This document discusses community health nursing, epidemiology, communicable disease control, and environmental health. It defines key concepts in epidemiology like causality, risk, and rate of occurrence. It compares the community health nursing and epidemiological processes. It describes modes of transmission for communicable diseases and strategies for prevention. It also outlines major areas related to environmental health like living patterns, work risks, atmospheric quality, water quality, housing, food quality, waste control, and radiation risks.

1. Master Program
Nursing Specialties
Community Health Nursing
Epidemiology
Communicable Disease Control Program
environmental health
By
‫ارميح‬ ‫وليد‬
Supervises
‫د‬.‫الحسناوي‬ ‫فاطمه‬

2. Epidemiology : Is the study of the distribution of
health and illness within population .
Basic concept in epidemiology
1-Causality
2-Risk
3-Rate of occurrence

3. What the difference between Epidemiological process
and CHN process
CHN process
1-Assessment
2-Diagnosis
3-Planning
4-Implementation
5-Evaluation
Epidemiological process
1-Defining the condition
2-Determining natural history
3-Identify strategies
4-Implement control strategies
5-Evaluating control strategies

4. The relationship between community health nursing and
epidemiology
1-Primary prevention ‫ــــــــــــــــــــــــ‬Susceptible stage
Exposure stage
2-Secondary prevention ‫ــــــــــــــــــــ‬During the onset stage
3-Teratery prevention ‫ـــــــــــــــــــــــ‬Termination stage

5. Communicable Disease Control Program
Communicable diseases : are disease that spread by
direct contact from infected person to a susceptible host.
Classification of disease
1-Acute diseases:-are those condition in which the peak
severity of symptom occurs within three month, and
recovery is usually completed.
2-Chronic disease:- are those condition in which
symptom continue longer than three month, and
recovery is usually incomplete.

6. Mode of transmission
1-Direct transmission
2-In-direct transmission
Direct transmission
A-Immediate transfer of the disease agent by direct
contact between the infected and susceptible individual.
B-Occurs through such act as touching, biting, kissing,
sexual intercourse or by direct projection (by coughing or
sneezing) within a distance of one meter.
C-Example of diseases for which transmission is usually
direct are AIDS, syphilis and the commomcold.

7. In-direct transmission
May be one of the three types:
Air borne, Vehicle borne or Vector borne
1-Air borne: transmission of microbial aerosols to a
suitable port of entry, are suspension of dust or droplet
made up wholly or in part by micro-organism may be
infected for long period of time. Example of air borne
disease include tuberculosis, influenza.
2-Vehicle borne transmission: non living object by
which communicable agent are transferred to susceptible
host. Example of vehicle include toys, handkerchiefs,
soiled clothes, bedding, food service utensils and
surgical instrument.

8. 3- Vector borne transmission: disease transfer
by living organism, such as mosquito, fly
transmission may be mechanical via the
contamination mouth or feet of vector, or
biological involve multiplication or developmental
change of the agent in the vector e.g. organism
that cause dysentery, cholera, typhoid fever.

9. Prevention of communicable diseases
1-Primery prevention
-In chain of infection model, primary prevention
strategies are evident at each link of the chain.
-Successful application of each strategy can be
seen as weakening the link, with the ultimate
goal of interruption the disease transmission, e.g.
chlorination of the water supply.
-Personal/ individual action: hand washing,
proper cooking of food, adequate clothing and
housing and obtain all of the available
immunization against specific diseases.

10. 2-Secondary prevention
-Community effort includes measurement taken to
control or limit the extended of diseases e.g.
reporting of cases and compliance requiring of
reporting for notifiable diseases.
-Individual effort includes ether (1) self diagnosis
and treatment with nonprescription medications.
(2) diagnosis and treatment with antibiotic or
other physician prescribed medication.
- Secondary control of disease measure may
include isolation = separation for the period of
communicability of infected person or animals
from others to prevent the direct and in-direct
transmission of diseases.

11. 3- Tertiary prevention
- Tertiary prevention recovery from infection
recover to full or partial health and return to
normal activity in some cases, such as paralytic
polio return to normal activity.
- Tertiary prevention may also involve the
reapplication of primary and secondary measures
to prevent further cases.

12. Tools available ((program)) for the control of
communicable diseases
1-Investigation: most health department are
required to investigate unusual occurrence of
disease or injury. This include the authority to
review medical record to perform laboratory
investigation, to examine the patients, and to
review both patients and others who may have
been exposed to the disease or injury.

13. 2-Screening: is the identification individuals
with unrecognized health risk factors or
asymptomatic diseases condition in population.
There are three types of screening, they are:
A-mass screening
B-selective screening
C-multiphase screening
3-Case finding : that give terminal results of the
diagnostic.

