HAZARDS OF NUCLEAR RADIATION AND PROTECTION

                                                                                                                                                                  1.The atom is like a small copy of solar system,having a nucleus with electrons orbiting around it  like the planets going round the sun.Generally the nucleus has protons and each having a positive charge,and neutrons.The number of protons decides the atomic number of an element.The atomic weight or mass of an atom constitute by protons and neutrons together.Each orbiting electron has a negative charge balancing the positive charges of the protons.The number of protons is balanced by that of the neutrons.The heavy nucleus uranium is made up of 92 protons giving the atomic number of 92 to the element,plus 146 neutrons making an atomic weight of 238.Where imbalance occur,as in uranium atom,the nucleus becoming more stable and in the process gives off energy in the form of alpha particles identical with the helium nucleus.So losing four units of atomic weight and 2 positive charges of uranium 238.becomes thorium 234 and releasing beta particles/electrons or gamma rays similar to x-rays,or both.Fission of an atom or fusion of 2 atoms can release a tremendous amount of energy bringing about explosion.When harnessed it can be used for constructive processes.

2.In a fusion reaction,release of energy comes with fusion of lighter nucleides to build up new elements of greater atomic weight at temperature of millions of degrees centigrade.The fission reaction bringing about the explosion and release of lot of energy is caused by introducing an additional neutron into already unstable nucleus of uranium 235.This splits the nucleus into two unequal parts producing lighter elements and their isotopes.In the process of spiting 2 or 3 neutrons are thrown off with 2 gamma rays those bombard nearing nucleus and make a chain releasing a huge amount of energy.There are at least 40 ways in which the atom of uranium 235 may split producing 200 or more isotopes of 35 lighter elements each of which has an atomic weight close to 95 or 139.

3. Ionising radiations are produced by nuclear fission,radioactive elements.materials,isotopes and contaminated materials including nuclear wastes,radiated waste materials,vegetation,fall-outs and etc. and also those from x-rays,fluoroscope and medical isotopes.They are gaining importance in human ecology since they are produced more and more,transported.handled and used in reactors ,industry,medical tests and treatment and warfare.They are emitted in the environments in the form of wastes,dusts,vapours,fumes,effluents and fallout.The threat by a nuclear weopen or an atom bomb overwhelms our imagination due to the dramatic sadness of the mass destruction,sufferings and ill effects and thus engaged our attention.The hazards from exposure while handling nuclear substances for peaceful purposes are constantly present and are increasing and dangerous equally combined with more use.It is ,there fore,health education to public is necessary to clearly understand the nature

of hazards and protection against them and act when necessary.
4.The fusion and fission reactions complement each other in an explosion such as the one that happens with hydrogen bomb.The highly temperature is necessary for fusion to take place can only be attained by a fission explosion.So also certain fission  reactions release neutrons which makes the fission of uranium or plutonium.so adding the total energy release of the combined fission-fusion system present in the thermonuclear weapon.By controlling the chain reactions with fission and fusion the energy out put can be controlled and harnessed for other uses than as a weapon of war.the radiation emitted by the radioactive elements involved in such reactions affect biological environs as well.

5.Our knowledge of the biological effects of radiation has been known over the last 90 years through the experience in the fields of early x-ray workers,painters,patients who have been administered radium salts and high doses during radiation ,uranium miners,atomic bomb survivors in Japan,victims of reactor accidents and children whose mothers received radiation exposure during pregnancy.Human experience being limited,we have to mostly rely on animal  experiments.The biological effects are external or internal somatic and genetic.Somatic effects are manifested in the person himself soon after exposure to radiation or exhibited after a latent period of several years. A genetic injury may not affect the exposed person but due to the damage to the genetic tissues causing the 'gene mutations' and pregnancy suffers.The external hazards most probably from the penetrating gamma rays and neutrons ;beta particles those causing burns on the bare skin and ordinary clothes stopping them and alpha rays can not penetrate the tissue.Internal hazard comes due to the entry of radioactive substances into the body through inhalation of radioactive dusts and vapours and ingestion of radio-active materials or absorption through cuts and wounds.The effects due to internal radiation are more serious.It gets lodged in the bone for many years and together with its products gives off alpha.beta and gamma radiations,damaging vital tissues in the bone.Whole body exposure is the most dangerous.The total effect depends on the nature of radiation,length of retention in tissues,the radiation it emits,the total radiation dose,the period over which it is spread,and etc.Neural,reproductive and gastrointestinal tissues are particularly radio-active,and acute exposure  received over a short period is more injurious than the intermittent radiation.

6.The early effects of an acute whole body exposure may occur in reactor accidents or nuclear war,depend on the dose received.A small percentage of people exposed to a small dose.i.e 50-200 rem may vomit with in a day.Some may feel weakness and some may show decreased blood count.Every one exposed to a moderate dose i.e.200-450 rem will have radiation sickness with vomiting soon after exposure and will be sick for few days.For doses less than 50 rem no symptoms may occur.At 450 rem about half of the  number of persons exposed will die.An exposed person will have a 50-50 chance of survival.With increasing doses the sickness becomes more acute and with a dose of 600 rem the chance of survival is very rare.If the doses are divided and much radiation can be tolerated as experienced in cases of very ill patients suffering from incurable cancer.Early effects of on some of the vital functions of the body are central nervous system,Gastro-intestinal tract,bone marrow,Lymph nodes and skin.Late effects can occur after chronic or acute exposures and symptoms may be manifested after many months or years.They include ageing,life shortening,sterility,cancer,developmental defects and etc.The large scale of usage of atomic power in the field of industry medicine and agriculture is inevitable and more people will have to live and work in intimate contact with ionizing radiations.The mental health problems that may occur among workers in atomic reactors,chemical plants and allied nuclear industries are of immediate importance.Food and water are not spoiled by radiation,but contamination by radio-active materiel from accidents in reactor or fallout from nuclear bursts makes them dangerous for consumption. 

PROTECTION AGAINST RADIATION HAZARDS.

7.Many initiators in radiology suffered  pain full and often fatal injuries from over-exposure to x-rays since the discovery of x-rays of last 19th century in 1895.In a short time they suffered from dermatitis,weakness,tiredness,nausea,vomiting anaemia,blood changes,cancer x ray ulcers and etc.The hazards to the radium dial painters arose due to the practice of pointing the brushes by licking which led to ingestion and retention of radium in the body and acting as a prolonged source of internal ionizing radiation.In 1921the British x-ray and radium committee was formed to the purpose of organizing protection against radiation.In 194,the development of 'chain reacting piles' the sudden development of atomic war-heads and nuclear weapons and their tests and their growth of atomic energy industries have increased widely the need for providing protection against radiation to persons who have to work in contact with radiation and populations exposed to environmental pollution.Radiation hazards associated with use of radio-isotopes in medical practice increased due to their increasing use in diagnosis and therapy.Radiation hazard inherent in nuclear war fare.the hazard of deposition of radio-activity materials in body through eating contaminated food,drinking water and contaminated air,exist due to nuclear blast tests.These dangers demand a good initial design of plants and isotope laboratories and efficient protective measures.

8.Protection against hazards from x rays and fluoroscopy..An increasing use of diagnostic x rays and flouroscopy has resulted in an increased radiation level to mankind  causing concern and awareness of the possible risk to patients,medical and paramedical workers and to the population.Complete protection against x ray radiation can be ensured by its intelligent use.for example,examination should be restricted to those cases in which it is of established value and 100% essential and should be avoided if not clearly indicated,specially the repetition of identical tests,particularly of the female pelvis,hip joints and lumber spines and mostly the foetus lies in the direct beam of radiation.In the examination of hips,spines,pelvis or abdomen,the patient is protected by shielding of gonads and proper filtration,colonization of beam of x-rays by the use of proper cones,by utilization higher kilo voltages and observing other standard precautions in the practice of radiology which help to reduce exposure to unwanted radiation.Periodical examination of radiologists,radiographers,technicians and others workers is carried out when considered necessary.This must include a blood examination also. Self protection by the doctor and radiographer should be ensured by the use of appropriate shields and the screens,automatic protective devices,use of rubber aprons and clothing as recommended.Film badges and dosimeters should be used for monitoring;periodical examinations are useful.The use of intensifiers during flouroscopy can reduce the dose of over 10r. Radiological tests of infants and small children involve total body exposure,therefore,all parts out side the field of interest to be protected. Fluoroscopic out put must be kept at the lowest level with out interference with the brilliance of image.Unit with an out put in excess of 10 rem per minute should be modified to reduce
radiation.The radiologist should avoid placing his ungloved hand in the fluoroscopic field.All palpitation should be preferably done with the current off.

