Environmental Health Flashcards
What is Force Health Protection (FHP)?
Conservation of the fighting potential of a force so that it is healthy and fully combat capable.
This consists of actions taken to counter the debilitating effects of environment, diseases through preventative measures.
What are the main roles of environmental Health?
7
vector and pest control Op sanitation and waste disposal Communicable disease prevention and control Environmental Monitoring Occupational Health and Safety Food Hygiene and Safety Water quality monitoring and analysis
Who is available for the 1st line of environmental health support?
(3)
Unit medical staff
Combat Health Advisors (CHA)
Combat Health Duties (CHD)
Key Responsibilities of CHDs
3
Apply and maintain Op sanitation measures
Identify and control disease vectors and pests
maintain unit water supply
Benefits of CHD trained persons?
7
Self sufficiency proactive pest control improved sanitation water safety lower disease non-battle injuries maintain Op efficiency Intelligence tasking of EH teams
Constraints of CHD personnel
4
Lack of space
proximity of sleeping/eating areas
Logistics - low priority
High tempo of activity
Key responsibilities of a CHA?
4
identify hazards in AOR
Undertake threat assessment / hazard recognition
Implementing FHP measures
Advise the CoC on measures to manage/mitigate risk
Who is available for 2nd line EH on Ops?
3
Single Service EHO
Single Service EHP
UK Med Group EH Team
3rd Line EH support is provided by?
RN- EH Officers
Army - Army regional command environmental health teams
RAF- Station environmental technicians
When further specialist advice or equipment is required the 4th line is provided by?
(4)
-Commander field army medical support branch; environmental monitoring teams
-RAF centre of aviation medicine
-Institute of Naval medicine
DMS W
Define Risk Assessment
Helps CMDRS and staff to prioritise and allocate resources for FHP. The primary purpose is to evaluate the importance of health hazards and to compare the risk between different hazards.
Define a Hazard
Anything that can cause harm
Define Risk
the probability that someone could be harmed by a hazard (risk= Likelihood x Severity of consequences)
Main FHP hazard categories
3
Physical
Chemical
Biological
Define a DNBI?
Disease non-battle injury - a person who is not a battle cas, but who is lost to the organisation by reason of disease or injury
Two categories of DNBI
Descriptions
External; outside control and immediate area eg - Climate, disease, flora/fauna, environmental and industrial hazards
Internal; integral to immediate location and strongly influenced by our actions - eg. Disease, food and water, waste, premises, processes.
Examples of Population at Risk (PARs)
4
friendly forces
LECs
Civ Pop
Pows / detainees
Examples of Audit and Surveillance techniques
5
Local Med Int EHT Audits F Med 85 Specific Monitoring Lab Reports
Reasons to monitor activity
5
Threats and hazards may change Implementation and effectiveness of control measures general control Information training and policy Medical Counter measures and treatment
Who can contribute to unit risk management
4
All deployed personnel
Leaders
Trained Personnel - CHD, CHAs
Medical Personnel
Definition of health
A state of complete mental, physical and social wellbeing, not merely the absence of disease
Definition of disease
Any state that its a departure from positive health, whether that departure is physical or not
Impacts of disease on a military force
3
Manpower wastage
Unit mission failure
Wastes limited unit resources
Two categories of disease and discriptions?
Communicable - Transferable, transmitted from an infected host, either directly or indirectly to a susceptible host.
Non-Communicable - non-transferable, cannot be spread from an infected host
Entry points microorganisms can enter the body
7
Eyes Nose Mouth Injection/ingestion Open cuts/sores Genitals Anus
Potential sources of disease and discriptions
5
Case - Individual with S/S of a disease
Carrier - Apparently healthy, can transmit pathogens
Contact - Exposure to disease
Corpse - dead for decaying
Convalescent - recovering but still infectious
Potential routes of diseases with examples
4
Airborne - flu, covid
Ingestion - Polio, cholera
Contact/Animal - Rabies
Arthropod - Malaria, yellow fever
The Target is described as:
A healthy but susceptible human
Ingestion Bourne Diseases
Mode of Spread-
Types of Contamination-
How does Contamination Occur
Mode - entry into body via mouth
Types - Chemical (Lead, Mercury) Physical (Glass, Paint) Biological (Pathogens)
How - pests, poor hygiene, poor waste disposal, poor food handling
Common Ingestion Bourne Diseases
WILDCATGP
Worms Leptospirosis Dysentery Cholera Amoebic Dysentery Typhoid schistosomiasis Gastroenteritis Polio
Control of an Ingestion Bourne Disease
SOURCE-
Isolation, Treatment, Health Education, Notifications, Disinfection
ROUTE-
Treatment/protection of water, good waste disposal, good food hygiene, camp siting, cleanliness of environment/person, insect/rodent control
TARGET-
Health Education, immunisation/vaccination, prevent exposure, good hygiene, eat/drink at approved sources
Airborne Diseases
Mode of Spread
Common Diseases
Mode of spread - Droplets, Inhalation of droplets, 3 sizes (Heavy, medium, nuclei)
Meningitis, Influenza, Common Cold, Legionella, TB, Small Pox, MMR, Anthrax, Diphtheria, Q fever, Chicken Pox
Control of Airborne Disease
Source, Route, Target
SOURCE-
Isolation, treatment of cases, dispose of corpses, contact tracing
ROUTE-
Personal/Communal Hygiene, Damp Dusting, Barriers, prevent overcrowding, Bed Spacing
TARGET-
Health Education, immunisation/vaccination, prevent exposure, hygiene
Arthropod borne diseases
Mode of Spread (2)
Common Diseases
Biological - insect bites
Mechanical - contact with food
Malaria, yellow fever, plague, dengue fever, lymes disease, Zika virus.
