of protection:
1. Microsome oxidation by microsome monooxigenazes (MOGS). Indicators - cytochromes
Р-450, b 5, etc. Is possible accumulation oxide radicals, etc.
2. Reaction conjugation (connection) with proteins. Indicators - restored glutation, etc.
3. Biopower processes for detoxication - oxidizing phposforilation etc.
4. Processes the peroxidation lipides. Indicatiors – level of malonov dialdegid, dienov
conjucates.
5. Antiradical and antiperoxidation protection (activity of enzymes catalaze, peroxidaze,
superoxiddismutaze, vitamin C etc.)
On a condition and interrelation of these 5 parts it is possible to reveal adaptation or
compensation: at activation 1 and 4 links should be activated the others; at it deactivation -
it is toxicogenic disgomeostasis (latent decompensation).

WAYS of RECEIPT INDUSTRIAL POISONS TO the ORGANISM

1. Inhalation way - most frequently and dangerously way (the area of lungs 100 –120m 2
with blood capillaries, there is no barrier function of a liver). For flying poisons and at it
good solubility in blood is the more dangerously,
2. Through skin and mucous - lipothrope poisons (soluble in fats) - through the intact skin,
hair follicles, sweat and tear glands.
3.Per os - Through mouth and mucous stomach and intestines – in professional conditions
very rare way - at non-observance rules of personal hygiene, it is casual with products.

ADSORBTION POSONS IN ORGANISM:

After absorbtion poisons can accumulate in Liver, in Blood, in Bones, in Lymph, in
Hair, in Nails.

WAYS of REMOVING INDUSTRIAL POISONS from ORGANISM

1. Through kidneys - it is more often way for many substances.
2. Through intestines – it is for badly soluble poisons - lead, mercury.
3. Through lungs – it is for flying substances - aromatic hydrocarbons.
4. Through skin and glands of external secretion (through grease, milk glands - fat-soluble
substances, through sweat, salivary glands - heavy metals).
Biosubstrates, in which it is determined the contents of poisons or it metabolites for
confirmation the diagnosis poisoning: blood, urine, the excrements, exhaled air, secret of
glands.

DISPLAYS of TOXIC ACTION INDUSTRIAL POISONS:

1. Sharp intoxications
2. Chronic intoxications,
3. Specific action (allergenic, gonadotropic)
4. Remote effects (mutagenic, oncogenic)

REGLAMENTATION INDUSTRIAL POISONS

There are 3 limiting attributes of harm at normalization industrial poisons in air of
working zone:
1) Organoleptic 2) Irritating action on person or experimental animals; 3) Toxic specific and
nonspecific action in experiment with laboratory animals.

Sheme of research toxity poisons in experiment:

1. Research physical and chemical structure of poison, its chemical properties,
toxicological parameters of chemical analogs for rough estimation level of toxicity.
2. Studying acute toxicity poison in sharp experiments at per os, inhalation action, at skin
drawing (LD50, Lim ac.)
3. Studying half-acute toxicity in experiments 30-45 days – definition C. cum., selectivities
of toxic action.
4. Research chronic toxicity in 4-6 monthly experiences - definition Lim ch.
5. Substantiation threshold concentration (LOAEL), MPC for the person.

PREVENTION PROFESSIONAL POISONINGS:

1. Administrative - legislative measures (the list of harmful manufactures - medical contra-
indications, privileges, restriction of age etc.);
2. Hygienic measures - preventive and current sanitary control;
3. Medical - preventive - preliminary and current surveys, investigation and treatment
professional poisonings; treatment-and-prophylactic feed on manufacture;
4. Technological - change chemical technologies in industry, ventilation, hermetic sealing,
automation, clearing constructions etc.;
5. Individual - overalls, gas masks, respirators, dietetic therapy.

THE REMOTE And SPECIFIC EFFECTS OF INDUSTRIAL POISONS

And POLLUTANTS OF ENVIRONMENT
The remote effects Specific effects
Oncogenous (cancerogenic) Gonadotrophic
Mutagen Allergenic
Teratogenic Emryotropic
Drop of lifetime Immunodepressive
Acceleration of olding of organism

ONCOGENOUS (CANCEROGENIC) ACTION

Chemical cahcerogen – it is:
1) Substance or it admixture, which can cause in the man or animal formation tumours
which are not meeting without it action (true cancerogens - the initiators)
2) Substance which can cause acceleration of formation or earlier appearance usial
tumours (promoters – pre-cancerogens)

CLASSIFICATION CANCEROGENS
(By International Agency Cancerogen Investigation)
1. Cancerogenic for the man (23 substances - arsenic, asbestos, chrome, beryllium,
nickel, carbon black, petroleum, benzene etc. – cancerogen effect is proved by the
epidemiological data – on the people)
2. Probably cancerogenic for the man:
а) Probable cancerogens (produce tumours in 80-100% of experimental animal in 4-6
months) - 14 substances - benz (а) pyren, chlorine – organic combinations etc.
b) Possible cancerogens (produce tumours in 20-30% of experimental animal during life) -
47 substances, for example, cadmium, nitrozocombinations, some pesticides
3. Not categorized on cancerogenic ability (the data about cencerogen activity are
discordant) - 64 substances, for example, lead and its salts
4. Is probable, not cancerogenic for the man – all other substances – for which until now
no data about cancerogen activity.

MUTAGENITY OF CHEMICAL SUBSTANCES

Now it is found more than 600 substances, which have mutagen activity on the person
or laboratory animals.
CLASSIFICATION CHEMICAL MUTAGENS
1. NATURAL - inorganic and organic matters meeting in a nature (mycotoxins, oxides of
nitrogen, nitrites etc.)
2. ANTHROPOGENIC - medicines, pesticides, alimentary additives etc.
EXAMINATION MUTAGEN ACTIVITY SUBSTANCES:
1) In experiments on model tests - systems - microbes, plants, hexapods, cells of the man
and animal in experience in vitro, in vivo
2) Cytogenetic monitoring of the population and working in contact with mutagen factors
3) Biological indication mutagens in biosphere (ecumene)
For the proof mutagenicity of chemical materials for the man will utillize 4 systems:
1) Dotted mutations in microorganisms with a metabolic activation
2) Dominant lethal mutations for mice
3) Chromosome changes in osteal brain of mammalia
4) Chromosome violations in leucocytes of the man

EMBRYOTROPIC ACTIVITY
KINDS VIOLATION of FETATION UNDER INFLUENCE of CHEMICAL MATERIALS:
1. Embryotoxic activity - destruction of fetus, drop mass and dimensions embryons,
infringement normal differentiation of tissues
2. Teratogenic activity - anomalies and defects of development new-born.
Now it is new science in toxicology – chemical teratology – studing teratogenicity of
chemical substances for the person and animals, indication it in biosphere.
The list of chemical teratogens - more than 600 materials - Hydrargyrum and its
combinations, dioxines, pesticides, benzol, benzine, etc.
The evaluation of embryotoxity will be carried out in experiments on laboratory
animal.
PARAMETERS OF EMBRYOTOXIC ACTIVITY:
- Common embryonal mortality
- Pre-implantation and post-implantation mortality
- Number new-born in a litter (brood)
- Middle mass and dimensions embryons
PARAMETERS of TERATOGENIC ACTIVITY:
- External and internal anomalies of development
- State places of ossification
- Distribution brood on a sex.
It is determined Lim sp. and Z sp. = Lim integr. / Lim sp.
If Z sp. > 1, the material has selective embryotropic activity - is taken into account at
installation MPC.

OTHER REMOTE EFFECTS ACTION CHEMICAL MATERIALS:

Neuro- psychical violations at action phosphorus-organic combinations.
Infringements of hemopoiesis (anemia), cardiac functions (acceleration of infarcts,
development of atherosclerosis) – at action chlorine-organic combinations/

TOXICOLOGIC AND HYGIENIC CHARACTERISTIC BASIC INDUSTRIAL POISONS.

Irritating substances (chemical substances primary irritating action).
To such poisons concern Ammonia, oxides of nitrogen, sulfur, pairs the chloric,
hydrochloric, nitric acid, CO2, CO, chlorine and its connections.
These substances wide use in the industry and frequently can influence on working.
The common features of influence: irritation respiratory ways and mucous
membranes of eyes. Influence depends on solubility in water: good soluble: chlorine,
sulphurous gas, ammonia - basically is late in the top departments of a respiratory path
and cause here chemical irritation or burns. Less soluble - oxides of nitrogen - reach deep
departments and can cause lung’s hypostasis.
 Action of chlorine. Chlorine - yellow gas with a special smell, in 2,5 times is
heavier than air. Getting on mucous membranes, chlorine is dissolved with formation
hydrochloric acid and atomic oxygen - irritation action on lung’s tissue – inflammation, may
be secondary infection.
Poisonings by chlorine are more often sharp and has 2 stages:
а) Initial - irritation top departments of a respiratory path and mucous;
b) Lung’s hypostasis – respiratory deficiency, rise temperature, leucocitosis.
At chronic poisoning - bronchitis, emphysema, pneumosclerosis, on skin – dermatitis,
exema.
Action of ammonia. Similar on poisoning with chlorine, there are heavy defeats at
hit in eyes and on a skin.
Action of oxides of nitrogen and pairs nitric acid.
More often sharp poisoning with 3 stages –
а) Initial - irritations, b) latent period – no any symptoms, c) increasing lung’s hypostasis.
In blood may be formation met-gaemoglobyn - hypoxia – violations CNS and
vegetative NS.
Action CO 2. Action on the respiratory center, hypoxia.
Action CO (carbonic oxide). Gas without color and smell, formed at incomplete
combustion of fuel in insufficiently ventilated premises. In blood it is formed carboxy-
gaemoglobin - affinity Hb to CO in 300 times more, than to O 2, has scarlet color - scarlet
stains on skin. It can not transport oxygen in blood – formation haemical hypoxia. Direct
action CO on fabric breath in CNS and internal bodies is blockade cytochromoxidaze.
Stages of sharp poisoning:
а) Initial - headache, infringements CNS,
b) Euphoria - strengthening defeat CNS,
c) Coma - loss of consciousness, oppression of reflexes, paralysis of the respiratory
center.
In the remote terms after poisoning by CO - loss of memory, infringement of
mentality, defeats CNS, etc.

POISONINGS BY HEAVY METALS

Such metals are lead, tethra-aetyl-lead, mercury etc.
Poisonings by lead. More than 100 trades have contact with lead or its
connections. Poisonings is chronic, more often at inhalation action. Pathogenesis -
blockade tiolovic enzymes (contain SH - groups) and others. Mutagen, gonado-,
hepatotropic action.
Cardinal symptoms of lead poisoning:
1. Lead border – grey border at edge of gum teeth due to sulphurous lead (reaction of
lead allocated with saliva and hydrogen sulphide, formed in mouth).
2.Lead colour - pale colouring of skin - angiospasm and the increased contents porfiryn in
blood.
In blood:
- Reticulocytosis – increasing reticulocytes (is above 15 on 10 thousand) in blood
(irritation bodies of blood forming).
- Basophyl eritrocytes in blood - irritation bodies of blood forming.
In urine:
- Porfirinuria - more than 50-60 mkg / l.
- The increased contents of lead in urine - more than 0,04 mg / l.
Besides in clinic it is marked:
Defeat of nervous system - in the beginning astenic syndrome, then lead
encephalopathia and polyneuritis.
 Changes in blood: in the beginning reticulocytosis and basophyl granularity of
eritrocytes, then - anemia and decrease Hb.
Defeat intestines - dyspepsia, in heavy cases – lead pains - the strongest pains in a
stomach, which is not stopped at action spasmolytics.
Defeat of liver - toxic hepatites with infringement of all of its functions,
bilirubinaemia.
POISONINGS BY TETRAAETYLLEAD (TEL)
Organic connections of the heavy metals are more toxic, than elementary metals.
TEL is used as the additive to gasoline - for decrease of detonation. Poisonings is by
inhalation way, very heavy (TEL - 1 class of danger). There is infringements CNS -
headache, astenyc syndrome, euphoria, infringements of dream, memory, oppression
CNS. Oppression vegetative NS gives vegetative triad: hypotonia, bradycardia (rare
cardiac contractions), hypothermia. In heavy cases – may be mental frustration and
organic defeats CNS. In years after poisoning - the remote consequences - astenisation,
emotional unbalance, decrease of intelligence.
POISONINGS BY MERCURY
More often - by inhalation way (mercury pairs). Often there are asymptomatic
cumulation (the contents in urine 0,05 mg / l and more) and chronic poisonings by
mercury.
Clinic of poisonings. First of all there is action at CNS. In Europe in past there
was sentence “he is fool as hat maker” because in past at making hats widely used
mercury.
- Mercurial “border“on gingivas black colour
- Mercurial neurotism
- Mercurial eretism (psychological frustration in emotional sphere - whining, sense anxiety)
- Mercurial encephalopathy
- Mercurial gingivites (inflammation tonque), and stomatitis, gastritis, colitis
- Violations cardiac system (changes at electrocardiogramma), kidneus (nefroses)
- In blood - lymphocytosis, monocytosis, leukopenia, anemia
- Content of Hydrargyrum in urine more than 0,01 - 0,02 mg/l
Organic connections of mercury are more toxic - illness Minamata (poisoning by
metylmercury).
POISONINGS BY AROMATIC HYDROCARBONS
Hydrocarbons aromatic structure (dissolvents) - benzene, toluene, ksylol.
In clinic:
- Violation CNS as narcotic action, polyneurites
- Violation hemopoesis - leukopenia, thrombocytopenia, aplastic anemia
- Hepatotropic action - toxic hepatitis
- Allergenic effects
- Gonadotrophic activity
- Mutagen and cancerogenic action - polycyclic aromatic hydrocarbons - classical
representative of cancerogenic substances is (benz (а) pyren)
SYNTHETIC POLYMERIC And PLASTIC SUBSTANCES
At heating can formed the different excreting builders, which gives such kinds of
action:
- Narcotic action
- Irritation action
- Influence on blood genesis, internals
- Infringement pregnancy
- Allergenic activity
- Teratogenic and embryotropic action
- Cancerogenic effects
 HYGIENE of WORK IN the AGRICULTURE.
HYGIENE APPLICATION AND TOXICOLOGY AGROCHEMICALS.
Modern ecologic and hygienic problems of agriculture.
Agriculture is a large field of activity of the person in which many people are
occupied. In many regions, including Crimea, this branch takes conducting place in
structure of public economy.
Modern way of the development agriculture is intensification – it means to receive
more production at the same agricultural areas. But this way demands using many
agrochemicals - application pesticides, fertilizers, growth factors etc. It substances can act
on the working, polluted bosphere and collect in food products.
Features of hygiene of work in agriculture.
As a whole work in agriculture has a number differences from other spheres of
industry production which negatively can influence at health working:
1. Seasonal irregularity and urgentness of works - it is non-uniformity of loading during
year, in some periods - very heavy not normalized work (for example, the period of sowing,
harvesting). It can promote fast exhaustion, overfatigue and possible infringements of
health.
2. Work on open air in different seasons of year at the influence of adverse
metheorological factors - overheating, overcooling, surplus UVR + chemicals –
melanomas at skin more often between agricultural workers in South regions.
3. Heavy physical work. May be quick development of overfatigue.
4. Contact with trauma danger mechanisms. The level of traumatism in agriculture is
higher, than in industry.
5. Far distance places of work from a residence. Absence transport - big energy expences
- fast exhaustion.
6. Wide chemization of agriculture - contact with big amount of different toxicants at
combined and complex action on organism. It is the most adverse feature of agricultural
work and on it we shall stop in detail.
HYGIENE APPLICATION AND TOXICOLOGY AGROCHEMICALS.
Agrochemicals - the big group of chemical substances, used in agriculture. There
are more than 5000 chemical substances, used as agrochemicals. The basic groups of
agrochemicals: pesticides, fertilizers, growth factors, etc.
Hygiene and toxicology pesticides.
Pesticides (in translation - destroying harm) - chemical and biological means
protection plants from wreckers, weeds and illnesses. It is the most dangerous group of
agrochemicals by high level toxity for person.
Despite of great toxicological and ecological damage from application pesticides,
prohibition it using is impossible - it means destruction about 50 % of crop, what in
conditions of world deficiency of products, especially proteins, is inadmissible.
For decrease danger of pesticides for the person and environment it assortment is
constantly updated and reconsidered by prohibition especially proof and toxic
preparations, goes constant toxicological and hygienic selection new synthesized
preparations with high selective toxicity for wreckers and low toxic for the person and
biote. Conducting world chemical concerns (Bayer etc.) constantly synthesize new
pesticides, but to application it is supposed only 1 of one million offered preparations.
Development hygiene and toxicology of pesticides.
The USSR was conducting country on studying this problem - researches have
begun in 30-th year XX century. The founder of the doctrine about hygiene work with
pesticides - academician L.I.Medved - worked in Kiev Research scientific institute hygiene
of work and occupational diseases, in 1965 he organized all-USSR research institute of
hygiene and toxicology of pesticides; academician J.I.Kundiev - developed the doctrine
about per-skin influence of pesticides. Academician J.S.Kagan – conducting scientist in
toxicology pesticides, acad. E.I.Goncharuk founded the theory reglamentation pesticides in
ground.
CLASSIFICATIONS PESTICIDES
HYGIENIC CLASSIFICATION PESTICIDES
1. On general toxity for animals
Degree toxity LD 50 mg/kg per os
Strongly working poisonous substances < 50
High toxic 50 - 200
Middle toxic 200 - 1000
Low toxic > 1000