Safety measures in handling isotopes.
9.There can not be set any hard and fast and rigid rules applicable universally to all laboratories handling isotopes.They depend upon the demand type,chemical and physical behavior,the amount and the nature of radioactivity of isotopes handled in laboratory.Good house keeping,vigilance,alertness and good work habits are most important and the following measures/precautions minimize the danger of exposure isotopes.Selection of staff/workers those who are naturally neat,careful,healthy, mentally balanced and not accident prone for employment in isotope work.Education regarding the dangers
involved in work,training,in work methods,supervision to ensure their familiarity with rules,and initial and periodical medical check up.Obedience of safety rules and adherence of proper work methods and health'physics'practices.                                                                                                       10.prohibition of bringing unnecessary materials or doing any unnecessary work,eating,drinking or smoking.Proper storage of all radioactive materials to reduce the general background dose to minimum.Liquid radioactive waste like water used for cleaning can be disposed of through sewage system provided otherwise like solids it may require storage for decay before disposal.Solid wastes and contaminated substances,like bottles,blotting papers,dressings and etc,should be placed in a labelled waste cans and stacked away until radioactivity is reduced to a safe level and not discharged into a drain.After 2 or 3 months they are checked for radioactivity and if found safe should be disposed of like any other waste or otherwise retained for further decay before final disposal.Protective clothing,coats,gloves,goggles,masks,and shoe covers must always be used.They should not be taken out side the laboratory and worn in other rooms.When dusty radioactive material  is handled,a dry box should be kept or if the operation is continued in a hood,the workers should wear a face mask.The international sign signifying the danger of ionizing radiation is to be displayed on all the doors and the windows and such other places where work on isotopes is conducted.A medical record of each individual should be maintained with care even though there may be no fear of overexposure.If a laboratory contamination is suspected,a survey should be made soon,followed by cleansing to reduce the radioactivity to an acceptable level.

11.For external radiation,monitoring is done by studying dosimeter or the film badge which are worn continuously on the front of the body,on the breast pocket,or attached to a finger ring,or wrist by each person exposed to radiation.Radiation incident is shown on film on its development.The developed film badge serves as a permanent record of the exposure of a person.If an internal hazard is suspected examination of urine,faeces,nasal discharges/smear or sputum may be helpful depending upon the metabolism of the special element involved.Measurements over the thyroid may be used to estimate the body burden of radio iodine where it is being used.A monthly thyroid count of workers would show whether the radioisotopes have been inhaled or ingested.Hands and shoes,floors,table tops,gloves and etc,are checked for contamination.For large radioisotope units have a 'count rate' meter which is necessary as per the nature of the radiation exposure.The total body burden can be estimated by assaying the amount of radioactivity excreted in the urine,faeces,or exhaled air and by a direct measurement of radiation from the 'critical organ'.Smoking,drinking or eating in areas where there is a chance of contamination and pi-petting of radioactive solutions by mouth is avoided.Rubber bulbs for aspiration are used for this purpose.Rubber or plastic gloves are worn for handling radioactive substances.When a risk of air borne contamination is present,suitable devices mechanically suck and carry the fumes,mists,dusts and vapours away from the worker and respirators or special hoods are used.Fixed radio active contamination is not a source of internal hazards as it can not be inhaled or ingested,but loose contamination leads to hazards.The cleanliness,protective clothing,washing of hands,and mouth,inhibition of eating,drinking smoking or application of cosmetics in work rooms may give considerable protection against internal radiation hazards.

12.For ensuring those precautions taken are complete,monitoring should be done from time to time the total dosages to which workers have been exposed in a given period.Prevention of exposure to radioactive material in industries such as radium dial painters where the substance comes in contact is affected by providing workers with glass screen booths and efficient exhaust mechanical ventilation and sufficient facilities for washing hands before meals should be provided.Rubber aprons,paper handkerchiefs,to be collected daily and destroyed.workers do not use their own handkerchiefs.Special separate rooms for eating and smoking.food,tobacco,drinks and cosmetics must not be introduced into the work room.Cleaning of floors must be by done by wet method.Special solvents to remove paints from hands should be provided.They should be rubbed into the hands and removed with soap and water.Employees should be medically examined with in 7 days of employment and there after monthly intervals,The first sign of finger  a reddened glazed appearance of finger tips commencing with the erasure of the finger print,followed by cracking of the nail.At this stage complete stoppage of exposure the finger will revert to normal.A total WBC count below 4500 with reduction of poly morphs and relative lymphocytes show ingestion of larger doses.

13.A premedical check up is necessary to eliminate persons mentally and physically unsuitable to work with radiation The pre-employment medical standards are laid down in the ILO publication on protection of workers against radiation, Periodical medical tests of person who are exposed regularly  exposed to ionizing radiation are necessary.A complete such medical record should me maintained and this should include information regarding pre-employment state of health,the radiation hazards exposed to,details of full clinical check ups and special investigations relating to special organs or tissues.Workers exposed to ionizing radiations and internal changes that should be watched for protective measures that should be taken.In fact that carelessness may lead to harm themselves and others.They must report soon to their doctor any abnormal signs detected on the skin or any other diseases.Dope paint workers should check their blood count regularly and they are entitled for extra  milk during their work.Health education should be given to workers before commencing their works regarding ionizing radiation and its prevention and necessary measures to be taken by them.'health physic'is a composite discipline dealing with radiation safety.Persons exposed to accidental radiation and ingestion of radioactivity material and exposed to radioactivity dusts,vapours,etc,are soon sent to decontamination centers where they are given a shower bath after removal of their clothing.

14. After the bath the skin,hair,nails,urine,sputum,stool and exhaled breath are examined for radioactivity.If the internal body burden is high correct/appropriate medical care is instituted,If he has swallowed radioactivity material treatment for ingestion will be given.the use emetics/induce vomiting and stomach wash drugs given by doctors.and with this the radioactive/isotopes in the intestine will help in eliminating active materials.A contaminated skin should be washed for 2 minutes with soft soap warm water and giving special attention to nails and the inter digital areas.This may be repeated for 2 minutes if found necessary after monitoring,using a soft brush but taking care not to scratch or erode the skin.If the contamination still persists titanium dioxide paste should be applied and rubbed for 2 minutes.After rinsing off and brushing with soap and water the part is monitored.If necessary washing is repeated with 0.1% ammonium chloride.Floor and bench tops should be decontaminated with water and detergents.A solid wood surface may also be decontaminated by planning a thin layer of the surface.

15.Use of atomic energy as a weapon of war has brought to the forefront the need of providing special medical aid/care for the victims.The destructiveness of an atomic bomb is due to the most instant occurrence of a atomic mass into energy.The air burst over a city will cause maximum degree of destruction by blast,thermal radiation and secondary fires.and also immediate,delayed,and persistent radiation effects will be inflicted upon living beings and plant life.In case of bursts on the ground or near ground level,the overall blast damage and destruction by heat flash and secondary fires would be less than in the case of an air blast.The heaviest destruction and radiation will occur near the centre of explosion.The main difference between an atomic disaster and other heavy explosions are the suddenness and magnitude of the former event.At about 40000 to 50000 causalities may occur,excluding the dead as a result of one detonation. 10 to 30 percentage of the wounded in an atomic explosion would have received ionizing radiation as well.So medical aid for sudden occurrence of a large number of causalities,their evacuation to safe areas and further specialist treatment of medical.surgical and radio logical needs to be planned.planned. Immediately following the incident,medical persons and equipment enough to give minimum essential early treatment and preventive supervision would be required.As a practical consideration all causalities have to be regarded as radiation victims.unless proved otherwise.

