新編-預(yù)防醫(yī)學(xué)導(dǎo)論-精品課件

1、1Environmental Health Science環(huán)境衛(wèi)生學(xué)概要Department of Environmental Health ScienceSchool of Public Health and Tropical Medicine 環(huán)境衛(wèi)生學(xué)系 周宏偉 61648327BiodegradationgmailYou cannot select your genome but you can change your environment什么是環(huán)境衛(wèi)生？環(huán)境衛(wèi)生是指城市空間環(huán)境的衛(wèi)生。主要包括城市街巷、道路、公共場(chǎng)所、水域等區(qū)域的環(huán)境整潔，城市垃圾、糞便等生活廢棄物收集、清除、運(yùn)輸

2、、中轉(zhuǎn)、處理、處置、綜合利用，城市環(huán)境衛(wèi)生設(shè)施規(guī)劃、建設(shè)等。 文章來(lái)源：（ 淄博市黨員干部現(xiàn)代遠(yuǎn)程教育中心 ）一、環(huán)境衛(wèi)生學(xué)定義定義1研究自然環(huán)境和生活環(huán)境與人群健康的關(guān)系，解釋環(huán)境因素對(duì)人群健康影響的發(fā)生、發(fā)展規(guī)律，為充分利用環(huán)境有益因素和控制環(huán)境有害因素提出衛(wèi)生要求和預(yù)防對(duì)策，增進(jìn)人體健康，提高整體人群健康水平的科學(xué)。是預(yù)防醫(yī)學(xué)的重要分支學(xué)科，也是環(huán)境科學(xué)不可缺少的重要組成部分。陳學(xué)敏，楊克敵Definition 2In its broadest sense, environmental health is the segment of public health that is conc

3、erned with assessing, understanding, and controlling the impacts of people on their environment and the impacts of the environment on them.-Moeller D.W. Environmental Health二、環(huán)境對(duì)健康的影響到底有多大？通過健康環(huán)境預(yù)防疾病:對(duì)疾病的環(huán)境負(fù)擔(dān)的估計(jì) Preventing disease through healthy environments: Towards an estimate of the environmenta

4、l burden of diseaseWHO 2019估計(jì)全球疾病負(fù)擔(dān)的24%和全部死亡的23%可歸因于環(huán)境因素。最大絕對(duì)負(fù)擔(dān)可歸因于可改變的環(huán)境因素的疾病包括：腹瀉、下呼吸道感染、“其它”意外傷害和瘧疾。地區(qū)差異傳染病和傷害給發(fā)展中地區(qū)造成極其沉重的負(fù)擔(dān)在可歸因于環(huán)境的非傳染病的分值上，發(fā)達(dá)國(guó)家與發(fā)展中國(guó)家的整體差異不明顯發(fā)達(dá)國(guó)家，可歸因于環(huán)境的心血管疾病和癌癥負(fù)擔(dān)較大。兒童承擔(dān)了過分沉重的環(huán)境性健康負(fù)擔(dān)（高4倍）。三、環(huán)境衛(wèi)生學(xué)研究?jī)?nèi)容研究?jī)?nèi)容大氣、水體、土壤與健康；飲水衛(wèi)生與健康；住宅以及室內(nèi)環(huán)境與健康；公共場(chǎng)所衛(wèi)生；人居環(huán)境與健康；家用化學(xué)物品、個(gè)人用品與健康；環(huán)境質(zhì)量評(píng)價(jià)和健康危險(xiǎn)度

5、評(píng)價(jià)；環(huán)境衛(wèi)生監(jiān)督與衛(wèi)生管理；災(zāi)害衛(wèi)生；全球環(huán)境變化與健康。環(huán)境衛(wèi)生學(xué)課程內(nèi)容The Scope/ Toxicology/ Epidemiology/ The work place/ Air in the home and community/ Food/ Drinking water/ Liquid waste/ Solid waste/ Rodents and insects/ Injury control/ Electromagnetic radiation/ Environmental economics/ Environmental law/ Standards/ Monitorin

6、g/ Risk assessment/ Energy/ Disasters/ A global viewMoeller DW Environmental Health四、環(huán)境衛(wèi)生學(xué)發(fā)展簡(jiǎn)史環(huán)境衛(wèi)生學(xué)形成（Environmental Hygiene)19世紀(jì)后形成德國(guó)Max von Penttenkofer (1818-1901)首次提出腸傷寒和霍亂等傳染病的流行與空氣、水以及食物等生活環(huán)境有關(guān)；1865年在德國(guó)慕尼黑大學(xué)開設(shè)衛(wèi)生學(xué)講座，以空氣、水、食物、住宅、土壤等為研究對(duì)象，采用物理和化學(xué)方法，開展了空氣中二氧化碳濃度測(cè)定方法的研究，稱為實(shí)驗(yàn)衛(wèi)生學(xué)(experimental hygiene)