2. On skin toxity for animal

Degree of toxity LD 50 on a skin, mg/kg

Sharply expressed toxity < 300

Expressed toxity 300 - 1000
Poorly expressed toxity > 1000

3. On ability to cumulation
Ability to cumulation factor cumulation

Over cumulation <1

Expressed 1-3
Moderate 3-5
Weak >5

3. On a degree of flying
Danger of inhalation poisoning parameters

Very dangerous substances- the saturating concentration at 20 0С more or is equal toxic

The dangerous substances- saturating concentration are more threshold concentration
Low dangerous substance- saturating concentration below threshold concentration

4. On stability in an environment
Degree of stability time of decomposition up to not toxic components

Very proof > 2 years

Proof 0,5 - 2 years
Moderately proof 1 - 6 month
Low proof < 1 month

2. BY APPLICATION:
- Insecticides - for struggle against insects
- Acaricides - for destruction pincers
- Algicides – for destruction seaweed
- Arbiricides - for destruction trees and bushes
- Bactericides – for struggle with bacterial illnesses of plants
- Larvicides - for destruction larves and tracks of insects
- Ovicides - for destruction eggs of insects
 - Zoocides - for struggle against rodents
- Limacides - for destruction molluscs
- Fungicides – for destruction fungi
- Herbicides - for struggle against weeds:
- Defoliants - for remove foliages of plants

3. ON WAYS OF HIT TO THE ORGANISM OF INSECTS:

Contact - at contact to any part of a body of insect
Intestinal – getting in organism insect per os
Fumigants - through a respiratory organs of insect
Systemic – plants become poison for insect in all part

4. CLASSIFICATION PESTICIDES ON CHEMICAL STRUCTURE:

1. Chlorine- organic (CHOP) - DDT, aldrine, dildrine, hexachlorane etc.
2. Phosporos-organic (PHOP) – carbophos, chlorophos, fosphamid, etc.
3. Carbamates - derivatives carbamin acids – sevin, zineb, maneb, ziram etc.
4. Mercury and arsenic organic – mercuran, granozan, arsenit calcium etc.
5. Preparations copper – connections of copper - Bordo liquid
6. Derivatives simmetric triasines – atrazin, propazin, simazin
7. Synthetic pyretroids – ambush, zimbush, decis etc.

TOXICOLOGICAL CHARACTERISTIC MAIN GROUPS of PESTICIDES

1. CHOP. Mechanism insecticide and toxic action - blockade respiratory enzymes in
tissues, it is especial cytochromoxidaze (display enzyme for diagnostics poisoning).
Clinic of poisoning: defeat CNS, liver, kidneys, endocryne systems, mutagen,
cancerogenic action.
Ecological danger - very much stable in biosphere, therefore practically all are
forbidden to application. According to Washington Academy of Sciences, half-life period of
DDT in biosphere - some centuries.
2. PHOP. Mechanism action – blockade enzyme cholinesteraze in blood. Cholinesterase
need for destruction acetylcholine, when it is inactivated - accumulation acetylcholine in
cynapses. 2 stages of poisoning - excitation, then oppression and destruction vital
centers CNS. Clinic - overexcitation choline-reactive systems. Poisonings because of
small stability PHOP in the environment (1-3 months) are more often sharp. Last years
for PHOP is found out remote neurotoxity - defeats of peripheral nervous system and
CNS after years after poisoning (functional cumulation). Prospects of the further
application are insignificant because of big toxicity and accustoming of wreckers (the
oldest group of pesticides).
3. Carbamates. (The salts of carbaminic acids). Now it group frequently offered by
chemical firms. The mechanism of action is like PHOP, but blockade of cholinesterase
is convertible and through time its activity is restored, therefore poisonings less heavy,
than at action of PHOP. Rather stable in biosphere (about one year and more), for
some preparations are established the remote effects (in experiment).
4. Mercury and arsenic organic pesticides. Mechanism of action - blockade tiolov
enzymes (contain SH-group.), are extremely toxic. Are applied as fungicides at grain.
5. Preparations of copper. It is old preparations, are applied on vineyards, including in
Crimea. Has low toxity - in intestines formed copper albuminates - is not absorbtion in the
blood, has irritating action in intestines. Poisonings are usually easy or average degree.
Treatment is washing stomach, application antidotes of heavy metals - pectins, unitiol.
6. Symmetric triasines. It is widely applied as herbicides in rice checks in Crimea and
with waste waters pollute coastal sea water areas. Basically is low toxic. Has high stability
in biosphere. It is revealed cytotoxic action - influence at structure nuclein acids.
7. Synthetic pyretroides - rather new group with sharp selectivity for insects. Are
synthesized on the basis of natural pyretrins (flowers of Dalmat camomiles in the
beginning of 20 th century were applied as insecticides). It is low toxic for the person and
also are unstable in the environment, the mechanism of action not good studied, there are
separate messages about the remote effects. Perspective group, but rather expensive
preparations.

HYGIENE of WORK WITH PESTICIDES

Because it is very toxic group of agrochemicals, there are very strong demands to
conditions of work and contact with these substances.
Hygiene of work at storage pesticides.
The territory of warehouse for pesticides should be protected from access of other
persons, must be removed from living houses and other objects on 200-1000m (depending
on toxicity of stored preparations – if there is extremely toxic group of pesticides – 1 km).
On territory must be platforms for washing motor transport and mechanisms from the rests
of pesticides, measures for prevention drains in environmental places. An internal covering
of a warehouse must be from not adsorbing materials, preparations should be stored in
tight container, good ventilation, must be premises for stay of the personnel, storage
clothes, souls. It is necessary constant current sanitary control levels pesticide pollution
air, hands, overalls of the personnel, tightness of packing preparations, rules of work with
toxic substances.
Hygiene of work at transportation pesticides.
Common rules of transportation chemically dangerous cargoes: special transport,
the routes specially chosen by sanitary service – far off towns, hospitals, sanatoria, etc. In
the car must be means of individual defence and desintoxication pesticides in case of
failure.
Hygiene of work at application pesticides.
Because many pesticides are highly toxic substances, at work with them - strict
safety requirements:
- Restriction of work time - 4 hours (pesticides 2-3 class of danger) or 2 hours (1 class of
danger);
- Observance term of renewal works (after processing plants), in hothouses it is very small
- 1-3 days;
- Observance term of expectation - the period between processing and harvesting
(depends on toxicity, stability of preparation, culture of plants), for example, for PHOP on
apple trees - 20 days;
- Preliminary and current physical examinations, early revealing and treatment pesticide
poisonings (in special clinics);
- Preventive and current sanitary control at application pesticides;
- Use individual means of protection bodies of breath and skin;
- Observance rules of personal hygiene - bath after work, feed in special places.
Ecologic and hygienic estimation ways of application pesticides.
Pesticides in agriculture are applied by 3 ways: airprocessings, tractor sprayers and
individual sprayers. Each way has the advantages and lacks concerning health working
and protection of biosphere.
The hygienic characteristic biological pesticides.
Biological means protection of the plants intensively take root into last years in
connection with toxicity of chemical pesticides. It based on prevention destruction and
illnesses of plants due to biological means.
The basic groups of biological means:
- Bacterial, fungoid means. (Virus preparations, causing illnesses of wreckers);
- Biological products for struggle against illnesses of plants (antibiotics);
- Ferromones (sexual hormones) insects - for attraction in chemical traps or scaring away.
Lacks of biological way protection plants:
- Low efficiency in comparison with chemical pesticides (30 %);
- High cost;
- Allergenic action on working.
Toxicology and hygiene of work at application fertilizers.
Except pesticides, in agriculture are used many other chemicals, on 1 place on
scales of application there are fertilizers. Fertilizers - the substances used for increase
productivity of plants.
Classification fertilizers:
- Organic (peat, manure);
- Mineral - macrofertilizers (nitrogen, phosphorus, potassium – in form simple fertilizers
and complex fertilizers) and microfertilizers (microelements for plants).
Among all fertilizers on application 90 % make nitric - give fast growth weight of
plants, but thus in ground and plants can collect nitrates and nitrites – in big amounts in
person may be methaemoglobinaemya. The control production under the contents of
nitrates is necessary.
Phosphoric fertilizers as impurity frequently contains fluorine, and it may be
fluorosis among population near this working manufactures and at application, formation
anthropogen biogeochemical provinces on fluorine.
Hygiene of work with fertilizers.
As fertilizers concern to low toxic substances, at their use no so strict measures as
at work with pesticides - protection bodies of breath against dust of fertilizers and
protection skin (individual means of protection) are necessary.

INSTRUCTION FOR PRACTICAL LESSON ON THE THEME

Educational questions:
1. Subject and tasks industrial and agricultural toxicology
2. Parameters of toxity of substances at sharp, half-sharp and chronic action.
3. Basic laws of influence toxic substances on organism.
4. Classification industrial posons and pesticides.
5. Way of receipt and removing poisons from organism. Ways of neutralization poisons in
organism. Detoxication system and its parameters.
6. Display toxic action of these substances on organism of working
7. Toxicologic characteristic of the basic groups industrial poisons.
8. Prevention professional poisonings.
9. Classification and purpose of basic groups of agrochemicals.
10. Toxicologic and hygienic characteristic of the basic groups pesticides.
11. Hygiene of work at a storage, transportation and application pesticides and fertilizers.

Tests for the control level of knowledge

1. If the factor of cumulation is less 1 - what it means?
1. over cumulation
2. weak cumulation
2. In the atmospheric air of an industrial centre the emissions of the metallurgical enterprises act:
oxides of sulfur, nitrogen, metals, which negatively influence a condition of health of the
population. The action of these harmful factors is characterized as:
1. combined
2. complex
3. incorporated
4. isolated
5 mixed
3. The excess of MPC of toxic substance in atmospheric air makes 100. What changes in a
condition of the population it is necessary to expect?
1. fatal poisonings among children and elderly
2. sharp poisonings
3. changes in a condition of health on separate parameters
4. chronic poisonings
4. Specify parameters of sharp toxity industrial poisons
1. DL 16
2. DL 50
3. C cum
4. Lim ac
5. Lim ch

Situational tasks
1. What work will carry out the doctor on hygiene of work at realization periodic medical surveys at
the industrial enterprises?
2. It was carried out giving toxic substance to animals daily by dozes equal 1/20 from DL50. Thus
each animal has received totally for 4 months at action 5 of time week 10,5 doses equal DL 50 of
substance. Determine factor cumulation and give it estimation.
3. At realization of electrowelding works in an atmosphere of shop the aerosols containing oxides of
iron, manganese, carbon, chrom, silicon are allocated. At the welders the defeats of nervous system
(chronic intoxication) are diagnosed. What can cause chronic intoxication?
The standards of the answers:
1. He must determine the list of the persons for physical examination
2. Factor cumulation - it is the relation of total LD 50 to a doze at unitary introduction (LD50). So,
C cum = 10,5\5 since in a task is taken 1\20 from DL50; C cum = 2,1, that is expressed cumulation.
3. Oxides of manganese

Final lesson on "Hygiene of work" and "Hospital hygiene "

