Public health and environmental medicine

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.

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.