HEALTH CARE YEAR 1 BATCH
LESSON 9 TERM 2 DAMIANOS
Lecturer: Ms. Hazel Millanar, RMT, MLS (ASCPi)
Lecturer: Ms. Hazel Andreana B. Millanar, RMT,
RESIDENTIAL, MLS (ASCPi)
OCCUPATIONAL,
Residential Environment
When you hear the word ‘residential’, it would simply mean
something that pertains to housing.
Housing Quality
Physical condition of a person’s home, as well as the quality
of the social and physical environment in which the home is
located.
Good quality housing is a key element for ensuring a
healthy village.
The internal housing environment which consists of
heat, light, ventilation, plumbing, and so forth – affects
the physical, emotional, and mental states of the
occupants, and individuals need to be protected against
the elements of heat, cold, disease, insect, and harmful
chemicals.
People need to know that when they arrive home, they
can leave the pressures of the society behind them, can
relax in safety and comfort, and can face the challenges
of the society again.
I. HOUSING QUALITY
I.I Heat
 The CDC housing code = temp at least 68°F at a
distance of 18 in. above the floor level.
o If a person needs a higher temperature
because of age or physical condition, 70°F is
required.
I.II Light
 Must have at least one window or skylight facing
outdoors.
 Window area must be at least 8% of the total floor area
of the room.
 Daylight should be used wherever possible in such a
way that the amount, distribution, and quality of the
light aids in instead of distracts from visual paths.
I.III Plumbing
 Piping for water service should be as short as
possible; elbows and bends should be reduced to
maintain water pressure.
 Water line to the house should be at least 4ft below
the soil to prevent freezing.
 Valves are usually located outside the building so that
the building supply may be turned off when it is
necessary to service to building.
I.IV Ventilation
 45% of the minimum window area can be easily
opened, or an improved mechanical means of
ventilation can be installed.
I.V Water
 All housing colds require that adequate quantities of
running water be provided for a dwelling.
 1 gal/min of hot and cold running water per each
fixture in the house.
I.VI Physical Structure
 Houses are in framed in many ways, however all of
them have foundation walls that provide support for
the outside walls of the building.
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AND RECREATIONAL ENVIRONMENTS
 All openings (such as windows or doors) must be
framed with studs to provide support for that portion of
the wall.
 The exterior walls and trim may be made from a
variety of materials. Their function is to enclose and
weatherproof the building and serve as weight bearing
walls.
 The roof covering must keep the house dry and intact.
 Insulation material used to keep the house cooler in
the summer and warmer in the winter.
o Although we do not have the four seasons in
the Philippines, the purpose stands still.
Good insulation prevents the loss of vital
energy.
HOUSING QUALITY
 Poor-quality housing is associated with various negative
health outcomes including chronic disease, injury, and
poor mental health.
 Low-income families may be more likely to live in poor-
quality housing. For these families, homes might be
under insulated, lack air conditioning, and cost more to
heat living homes either too hot or too cold which has
been linked to poorer health outcomes (e.g. spending
time in a cold home may raise blood pressure or even
lead to a heart attack.
 Residents of overcrowded homes may be at risk for poor
mental health, food insecurity, and infectious diseases.
Substandard Housing
A type of housing that does not meet the standards for living
by people.
For example, there might not be appropriate heating,
plumbing, electricity, or proper sanitation.
These standards are usually set by governments and deal
with how safe the dwelling is for people to live.
Deteriorated housing that has not been repaired or
temporary housing that does not meet building codes.
Most of the time, we have this notion that substandard
housing is old or outdated. But in reality, it is housing
that poses risk to the health and physical well-being of
its occupants, neighbors, and visitors.
Substandard housing brings increase risk of disease
and decrease mental health to the families and
individuals who live there.
Slum
When worse comes to worst a more colloquial term for
substandard housing is a slum, which is a heavily populated
urban informal settlement characterized by substandard
housing and squalor.
Shanty houses to professionally built dwellings that have
deteriorated into slums because of poor quality construction
or provision of services.