Questions to final lesson:
HOSPITAL HYGIENE
1. Concept about treatment-quarding mode and its basic components. The hygienic requirements to
accommodation of hospitals of a different structure.
2. Hygienic requirements to a site of hospital. Functional zonning of a hospital site. Historical types
of construction of hospitals.
3. Hygienic estimation of various systems of hospital construction. The basic directions of
prevention intrahospital infections.
4. Hygienic requirements to an internal lay-out of hospital. Typical ward section and its lay-out.
5. Hygienic requirements to the hospital ward (lay-out, microclimate, ventilation, illumination).
6. Hygienic requirements to a reception department of hospital, it functions and structure of
premises.
7. Hygienic requirements to infectious branch. Features of a lay-out of wards and their reasons.
8. Hygienic requirements to the operational block and operational (lay-out, microclimate,
illumination, ventilation).
9. Concept about intrahospital infections, reason of it growth, structure, basic sources and ways of
transmission. Prevention.
HYGIENE OF WORK
10. Hygiene of work of the surgeons and anaesthesiologists. Basic professional harm factors and
prevention occupational diseases
11. Concept about a radio-activity, hygienic characteristic of kinds radiation, shielding materials.
Natural and artificial sources of radiation.
12. Mechanisms of action radiation on the organism, kinds of biological effects of radiation.
13. Radiosensitivity of bodies and fabrics (law Berganie). Groups of critical bodies. Limiting dozes
of an external and internal irradiation
14. Hygiene of work with the closed sources of radiation. Ways of protection from beam defeats.
15. Hygiene of work with open sources of radiation. The hygienic requirements to radiologic
laboratories.
16. A natural radiating background, its structure, level, sources and dynamics of changes. The
contribution of anthropogenous sources to its increase.
17. Failures on atomic power stations, their reason and feature. Failure on Chernobyl atomic power
station, its scales and influence on quality of an environment.
18. Influence of failure on on Chernobyl atomic power station on health of the population living on
polluted territiries. Features of a feed of the population on is radioactive the polluted territories.
19. Concept about serviceability, its dynamics in time and after work, reason of changes of
serviceability. Methods of study of serviceability of the man and it purpose.
20. Changes in organism during work. Exhaustion, reason of its development (theory of
exhaustion). Overfatigue. Prevention of exhaustion on manufacture.
21. Professional harm factors and occupational diseases. Classification. Physical examinations
working: kinds, purpose and organization.
22. The order of registration, account and investigation sharp and chronic occupational diseases in
Ukraine. Prevention occupational diseases.
23. Noise, its classifications, action on the person. Noise illness, its diagnostics and prevention.
MPL of noise and their substantiation for various premises(rooms).
24. Electromagnetic fields, their basic kinds and sources, action on the person. A MICROWAVE -
syndrome: displays and prevention.
25. Vibration, action on the person general and local vibration. Clinic and prevention of vibrating
illness.
26. Industrial poisons, classification it on level of toxity, specific action and ability to cumulation.
The factors influencing on toxic effect industrial poisons.
27. The basic parameters of sharp, half-sharp and chronic toxity of industrial poisons and methods
of it study in experiment.
28. The specific and remote effects of industrial poisons and methods of it study.
29. Ways of receipt and removing industrial poisons. Ways of detoxication poisons in the organism.
Detoxication system of the organism and its parameters.
30. The combined action industrial poisons, its kinds, methods of study and importance for a
sanitary estimation of industrial environment.
31. Kinds of harmful action industrial poisons on organism of working, prevention professional
poisonings.
32. The reasons and displays of poisonings industrial irritating poisons (CO, ammonia, chlorine,
oxides of nitrogen) and aromatic hydrocarbonates (benzol, etc.).
33. The reasons and clinic of professional poisonings heavy metals (lead and mercury); clinical and
hygienic confirmation of the diagnosis.
34. Industrial dust, classification, action on the person, MPC of a dust of different structure.
Diagnostics and prevention pneumoconiosis.
35. Features of work in an agriculture and influence it on the organism working. Basic occupational
diseases, it reasons and prevention.
36. Pesticides, it purpose and classifications on toxity, purpose and chemical structure. An
ecological estimation pesticides on stability in biosphere.
37. Toxicologocal characteristic of the basic groups of pesticides (phosphorus- organic, chlorine-
organic, carbamates, mercury and copper-organic). Indicator enzymes.
38. Hygiene of work at a storage, transportation and application pesticides. Measures on prevention
poisonings by pesticides working and population.
39. Toxicological characteristic of mineral fertilizers (nitric and phosphoric). Hygiene of work at it
application.

Tests for the control level of knowledge

1. What is the work capacity of the man?
1. Functionalities of the person, which are characterized by amount and quality of the work
at its maximal intensity and duration
2. Ability of the man to carry out the certain work without exaustion
3. A condition, which at intensive trainings can not cause harm for the man
2. At graduation examinations the student has answered to the examiner, that the greatest
penetration in organism of the man has alfa- radiation. The correct answer is:
1. neutron
2. alfa
3. gamma
4. beta
5. proton
3. The general area of the hospital ward makes 28 m2. For what maximum quantity of beds this
ward is designed?
1. 7
2. 5
3. 4
4. 3
5. 2
4. Mercurialism- it is chronic poisoning by:
1. Lead
2. Mercury
3. Manganese
4. Nitrates
5. Benzol
5. Factor cumulation – it is relation:
1. DL100 / DL 50
2. DL50 / DL 100
3. DL50 at repeated introduction to DL50 at unitary introduction
3. From what age it is authorized to work in harm professional conditions?
1. since 24 years
2. since 16 years
3. since 20 years
4. since 18 years
5. since 17 years

Situation tasks
1. At the worker of a hothouse at inspection in blood it is the decrease of activity cholinesterase and
cytochromoxidase. What reasons of the given professional poisoning, what preventive measures are
necessary in this case?
2. The doze of an irradiation of the doctor - rdiologist for one week has made 110 mBER, for one
year - 6 BER. What protective measures in this case are necessary?
3. Give a hygienic estimation to working conditions in furniture shop at a dust content of air 30
mg/m3 and level of high-frequency noise 85 dB. What occupational diseases can arise?
The standards of the answers:
1. The reason of occurrence occupational poisoning was the action of high concentration
phosphorus and chlorine-organic pesticides in view of excess of norms of the charge or non-
observance of term of renewal of works in a hothouse after processing pesticides. For prevention
occupational poisoning at the worker it is necessary to stop contact with pesticides before
restoration of biochemical parameters, in the given hothouse to take tests of air, ground, production
on the contents of pesticides and if it excess MPC to carry out a complex of measures on decrease
pesticid loading. For the personnel it is necessary to carry out conversations on observance of the
safety precautions at work with toxic substances (pesticides).
2. The doze of an irradiation exceeds MPD of radiation at an external irradiation (40 mBER per one
week and 2 BER for one year), that can result in chronic beam illness and occurrence of the remote
harmful effects (mutagen, cancerogen, etc.). The radiologist work with open sources of radiation
(allocate radiation and flows of radioactive particles). It is necessary the protection by a doze, time,
distance, screens and complex of measures on prevention of hit radioactive particles inside
organism (hermetic sealing, isolation, ventilation etc.).
3. Working conditions in shop not correct hygienic demands. It may be pneumoconiosis, noise
illness.

Sources of the information.

The basic literature:
1.I.I.Даценко, Р.Д.Габович Профiлактична медицина.- Київ: Здоров'я, 1999.- 694 с.
2.Е.И.Гончарук, В.Г.Бардов, Г.И.Румянцев. Общая гигиена.- Київ: " Вища школа ", 2000.-
652 с.
3.Р.Д.Габович. Гигиена.- Киев: " Вища школа", 1983.- 320 с.
4.Lectures on common hygiene and ecology.- Simferopol, 2003.- 130p.
5.Загальна гiгiена. Посiбник для практичних занять з гігієни. – Львiв,1992.-С. 200-219
6. Пивоваров Ю.П. Руководство к практическим занятиям по гигиене. – 1983
7.Мащенко М.П., Мечов Д.С., Мурашко Радiацiйна гiгiена Харкiв, 1999
8.И.И.Никберг. Гигиена больниц. – Киев, 1993
3. Park’s textbook of Preventive and Social medicine. India, 2000.- 16-th edition. – 660p.
10. Руководство к практическим занятиям по общей гигиене и медицинской экологии. / Под ред. Проф.
С.Э.Шибанова. – Симферополь, 2003. – 260с.
The additional literature:
1. Е.Г.Гончарук. Загальна гiгiена.- Київ, " Вища школа", 1995.- 652 сю
2.В.А.Покровский. Гигиена.- Москва, 1979.- 495с.
3.А.А. Минх. Методі гигиенических исследований. – Москва, 1971.- 584с.
4.В.Ф.Кириллов. Руководство к практическим занятиям по гигиене труда. – Москва, 1993. –
С. 237 - 249
5.В.К. Овчаров. Работа и здоровье медицинских работников. – Москва, 1985
6.А.М. Шевченко.- Гiгiена працi. - Київ, 1993.- С. 228-281

SECTION “HYGIENE CHILDREN AND TEENAGERS”

THEME № 21. PHYSICAL DEVELOPMENT OF THECHILDREN AND

TEENAGERS AS CRITERION OF THE HEALTH.
The Subject and tasks hygiene of children and teenagers (HCT).
HCT - the section of hygiene studying action factors of environment on a growing
organism and developing preventive actions for preservation and strengthening health of
children and teenagers.
Primary goals HCT: studying physical development, development hygienic
requirements to children's preschool and school establishments, to hardening, to physical
training children, to children's toys, hygiene of work of schoolboys and teenagers, hygiene
of children nutrition, realization medical - professional consultations at school.
The basic methods research in HCT.
1) Epidemiological method (studying state of health children's contingents depending on
factors of environment);
2) Method of the sanitary description (sanitary inspection children's preschool
establishments, schools etc.);
3) Method of sanitary examination (examination children's toys etc.);
4) Methods of laboratory experiments (for example, studying influence of harmful
factors on a growing organism in experiments at laboratory animals).
Laws of growth and development children
- Non-uniformity growth and development organism depending on age – than more
youngly organism, that these processes go more intensively;
- Non-uniformity growth and development different bodies and systems in different age;
- Connection growth and development with a sex - unequal rates of growth and
development at boys and girls;
- Influence on growth and development genetic factors, environmental factors and
social conditions, disease;
- Influence of acceleration.
Acceleration as actual problem HCT
Acceleration it is acceleration physical development children and teenagers by
comparison with anthopometric parameters children many years ago. Last 10-15 years
rates of acceleration decreased and even there is decceleration – decreasing physical
development children and teenagers by comparison with anthopometric parameter
children 10-15 years ago.
Theories (reasons) of acceleration.
Till now the universal reason of acceleration is not established in view of big amount
factors influencing physical development.
The basic theories:
1) Improvement qualitative and quantity indicators of nutirtion of the population –
alimentary theory;
2) Decrease of disease, gynecologic pathology because development medicine –
medical theory;
3) Geliogenic theory - influence cyclic changes solar activity and levels of UVR;
4) Ecological theories - growth contents СО 2 in atmosphere, increase intensity of
electromagnetic fields, increase level of natural radioactive level;
5) Theory geteresis - increases mixed marriages between different races and
nationalities.
Medical and social consequences of acceleration
Medical adverse consequences:
- juvenation many diseases (oncological, cardiovascular etc.);
- functional violations development bodies and systems;
- problem of a large fruit in obstetrics due to intra-uterine acceleration;
- necessity revision hygienic norms (norms of feeding, sizes of school furniture,
standards of physical development);
- gynecologic pathology because of early pregnancy and abortions.
Social consequences, caused by backlog of mental development from physical: growth
teenage criminality, growth number of divorces, many children is now without care of
parents etc.
Schemes age periodization.
The biological periodization accepted in HCT:
The period new-born (1-10 days); Baby age - till 1 year; Earlier childhood - 1-3 years;
The first childhood - 4-7 years; The second childhood - boys 8-12; girls - 8-11 years;
Teenage age - boys 13-16; girls - 12-15 years; Youthful age - young men 17-21; girls - 16-
20 years.
Social age periodization:
 Day nursery age - till 3 years; Preschool age - 3-7 years; Younger school age - 7-10
years; Middle school age - 11-14 years; Elder school age - 15-18 years.

PHYSICAL DEVELOPMENT CHILDREN AND TEENAGERS

Physical development – complex of morphological and functional attributes,
determining growth, formation organism of the child, stock of its vital forces, endurance
and capacity.
Physical development - one of the major parameters describing state of health of the
population and influence on it various factors.
For estimation health of children's contingents this parameter is used most
frequently together with disease.
The purposes of research physical development:
- revealing laws of growth and development;
- estimation individual and population level of health;
- studying influence factors of environmental, social environment, genetic factors;
- estimation efficiency of treatment-and-prophylactic measures.
Methods research physical development.
Requirements to methods research:
- application simple and accessible techniques,
- realization researches in one time (it is better - in the morning after dream),
- sufficient accuracy of measurements.
1. Somatometrical (anthopometrical) - growth, weights of body and circle of chest.
2. Somatoscopical - the description the form of skeleton, backbone, chest, legs,
development muscles, state of skin, sexual development by criteria Tanner.
3. Physiometrical - vital capacity of lungs, excursion chest, muscular force, arterial
pressure, pulse.
Methods estimation physical development.
1. Method of indexes, for example, index Broka:
growth in sm - 100 sm = Ideal weight in kg (with coefficients on age).
For children it method is used rare.
2. Method of sigmal deviations.
Sigma in statistics means average quadratic deviation. There are standard tables of
physical development of children and teenagers on age and sex on the basis of statistical
researches of the big contingents where it is underlined average indices of growth, weight
of body and circle of chest with it sigma.
After definition somatometric parameters of the concrete child from it subtract value of
average sizes from the table and difference divide on given sigma.
For example, the boy 10 years old, has masse of the body 45 kg, in table for boys this
age average masse of body – 40 kg, sigma +- 2,5.
Estimation: 45 – 40 kg = 5 kg / 2,5 = + 2.
If quotient from division is from +1 up to -1 - development average (correspond to age
norm); (+1 - + 2) - is above the average; (-1 – 2) - is lower than average; more than (+2) or
low (-2) - high or low development.
Lack of this method - each parameter is estimated separately, without interrelation, it is
impossible to estimate harmonicity physical development.
For elimination this lack method sigmal deviations is offered construction diagram
(profile) of physical development:
Table
The diagram (profile) of physical development:
- 2s -1s M +1s +2s
(average data)
1. Mass of body -------------------------------------------------------------------------------
 2. Growth of body------------------------------------------------------------------------------
3. Circle of chest--------------------------------------------------------------------------------
At it graphically represent the data received on each parameter, if all quotient on 3
parameters within the limits 1 sigma - development proportional (harmonious), up to 2
sigma - disharmonious, more than 2 sigma - sharply disharmonious.
3. On scales of regress (regression sigma), showing on the basis of statistical
researches what the mass of body and circle of chest should correspond to the given
growth. From the received parameters of mass of body and circle of chest of the given
child we deduct the average indices appropriate to the given growth (from estimated
tables) and difference is divided on regression sigma, showing, in what limits changes of
mass and circle of chest in relation to growth are possible at harmonious development.
Variants of estimation: development harmonious in limits from +1 up to -1 sigma;
disharmonious - from +2 up to -2 sigma and sharply disharmonious - more than +2 or less
-2 sigma.
4. Method centyl lines (centyls). American method. Most used in pediatrics.
For research it is necessary not less than 100 children, available on increase of each
parameter (growth, weight, circle of chest), thus the first child named 1 centyl, last - 100
centyl. Development is considered average between 16 and 84 centyls (+ - 2 sigma for
100 supervision). More often in pediatrics it use range 25-75 centyls.
Lacks of this method: the interrelation of parameters and harmonicity of development is
not estimated, for researches plenty of children are necessary.

