LIST OF QUESTIONS FOR PREPARATION TO FINAL MODULE CONTROL 2. Special questions on hygiene and ecology Thematic Module No 7. Basics of preventive and regular sanitary inspection 1. Main tasks and stages of the preventive sanitary inspection. 2. Tasks and content of the regular sanitary inspection. 3. Project of the construction and its main parts (textual and graphical) during each phase of the project (draft or conceptual design, architectural and technical project, construction drawings). 4. Main types of construction drawings (situational and general layouts, floor plans, elevations (facades) and slits of buildings, drawings of sanitation communications etc.). Thematic Module No 8. Hygiene of the patient care institutions. Radiation hygiene 1. Hygienic significance of the optimal regime of the patient care institutions as the conditions for the increase of patients’ treatment efficacy, prophylaxis of nosocomial infections and creation of medical personnel safe labour conditions. 2. Hygienic requirements concerning the location of the hospital ground area, its planning and hospital territory zoning. 3. Hygienic requirements concerning the location, planning, sanitary appliance, regime of exploitation of the facilities for the patients of different type admission and discharge (children, infectious patients, pregnant women, surgical patients and others). 4. Hygienic requirements concerning the location, planning, sanitary appliance, optimal sanitary and hygienic regime of exploitation of the departments and ward sections – therapeutic, surgical, obstetric, children’s, infectious and other ones. 5. Hygienic requirements concerning the microclimate, ventilation, natural and artificial lighting of different hospital facilities. 6. Peculiarities of the planning, sanitary appliance, optimal sanitary and hygienic and antiepidemic regime of exploitation of the hospital operating block and the intensive care units. 7. Peculiarities of the location, planning, sanitary appliance, optimal sanitary and hygienic and anti-epidemic regime of exploitation of the hospital infectious department (building). 8. Hygienic requirements concerning the location, planning, equipment, engineering process of food preparing in the hospital nutrition unit. 9. Prophylaxis of the food poisoning at the in-patient department. 10. Medical control of food transporting and dispensation in the departments in order to keep its full-value and taste qualities. 11. Sanitary and hygienic requirements concerning collection, removal and elimination of the hospital specific wastes. 12. Personal hygiene of patients and medical workers of the surgical, obstetric and children’s departments, the operating block and maternity houses. Hygienic and anti-epidemic measures of the nosocomial infection prevention. 13. Occupational hazards, the medical workers’ labour hygiene and peculiarities of different medical personnel labour (surgeons, obstetricians, infectiologists, experts in resuscitation, anesthesiologists, doctors of the artificial kidney and hemotransfudion departments, manipulation nurses, clinical laboratory assistants, disinfectors, physiotherapeutists and others). 14. Classification of the ionizing radiations according to the types of radiation, their use at the manufacture, in science, medicine, their sources (nuclear material, bare and sealed sources, nuclear accelerators, radioactive wastes). 15. Qualitative and quantitative characteristics of radionuclides as sources of ionizing radiation (types of nuclear transformation and ionizing radiations accompanying them, half-life period, activity, gamma-equivalent), their measurement units. 16. Qualitative and quantitative characteristics of ionizing radiations (energy, penetrating and ionizing power). Types of doses and their measurement units. The doses’ rate. 17. Ionizing radiations as the occupational hazard in industry, in the scientific researches, medicine. 1 18. Main types of radiation damages to the body, and their causes. 19. Acute and chronic radiation sickness, its causes, stages of its course, main clinical manifestations. 20. Long-term consequences of the radiation damage, local damages (cancerogenic, teratogenic, embryotoxic effects, radiation burns and others). 21. Regulations of the radiation safety (Norm of radioactive safety of Ukraine-97 (НРБУ-97), Basic sanitary rules of Ukraine-99 (ОСПУ-99)). 22. Methods and measures of the radiation and medical control during work with bare and sealed sources of the ionizing radiation. Means of measurement of the ionizing radiation capacity, individual irradiation doses, the working surfaces pollution by radionuclides, radionuclide concentration in the environmental objects – the atmosphere air, the working zone air, water, soil, foodstuff. 