UN-HABITAT in 2006 found that 90% of slum residents are
in the developing countries with struggling economies.
The fact is these cities were not meant for handling
millions of people streaming in when designed. This
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 impacts the availability and affordability of housing,
forcing millions to live in substandard dwelling.
UN-HABITAT defines a slum as lacking at least one of the
following: access to safe water, access to sanitation, safe
and secure tenure, durable housing structures.
Durable housing means housing that is located away
from natural or manmade hazards. It is structurally safe
and protected against extreme weather.
The rapid increase of population in the urban centers
resulted in the increase of the cost of living because of
higher demand on urban commodities that are getting
shorter in supply of the day. This explains the reason
why a greater percentage of the poor in the urban area
lives in the slum areas of the city. This is mainly because
substandard accommodation there is very cheap and
the neighborhoods are in close proximity to their
workplaces.
II. PROBLEMS ASSOCIATED WITH POOR HOUSING
II.I Poor Hygiene
 According to WHO, poor housing entails a lot of
problems. One is that cramped and crowded
conditions give rise to poor hygiene by providing
places for vermin to breed and transmit diseases via
fleas, ticks, and other vectors.
 There is high susceptibility that there’s infectious
diseases due to: lack of safe drinking water, absence
of hot water for washing, ineffective waste disposal,
intrusion by disease vectors, and inadequate food
storage.
II.II Food & Water Contamination
 Poor household hygiene leads to food and water
contamination within the home.
 Diseases cause by salmonella, staphylococcus, and
streptococcus may be found in the housing
environment.
 Surveys indicates the individuals living in substandard
housing with a previously mentioned problems have:
higher infant mortality rates, greater level of disease,
poorer health, more nutritional and dental problems,
and numerous other health defects.
II.III Respiratory & Eyesight Problems
 Poor indoor air quality leads to respiratory problems,
and inadequate lighting leads to eyesight problems.
 The serious concern over contaminants in the indoor
air is due to the fact that they are not easily dispersed
or diluted.
o The indoor air contaminant concentration is
many times higher than the outdoor
concentration of these pollutants.
o The degree of risk depends on how well the
buildings are ventilated, and the type,
mixture, and amount of pollutants present in
the structure.
 The sources of light in a dwelling are both natural and
artificial.
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o Few dwellings have been built to maximize
natural lighting from the sun’s rays, which
serve not only to illuminate but to control
temperature as well.
o Light is essential for cleanliness and
avoidance of accidents, and it contributes to
a healthy mental attitude.
II.IV Higher Stress
 Stress is higher for individuals living in poor housing
and poverty.
 Environmental stress not only reduces our ability to
fight off infectious diseases but also causes rather
specific environmentally related diseases.
o For the chronically ill, environmental stress
causes further problems, contributing to
deterioration of their conditions.
III. ASPECTS OF HOUSING QUALITY
Include the following:
1. Ventilation
2. Lighting
3. Overcrowding
4. Disease Vectors
We’ll be focusing on disease vectors because this is of great
importance to us since as medical professionals, we ought to
have idea on how diseases spread. Poor housing structures –
including cracks in roofs, floors, walls and eaves, as well as
lack of window and door screenings – increase risks of vector-
borne diseases carried by pests or insects. Unless homes are
clean and steps taken to prevent insects from entering, the
homes can become infested with disease vectors.
VECTOR DISEASE/S CAUSED
Rodents - Plague (Yersinia pestis)
- Murine typhus (Rickettsia typhi)
- Leptospirosis (Leptospira spp)
- Rickettsial pox (Rickettsia akari)
- Rat-bite fever (Streptobacillus
moniliformis)
Rodents are one of the most common
disease vectors. These cunning creatures
tend to destroy property, spread disease,
compete human for food sources, and are
aesthetically displeasing.
