MINISTRY OF HEALTH OF UKRAINE
DNIPRO STATE MEDICAL UNIVERSITY»
DEPARTMENT OF HYGIENE, ECOLOGY
AND OCCUPATIONAL SAFETY
Protocols for practical training
"Hygiene and Ecology"
for students of 6 courses of International faculty
Specialty "General Medicine"
Dnipro 2021
Content
Substantial module 1. Municipal hygiene.
Тheme № 1. Hygiene of water and water supply of settlements. Sanitary
protection of water objects.
Theme № 2.Sanitary protection of atmospheric air. Hygiene of planning in
the urbanized territories.
Тheme SIW. Sanitary protection of soil and clearing of the settlements.
Тheme № 3. Hygiene of the residential and public buildings and facilities.
Тheme № 4. Features of hygienic requirements towards planning,
functioning of health care facilities, and conditions carried out for
ambulatory patients. Complex of hygienic measures in order to prevent
nosocomial infections.
Substantial module 2. Hygiene of nutrition.
Тheme № 5. Nutrition in the preventive medicine. Organization of the
treatment-and-prophylactic nutrition on the industrial enterprises.
Тheme №6. Medical control over the organization of therapeutic (dietary)
nutrition in medical and preventive institutions and in the system of public
catering. Prevention of food poisoning.
Substantial module 3. Occupational hygiene.
Тheme № 7. Legislative basis for sanitary supervision in the field of
occupational hygiene. Hygienic assessment of the factors of the labor
process and the working environment
Substantial module 4. Hygiene of children and adolescents.
Тheme № 8. Analysis of the health of children and adolescents in organized
groups and a hygienic assessment of the educational process in a pre-school
educational institution and in school
Substantial module 5. Radiation hygiene.
Тheme №9. Application of the system of radiation and hygienic regulations
in the conditions of practical activity, medical practice and technogenically
intensified ionizing sources of natural origin
Тheme № 1: Hygiene of water and water supply of settlements. Sanitary protection
of water objects.
1. PURPOSE: estimate quality of potable water, water supply sources
(centralized and decentralized); estimate schemes of clearing city sewage, according to
standard norms.
2. QUESTIONS FOR SELF-PREPARATION:
1. Which indicators of drinking water, regulated by SSanR&N 2.2.4-171-10 "Hygienic
requirements
to
drinking
water,
intended
for
human
consumption"?__________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
2. Specify presence of coliphage in water and measures, which should be taken in this
case?__________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
3. Which disease can cause consumption of drinking water with overnormal
concentration of fluorine in the drinking water? What are the clinical symptoms and
preventive measures?_____________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
4. Specify evidence of overnormal concentration of ammonia in the drinking water?
What preventive measures should be taken?___________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
5. What are the basic technological methods, carried out for centralized water
supply?________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
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______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
6. Which indicators of drinking water provide effectiveness of disinfection by
chlorine?_______________________________________________________________
______________________________________________________________________
______________________________________________________________________
7. Waterborne infectious diseases. Peculiarities of waterborne epidemics, their
prophylaxis. ____________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
8. Which disease (poisoning) can cause consumption of drinking water with overnormal
concentration of nitrates? __________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
9. What is the most important condition in order to use source of water supply for
drinking purposes? _______________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
10. What hygienic standards and regulations provide requirements for water objects
sanitary protection zones?_________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Situational task:
"Hygienic requirements to potable water, quality estimation"
At the current state sanitary-and-epidemiologic supervision of centralized drinking water
supply in the city N. water tests at clearing station were selected. Laboratory researches showed such
results:
Investigated indicator
1. Indicators of epidemic safety:
- TMN, CFU/ml
- Coli-index
Standarts
(maximum)
Result of research
2. Chemical compound indicators:
- рН
- oxidation, mg/dm3
- nitrates, mg/dm3
- iron, mg/dm3
- residual chlorine, mg/dm3
- chloroform, mg/dm3
3. Indicators of organoleptic qualities:
- color quantity, degrees
- feculence, mg/ dm3
- aftertaste, points
- smell, points
1. Enumarate indicators, which were not correspond to the quality of potable water by
SSanR&N 2.2.4-171-10.__________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________
2. Carry out hygienic estimation quality of potable water by results of laboratory researches, and
proposed hygienic recommendation in order to supply population with good – quality potable water.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Scenario – based task: "Modern technologies of clearing of city sewage"
In the city D. drains from constructions of a city sewer network, chemical enterprises and rain drain
are dumped into river C. River C. is used for the organization of centralized drinking water supply
(above on a current). Lower on a current the zone of rest and a city beach is located. At sampling of
water of the river C. in control alignments (on 1 km above the city D.) following results are received.