INSTRUCTION FOR PRACTICAL LESSON ON THE THEME

The educational tasks
1. Anthropometrical, anthroposcopical, physiometrical methods study physical development of
children and teenagers.
2. Methods of an estimation of physical development of children and подростков:
A) Metod indexes
B) Method sigmal deviations and profile of physical development
C) Method of scales of regress
D) Method centyl lines
E) A complex method of an estimation of physical development
3. Definition of groups of health of children
4. Definition of groups for lessons by physical culture
5. Method of comparison of physical development of various collectives of children
6. Laws of growth and development organism of the child.
7. Biological and social schemes of age periodization.
8. Acceleration. The theories, essence, consequences, phenomenon decceleration.

Tests for the control of the level of knowledge

1. What range of centyls testifies to the growth, appropriate to age, of the child?
1. 25-75
2. 5-95
3. 16-84
4. 20-80
5. 3-97
2. How many groups of health are known at children?
1. 2
2. 3
3. 5
4. 4
5. 6
Situational tasks
1. At medical inspection of the schoolboy 14 years is revealed chronic tonsilitis, caries. At
inspection - growth average, physical development harmonious. Determine group of health.
2. Estimate physical development Tenya L., 14 years by method of scales of regress. Growth of the
child - 120 sm (+0,5 sigma regression), weight of a body - 20 kg (+0,8sR), circle of a breast - 90 sm
(+0,4sR).
The standards of the answers:
1. 3-th group of health, as at the child are present chronic tonsilitis
2. Differences between all regression sigma not more, than 1, therefore physical development is
harmonious.

Sources of the information.

The basic literature:
1. Е.И.Гончарук, Ю.И.Кундиев, В.Г.Бардов. Общая гигиена. Пропедевтика гигиены.-
Київ: Вища школа, 2000, 2 изд. –652с.
2.І. І .Даценко, Р.Д.Габович. Профілактична медицина. – Київ, 1999.- 694с.
3. І. І .Нікберг, І .В.Сергета, Л. І. Цимбалюк. Гігієна з основами екології.- Київ, 2001.- 504
4.Lectures on common hygiene and medical ecology.- Simferopol, 2003. - 160p.
5. Park’s textbook of Preventive and Social medicine. India, 2000.- 16-th edition. – 660p.
6. Руководство к практическим занятиям по общей гигиене и медицинской экологии. / Под ред. Проф.
С.Э.Шибанова. – Симферополь, 2003. – 260с.
The additional literature
1.Г.Н. Сердюковская и др. Гигиена детей и подростков. – Москва, 1986.- 420с.
2. В.И.Берзинь и др. Руководство к практическим занятиям по гигиене детей и подростков.-
Киев, 1989.- 120с.

THEME № 22.
HYGIENIC REQUIREMENTS TO CHILDREN'S PRESCHOOL
ESTABLISHMENTS AND SCHOOLS.

HYGIENIC REQUIREMENTS TO CHILDREN'S PRESCHOOL

ESTABLISHMENTS (CPE).
Kinds of CPE: kindergarten (for children 3-7 years), day nursery (till 3 years),
children's combine (day nursery + kindergarten), children's home, the preschool children's
home, specialized CPE for children with infringements of development, preschool
improving establishments for summer holiday.
Requirements to choice site of CPE
- Availability to population - radius of service in city – 300 m;
- Optimum hygienic conditions on the site (optimum microclimate, absence air pollution by
chemical and physical factors, presence of green plantings).
Requirements to site of CPE:
1. The area of site is 30-40 m2 on 1 child.
2. There are must be 2 entrances - main and economic, the form of site - rectangular.
3. There must be special functional zones on site - principle of group isolation: Zone
building; Zone group play-grounds; Zone sports platforms; Economic zone; Zone green
plantings.
Requirements to functional zones at site of CPE.
ZONE BUILDING.
Systems of building CPE
1) Centralized (is not good from hygienic position - all groups and economic premises
(rooms) - in one building),
2) Decentralized (many buildings, need a lot of the place, expensive construction),
3) Block (modern projects - the block of day nursery, kindergarten, gymnasium, the
economic block).
The building must be not closer 25 m from border of site, is surrounded with green
plantings (trees - not closer 10 m, bushes – 5 m from a building – for the normal natural
light exposure).
ZONE GROUP PLAY-GROUNDS
Group platforms must have square 7,2 m 2 on the 1 child, a shadow canopy 40 m 2,
game and sports equipment according to age. Calculation necessary amount of platforms -
1 platform for 2 day nursery groups or for 4 kindergarten groups. Platforms are separated
by zone of green plantings.
ZONE SPORTS PLATFORMS
There must be 2 sports platforms 150-250 m 2 - separately for younger and senior
age groups, there are racetracks, other sports equipment.
ECONOMIC ZONE
It is located in a distant part of a site, is closer to economic entrance, must be
separated by green plantings.
ZONE GREEN PLANTINGS
Should occupy not less than 50 % of the area of a site. Among plants there should
not be with the prickles, rendering irritating and allergenic action, poisonous wild-growing
plants.
REQUIREMENTS TO the LAY-OUT of BUILDING CPE
Major principle of the lay out is the group isolation:
1) prevention infectious diseases,
2) opportunity of quarantine actions;
3) various mode of day in different age groups;
4) prevention traumatism at association children different age.
 The building must be not higher than 2 floor, the basic groups of premises: group cells,
general purpose premises, medical premises, administrative.
HYGIENIC REQUIREMENTS TO the GROUP CELL
Group cell is the basic functional part CPE - the set of premises intended for 1
group of children. Structure of group cell: reception - locker room, group room (or
separately game room, bedroom, dining room), buffet, bathroom, verandah (for day
nursery groups).
Reception - locker room - the area 18 m 2, cases for outer clothing, benches, racks
for the toys used on walks. In day nursery groups – also must be tables for feeding
children by mothers.
Group room - the common room or is divided into game room and bedroom. The
general area is 4 m2 on 1 child. Hygienic requirements:
Microclimate - temperature of air 21-22 oC (day nursery) or 18-20oC, humidity 40-60
%, speed movement of air 0,1-0,3 m/s.
Ventilation: frequency rate 3, volume ventilation on 1 child 20 m 3/hour, CO2 - up to
0,1 %.
Illumination: natural - LC 1/4-1/5, CNI - 1,5 %, corner of falling on tables 27 o, corner
of aperture – 5o. Artificial common illumination - 150 lux.
Premises general purpose: gymnastic and music hall (75m 2), methodical study,
additional: swimming pool, visual hall, study for manual skills and drawing.
Medical premises: medical room, procedural study, isolator.
Administrative premises: study of the manager with a hall for realization meetings
with parents, wardrobe for the personnel, washing and ironing, kitchen.

HYGIENIC REQUIREMENTS TO the EQUIPMENT IN PCE

Hygienic requirements to children's furniture:
1) conformity to the anthopometrical sizes of children,
2) trauma safety,
3) must be made of not toxic materials (better from tree),
4) must be covered by non toxical paints, smell of paint – not more 1 point.
Hygienic requirements to toys in PCE:
1. Weight: till 3 years - up to 100 g, 3-7 years – 400 g, more than 7-10 years – 800 g.
2. The sizes of fine details till 3 years - not less than 3 sm (may be aspiration small
details).
3. Material is food grades of rubbers and plastic. Paints must be not toxical, steady to
disinfection, smell of paints till 3 years - 1 point, 7 years - 2 points.
4. Application the toys which are badly can be disinfected (soft toys) is not recommended.
5. Electric voltage in electric toys - up to 12 Volt.

HYGIENIC REQUIREMENTS TO SCHOOLS.

Requirements to accommodation schools:
1) availability (radius of service 1,5 km in city and 3 km - in village);
2) optimal hygienic conditions in a place of a site.
Requirements to a school site
The area - 20-50 m2 on 1 pupil, the rectangular form.
Functional zones of school site: Zone building (school building); Zone rest; Educational
- skilled zone; Sports zone; Economic zone; Zone green plantings.
Zone building - building must be not closer 25 m from borders of a site, is surrounded
with a strip of protective green plantings (not closer 5-10 m from a building – natural
illumination at 1 floor).
Zone rest - 2 platforms for outdoor games for younger and senior classes, platform for
silent rest, bench.
Educational - skilled zone - garden, kitchen garden, hothouses, educational workshops
etc.
Sports zone - stadium with racetracks and holes for jumps, platform for volleyball, sports
shells etc.
The economic zone - at the end of a school site is closer to economic entrance, is
separated by green plantings.
Zone green plantings - not less than 40-50 % of the area of a site.
Requirements to school building.
Systems of school construction:
1) Centralized (all premises in one building - old projects - high level of infections, noise,
air pollution),
2) Pavilion type (many small buildings, it is accepted now for schools of sanatorium type),
3) Block type (blocks for younger, average, senior classes, for sports hall, kitchen).
The basic groups of premises in school:
Educational section, general purpose premise (lobby, wardrobe, dining room, sports
hall, assembly hall, library etc.), office accommodations (studies of the director, teachers, a
first-aid post, eating establishment).
The basic functional unit in school is educational section - some classes or studies,
zone of recreation (hall, corridor), bathroom. Unilateral building of a school corridor with
windows and halls is optimal.
Hygienic requirements to a class room at school.
The area must be 1,25 m2 on 1 pupil, as a whole not less 50 m2.
Microclimate - as for usial premises, frequency rate of ventilation - 4, volume 20-30
3
m /hour on 1 pupil, concentration CO2 in air not more 0,1 %.
Requirements to illumination are very important:
- Natural: LC 1/4-1/5, CNI - 1,5 %, corner of falling 27 o, corner of aperture – 5o;
- Artificial: common illumination 150 lux (luminescent lamps - 300 lux).
Requirements to school desks (educational tables): In class must be desks not less
than 3 sizes, are placed in 3 lines, distance between lines 0,7m, up to school board 2,5m,
up to walls 0,5m.
Hygienic requirements to educational laboratories.
Laboratory chemistry, physics, biology. The area 70-100 m 2, have laborant room 6
m2, it is better to place it on the top floors of school building (better airing), should be
equipped with artificial ventilation, waterpipe for washing utensils and the equipment.
Advantages and lacks of laboratory system building school.
Advantages: it is easier to concentrate the equipment and didactic material in 1-2
studies and not transfer it to different classes.
Lacks: the big counter streams of schoolboys on changes (infection), reduction time
of recreation, discrepancy of furniture to anthopometrical parameters of schoolboys
different age.
Requirements to sports hall at school.
It is better to have it on 1 floor, at block system of construction - in the separate
block (noise prevents lessons in other classes). The area – 4 m 2 on 1 pupil, height 4,5-6
m, should be a locker room and material for storage of stock. Feature of microclimate - air
temperature 160C (overheating children at intensive physical activity), frequency rate of
ventilation 4-5.
Common hygienic requirements to school furniture:
- Conformity to the anthopometrical sizes of children (prevention infringements of the
skeleton and eyes)
- Trauma safety;
- Non toxity materials and dyes, stability to disinfection;
- Light or green colouring tables.
 The sizes of school desks (tables).
In each class must be desks not less than 3 sizes, at schools are used desks 6-12
sizes having multi-coloured marks for the teacher. In the beginning education the teacher
should distribute schoolboys on the sizes (ruler Flerov or under formula Listov: № school
desks = 2 first figures of growth - 5).
Hygienic specifications of school furniture (see picture):
1. Differention - vertical distance from a table to chair – must be 1/7-1/8 part of
growth or from the lowered elbow to sitting.
2. Distance of sitting - horizontal distance between edge of table and edge of
sitting – must be (- 4 –5) sm.
3. Distance back of chair - horizontal distance from edge of table up to back of
sitting = front-back section of a body + 3-5 sm.
4.Height of sitting - length of a shin + 2 sm.

Picture
Distance of a seat of desk.
A - negative, б - zero; В - positive.
 Medical - professional consultation and orientation at school.
It will be carried out by doctors, teachers and experts of the centers of employment
of youth with the purpose definition the future trades and the recommendation to
schoolboys the trades, suitable for them on a state of health.
Professional orientation: reference service about presence of vacant trades,
psychological consultations in view of type of the supreme nervous activity.
Medical professional consultations.
It is carry out 2 times - 1) in 5 class for children with defects of physical
development, for the others - in 7 class, 2) at 10-11 classes. First time - for early revealing
and treatment the diseases limiting work capacity, second time - for final definition of
trades.
At realization medical professional consultations is used the medical documentation
on the schoolboy, definition physical development, physical examination, if necessary - the
profound medical inspection in hospital.
From the medical point of view all trades share on 4 groups:
- Where there are no heavy working conditions;
- Connected to action harmful factors;
- Are connected to constant influence complex harmful factors;
- Are connected to heavy and harmful working conditions.
Hygienic requirements to technical training college.
Accommodation is close to the base industrial enterprises or on surburb of
settlement. The size of a site – 20 m 2 on 1 pupil. Functional zonning: industrial practice
zone (the theoretical case and educational workshops), sports (it is increased in
comparison with school), economic, inhabited (hostel), green plantings. At block system of
building - the appropriate blocks. Requirements to a hostel: the area – 6 m 2 on 1 person, a
first-aid post.
 INSTRUCTION FOR PRACTICAL LESSON ON THE THEME

The educational tasks

1. The hygienic requirements to the site of CPE. Functional zonning of a site
2. The hygienic requirements to a group cell in CPE(lay-out, illumination, microclimate)
3. The hygienic requirements to children's toys, clothes and footwear
4. The hygienic requirements to a mode of day children of different age.
5. Organization of physical education and its control
6. Adaptation of children to training at school
7. Definition of readiness of children to training at school
8. Definition " of school maturity " under the test Kern-Ierasik
9. The medical indications to a delay of receipt in school of children of six-years
10. The hygienic requirements to a site and area of a school site.
11. The hygienic requirements to a lay-out and building of the ground area of school, functional
zonning of a site.
12. Systems of school construction. The hygienic requirements to a building of school.
13. The hygienic requirements to the basic functional groups of premises (rooms) of school.
14. The hygienic requirements to a class
15. The hygienic requirements to a sports hall, rational construction of a lesson of physical culture.
16. The hygienic requirements to school furniture.
17. The hygienic requirements to the equipment of school workshops
18. The hygienic requirements to the school time-table of lessons.
19. Organization of health services at school.
20. Organization of medical-professional advices at school.
Tests for the control level of knowledge
1. For how many 5 year children one group cell in CPE is designed:
1. 20 children
2. 10 children
3. 5 children
4. 30 children
5. 25 children
2.What is a group cell in CPE?
1. a Room for games
2. a Premise (room) for walks
3. a Set of premises (rooms) for stay of one group of children
4. a Set of premises (rooms) for all structure of children in CPE
5. a Set of premises (rooms) for health services of children
3. On one pupil in a class should have of cubic metre of air:
1. 3,75м3
2. 4,75м3
3. 1,25м3
4. 1,0м3
5. 5,0м3
4. The educational section in school is:
1. a Set of premises (rooms) for stay of one class
2. a Premise (room) of a class
3. a Set of premises (rooms) for stay 3 classes of children of one age or 2 classes of
adjacent age groups (2 and 3 classes) with common for them a recreational premise (room)
4. One block at school at a block lay-out
5. a Set of premises (rooms) for stay of children 1 - 10 classes

Situational tasks
1. On the ground site of CPE there are following zones: green plantings, group platforms,
economic, building. On each child it is 10 sq. meters of the ground area. Radius service of CPE -
500 m. What hygienic specification is broken in this case?

