Ученым Советом Донецкого национального медицинского университета им. М. Горького как учебное пособие icon

Ученым Советом Донецкого национального медицинского университета им. М. Горького как учебное пособие




НазваУченым Советом Донецкого национального медицинского университета им. М. Горького как учебное пособие
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ACADEMIC CONTENT

On mastering required knowledge start to study the following literature :

  1. Гігіена та єкологія. Підручник. / За редакцією В.Г.Бардова.- Вінниця: Нова Книга, 2006.– С. 34 – 50.

  2. Пропедевтика гигиены. Общая гигиена. /Е.Г. Гончарук, Ю.И. Кундиев, В.Г. Бардов и др. – К.: Вища школа, 1995. – С. 207 – 239.

  3. Даценко І.І., Габович Р.Д. Профілактична медицина. Загальга гігієна з основами екології: Учбовий посібник. – К.: Здоров’я, 1999. – С. 97 – 106, 474.

  4. Даценко І.І., Денисюк О.Б., Долошицький С.Л. та ін. – Загальна гігієна: Посібник для практичних занять. – Львів: Світ, 2001. – С. 78 – 84.

  5. Общая гигиена /Под ред. Г.И. Румянцева, М.П. Воронцова. – М.: Медицина, 1990.- С. 90 – 96.

  6. Guide of department.

  7. Lectures on a theme.

  8. Count of logical structure of theme.

Supplementary:

  1. Габович Р.Д., Познанский С.С., Шахбазян Г.Х. Гигиена. – К.: Вища школа, 1983. – С. 31 – 36.

  2. Пивоваров Ю.П., Гоева О.Э., Величко А.А. Руководство к лабораторным занятиям по гигиене. – М.: Медицина, 1983. – С. 199 – 210.

Theoretical questions underlining the implementation of purpose full activities:

  1. Composition of sun radiation. Ultraviolet part of sun spectrum.

  2. Biological action of ultraviolet radiation.

  3. Methods of research of intensity of ultraviolet radiation. Units of measuring. Concept of biodoses, prophylactic and physiological doses.

  4. Violations of health and disease, caused by ultraviolet insufficiency.

  5. Prophylaxis of ultraviolet insufficiency.

  6. Application of the artificial sources UV-radiation in prophylactic and medical aims.

  7. Application of artificial sources of short-wave UV-radiation for sanitation of objects of external environment.

  8. Unfavorable consequences of the surplus influencing UV-radiation on an organism.

  9. Prophylaxis of the surplus influencing UV-radiation.

Oriented bases for activities

After mastering the above problems acquaint yourself with algorithms which will allow you to muster professional skills in a more successful ( suppl. 2).

To check knowledge of the given material do the following tasks.

Tasks of teaching type:

Task 1.

Vitaminorigin (antirachitic) affect UV-radiation is peculiar:

  1. Interval A UV-spectrum (400 - 315 nm);

  2. Interval B UV-spectrum (315 - 280 nm);

  3. Interval C UV-spectrum with a wave-length less than 280 nm;

  4. Interval A and C;

  5. To all interval UV-spectrum.

Contra-indication for the intensive ultraviolet irradiation as:

  1. Hypovitaminosis C.

  2. Diabetes mellitus.

  3. Diseases of thyroid;

  4. Cold diseases;

  5. Alimentary obesity

TASK 3.

The sensitiveness of skin to UV-rays increases sharply:

  1. At the patients of pneumoconiosis;

  2. After the measles;

  3. At mycotoxicosis;

  4. At hypervitaminosis A;

E. At hypovitaminosis C.

TASK 4.

Superirradiation by the artificial sources UF-radiation with a wave-length less than 320 nm without the observance of accident prevention can result in the origin as:

  1. Hyperthermia;

  2. Myxedema;

  3. Chronic radiation illness;

  4. Sharp radiation illness;

  5. photoophthalmia.

TASK 5.

