Environmental Health Flashcards
List 5 military significant vector diseases
Malaria Leishmaniasis Yellow fever Lymes disease Plague Dengue Fever Epidemic typhus Relapsing fever Tryapanosomiasis Encephalitis Murine typhus Scrub typhus Zika virus
Describe mechanical transmission of an arthropod borne disease.
Insect carries pathogen on outside of its body, it then deposits it on surfaces or food it is then ingested by humans.
Name two types of localised freezing injury.
Frost nip
Frost bite
3 Categories or Cold Injuries
Generalised
Local
Non-Freezing
State 5 individual risk factors that increase chance of heat illness.
Overweight Smoking Alcohol Previous heat illness Medication Dehydration Poor nutrition
How long does it take to acclimatise to a hot environment following JSP 539
8-15 days
Prior to any activity which may involve a risk of heat related illness what risk factors should a commander consider when trying to help prevent heat illness?
Environmental Clothing Acclimatisation Sun cream Work rate
What piece of equipment could you use to give a commander advice regarding the risk from environmental/ thermal conditions?
WBGT
What impact would be experience by the military personnel if commanders fail to effectively manage climatic injuries?
Waste of limited resources
Discharge
Loss of manpower
What environmental factors can affect risk of heat illness?
Radiant heat
Wind speed
Ambient air temperature
Relative humidity
State ways in which the target can be protected against vector borne diseases.
Avoidance
Protective clothing
Reppelents
List measures that can be implemented to control a vector borne disease.
Bed nets
Don’t expose skin
Unit dry day
Remove vector
Two pieces of equipment to spread insecticides.
Swing fog- knockdown
Compression sprayer- residual
List 3 main categories of control measures at the route of the sterile disease.
Chemical
Biological
Physical
What is the ROUTE for leishmaniasis?
Ingestion sand fly/arthropod
Malaria and leishmaniasis are caused by which type of microorganism?
Protozoa
Which arthropod disease is endemic in the UK and which arthropod spreads it?
Lymes disease
Tick
You have seen a patient who you suspect has contracted leishmaniasis. You refer him to the Medical Officer, but who would you send an FMED 85 to?
SO2 Health Protection
State 5 reasons why you would investigate a disease outbreak.
Find source Prevent spread Eliminate risk Confirm Assess the scale Investigate origin Fulfil statutory requirement
You are deploying to an area at high risk of schistosomiasis. One of the commanders has asked what the signs and symptoms are.
D+V
Abdominal pain
Spleen enlargement
Itchy skin
List 4 types of camps and their durations.
Short halt 24hrs
Temporary 24hrs-7 days
Semi permanent 7days - 6 months
Permanent 6 months+
State 4 advantages of good waste management.
Discourage pests and vectors
Maintain camp moral
Minimise risk of disease
Prevent food or water contamination
State 3 advantages of incinerating waste.
Low waste management
Cheap and easy to do
Less attractive to pests
Heat can be used for energy
List four types of waste generated in the field.
Urine
Soil
Sullage
Refuse
Name two methods of clinical waste disposal.
Sharps box
Baggage
What are the main types of PPE you would wear when handling clinical waste?
Gloves
Apron
Mask
Eye wear
What is the name of the chemicals used for disinfection and de-tasting principles of water purification?
Calcium Hydrochloride
Sodium Thiosulfate
List 2 occasions where contact period for water disinfection will be increased from 15 mins to 30 mins?
Temperature below 5^
No lovibond check kit available
When carrying out a recce on a water source, how far and what direction?
2km upstream
Describe EpiNato and where it is used.
Health surveillance tool utilised on exercise
Six principles of water purification.
Check
Select source- quantity quality Clarification -filtration sedimentation Disinfect - physical chemical Contact period - 15mins or 30 mins when Shistomiassis, water is cold, lovibond check it not present Test - lovibond check kit De-taste - Sodium thiosulfate
How often should water sampling be carried out and what should be tested for?
Daily- Chlorine
Monthly- Bacterial
Quarterly- Chemicals
What is the purpose of purifying water?
To eliminate microorganisms in the water.
List 3 considerations when selecting a location to establish a military camp.
Location
Terrain
Access
What JSP provides details of the disease control policy?
JSP 950
2 methods to disinfect water.
Chemical- Calcium Hydrochloride in the water.
Physical- boiling water
Diseases associated with contaminated water.
Cholera
Shisstomiasis
Worms
2 methods to clarifying water.
Filtration and sedimentation
Semi Permanent Camp U S S R
7 days - 6 months
U
Funnel urinal soakage pit
1 per 25 men max 4 funnels per pit 6 months usage
Trough urinal and soakage pit
1 trough per 100 men 6 month usage
Female urinal and soakage pit
1 per 25 females 6 months emptied daily incinerated
S Receptacle Latrines Re grease trap Oil drum incinerator Inclined plane incinerator Semi enclosed incinerator Deep trench latrine 5 seats for 1st 100 personnel 3 seats for additional 100 more than 6 months usage
Benefits of CHD trained personnel
Self sustained Proactive pest control Improve sanitation Water safety Lower DNBI Maintained Op effectiveness Intelligent tasking of EH team
What does DMHS defence mental health provide?
Effective care
Education
Research
Act in command liaison role
What is the 1st line of EH support?