2. At Tanya С. before receipt in school defined by the test Kern-Ierasik readiness for training at
school. Thus, total of numbers received by her - 5. Whether she is ready to receipt in the first class?

3. On the ground area of a rectangular configuration by the area of 4,4 hectares (44000 м2) in city it
is planned the construction of a comprehensive school for 40 classes. The borders of a site are on
distance of 55 meters from inhabited and public buildings. On the ground area there are green
plantings - white acacia, oak, pine, wild grapes. Give sanitary - hygienic estimation to the ground
area. Solve the problem on an opportunity of use of available green plantings in scholl site.

4. Give a sanitary - hygienic estimation to accommodation of various premises (rooms) of a

comprehensive school. The building of school is a block type, has three floors. On the first floor of
a building are located: tambour, lobby - wardrobe, corridor, teacher's study, 5 classes, 2 studies of
chemistry, library, toilet for the schoolboys and personnel of school. On the second floor - 3 studies
of the English language, 2 studies of plotting and fine art, 3 studies of mathematics, 3 studies of
physics, 1 study of Russian and literature, 2 studies of chemistry, study of the director, recreation
hall, toilets. On the third floor - 3 studies of biology, study of the doctor, teacher's room.
The standards of the answers:
1. The area of the ground site of CPE on one child is reduced (in norm it is 40 m2).
2. She is not ready (minimal norm of the test – 9)
3. The area of the ground area is sufficient. The cultivation on a site of schools a wild grapes is
forbidden.
4. The studies of chemistry should settle down on last (3-d) floor, study of the doctor - on the first
or second floor
 Independent work for the students
Sanitary inspection of comprehensive schools and children's preschool establishments

The appendix № 1

THE SCHEME OF SANITARY INSPECTION OF CHILDREN'S PRESCHOOL

ESTABLISHMENT (CPE)
1. Name of checking and present on inspection.
2. Name CPE, address, date of inspection.
3. Area of the ground area, amount of square meters for one child. Presence of all functional
zones on a site.
4. Zone of green plantings: percent from the general area of a site, on what distance from borders of
a site the trees and bushes are located.
5. A zone of group platforms: on how many of groups one group platform is designed, whether
there is any equipment, shadow canopies
6. Zone of sports platforms: how many them are present, equipment of it
7. Economic zone: where is located, what into it enters, whether it is separated from other zones by
green plantings.
8. Zone of building: an arrangement of a building (in meters) from borders of a site, system of
building, how many floors. Scheduled number of places in CPE. An arrangement day nursery and
preschool group cells in a building.
9. Structure and equipment of premises (rooms) of a group cell: reception room, group room,
buffett, bathroom.
10. The hygienic requirements to children's furniture are observed: conformity to age and growth,
safety, the colouring, smell, from what material is made.
11. What toys are available in a group room (weight, material, smell, colouring).
12. How many children visit one group cell.
12. Microclimate and illumination (artificial and natural) in a group room
13. Is there are premises (room) of general usage: a gymnastic, musical hall, methodical study. It
equipment and arrangement.
14. Arrangement and equipment of medical premises (rooms) (medical room, procedural study,
isolator)
15. The arrangement of administrative - economic premises (rooms) (study of the manager, laundry,
kitchen)
16. Catering services of children:
А) Presence of cold and hot flowing water;
B) Security by a refrigerating machinery, kitchen utensils, marks;
C) Sanitary condition of premises (rooms) of the kitchen, presence detergents and disinfectants;
D) Complect of the staff, presence of the sanitary books, timeliness of passage of physical
examinations.
17. The conclusion about sanitary state of PSE
18. Specify all revealed lacks.
19. The recommendations and plan terms of liquidation of lacks
Date: the signature:
 THE APPENDIX № 2

THE SCHEME of SANITARY INSPECTION of SCHOOL

1. Name of checking and present on inspection.
2. Name of school, address, telephone, date of inspection.
3. Area of the ground area, its gardening, presence of game and sports platforms, it equipment.
4. Building typical, specially constructed or adapted.
5. Scheduled number of places at school.
6. Number learning in classes.
7. Number of classes at school, amount of the pupils, which are engaged in the first and
second classes.
8. Amount of class rooms, studies, their area.
9. Average of the pupils in 1-3, 5-8 and 9-11 classes, area in classes on one pupil.
10. Equipment of school by tables, marks at it, number non-standard tables on an example of
one - two classes.
11. Distribution of the pupils for tables according to their growth and condition of health.
12. Presence of a sports hall, its area, equipment, presence at a sports hall of undressing rooms,
bathrooms. Division learning on sports by groups.
13. Presence of industrial workshops, their area, equipment, arrangement of machine tools, sizes
of passes, presence of supports to machine tools used in workshops tools, conformity of their sizes
to age of the pupils.
14. Illumination at school (classes, studies, workshops, sports hall). Natural, artificial
(luminescent or incadescent lamps). Artificial illumination, amount of electropoints, name of the
electrofixture, capacity of lamps (Vatt/m2).
15. Heating of school (central, oven). An air-thermal mode in premises (rooms), temperature of
air in classes, workshops, sports hall. A mode of airing of premises (rooms). Presence of
mechanical ventilation.
16. A drinking mode, presence drinking furniture.
17. The water drain of school, sanitary - technical condition of sanitary units.
18. Room system of training, presence of studies for two age groups.
19. A hygienic estimation of the time-table of lessons in younger, average and senior classes
(on an example of one class in these age groups).
20. Presence of breaks between lessons and its time.
21. A sanitary - hygienic condition of school, quality of the current cleaning.
22. Organization and control of self-service.
23. Catering services of children:
А) Presence of a restaurant, buffet, amount of landing places in a lunch hall;
B) Presence of cold and hot water;
C) Security by a refrigerating machinery, kitchen utensils, marks;
D) Sanitary condition of premises (rooms) of a restaurant, presence detergents and disinfectants;
E) Complect of the staff, presence of the sanitary books, timeliness of passage of physical
examinations.
24. Amount of groups of the prolonged day at school. Presence of the premises (rooms) allocated
for prolonged day.
25. Personal hygiene of the pupils.
26. Health services:
А) The surname, name of the doctor, medical syster, medical establishment, which serves school;
B) Presence of a medical study and its equipment; presence of a separate study of the dentist;
C) Medical control of a sanitary condition of school, restaurant, hygienic condition of training,
condition of health of the pupils.
27. PRESENCE In SCHOOL LIBRARY of the POPULAR MEDICAL LITERATURE.
27. Hygienic preparation of the personnel of school.
28. The conclusion about sanitary state of school.
29. Specify all revealed lacks.
30. The recommendations and plan terms of liquidation of lacks, having coordinated them with
administration of school.
Date: the signature

The appendix № 3
The estimation of a scale of difficulty of lessons in school
Range scale of difficulty of school subjects (in numbers)
Mathematics, Russian 11
Foreign languages 10
Physics, chemistry 9
History 8
The literature, native language 7
Biology, geography 6
Physical culture 5
Work 4
Plotting 3
Drawing 2
Singing 1
THEME: HYGIENIC REQUIREMENTS TO LEARNING, PHYSICAL
TRAINING AND HARDENING CHILDREN AND TEENAGERS.
Hygienic requirements to learning children and teenagers.
The basic problem of learning is necessity mastering big amount of the information,
which is doubled each 10 year.
Therefore by development hygienic requirements to learning it is necessary to solve
two problems:
а) To give the child volume of knowledge necessary for professional work and skills;
b) To keep health of children, to not allow overfatigue.
The basic ways decision this problem (in any educational establishment, including
in high school):
1) The increase terms of learning - is already impossible by physiological opportunities of
organism;
2) Optimization learning - use new intensive forms of learning, rational drawing up and
revision of schedule, optimization mode of learning and rest.
In difficult process of learning children it is possible to allocate 2 main stages:
1) Development skills of long sitting, the letter, reading, concentration of attention -
preschool stage (in preschool establishments, houses etc.);
2) Stage of accumulation knowledge, development logic and abstract thinking – it is at
school, technical training college, in high school. It is the most difficult stage.
Ways of adaptation to learning at school - 1-st stage:
Gradual change of dynamic stereotype - mode of day of the child:
- In 3-5 years - 2 lessons till 15-20 mines as game;
- In preschool group - 4 days per one week with 4 lessons by the common duration 1 hour
50 mines per day;
- In 1 class - up to 20 lessons per one week on 35 mines (no more than 4 lessons per
day).
Age of the beginning learning at school.
It is determined not by calendar age, but psycho-physiological features of the child,
his physical development, state of health. It is the important problem for the pediatrist.
There are some psycho-physiological tests for definition readiness for learning at
school (for example, test Kern-Ierasik).
Exhaustion and overfatigue of schoolboys and its prevention.
At the wrong organization of educational process among schoolboys frequently
observed attributes of exhaustion and the overfatigue, resulting subsequently to violations
of health.
Attributes of exhaustion of schoolboys:
- Decrease efficiency of work (growth number of mistakes and decrease volume of the
processed information at realization corrector test);
- Easing internal braking (growth number distractions of attention, excitation);
- Deterioration regulation physiological functions (violation intimate rhythm and
coordination of movements);
- Occurrence feeling of weariness.
Usually these attributes quickly pass during breaks and after school, their long
preservation testifies development of overfatigue:
- Sharp and long decrease of serviceability;
- Psychological frustration (infringements of dream, feeling of fear, hysterics);
- Proof infringement regulation of vegetative functions (arythmya, vegetative vascular
distonya, infringements function of internal bodies);
- Decrease resistibility to infections etc. adverse factors.
 PREVENTION exhaustion at schoolboys:
1) Creation optimum hygienic conditions of learning: normal light exposure, ventilation,
microclimate, observance MPL of noise etc. harmful factors.
2) Optimization mode of learning - correct drawing up the schedule of lessons, correct
construction of a lesson, effective utilization breaks, optimum mode of day;
3) Optimization and revision schedules of lessons.
Hygienic requirements to the school schedule:
а) Restriction amount of lessons per one week: in 1 class - up to 20 on 35 mines, 2 class -
up to 22 on 45 mines, 3-4 class - 24, 5-8 class - 30, in 9-11 class - 31 lesson per one
week;
b) Distribution lessons on complexity within day and weeks:
Scale complexity of lessons - the exact sciences - 11 points, singing - 1 point.
Requirements: it is impossible to put 2 difficult lessons together, in the beginning and at
the end of day and week. A maximum of complexity of lessons must be on Tuesday –
Wednesday (middle of the week). It is correspond to dynamics of serviceability.
Hygienic requirements to structure lesson.
Researches serviceability of schoolboys has shown: phase in-work is in the first 5
mines, phase of working excitation - 5-25 mines, then - beginning exhaustion. From here
recommendations for construction of a lesson: the prologue must be 10 mines, the basic
part (explanation new material) - up to 25 mines, then - repetition. Using physical training,
game elements etc.
Rational use school breaks.
Break after each lesson must be 10 mines, after second lesson - main break for 30
mines or two for 20 mines - after 2 and 3 lessons. Their use for other actions is forbidden.
During breaks it is necessary the maximal stay children on open air.
Hygienic requirements to mode of day of children and teenagers.
Main principles of hygienic requirements:
- Conformity to daily biorhythms of the child;
- The maximal preservation of a dynamic stereotype, if necessary - its gradual change (the
new mode should be entered gradually);
- Rational distribution of the basic components of a mode of day (dream, study, games,
stay on air, a feed, personal hygiene) within day and their alternation;
- Conformity to limits of serviceability and to psycho-physiological opportunities of the
child.
THE BASIC COMPONENTS of DAY REGIMEN of CHILDREN And TEENAGERS
1. Dream. In the new-born age - dream inordinate - 16, 5 clocks.
Day dream: at 1,5 - 2 years - 2,5 - 3 hours.
From 3 up to 6 - 7 years - 2 - 1,5 hours.
Night dream: since 1 year till 7 years - 10 hours 40 minutes - 10 hours 15 minutes.
From 8 years dream only at night:
At 8 - 10 years - 10 clocks, 11 - 14 years - 9,5 - 9 clocks, 15 - 17 years - 9 - 8 clocks.
2. Stay on fresh air
Up to 1,5 years stay on open air is at the day dream.
At 2 - 3 years - not less than 4,5 - 5 clocks per day (2 walks - in PCE and house before
dream)
At 4 - 6 years - 4,5 - 3,5 hours
At 7 - 10 years - 3,5 hours
At 11 - 14 years - 3 hours
At 15 - 17 years -2,5 hours
3. Educational activity
At 1,5 - 2 years - some occupations per one week on 8 - 10 minutes.
At 3 - 4 years -10 occupations on 10 - 15 minutes
 At 4 - 5 years - 10 occupations on 20 minutes
At 5 - 6 years - 15 occupations on 20 - 25 minutes
At 6 - 7 years - 19 occupations on 25 - 30 minutes
At school: 1 class - 20 occupations on 35 minutes, 2 classes - 22 occupations 45 minutes,
3-4 classes - 24 occupations, 5 - 8 classes - 30 occupations, 9 - 11 classes - 31
occupations per one week
4. Game activity or rest
In prescholl age - 4,0 - 5 hours, for schoolboys - 1,5 - 4,0 hours.
5. Receptions of nutrition and personal hygiene.
2,5 - 4 hours per day (morning, evening toilet, charging, hydro procedures, changing
clothes, transferrings, receptions of nutrition).