Cockroaches - Diseases associated with Salmonella
typhimurium
- Entamoeba histolytica
- Poliomyelitis virus
- Asthma trigger
Cockroaches have become well-adapted
to living with and near humans. Their
hardiness is legendary. The cockroach is
considered to be an allergen source and
an asthma trigger for residents. The site of
cockroaches can also cause considerable
psychologic or emotional distress in some
individuals.
Fleas - Murine typhus (Rickettsia typhi) and
bubonic plague (Yersinia pestis)
- Intermediate Host (IH) for dog and
rodent tapeworms (occasionally infest
people) and filarial worms (heartworms)
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Although not all fleas are considered as
disease vectors, the most important fleas
considered as disease vectors are those
that carry murine typhus and bubonic
plague.
Sandfly - Leishmaniasis (Leishmania spp)
Flies are not the same as fleas. The public
health view is to classify flies as biting
(sandfly that are mostly found in
Mediterranean areas where they thrive in
dirt of inside houses and transmit
leishmaniasis) or non-biting (common
housefly wherein in general, the presence
of flies is already assigned of poor
sanitation and the primary concern of most
homes is non-biting flies).
Housefly - Diseases associated with Shigella spp.
(causes dysentery and diarrhea that is
cause by Shigella – called Shigellosis)
- Salmonella spp. (causes typhoid fever)
- Escherichia coli (causes traveler’s
diarrhea)
- Vibrio cholera (causes cholera)
Each housefly can easily carry more than
one million bacteria on its body,
Termites - Allergic reactions
- Asthma attacks
The most destructive insect pests of wood.
They can cause more property damage
than that cause by fire and windstorms
combined. They are not known to carry
diseases that are harmful to humans
either. However, people living in homes
infested by termites may suffer from
allergy and asthma.
Mosquitoes - Dengue
- Malaria (Plasmodium falciparum)
- Yellow fever (Flavivirus)
- Lyme disease (Borrelia burgdorferi)
- West Nile virus
Mosquito-borne diseases (such as
malaria and yellow fever) have plagued
civilization for thousands of years. New
threats include lyme disease and west nile
virus. Here in the Ph, the number one
mosquito-borne disease is dengue.
Upper left is an example of a man having a bubonic plague
characterized by black or charcoal-colored fingers. This plague
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is the highlight of the dark ages, and this disease – although it
is not yet eradicated – the CDC has been vigilant in making
sure that history won’t repeat itself.
Bottom left is an example of amoebic dysentery characterized
by bloody stool which is a common symptom of people infected
by the parasite, Entamoeba histolytica. This is the most
pathogenic amoeba that Medtechs should be able to identify,
and this parasite will stay dormant once a person has taken the
medicine but will reactivate once ingested triggers like dirty
food or unsanitary hygiene.
Upper right is an example of murine typhus caused by bacteria
Rickettsia typhi. This is often confused with chickenpox
because of the rashes but then, we have tests in which the
doctors can tell the difference between the two.
Bottom middle is an example of a person having cutaneous
leishmaniasis. There are three forms of leishmaniasis:
cutaneous, mucocutaneous, and visceral. This infection is
endemic in South American countries like Brazil, Peru, and the
Mediterranean region.
Bottom right is an example of a tapeworm, wherein if you try to
look closely, you’ll observe the head of the tapeworm (scolex).
Bottom right is a picture of termites feasting in the wood. The
presence of these termites may indicate that the house is
probably poorly maintained.
Upper right is an example of a person with yellow fever. From
the name itself, the person having this disease is quite yellow
in appearance (the medical term is jaundice).
Upper middle is a picture of a characteristic symptom of a
person with lyme disease. This symptom is what we called as
erythema migrans, which is resembling a bull’s eye. Thus, this
is a central erythema surrounded by a pale ring and
erythematous halo.
Upper left is an example of a child suffering from malaria.
Malaria is known to be endemic in most parts of Africa but here
in the Ph, cases have been reported in Palawan. That’s why
when you try to donate blood, one of the questions ask by the
Medtech is if you’ve ever been to Palawan because there is
deferral period of 1 year for donors who have indeed travelled
there. Malarial testing is also part of the proper screening of
donated blood since Plasmodium spp. are blood parasites.