23. Methods and measures of the protection from external irradiation based on physical laws of radiation decay (protection by amount, time, distance and shielding), their legislative, organization and technical bases. 24. Principles of the choice of material and calculation of thickness of the protecting shield from β,γ- and X-ray radiation. 25. Calculation methods of assessment of the radiation safety and parameters of protection from the internal and external irradiation as part of the personnel radiation protection measures. 26. Ionizing radiations as the occupational hazard for the patient care institutions personnel. 27. Peculiarities of the radiation danger and radiation protection in the departments of bare and sealed sources of the ionizing radiation, in the department of the teletherapy, diagnostic X-ray departments. 28. Regulations of the radiation safety for the patient care institutions personnel and patients (Norm of radioactive safety of Ukraine-97 (NRSU-97), Main sanitary rules of Ukraine-99 (MSRU-99) and other legislative documents). 29. Methods of collection, removal and elimination of the radioactive wastes during work with bare and sealed sources of ionizing radiation. 30. Methods and measures of the sanitary and radiation control during work with the ionizing radiation sources at medical institutions. Stages of hygienic control as to the environmental factors, working and living conditions. 31. Observation zones for health study depending on the environmental condition. Determination of notion, demands to choice. 32. Method of integral assessment of the environmental condition. 33. Methods of detection of influence of the environmental actors on the public health. 34. Risk factors of the environment, their classification and influence on the development of public health. 35. Investigation schemes of the environmental factors influence on the public health. 36. Indices that characterize the public health. Method of determining the integral health index. Thematic Module No 9. “Tropical hygiene” 1. Social and hygienic peculiarities of nutrition of different age and sex population groups in tropical regions. 2. Peculiarities of rational nutrition and ways of its realization in tropical climate. 3. Organism energy, protein, fat, carbohydrate requirements and their quantity and balance peculiarities in tropical climate. 4. Vitamins, mineral salts, microelements, taste substances (spices) and their role in nutrition of tropical regions population. 5. Hot climate influence on food and some its components assimilation. Metabolism and nutrition pattern peculiarities in tropical regions. 6. Hygienic characteristics of food products, consumed by population of arid and humid tropical regions. 7. General characteristic of alimentary diseases of tropical regions population. 2 8. Malnutrition and complete starvation diseases (protein and energy insufficiency) among tropical regions population. 9. Vitamin deficiency diseases (hypo- and avitaminosis) among tropical regions population. Polyunsaturated fatty acids deficiency diseases. 10. Specific of microelements deficiency diseases among population of arid and humid areas. 11. Mineral and microelements deficiency diseases among population of tropical regions. 12. Overeating diseases in tropical regions. 13. Diseases caused by poor quality of food intake (foodborne diseases, helminthiasis, food poisoning, fermentopathies). 14. Methods of medical control over tropical regions population nutrition. 15. Calculation methods of the population nutrition assessment. 16. Sanitary inspection of food products and ready-made meals, its consumption in tropical region countries. 17. Food products storage and preservation peculiarities in tropical conditions, usage of preservatives and antibiotics. 18. Methods and measures of prevention of the foodborne diseases with alimentary transmission mechanisms, food poisoning. 19. Methods and measures of prevention of the infections diseases and invasions with alimentary transmission mechanisms. 20. Physiological functions of water (structural, exchanging, transporting, excretory, heat exchanging, etc.) and their peculiarities in tropical conditions. 21. Epidemic and endemic waterborne diseases of arid and humid tropical regions. 22. Human body dehydration in tropical climate, its signs and symptoms. 23. Scientific substantiations of norms of physiological, residential, industrial water requirements and their peculiarities in tropical regions. 24. Hygienic requirements to water quality and their peculiarities in tropical conditions. 25. Organoleptic and chemical characteristics of water, their hygienic significance and peculiarities in water of tropical regions. 