2/10/99
Public Health
Hazards Associated w/ Food
-safeguarding food-p 767 - 771
-several different methods have been mentioned
for food
-canning
-refrigeration/freezing
-irradiation
-drying
-lyophilization
-p770,
combating Salmonella
-antibiotics
-pasteurization--milk
and other things, helpful in preventing food poisoning and food borne diseased
(temp and time)--high temp/short time, low temp/long time, ultra high temp
-washing
of hands
-sanitation
-hygiene
-clean
utensils
-not
touching food w/bare hands
-help eliminated 1000's of outbreaks of food
poisoning in the US every year
Video on Ebola
2/12/99
Public Health
Methods of Safe Guarding Food
-pages from book to read
-prevent sickness from contaminated food
-prevent spoilage of food
-temperature Control
-best
and worst technique used in the Western World
-most
extensively used technique in the Western World
freezing refrigeration
-certain food for months -4~C
-(-35~C)should be frozen at -only some foods can be stored
-kept at (-10~C)
for a short time (3-5days)
-assumed to be sterilizing but -temp guidelines during
is not
serving of food
-most organisms are killed -kept at or below 4~C
-cysts, spores, bacteria, etc -served hot, kept above 60~C
can
survive -b/w
4-60~C is mesophilic
-reduce metabolic activity of area of microbial growth
foods
and microorganisms
-maintains freshness, taste,
and
flavor
-warning--any frozen food should be
thawed
quickly and not re-frozen
-thawing should be done in
refrigeration temperatures
-freezer burn--loss of taste
Drying
-poor countries; drying in open air and sun has
been very effective
-drying can be used for some foods and not
others
-Western world, special ovens for drying
-drying is to dehydrate foods which prevents
metabolic activity to occur
-will not allow microbes to grow
-should be stored in a dry cool place
-does take a way from flavor and taste
-oven drying does not
-Lyphilization
-expensive
-freeze
drying
-coffee,
nuts, tea, etc
-food
is frozen by using especially designed system to lower temp of contents of food
to (-100~C)
-food
is inside a cylinder w/outside temp at (-100~C) by liquid nitrogen or CO2
-exposed
to suction pressure--very high
-water
that is frozen in food is changed into vapors w/o turning it into a liquid
-preserve flavor, nutrients, quality, taste and
freshness to a high degree
Vacuum Packaging
-putting a thin plastic layer around food
quickly
-strong pressure
-not enough to dehydrate the food
-no air, less chance of aerobic organism to grow
-preserve food to some time
-different from freeze drying
Smoking
-flavor, cooking techniques
-not a healthy practice
-not want to make a practice
-uses chemicals in the process
-has been well recognized that carcinogens are
left in from the smoke
BBQ
-unhealthy b/c of burning of food--carcinogens
Microwave
-healthy practice
-least likely to leaving carcinogens
-need to make sure food is cooked appropriately
-slow cooking w/o burning food is healthy
Sunny side up Eggs
-bad b/c eggs by themselves may have salmonella
Irradiation
-ultraviolet--bactericidal, viralcidal,
fungicidal--kills most things when they are exposed
-render
area free of microorganisms
-used
for packaging food
-aseptic
conditions
-disinfect
food
-not
recommended b/c leave some residues that may cause problems
-non-ionizing
-ionizing radiation
-questioned
very seriously
-radionuclear
products produced in the food
-in
animals that eat this food, have shown polypoidy
-good
indicator of tumor or cancer
-only
certain foods are being recommended for this
-not generally safe, needs more research to
confirm that
Brine--high salt concentration
-kill
microorganism by increased osmotic pressure
Pickling--high acidity
-limitations,
only certain foods can be done
Syrups--sugar solutions
-high
osmotic pressure
-fungi
and yeast can still grow
Chemical Preservatives
-boon (good) and a curse
-cheep
-responsible for saving millions of lives
-can be found in almost all foods
-curse
-high
sodium
-some
carcinogens
-hypertension
-cancer
-heart
disease
-proper hygiene and sanitation-Common sense
-washing
of hands--major way of preventing contamination of foods--many diseases
transmitted this way
-do
not handle food w/bare hands
-keep
things covered
-do
not talk or cough around food