For the goals of disinfection of environmental objects apply as:

  1. Erythermal lamps EUV-15;

  2. Lightirradiation options;

  3. Luminescent lamps enriched by UV-spectrum;

  4. Erythermal lamps EUV-30;

  5. The BUV Lamps.

TASK 6.

Chromogenesis (tan) affect UV-radiation is most characteristic:

  1. For the UV-spectrum interval with a wave-length 400 - 380 nm;

  2. For the UV-spectrum interval with a wave-length 380 - 340 nm;

  3. For a interval C (shorter 280 nm);

  4. For interval with a wave-length 340 - 280 nm.

  5. For all spectrum UF-radiation.

Keys: 1-B,2-C,3-B. Decide the other tasks independently.

Short guide to conducting of employment

At the beginning of employment verification and correction of initial level of knowledges is conducted. Then students execute independent work: conduct laboratory work on determination of intensity of ultraviolet radiation by a photochemistry method (Suppl. 3) and decide individual situation tasks.

A situation with the use of biological method of determination of the UVR intensity by the Dal'fel'da-Gorbacheva biodosimeter is designed in the first individual task (Suppl. 4).

It is necessary to assess time of receipt of biodosis and to evaluate a minimum day's prophylactic and physiological doses.

In the second task it is necessary to give recommendations on duration of reception of sun-baths and stakes of the biodosis got for the children of a different age depending on a month and time of day in a dynamics (from the prophylactic ultraviolet irradiation first for the eighteenth day). This task is executed according to the developed chart of the prophylactic doses UVI for the north regions of Ukraine (The suppl. is given out by a teacher).

The third individual task foresees mastering of skills of calculation of necessary amount of bactericidal lamps for conducting of effective sanitation of apartments depending on his volume and consumable power of lamps (Suppl. 5).

In a fourth situation task assessment of efficiency of sanitation of air in the apartment is conducted with the use of microbiological methods of research (sowing of microorganisms by the Krotova device before and after sanitation). The indexes are thus evaluated: degree of efficiency of sanitation (DES) and coefficient of efficiency of sanitation (CES). A calculation and assessment is given in accordance with the suppl. 6.

Technological card of practical employment

№ п/п

Stages

Time, min.

Equipment of lesson, teaching mean

Place of conducting and kind of lesson

1.

Verification and correction of initial level of knowledges

15

Tables, count of logical structure of theme

Laboratory of department, seminar-practical

2.

Independent work: 2.1. decision of situation tasks

35

Algorithm, suppl.es







2.2. laboratory work on determination of intensity by the UV-radiation photochemistry method

35

Instructions, quartz test tubes with the exposed to the rays solution of oxalic acid, reagents, burettes







2.3.Discussion and correction of conclusions.

25







3.

Final test control and work out the totals of employment

25

Test tasks





Suppl. 1

Graph of logical structure of the theme:

«^ DETERMINATION OF ULTRAVIOLET RADIATION INTENSITY AND PROPHYLACTIC DOSE AND ITS USE FOR DISEASES PROPHYLAXIS AND SANITIZATION OF AIR »




Suppl. 2

ALGORITHM

OF ULTRAVIOLET RADIATION INTENSITY AND PROPHYLACTIC

^ DOSES DETERMINATIONS OF AND ITS

USE FOR PROPHYLAXIS OF DISEASES AND AIR SANITIZATION»


Determination of indices characterizing ultraviolet radiation biological effect


By a photochemistry method

(laboratory work)


By a biological method

(by situation task)


Sanitization efficiency assessment


Determination of UVR intensity

Sanitization efficiency calculation

(by situation task)

By lamps specific power

Calculation of the SED and sanitization efficiency coefficient(SEC)


Determination of prophylactic air and sun baths taking plan

Composition of conclusion by results of carried out laboratory researchesи по ситуационным задачам





Suppl. 3.

Determination of intensity of the UF-radiation by photochemistry method.