26. Organoleptic, chemical, bacteriological, toxicological water pollution indices, their peculiarities in tropical conditions. 27. International water quality standards and peculiarities of their usage in tropical conditions. 28. Hygienic characteristic of water resources and water supply sources in arid and humid tropical areas. 29. Hygienic characteristic of methods and means of purification, disinfection, special water conditioning methods in tropical conditions. 30. Methods and organization of drinking water quality sanitary control in cases of centralized and decentralized water supply in developed countries of tropical regions and in developing counties. 31. Meteorological factors’ complex influence on human work capacity, heat exchange and other physiological processes in the organism in tropical and desert climate conditions. 32. Peculiarities of personal hygiene in tropic and hot climate, hygiene of skin, clothes, hygienic principles of day regimen and their substantiation. 33. Peculiarities of inhabited area planning and build-up in arid and humid tropical climate. 34. Hygiene of residential premises in hot climate conditions, microclimate of premises. 35. Hygienic peculiarities of building materials and constructions which are used for building in tropical climate. 36. Peculiarities of working regimen in arid and humid climate. Thematic Module No 10. Healthy mode of life, personal hygiene and psychohygiene. 1. Personal hygiene as a way to keep and strengthen the population health. 2. Physiological functions of skin – protective, metabolic, excretory, heat regulatory, bactericidal, receptor, D-vitamin forming and others. 3. The influence of the skin vital functions products and factors of domestic and industrial environment on skin physiological functions. 3 4. Washing agents, their classification and hygienic assessment. Soap, its chemical structure, detergency, positive and negative characteristics, dependence on the water hardness. 5. New washing agents: detergents, shampoos, their classification, hygienic assessment, positive and negative characteristics. Solid and liquid soaps. Bactericidal soaps. 6. Allergic and other skin responses to the long-term action of washing agents. 7. Chemical means of skin protection from the unfavourable influence of domestic and occupational hazards – ointments, pastes and others, their hygienic characteristics. 8. Bath-houses and saunas as ways to maintain skin cleanliness and stimulate its physiological functions. 9. Hygienic significance, functions and types of clothing of different purposes (everyday, working and hospital). 10. Main types of fabrics, their classification, physical and chemical properties, peculiarities of their use for the clothing of different purposes – everyday (summer, winter), and work ones. 11. Hygienic characteristics of synthetic fabrics and possibilities of their use in different clothing set layers. 12. Hygienic requirements concerning the hospital clothing of different purposes (for surgeons, Xray doctors – radiologists, infectiologists, personnel of the laboratories of especially dangerous infections, disinfectors and others). 13. Classification and hygienic assessment of the protective clothing from dangerous factors of the industrial environment – physical, chemical and biological ones. Hygienic conditions of labour in case of usage of such clothing. 14. General scheme of the fabric assessment, the methods of its certain indices determination (thickness, specific weight, porosity, capillarity, hygroscopic property, relative steam and heat conductivity, resistance to acids, alkali, the organic solvents, to the mechanic effect (wearability), heat radiation). 15. Psychohygiene as a science, basic tasks, methods and measures of psychohygiene. 16. Concept of the human’s psychic health and the main criteria of its assessment. The borderline neuropsychic shifts and the psychic health disorders as a hygienic problem. 17. Main peculiarities of the people’s personalities (temperament, character, neuropsychic state) and their study methods. 18. Psychohygienic basics of everyday activity optimization. The psychohygiene and the psychic prophylaxis of health disorders of different population groups. 19. Biological rhythms and man’s health. Medical biorhythmology as a science. The classifications of the most widespread biological rhythms. 20. Methods of determination of different types of daily, seasonal and other biological rhythm curves. 21. Types of desynchronosis and its medical and hygienic characteristics. 22. Methods of labour and rest regime optimization as measures of physiological and biological rhythms preservation and the prevention of health disorders. Concept of chronohygiene. 