Indicator of water quality
Above of the city D.
Maximum concentration
Class of
limit in water of reservoirs
danger
Oxidation
≥4.0
Biochemical
need
in
≤3.0
oxygen
Chemical need in oxygen
≤15.0
Activators of intestinal
Should not contain in 1dm3
infections
3
Index intestinal sticks
≤10.000 in 1dm
Coli-phage
≤100 in 1dm3
3
Acetone
≤0.7 mg/dm
3
Freon-12
≤10.0 mg/dm3
2
3
Methanol
≤3.0 mg/dm
2
1.
Give hygienic estimation of water from the reservoir by results of laboratory researches
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Calculate
additive
action
of
chemical
substances
by
Averianov
formula.
С1
C2
Cn


 1.0,
MCL1 MCL 2 MCLn
where C -value of chemical substances (1-2 class of danger);
MCL-maximum concentration limit of chemical substances.
__________________________________________________________________________________
__________________________________________________________________________________
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2.
Carry out recommendations focused on the prevention population health with harmful
influence pollution by wastewater discharges into water C in the city D. ________________________
__________________________________________________________________________________
__________________________________________________________________________________
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__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Signature ______________
Theme № 2: Sanitary protection of atmospheric air. Hygiene of planning in the
urbanized territories.
PURPOSE: carry out hygienic estimation actions for sanitary protection of atmospheric
air, system of sanitary control over sources of pollution in the atmospheric air.
QUESTIONS FOR SELF-PREPARATION:
1. Determine chemical composition of the atmosphere.__________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
2. What diseases are caused by high levels (100) of an air chemical pollution?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
___
3. Air preventive measures (technological measures, architectural-planning measures,
sanitary-technical
measures,
hygienic
standardization,
etc.)___________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Describe technological measures of air protection :_____________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
4. Which types of sanitary - protective zone carried out at the planning of settlements?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
5. Define the terms MCL of harmful substances in the air?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
6. Determined the difference between maximum concentration limit (MCL) and
maximum-permissible dose (MPD). _________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
7. The concept of "maximum allowable concentration" and "estimated safe level of
exposure." _____________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
8. Carry out hygienic requirements to the sanitary - protective zone, and requirements to
its green zoning. ________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Situational task: "Technologies and constructions for clearing of industrial aerosol and gaseous
emissions in atmosphere"
Arithmetic values of daily average concentration of chemical substances in the atmospheric air
of region of Dnipropetrovs’k for 12 months on the stationary post was established:
Substances
Maximum concentration limit Concentration in
atmospheric air,
mg/dm3
Dust inorganic (with maintenance SiО2 <20 %)
0.25
Anhydride sulphurous
0.05
Carbon оxide
3
Nitrogen dioxide
0.04
Formaldehyde
0.003
Maximum allowable pollution index
Index of factual pollution
1. Give hygienic estimation of quality of atmospheric air by results of laboratory researches, according
to the State Sanitary Rules-201-97 "Protection atmospheric air from pollution".
__________________________________________________________________________________
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__________________________________________________________________________________
2. Carried out necessary hygienic actions for improvement of condition of atmospheric air in the
occupied places_____________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Quantity indicators of estimation atmospheric air pollution
(State Sanitary Rules-201-97 Protection of atmospheric air from pollution)
Level of pollution
Degree of air cleanliness
Exceeding of
maximum permissible
concentration (MPC),
degree of points
admissible
clean
<1
inadmissible
weakly polluted
> 1-2
inadmissible
moderate polluted
> 2-4
inadmissible
polluted
> 4-8
inadmissible
heavily polluted
>8
Signature ______________
Тheme of SIW: Sanitary protection of soil and clearing of the settlements.
PURPOSE: estimate sanitary condition of soil and degree of its pollution by chemical
substances; carry out hygienic assessment of soil.
QUESTIONS FOR SELF-PREPARATION:
1. Enumerate basic components of the soil and its hygienic significance
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
2.
What
are
the
main
sources
of
soil
pollution?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
3.