16.Against explosive blasts,flashes and fire,depending on the distance from the point of explosion reinforced concrete buildings,deep shelters,tunnels,caves and trenches afford protection to some extent. Inflammable materials like wooden structures catch fire easily,concrete bricks and earth have greater protective value.The greater thickness of wall of the shelter the lesser are the chances of exposure to penetrating external radiation.To avoid internal radiation by inhalation of radioactive air and dust in the contaminated area or by ingestion of contaminated food or water no person should enter a contaminated area with out a respirator and should not touch food or water unless it has been declared safe by monitoring team.To summarize the protective measures are:-suitable underground shelters with thick nonflammable walls and roofs,monitoring of all suspected areas and materials,use of suitable clothing like respirators,over halls gloves gumboots,or strong leather boots,avoidance of entry into the contaminated area,prohibition of the consumption of suspected food,water,fruits,milk and vegetables,decontamination of persons and equipment at decontamination centers,and a periodical medical check up of rescue workers and cases likely to have been exposed to small doses of radiation.
pm kutty.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        

NEUROSPINAL HEALTH

1.Science which deals with brain,spinal cord and peripheral nerves such as motor nerves and sensory impulses and autonomic nervous system,etc,are comes in neurology and its health is most important to maintain a happy life with mental,physical and social well beings.The main diseases of nerves and spinal cord and the brain are the stroke,Parkinson's disease,fits,cerebra spinal injury due to road transport accidents and diseases.etc.

2. Avoidance of stroke.Maintain a healthy body weight and life style.Keep your body mass index always between 18 to 25.To find out your BMS,see your weight and divide it by your height in meter square. Exercise aerobically 4 times in a week for 10 to 40 minutes.Eat lot of fruits,vegetables and high fiber diets.Avoid fats especially saturated fats found in meat,butter and beef shortening.Measure your blood pressure and see whether it is high or not.High blood pressure makes the heart and blood vessels work harder.Treat high blood pressure as told by your doctor.

3.Check your cholesterol and maintain it in normal level.Test your blood sugar.Chronic high blood sugar is harmful to the arteries.Free blood sugar is often tested at clinics,laboratories and pharmacies.Ask your doctor to check your blood sugar level high hematocrit,High hemotocrits make a person more prone to strokes.Stop smoking.Nicotine causes the blood vessels to narrow and constrict which impedes circulation,and reduce or eliminate drug and alcohol intake.Abuse of either can cause strokes even in teenage and young adults.Avoid constipation.Straining to more our bowels is hard on our heart and blood vessels.Reduce your stress.Chronic stress and strain causes the blood vessels to narrow,which makes the blood pressure rise and the heart work harder than normal.Relax.with yoga class,read a good book to your beloved one,pray,meditate or do whatever else relaxes you.and increase your sense of being.

4.To avoid Parkinson's disease take anti-inflammatory medicines with medical advice.It is a result  of an inflammatory process.Keep your cholesterol level under control.A study reports that a high cholesterol level can increase Parkinson's.Anti inflammatory Parkinson medication may reduce and curb the disease in many patients.Maintain a healthy diet and exercise regularly to keep your cholesterol level in normal status.Take supplements. As per studies supplements are effective and efficient in combating neuro degenerative diseases such as Alzheimer's and parkisons diseases.The preventive health website states that taking antioxidant can improve your brain health for the diseases of parkisons and Alzheimer diseases.Vitamin c and fish oil supplements can also promote healthy brain activities.

5.To avoid migraines,wake up in the same time each day,disrupting your natural sleep patterns encourages your migraines.Avoid fatigue and have plenty of rest.Avoid sudden bright flashes of light which triggers migraines in some persons. Breathe deeply,high dozes of oxygen and exercise aerobically at least 4 times in a weeks 20 to 30 minutes each time. Specially hormonal active women are more at risk of developing migraines.Regular brisk exercise keeps hormone in a better balance.If steps mentioned above do not keeps you from getting migraines see your doctor for a medical advise.

6.The excessive use of Laptop is causing lot of people to suffer from back and shoulder and neck pain.For sustained periods of work,use a laptop with a docking station.Place the laptop on a stable base and not on your lap and take regular breaks and walk for at least one minute or more in your office to relieve upper body tension.Sit up straight with your lower back supported.In order to achieve a full and faster recovery of a back injury,oxygen is an important nutrient in the healing process of tissues of the back-must be present.In addition to the broad harmful effects of smoking causes reduced levels of oxygen to reach the discs and spinal tissues.Diminished oxygen levels cause early degeneration and weakness of disc and can take more time for healing process from a spinal injury or disease.

7.Swimming provides a better cardio-vascular activity.Many people suffering from chronic neck and back pain have a difficult time with lots of forms of exercise.Swimming is ideal.because the water counteracts the force of gravity and takes pressure off the spine and the back muscles.This helps strengthen the neck,abdominal and back muscles which you need to protect your back,by lightening of load always relieves certain forms of back pain.It is also very important to get a mattress that provides sufficient back support.Have a medium firm mattress rather than a very firm or very soft mattress to ease back pain.A healthy back is the working combination of nerves,muscles and bones and more,but over weight puts pressure on these structures.If you keep a healthy weight for your height,you can decrease your risk of back pain.

8.Poor lifting and carrying loads are most common and easily avoidable, causes of back pain.Never carry loads that are so heavy and can not lift alone.Work places are furnished to provide correct equipment for you to carry out your work.If you think you may have trouble by lifting  something,get help.Do not risk back injury.Good posture and regular exercise help in minimizing chronic back ailments.Regular exercise is good.But it is necessary not to strain your back.Walking and cycling help your muscles to function well.If you do not have already disc complaints,you can take yoga classes.Many of the exercises strengthen your abdominal muscles and your back,which can us to stand straighter.Remember to take advice from your doctor if you have back with or with out leg pain and you are worried or doubts about new forms of exercise.

9.Eating nutritious foods,keep you healthy and may help slow down spinal complaints.Nutrition will decide how strong your bones and connective tissues are.Eat lot of fresh fruits and fresh vegetables and whole grains,include sea foods.poultry and low fat or non fat diary products in your daily diet.Drinking sufficient amount of water is also essential and also getting enough sunshine exposure that give you vitamin D,an important vitamin to help build stronger bones.What you eat during your whole life will determine how able you are to repair bones,muscles,cartilage,tendons and ligaments.Try to move every 30 minutes-even walking inside the office for less than one minute can help to stimulate your back muscles.That is all,at present,think twice that your health is your wealth.

pm kutty

EBOLA VIRUS DISEASE

1.It is an animal borne virus disease of humans and other mammals caused by Ebola viruses and starts sign and symptoms starts between 2 days to 3 weeks after contacting the virus and characterized by fever,sore throat,muscle pain and head ache,followed by vomiting,diarrhea,and rash and usually with decreased function of liver and kidneys.At the same time some one may start bleeding internally or externally.Most of cases have a high risk of deaths from 20% to 90% of infected with Ebola.This is due to hypo tension/low blood pressure due to fluid loss and follows from 6 to 16 days after the symptoms appear.

2.The name of Ebola originates from the river Ebola in the Congo and the first time the disease was appeared in 1976,and the patient was a school teacher who was touring along the Ebola river.Just few days before he was identified with what became known as the Ebola virus.This was the beginning of a virus which has an average rate of mortality of 83 percent.Up to 2013 WHO recorded a total of 2000 Ebola cases in 24 out breaks,all of them in Africa,thus may be known as home of Ebola viral disease.It also says known as a green monkey fever, hemorrhagic fever.which is extremely unpleasant disease,almost fatal and for which there is no vaccine or specific/licensed treatment.

3.Ebola put breaks commonly occur in central and west Africa,it was first seen about 4 decades ago,during out breaks occurred in Sudan,Nzara and yambukku in  democratic republic of Congo.It also occurred in countries out side Africa,including Philippine and one case of human Ebola virus was recovered in united kingdom,In 1989,1990 and 1996 the virus was detected in mammals in the Philippines in monkeys all over the globe,leading to 3 cases viral infection among humans,and in the same 3 years monkeys introduced virus in USA causing 4 cases of human infection.