-salad
bars and others have troubles w/this
-S
aures infections--enterotoxin--food poisoning
-clean
utensils (knifes, cutting boards--cook and stored)
-food
from cans if they are distorted or broken seal-- do not eat--may have changed
due to microbial growth
-food
should look good and smell good and have a consistency
2/17/99
Public Health
Milk
· Most nutritious food
· All of the nutrients
· Mother’s milk
· Antibodies; esp. IgA
· Copro antibodies (tears, GI tract, mother’s milk)
· Milk is the best kind of food
· God’s gift to humans
· Iron as a mineral and vit C are not present in milk
· Nutritional index—volume or weight of a food for proteins, CHO
· Milk seems to beat all other foods
· Mother’s milk for first 18 months was happy, healthier, and higher IQ than children who were put on bottled formula right away
· 3 types of IgA
Cow’s milk
· dealt w/on a large scale for humans
· good nutrient for microbes and bacteria
· sterile when released by animal, but becomes infected immediately
· M. bovis—TB in milk
· Table 27.3 from micro book p767
· Brucella abortus—Brucellosis or Relapsing fever
· Milk that is sold in grocery stores is not sterile
· Needs to be protected, if not can suffer from these diseases
· Several of the microbes causes spoilage
· Streptococcus cremoris and others if they are allowed to stay in milk can spoil it
· FDA requirements to keep milk safe in the markets
· Against the law to sell unprocessed milk
· Lactobacillus
· Table
· E. coli seen in milk and can spoil it
Pasteurization
· Prevent microbial growth
· Table 27.4—tests used for determining quality of the milk
· Phosphate test—determine how well milk has been pasteurized
· Simple heating process to kill the microorganisms—kill and bring them down to a level where drinking milk is brought down to acceptable level
· Monophosphodiesterase—release phenol from phenolic esters
· Phenol can be measured by titrated
· If milk is heated, the enzyme is denatured and have less phenol
· Required by law to sell all milk as grade A pasteurized milk
· Every particle is exposed to one of the 3 methods
· P771
end milk
Worms
· helminthic organisms
· parasites by some
· living organism living on a living system
· 3 kinds of worms
1. round worms—Nematodes (x-sec is round)
2. flat worms—Platyhelminthes
· Book
· Ch 12 is general body structure p 315-322
·
2/19/99
Public Health
Drugs of Abuse Potential
· Handout 18-explanation
19-20 questions
20-list of classification schedule; CSA (Controlled Substance Act) put forth by the DEA(drug enforcement agency); CSA-I – CSA-V
CSA-I—have most abuse potential and no medical application, most deadly; most likelihood for being addictive; highest dependence potential
CSA-V—least abuse potential; often have medical application; least likely to be addictive/dependence potential
· Know the category the drug belongs to : narcotics, cannabis, depressants, stimulants, halucinagens
· How consumed
· Medical use-what is it
Worms
· Can be found almost anywhere in the body
· Know where each worm can be found in the body from handout 18
· Unique biological ways to enter human system
· Unique survival ways to survive defense mechanisms
· Ex: penetrate through the skin, can be ingested, can become blood borne and move to other parts of the body, penetrate tissues and organs
· Have ability to survive in our system by virtue of having a very thick cuticle (covering) which is not digested by enzymes in our system
· Many reproduce at an enormous rate and often time 99% of the larvae are expelled from the body, the 1% that remains is enough to cause problems for the host
· Larvae may be source of disease
· Ability to penetrate, cut, attached by having hooks, cutting plates that help them to remain in the system
· Most cause disease by physical obstruction or damage to organs by their presence and the growth rate—blocking the passages; a few produce toxins that can by involved in pathogenicity
· Some have vegetative reproduction—cloning, Planaria can be cut into pieces and regenerates the missing portions to create a complete organism
· Many are hermaphrodites—has both male and female sex organs on the same animal
Trichinosis
· In many larval stages cause sickness. Larvae many be bigger than the adult form.
