Introduction to Hygiene

Introduction to the Specialty. Hygiene as a Basic Preventive Discipline

Hygiene Definition

Hygiene is a basic preventive medical discipline focused on preserving and improving population health. It studies the patterns of environmental influence on the human body and public health to substantiate hygienic standards, sanitary rules, and measures for strengthening public health, disease prevention, and human longevity.

Subject and Goal of Hygiene

  • Subject: The study of the interaction between natural and social environmental factors and the human body, focusing on cause-and-effect relationships in the "external environment - human health" system.
  • Objects of Research: Healthy individuals, social groups, populations, and the external environment.
  • Goal: To protect and strengthen public and personal health by improving the natural and social environment, including specific conditions of work, life, and human behavior.

Definition of Health (WHO)

Health is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.

Factors Influencing Health

  • Hereditary.
  • Endemic.
  • Natural and climatic.
  • Epidemiological.
  • Professional.
  • Environmental (chemical, radiation, biological pollution).
  • Social (material well-being, nutrition, lifestyle, medical care).
  • Psycho-emotional.

Main Tasks of Hygiene

  • Study the influence of the external environment on health and performance.
  • Provide scientific basis for hygienic standards, rules, and measures to improve the external environment and eliminate harmful factors.
  • Increase the body's resistance to harmful environmental effects.
  • Promote hygienic knowledge and a healthy lifestyle.

Hygienic Standardization

Hygienic regulation is the establishment by law of harmless levels of exposure to harmful environmental factors, such as maximum permissible concentrations (MPC) of chemicals and maximum permissible levels (MPL) of physical factors. Hygienic standards include MPCs, MPLs, and approximately safe exposure levels (ASEL) for air, water, and food.

MPCMPC is the maximum concentration of chemical elements and their compounds in the environment that, upon daily exposure over a long period, does not cause pathological changes or diseases.

Principles of Hygienic Standardization

  1. Guarantee principle: Hygienic standards must guarantee the preservation of human health.
  2. Comprehensiveness principle: Considers all possible adverse effects of the factor under study.
  3. Differentiation principle: Establishes different quantitative values or levels for the same factor based on the social situation.
  4. Principle of socio-biological balance: Regulates harmful factors considering health benefits and economic costs, prioritizing health indicators.
  5. Dynamic principle: Continuously monitors and updates established hygienic standards.

Relationship with Other Disciplines

Hygiene is closely related to biology, physiology, microbiology, ecology, and clinical disciplines. It utilizes methods and data from these sciences to study the impact of environmental factors and develop preventive measures. Hygiene also relates to general ecology and human ecology but focuses on the individual, unlike general ecology.

Environmental Standards

  • MPE (maximum permissible emissions): The maximum amount of pollutants that can be released without causing harm.
  • MPD (maximum permissible discharges): The maximum volume of harmful substances discharged into water bodies without exceeding water quality standards. These are calculated based on hygienic standards (MPC).

Branches and Sections of Hygiene

Branches include communal hygiene, occupational hygiene, hygiene of children and adolescents, food hygiene, and radiation hygiene. General hygiene is a propaedeutic discipline that reveals the main provisions of environmental factors and their effects on population health.

Hygienic Methodology

Involves methods for assessing environmental factors, including sanitary examination, physical, chemical, and biological methods, sanitary expertise, epidemiological, sanitary-statistical, clinical methods, and hygienic experiments.

Brief History of Hygiene

Hygiene existed long before it became a science. Hygienic skills were formed based on practical experience, recognizing favorable and adverse conditions.

Ancient World

In ancient Egypt, India, Greece, and China, hygienic knowledge consisted of practical household rules, religious concepts, and laws. Ancient China had a custom of paying doctors to keep patients healthy, reflecting the motto: “It is better to prevent disease than to treat it."

Mythology

The word “hygiene” was first used in Mythology and relates to figures like Apollo, Nymph Koronida, Asclepius (Eskulap) and his children: Telesfor, Machaon, Podalirius, Hygeia, Panacea, Iazo and Ogle.

Hygeia was responsible for health, giving the name to the science of health preservation - Hygiene. She was engaged in disease prevention and patronized cleanliness and healthy lifestyles.

Hippocrates

Hippocrates (the Father of Medicine) noted that environmental conditions affect human development and disease occurrence. His oath reflects these ideas.

Greeks and Romans

Greek philosophers Plato and Aristotle developed Hippocrates' ideas. Romans implemented sanitary measures like aqueducts and baths, though these were not universally accessible.

Middle Ages

The Middle Ages saw a decline in personal and public hygiene, leading to epidemics. However, doctors like Ibn Sina (Avicenna) made valuable contributions, such as the "Canon of Medicine".

Renaissance

The Renaissance brought a revival of interest in hygiene, particularly occupational health, as seen in Ramazzini's work on artisan diseases (1700).

Capitalism

Hygiene knowledge during the era of capitalism is associated with the growth of cities and factories. The need for scientific research led to the establishment of hygiene departments in universities during the 1860s-1870s.

Founders of Experimental Hygiene

  • Max Pettenkofer (Germany).
  • E. Parks (England).
  • Mishel Levi (France).
  • A.P. Dobroslavin and F.F. Erisman (Russia).

Development in Russia

Russian hygiene had an original path due to its social and economic development. Key figures include A.P. Dobroslavin and F.F. Erisman.

Key Figures in Russian Hygiene

  • Alexey Petrovich Dobroslavin: The first professor of hygiene and founder of a large school of Russian hygienists.
  • Fyodor Fyodorovich Erisman: Creator of public hygiene principles and the social-hygienic direction of medicine.
  • G.V. Khlopin: Contributed to sanitary and chemical research and water supply hygiene.
  • Nikolai Alexandrovich Semashko: Organizer of healthcare and head of the first department of social hygiene in the Soviet Union.

Modern Developments

In the 1920s, Soviet Russia saw intensive development in sanitary science. In 1991, the Federal Law "On Sanitary and Epidemiological Welfare of the Population" significantly changed state surveillance.

State Sanitary and Epidemiological Service of the Russian Federation

A unified federal system implementing state sanitary and epidemiological supervision. It aims to ensure sanitary and epidemiological well-being, prevent diseases, and provide hygienic education.

Prevention

A set of measures aimed at maintaining and strengthening health.

Types of Prevention

  • Primary (radical): Prevents the occurrence of risk factors.
  • Secondary (palliative): Eliminates pronounced risk factors.
  • Tertiary (rehabilitation): Rehabilitates patients to restore function.

In short:

  • goal of primary prevention is to prevent the occurrence of diseases;
  • the goal of secondary prevention is to prevent the progression of diseases;
  • the goal of tertiary prevention is to prevent complications of the disease.