Bottom left is a picture of a heart full of filarial worms (or heart
worms). These heart worms are usually scene in dogs.
DISEASE VECTORS
 Insect disease vectors can be reduced by keeping food
covered and properly disposing of waste.
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  For problem with flies, windows and doors should be Occupational  Focuses Mainly on Illness
covered with mesh screens and kept shut at night. Health prevention
 For mosquito problems, mosquito nets should be placed  Occupational Health
over beds. Professionals are
 Cleanliness within and around home areas significantly traditionally called
reduces the risk of disease transmission. ‘Hygienists’

Occupational  Focuses Mainly on Injury

IV. HOUSING STANDARDS IN THE PHILIPPINES Safety prevention
Here in the Ph, if you’re planning to build a house, you can’t just  Occupational Safety
proceed to planning and calculating your expenses. There will Professionals are commonly,
be a lot of things to take care of and one that is The National but not exclusively, called
Building Code of the Philippines (Republic Act No. 6541). ‘Safety Engineers’

IV.I Scope
 Design, location, siting, construction, alteration,
repair, conversion, use, occupancy, maintenance,
moving, and demolition.
IV.II Observe Public Health and Safety
 One of the main reasons why the National Building
Code is created is to ensure public safety.
IV.III Maintenance
 Regular maintenance check is a must for all buildings.
IV.IV Dangerous Sites
 Property should be in safe distance to the following
elements: polluted streams or bodies of water,
volcanic site, and any type of land that can be a source
of explosion.
IV.V Dangerous Buildings
 The law also defined the characteristics of a
dangerous building. The law asks the owner and the
people who use it to vacate the property right away.
IV.VI New Design
 The code wants those who are remodeling or
redesigning to use good structure and materials.
IV.VII Coordinate with Municipal & Provincial Ordinances
 The code asks both owners and the local government
to cooperate with each other.
This law ensures that the property that you are going to build is
of quality and that it won’t obstruct the national safety. A person
who does not follow these laws may face certain punishments.
Thus, do research first before starting to build any property in
the country.
Occupational Environment
Although many occupational health and safety principles and
practices overlap, a distinction exists between the 2 areas,
Occupational Health and Occupational Safety
Indeed, ideally, both Health and Safety issues must be
simultaneously addressed to minimize risk of illness, and injury
among workers efficiently and effectively.
ARTICLE 23 of the Universal Declaration of Human
Rights
 A Common Standard of Achievements for All
People, and All Nations
 Every Adult has the Right to Work, to a Fair Wage
for their Work, and to Join a Trade Union.
 It recognizes the Right to Work, which includes the
Right of Everyone to the opportunity to gain his
living by work, which he really chooses or accepts,
and will take appropriate steps to safeguard this
right
ILO’s Framework of Action
 ILO or International Labor Organization
 A United Nations agency whose mandate is to
advance social justice and promote decent work by
setting international labour standards. It was the first
specialized agency of the UN
 ILO’s contribution in the design of workplace policies
and preventive programs on OSH takes in to account
global knowledge gained through research and good
practices
 ILO/WHO Joint Committee on Occupational Health
adopted a comprehensive definition of the aim of
occupational health:
“The Promotion and Maintenance of the highest
degree of physical, mental and social well-being of
workers in all occupations”.
 And so to achieve this objective a safe and healthy
working environment, an access to occupational
health services should be ensured for all workers

Hazard Occupational Hazard

 Has the Potential to
cause harm
 Can Cause an
Injury or Illness
 Hazard
experienced in the
workplace
 Signifies both long
term and short term
associated with the
workplace
environment, and

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 is a field of study  Psychosocial Hazards
within occupational
o Description – Caused by interacting with the
safety and health,
people and social conditions at the
and public health.