4 1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 6. 7. 8. 9. LIST OF PRACTICAL WORK AND TASKS TO FINAL MODULE CONTROL 2. Special questions on hygiene and ecology Thematic Module No 7. Basics of preventive and regular sanitary inspection Thematic Module No 8. Hygiene of the patient care institutions. Radiation hygiene To determine and assess the project patient care institutions’ location and territory zoning, taking into account objects, adjacent to the land parcel, “wind rose”, correspondence with the site development, percentage of green area and the constructions’ orientation. To determine and assess the correspondence of the hospital premises’ area, cubic capacity and sanitary accomplishment to hygienic standards; their correspondence to the functional purpose. To carry out the sanitary inspection and determine the objective figures of the hygienic condition of the medical institution different subdivisions. To determine and assess harmful and dangerous factors of different subdivisions of the medical institution and their influence on the patients’ and medical personnel health. To prepare of devices of radiation control for work, conduct measurements, read devices, assess results. To measure and assess parameters which characterize radiation environment in work and adjacent premises and individual doses of personnel during work with radionuclides and other sources of ionizing radiation. To carry out sanitary inspection of radiological and X-ray departments of hospitals. Thematic module No 9. Tropical hygiene To carry out the sanitary inspection of water supply sources, to take water samples for laboratory analysis taking into account tropical conditions. To disinfect water in tropical conditions. To be able to conduct individual disinfection of water supplies in hot climate. To be able to use special methods of water quality improvement in tropical conditions. To carry out medical control of nutrition sufficiency and safety in tropical regions. To be able to use calculation methods of the population nutrition assessment and correction. To be able to work out preventive measures of pathology associated with exposure to unfavorable arid and humid hot tropical climates when performing physical work. To be able to work out preventive measures of water supply organization in arid and humid areas. To be able to work out preventive measures of nutrition organization in arid and humid areas. Thematic Module No 10. Healthy mode of life, personal hygiene and psychohygiene 1. To recommend and apply into practice of public health the basics of healthy lifestyle, methods and means of personal hygiene and tempering of the organism. 2. To research and state a hygienic value of washing agents, bath-houses, methods and means of maintenance of oral cavity and teeth in healthy condition. 3. To determine the physical and chemical properties of the fabric. 4. To determine the textile porosity. 5. To determine the capillarity of a fabric pattern. 6. To determine the relative heat conductivity of dry and wet fabric. 7. To determine the origin of fabric fibres. 8. To determine the leading human personality peculiarities. 9. To use psycho-hygienic principles of person’s daily activity optimization during training and in free time. To determine different types of biological rhythms day curves, the type of day work capacity and calculation biological rhythms. 10. To use during the organization of educational (working) process and in one’s free time the biorhythmological principles of the rational organization of the everyday activity. 11. To determine different types of biological rhythms day curves, the type of day work capacity and calculation biological rhythms. 12. To use during the organization of educational (working) process and in one’s free time the biorhythmological principles of the rational organization of the everyday activity. 5 LIST OF SITUATIONAL TASKS TO FINAL MODULE CONTROL 2. Special questions on hygiene and ecology 1. Give hygienic estimation of ward for patients with thyrotoxicosis: an area is 30 m2, height – 3 m. The microclimate of ward is characterized by air temperature – 17°C, radiation temperature of walls –15 C°, relative humidity – 70 %, speed of wind – 0,1 m/s. Concentration of CO2 in the ward during the inspection was 0,2 %. Give hygienic estimation of the sanitary mode of ward and give recommendation concerning its improvement. 2. The department for the new-boms of a physiology maternity unit consists of two 10-bed wards. All wards of observational unit and pathology of pregnancy unit have 3-4 bed-wards. Apartment for discharge of women with babies is one for the whole obstetric department. Give hygienical characteristics to the departments' planning, capacities of the wards and offer sanitary measures. 