Principle of photochemistry method is based on ability of ultraviolet rays to decompose oxalic acid in presence nitrate of uranyl to carbon dioxide and water. The amount of decomposing oxalic acid is proportional to the UV-radiation intensity and duration of irradiation, I.e. to the got dose.

The UV-radiation intensity is expressed in the mg of decomposing oxalic acid for time unit(hour) to unit of area of the exposed surface to the rays (sm2).

^ Research method: UF-radiation measuring by photochemistry method is conducted in a few stages.

The first stage consists in determination of amount of oxalic acid in the solution taken for the irradiation. For this purpose in a heat-resistant retort measure a 25 ml 0,1 n solution of oxalic acid with nitric acid uranyl and add 2,5 ml 25 % solution of sulphuric acid.Retort heat on the closed electro-tile approximately to 90 - 95° C (does not boil). At once, in a hot kind, solution titrate by a 0,1 n solution of manganeseacid potassium (permanganate of the potassium -КMnО4) to the proof poorly-rose painting. The amount of ml permanganate of potassium, going on titration, is written down (control test).

^ Second stage - In the quartz test tube covered by black varnish, with a window for the UF-rays penetration and with apertures for the output СО2 pour a 0,1 n solution of oxalic acid with uranyl and expose to the rays by the artificial source UV-radiation. (This stage is conducted by laboratory assistants and a test tube with the exposed solution to the rays is given out to the students).

25 ml solution by the measured cylinder carry in a heat-resistant conical retort, add to it 2,5 ml 25 % solution of sulphuric acid, heat a mixture on the closed electric flag to 90-95о With and in a hot kind titrate by a 0,1 n solution of permanganate of potassium to the poorly-rose painting not vanishing during 1 minute (experimental test).

Difference in ml permanganate of potassium, going on titrating of control and experimental tests, multiply by a correction coefficient (C) -(it corresponds to the amount of a 0,1 n oxalic acid (in ml) decomposing under the UVR action), and on the 6,3. Further calculation of intensity of ultraviolet radiation is produced taking into account duration irradiations and areas of window, which the irradiation of solution was produced through.

Thus, the UVR intensity settles evaluate on a formula:

A = c - Х ex) х C х 6,3

S x t

where Х ex is amount of ml 0,1 n solution of КМnО4, going on titrate of experimental test;

Х k- amount of ml 0,1 n solution of КМnО4, going on titrate of control test;

C- correction coefficient (titre of solution of КМnО4, a teacher reports);

S is area of window for the irradiation, sm2;

t - time of display, hour.

6,3 is translation in the mg of decomposing oxalic acid ( 1 ml 0,1 n solution of permanganate of potassium contains a 6,3 g oxalic acid).

For expression of the UVR intensity in biodosis got result divides by an erythermal equivalent (EE). For the artificial sources of ultraviolet radiation an erythermal equivalent is permanent. For erythermal uviol lamps he is equal 0,0275, I.e. if to expose to the rays at identical terms solution of oxalic acid and examinee, at decomposition of a 0,0275 mg/sm2 oxalic acid a man will get a 1 biodose.

For the sun ultraviolet radiation EE is variable and depends on the concrete terms of season of year, height of a sun above horizon, transparency of atmosphere etc. So, at the irradiation in clear sun weather in a morning clock a 1 biodose will correspond to decomposition of a 3,7 мг/см2 oxalic acid, and at midday - 4,1 мг/см2.

Thus, at the reception of sun-baths to one biodose corresponds an approximately 4 mg/sm2. hour decomposing oxalic acid. To the physiological dose - 1 mg, and prophylactic is a 0,5 mg.

Suppl. 4.

^ Assessment of intensity by the UVR biological method

A method is based on assessment of biodose - minimum erythermal dose of irradiation (MED), which corresponds to minimum time of irradiation, after which redness (erythema) of the unsunburnt skin in 8 - 20 hours appear. This threshold erythermal dose is inconstant. It depends on a sex, age, state of health and other individual features of organism.