4.Ebola infects human beings through close contact with the body fluids and secretions of infected animals or humans.According to world health organisation,fruit Bats are the most common host of virus,causing to other animals infected with virus are non human mammals,like monkey,forest anti lops.It is also noticed that large Ebola out breaks occur often in west and central Africa due to hunting and eating meat from wild animals always infected with virus by local people.People can directly also infected via exposure to objects or areas that have been contaminated with body fluids of infected,like used syringe needles or improperly sterilized medical equipment used during an out break.Even those who have recovered from disease can still pass the virus,as per WHO there have been cases where men have been cured from the  EVD can still pass virus through their semen up to 7 weeks as temporary carriers.There is no cure yet to combat medicine/vaccine Ebola virus disease.In the past out breaks Evd killed around 25% to 90% of number in infected persons.

5.Symptoms of Ebola virus disease are difficult to diagnose as those are like malaria,typhoid fever,cholera and other viral hemorrhagic fevers.Timely treatment of Ebola is a challenge due to difficulty to diagnose.The early stages of disease/infection says several laboratory tests are required to find out Ebola virus and acquiring these samples for these tests is hazardous and to be conducted under maximum precautions to avoid get infection to health work providers.During the recent out breaks in 2014,Dr.Oman khan who was the in charge of the main Ebola treatment in Kenena sierra
was infected with virus and died of disease.

6.Prevention.If an animal is suspected to be infected by the virus,the best and first method is to quarantine that entire group of animals.The infected animal must be slaughtered and its body should be destroyed/burred deeply with 5% cresol solution.Persons with infected virus should be quarantined.Health workers and family must wear protective clothing when they visit patient. Continuous use of infection control measures in the health care centers and other areas where the patient is kept.Same measures are to be taken at air port.Proper investigation of the passengers ,especially coming from African countries.All passengers travelling to other countries via airways from Ebola affected countries must fill a check list health form. Travelers address records will be maintained so as to track them easily if any symptoms are detected.Compulsory self reporting by passengers at the immigration check.Air port officials customs and immigration sections must keep tight monitoring.Help desks are set up at air ports and ports to deal with travelers showing any potential Ebola symptoms.Immediate action to be taken after detection.Air port authorities are in touch with doctors.There are 2-3 reports of Indian passengers coming from the affected countries carrying the virus infection with them but,in the proper screening reported negative results.

Let us ourselves take precautions like maintaining a high degree of hygiene,sanitation and cleanliness all the time,visiting the doctor if we detect any symptoms and increasing awareness among the people about the disease

pm kutty.

AVIAN INFLUENZA AND PREVENTION.

1. Most of us have heard and some must have suffered from influenza/flu which occurs pandemic-wold wide or epidemic with its symptoms with high fever,difficulty in breathing ,head ache ,malaise,nose running,cough,sneezing,etc near about 4 days of its occurrence,The incubation periods is 2 to 4 days,It is due to a virus of 250 groups estimated and human being has no natural immunity for those.Can infect by other group after fortnightly or after a month by other group of organism/virus.It is all known as influenza/flu.Avian flu is deferential from that and through birds.
2.  But Avian influenza/Flu is different from that which causes an organism/virus called H5N1,and normally infected birds including chickens ducks,wild birds,other poultry can infect other birds flu can pose health of people.A case of bird flu directly infected a man N5N1was in Hon gong,China in 1997 then the bird flu has spread the other in countries in Asia,middle east and Europe. Human  infection is still rare,but the virus that causes infection in birds might change and infect humans thus could lead to pandemic,a world wide out break of illness.During an out break of bird flu,people who have contact with infected birds can become sick.May be catch with,bird flu may be possible by eating poultry or eggs that are not properly cooked or that a person contacted with the disease who has it.It can make more people sick and fatal.Antiviral drugs may make the illness less severe may prevent the flu in man ,who were exposed to it,There is no vaccine currently available for it.
3.  Risk of getting flu virus is higher to poultry farmers, travelling country when virus is present,eat a under cooked poultry meat,eggs or blood from infected birds.People who live in the same house with bird flue may also be at higher risk of infection,The flu virus H5N1 lives in the environments for a longer periods of time infection should be spread such by touching surfaces that have the organisms of illness.The birds who were infected with this disease/flu may give the virus in their faces and saliva as long to 8 or 10 days.
4.  Symptoms depend upon the strains of viruses in infected man.The H5N1 virus in infected man causes influenza like symptoms such as cough,diarrhea,breathing trouble,fever.Temperature above 38 C,head ache,malaise,muscles pains,watery nose and sore throat.Tests,x ray chest.blood differential counts,and other tests as per the functioning of heart,liver,kidneys.Treatment differs as per the symptoms out break depend upon the the type of flu and how bad the infection is.The disease can be fatal and the possible  complication are,sudden respiratory failure,jaundice,pneumonia and sepsis.
5.  Prevention.Use protective clothing and wear of special breathing musk,if any one work with mask.If travelling to an area to that H5N1 Out break.avoid going to live birds markets.During this time,does not recommend travel to countries affected H5N1.Avoid uncooked or under cooked meat.Reduce risk of exposure to Avian flu and other food borne diseases.Burial of carcasses flu infected by H5N1 with quick time.Very recently 3-4 days back in Kerala,India in Kuttanadu and Alapuzha ducks were died totally and their blood were examined and found it was due to H5N1,there,fore,all destroyed and buried/burned to prevent infection  to other birds/chickens and human beings.

by pmkutty

EFFECTS OF EXTREME COLD CLIMATE AND PREVENTION OF ITS HAZARDS

1.Winter season started and it will last  up to March 2015, and personal protection and prevention of its hazards to maintain a healthy life is essential. Not only in high altitude, but also those occur in low altitude in the plains of northern India, where effects of cold climate become more complicated due to extreme cold. Cold may exist with very low atmospheric humidity as in Rajasthan or in Punjab or with high humidity and rain fall as in Sikkim and J and K or in NE FA or with low humidity as in the north Indian plains. Height above 3000 meters in the western and 4000 meters in eastern Himalayas represent the same climatic conditions as in the arctic region.Here the temperature in winter ranges between minus 20 C to minus 50 C, there is not much vegetation, the cold is dry cold and is accompanied by severe biting winds with snow particles moving in the air, and deep snow drifts are common. Frost-bite and snow blindness are common dangers.

2.Below that altitude and above the winter snow line at about 2000 meters in western and 2500 in eastern Himalayas, subarctic condition overcome. Melting snow in summer produces watery mud.Winds are cold but less severe because of the protection given by forests and scrub.Atmospheric temperature is normally very low and the region has pleasantly cool summers and the great revers take origin here.Though snow storms are often and frost-bite may occur.Trench foot is more common risk and chilblain is the most common hazard and happens down to the lowest height of this region.

In foothills up to 1000 meters height the climate is humid and warm in summer with high rain in monsoon and with tropical forests and winter seasons are mild.Below the height of winter snow line

the climate is semi-liar to the higher temperature zones with forests,cold is severe in winter but not as more as to produce frost-bite or trench foot,but chilblain is common in susceptible individuals.In western parts,winter rains comes and summers are pleasant.

3.Local effects of severe cold climate are frost-bite,trench foot and chilblains.Frost bite is due to freezing of protoplasm,trench foot is due to the stagnation of circulation and chilblain is due to an allergic type of reaction to cold insusceptible individuals.The area become red and there is irritation specially when the patient is in bed or sitting in front of fire.Frost bite occurs in lower and upper extremities and exposed superficial areas like nose tips and ear lobes.While the tissue temperature goes down below the critical temperature,the the protoplasm in the cells wholly frozen and the cellular frame work gets disrupted and causing negative changes in the affected tissue.Two clinical types are recognized; acute and insidious.Acute frost-bite occurs and develops in extreme cold weather with high wind.Trench foot occurs above the critical tissue temperature in combination with dumpiness due to circulatory stagnation.