Necator Americanus—New World hook worm
2/23/99
Public Health
Worms
Handout PH17
Table in book, p638
Filiaria
·
Wuchereria
bancrofti
· Burgia malayi
· Blockage of the lymphatic system
· Enlargement of organs and limbs
· Transmitted by insects like aides, culex, anophlene (mosquito, blood sucking)
· Ch 12 in book, life cycle Wuchereria bancrofti p 302
Old World Hook Worm
·
Anclostoma
duodenale
· Necator americanus—New World Hook Worm—rhobditiform
· ground itch found where worm enters, allergic reaction
· Can penetrate the skin of the feet to become blood borne
· P 635 in text
· Carried to heart and lung
· Swallowed and get to GI tract
· Leave the body
· Problem w/blood vasculature
Ascaris lumbricoides
· GI nematode
· Grows abundantly in GI tract
· Responsible for physical blockage of GI tract lumen,
· Persistent constipation
· Can be removed by surgical means
· P 635 figure
Anisakis species
· Raw fish
· Public health block on p635
· Have pulled out large worm from the esophagus
Enterobius vermicularis
· Pinworm
· Commonly seen in children
· Known for conditions known as oxuriases or pinworm infestations or seatworm infestation
· Ingestion of contaminate food and soil
· Gives the feeling that someone is sticking you w/a pin
· Lower GI tract
· Adult worm gets out at night to lay eggs and then returns to system
· Eggs released into fecal material
· Retrofection—adult female getting out and coming back
· Dx: scotch tape or swab who have intense itching in perianal area
Trichinella spiralis
· Hog feeding on garbage
· Trichinosis
· Transmission: Ingestion of contaminate pork that was not properly cooked
· Goes to GI tract
· In GI tract can penetrate gut wall and become blood borne
· P 634; description and picture of
· Cyst embedded in muscle
· Clinically: depends upon where in the body the cyst develops
· Can be in heart, kidney, lung
· Can produce toxin which can be hazardous
· Freezing of food does not necessarily kill larvae
· Microwave cooking is safe only if internal temp of meat reaches 77`C
Strongyloides stercoralis
· Thread worm
· P 637
Trichuris trichiura
· Whip worm
· Found in cecum
Flukes
· Involve many host
· Trematodes
· Snails, human, crab, fish
· Schistomsoma—blood fluke, most common, several different species
· Transmitted to humans by penetration of skin by head portion of cercaria (larvae)
· Life cycle from the book—p 647-8
· Maturation in lever blood vessels
· Carried by urine and fecal material
· Maracidum found in snail, ciliated
· Oriental countries where they grow rice, it is found where it can penetrate the skin
· Major disease in the world
· No hermaphroditic
· Swimmer’s itch is S. mansoni—allergic reaction at the site where it enters the human system, can be released in bird feces
2/24/99
Public Health
Flukes—Trematodes
Handout PH23
Opisthorchis—Chinese liver fluke
· Live in liver, bile duct
Fasciola Hepatica
· Sheep liver fluke
Fasciolopsis buski
· Largest fluke
Heterophyes heterophes
· Smallest fluke
Paraoniums westermani
· Lung fluke
· Similar to Schistosoma
· Can be transmitted 2 ways
1. direct penetration of skin--cercaria
2. ingestion of improperly cooked crabmeat
· chronic cough, blood streaked sputum
Cestodes—Tape Worms
· handout PH23
· ribbon shaped
· can be as long as 10m
· like to survive in human system
· not a single animal
· colony of animals
· scolex—similar to the head (tip portion), has special gripping things and suckers
· broken up into segments—proglotids
· Strobila—chain of proglotids
· Teania saginata—beef tape worm; eggs are released in human feces; can contaminate feet of animals
· Taeniarhynchys—more serious than pork tape worm
· T. solium—pork tape worm
· Abdominal pain, local sensitivity, lack of appetite, stunted growth, no vigor, lethargy,
· Has a great ability to reproduce
· Echinococcus granulosis
· Hydatid disease causing tapeworm
· Transmitted by contaminated food
· Carried by dogs and humans
· Problem is can form cyst that can be large and formed almost anywhere in human body (bone, brain, heart, kidney, liver, lungs, spleen
