Population Health, Community Health & Ethics

Question 1

Occupational health hazards: Coal Miners

Answer 1

Pneumoconiosis

Question 2

Occupational health hazards: Gold, copper and tin miners

Answer 2

Silicosis

Question 3

Occupational health hazards: Aniline dye workers

Answer 3

Bladder cancer

Question 4

Occupational health hazards: Health care providers

Answer 4

Hepatitis B

Question 5

Occupational health hazards: Asbestos workers and builders

Answer 5

Asbestosis and mesothelioma

Question 6

Screening for adults: Blood pressure

Answer 6

Every 1–2 years on all people 16 years and over.

18

Question 7

Screening for adults: Cholesterol

Answer 7

45 and over should have a 5-yearly.

Question 8

Screening for adults: Fasting blood glucose

Answer 8

Screen every 3 years for all patients >40 years of age.

ATSI: > 18 yo every 3 years

Question 9

Immunisation Gral Criteria

Answer 9

All adults should receive an adult diphtheria and tetanus (ADT) booster every 10 years.

All women of child-bearing years should have their rubella antibody status reviewed.

During pregnancy, it is recommended to have the seasonal influenza vaccination any time in the pregnancy and a pertussis booster in the final trimester (20–32 weeks).

Fever and illness. Children with minor illness (providing the temperature is <38.0°C) may be vaccinated safely. Otherwise it should be delayed.

A simple past febrile convulsion or pre-existing neurological disease is not a contraindication to pertussis vaccination.

Absolute contraindications include encephalopathy within 7 days of a previous DTP or an immediate severe or anaphylactic reaction to DTP.

Question 10

Influenza vaccine

Answer 10

65 years of age and over.

All Aboriginal and Torres Strait Islander over 12 months, especially adults over 50 years og age.

Chronic debilitating diseases, especially chronic cardiac, pulmonary, kidney and metabolic diseases.

Persons receiving immunosuppressant therapy.

Health care personnel.

Question 11

Pneumococcal vaccine

Answer 11

2, 4 and 12 months.

Children with specified medical risk conditions and Indigenous children in WA, NT, SA, Qld also 6 months and 4 years.

Indigenous adults 50 years and over.

All adults 70 years and over.

Same risk groups as the influenza vaccine.

Those at higher risk of fatal pneumococcal infection (e.g. post-splenectomy or Hodgkin lymphoma) should receive a booster every 5 years.

Question 12

Hepatitis A vaccine

Answer 12

Indigenous children in WA, NT, SA, Qld: 18 months and 4 years

Certain occupational groups at risk (e.g. health workers, child care workers, sewage workers)

Non-immune homosexual men

Chronic liver disease

Recipients of blood products

Travellers to hepatitis A-endemic areas (India)

Question 13

Hepatitis B vaccine

Answer 13

Birth, 2, 4 and 6 months

Health care personnel

Personnel and residents of institutions Prisoners and prison staff

Persons with frequent and/or close contact with high-risk groups, and persons at increased risk due to their sexual practices.

Household contacts of any of the above groups should be considered for immunisation.

Booster doses are not recommended for immunocompetent people but are recommended for immunosuppressed individuals.

Universal vaccination represents a preventive step against hepatocellular cancer.

Question 14

Haemophilus influenzae typeB vaccine

Answer 14

2, 4, 6 and 18 months.

For people with asplenia or hyposplenia (5 years and over), a single dose is required if the person was not vaccinated in infancy or incompletely vaccinated.

Question 15

Q fever vaccine

Answer 15

Abattoir workers

15 years and over

Contraindications: Allergy to egg protein and pregnant women

Pre-vaccination screening has 3 stages:
1. Interview with the GP about Q fever infection or past vaccination.
2. Blood test to check for immunity.
3. Skin test to check for immunity.

Any positive result cannot be vaccinated.

Abattoir workers are people who work in slaughterhouses, where animals are killed and processed for meat. They perform tasks like slaughtering animals, cutting meat, and preparing it for sale.

Question 16

Measles-mumps-rubella vaccine (MMR)

Answer 16

12 and 18 months

All non-immune women who are postpartum or of child-bearing age should be immunised.

Live vaccine. Not to be used in people with compromised immune function.

Question 17

Varicella and Zoster vaccines

Answer 17

Included in the MMR vaccine (12 and 18 months)

Those over 12 years have a course of two injections.

For all immunocompetent people aged 70 -79 years old with a five-year catch-up.

Not to be used in people with compromised immune function (live virus).

Question 18

Meningococcal vaccine

Answer 18

12 months and between 14–16 years Meningococcal ACWY

Indigenous children: Plus Meningococcal B at 4, 6 and 12 months

For people with asplenia, hyposplenia, complement deficiency and those undergoing treatment with eculizumab. The number of doses required varies with age.

Neisseria meningitides, 13 serogroups of which A, B and C account for over 90% of isolated cases, with serogroup B responsible for most cases.

The main vaccine is a quadrivalent polysaccharide vaccine against serogroups A, C, Y and W125 for use in individuals.

Question 19

Rotavirus vaccine
Babies
What is the risk it can cause?

Answer 19

2 and 4 months (14 and 24 weeks)

Two (usually) or three oral live attenuated rotavirus vaccines.

Inform parents of the risk of intussusception with the first dose.

Live vaccine. Not to be used in people with compromised immune function.

Question 20

Human papillomavirus vaccine

Answer 20

Single dose recommended at 12–13 years

If dose was missed and not previously received, a catch-up is available up to and including 25 years of age.

Question 21

Diphtheria, tetanus, pertussis vaccine (DPT)
🤰🤰🤰🤰

Answer 21

2, 4, 6 months and 4, 12 years.

Single dose recommended each pregnancy, ideally between 20–32 weeks, but may be given up until delivery.

Question 22

Live vaccines

Answer 22

People who are immunocomprised are at risk of adverse events or vaccine-related disease if they receive alive vaccine.

Live vaccines include:
* BCG vaccine (BK)
* Some Japanese encephalitis virus vaccines
* MMR(measles-mumps-rubella) vaccine
* rotavirus vaccine
* oral typhoid vaccine
* varicella vaccine
* yellow fever vaccine
* zoster vaccine

Question 23

Polio vaccine

Answer 23

2, 4 and 6 months and 4 years

Healthcare workers and laboratory workers who may have contact with polio cases or poliovirus

Travellers to areas or countries where polio is epidemic or endemic

Question 24

Ross River virus

Answer 24

Joint pain, fever and rash

The most common symptom is pain in the joints — mainly the fingers, wrists, ankles, and knees, but it can affect any joint.

Other symptoms include:
body aches
headache
joint swelling and stiffness
fatigue
swollen lymph nodes

Symptoms can start at any time between 3 days and 3 weeks after an infected mosquito bite

Symptoms usually pass within 6 weeks

Tropical areas of: Queensland, the Northern Territory and Western Australia

The diagnosis is confirmed by a blood test to measure the antibody levels to the virus. Two blood tests are taken 2 to 4 weeks apart so the levels can be compared

Symptomatic treatment

Ross River virus is an illness spread by mosquitoes in Australia and some parts of the Pacific. It causes symptoms like joint pain, fever, and rash. Most people recover fully, but the joint pain can last for several months.