4.First aid should be started by removing the individual to a sheltered place soon.Patient must be put in sleeping bag or wrapped in blankets and insulated around between him and ground.The best way of warming the patient is by immersing him in a warm bath,the temperature of which should be 35 C.

Then it should be brought up gradually to 40 C in 10 to 15 minutes.Moisture is a  good thermal conductor and its presence in contact with skin interferes with natural insulating action on the skin.Presence of moisture in clothing increases its thermal conductivity.Local blood supply stagnation allows local temperature to be lowered.Physical inactivity increases the risk of cold injuries.Activity decreases the liability to reduce them and is an important prophylaxis against cold injuries.Nutrition plays an important role in resisting cold effects and malnutrition increases a person to cold injuries.Vitamin A and C deficiency also increases healing power of tissues.Fatigue,fear and anxiety are common in cold climate specially at high altitude cause increasing the liability to cold injuries.Local injury or skin infection increases the particular part to cold injuries.Use of tobacco increases the risk of frost bite and alcohol consumption in large quantities increases local cold injuries.

5.Preventive and control measures.The clothing should be in many layers and loose.Wool is the good material.and the outer layer should be wind proof.Boots/shoes socks gloves and head covering should not be tight Snow clothing must be worn and training for its proper use should be given.Damp clothing must be changed soon.In cold weather 2 pairs of socks are worn.Boots should be loose fit,otherwise,inflict injury on feet and toes,if it is so tight;kept soft and water proof,and every person should have an extra pair of dry socks and boots,to change into if his feet get wet.If the person has to work in water or slush,gum boots are of great advantage.Snow boots are used with extreme cold clothing.boots should be used after trying them out with thick woolen socks after walking at least 50 yards and while standing. Socks should not be tight.every person should have 4 pairs of good woolen socks all the time.Regular checking is necessary.Badly torn socks become dangerous,bad one must be changed soon.                                                                                                                                                 

(a)The feet should be inspected before going to bed every night.They must be washed with warm water and dried and applied with little animal or mineral Vaseline before sleeping every night.This helps 'supercooling' and avoid frost-bite.Individuals with ulcers and abrasions should not be exposed to out side in extreme cold weather till it is healed.Foot powder should be used before wearing socks in the morning to reduce dampness and friction with socks.Venous circulatory congestion and stagnation must be avoided,persons should not sit for long periods in enclosed places or upon the railings with feet hanging down and especially over the edges of seats.Too tight clothing also causes venous block.

(b)Shelter from strong wind is necessary.while resting or sleeping.Regular moderate exercise to keep up circulation with out causing any exhaustion or excessive sweating should be taken regularly. Wringing of toes and fingers should be practiced regularly and face muscles should be wrinkled to keep up the circulation.If the tip of nose or ear lobes or cheeks of the one is affected the other persons draw attention and first aid is given.To maintain general heat of the body caloric requirement in the cold is higher,due to higher metabolism.There fore to maintain general heat of the body,the caloric value of food must be taken,hot and adequate appetizing meals to be consumed.Well cooked and nourishing hot foods and drinks increase resistance to cold,promote mental and physical well being and prevent the body against infection,fatigue and dangers of climate extremes.Vitamin C in the form of multivitamin tablets should be taken during extreme cold climate to resist the body from hazards.

(c)Personal cleanliness,dry clothing,ventilated shelter,warm bed and recreational facilities are helpful.At least 2-3 hot baths in a week in snow bound and cold environs are necessary.bathing places should be sheltered from snow fall and wind.Do not use too much soap as it removes the greasy material and decreases insulation and advantage of supercooling phenomenon.Contact with cold metals should be avoided.Metal articles should be covered with adhesive taps.Touching cold metals with bare hands peels off a thin layer of outer skin,especially when the hands  are dump. Alcohol never should be consumed in excess over a short duration.It should be taken at all when likely to be exposed to cold wind,Smoking must be always in moderation or if possible be avoided.Once the cold injury occurs,it should be definitely prohibited.Once a person suffered cold injury due to high altitude effects,must not be exposed to a semi-liar risk again.

(d)First aid and early treatment is aimed at arrest  and prevention of tissue damage.All cold injury cases must be treated as lying cases and transferred to a sheltered place by stretcher in warm surroundings and given extra cloths and blankets,at high altitude oxygen must be given through mask.All tight clothing should be loosened and boots/shoes removed and affected part to be kept at complete rest and the part must be gently and thoroughly cleaned,and wrapped in sterile dressing.Blisters should not be opened.The body should be warmed slowly,but affected limb must be warmed up quickly with warm water at about 42C. The limb must be kept continuously warm for a long time after thawing.Rest,nourishing diet and sleep are necessary to the patient,hot nourishing fluids and meals are helpful in restoring morale and health. Alcohol is contraindicated as it cause heat loss and smoking should be avoided totally.

(e)There is no specific prevention or treatment for chilblain.To improve local circulation such as a hot paraffin wax bath and ultra violet rays are help full.When the skin is intact a paint containing 50% menthol in a compound tincture of benzoin or ointment with 3% of camphor and 0.5% of phenol in linolin paraffin mixture should be rubbed gently into the chilblains every night and morning,after immersing the affected parts in warm water and drying them nicely.Chaffing of cheeks and lips can be prevented by applying lip salve or paraffin jelly.

(f)Effects at high altitude.These are encountered in high altitude aviation and mountaineering.The most frequent and important clinical problems unexpectedly meeting at high altitude are Acute mountain sickness,Acute pulmonary edema,Chronic pulmonary hypertension,coronary and cardiovascular insufficiency and congestive heart disease,manifestations of diabetes mellitus,Psychological effects,etc.Prolonged exposure to hypoxia may produce other minor effects after a long time are Dimness of vision,loosening of teeth,loss of weight,indigestion,anaemia,loose bowels,thyroid deficiency,increase severity of infections,etc may be met in contest.These symptoms normally disappear with in 4 to 5 weeks of move to the plain areas.A high protein diet is necessary in high altitude areas due to subnormal tissue metabolism.The atmosphere being cold,the air has very low atmospheric moisture contents.Much water is so lost from the body through the breath.Lack of interest,irritability,insubordination,and lengthening of reaction time may happen.There is no increased incidence of psychiatric break downs at high altitudes in comparison with plain areas.Lack of concentration and mental impairment may occur on arrival at high altitude as a part of acute mountain sickness for few days which may subside with in few days.If not cured during this period such persons may be brought to sea level and become normal.

6.Prevention of effects of high altitude environments. All individuals going to high altitude should be examined.The persons with sound health of cardiovascular and respiratory system should be selected for long residence in high altitude.The ascent should be slow and in stages,like 3000,3700,4300,5000 meters.It is better to avoid alcohol consumption and evening meals should be consumed 2 hours before sleeping.If any one develop with respiratory distress,more cough or fever develops they should be brought down to a height below 1500 meters and treated soon.Gradual acclimatization is the most important preventive measure against sudden effects of high altitude hypoxia. Avoiding trips to higher altitudes if suffering from nose and throat infections.and avoidance of excessive consumption of alcohol and smoking,and adequate consumption of fluids.well cooked food and sufficient rest and,

and also healthy recreation reduce the effects of hypoxia.In order to counteract this increased protein consumption is required.Due to hypoxia the fats can not be well metabolized,there fore,low fat consumption is substituted by high carbohydrate intake meets meets the physiological needs.Fats require more oxygen for its katabolism than the carbohydrates per gram,and per 100 calorie out put.Water drinking must be adequate.This should be had through often drinks.The high altitude foods meets these requirements.

7.First aid and early managements.Complete rest in bed,warmth,and nutritional diets will relieve minor symptoms.Aspirin will relieve most of symptoms including sleeplessness.head ache,cough and irritability.It should not be taken as a preventive measure or more than one .g.(2 tablets) with in 8 hours with  medical advise.It is easier to work during day but sleep may be disturbed or difficult for first few nights..A sleeping tablet may be given under medial advise.persons showing mental irritability,impaired judgement,severe headache vomiting etc,should be removed to a lower shelter at 3000 meters for 3-4 days.Then they can be ascent again to higher shelter.