workplace. It affects someone’s social life or
 Can encompass psychological health. Psychological factors
many types of focus on Emotional Stressors and Pressures
hazards which encountered by Worker’s fatigue, monotony,
includes: Biological and boredom
Hazards,
o Example –
Chemical,
Psychocial which is  Occupational burnout and Stress
short for
Psychological and  Violence
Societal, also  Sexual Harassment
Ergonomics, and
Physical Hazards  Depression
 Alcohol and Drug Addiction

Types of Hazards, its Descriptions, and its Examples  Ergonomic Hazards

 Biological Hazards o Description – Strains and Stresses on the
body caused by workplace motions and body
o Description – Microorganisms or toxins
positions. Physical factors within the
produced by living organisms that can cause
environment that harms the musculous
injury or illnesses
skeletal system, this involves strains,
o Examples – stresses on the body caused by workplace
motions and body positions, may also
 Influenza, an example of Biohazard include unusual body positions, repetitive
which affects a broad population of motion, poor equipment and workplace
workers design
 Bites and Stings o Example –
 Contact Dermatitis, from exposure  Poorly Designed Work Areas
to poisonous plants
 Repeated Motions
 Blood-borne Diseases, healthcare
workers are at risk to be in affected  Lifting Heavy Weights
with Blood-borne diseases, such
 Poor Body Positioning
as, HIV, Hepatitis B, and Hepatitis
C, and also in particularly,  Physical Hazards
emerging diseases especially when
not enough resources are available o Description – Environmental hazards that
to control the spread of the disease, can cause harm with or without contact. Can
for example the Corona Virus that include ionizing radiation, non-ionizing
causes CoVid19 radiation, noise, vibration, extreme
temperatures, and pressures.
 Zoonosis, Veterinary Health
Workers such as Veterinarians, are o Example –
at risk to exposure to zoonotic  Pollution
diseases.
 Natural Disasters
 Chemical Hazards
 Radiation
o Description – Dangerous chemicals that can
cause acute or long-term detrimental health  Safety Hazards
effects, the chemical stresses include Toxic, o Description – Causes immediate injuries and
Flammable, Reactive or Corrosive Solids, illnesses, and may lead to death. Unsafe
Liquids, and Gases working conditions that can cause injury,
o Examples – illness, and death. Most common
Workplace Risk.
 Silica Dust
o Example –
 Engine Exhausts or Welding
Fumes, Asbestos  Slip
 Carcinogens  Trip
 Asthmagens  Fall Hazards

 Sensitizers  Electrical Hazards

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 FACTS
 A Hazard is not the same thing as the injury or illness
itself
 A hazard may never cause an injury or illness, but has
the potential to.
 Identifying hazards before they because harm gives
you a chance to remove or reduce the potential for
harm
NIOSH or National Institute for Occupational Safety and
Health
 The National Institute for Occupational Safety and
Health is the United States federal agency
responsible for conducting research and making
recommendations for the prevention of work-related
injury and illness. NIOSH is part of the Centers for
Disease Control and Prevention (CDC) within the US
Department of Health and Human Services.
Responsible for related research and education, and
training program. The data from research, help
develop or modify the criteria used for recommending
health or safety standards, surveillance, technical
service programs, including hazard evaluation also
are conducted by NIOSH
OSHA or Occupational Safety and Health Administration
 The Occupational Safety and Health
Administration is an agency of the United States
Department of Labor. OSHA’s mission is to “assure
safe and healthy working conditions for working men
and women by setting and enforcing standards and by
providing training, outreach, education and
assistance”
Each organization plays an important role in ensuring the day
to day health safety of workers, but each has distinct purposes
and goals.
How are NIOSH and OSHA different?
NIOSH is more researched-centered and focused on health,
while OSHA is a regulatory committee that enforces safety
NIOSH, looks a lot at chronic on the job health issues
How do they work together or complement one another?
NIOSH is basically a watchdog for worker health and safety. It
determines what’s hurting the workers in the workplace,
everything from respiratory diseases to exposure to chemicals.