7、。其后，衛(wèi)生學(xué)的發(fā)展進(jìn)入新階段，實(shí)現(xiàn)了專業(yè)分化，產(chǎn)生了環(huán)境衛(wèi)生學(xué)等多種專門學(xué)科。環(huán)境衛(wèi)生學(xué)發(fā)展近幾十年來(lái)，環(huán)境科學(xué)學(xué)科蓬勃發(fā)展，形成與傳統(tǒng)的環(huán)境衛(wèi)生學(xué)在研究?jī)?nèi)容上相互交叉的學(xué)科：環(huán)境工程學(xué)、環(huán)境化學(xué)、環(huán)境生物學(xué)、環(huán)境管理學(xué)、環(huán)境毒理學(xué)環(huán)境衛(wèi)生學(xué)的研究?jī)?nèi)容從強(qiáng)調(diào)hygiene逐漸轉(zhuǎn)變?yōu)橐越】?health)為核心。Environmental Health Science環(huán)境科學(xué)和公共衛(wèi)生學(xué)（Public Health)的交叉學(xué)科。發(fā)展方向加強(qiáng)環(huán)境污染對(duì)人體健康影響的調(diào)查研究。加強(qiáng)對(duì)環(huán)境污染物在低劑量、長(zhǎng)時(shí)間作用下的健康效應(yīng)研究加大環(huán)境因素與傳染病發(fā)生和流行關(guān)系的研究。開拓環(huán)境衛(wèi)生研究和環(huán)境衛(wèi)生工

8、作的新領(lǐng)域。做好突發(fā)公共衛(wèi)生事件應(yīng)急處理的科學(xué)技術(shù)和人才儲(chǔ)備。五、環(huán)境衛(wèi)生學(xué)核心概念The 5 Core ConceptsA Toxic Word GameToxic means _.Toxic_ is the study of poisons.Toxic_ is a measure of how dangerous a chemical is.poisonous or dangerousologyityA Toxicity ScaleToxicity RatingSignal Words on PackageSymbol on Package Highly ToxicDANGER or PO

9、ISON Moderately ToxicWARNING Slightly ToxicCAUTION Not ToxicnoneHow would you rate these products?Toxicity Rating Highly Toxic Moderately Toxic Slightly Toxic Not ToxicAnd the answers areToxicity RatingHighly ToxicModerately ToxicSlightly ToxicNot ToxicExposure （暴露） isThe total amount of a hazard th

10、at comes in direct contact with your body.The 3 parts of exposureTheSourceof the hazard(bus exhaust)TheEnvironmentalPathway(air)TheContact(inhaled fumes)Which route will the hazards take?Route #1: Inhalation （呼吸）Hazard!Inhalation:Breathing. When chemicals enter the body through this route of exposur

11、e, they can get stuck in the lungs and/or be taken up into the bloodstream. Route #2: Ingestion （消化道）Hazard!Ingestion:Swallowing (usually by eating or drinking). When chemicals enter the body through this route of exposure, they can easily be taken up into the bloodstream. Route #3: Dermal Absorptio

12、n （皮膚）Hazard!Dermal Absorption:Absorbing a chemical through any part of the skin, including the eyes. When chemicals come in contact with the skin, they can sometimes enter the bloodstream through this route of exposure.南方醫(yī)科大學(xué)公共衛(wèi)生與熱帶醫(yī)學(xué)學(xué)院 環(huán)境衛(wèi)生學(xué)系 周宏偉 ehscoursegmail32barrierArea (m2)Thickness (m)Weight

13、 (kg)Daily exposure (kg)Skin 210012-16variableGI tract20010-1273-4Lungs1400.2-0.40.8-0.924ExposureXXWhat is dose(劑量)?XXXXXX = hazardDoseDose is the amount of a hazard that actually enters your body.XXXXXXDose can depend onDuration of Exposure:How long?Frequency of Exposure: How often?Body Size:How b

14、ig or small are you?MLSSDuration of Exposuremight not have any harmful effects.30 minutes of sun exposureDuration of Exposuremight be very harmful indeed!But 4 hours of sun exposureThe larger the dose, the more extreme the response will be.Dose/Response Relationship(劑量反應(yīng)關(guān)系)1 can of pop in 15 minutes

15、3 cans of pop in 15 minutes 不同化學(xué)物有不同類型劑量-反應(yīng)關(guān)系飲用水中氟含量和齲齒數(shù)、氟斑牙的關(guān)系三種化合物的劑量反應(yīng)關(guān)系有閾值化合物無(wú)閾值化合物必需微量元素Individual Susceptibility （個(gè)體易感性）Why are these people more likely to be harmed by exposure to a hazard than the man below?Individual SusceptibilityPregnant women and their developing babiesElderly people who

16、se defense mechanisms are less efficientInfants and children who are still developingSick people who have weakened immune systemsGenes & SusceptibilityYour genes can also make you more or less susceptible to harm from an environmental hazard. For example, some people are more likely to get sick when they are exposed to certain kinds of pesticides.Risks & Benefits （風(fēng)險(xiǎn)效益）What are the risks and benefits when grape growers use pesticides on their crops?Risks & BenefitsRISKSBENEFITSNo bugs!Better looking fruit that is more visually appealingBigger crops so farmers can make m