Individuals suffering from irritable cough and lung edema,pain chest,breathlessness or bruise co-lour in the body,vomiting sensation,severe giddiness etc should be rested soon and given oxygen.They should not be left alone.Arrangements should be made for sudden removal to an altitude below 2000 meters if complaints prevail.Complete bed rest,continuous oxygen and and rapid evacuation to a lower altitude are the 3 initial MUSTS.The congested lungs normally clear with in 6 to 48 hours after removal to a lower altitude.In addition to atmospheric hypoxia it is possible at high altitude to give a rise to psychological voidness,and the appetite becomes poorer,the re activity becomes slower and duller,the ability to grasp the situation becomes blunted and the attitude of mind may assume inclination.This makes a man interpret wrongly and disregard administrative tasks or his health.

pm kutty

INDUSTRIAL HEALTH

Industrial health in relation with the conditions specially to the industrial conditions of the workers can be dealt with the worker,environments,the machinery,the materials used,and method and process of work,,.All buildings,temporary or permanent must be structurally safe and sound to with stand the strain and stress of machinery and single storey construction is the usual rule as it helps flexibility to lay out. It is easier to manage natural ventilation and natural light can be obtained in it by a combination of walls and roof lighting. By care full orientation,direct exposure to the tropical sun can be avoided. protection conducted heat can be achieved by a choice of suitable material. Spreading of  the surface area of walls and ceilings with asbestos reduces the noise of machines and also makes

building fireproof.Work-rooms must be provided with natural and/or artificial lighting.Recently,the fluorescent lamps/tubes in strip lighting is being increasingly used due to their efficiency is high and running costs are law.They give a uniformity of illumination and low heat formation with absent of shadows.But after some time it starts flicker effect,and it is danger,so immediately changed and voltage must be checked and the chock and starter of the tube should be renewed.

Efficient ventilation must be provided in work rooms by natural and artificial means to eliminate stagnation of air,excessive heat or cold and excessive humidity and dryness and objectionable ordours. Clean and fresh air should be supplied to all rooms/enclosed work places at an average rate of not less than 30 to 50 cum per hour per worker or a complete change of air at a rate varying from six per hour for sedentary workers to ten hour for active workers.If a good supply of fresh air could not be maintained by natural ventilation to the centre rooms mechanical ventilation should be provided,All dust,fumes,gases,vapours or mists generated and released during industrial process must be removed at their point of origin.Funnels,flues and vents should be used to extract dangerous fumes vapours,mists and smoke from the immediate vicinity of the workers,All employees should be protected from radiant heat and excessive temperature from heated machines and hot process by the heat insulation of the of the equipment or by suitable protective clothing.Suitable thermal comfort and working comfort should be maintained to all industrial/factory employees to achieve maximum productivity,Seats and work benches should be provided to all workers who can perform their work in sitting posture.Work tables also must be of convenient height with regard to that of the seats.

Sanitary conveniences like toilet rooms,latrines and urinals should be provided in sufficient number as per accommodation.For female workers separate sanitary convenience must be provided as per the strength of female workers.Washing places should be conveniently located.Sufficient washing facilities for maintaining personal cleanliness should be provided in all industrial establishments.For persons whose work  involves contact with any injurious and noxious substances there should be at least one tap for 15 persons.Mixing valves for shower baths,if provided should be a such a type and so installed and adjusted that water can not be supplied at a temperature exceeding 100 degree Fahrenheit.Shower baths and flooring should be thoroughly cleaned at least once in a day and disinfected to prevent fungal infections,All industrial establishments must have suitable and sufficient arrangements for accommodating clothes of workers and drying them,A separate working room should be provided for all employees whose working clothes are exposed to contamination with poisonous materials,infections and irritating or radio active substances.Benches or other suitable seating arrangements are necessary in dressing rooms.

A sufficient supply of cool and safe drinking water should be provided for in a readily available place in all work places.Closed electric water coolers are ideal and most hygienic.Proper care must be taken to prevent contamination in water tanks and other containers.if water cooler is not provided.Section 18 of factory act says a minimum scale of drinking water per day per worker.House-keeping implies general cleanliness and orderliness of the plants,the tools and the products.Cleaning and working must be done during none-working hours.For any technical reason,cleaning must be done during working hours.Wet mopping of floors after sweeping or vacuum cleaners are to be used as a routine method.Wet work process should be done in dusty industries and effective drainage has to be maintained.False floors,platforms,mats or other dry standing places with suitable foot wear for use must be provided. While at work on an oily or greasy working places floor constitutes the commonest slipping hazard.House-keeping means keep the working places neat and clean.Due to improper house-keeping is a another cause of accidents.Many a punctured wound is a result of stepping on the screws,nails and other sharp objects carelessly thrown on floors.Infestation of rodents,vermin and insects should be eliminated by control measures.Protective fencing around factory/industry should be installed to avoid hot pieces of iron coming out from the furnaces before cooling.

Accidental injury due to machinery is the most important industrial hazard.It is due to various causes,like bad house keeping,faulty and unguarded machines and carelessness,etc.Most of the accidents are preventable by the close collaboration of safety officer,engineer,welfare officer,chemist and hygienist and medical officer.There fore,workers must be educated and trained in various industrial processes and handling of various different types of machines.The materials handled and industry uses and makes wide range of materials/substances which are known or suspected to cause toxic effects in the employees working with them.Industrial toxicology deals itself with the study of various substances used in industry either as media for processing some materials or as raw materials or the finished product.Things used solids,liquids and gases-may produce dusts,fumes,gases and rays.which may be inhaled,swallowed,absorbed by skin or attack the skin and cause harmful effects like occupational hazards and diseases.Where ever practicable the use of offending substance should be prohibited.failing that,a harmless materiel should be substituted for the harmful one.For example,use of yellow phosphorus has been prohibited in match factory under international law;sand-blasting may be substituted by shot blasting.Gasoline derivatives may be used in place of benzol as solvents.

Total enclosure of plant.personal contact with harmful materials such as dusts,fibres,fumes,gases mists or vapours into the air of the work room would be prevented.Elimination of the dangerous products by suction hoods properly connected to efficient exhaust systems where an air tight apparatus can not be used.Where practicable the materials should be used in a moist or wet state to prevent the evolution of dust,for example.lead.Health education is the most important safety factor.The atmosphere of work rooms should be tested periodically to ensure that the concentration of toxic or irritating dusts,gases,fumes mists,etc are with in normal and safe limits.Disinfection of articles infected with bacteria should be carried out.Wearing of personal protective clothing and equipment such as respirators/breathing apparatus and also skin must be protected by use of protective creams.prohibition of taking or preparing meals and smoking in work rooms. Separate meals rooms should be provided in the case of lead and radio-active processes.Prohibition of the employment of persons in particular industries,for example,women and young persons below 15 years in lead processes.Occurrence of certain diseases like lead poisoning,phosphorus poisoning,Mercury poisoning,manganese poisoning,Arsenic poisoning,Anthrax,silicosis,Toxic anaemia and toxic jaundice due to poisonous materials,etc.should be notified.

Common occupational hazards are acute poisoning by benzol inhalation of very high concentrations of benzene vapours,may result in unconsciousness and respiratory failure.Due to chronic poisoning

degenerative changes are observed in kidneys and heart.Red blood cells are decreased and anaemia may develop.The ventilation of the of the rooms of workman should be improved by mechanical exhaust ventilation is one of the preventive measures.Carbon monoxide poisoning is an acute poisoning with a sudden on set of unconsciousness and rapidly developing bluish co-lour and death.

It is formed from incomplete combustion of materials containing carbon.It is coming from various industries like gasworks,foundries coke-ovens,blast furnaces and in automobile garages.The chemical

causes asphyxia/suffocation,if the exposure continues the victim become unconsciousness,resulting in death from respiratory failure.Chronic poisoning shows all these symptoms coming on gradually and then continuing for longer periods.Head ache,breathlessness,physical and mental weakness  are the common symptoms.Carbon monoxide poisoning can be prevented by prevention of its production

in combustion,then give attention to all possible leakage in the exhaust system and ensuring good ventilation and finally by observing the rules of personal protection.A competent person must be made responsible for all circuit.