Once they’ve determined what needs to change, they then
work hand in hand with OSHA, which determines whether to
adopt new standards
OCCUPATIONAL SAFETY AND HEALTH STANDARDS IN
THE PHILIPPINES: Republic Act No. 11058 or Occupational
Safety and Health Standards Act
 Employers:
o Provide complete safe and work procedures
o Inform workers of hazards associated with
their specific jobs
o Provide appropriate and personal protective
equipment, which has passed the DOLE
required tests
o Provide access to mandatory OSH trainings
as described by DOLE
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 Employees:
o Encouraged to know all they could about the
risk inherent in the tasks they perform
o Refuse unsafe work
o Report accidents
o Actively participate in planning and
implementing the safety and health program
of the company they work for
RECREATIONAL ENVIRONMENT
Recreation is a vital part of public health. Recreational
activities provide necessary exercise for individuals to control
weight problems, strengthen hearts, and provide an emotional
release from the day to day cares faced from home and work.
Recreation Area
 Land and Water areas dedicated to the enjoyment of
the public
 Parks, campgrounds, shelters, picnic areas, travel
trailer parking areas, resorts, motels, hotels, cabin
camps, marinas
 Other facilities for activities like swimming, fishing,
hunting, boating, sailing, hiking, picnicking, camping,
touring, sightseeing
Effects of COVID-19 on Recreation
 The COVID-19 virus is primarily spread from person
to person among those in close contact, within 6 feet
(2 meters). The virus spreads through respiratory
droplets released into the air when talking, coughing,
speaking, breathing of sneezing. In some situations,
especially in enclosed spaces with poor ventilation,
the COVID-19 virus can spread when a person is
exposed to small droplets or aerosols that stay in the
air for minutes to hours. When you’re outside, fresh air
is constantly moving, dispersing these droplets. So
you’re less likely to breathe in enough of the
respiratory droplets containing the virus that causes
COVID-19 to become infected. But be sure to wear a
mask when you can’t maintain distance from others.
Being outside offers other benefits too. It offers an
emotional boost and can help you feel less tense,
stressed, angry, or depressed. And sunlight can give
your body vitamin D too.
 The CDC has not completely banned the thought of
being able to go out despite the pandemic, hence they
have provided a set of guidelines that people may
follow whenever they decide to spend some time for
recreational activities.
According to CDC
 GENERAL PRINCIPLES
o Stay at least 6 feet apart from people who
don’t live with you
o Limit your time around others
o Bring a mask with you to put on when you
encounter people who may get closer than 6
feet
o Follow local mask mandates
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  PARKS
o Visit parks that are close to your home
o Check with the park or recreation area in
advance to prepare safely
o Use social distancing and avoid crowded
parks
o Wear a mask
o Clean hands often
o Stay home if you are sick
 CAMPING
o Follow general principles as previously listed
o Camp and hike only with people in your
household
o Pack hand soap, hand sanitizer and supplies
to clean and disinfect surfaces
o Continue hand hygiene practices
 BEACH
o Follow general principles as previously listed
o There is no evidence that the virus that
causes COVID-19 can be spread to people
through the water in pools, hot tubs, or water
playgrounds
o Chlorine or Bromine is enough to disinfect
waters from SARS-COV 2
PROBLEMS IN RECREATIONAL AREAS
 Examples:
o Improper Drainage and Soil impermeability
o Inadequate Sewage Facilities
o Inadequate Kitchen Equipment and
Improper Cleaning Practices
o Improper Refrigeration of Food
o Contaminated Water Supply
o Unsuitable Solid Waste Disposal
o Swimming Pool Hazards
o Other Accident Hazards
o Inadequate Training and Physical Fitness of
Individuals visiting the recreational areas
 The Differences of Recreational Environment and
Other Environment
o Much more Dangerous. Humans have made
increasing use of the environment for
recreational purposes. These recreational
uses by large groups of branches and
individuals cause destruction to the
environment and intensify the potential to
spread of disease and injury. Limitation
number of individuals using an area along
with improvement of facilities and good
educational approaches are needed to
enhance recreational environment for
humans and to protect it for succeeding
generations
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