HYGIENIC REQUIREMENTS to physical training of children.

Moving activity is necessary condition of normal development organism of the child.
It is measured in locomotions.
At infringement of physiologically caused need of organism of the child in
movements may be 2 states:
а) hypodynamya (low moving activity) - asteno-vegetative syndrome, syndrome detraining,
excess weight. The reasons: wrong mode of day, disease, climatic conditions, social
factors;
b) hyperkinesia (high moving activity, which do not correspond to abilities of organism) -
miocardiodysthrophya, proof arterial hypertension. The reasons: speeding up employment
by sports, aspiration of full children to grow thin.
Hygienic requirements to physical training of children:
Main principles: Individuality; Adequacy to a state of health and opportunities of
organism; Systematic; Gradual increase loading at the medical control; Favorable psycho-
emotional condition and conditions of Environment.
Estimation adequacy of physical loading:
1) By external attributes: reddening of the person, frequency of breath, degree of
perspiration etc.;
2) By methods studying physical serviceability: on time of development physical
exhaustion;
3) On a pulse rate: measure before lesson (initial level) and everyone 5 mines during a
lesson of physical culture. Criteria: increase of pulse at unitary measurement - up to 90 %
from initial, on the average for a lesson - up to 50 %.
Requirements to duration moving activity in a mode of day:
The moving component of a mode of day should be up to 50 % of time of rest, thus
70 % of it are regular forms of physical culture, 30 % - independent moving activity.
UNITS OF MOVING ACTIVITY
Amount of locomotions (walks) per day
H = 1,3 n, where: H - necessary number of walks per day (in thousand walks)
n - age in years
2. Duration of a motorial activity.
T = 6,5 - 0,2 n, where: T - duration of a motorial activity per day (in clocks)
n - age in years

The note: At usage these formulas a standard deviation from daily norm - no more than 10
%.
For the girls in the teenage age (13 - 15 years) the estimated values of daily amount of
walks and time of locomotion should be diminished by 15 %, in connection with
physiological drop dynamical activity in this age.
 Hygienic requirements to hardening children.
The purposes of hardening:
а) Development and perfection thermoregulation organism (basically due to training a tone
of peripheral vessels). Features thermoregulation at children: increased heat-production
because of high basic exchange; high heat-return - big surface of body, lability vessels;
b) Adaptation to change climatic conditions;
c) Decrease sensitivity to cold diseases.
Principles of hardening - see principle physical training.
receipt Са and Р, because it participates in forming bones. Enough magnesium - 12-13
INSTRUCTION FOR PRACTICAL LESSON ON THE THEME

The educational tasks

1) Concept about a daily mode of day, distribution of its components within day in various age and
its physiological bases (dream, stay on open air, educational occupations, game activity and rest at
an own choice, reception of food and personal hygiene)
2) CONCEPT About IMPELLENT ACTIVITY. UNITS OF MEASUREMENTS IMPELLENT ACTIVITY.
3) Hypodynamia. The reasons, attributes, prevention.
4) Basic reasons, display and prevention hyperkynesia.
5) BASIC METHODS of PHYSICAL EDUCATION SCHOOLBOYS. THE HYGIENIC
REQUIREMENTS To CONSTRUCTION of a LESSON of physical CULTURE. The hygienic
requirements to a lesson of physical culture in schools.
6) BASIC PRINCIPLES of hardening of CHILDREN And TEENAGERS. THE BASIC KINDS of
hardening
7) Organization of hardening childs and schoolboys
8) Definition of readiness of children to training at school
9) Definition " of school maturity " of the children by the test Kern-Ierasik
10) Medical indications to a delay of receipt in school of children of six-years age

The tests for the control level of knowledge

1. To irreplaceable amino acidsа only for children concern:
1. Argynin
2. Gystidin
3. Methyonin
4. Cystin
5. Valin
2. Average level of a pulse rate during lesson of physical culture should be not more above initial
than:
1. 30 %
2. 40 %
3. 50 %
4. 80 %
5. 90 %

Situational tasks
1. Natasha С., 16 YEARS, GROWTH AVERAGE, WEIGHT of a BODY IS HIGHER AVERAGE
BY FATTY, the FUNCTIONAL PARAMETERS ARE REDUCED, 7 TIMES Per ONE YEAR
WAS SICK SHARP PESPIRATORY VIRUSES INFECTIONS. Within DAY 7 HOURS ARE
ENGAGED At SCHOOL, CARRIES OUT the HOME TASKS - 3 HOURS, ADDITIONAL
OCCUPATIONS ON PHYSICS And CHEMISTRY - 2 HOURS, VIEWING of the TV SET - 3
HOURS. PHYSICAL CULTURE DOES NOT ATTEND. FEEDING 5 TIMES Per DAY, RATIO
of PROTEINS : FATS : CARBOHYDRATES = 1 : 1: 4, DAILY CALORICITY OF FOOD - 2600
Kcal. WHAT BASIC REASON of the GIVEN SYMPTOMS?
2. Schoolboy C. 16 years, morphologic and functional parameters are higher average. Is engaged in
athletics section. On competitions occupies the first places. At medical survey is revealed
myocardiodystrofy, arterial hypertension. 10 days before the inspection has had been ill SHARP
PESPIRATORY VIRUSES INFECTION. Name the probable reason of the given changes.

The standards of the answers:

1. Hypodynamia
2. Hyperkynesia
 SECTION HYGIENE of the HOT CLIMATE.

THEME № 24. HYGIENIC CHARACTERISTIC OF THE HOT CLIMATE AND

ITS INFLUENCE ON THE PERSON. HYGIENE OF NUTRITION, HYGIENE
OF WORK, PERSONAL HYGIENE AND HYGIENE OF LIVING ROOMS IN
CONDITIONS OF THE HOT CLIMATE.

Characteristic of the hot climate.

The climate of South countries can be conditionally divided into 2 kinds: tropical
climate and climate of deserts.
Tropical climate.
Feature of it - constant high temperature of air with insignificant daily and annual
fluctuations (1-60C). There is the high level of solar radiation (100 and more Kcal\sm 2).
Next feature - high humidity of air -80-90 %, sometimes 100 % (at night). In it kind of
climate usually is high level of annual deposits, 2 periods of rains in one year (totally about
7 months). The combination of high temperature and humidity of air at its insufficient
circulation conducts to formation fogs, activization degradation processes in fallen foliage
therefore in air contents СО2 rises up to 0,3-0,4 %.
Climate of deserts.
There is small amount of deposits and low humidity of air - up to 5 %. As against
tropical climate, the temperature of air in deserts more various with significant fluctuations
within day (in Northern Sahara in December temperature at night –14 0C, at day +25-300C).
There is often strong winds and high dust content of air (sandy storms).
The listed features of these 2 kinds of climate considerably influence on organism of
the person and processes thermoregulation, at hit person in these climatic conditions from
other climate processes of acclimatization are sharply expressed. At acclimatization in
organism there are complex processes of reorganization functioning bodies and systems,
it is marked breaking established "dynamic stereotype" - mobile balance organism with
environment and establishment new balance according to changed climatic conditions.
This process occupies various period, that depends on level of health, adaptable
opportunities, age, etc.
The first phase of acclimatization is adaptation (partial acclimatization) from the first
hours about 14 day, 2 phase - full acclimatization - some months - year, sometimes is
more. During acclimatization, it is especial in 1 phase, is observed the asteno-vegetative
syndrome, increase of disease, decrease serviceability.
Influence of a hot climate on the system of the thermoregulation organism.
The major factors influencing on thermoregulation in hot climate are the high
temperature and humidity of air. The system thermoregulation of the person provides
maintenance temperature of his internal environment in narrow constant range. Rise
temperature of body on 2-3 acclimatization 0C essentially influences at function CNS,
cardiovascular and renal systems, it increase on long terms on 4-5 0C and more is
incompatible to life.
Thermoregulation - the complex process, consisting from heat-formation (chemical
thermoregulation) and heat-return (physical thermoregulation). Heat-formation is provided
due to biochemical exchange processes (so, at easy work in organism of the person it is
formed about 3000 Kcal heat for day). In hot climate organism receives from environment
additional amount of heat (up to 200-400 Kcal / hour). The level heat-formation in
organism basically depends on temperature of air; the zone of indifference is 15-25 0C, at
higher temperature heat-formation is reduced. Heat-return consists of conducting heat to
air (convection), thermal radiation IR-beams and evaporation sweat. In conditions of hot
climate at high temperature and humidity of air these processes are reduced that conducts
to overheating organism and occurrence infringements thermoregulation: heatstroke,
thermal spasmes, thermal faint, thermal exhaustion by water and salt losses, thermal
hypostasis of foot.
The factors conducting to overheating of organism.
- High temperature and humidity of air, small speed air movement;
- Heavy muscular work - increases heat-production;
- Multilayer clothes;
- Insufficient water inflow in organism - is worsened ewaporation of sweat.
The heatstroke more often arises at people with cardiac-vessel diseases (hypertension,
heart diseases), endocryn diseases (adiposity, hypertireosis). Overheating easily comes at
children till 1 year. Depending on prevalence of those or other symptoms distinguish some
forms of heatstroke: 1) cardio-vascular, 2) pulmonary (atelectasis), 3) brain, 4) shock, 5)
delirious.
On weight it may be easy, average and heavy degree.
Influence hot climate on a water and mineral exchange.
In conditions of hot climate water-salt exchange has a number of the features
connected to participation water in thermoregulation and its allocation through a skin as
sweat. Researches show, that at usual temperature about 20 0C water is allocated through
kidneys, skin, lungs and intestines in the ratio 6 : 2 : 2 : 1. At high temperature of air water
basically (up to 70-80 %) is allocated through a skin as sweat. Loss of water with it at
temperature 37,80C makes 0,3 l / hour and with rise temperature by everyone 0,5 0C is
increased on 20 ml. In hot climate at weakened people at heavy physical work daily losses
of water can reach 12 l - thus can give dehydrotation of the organism different degree of
weight. Thus plasma of blood (at dehydrotation organism on 11 % of weight of body
plasma loses water in 2,7 times more, than all organism as a whole) first of all suffers.
Thus viscosity of blood, the contents of hemoglobin sharply raises, the volume of
circulating blood decrease - reduction speed of blood circulation, reduction shock volume
of heart, increase frequency of cardiac reductions.
Large loss water from organism name DEHYDROTATION EXHAUSTION which
symptoms depend on size of water-loss. So, at loss water up to 5 % from weight of a body
there are feelings of indisposition, drowsiness, irritability; at 6-10 % - dizziness, headache,
termination salivation, dysartria; more than 10 % - infringements of sight, hearing, speech,
unconsciousness, delirium. Then all phenomena progress and the person died from
irreversible frustration CNS, blood circulation and intimate activity. At loss water 15 % from
weight of a body at temperature above 30 0C there can come death, at lower temperature -
at loss water 25 % of weight.
Lack water in organism is accompanied by subjective feeling of thirst; distinguish true
(at dehydrotation organism) and conditioned-reflex thirst (at absence deficiency of water in
organism). The feeling of thirst has some inertness and is eliminated not right after drink,
and after long time - till 10-12 minutes. In hot climate at weakened people at heavy
physical work the original condition of water famine can arise: the more the person drinks,
the more he would like water. If such condition to not remove, there can come a heavy
stage - DRINKING ILLNESS or the WATER INTOXICATION: salivation, nausea, vomitting,
strengthening urine formation, frustration coordination movements.
Changes salt exchange in conditions of a hot climate.
Special value here has infringement exchange natrium chloride (NaCL) . At small sweat
evaporation from total NaCL lost by organism per day (15-20g) with sweat is lost 2-6
g/day. At significant sweat evaporation losses NaCL reach the big sizes (sweat contains
0,3-0,6 % NaCL) and cause the infringements of salt exchange, which not compensated
even at full completion water-loss. Compensation reactions organism for prevention salt
deficiency: decrease the contents chlorides in sweat up to 0,1 %, decrease diuresis up to
minimum (360-400ml/day). Oligouria (decrease diuresis) is the original reflex directed not
so much on preservation water in fabrics, but on preservation Na in organism. The addition
NaCL to food is not required, as food completely covers needs for salt, and surplus NaCL
promotes removing vitamin C with urine and occurrence its deficiency in organism.
In some cases at the big losses salts with sweat, can arise the heavy condition - the
SALT EXHAUSTION: strong gastric spasms, vomitting, apathy, faints, are possible
spasmes (increase excitability muscles at decrease chlorides in plasma). For treatment it
is required additional introduction NaCL.
In conditions of a hot climate some restriction of water consumption is necessary. For
example, at work at +39-400C for person it is necessary 6 l / day by fractional reception of
water - 100-150 ml for 1 time.

HYGIENE OF NUTRITION IN CONDITIONS OF THE HOT CLIMATE.