A biodose must be set experimentally at each or selective at the most debilitated persons of the exposed contingent to the rays. Assessment of biodose is conducted by that source of artificial UVR, which will be applied for the prophylactic irradiation.

Assessment of biodose is perfomed through the special device - the Dal'fel'da-Gorbacheva biodosimeter which is dish with six apertures measuring 1,5 х 1,0 sm, which are closed by a mobile plate. A biodosimeter is fastened on the unsunburnt part of body, more frequent than all on the inside of forearm, or on an epigastric part or back. On a skin by a ball-point pen the location and number of windows is marked. A patient is disposed in the distance by 0,5 m from the UVI source(after the preliminary warming up of lamp during 10-15 minutes), occluding consistently apertures of biodosimeter in every minute, since a 6th window. Thus, under a window № a 1 surface of body is exposed to the rays during 6 minutes; under № 2 - 5 minutes; № 3 - 4 minutes; № 4 - 3 minutes; № 5 - 2 minutes; № 6 - 1 minute. The control of appearance of erythema is conducted in 8 - 20 hours after the irradiation.

^ A biodose is expressed in minutes on the number of window, which erythema will be barely noticeable under.

It is experimentally set that for the prophylaxis of ultraviolet insufficiency (hypo- and the D avitaminosis, violations of phosphoric-calcium exchange and other unfavorable consequences) it is necessary daily to get 1/8 - 1/10 of biodose (minimum day's prophylactic dose).

Optimum, or physiological, a dose from point of its adaptogenic affect is 1/2 - 1/4 of biodose.

Time of receipt of biodose depends on distance to the UVR source.

Х = A х (В/С) 2

Where Х is biodose, mines.;

A - biodose on standard distance 0,5 m, minutes.;

B- distance, which a patient is on, m;

C- standard distance, on which assessmented a biodose, m.

Suppl. 5.

Assessment of efficiency of sanitation of air environment by UV radiation


For assessment of efficiency of sanitation of air it is necessary to conduct sowing of microorganisms on the Petry cups with beef-extract or the special nutritional medium by the Krotov device before and after irradiations of apartment by bactericidal lamps. After growing of microbes in a thermostat during 24 produce hour count of colonies.

Assessment of microbal contamination of air is conducted by determination of microbal value ( common amount of microorganisms in 1 м 3 airs) and hemolytic staphylococcus.

A microbal value is expected on a formula:

^ M. v. = (A х 1000) : (Т х V), where

A is amount of colonies on the Petry cup;

Т is duration of selection of test of air, minutes;

V is speed of reaching of air through the Krotov device, L/minute.

Bactericidal effect of ultraviolet radiation is characterized by the degree of efficiency of sanitation (DES) (relation of difference shown in percents between the amount of colonies before and after sanitation to the amount of colonies before sanitation) and coefficient of efficiency of sanitation (CES), showing in how many times the amount of colonies of microorganisms diminished as a result of sanitation).

^ Sanitation is considered effective, if DES is 80 % and more, and CES - no less than 5.

Indexes after sanitation (microbal value) is compared to information of possible bacterial contamination of air of the closed apartments (see Suppl. 7).

Suppl. 6.

Reference indexes for assessment of microbal contamination (degree of cleanness) of air of some apartments

Apartments

microbal value in m 3

Description of air




Common microbal value

Including hemolytic staphylococcus




Dwelling

Child's establishments

Public


To 2000

To 10

Very clean

2000 - 4000

11 - 40

Clean enough

4000 -7000

40 - 120

Moderately muddy

More than 7000

More than 120

Strongly muddy

Operating-room: a)before operations

To 500

It must not be

Clean

б) at the end of work

To 1000

No more than 3

Clean

Bandaging: and)до works

To 500

It must not be

Clean

б) at the end of work

To 2000

No more than 3

Clean

^ Manipulation room

To 1000

To 16

Very clean

To 2500

To 16

Very clean

^ Medical chamber

To 3500

To 100

Clean
1   2   3   4   5   6   7   8   9   10

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