14. 4-Surveillance: the systematic measurement of
the health status and risk factors. This
systematic are:
a-Identify cases
b-Report
c-Analysis and interpret data
d-Investigate and confirm
e-Respond
f-Provide feedback
g-Evaluation

15. Environmental Health
Environmental health addresses all the physical,
chemical, and biological factors external to a
person, and all the related factors impacting
behaviors. It encompasses the assessment and
control of those environmental factors that can
potentially affect health.

16. Effects of Environmental Hazards
A. Environmental effects on public health are complex and
often interconnected.
1.Nuclear power plant emissions can contaminate both water
and air supplies.
2. Overcrowded housing may result in problems managing
human wastes and perpetuate violent behavior.
B. Effects of environmental hazards may be general or specific,
and may be categorized as immediate or long or Transgenerational
1. Examples of immediate effects include burns, gunshot
wounds, hurricane damage, and food poisoning.
2.Examples of long-term health effects include gradual
occupational hearing loss, “black lung” disease in coal miners, and
increased rates of cancer among migrant farm workers who are
sprayed with pesticides.
3.Transgenerational effects may occur with radiation exposure
of female factory workers at nuclear power plants

17. major areas related to environmental health
apply to public health and the community
health nurse's practice:
A. living patterns
B. work risks
C. atmospheric quality
D. water quality
E. housing
F. food quality
G. waste control
H. radiation risks

18. A.Living Patrns te
1. …. …the relationships among persons,
communities, and their surrounding environments that
depend on habits, interpersonal ties, cultural values, and
customs.
2….. …are not individual lifestyle choices, (i.e.,
eating a high-fat diet or substance abuse), but they reflect
population exposure to environmental conditions that are
affected by mass culture, social practices, ethnic customs,
and technology.
3….. A significant living pattern problem is
marginalization of unwanted land use (waste
incinerators, sewage treatment plants, landfills, prisons)
in urban environments with concentrations of poor,
elderly, and minority groups.

19. B.Work Risks
1. Work risks include the quality of the
employment environment as well as the potential
for injury or illness posed by working conditions.
2. Work risks pose the following environmental
health threats
a. Sexual harassment
b. Occupational toxic poisoning
c. Electrical hazards
d. Repetitive motion injuries
e. Work sites containing carcinogenic
particulate inhalants such as heavy metals.

20. C.Atmospheric Quality
1. Atmospheric quality refers to the protectiveness of
the atmospheric layers, the risks of severe weather, and
the purity of the air.
2. Environmental dangers related to atmospheric
quality include chlorofluorocarbon destruction of the
ozone layer, forest destruction, tornadoes, electrical
storms, smog, carbon monoxide, herbicides, and acid
rain.
3. Severe weather conditions affect the public’s health
resulting in injury and loss of life, destruction of plants
and wildlife, and property damage.
4. Atmospheric pollutants can cause lung cancer,
chronic respiratory disease, and death as well as harming
animals and plants.

21. D.Water Quality
1. Water quality refers to the availability and volume of
the water supply, mineral content levels, pollution by toxic
chemicals, and presence of pathogenic micro-organisms.
2. Water quality consists of the balance between water
contaminants and existing capabilities to purify water for
human use.
3. Problems of water quality include droughts,
contamination of drinking supply by human wastes,
pesticide-contaminated aquifers, lead leaching from water
pipes, oil spills, water-borne bacteria, and excessive
chlorination.
4. Results of poor water quality may be an increase in
water-borne diseases or problems brought about by toxic
chemical pollution.

22. E.Housing
1. Housing refers to the availability, safety,
structural strength, cleanliness, and location of shelter.
2. The following environmental health problems are
related to housing
a. Homelessness
b. Fire hazards
c. Inaccessibility for disabled persons
d. Illnesses caused by overcrowding, dampness,
rodent or insect infestation
e. Injuries sustained from collapse of building
structures
g. Winter deaths from inadequate indoor heating.

23. F.Food Quality
1. Food quality refers to the availability and
relative costs of foods, their variety and safety, and
the health of animal and plant food sources.
2. Food quality problems include malnutrition,
bacterial food poisoning, carcinogenic chemical
additives, improper or fraudulent meat inspection,
viral epidemics among livestock, and food
products from diseased animal sources.
3. Foods can be contaminated by toxic
chemicals

24. G.Waste Control
1. Waste control is the management of waste
materials resulting from industrial and municipal
processes and human consumption as well as
efforts to minimize waste production.
2. Several environmental health problems are
related to waste control.
a. Use of no biodegradable plastics
b. Lack of efficient and affordable recycling
programs
c. Unlicensed waste dumps
d. Inadequate sewage systems
e. Industrial dumping of toxic wastes

25. H.Radiation Risks
1. Radiation risks are the health dangers posed by
the various forms of ionizing radiation.
2. Radiation risks include nuclear power emissions,
radioactive hazardous waste sand wartime use of
nuclear weapons.
3. People and animals living in the vicinity of
nuclear facilities such as power plants, waste
storage sites, and nuclear test sites have increased
rates of cancers, strokes, diabetes, immune system
damage, infertilityand birth defects.