Public health and environmental medicine

A.A. 2019/2020
12
Crediti massimi
144
Ore totali
SSD
MED/42 MED/44 SECS-P/06
Lingua
Inglese
Obiettivi formativi
The course integrates two modules. general and applied hygiene and occupational medicine.
The course integrates two modules: general and applied hygiene and occupational medicine.
In the first module, students will learn:
- the basic epidemiology principles, concepts, and procedures useful in the surveillance and investigation of health-related states or events.
- the objectives, strategies and actions put in place to control and prevent diseases and to promote health at the individual and community levels.
- the methodology of primary, secondary and tertiary prevention.
- the strategies and interventions able to avert, eliminate and eradicate infectious diseases on a global scale, the impact of vaccination in preventing infectious diseases at national and global level.
- the variety of factors which favor the risk of emerging and re-emerging infectious diseases to strengthen global surveillance and control.
- the educational strategies to support behaviors' change among patients and communities.
- the essential concepts of global health and trans-national determinants and solutions in health.
- the general principles and values of healthcare systems and their performance using different datasets. The Italian National health service is presented as a universalistic model of delivery of care.
- the risk management using the current taxonomy.
- the quality of all the elements of the process of care.
In the second module, students will learn:
- the history of Occupational Health, from its "clinical phase" to the current situation, characterized by a focus on primary prevention but without losing some specific medical aspects .
Basic principles regarding the main existing occupational diseases groups of risk factors and related occupational diseases together with criteria for diagnosis, prevention and compensation.
- the lists of occupational diseases (ILO, EU, National Lists) and Occupational Health in the forthcoming ICD11 as useful tools to drive the diagnosis, reporting and compensation of occupational diseases. The need of Occupational Health Surveillance addressed at monitoring new and emerging (or re-emerging) occupational risks and diseases will be also addressed with specific examples.
- The basic principles of human and occupational toxicology, including the concepts of: toxicokinetics of chemicals, dose-response relationship and quantitative evaluation of toxicity.
- selected aspects of regulatory toxicology useful for the medical doctors will be addressed: general concepts in risk assessment and management, health-based exposure limits setting and use, regulations for the management of chemical risk for human safety and health in a global and European perspective, including the "REACH System".
- the definition and the use of occupational and environmental exposure limits, and the classification and labelling of chemical products with a specific focus on the classification of carcinogens (research, international agencies, regulation).
- human exposure to chemicals in the working and living environment (risk assessment and management), pesticides, metals, organic solvents, persistent organic pollutants, benzene, the emissions of a steel smelter industry. Definition of a method to explore different databases for searching scientific documentation and papers on chemical toxicity.
- the main epidemiological methods to study the impact of the general and occupational environments on human health; the point of view of WHO.
- human exposure methods for epidemiological research are described.
- environmental epigenetics as the missing link between environment and chronic diseases.
-how medical decisions imply the use of scarce resources (time, drugs, technologies, etc.) and how doctors should use them effectively and efficiently.
Risultati apprendimento attesi
At the endo of the course students are expected to have knowledge on:
- the basic epidemiology principles, concepts, and procedures useful in the surveillance and investigation of health-related states or events.
- the objectives, strategies and actions to control and prevent diseases and to promote health at the individual and community levels.
- the educational strategies to support behaviors' change among patients and communities.
- the essential concepts of global health and trans-national determinants and solutions in health.
- the general principles and values of healthcare systems and their performance.
- the risk management and the quality of the process of care.
- how to address suspected occupational diseases: diagnostic and exposure criteria, diagnosis and prevention.
- how to classify occupational diseases according to the existing national lists and the ICD codes.
- how to report an occupational disease.
- how to address chemical risks, to identify priorities, to decide prevention strategies.
- how the environment affects health through impact on genome and gene expression.
- how to manage big records of patients, from the general practice to specific specializations and to do basic statistical elaboration.
Programma e organizzazione didattica