First aid and early treatment must be given to all poisoning cases immediately.The first object is to restore normal breathing and the to eliminate shock.The victim must be removed into  fresh air on a stretcher and should not be made to walk even though he is conscious.The oxygen carbon dioxide mixture should be given.if the breathing has stopped or is shallow artificial respiration should be continued till normal respiration returns.Complete bed rest and warmth are necessary,and give hot tea with plenty of sugar.Watch the patient for long time in all cases because of the tendency to relapse. If the breathing again become shallow,give artificial respiration and administration of 95% oxygen and 5% carbon dioxide mixture should be given.Chronic ulceration,cutting oil dermatitis,caustic acids and alkalies,cyanide poisoning,lead poisoning,metal fume fever,mercury fulminate,nitroglycerin,nitrous fumes,physical hazards,welding hazards,silicosis,etc are the some common industrial hazards.

The worker is the most important component of the industrial set up.The workers remain in an optimal state of mental,physical and social health and it is necessary for industrial productivity.

To achieve this it is the main and prime importance to fit the skill of worker to the job and job his skill.Hence medical point of view,a pre-placement of medical examination must be carried out taking into the consideration the hazards which the factory life will impose on the employee.It should not mean,however,the factory job does not require highest physical standard of health.A disabled person can be accepted how much really he can do his job safely.For example,a totally full blind ex-soldiers

have been employed in an optical factory and it has been found that their out put has been more than

that of a normal man.The work through the sense of touch which they have developed in themselves to an extraordinary degree of proficiency and also some times, blindness in their case has actually helped greater concentration on work by excluding visual distraction.After selection and placement it is the duty of the management to provide sufficient safeguards to protect him from accidents,toxic and other industrial hazards.It is then essential to train him in work methods and self protection from all possible occupational hazards.Working clothes should protect him from or minimize the effects of hazards to which the wearer may be exposed and improve working efficiency and physical comfort.

Protection of head,eye and ear protection,hand and arm protection,foot and leg protection and respiratory protection with proper apparatus are essential during the process of work carried out by employees.Occupational psychology enables the study of psychological fitness for employment and investigation into the causes of psychological beak-down due to strain and stress in some industry occupations.This also include certain aptitude investigations/tests for different kind of work and into the causes of industrial fatigue.There are many psychological factors involved in industrial morbidity

by which work may be dull,monotonous,repetitive or other wise unsuited of some persons of certain

character or temperament.All persons must undergo a medical check up before entering industrial

employment for the first time or with in 15 days of employment.Medical services should collaborate

closely with technical services of industrial establishments to ensue as perfect selection of workers and also the skill of workers.Periodical medical examination should complete and thorough including special investigations.

Industry not only presents hazards to workers but also creates hazards and annoying conditions to the residents in the vicinity or in the township.Air pollution by smoke and poisonous gases and dusts are common in residential areas near to factory/industry.and water pollution due to industrial effluents.and also noise produced by machinery during work processes.disturbing calm of residential areas.Use or consumption of final hazardous products produced by industry.In recent years air pollution by smoke and poisonous gases,dusts and fumes has become an important public health problem.Most cokes,coals and heavier oils contains sulphur compounds when burnt,most of them emitted as sulphur dioxide and other chemicals such as gasoline produces carbon monoxide and Irritating hydrocarbon as Ole-fin.Other organic compounds found in polluted air in big cities are cresol,phenol,xylene,soot and tar compounds.Dust is a special hazard from cement manufacturing

industries and radio-active wastes from atomic reactors.

Ill effects are air polluted with sulfuric acid and sulfuric dioxide can cause respiratory distress and

acute respiratory irritation.This may show finally the persons suffering from respiratory/cardiac diseases and allergic disorders of the respiratory tract.to the aged ,and premature infants.Eye disorder

also may be increased in smoky atmosphere.Unpleasant or-dour may cause gastric troubles and vomiting sensations/anorexia.Silicosis occur due to pollution with dusts in lungs.The disposal of waste water from factories is another public health problem.Untreated liquid wastes are lead into a stream which makes the water unpotable,destroys fish and renters it unfit for bathing and recreational

facilities.Live stock and diary cattle may get poisoned by drinking contaminated with industrial wastes like insecticides and mineral oil trade or even unpleasant flavour to milk.Anthrax is known is to be transmitted by using the polluted water in slaughter houses.Waste water from ammunition and chemical factories remove waste products like arsenic cyanide,which are toxic to plant,animal and human life.Some effluents from industries are discharge to sewer with out correct treatment make the final treatment of sewage unsatisfactory.Trade wastes from gas works give an offensive tastes and smell to the water.The indiscriminate discharge of waste waters on land may cause water logging and

infertility and destruction of standing crops.It may produce foul smell and make the place ugly for any other purposes.

Control measures are effective legal provisions for control of waste water and soil pollution.A technical organization to assess nature of water pollution is necessary,and legislative procedures for control of smoke nuisance and rigid enforcement of these provisions.Standard for the sulphur content of coal and smoke in the air must be laid down.An administrative body to enforce legal provisions with representatives from the state health department and factory inspectorate and public health engineering should be established.Proper siting of residential areas and industrial areas by sound town planning is important to decrease the hazards of air pollution.Smoke nuisance from railway locomotives,ships and also from the industry can be eliminated by a change over to diesel or electric power.The active cooperation of industrialists who must recognize their responsibility in this matter

plays a vital roll in the control of air and water pollution.The education of the legislators,industrialists and workmen is important  to make them appreciate the problem and their respective roll in cut down the hazards to minimum.

pm kutty

PREVENTION AND CONTROL OF DENGUE FEVER

Dengue is a sudden specific fever of about seven days duration,and characterized by pains in all over the body.a rash and a raise in temperature,by the cause of a specific filterable virus.Man is the reservoir of infection.The Aedes mosquito which has acquired infection from a case is the immediate source of infection.

The virus multiplies in the stomach of the female mosquito of Aedes and its transmission occurs to man through its bite about 10 days after taking a blood meal from a case of dengue during its infective period.The most Important vector species in India is Aedes aegypti which bites man in day and night.The incubation period is normally 4 to 7 days and can limit from two to fifteen days.

A case is infective to mosquitoes during the first 3 days of the illness,and the mosquito remains infective for the whole of its life period of 3-4 weeks after it becomes infective. Man possess no natural immunity,but an attack confers considerable immunity.Second or third attack may occur occasionally,but they are much milder than the first attack. In an endemic area local people enjoy

almost complete immunity.The new comers from non-infected areas are particularly susceptible and among them the disease occur with suddenness affecting large numbers.

Dengue has a wide distribution in tropical and sub-tropical areas and mainly in coastal region and and the deltas of great rivers.it is a disease of towns rather than of the villages of the country,In the tropics the disease is always onset of the monsoon rise.In the sub-tropics the incidence occur in summer and autumn.In India Dengue occurs in the eastern side of the country mainly north east and less in south east.It is also occurs in epidemic form in north-west India.In Bengal the highest disease occurs in August and September and also it may occur in epidemics.In Kerala also endemic cases occur during rainy season.

Though the disease is with no mortality,it is important as it may affect a number of people when occurring in epidemic form.

Prevention and control of the disease.

The only preventive measure of dengue is the control of the vector mosquito i.e .Aedes aegypti. This

mosquito has limited power of infiltration so that its breeding places to be eliminated from human habitations and places of working areas.This is effective in controlling dengue in epidemic areas.Use of repellents and protective clothing and mosquito nets come under personal protective measures.The use of insecticides are very important during epidemics. The patient should be treated under a mosquito net during day and night,as the vector Aedes aegypti mosquito is active in day and night.For attendants and contacts no action is essential.

pm kutty

PREVENTION AND CONTROL OF RABIES/HYDROPHOBIA

Rabies is an acute,almost fatal infectious disease of animals mainly in canidae  tribe from which man is secondarily infected.After 15 days of incubation period the infected dog shows symptoms in one of the two forms i.e dump or paralytic form and furious form.Furious canine rabies causes maximum cases of the diseases in man.Stray dogs and pet dogs are the intermediate host of the disease to human beings and animals like cow,be-fellow,cat,sheep,etc.When the disease occur in man it is known as Hydrophobia, means fear of water.In man the disease is characterized by sudden onset with headache malaise and nervous symptoms of depression progressing to paralysis with spasms of muscles on attempt to drink,followed by delirium and convulsion and resulting to death from respiratory failure with in two days to a week.The difficulty to drink water is in patients only in human beings,and does not occur in dogs or other animals.