Features of nutrition in a hot climate.
At long action high temperature and humidity of air decrease the basic exchange to
10 % as a result influence of heat on vegetative nervous system. There can be decrease
appetite, salivation, gastric secretion and motility is especially to meat food.
In a diet of the population of some regions with a hot climate (Africa, Southeast
Asia, South America) is marked significant deficiency of proteins animal origin with
prevalence vegetable carbohydrates (carbohydrate monofagism). It is connected to a low
level of material maintenance of the population, religious and traditional factors. The
contents in food much cellulose conducts to constant mechanical irritation of intestines,
especially thick, and to development colitis. High temperature and many carbohydrates in
food promote activization fermentative processes in intestines, especially in children – may
be toxic dyspepsia.
Unilateral carbohydrates feed at lack of irreplaceable amino acids, animal fats and
some vitamins results in occurrence specific diseases:
Kvashiorcor (in translation - "the red boy"). Heavy disease children after their
excommunication from female milk and translation into a carbohydrate feed (lack of animal
protein, methionin, fat-soluble vitamins): inhibition growth, backlog in weight, hypostases,
dermatosis and depigmentation skin, backlog of intellectual development, fatty infiltration
liver, atrophy of a pancreas, hypoxromic anemia.
Spru - heavy chronic disease - the persistent diarrhea, gastritis, anemia, atrophy
mucous of stomach and intestines, violations in bone brain and liver, gradually develops
general cahexya (big loss masses of body).
It may be specific food poisoning– Helyotropic TOXICOSIS (helyotropic hepatites) -
at the use cereals with impurity of weed heliotrope. Illness begins with gasrtoenteritis, in 1-
2 weeks - ascitis, atrophy of liver, decrease proteins in blood, anemia, leucopenia. Disease
quickly can be finished by death at hepatic insufficiency or in 1-2 years with development
cirrhosis of liver.
In tropical climate it is good conditions for development microbes in food, so often
may be food poisonings microbe aethyology (toxicoinfections, bacterial toxicosis – see
theme “Food poisonings”).
Prevention alimentary diseases in a hot climate.
Basis of it is observance principles of a balanced diet, especially equation of a feed
on proteins, fats, carbohydrates, mineral substances and vitamins. Maintenance proteins
full value is very important - processes of biosynthesis depend on it. It is necessary use
animal fats - 60-70 % from total amount. In feeding it is necessary liquidation carbohydrate
monofagism, raised receipt of vitamins C, В1, В2, В6, РР etc.
Features of a diet: reception food in more cool time of day - up to 40-50 % of a daily
diet in the morning or in the evening.
HYGIENE of WORK IN CONDITIONS of the HOT CLIMATE
 Primary goal is the prevention overheating and infringements water-salt exchange. For
this purpose work should be carried out in more cool periods of day - earlier begin work,
having rummaged from 12 o'clock till 18 o'clock. In an operating time are necessary often
breaks (10-15 mines each hour) with rest in a cool place and acceptance water. For
prevention strengthening toxic influence professional harmful factors in conditions of heat
climate the important value has automatization, hermetic sealing, ventilation at
manufacture, mechanization heavy physical work.
Requirements to working clothes: not multilayered, from easy natural materials, light
colouring, free breed. At work on open deserted district the clothes as much as possible
should protect all parts of a body from action of direct solar beams and dust, for protection
eyes - smoky glasses.

PERSONAL HYGIENE IN CONDITIONS of the HOT CLIMATE

It is necessary early morning rise, often acceptance soul (prevention overcooling)
and washing clothes (the polluted clothes worsen heat exchange), cleanliness of a body
(the high temperature and humidity of air promote occurrence dermatitis, cracks of a skin),
employment physical culture and sports at cool o'clock, sufficient night and day time
dream.
HYGIENE OF LIVING ROOMS In the HOT CLIMATE
The basic purpose - protection rooms from overheating. Optimum parameters of
microclimate in premises in conditions of a hot climate (at temperature of air outside 30 0C
and higher) must be: temperature 24-25 0C, humidity 45-55 %, speed movement of air 0,1-
0,2 m/s. At temperature of environment more than 35 0C to achieve such parameters only
by aeration (airing) it is impossible - it is necessary application air conditioning of premises
(rooms). The complex building and sun-protection measures is necessary: apartment
houses are better for building near to green plantings and reservoirs, orientation of
windows - to the north, building materials should be heatproof: tree, brick, foam concrete,
pise-walled materials. Building with an attic with good isolation and aeration is necessary.
It is expedient to increase the sizes of rooms and their height. Colouring of external walls
is recommended light for reflection of solar radiation; special canopies, a venetian blind
above windows.

INSTRUCTION FOR PRACTICAL LESSON ON THE THEME

Educational questions:
1. Concept “ tropical illnesses ”.
2. Concept about a climate. The climate-forming factors.
3. The basic parameters describing a climate.
4. The basic classifications of a climate.
5. The climate characteristic of a tropical zone.
6. Influence of a climate of tropics on working conditions and life of the living population, its
health.
7. Influence of a hot climate on thermoregulation of the person. Kinds of infringements of
thermoregulation of the person in these conditions, it pathogenesis, display and prevention.
8. Influence of hot climate on a water-salt exchange of the person. Pathogenesis, display and
prevention of infringements.
9. Alimentary disease and food poisonings, characteristic for a hot climate, their reason, display and
prevention.
10. Features of hygiene of nutrition in a hot climate.
11. Features of hygiene of work, personal hygiene, hygiene of inhabited buildings in conditions of a
hot climate.
Tests for the control of the level of knowledge
1. What mechanisms prevent overheating of the person under following conditions of environment:
air temperature 45 0С, relative humidity 40 %?
1. Convection and evaporation of sweat
2. Heat-irradiation and evaporation of sweat
3. Heat-conduction and convection
4. Heat-irradiation and convection
5. Heat-irradiation and conduction
2. What the specified symptoms are observed at solar impact?
1. dryness of skin covers
2. pains in a stomach
3. general weakness
4. vomiting
5. epileptiod attacks

Situational tasks
1. In conditions of a hot climate the population will carry out a significant part in the street, among
green plantings, and consequently the device of habitation is more focused on wide use of open
space before the house. What (is under construction) is made with this purpose?
2. Explain a difference:. Bordeaux (France) and Vladivostok (Russia) are at one breadth, both on a
coast the sea, average t of January in Bordeaux + 5 0 C, and in Vladivostok - 13,5 0 C, i.e. is lower
on 18,5 0. Why it is so?
3. In what time there is an expressed adaptation of the person in conditions of a hot climate, at
action of high temperature, at work of average weight?.

The standards of the answers:

1. Use half-opened spaces: internal gardens, verands, balconies, terrases, fountains.
2. The difference is explained that in Bordeaux in the winter prevail South-East winds, which bring
warm air from the Atlantic ocean, and in Vladivostok at this time prevail North-East of a wind,
which bring cold weights from Siberia.
3. The adaptation is formed during 1 month. For proof adaptation it is necessary more time.

Sources of the information.

The basic literature:
1. Lectures on common hygiene and medical ecology.- Simferopol, 2003.- 160 p.
1. Шибанов С.Э., Михайлов В.В. Руководство по гигиене жаркого климата.- Симферополь,
2000. – 50 с.
2.Лысенко А.Я. Руководство по тропическим болезням.- Москва, 1983.
3.Кошелев Н.Ф. Гигиена водоснабжения и питания в условиях жаркого климата.- Ленинград,
1975. – С. 5-19.
4.Е.И. Гончарук и др. Общая гигиена.- Киев, 1991.- С. 98, 264-308
5.Lectures on common hygiene and medical ecology. – Simferopol, 2003. – 130p.
6.Park’s textbook of Preventive and Social medicine. India, 2000.- 16-th edition. – 660p.
7. Руководство к практическим занятиям по общей гигиене и медицинской экологии. / Под ред. Проф.
С.Э.Шибанова. – Симферополь, 2003. – 260с.
The additional literature:
1. Шандала М.Г., Звиняцковский Я.И., Зарницын М.И. // Гигиена населенных мест— К.,
1981 вып. 2.
1.Хроники ВОЗ. Белково-энергетическая недостаточность питания и проблемы здоровья
населения. ВОЗ, 1971.- т. 25, № 4.
2.Бехар М. Питание и здоровье детей // Health of the world.- Geneva, 1979, February - March,
р.16-19.
 EXAMINATION QUESTIONS
To the examinations in common hygiene with ecology on 4 course of medical
faculty

1. GENERAL PROBLEMS of HYGIENE And ECOLOGY

1. Subject and basic sections of hygiene. A history of development of hygiene. The basic
laws of hygiene and it importance for preservation of health of the population and
protection of an environment.
2. Basic methods of hygienic researches, examples. Interrelation of hygiene with other
medical sciences.
3. Concept about an environment and biosphere, it components. Classification of the
factors of environment in hygiene and ecology. The basic criteria of quality of an
environment.
4. Structure sanitary - epidemiologic services of Ukraine, sanitary - epidemiologic station,
kinds of state sanitary supervision and forms of its realization.
5. Concept about the hygienic specifications of the harmful factors in an environment, it
versions, basic principles hygienic reglamentation.
6. Feature hygienic reglamentation pollutants in various objects of an environment limiting
attributes of harm action.
7. Principles hygienic reglamentation bacterial pollution in objects of an environment,
examples of such specifications.
8. Principles of a hygienic estimation objects of an environment at joint pollution in view of
a type of the combined action.
9. Subject and tasks of ecology, interrelation and differences from hygiene. Classification
of the ecological factors, version of influence it on the organism.
10. Laws of action of the ecological factors on organism (law of an ecological optimum,
zones pessimum). Concepts about ecological valency and spectrum of a kind.
11. Concept about trofic circuits, importance of study it for hygiene. Ecosystems and
biocenosis, it basic characteristics and properties.
12. Basic problems of protection of resorts from pollution. Main pollutants of resort-
recreational resources and its reglamentation.
13. Concept “ health of the population ”, major factors influencing on health of the
population, importance of hygiene in improvement of health of the population.
14. Basic parameters of health of the population, ways of it study and use for study of
influence of quality of an environment.
15. Direct and indirect negative influence of pollution of an environment on health of the
population and condition of its life, examples.
16. Methods of study of influence of quality of an environment on health of the population.
Rules of a choice of zones of supervision.
17. Basic sources and factors of pollution of an environment, protection of biosphere from
anthropogenous pollution. Hygienic measures in this area.

2. HYGIENE OF NUTRITION
18. Subject and tasks of hygiene of nutition. The basic kinds of nutition and it purpose.
Norms of nutition of the population, what parameters are taken into account at it drawing
up. Modern problems of nutition of the population of Ukraine.
19. Basic principles of a balanced diet of the healthy man and methods of check it
observance at the separate man and groups of the population as a whole.
20. Classification alimentary and alimentary-caused diseases, examples. Tactics of the
doctor at treatment various groups of such diseases.
21. Methods sanitary examination quality food products, classification food products on
quality, examples. Rules of tests food products for the analysis.
22. Hygienic characteristic dairy, grain, meat products. Sanitary examination milk: the
basic parameters of quality, methods of it definition and norms.
23. Structure of foodstuff. Basic nutrients and it physiological meaning.
24. Role proteins in nutition. Attributes of full value proteins. The protein problem and
hygienic estimation ways of its decision. Concept about protein norm and protein
minimum.
25. Irreplaceable amino acids, its functions, products - suppliers. Irreplaceable amino acids
for children, reasons of differences in comparison with the adult man.
26. Role fats in nutition. Classification and hygienic characteristic kinds of fat acids. A
hygienic estimation different food fats.
27. Not polysaturated fat acids and phospholipides. The representatives, functions,
products - sources. Importance of cholesterol, alimentary antysclerotic factors.
28. Role carbohydrates in nutition. Classifications. The hygienic characteristic it basic
groups. Importance of the unprotected and protected carbohydrates.
29. Importance of the superprotected carbohydrates and pectin substances in a rational
and medical nutition, products - suppliers.
30. Role mineral substances in nutition. Classification diseases connected to infringement
of the contents of microelements in food (microelementosis), it reasons and examples.
31. Importance macroelements in nutition on example Ca and phosphorus, conditions of it
mastering, products - suppliers.
32. Classification vitamins. Kinds of the vitamin status of organism and methods of its
diagnostics. The factors raising need organism in vitamins.
33. Importance vitamin C, daily need, ways of preservation it in food. A role vitamins A and
D, display avitaminosis and hypervitaminosis, it prevention.
34. Concept about food poisonings, it classification and reasons of occurrence.
35. Food poisonings microbe nature: kinds, pathogenesis, products - sources. The
toxicoinfections, reasons of it occurrence, clinical forms, prevention.
36. Food toxicosis, kinds, reason of occurrence, clinic, prevention and treatment.
37. Botulism, features of the activator, products - sources, pathogenesis, clinic and
treatment. Prevention measures.
38. Food poisonings by poisonous plants and mushrooms: the representatives, basic
toxins, pathogenesis, clinic, prevention.
39. Food poisonings by salts of heavy metals (lead, zinc, copper): the reasons,
pathogenesis, clinic, prevention.
40. Food poisonings by pesticides and nitrates: the reasons, pathogenesis, prevention.
Problem of the nitrozoconnections in nutition.
41. Micotoxicosis, kinds, reason of it occurrence, clinic, prevention. A problem aflotoxicosis
in the south of Ukraine and Crimea.
42. Tactics of the doctor of a medical structure at detection of a food poisoning. Rules of
registration of the documentation.
3. MUNICIPAL HYGIENE
43. Concept about climate and microclimate. Influence of the factors of a microclimate on
system thermoregulation of the person. Problems of acclimatization.
44. Methods measurement factors of microclimate, devices, specifications for various
rooms and it substantiation.
45. Kinds of violations of the thermoregulation of the person in conditions of a hot climate,
it mechanisms and prevention.
46. Methods of complex estimation of a microclimate and it application. Norms of
parameters and ways of definition.
47. Basic weather forming factors and it influence on the person. A medical estimation and
classifications of weather.
48. Heliometheotropic reaction of the man, it displays. Diseases, accompanying by such
reactions. Prevention metheotropic reactions.
49. Structure of atmospheric air, action of its components on the man. Pathogenesis, clinic
and prevention of the mountain (high-altitude) and kesson (decompression) illness.
50. Contents CO 2 in an atmosphere, its dynamics and reasons. Action on the man of
various concentration CO 2. The maximal permissible concentration of CO 2 in air of
rooms and it substantiation.
51. Basic sources and factors of pollution of an atmosphere, way it purification, factors
influencing on the size of pollution in concrete region. Kinds of clearing structures.
52. Direct and indirect negative influence of atmospheric pollution on health of the people
and condition of their life, its versions and examples.
53. Protection of atmosphere from anthropogenous pollution: the basic directions and
examples. Reglamentation harmful substances in atmospheric air.
54. Importance of solar radiation. The reasons, display and prevention solar starvation.
Concept about a biodoze of a ultra-violet irradiation, method of it definition.
55. Structure of solar light at a surface of the Earth. Action of components of solar light on
the person. Biological effects of a ultra-violet irradiation, it mechanisms.
56. Hygienic requirements to natural illumination in inhabited, educational and hospital
premises (rooms). Methods of estimation and specifications.
57. Hygienic requirements to artificial illumination, kinds and systems of such illumination,
methods of estimation and specifications in various premises (rooms).
58. Hygienic characteristic of sources of water supply. Zones of sanitary protection
sources of water supply and it purpose. Kinds of water use, structure of waterpipe.
59. Hygienic requirements to quality of drinking water. Organoleptic parameters of drinking
water, its importance, methods of definition and norms.
60. Hygienic requirements to chemical structure of water, diseases caused by its changes,
it reason, display and prevention.
61. Epidemical meaning of water, attributes of water epidemics, parameters of epidemical
safety of water.
62. Methods of improvement of quality of water. Methods of clearing of water, control it
efficiency.
63. Methods of the desinfection of water, it comparative hygienic estimation and control it
efficiency.
64. Chlorination water, its kinds, cheme, parameters of efficiency, lacks of this method of
desinfection water.
65. Basic sources and factors pollution of reservoirs, way purification reservoirs. Protection
of reservoirs from anthropogenous pollution. Reglamentation pollutants in water.
66. Hygienic importance of ground, its basic parameters. Basic pollutants and ways of self-
purification of ground. Endemical value of ground: endemical diseases.
67. Reglamentation harmful substances in ground. Protection ground from anthropogen
pollution.
68. Urbanization and its hygienic estimation. The modern town-forming factors and it
importance for development of cities.
69. Hygienic estimation systems of building cities and inhabited quarters. Functional zones
of cities.
70. Hygienic requirements to ventilation of rooms, its kinds and criterion of estimation.
Concept about air conditioning.
71. Methods clearing of the occupied places from firm waste. Methods of destruction firm
household and industrial wastes.
72. Methods clearing waste water. Natural and artificial methods of clearing waste water.
4. HOSPITAL HYGIENE
73. Concept about treatment-guarding mode in hospital and its basic components. The
hygienic requirements to accommodation hospitals of a different structure.
74. Hygienic requirements to a site of hospital. Functional zones of hospital site. Historical
types construction of hospitals.
75. Hygienic estimation various systems of hospital construction. The basic directions of
prevention intrahospital infections.
76. Hygienic requirements to internal lay-out of hospital. Ward section and its lay-out.
77. Hygienic requirements to hospital ward (lay-out, microclimate, ventilation, illumination).
78. Hygienic requirements to a reception of hospital. It functions and structure.
79. Hygienic requirements to infectious branch. Features of a lay-out of wards in it and it
reason.
80. Hygienic requirements to the operational block and operational (lay-out, microclimate,
illumination, ventilation).
81. Concept about intrahospital infections, reason of it growth, structure, basic sources
and ways of transmission. Prevention of such infections.
82. Hygiene of work of the surgeons and anaesthesiologists. Basic professional harm
factors and prevention occupational diseases.