Specify
criteria
of
sanitary
cleanliness
of
soil?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
4. Which microbiological indicators describe fresh faecal contamination of soil?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
5. What belongs to the direct and indirect indicators of soil pollution? ______________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
6. Define a term "biogeochemical province". Found out examples of natural
(endogenous)
and
anthropogenic
biogeochemical
provinces.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
7.
Enumerate
major
endemic
diseases,
transfer
from
soil?__________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
8. Define the concept of "buffering" or “buffer value” ___________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
9. Specify the common intestinal infections, transferring from polluted soil? Which of
them
are
the
most
dangerous
to
humans?_______________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
10. Which sanitary measures focused on the prevention of soil pollution?____________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Situational task № _____: "Sanitary protection of soil"
To the municipal hygiene department the administration of high school has addressed with
complaints to the local municipal enterprise, which is periodically carries out export of dust from the
apartment houses located close. Besides, in the absence of special motor transport and enough of
containers for gathering of dust from apartment houses, in the territory of school dumps of household
dust and food waste are formed. At the sanitary inspection of the soil, selected from the school
territory, such results are received:
Investigated indicator
1. Sanitary-chemical indicators:
- Nitrogen organic, mg/100 g
- Nitrogen soil albuminous, mg/100 g
2. Sanitary - bacteriological indicators:
- Coli-tytre
- Perfringens- tytre
3. Sanitary-helminthes indicator:
- number of helminthes eggs in 1 kg
4. Sanitary-entomological indicator:
- flies larvae in 0.25m2
Result of research
1. Give hygienic estimation of sanitary condition of soil ________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. Define etiological factors and-or risk factors for health of pupils ________________________
______________________________________________________________________________
______________________________________________________________________________
3. Find necessary standard documentation for a hygienic estimation _______________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. Offer plan of hygienic measures to prevent soil pollution on the population health __________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Scenario – based task № 2: "Sanitary protection of soil"
Carried out sanitary condition of soil in the city, where enrichment polymetallic ore company
was located in the residential zone, had been revealed heavy metals, which exceeds their clark values.
At the same time samples were selected in the outskirts behind the industrial zone, but with similar
types of the soil. Following results have been taken:
Concentration, mg/kg
Heavy metals
Factual
Clark
manganese
500,0
copper
33,0
zinc
65,0
lead
20,0
vanadium
150,0
1.
Calculate concentration coefficients as well as separate heavy metals
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2.
Propose complex of the primary preventive measures ____________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Signature ______________
Тheme № 3: Hygiene of the residential and public buildings and facilities.
PURPOSE: carry out hygienic assessment quality of an internal environment of
premises, in accordance with hygienic standards and laboratory research results.
QUESTIONS FOR SELF-PREPARATION:
1. Which groups of factors (parameters) of the premises have a vital hygienic value
(enumerate)? __________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
2. Enumerate microclimate parameters, values of these parameters? _____________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
3. Which engineering systems and construction should effectively provide
microclimate parameters to an acceptable level? ______________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
4. Which control parameters carried out in order to assess effectiveness of the
ventilation system? _____________________________________________________
_____________________________________________________________________
_____________________________________________________________________
5. Enumerate illumination systems which should be taken in the different functional
premises of an apartment, house? __________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
6. Concept "illumination" of the premises, specify its hygienic value_______________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
7. Which factors determine optimum (permissible) illumination in the premises? ____
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
8. Carry out methods of estimation effectiveness (sufficiency) of artificial or natural
illumination____________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
9. Enumerate advantages and disadvantages modern sources of artificial illumination
(fluorescent lamps and bulbs)? ____________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
10. Which sanitary requirements carried out for interior decoration of apartment
materials? ____________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Situational task _____: "Hygiene of the residential and public buildings and
facilities"
In order to research residence conditions in the _____-premises apartment were
estimated common square _____ m2 and residential square _______ m2, where 3 persons
family lived. Among the family members one person was suffered from_____________,
i.e. lab results showed that temperature in the living room, carried out by dry thermometer
of Assman psychrometer –_________°C, by damp thermometer - _______ °C, an average
temperature _______°C, temperature on 1.5 m height - _______ °C, temperature on 0.2 m
height –________°C, temperature near the inner walls - ________ °C, temperature outside
- ________ °C. Daily temperature was varieties, according to the thermograph, being on
the range from _____°C to _____ °C. Indoor air contains phenol in the concentration
_______mg /m3.
Carry out hygienic assessment residence conditions among the family members and
predicts possible impact of residence conditions to the bronchial asthma diseases.