Definition of an infestation
the presence of an unusually large number of insects/animals in a place that can cause damage or disease
Two Types of insecticide and equipment
Residual - compressor sprayer
Knockdown - Swingfog
Contact Borne Diseases
Mode of Spread
Diseases of military significance
Modes-
Direct - Via direct contact w/ infected person or animal
Indirect - via fomites
STIs, Scabies, Rabies, Q fever, Fungal skin Infection, Impetigo, Verruca
Control of Contact Bourne Diseases
Source, Route, Target
SOURCE-
Isolation, treatment of cases, dispose of corpses, health education, contact tracing, disinfection
ROUTE-
Direct; abstinence, monogamy, STD checks, avoid infected animals, don’t use prostitutes.
Indirect; Disinfect ablutions, wash bedding/clothes, don’t share kit, wear flip flops.
TARGET-
Health education, immunisation/vaccination, personal hygiene.
What is a notifiable disease?
How is it reported?
Who is it reported to?
A Disease that is required by law to be reported to Gov’t authorities.
FMED 85 sent upon provisional diagnosis and again at confirmation/de-notification
SO2 Health Protection and Proper Officer
What is an outbreak?
Two or more cases of a communicable disease with are, or may be linked, by time and/or space
Outbreak investigation is necessary for what reasons?
6
To assist in confirming outbreaks Asses scale and extent of outbreak Prevent further spread Investigate origin Lessons to be learnt Statutory requirements
An initial outbreak investigation as 1st line support will include what 4 phases?
Prelim
Communication
Confirm Notification
Control Measures
If a disease outbreak is confirmed what actions should be carried out?
(7)
Collect Specimens Conduct Camp Visit/inspection Conduct Interviews with approved questionnaire Identify common factors Prelim decision on outbreak Consider Public health risk Initiate immediate control measures
`What is the purpose of good waste management?
4
Minimise risk of disease
prevent food/water contamination
Discourage pest vectors
Maintain comfort and morale
Types of waste generated in the field
USSR Urine Soil Sullage Refuse
Types of camp and time frames
4
Short halt - 24hrs
Temporary - 24hrs - 7 Days
Semi-Permanent- 7 days to 6 months
Permanent - 6 months +
Temporary Camp Improvised Appliances
U - shallow trench urinal
S - Shallow trench latrine
S- Improvised Grease strainer and soakage pit
R- Refuse/Ash Pit
Semi-Permanent Camp Improvised Appliances
U- Funnel, Trough, female urinals
S- Deep Trench Latrine, receptacle, bucket latrines
S- Strainer/Grease trap - Evaporation pans/drainage
R- Incinerators
Basic principles of Camp siting
4
Front of camp faces prevailing wind
Accommodation at the front
Sanitary facilities downwind of accommodation
Latrines away from water/kitchen
Safety precautions to reduce the risk of clinical waste hazards
(7)
good personal hygiene use gloves wear gloves when disinfecting change gloves after each task eye pro + masks gowns/aprons/labcoats Minimise contact with waste
What is the purpose of water purification in the military?
To prevent disease by removing disease causing organisms, therefore maintaining force effectiveness.
Two types of water impurities and examples
Suspended- leaves, sand, worms, sewage
Dissolved- poisons, detergents, salts, heavy metals
Diseases associated with water
WILDCATSGP
Worms Infectious Hep Leptospirosis Dysentery Cholera Amebic Dysentery Typhoid Schistosomiasis Gastroenteritis Polio
6 Principles of Water purification
Selection of source Clarification Disinfection Contact period Test De-Taste
Basic considerations of how much water to provide
10 litres per day minimum
25 optimum
What are the considerations relating to the quality of the water
Quantity vs quality
Oxygenated Large wide stream Up stream of human habitation Up stream of industry Limited vegetation
Two methods of clarifying water
Filtration- mechanical vs Improvised
Sedimentation - passive vs Chemical
Two methods of disinfecting water
Physical
Chemical - calcium hyperclorite 65%
4G per 225 litres
Water contact period is normally 15 minutes. When would it increase to 30?
(3)
Below 5 degrees
Schistosomiasis in the area
If check kit is unavailable
When testing water how much chlorine should be present at the end of the contact period.
5.0mg/L
5ppm
What chemical is added to de-taste water?
Sodium Thiosulphate pentahydrate crystals
2g per 225ltrs
What is EPiNato and why do we need it?
A disease surveillance program used by NATO overseas
It is used to interpret disease and injury trends via standardised collection of patient data
What does EPINATO allow commanders to do?
6
Evaluate Op capabilities
Choose appropriate medical counter measures
Know the risk areas where conducting ops
Develop early warning systems for bio and chemical threats
To detect outbreaks at an early stage
To have a comprehensive surveillance system of the health events and environmental exposure of a deployed force
What are the military impacts of climatic injuries?
6
Can kill Downgrading/morbidity Medical discharge Loss of Op Effectiveness Waste of limited resources Mission failure
What is a localised cold injury?
What are the two types of localised cold injury?
When individual body parts are exposed to cold, leading to damage
FCI, NFCI
What are the two most common types of freezing cold injury
Frost Nip
Frost Bite
Signs and symptoms of a local NFCI (trench foot)
Numbness in extremities
Pain
Pins and needles