5. RADIATING HYGIENE
83. Concept about a radio-activity, hygienic characteristic of kinds of radiation, screening
materials. Natural and artificial sources of radiation.
84. Mechanisms of action radiation on organism, kinds of biological effects of radiation.
85. Radiosensitivity of bodies and fabrics (law Berganie). Groups of critical bodies. Limiting
dozes of external and internal radiation.
86. Hygiene of work with the closed sources of radiation. Ways of protection medical
personnel from beam defeats.
87. Hygiene of work with open sources of radiation. The hygienic requirements to
radiologic laboratories.
88. Natural radiating background, its structure, levels, sources and dynamics of changes.
Anthropogenous sources to its increase.
89. Influence of failure on Chernobyl atomic station on health of the population living on
polluted territories, the nearest and remote effects.
90. Features of nutrition of the population on radioactive polluted territories.

6. HYGIENE of WORK
91. Concept about serviceability, its dynamics in time and after work, reason of changes of
serviceability. Methods of study serviceability of the man.
92. Change in organism during work. Exhaustion, reason of its development (theories of
exhaustion). Overfatigue. Prevention of exhaustion on manufacture.
93. Professional harm factors and occupational diseases. Classification. Physical
examinations working: kinds, purposes and organization.
94. Order of registration, investigation sharp and chronic occupational diseases and
intoxications. Prevention such diseases.
95. Noise, its classifications, action on organism. Noise illness, its diagnostics and
prevention. Maximal permissible level of noise and it substantiation for various premises
(rooms).
96. Electromagnetic fields, it basic kinds and sources, action on organism. MICROWAVE
- syndrome: displays and prevention.
97. Vibration, action on organism. Clinic and prevention of the vibrating illness.
98. Industrial poisons, classification it by level of toxity, specific action and ability to
cumulation. The factors influencing on toxic effect of industrial poisons.
99. Basic parameters of sharp, half-sharp and chronic toxity industrial poisons and
methods of it study in experiment.
100. Specific and remote effects of industrial poisons and methods of it study.
101. Way of receipt and removing industrial poisons. Ways of detoxication poisons in
organism. Detoxication system and it parameters.
102. Combined action of industrial poisons, its kinds, methods of study and importance for
sanitary estimation of industrial environment.
103. Kinds of harmful action of industrial poisons on working, prevention of professional
poisonings.
104. Reason and display of poisonings by industrial poisons of irritating action (CO,
ammonia, chlorine, oxides of nitrogen).
105. Reason and clinic of professional poisonings by heavy metals (lead and mercury);
clinical and hygienic confirmation of the diagnosis.
106. Industrial dust, classification, action on organism, maximal permissible concentration
of dust of different structure. Diagnostics and prevention pneumoconiosis.
107. Feature of work in agriculture and influence it on organism working. Basic
occupational diseases, it reasons and prevention.
108. Pesticides, it purpose and classifications on toxity, by purpose and chemical
structure. The ecological estimation of pesticides on stability and toxity.
109. Toxicological characteristic of the basic groups of pesticides (phosphorus-organic,
chlorine-organic, carbamates, mercury-organic). Display enzymes.
110. Hygiene of work at a storage, transportation and application pesticides. Measures on
prevention of poisonings by pesticides working and population.
111. Toxicological characteristic of mineral fertilizers (nitric and phosphoric). Hygiene of
work at it application.

8. HYGIENE of CHILDREN And TEENAGERS

112. Subject and tasks of hygiene of children and teenagers. Laws of growth and
development of children. The schemes of age periodization. Problems of the acceleration.
113. Physical development of children and teenagers as criterion of individual health and
health of children's quota as a whole. Methods of research of physical development.
114. Ways of estimation of physical development of children and teenagers. Methods of
estimation harmonicity of physical development.
115. Hygienic requirements to accommodation, lay-out of a site and building of children's
preschool establishments. Functional zones of a site. A principle of group isolation.
116. Hygienic requirements to a group cell in children's preschool establishments. The
specifications of a lay-out, microclimate, illumination in a game room. The requirements to
toys.
117. Principles of hardening and physical education of children. The control of adequacy of
physical loadings. The basic reasons, display and prevention hypodynamia and
hyperkynezia.
118. Hygienic requirements to a mode of day of children and schoolboys. Ways of
adaptation to training at school. The requirements to drawing up of the school time-table.
119. Medical-professional consultation at school, its task and organization in conditions of
school and polyclinic. Groups of health of children and basic groups of trades.
120. Hygienic requirements to accommodation of schools and school site. Zones of a site.
The characteristic systems of school construction. A lay-out of a building of school.
121. Hygienic requirements to a lay-out, microclimate, illumination of classes and
educational studies at school. Advantages and lacks of cabinet system of education.
122. Hygienic requirements to school furniture, basic parameters and norms. Methods and
marks of school furniture, requirement to accommodation tables in a class.
123. Feature of hygiene of nutrition of children and teenagers. The reasons of differences
from nutrition of the adult man.

9. HYGIENE of a HOT CLIMATE.

1. Kinds of a climate of the hot countries and it influence on the person.
2. Feature of a tropical climate and it influence on the person.
3. Feature of a climate of deserts and it influence on the person.
4. Influence of a climate of the hot countries on thermoregulation of the organism (on
processes of heat-production).
5. Influence of a climate of the hot countries on thermoregulation of the organism (on
processes of heat-return).
6. Acclimatization to conditions of a hot climate.
7. Prevention of adverse displays of acclimatization to conditions of a hot climate.
8. Kinds of violations of the thermoregulation of the organism in conditions of a hot climate,
it reason and pathogenesis.
9. Prevention of violations of the thermoregulation of the organism in conditions of a hot
climate.
10. Factors, promoting overheating organism in conditions of a hot climate.
11. Methods of measurement of the microclimatic factors in premises (rooms) (devices
and specifications of parameters) in conditions of a hot climate.
12. Change of the microclimatic factors in premises (rooms) in conditions of a hot climate
and ways of it regulation.
13. Complex methods of the estimation of a microclimate in premises (rooms) in conditions
of a hot climate.
14. Influence of a hot climate on a water exchange. Drinking illness, clinic, prevention.
15. Degidrotation of the organism in conditions of a hot climate, its reasons and
prevention.
16. Influence of a hot climate on a salt exchange. Salt deficit, clinic and treatment.
17. Influence of a hot climate on the central nervous system, kinds of violations of its
function, treatment.
18. Feature of hygiene of nutrition in conditions of a hot climate.
19. Alimentary diseases in a hot climate (kvashiorcor, spru), it reason, clinic and
prevention.
20. Food poisonings microbe nature in a hot climate.
21. Influence of a hot climate on occurrence of food poisonings microbe nature.
22. Prevention of food poisonings microbe nature in conditions of a hot climate.
23. Food poisonings not microbe nature, characteristic for conditions of a hot climate
(heliotropic toxicosis, aflotoxicosis).
24. Hygiene of work in conditions of a hot climate.
25. Influence of a hot climate on occurrence professional poisonings and it prevention.
26. Ways of improvement of the microclimatic factors on manufacture in conditions of a hot
climate and control it efficiency.
27. Epidemic value of water in conditions of a hot climate, attributes of water epidemics.
28. Control epidemic safety of water in conditions of a hot climate
29. Hygienic requirements to a lay-out of inhabited quarters in conditions of a hot climate.
30. Hygienic requirements to inhabited premises (rooms) in conditions of a hot climate.

EXAMPLES OF SITUATIONAL TASKS AT THE EXAMINATION

ON GENERAL HYGIENE

1. Hygiene of nutrition
Example № 1.
Give a hygienic estimation of nutrition of the man 60 years old, receiving for day 150g
proteins, 100g fats and 500g of carbohydrates. In the blood is hypercholesterolaemya. A
nutrition will be carried out 3 times per day. What correction of the diet it is necessary in
this case? What alimentary antysclerotic factors must be included in the diet?
Example № 2
Give a hygienic estimation to milk, at which analysis is established:
Densities at 20 oC - 1,020, fat content - 1 %; the dry rest - 10 %, acidity - 12 o Terner. What
devices are used for sanitary examination?
Example № 3
At the patient the weakness is observed vomiting, dyarrea, strong pains in a stomach. In
anamnesis: the use cakes bought in the market.
Put the diagnosis of a food poisoning, what documents are necessary for issuing in this
case?
Example № 4
At the patient is observed violation of a voise, ptosis of the left eyes, complaint to
deterioration of sight and difficulty of swallowing. At the evening used marinated
mushrooms. Put the diagnosis of a food poisoning and nominate treatment.

2. Municipal hygiene.
Example № 1
At the estimation of a microclimate in a class is established: temperature of air 26 degrees;
air humidity 50 %, speed of movement of air 0,5 m/s.
Give a hygienic estimation to a microclimate, what devices were used for measurement
the specified parameters?
Example № 2
At measurement of a microclimate in operational is established: temperature of air - 20
degrees, humidity 85 %, cooling ability of air 8,5 milicalories/sm2 sec.
Give a hygienic estimation to a microclimate, what devices were used, what it is necessary
to do for emprovement of microclimate?
Example № 3
At the estimation of a microclimate on a beach of sanatorium is established: speed of
movement of air 1,5 m/s, relative humidity 85 %, temperature 28 degrees, effective
temperature 25 degrees ET. Give the recommendations for reception of air baths having a
rest.
Example № 4
In hospital ward by the sizes 6 х 5 х 3 m 5 patients lay. At the expense of natural
ventilation in ward in one hour acts 100m 3 of air. The contents СО2 - 0,2 %. Give a
hygienic estimation of ventilation and area of chamber.
Example № 5
Estimate hygienic conditions in hospital ward by the area 20m 2, designed on 4 cots;
multiplicity of ventilation 1,2; the contents СО2 0,07 %; light factor 1/7; CNI 1 %; common
artificial illumination in ward 30 lux.
Example № 6
At the analysis of water is established:
Smell of water - 3 ball Contents nitrates – 50mg/l
Smack - 4 ball Contents of iron - 0,5 mg/l
Color - 30 degrees Microbe number - 150
Turbidity - 2,5 mg/l Contents fluorine - 0.2 mg/l
The dry rest – 1000 mg/l Coli - index - 30
Give a hygienic estimation to water, what diseases are possible in this case, what
measures are necessary concerning the given water?
Example № 7
Estimate sufficiency of disinfection of water, which after chlorination has such parameters:
microbe number - 200, coli - index - 10, coli - titr - 100, residual chlorine - 0,8 mg/l. What
methods of disinfection are necessary for using in this case?

3. Hygiene of work and radiating hygiene

Example № 1
Estimate working conditions in shop of a factory at dust content of air 27 mg/m3, contents
СО2 - 1,5 %, level of high-frequency noise 85 dB. What occupational diseases are
possible, what preventive measures are necessary for improvement of working conditions?
Example № 2
At the worker of a hothouse in blood is the reduction of activity cholinesterase is marked,
there are complaints to weakness, pain in the field of a liver. What reasons of the given
professional poisoning, what preventive measures are necessary concerning the given
worker and as a whole in a hothouse?
Example № 3
The contents of a leaden dust in air of shop exceeds MPC in 15 times. What attributes of a
professional poisoning can be at working, what methods of laboratory researches should
be used for confirmation of the diagnosis?
Example № 4
The doze of an irradiation of roentgenologist makes 250 mBER/week. Whether the
protective measures from radiation and what are necessary? What professional disease is
possible in this case?
Example № 5
At work with radioactive isotopes in laboratory the doze of an external irradiation has made
100 mBER/hour at 30-hour working week. Whether are necessary in laboratory protection
and what?
 4. Hygiene of children and teenagers
Example № 1
In a class of school the tables are placed in 2 lines with distance between lines 40 sm,
distance up to a school board 1m, up to walls 20 sm, tables have green and yellow marks,
at selective inspection of the schoolboys in 3 class the differention of tables made 1/5-1/6
of growth, distance + 4 sm. Give a hygienic estimation to selection and arrangement tables
in a class.
Example № 2
Estimate physical development of the boy 16 years by growth 179см, weight of a body
71,1кг. Data of the table (average + - sigma): growth 164,0 +-5,5 sm, weight 65,1 +-6,2 kg.
What else methods it is possible to estimate physical development of this boy?
Example № 3
In a game room of a children's garden by the area 40 m2 temperature of air 23 degrees,
relative humidity 60 %, speed of movement of air 0,7 m/s, common artificial illumination 80
lux. Give a hygienic estimation.
Example № 4
For construction of children's gardens and day nursery establishment for 2 day nursery
and 4 preschool groups the ground area 100 х 400 m is allocated. Estimate sufficiency of
a site, what functional zones it should include?