3. In radiological department of the hospital and in premises – the permanent place of the medical personnel (i.e. treatment room in particular), the actual power factor dose of irradiation is equal to 6,8mP/h, the distance of screen to X-ray tube – 2m, anode current – 3mA. 1. Calculate the coefficient of irradiation reduction; Point out the permissible of power factor of the irradiation dose in the exact premises. 4. An infectious hospital is equipped by boxes (general area 27 m2, with 3 beds in each). For ventilation of boxes is used outlet-inlet ventilation system. The centralized water supply system serve of water in an amount 350 1 per one patient. Cleaning by disinfection of flow waters is carried out on general cleansing building. CNL (coefficient of natural illumination) - 1%, lightening coefficient — 1:6, general artificial illuminance 100 lux. Give hygienic estimation of area and capacity of boxes, technical equipment (ventilation, water-supply, lighting).. 5. The results of the laboratory analysis of water sample from water-pump of the river watertower in tropical areas are the following: colour - 32º, transparency -30 cm, smell and taste - 4 points, ammonia nitrogen - 1,5 mg/1, nitrite nitrogen - 0,004 mg/1, nitrate nitrogen - 1 mg/1, iron – 0,1 mg/1, general hardness - 15 mmol/ dm3, fluorine - 0,2 mg/l, coli-index - 2. 1. Give hygienic estimation of quality of the water. 2. Suggest the methods of water quality improvement. 6. The laboratory assistant of the X-ray department works with the γ-irradiation sources Co60 (Kγ–13,2) with activity 10mKi within 30 hours per week (on 1 metre distance/50 working weeks per year). Calculate and estimate the annual dose irradiation of a laboratory assistant. 7. The results of the laboratory analysis of water sample from a water-pump are the following: iron – 0.1 mg/l, nitrate nitrogen – 8 mg/l, fluorine – 2.4 mg/l, general hardness – 4.0 mmol/l. 1. Give hygienic substantiation of required special water conditioning method. 2. What pathology in human organism may cause long-term consumption of such drinking water? 8. A female patient addressed the neuropathologist with complaints: bad sleep, overirritation, undue fatiguability and poor working, capacity. She suspected that her general malaise and fatigue and other disorders were due to changes in her work regime; that is when she was transferred from the first sift to the third one. 1. Make evaluation of the desyncronous form of the patient; 6 2. Give recommendations as to the preventive measures concerning the development of the pathological condition.. 9. An operating-room of a general surgical department with the area of 36 m is equipped with two operating tables. General illuminance is 400 lux, illuminance of the operating field 5000 lux, orientation of windows at the operating room - south-western, ventilation of the operating-room is conducted due to outlet and inlet ventilation with ventilation rate in both directions 1.5 times per hour. Give hygienical estimation to the planning and sanitary equipment of the operating-room; offer sanitary measures. 10. A surgeon of a district hospital is in stationary work position 80% of his working time. After each 1.5-2 hours of work during operation he has 10-15 min breaks. According to the data of local sanitary epidemiological station temperature in the operating-room in summer is 24-25°C, in winter- 17-18°C, relative humidity - 55%, air movement - 0.15 m/s. The air of the operating-room contains 1.19 % of carbon dioxide at the end of the operation, the level of microorganisms -1500 in m3. General artificial illuminance of the operating-room is 300 luk, illuminance of the operating field - 2000 Iuk. Define the character of unfavorable action of the mode of labour and rest, give hygienic estimation of the sanitary regimen of hospital and offer recommendations. 11. The X-ray room of the district hospital consists of the treatment room (30m2); control panel room (4 m2), photolaboratory (4 m2) the consulting room of the physician (X-ray specialist) (6 m2) reception ward (4,8 m2). Ventilation in the treatment room – natural plenum-exhaust, with ventilation dust near the floor and near the ceiling (height 3m). In order to protect the X-ray specialist, the leadsaturated glass with 10mm thickness and small protective screen with the lead-saturated rubber with 4mm thickness. 1. Determine whether the hygienic norms and working conditions of the medical personnel in the X-ray room of the district hospital meet the requirements; 2. Propose (if it necessary) the well-grounded recommendations as to the optimization of conditions in the X-ray room. 12. The land area of a district hospital for 150 beds is 22500 m2. 