Answer
Results of laboratory and instrumental research, carried out quality of internal air in
the premises of the given apartment, evaluated in accordance with requirements SSanN&R
2.2.000-98 "Houses of an apartment type", as well as the following conclusions:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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_________________________________________________________________________
_________________________________________________________________________
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_________________________________________________________________________
Signature ______________
Тheme № 4: Features of hygienic requirements towards planning, functioning of
health care facilities, and conditions carried out for ambulatory patients. Complex
of hygienic measures in order to prevent nosocomial infections.
PURPOSE: research basic architecture, sanitation and hygiene techniques and means
of prevention nosocomial infections in the modern health care facilities, providing
safety conditions for ambulatory patients and medical staff.
QUESTIONS FOR SELF-PREPARATION:
1. What types of health care facilities should be located within the residential area of the
settlements, which in a suburban area, specify why?_____________________________
______________________________________________________________________
______________________________________________________________________
2. Which functional zones and entrances should be allocated in the territory of multi –
department health care facilities? ___________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
3. What is the main unit of usual physician services; enumerate basic premises of the
usual physician services? _________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
4. What is the main unit of infectious department; enumerate basic premises of the
infectious department? ___________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
5. Specify basic architectural & planning issue in order to prevent nosocomial infections
in an ambulatory surgical center; enumerate basic premises of the ambulatory surgical
center? ________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
6. What is the main principle towards planning of operational units; enumerate basic
premises of the operational units? ___________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
_____________________________________________________________________
7. Specify, to which department should be hospitalized pregnant woman, suffer from
infectious disease, acute stage of clinical manifestations? _______________________
______________________________________________________________________
_____________________________________________________________________
8. Specify way of discharged wastewater from infectious and tuberculosis hospitals,
which features have cisterns in the toilets in these hospitals? _____________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
9. Which way (where and how) should neutralizes specific hospital waste (potentially
infectious materials and instruments, contaminated with body fluids, i.e. blood,
secretions of the patients, pathological waste, organic operating waste, infectious
departments waste, etc.)? _________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
10. Which kind of heating system (specify why) carried out in the health care facilities:
a) the aseptic mode; b) the common mode? ___________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
11. Specify way of sterilization an air in the specialized premises of health care
facilities; how should control their effectiveness (directly and indirectly)? ___________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Situational task _____"Features of hygienic requirements towards planning, functioning of
health care facilities and conditions carried out for ambulatory patients. Complex of hygienic
measures in order to prevent nosocomial infections"
Premises
Time of measurement
General microbes
number
(GMN in 1 m3)
Number of
hemolytic
streptococci’s
(Str. in 1 m3)
Before work
After work
Before work
After work
Before work
After work
Before work
After work
1.
Hygienic
conclusion
by
results
of
sanitary
inspection:_________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2.
Etiological factors and-or risk factors for health of patients_____________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
3.
Hygienic actions in order to prevent flash of nosocomial infection among patients __________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Signature ______________
Тheme № 5. Nutrition in the preventive medicine. Organization of the treatmentand-prophylactic nutrition on the industrial enterprises.
PURPOSE: research types of rational nutrition. Carry out hygienic assessment of
medical-preventive nutrition at the industrial enterprises.
QUESTIONS FOR SELF-PREPARATION:
1. Food functions and its major factors______________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
2. Alimentary diseases (primary and secondary diseases of the insufficient and superfluous
food) ________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
3. Enumerate types of nutrition ___________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
4. What is the purpose of the treatment-and-prophylactic nutrition; specify to which
population group apply the treatment-and-prophylactic nutrition? __________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
5. What is the purpose of the treatment (dietetic) nutrition; specify to which population
group apply the treatment (dietetic) nutrition? ________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
6. What is the principle of quantitative usefulness of a diet?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
7. What is the principle of a high quality balanced diet? ________________________
______________________________________________________________________
______________________________________________________________________
8. What is the principle of an optimality diet? ________________________________
______________________________________________________________________
______________________________________________________________________
9. What is the principle of a diet safety?_____________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
10. Enumerate types of the treatment-and-prophylactic nutrition _________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Situational task № _____ "Nutrition in the preventive medicine. Organization of the treatmentand-prophylactic nutrition on the industrial enterprises"
Carry out hygienic conclusion of organization of treatment-and-prophylactic nutrition in the
industrial enterprise, which characterized by harmful occupational factors, as well as _________________
_____________________________________________________________________________________
___________________________________________________________________________:
• ration is carried out at the end of a working day;
• menu of a ration for 2 days:
1 day
2 day
• Energy value intake and chemical composition of ration № ________:
Protein – _____ g
Fats – ______ g
Carbohydrates – ______g
Energy value intake – _______ kcal
Answer.