· Depending upon location the damage can be great
· Bladder cyst—thick leathery outer covering, filled w/water and other fluids
· Sheep tape worm
· Dibothriocephalus latus—Diphyilobothrium lattus
· Fish tape worm
· Found in intestine
· Not as serious as hydatid disease
END OF WORMS
Agencies related to health care
· Every country has a department of health
· US
· Secretary level position—Secretary of Health
· Heads the department Health and Human Service
· Human Service—Social Security
· Health—USPHS—undersecretary
· CDC—Center for Disease Control
· FDA—Food and Drug Administration
· HRA—Health Resources Administration
· HSA—Health Services Administration
· NIH—National Institute of Health
· ADAMHA—Alcohol Drug Abuse and Mental Health Administration
· USDA—Agriculture—produce and insecticides
· EPA—Environmental Protection Agency
· Navy
· Air Force
· Army
· Marines
·
3/3/99
Public Health
Continuation of Health Services Administration
HRA—Health Resources Administration
· Located in Washington DC
· Watches the resources in the area
· Manpower, how many professionals are available
· National Center for Health Statistics—health related data are sent to from all over the country, processed, distributed and can ask about different situations
· Info comes from state public health departments
· Census Bureau is closely related to National Center for Health Statistics—not apart of the Public Health Service—a lot of information collected by them is used for Public Health research
· Longest history of census from 1785 to 1990
· Encourage practitioners to practice under privileged areas
HAS—Health Services Administration
· Clinics
· Community centers
· Family planning
· Migrant workers
Division of Coast Guard Medical Services
National Institutes of Health
· Bathesda, MD
· University type of set up
· Many different institutes employ people to do medical research
· 30 different institutes
· gives out grants to do research
· National Cancer Institute
· 2500 research grants are given out to universities, colleges, industry
· almost 100billion is spent
Alcohol, Drug Abuse, and Mental Health Administration
· run clinics, rehab centers
· people have the chance to recover
· also gives out grants to various agencies, universities and private individuals
WHO
· 1945
· international organization
· from United Nations meeting in San Francisco
· proposed by Brazil and seconded by US
· focused on international health problems
· programs that serve the need of the time
· immunization programs for small pox, polio, TB, etc
· today: AIDS is a major thrust
· headquarters is located in Geneva, Switzerland
· 6 regional headquarters that serve the member nations
· even though the agency is from UN, today it is an independent organization that serves all countries
· US—Washington DC
· Asia—New Deli
· Europe
· Far East
· Africa
Red Cross
· International, American
· Has major function of maintaining diplomatic ties w/countries that due not have ties
· During war, taking care of prisoners, giving them medical help
· Exchange of prisoners after war
· Most help during disasters
· Collection of blood
· In US, it is referred to as a quazi government agency
March of Dimes
· Raise money to develop vaccine for polio
· Private agency
American cancer agency
· Facilitate research of cancer
Department of Justice
· Take care of the health care of prisoners
Nuclear Regulatory Commission
· Indirectly helps take care of health
Occupational Hazords
· 20 million people can have major/minor problems associated to their work
· ph 27—identify occupational injury
· ph 26—to major occupational problems
· byssinosis cancer by constant cotton fiber
3/5/99
Public Health
OSHA—Act and an Administration
· Open to complaints
· Inspectors
· Department of Labor ensures safety of workers
· Administration—subpoena, citation, fines
Occupational Hazards
· Ph 26
· NIOSH—National Institute of Occupational Safety and Health—under the CDC of Atlanta
· Know first 5 in a row
· Pneumoncosis—lung problems, foreign substance present responsible for fibrosis of the lung, cancer