Unit medical staff
CHA
CHD Personnel
Role of CHD?
Apply and maintain appropriate op sanitation
Identify and control disease vectors and pests
Maintain unit water supplies
3rd line EH support?
Army regional command EH teams
RAF station environmental techs
RN EH practitioner are employed within med services branch of the RN
Occupational Health Vaccines
Hep B
Rubella
Varicella
4th line support
Commander field army
RAF centre officials aviation medicine
Institute of naval medicine
DMS W
2nd line of EH support
UK med group EH team
Population at risk on ops
Friendly forces
Locally employed civilians
Local civi population
POW and detained personnel
Different types of audit and surveillance
Lab reports Fmed 85 Specific monitoring Local med intelligence EHT audits
Constraints of CHD
Lack of space in FOB usually enclosed
Proximity to sleeping and eating areas
Logistics low priority for resupply of sanitation material
High tempo of activities fatigue lowers hygiene standard
CHA roles
Identify hazards in the AOR
Undertaking threat assessments and hazard recognition
Implementing force health protection measures
Advice for CoC on the measures
External DNBI threats
Climate
Disease
Flora and fauna
Environmental and industrial hazards
Internal DNBI threats
Disease Food and water Waste Premises Processed
Types of waste
Domestic
Clinical
Non clinical dangerous waste
Role of CMT in providing EH advice
Policy and procedures
Advice and Training
Monitoring and Investigation
Impacts of communicable disease
Manpower wastage
Unit mission failure
Waste limited unit resources
What is a DNBI
A person who is not a battle casualty but is lost by result of disease or injuring
Ingestion borne diseases
Worms Infective hepatitis Leptospirosis Dysentery Cholera Amoebic dysentery Typhoid Schistomiassis Gastroenteritis Polio
Examples of auditing
Fmed 85 Lab reports Specific monitoring Local medical intelligence EHT audits
Sources for communicable disease
Case Carrier Convalescent Contact Corps
What is an outbreak
2 or more cases of communicable disease
Fomite
An inanimate object with the possibility to spread disease
Temporary Camp sanitation methods
Shallow trench latrine
Shallow trench urinal
Improvised grease trap and soakage pit
Refuse burns pit
Semi permanent sanitation methods
Funnel urinal and soakage pit Trough urinal and soakage pit Female urinal and soakage pit Deep trench latrine Receptacle Latrine Sullage water grease trap Improvised grease trap Incineration
Refuse disposal incinerators
Oil drum
Inclined plane
Semi enclosed
Basic principles camp siting
Front of camp facing prevailing wind
Accommodation at front
Sanitation facilities down wind of accommodations
Late ones away from kitchen or water sources
Types of contamination and examples
Suspended
Sediment Sand Sewage Grit Disease organisms Leaves
Dissolved
War agents Heavy metal Chemical biological Salts Detergent Pesticides
Consideration for water source
Volume Fast flowing Upstream from human habitation And industrial pollution 2km recce upstream Min vegetation in water Cam and concealment
Water clarification and types
Filteration
Sedimentation
Water disinfection
Chemical
Calcium hydrochloride
Puritabs
Physical
Boiling
How much chlorine should be present? And test
5mg /l
Add 1/2 original does of calcium hydrochloride
Allow further contact period
Retest
Max 2 times
Water detaste
Sodium thiosulfate
Immidiayely before consumption
Water sampling routines
Weekly chlorine testing
Monthly bacteriological testing
Quarterly chemical testing
Role of CMT for EH
Advice and training
Investigate
Policy and procedure
Implement control measures
State 3 roles of CHA
Carry out threat assessment
Advise chain of command
Look after chd
What are the 5 steps involved in the health risk management process
Hazard identification Population at risk Risk assessment Risk management Monitoring activities
Examples of direct contact diseases
STD
Scabies
Rabies
Q fever
4 examples of indirect contact diseases
Fungal skin infections Impetigo Gingivitis Verucas Warts
Control measures to stop impetigo from spreading
Don’t touch blisters
Wash hand regularly
Don’t share bedding towels clothes of infected people
Avoid close contact with infected people
Ways direct contact diseases can be controlled at Route
Abstinence Avoid prostitution Use condoms Monogamy Avoid infected animals Don’t touch dead animals Health education
How does HIV affect the body
Virus that damages cells in your immune system and weakens your ability to fight everyday infections and disease
How to reduce spread of MRSA and PVL SA
Cover cuts with waterproof dressing Maintain best practices hand hygiene Maintain cleanliness of environment Use disposable PPE Dispose waste safely
Control at source of airborne diseases
Isolation
Treatment of cases
Dispose of corpses correctly
Contact tracing
Control at route airborne
Dusting Communal hygiene Disinfect areas Barriers masks Social distancing Bed spacing Adequate ventilation
Control measures of airborne at target
Health education
Vaccines
Good personal hygiene
Airborne diseases examples
Meningitis Influenza Common cold Legionella TB Smallpox Chicken pox MMR scarlet fever Diphtheria Pertussis Anthrax Q fever
What environmental factors affect risk of heat illness?
Ambient air temp
Radiant heat
Relative humidity
Wind speed
Hazards in water
Suspended impurity’s
Sediment disease grit sand sewage
Dissolved impurities
Heavy metals chemical toxic waste agents salts and detergents