__________________________________________________________________________________
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Chemical composition of ration № _________ has the following disadvantages:
1)_________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2)_________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Situational task № ______ "Nutrition in the preventive medicine. Organization of the treatmentand-prophylactic nutrition on the industrial enterprises"
__________________________________________________________________________________
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__________________________________________________________________________________
1. Carry out hygienic estimation of treatment-and-prophylactic ration: __________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2. Define etiological factors and-or risk factors for health of person ____________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
3. Find necessary standard documentation for hygienic estimation of treatment-and-prophylactic
ration: ____________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
4. Recommend preventive measures in order to correct treatment-and-prophylactic ration:___________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Signature ______________
Тheme №6. Medical control over the organization of therapeutic (dietary)
nutrition in medical and preventive institutions and in the system of public
catering. Prevention of food poisoning.
PURPOSE: reseach principles of dietetic therapy appointment at the treatment andprophylactic establishments in the public care system in order to prevent infectious
diseases with alimentary way of transfer, prevention of food poisonings.
QUESTIONS FOR SELF-PREPARATION:
1. What is the purpose of the treatment (diet) nutrition? ________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
2. What are the differences towards "treatment nutrition" and a "diet"? ____________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
3. On what principles based treatment (diet) nutrition?_________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
4. Why individualization of treatment (diet) nutrition is important? _______________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
5. Specify factors carried out at the individualization of treatment (diet) nutrition?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
6. What requirements should be corespond food products, carried out to the treatment
and-prophylactic establishments’ kitchen? ____________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
7. What are the requirements for cooking treatment (diet) nutrition in the treatment andprophylactic establishments’ kitchen? ____________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Sstuational task № _____ "Medical control over organization of the treatment (dietary)
nutrition at the treatment and-prophylactic establishments in the public care system"
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Answer:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Signature ______________
Тheme № 7. Legislative basis for sanitary supervision in the field of occupational hygiene.
Hygienic assessment of the factors of the labor process and the working environment.
PURPOSE: research technique of investigation cases of occupational diseases in the industrial
enterprises; carry out sanitary surveillance over organization and implementation of preventive
medical examinations.
QUESTIONS FOR SELF-PREPARATION:
1. What is the main purpose of preliminary medical examinations of working population?
__________________________________________________________________________________
__________________________________________________________________________________
2. What is the main purpose of periodic medical examinations of working population?
__________________________________________________________________________________
__________________________________________________________________________________
3. Explain, which categories of worker staff should be carried out to mandatory medical
examination?_______________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
4. Which duties of the employer do you know at the organization of the medical examination?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
5. Which duties of the medical establishment (hospital) do you know at the organization of the medical
examination?________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
6. Explain, which of the occupational environmental factors concern to the harmful factors?________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
7.Give definition of "harmful factors of working environment and working process".
__________________________________________________________________________________
__________________________________________________________________________________
8. Enumarate physical factors of working environment____________________________________
__________________________________________________________________________________
__________________________________________________________________________________
9. Give a definition of I class of working conditions, by harmful and dangerous factors of industrial
environment________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
10. Give a definition of the maximum permissible concentration of harmful substances in working
zone air (hereafter – MACm.s.).
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
11. Give a definition of II class of working conditions, by harmful and dangerous factors of industrial
environment________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
12. Give a definition of III class of working conditions, by harmful and dangerous factors of industrial
environment_____________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
13. Give a definition of IV class of working conditions, by harmful and dangerous factors of industrial
environment_____________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
14. What criteria determines the intensity of working process, according to the "Hygienic classification
of work"?______________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
15. Specify criteria of the severity of working process, according to the "Hygienic classification of
work"?____________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
PROTOCOL
on hygienic assessment factors of labour process and occupational environment
(should be completed by the situational task on the topic " Hygienic estimation occupational factors
of an industrial environment, in accordance with "Hygienic classification of work")
№
Occupational factors
Characteristic of
factors
Exceed of MAC
Industrial environment:
1.