17% of the territory is occupied by buildings, 58% - by green zone (parks, gardens). The hospital area has four entrances. Hospital wards are located at the distance of 20 m from the nearest residential buidings. Distance between hospital radiological building and other ones – no more than 20 m. Give hygienical estimation of hospital area, its planning and correspondence of the hospital planning to sanitary requirements, offer sanitary measures. 13. An infectious hospital is equipped by boxes (general area 27 m2, with 3 beds in each). For ventilation of boxes is used outlet-inlet ventilation system. The centralized water supply system serve of water in an amount 350 1 per one patient. Cleaning by disinfection of flow waters is carried out on general cleansing building. CNL (coefficient of natural illumination) - 1%, lightening coefficient — 1:6, general artificial illuminance 100 lux. Give hygienic estimation of area and capacity of boxes, technical equipment (ventilation, water-supply, lighting). 14. While working with the radioactive cobalt (γ – constant radionuclide 13,2), its activity (capacity) is equal to 5 mKi ina 1 – metre distance within 20 hours per week), the workman is exposed to radiation. 1. Calculate the external irradiation dose per a week, for a year. 2. Count up the permissible time of work of a worker thoughout a year; Give the sanitary of the obtained results (the permissible dose should be in roentgens (R). 15. The laboratory assistant of the X-ray department works with the γ-irradiation sources Co60 (Kγ–13,2) with activity 10mKi within 30 hours per week (on 1 metre distance/50 working weeks per year). Calculate and estimate the annual dose irradiation of a laboratory assistant. 7 16. Medical personnel of the X-ray department of a hospital while working with γ -irradiation sources with the activity 5mg/ekv of radium on 0,5 metre distance. The duration of a working week of a medical personnel is equal to 20 hours; 50 working hours a year. 1. Calculate the annual dose of irradiation for the medical personnel. 2. Indicate (write down) the effective limit dose of irradiation for medical personnel. Estimate the annual irradiation dose for medical personnel. 17. Define, whether an operating-room on 2 operating- tables of surgical brigades responds to hygienic norms of labour: area 30 m2, height 3 m, one window by sizes 2,5 h × 2 m is oriented to the north-east, outlet-inlet ventilation with ventilation rate in both directions 1,5 times per hour. 18. Define, whether meets standards of area, cubic capacities, natural illumination of the 6 beds ward, which based on the ground floor of the designed hospital. Sizes of ward on the draft: width 3,8 m, depth 7,5 m, height 3,0 m. One window 2,2 h 1,8 m2, oriented on a south-east. Height of windowsill 0,8 m. 4-floor building is designed in the distance 20 m from hospital. 19. Adult person has excessive body mass of 13 kg, and in order to decrease it to ideal theoretical body mass he gets limited ration of l 100 kcal instead of necessary 2400 kcal per day. (Losing every 1 kg of body weight during 15 days corresponds ration failure of total 4100 kcal). How long can this intake be used without pathological changes in the organism? 20. Make a hygienic evaluation of types of daily curves of biological rhythms taking into consideration the body temperature and heart beat rate of a medical student if the body temperature at 800 was 36,3C, his heartbeat rate was equal to 74 beats per minute, at 1200 – his body temperature was equal to 36,4C, his heartbeat rate – 70 beats per minute, at 2000 – his body temperature – 36,6C, his heartbeat rate was equal to 76 beats per minute. 21. A woman executes a work of middle hardness and gets the daily ration with caloricity of 3000 kcal during 15 days. For this period she lost 1 kg of body weight. The loss of each 1 kg of body weight during 15 days corresponds to insufficiency of energetic value in a ration of 4100 kcal. 1. What should be the daily diet in conditions of adequate (rational) nutrition? How can the daily intake be optimized? 22. Man (height 175 cm) works in the rice fields. During 15 days period, the person lost 2.0 kg of body weight. Ideal theoretical body mass equals 75 kg. Man performs medium intensity work and receives intake, worth 2600 kcal. Taking into account that every 1 kg of body weight loss during 15 days equals 4 100 kcal shortage for adults. Calculate how many calories the intake should be increased by to compensate his body weight loss. 23. A female patient addressed the neuropathologist with complaints: bad sleep, overirritation, undue fatiguability and poor working, capacity. She suspected that her general malaise and fatigue and other disorders were due to changes in her work regime; that is when she was transferred from the first sift to the third one. 1. Make evaluation of the desyncronous form of the patient; 2. Give recommendations as to the preventive measures concerning the development of the pathological condition. 