Single session

Responsabile
Prerequisiti
To take the Public Health and environmental Medicine exam, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Modalità di verifica dell’apprendimento e criteri di valutazione
Students' evaluation is assessed through one written multiple-choice examination at the end of the course. The professors or the IMS office informs the students about the results of the test.
The exam is deemed to be passed successfully if the final grade is equal to or higher than 18/30. In the event of a full grade (30/30) honors (lode) may be granted.
Registration to the exam through SIFA is mandatory.
Occupational medicine
Programma
Lecture 1 - Introduction into Occupational Health
Lecture 2 - Introduction to occupational and environmental toxicology
Lecture 3 - Introduction to Risk Assessment
Lecture 4 - Toxicodynamic
Lecture 5 - Industrial and environmental hygiene 1
Lecture 6 - Industrial and environmental hygiene 2
Lecture 7 - Derivation of health-based limits
Lecture 8 - Toxicokinetics
Lecture 9 - Searching scientific information on toxicology
Lecture 10 - Chemical risk factors: metals
Lecture 11 - Chemical risk factors: solvents
Lecture 12 - Chemical risk factors: pesticides
Lecture 13 - Disease caused by mineral dusts
Lecture 14: Muscle-skeletal occupational disorders
Lecture 15 - Occupational carcinogenesis I
Lecture 16 - Occupational carcinogenesis II
Lecture 17- Physical Risk Factors
Lecture 18 - Physical risk factors: ionizing radiations
Lecture 19 - Allergic and immuno-mediated diseases
Lecture 20 - The lists of occupational diseases and occupational health in the new ICD 11
Lecture 21: psychosocial risk factors at the workplace
Lecture 22 - Clinical cases in occupational medicine
Lecture 23 - Health effects of Air Pollution
Lecture 24 - Results from the Lancet Commission of Air Pollution and Health
Lecture 25 - environmental Epigenetics
Metodi didattici
Lectures, Seminars. Clinical problem discussions will be used to consolidate technical and soft knowledge acquired during frontal lectures.
Materiale di riferimento
OCCUPATIONAL HEALTH
· Hunter's Diseases of Occupations. Editors Baxter PJ, Aw T-C, Cockcroft A, Durrington P, Harrington JM. Tenth Edition, London: Hodder Arnold, 2010 (advanced textbook)
· Pocket Textbook: TC Aw, K. Gardenerm, JM Harrington. Pocket Consultant. Occupational Health. Black Publishing. ISBN-13: 978-1-4051-2221-4; ISBN-10: 1-4051-2218.
· European Commission, Directorate-General for Employment, Social Affairs and Equal Opportunities, F4 unit. Information notices on occupational diseases: a guide to diagnosis. Luxembourg: Office for Official Publications of the European Communities, 2009 ISBN 978-92-79-11483-0; doi 10.2767/38249 (provided without costs by the course coordinator)
General and applied hygiene
Programma
Lecture 1-2 - Epidemiology and public health: role of epidemiology in public health
Lecture 3-4 - Health education and health promotion targeting patients and communities
Lecture 5 - Introduction to the methodology of prevention
Lecture 6-7 - Vaccines and vaccinations as safe and effective public health tools to reduce, eliminate and eradicate infectious diseases on a global scale
Lecture 8 - Emerging and re-emerging infectious diseases in the era of globalization. A public health problem of major concern
Lecture 9 - Public health surveillance and surveillance of infectious diseases
Lecture 10 - Key concepts and definition of global health
Lecture 11 - Global burden of diseases
Lecture 12 - Recent phenomena and future of global health
Lecture 13 - Social and economic determinants of health and sustainable development goals (SDGs)
Lecture 14-15 - Tuberculosis as a model in global health burden and response
Lecture 16-17 - Global governance of health
Lecture 18-19- The big challenges: climate change and migration
Lecture 20 - Organization and management of Health Services
Lecture 21 - Risk Management
Lecture 22 - Patient safety 1
Lecture 23 - Patient safety 2
Metodi didattici
Lectures, Seminars. Clinical problem discussions will be used to consolidate technical and soft knowledge acquired during frontal lectures.
Materiale di riferimento
· Hunter's Diseases of Occupations. Editors Baxter PJ, Aw T-C, Cockcroft A, Durrington P, Harrington JM. Tenth Edition, London: Hodder Arnold, 2010 (advanced textbook)
· Pocket Textbook: TC Aw, K. Gardenerm, JM Harrington. Pocket Consultant. Occupational Health. Black Publishing. ISBN-13: 978-1-4051-2221-4; ISBN-10: 1-4051-2218.
· European Commission, Directorate-General for Employment, Social Affairs and Equal Opportunities, F4 unit. Information notices on occupational diseases: a guide to diagnosis. Luxembourg: Office for Official Publications of the European Communities, 2009 ISBN 978-92-79-11483-0; doi 10.2767/38249 (provided without costs by the course coordinator)
Applied economics
Programma
1. Introduction to Health Economics and the complexity of Health Systems
2. Organization and Management of Health Services and Organizations
3. Recent development in designing and reconfiguring Health Services
Metodi didattici
Lectures, Seminars. Clinical problem discussions will be used to consolidate technical and soft knowledge acquired during frontal lectures.
Materiale di riferimento
· Lega F., Prenestini A., Spurgeon P., Is management essential to improving the performance and sustainability of healthcare systems and organizations? Value in Health, 2013.
· Lega F., DePietro C, Converging patterns in hospital organization: beyond the professional bureaucracy, Health Policy, n. 74 2005.
· Lega F., Calciolari S., Coevolution of hospitals and patients: how changing epidemiology and technology advances drive organisational innovations and lay new challenges, Journal of healthcare management, February 2012.
Moduli o unità didattiche
Applied economics
SECS-P/06 - ECONOMIA APPLICATA - CFU: 1
Lezioni: 12 ore
Docente: Lega Federico

General and applied hygiene
MED/42 - IGIENE GENERALE E APPLICATA - CFU: 6
Lezioni: 72 ore

Occupational medicine
MED/44 - MEDICINA DEL LAVORO - CFU: 5
Lezioni: 60 ore

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