2.
2.1
3.
3.1
3.2
3.3
4.
4.1
4.2
4.3
Harmful chemical substances
- 1-2 class of danger
- 3-4 class of danger
Physical factors
Noise
Microclimate:
- in warm season of the year;
- in cold season
Air temperature
Speed of air movement
Thermal radiation
Severity of work:
Weight of cargo
Physical dynamic loading for
one shift
Cargo moving on the distance
Class of severity,
intensity, hazard and
dangerous of work
from 1 to 5 meters
4.4
Stereotypic
working
movements (number per shift)
4.5 Static loading per one shift
4.6 Working pose
4.7 Case inclinations, number per
shift
4.8 Moving on a space
5. Intensity of work:
5.1 Duration
of
concentrated
supervision (in % from shift
duration)
5.2 Monotony of the loading,
in % from shift duration
5.3 Quantity of elements for
realization of the task
5.4 Duration of working day,
hours
5.5 Quantity of working shifts
5.6 Emotional loading: degree of
responsibility for the results of
activities
Complex
assessment
of
working conditions
HYGIENIC CONCLUSION: at the estimation of occupational factors by „Hygienic classification of
work”, working conditions of the worker concern: by physical factors – to _____class _____degree
(specify which factor________), by microclimate – to _____class _____degree (______), by severity
of work to _____class _____degree (specify which factor_________), by intensity of work – to
_____class _____degree (specify which factor_________).
Finaly, working conditions concerned to class _____degree _____ (specify by which
factor_________), which carried out to... (underline the necessary):
 3 class 1 degree (3.1) - working conditions, which cause to the functional changes, falling
outside the limits of physiological fluctuations (which not restored to the beginning of a
following labour shift) and increase risk of deterioration of health;
 3class 2 degree (3.2) - working conditions, which are capable lead to the industrial-caused
pathology, occurrence of easy forms professional pathology (without disability), arise after a
long exposition (more than 10 years);
 3class 3 degree (3.3) - working conditions, which are resulted to development of
occupational diseases, easy or moderate severity level (with loss of professional work
capacity in labour activity);
 3 class 4 degree (3.4) - working conditions, which can lead to increase of chronic pathology
and level of disease with time disability, to development of heavy forms occupational
diseases (with loss of the general work capacity);
 4 class – Dangerous (Extreme) - working conditions, which influence on a labour shift creates
threat for a life, high risk of heavy forms professional defeats.
In order to preserve workers health in the manufacture you should carry out preventive
measures (enumerate basic hygienic actions, focused on the improvement of working conditions)___
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Signature ______________
Тheme № 8. Analysis of the health of children and adolescents in organized groups and a
hygienic assessment of the educational process in a pre-school educational institution and in
school.
PURPOSE: research techniques of complex estimation health status of children and adolescents.
QUESTIONS FOR SELF-PREPARATION:
1. Give the definition of "health"_______________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
2. Among numerous factors, forming health of children and adolescents and having most significant
impact on a growth and development of the child's body, are favorable or wellness factors and
unfavorable or risk factors. What factors are related to favorable factors (wellness)?_______________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
3. What factors are related to unfavorable or risk factors?_________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
4. Enumerate main criteria carried out by family doctors, pediatricians, doctor – hygienist of
educational institutions at the complex assessment health status of children and adolescents_________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
5. What criteria carried out distribution of children on health groups?__________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
6. Specify, and characterized groups of health among children and adolescents_________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
7. Which pathology should reveale distribution of children by health groups?___________________
__________________________________________________________________________________
__________________________________________________________________________________
8. What is the basis for identifying risk factors of an environment, educational process and other
conditions in childcare preschool institutions and comprehensive schools with preventive actions?____
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
9. Indicators of an individual health:_____________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
10. Indicators of population health:______________________________________________________
_____________________________________________________________________________________
11.Specify features of organization teaching &educational training for 6 y.o. children; school maturity,
methods of its determination___________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
12. Which medical criteria concerned to the definition "school maturity"?______________________
__________________________________________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________
13. Which psychophysiological criteria concerned to the definition "school maturity"?____________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
14. Enumerate criteria of readiness for 6 y.o. chidren to visit school____________________________
_____________________________________________________________________________________
____________________________________________________________________________________
15. What skills related to a personal hygiene of children?___________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
16. Specify maximum duration of computer games for preschool age children___________________
_____________________________________________________________________________________
17. What changes happened in the modern comprehensive schools?__________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
18. What are the basic principles of hygienic standardization teaching &educational training?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
19. What hygienic requirements carried out for lessons, schedule?___________________________
__________________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________________
__________________________________________________________________________________
3. SITUATIONAL TASK
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Schedule of lessons
Monday:
Tuesday:
Wednesday:
1.
