Block 13 - part 1 Flashcards
Percentage of deaths caused by CHD in UK
29% men, 28% women
why are death rates from CHD falling
improved risk factors, better treatments
effect of health inequalities on CHD
lower social class at higher risk - health behaviours
4 non-modifiable risk factors for CHD
increased age, fam hx, gender (men> before age of 60), race (high rate for african americans and asians)
modifiable risks for CHD
Elevated blood cholesterol, high LDL, low HDL, High BP, diabetes, smoking,obesity, inactivity, excessive alcohol, excessive stress
risk
probability of an event in a given time period
equation for risk ratio
risk ratio = risk (exposed)/risk (unexposed) a= risk and disease present b= risk present, disease absent c= risk absent, disease present d = risk and disease absent RR=a/(a+b)/c/(c+d)
equation for risk difference
risk(exposed)-risk(unexposed)
odds ratio
probability of disease occurring in exposed group/probability of disease occurring in unexposed group
equation for odds ratio
a= risk and disease present b= risk present, disease absent c= risk absent, disease present d = risk and disease absent
OR = (a/c)/(b/d)
=(ad)/(bc)
population attributable risk
the risk of disease will increase as the exposure prevalence or relative risk increases
leading cause of cancer mortality
lung cancer
main risk factors for lung cancer
smoking, radon, asbestos, environmental tobacco exposure, genetics, other lung diseases, prior radiation in chest area
percentage of lung cancer caused by smoking
90%
second leading cause of lung cancer after smoking
radon
types of lung cancer
small cell (13%), non small cell (87%): Adenocarcinoma (>40%), squamous cell carcinoma (20%), large cell carcinoma (2%) Mesotheloma
number of people in world infected with TB
1/3 of world population
deaths by TB each year
3 million
factors associated with recent increases in prevalence of TB
urban homelessness, IV drug use, growing neglect of TB control programs, AIDS epidemic
time of year for peak TB incidence
spring/summer
4 things which can be done to address riding rates of TB
put more people on ART, new vaccine, improved drugs, diagnose better
prevention paradox
a preventative measure which brings large benefits to the community offers little to each participating individual
pros of ‘high risk’ approaches to health promotion
appropriate to individual, motivated subject, motivated clinician, cost-effective resource use, benefit for risk is high
cons of ‘high risk’ approaches to health promotion
screening is difficult, palliative and temporary, limited potential as not many people at high risk, labelling
pros of ‘population’ approach to health promotion
large potential as targeting many peopl
cons of ‘population’ approach to health promotion
prevention paradox, poor motivation - compliance issues, small individual benefit, benefit for risk is lost
examples of occupational lung disease
occupational asthma, COPD, pneumoconiosis, toxic pneumonitis, hypersensitivity pneumonitis, infections including TB, malignancy of lung and pleura
how has occupational health risks changed over time
better environment control and health and safety, depends on health of population and local industry, diagnosis of occupational lung diseases has improved, biological factors (predisposing/genetic)
occupational asthma
characterised by airway inflammation, reversible airways obstruction, and bronchospasm, caused by something in workplace environment
causes of occupational asthma
bakers, welders, paint sprayers, laboratory workers
expected Hx from pt with occupatinal asthma
symptoms worse at work and better away from work, e.g. weekends and holidays, peak flow falls at work and improves away from work
occupational causes of COPD
coal mining, agriculture, construction, dock workers, brick making
pneumoconiosis
occupational restrictive lung disease caused by inhalation of dust (coal dust, silica, asbestos)
simple coal workers pneumoconiosis
after around 10 years coal mining, small nodules are present, shouldn’t cause major impairment in lung function, some coal workers have symptoms of chronic bronchitis
possible complications with coal workers pneumoconiosis
scarred fibrotic lung distorts remaining lung (gross obstruction and restriction)
silicosis (type of pneumoconiosis)
occupational lung disease caused by inhalation of crystalline silica dust, marked by inflammation and scarring in the form of nodular lesions in upper
siderosis
deposition of iron in lung tissues - no effect on lungs so no associated fibrosis or narrowed airways
acute pneumonia
acute inhalation of a substance that causes symptoms immediately, can be caused by chlorine, ammonia, organic chemicals, metallic compounts, form of acute RDS
hypersensitive pneumonia
type 3 hypersensitivity reaction, inflammation of the alveoli due to inhaled organic dust
causes of hypersensitive pneumonia
bird fancier’s lung (due to feathers and bird droppings), farmer’s lung (due to mouldy hay), metalworking fluids
% of lung cancers in men related to occupation
10%
asbestos
used a lot in 1950s and 1960s as a building material, fire retardant and could be used as cement.
problem with asbestos
found to cause malignant mesothelioma (pleural tumour) in 1960s
two types of asbestor fibre
serpentine (curly, white asbestos (relatively harmless), cleared with mucocilliary escalator)
amphibole (short sharp blue/brown asbestos - malignant potential)
mesothelioma
cancer of mesothelium, almost invariably caused by exposure to asbestos, latency period of around 40 years
where are claims submitted for compensation for occupational illness in the UK
disability benefits centre of benefits agency (DSS)