24. The results of the laboratory analysis of water sample from water-pump of the river watertower in tropical areas are the following: colour - 32º, transparency -30 cm, smell and taste - 4 points, ammonia nitrogen - 1,5 mg/1, nitrite nitrogen - 0,004 mg/1, nitrate nitrogen - 1 mg/1, iron – 0,1 mg/1, general hardness - 15 mmol/ dm3, fluorine - 0,2 mg/l, coli-index - 2. 1. Give hygienic estimation of quality of the water. Suggest the methods of water quality improvement. 8 25. Dose power factor from the γ -irradiation source in the panel room of the X-ray department of the hospital is equal to 8mber/h. The duration of work – 2 hours per day; 300 working days per year. 1. Make conclusions as to external irradiation dose of the medical personnel in the panel room of the X-ray department of the hospital; Estimate the dose of external irradiation of the medical staff received while working in the panel room of the X-ray department of the hospital. 26. During medical examination of the group of oil-workers on the Near East (Arabian Peninsula) it was revealed: polydipsia, increased sensitiveness of the skin to the ultraviolet radiation, increased skin capillaries penetration, hyperceratonic dermatosis , dry skin with fissures, seborrheic eczema, immunity decrease, hair loss. 1. Define the type of nutrition pathology. Offer prophylactic measures. 27. The aim of inspection in a boarding school is to find out how the pupils, follow the rules of personal hygiene. It is revealed that 10% of the 11th form schoolgirls wear underclothes made of nylon. The second layer of clothes – from lavsan (synthetic fiber), footwear-form leatherette with narrowed toe; high of heels–5-7cm. 1. Name the layer of clothes that do not respond to hygienic norms. 2. What may be the negative results if a schoolgirl wear such shoes. Give the hygienic recommendations as to the quality of underclothes. 28. The X-ray room for general examination is situated on the ground floor of the polyclinic has treatment room (20 m2), control panel room (6 m2), photolaboratory (10 m2), xerolaboratory (12 m2). The radiation monitoring reveals that the power of irradiation in the treatment room is equal to 17 mP/h. The following protective means for X-ray specialist are available in the X-ray room: leadsaturated glass, that protects the fluorescent screen, small protective screen, individual protective means – gloves, lead-saturated rubber apron (in textile cover). 1. Give an estimation of a hygienic condition and organization of the antiradiological protection of the physician in the X-ray room. Make conclusions and give necessary recommendations as to the equipment of the X-ray room. 29. In x-ray photography hospital department in the apartment for the permanent stay of personnel (procedural) actual power of irradiation dose is 6.8 mR/h, distance of a screen to the xray photography pipe is 2 m, anode current is 3 mA. 1. Count the actual coefficient of radiation ablation (damping factor of x-ray radiation (K)). 2. Give hygienical estimation to the radiation state in the department. 3. Specify possible power of radiation dose in the apartment. 30. A hospital consists of a main building in which surgical and therapeutic department are located, and a few smaller departments are intended for infectious, maternity and children's departments. The therapeutic department consists of two ward sections for 40 beds. A ward section consists of one 1-bed, two 2-bed, four 4-bed and three 6-bed wards, and also of the manipulation and procedure room (5-7 m2). The area for one bed in all wards is 5 m2. Windows of 60 % of wards are faced towards the north. Determine the systems of hospital building, give hygienic assessment to ward section planning, windows orientation of wards, correspondence of the hospital planning to sanitary requirements. 31. A land of a city hospital of general type for 500 beds with the area of 40000 m 2 the following sectors are separated: the zone of medical building for non-infectious patients, the zone of medical building for infectious patients, a zone of morbid anatomical department, a household zone, and also garden-park area for both medical buildings with the area of 5000 m2. 25% of the territory is occupied 9 by buildings, 40% - by park zone. Give hygienic estimation to this territory, correspondence of the hospital planning to sanitary requirements, offer sanitary measures. 10