1.
1.
2.
2.
2.
3.
3.
3.
4.
4.
4.
5.
5.
5.
6.
6.
6.
7.
7.
7.
Thursday:
Friday:
1.
1.
2.
2.
3.
3.
4.
4.
5.
5.
6.
6.
7.
7.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________________
Hygienic conclusion
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________________
Signature ______________
Тheme №9. Application of the system of radiation and hygienic regulations in the conditions of
practical activity, medical practice and technogenically intensified ionizing sources of natural
origin
PURPOSE: propose actions focused on minimisation level of the population irradiation from ionising
radiation, based on a quantitative estimation possible radiating impact.
QUESTIONS FOR SELF-PREPARATION:
1. Concept and origin of radioactivity. Specify activity unit in the International Units System (IUS)
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2. Enumerate types of nuclear transformations and characterize them?________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
3. Which types of radiation sources do you know? Provide their comparative description_________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
4.
Enumerate
qualitative
and
quantitative
characteristics
of
ionizing
radiation?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
5. Specify ways of interaction towards ionizing radiation and substances?______________________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
6. What means equivalent and effective dose? Specify their links to each other?________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________________
7. What types of irradiation of body do you know?______________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
8. Specify types of radiation effects of a human body? Give examples.________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
9. Which sanitary legislation provides system of the radiation-hygienic regulations?_____________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
10. How many groups of radiation-hygienic regulations do you know? Specify their characteristics.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
11.What does medical exposure mean? List principles of radiation protection
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________________
12. What actions (procedures) should contain medical exposure and which sources of radioactivity
cause irradiation of a particular person?__________________________________________________
_________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
13. Which categories of population could be exposed to radiation in the implementation of medical
practice?__________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
14. What means "recommended exposure levels (regulations of the second group)" and who carried
out them?________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
15. Which categories of patients carried out during radiological procedures?_____________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
16. Which "recommended limit of medical exposure" established by Ministry of Health of Ukraine for
various categories of patients?_________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
17. What are the limits of medical exposures carried out for routine patients, volunteers?___________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
18. To which categories of irradiation concern medical staff of the radiological and X – ray
departments in the health care facilities, specify LDE for these categories?_______________________
__________________________________________________________________________________
_______________________________________________________________________________
19. What means "individual monitoring" and to which categories of staff should they apply?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
20. Specify requirements to X – ray departments planning in the residential apartments, polyclinics,
medical care facilities._______________________________________________________
_______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________
Scenario – based task:
In radiological department of hospital at the operation room of computer tomography, which
was the source of X-ray and gamma radiations, with increase of level of ionizing radiation in the
working zone of the personnel has been established. The radiologist has received an annual individual
equivalent dose of the irradiation at level of __________ mZv.
Tasks:
1. Carry out hygienic estimation and give hygienic conclusion about conformity of the irradiation
to admissible levels. For a hygienic estimation find the basic dose border for a year of
individual irradiation, established for the given category of irradiated persons.
2. Find necessary specifications and technical documentation for a hygienic estimation of the
situation.
3. Specify limit of an effective dose for a year for category A (persons who constantly or
temporarily work with the sources of ionising irradiations) according to Radiation Safety
Standard of Ukraine (RSSU-97).
Hygienic conclusion
1. Individual equivalent dose received by doctor-radiologist, work with closed sources of γ - and
Х- ray radiation exceeds an annual limit of dose for category A (personnel directly contacting
to radioactive sources) in ________ times.
2. ___________________________________________________________________________
________________________________________________________________________________
__________________________________________________________________________________
3. Individual equivalent dose received by doctor-radiologist for category A (personnel directly
contacting to radioactive sources) should be carried out on the level_____________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Signature ______________