· Several different kinds
· Black—coal miner's lung; lack of proper protection
· Asbestosis—asbestos fibers in the lungs (used for fire retardant, building material, insulation; seen in demolition workers from old buildings who remove the asbestosis
· Byssinosis—cotton
· Silicosis—silica or sand; sand blasters who clean buildings
· Chert workers (fine stone for monuments)
· Siderosis—iron oxide; sharpen knives, sheet metal industry
· Talcum powder—can cause Pneumoncosis
Dye and Tool maker—foundry workers
Raynaud's phenomenon—affect on cardiovascular and respiratory systems
Accidents/Injuries/Death and Disability
· Fishing is the most dangerous occupation
· 400-500 deaths/day in US
· long weekend—more than normal day
· accident: unpredictable, uncontrollable event or happening
· upon analysis of each accident by engineers or public health workers—90% of accidents are preventable—but have to think of things ahead of time to prevent these
· 10% that is not preventable are natural events
· 500,000 are permanently disabled every year in the US
· 5 leading cause of death as of 1998
· catastrophe—5 or more people die in a single event
· 2% of all accidents are catastrophes
· emotionally bothersome, families destroyed, costly affaire
· every 3 minutes, $2million consequence of accidents (including property damage, health bills, compensation
3/9/99
Public Health
Accidents are the 5th leading cause of death in US
· 145,000 die each year from injuries
· 150,000 die each year from accidents
· 500,000 permanently disabled as result of accidents
ph28
· ~50,000 auto accident death due to alcohol each year (age group 15-24 is highest killed (19,0404)
· accidental deaths due to falls each year ~13,000 w/age group of 75+ being the largest (7,513) (most occurring in the bathroom)
· accidental deaths due to drowning; ages 15-24 is the highest 2000-3000 each year
· at least 2 million fires in US each year w/6000 deaths resulting
· smoke alarms absent
· kerosine heaters
· death by choking most common for 75+ people mostly in nursing homes
· accidental deaths by firearms is about 2000/yr (some maybe murders and suicides)
· poisoning (carbon monoxide) is main source—ordorless, colorless gas
· 27-30,000 suicides/yr—prominent age group is teenagers
· 2100 deaths/yr at construction sites
· 600 in mining
· 1800 in agricultural
· 1400 at public transportation—ground transportation for more hazardous than air transportation
· 1000 from manufacturing
· fatalities form large airline transportation is 235/yr
· 0.6 deaths every 100,000 flight hours
· from smaller airlines (air taxis) is 1.59 deaths every 100,000 flight hours
· public ground transportation = 3276 deaths/yr (doesn't count automobile accidents; only trains and buses)
· reasons for accidents
· alcohol
· 50-75% of fatalities from auto accidents involve alcohol
· 1/50 cars driven by drunk driver (BAC>legal level; 0.08% in IL)
· 0.15% BAC = level of intoxication; if caught driving w/this level, arrested
· accident proneness
· psychological behavior
· people who come from strict families
· develop hatred towards authority
· do things they were previously restricted from doing
· need counseling
3/12/99
Public Health
Vital Statistics
· Table 16.3 p435—diseases (50); reportable diseases
· Reporting of these is important to track the outbreak of how different diseases appear
· Many different departments help in collecting this information
Population: 270 million
· Ratio of females to males (105:100)
· Life expectancy is 77 years
· Women are 3 more years than men
· It takes about 87 yrs for US population to double
· 65 years or older is 14% of the population
· infant mortality rate is 1% (0.7-0.9%)—death of a child before attaining the age of one year
· Latin/South America—25 yrs to double
· Europe—112 yrs to double
· World population is about 6 billion
· Year 2000 the population should be 6 billion
· World is expected to double in 37 yrs—2040 will be about 12 billion
· Most populated countries and in the year 2025 from handout ph50