The organism causing this disease is a neurotropic filterable virus.The strain recovered from the stray rabid dog has been named as"the street virus".It is found normally in the hippocampus of the rabid dogs/animals brain and that of man dying of hydrophobia.Virus is present in the saliva one week before symptoms appear.The street virus loses its virulence and retains the antigenic properties when passaged a hundred times through the rabbit.This is used for preparation of antirabic vaccine and is named as"Virus fixe"

The temporary reservoir of infection is found in the canidae. Some of the members of these families harbour the virus with out suffering from the disease or death,and also excrete it in saliva at intervals

for long time.The Indian mongoose and the American Vampire bats are also found to harbor the virus.Some wild rodents also have been suspected of playing an intermediary role in the transmission of infection from animal to animal with in these tribes of canidae families and non-canidae families to the wild canidae tribe,with out themselves suffering from the disease.Therefore,these animals serve as permanent reservoir of infection in nature,migrating from this reservoir occur in wild canidae like,jackals,foxes,wolves and wild dogs in whom reservoir is found.Transmission of virus then occur

from wild canidae to domestic stray dogs,when meeting them on the out sides of town,near butcheries

and refuse disposal yards.In rural areas the wild canidae can meet the  domestic stray dogs with in the areas of the villages.Domestic stray dogs thereafter transmit to pet dogs.

The canines suffer and die of the disease with in 10 days after the symptoms appear.For man the source of infection is from the rabid ,domestic,street,or pet dogs or cats.In rural areas wild dogs,foxes,jackals or wolves may attack human beings,during epizootics among st domestic dogs and cats.Infection is transmitted through bites coming out blood or licks on broken skin surface by the rabid dog.Infection doesnot occur with out some injury of epidermis or mucosa. Virus deposited at the site lastly reaches the central nervous system and the route and its travel up to brain is doubtful but the blood stream do not play a part;perineural lymphatics of the secondary nerves may be the route of travel.The average incubation period developing hydrophobia in man is 3 to 8 weeks,may vary from 10 to 90 or longer up to 6 months as per location of the bite and wound from head.The nearer the dog-bite to brain the shorter is the incubation period.In animals incubation period

is about 2 weeks.

The saliva of a rabid dog or fox is ineffective for a week to ten days,before symptoms appear,till death of the dog.but some times occurs only a time before the starting first symptoms of rabies appear. All warm blooded animals and mammals are susceptible.Man possess no natural immunity against the disease.Rabies has a distribution all over the wold.It was absent long time in some countries like New Zeal and, Australia,Hawaii and some pacific islands,and some other countries  like U.K, Scandinavia were strict anti-rabies vigilance is observed.In Asia and Africa the disease is very common.In India more than 7000 cases of hydrophobia occur in every year.

Preventive measures against hydrophobia;Immediate first aid treatment of dog bite  should  be given on the spot.All bites from dogs and other animals should be regarded as dangerous and first aid treatment should be carried out immediately.

The wound should be suddenly cleaned and washed thoroughly with soap and water to reach the depths of pockets of the wounds with the help of a forcible jet of water and application of tincture

of iodine or 70 % of ethyl alcohol should be carried out with swab so as to reach the depths of wound.

In emergency 20 percent soap solution can be used for this purpose.Local application of 5 ml hyper immune antirabic serum around and underneath wound is an added helpful first aid if possible.Tetanus toxoid 0.5 ml given to all pre immunized persons.Antibiotic treatment may be needed to treat badly lacerated cases and subsequent infection.Normally sutures do not apply for 3 days.

A full course of antirabic vaccination is the only specific procedure which  prevents hydrophobia.The

principle is to make an active immunity by giving daily injection by the modified inactivated rabies virus during the incubation period.Vaccination must be started and completed very early after the rabid dog bite.

Generally there is no danger of infection through unbroken skin,but the virus may have been present in the saliva of the dog up to 10 days before the onset of the symptoms,the patient has to decide for himself whether there is any possibility of the dog having licked on the broken skin during that period.The medical attendant should not be expected to decide this for him.If the patient is with considerable doubt in such cases antirabic treatment is generally given to be on the safe side.

In some cases, antirabic treatment is not necessary.1.Drinking of milk from rabid animals.2.If the biting animal remains healthy and alive for a minimum period of 10 days after the bite.3.A bite through clothes with out tearing, when the skin not broken,even though the bruise co lour may be present.4.Handling of clothes or materials contaminated by the rabid animal or a patient of hydrophobia.5.Handling of animals bitten by rabid animals provided the skin of the individual is free from cuts,abrasions open injuries.6.Attendance on a case of hydrophobia,unless bitten by him.

Complication of antirabic treatment;Anaphylactic reaction may happen in sensitive persons.Non specific reaction may also occur, like,moderate local pain,redness and swelling,etc.mainly in obese patients.For these complaints local fomentation may apply.High fever,malaise,headache,pain and stiffness in neck and back or limbs may appear after 4th day due to allergic manifestations which is rare complication to antirabic vaccine treatment.In India the reported cases were one in fifteen thousand persons under vaccine treatment.This occurs between 9th and 15th day of treatment

more in males than in females.and among adults than in children.

Prevention and control of rabies in animals; It consists of mainly controlling the stray dog population,protection of pet dogs and cats and prevention of importation of disease from out side,if the country is already disease free, and personal protection against dog bite.Destroy or plan the growth of number of stray dogs in the country specially owner less dogs.All pet dogs to be registered

and use of metal badges on the collar,to identify from them stray dogs and owner less dogs.For promoting registration the local authorities should give free pre-exposure antirabic immunization and free treatment for other canine diseases.Ingress of wild canidae in habitations and their mixing with domestic dogs can be controlled making the slaughter houses,rubbish disposal yards,poultry farms and such other places attracting dogs,animal food and disposal of all such waste by burning.To  promote caniculture, publicity campaign should be carried out,registration of pet dogs,their protection and destruction stray dogs.Education regarding the dangers of rabies,rabid dog bites and important of early vaccine treatment must be carried out.During an epizootic,restrain the movements of all dogs and  observe them at least for 3 months.Dogs that have been bitten by rabid dog should be destroyed preferably.Dogs in contact with ,but not known to have been bitten by a rabid dog to be kept and given antirabic vaccine treatment and be observed for 6 months.Self protection from dog bites,as the bites are through clothes and likely to transmit disease,trousers and full sleeve shirts are more protective than other type of Indian clothing.Disinfect all places where a rabid animal has been confined and the carcase of a rabid animal must be buried with quick lime or cresol solution.Health laws of some countries do not permit any dog to import from any country.Some countries permit them to import after quarantining period of six months.Some countries with and others with out taking compulsory immunization as per their law permits.

Particulars of all dog bites and cases of hydrophobia to be warned all concerned regarding the presence of epizootic or endozootic in the area,and also report should be given to higher medical

authorities.All valuable animals should be given regular vaccination in endozootic areas.The mortality is 100 percent and no curative treatment is not available,patients should be admitted hospital and observed in a quiet room shaded light and all the forms disturbance must be avoided.Attendants must wear gloves,gown goggles.In case he comes to expose the risk of infection

by the bite of patient or contact with his saliva on broken skin,he must take correct course of treatment.Bedding and clothing used by patients or contacted by rabid dogs should be soaked in 5%

cresol solution or exposed to formalin mixed with potassium permanganate fumes for one day,then washed and dried in the sun for 24 hours.There being no other points presently with me,this has come

to an end.

pm kutty