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[Considerations on graduate education of sanitary engineering in Latin America].

The author reviews the profound process of change in Latin America which presents serious problems for environmental engineering and, consequently, for education in the various disciplines that comprise this specialization. The explosive growth of knowledge and the increase responsibilities of professionals place extreme pressure on engineering schools. These schools are forced to consider curricular changes as well as changes in admission policies and in the image and the service which they should present to society. At the present time, 25 engineering schools offer an "option" of sanitary engineering and 12 schools offer graduate courses for an M.A. in environmental engineering. In the schools themselves, a combination of fulltime and part-time professors prevails. Graduate teaching programs are expected to provide: a) increasingly complex, new scientific and technologic knowledge, b) duly selected disciplines; and c) balanced management techniques. Certain plans of action may be considered. Among these are increasing the number of schools that offer graduate courses, revising curricula, encouraging higher enrollment, including research as a standard element in teaching and, in general, seeking higher standards of excellent. Prospects for the future seem to indicate that the following actions should be taken: 1) increasing interdisciplinary programs; 2) making use of the potential offered by continuing education; and 3) encouraging the development of doctoral studies.

Curriculum

[Development of human resources for working in environmental health].

This paper was presented as a reference document in the First Meeting of the PAHO/WHO Textbook Program Committee for the Teaching of Sanitary Engineering and Environmental Sciences, held in Santo Domingo, Dominican Republic, from 24 to 26 November 1977. It analyzes the human resource development process in terms of the basic components: planning, development itself, and utilization. Its principal objectives are: to encourage the performance of studies and research on human resources in environmental health as sources of information for taking decisions, making policy, and drawing up training plans; to suggest ways of improving the quality of education and training services; to encourage the development of suitable techniques and methods for determining human resource needs; and to highlight some recent studies and publications on human resources in relation to environmental problems.

Allied Health Personnel

Occupational health and the environment in an urban slum in India.

The Indo-Dutch Environmental & Sanitary Engineering Project under the Ganga action Plan in Kanpur and Mirzapur is being executed within the Indo-Dutch bilateral development cooperation framework. The project aims to integrate physical, social and health related improvements. It is expected that the development approach and methodology can be replicated in other urban settlements in India. The project is being supplemented by a training and institutional strengthening programme to facilitate the transfer of new technologies and improvement of operation and maintenance of the new facilities. The project is also aimed at the improvement of the living conditions of the population, by installing drinking water and drainage systems. A socio-economic unit in the project supports the technical interventions by enhancing the community to participate in project activities. The Occupational Health Programme in Jajmau, an industrial slum of Kanpur, aims to improve the working conditions of tannery workers. Four hundred and ninety-seven tannery workers and 80 employees not engaged in leather work, from 20 tanneries, were interviewed and underwent physical examination. The mean age of tannery workers was 32 years, about half of them recently migrated to Kanpur. The majority of the workers are illiterate, have temporary jobs and 85% have a monthly income between 300 and 600 Rs. Occupational morbidity was 28.2%. Regular meetings with tannery owners, the training of tannery workers in first aid, and support for the installation of safety and health councils in tanneries are the main programme activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

An occupational health programme for adults and children in the carpet weaving industry, Mirzapur, India: a case study in the informal sector.

The Indo-Dutch Environmental and Sanitary Engineering Project under Ganga action Plan in Kanpur and Mirzapur is being executed within the framework of Indo-Dutch bilateral development cooperation. The project aims to integrate technological, social and health related improvements. It is expected that the development approach and methodology can be replicated in other urban settlements in India. The project is being supplemented by a training and institutional strengthening programme, which will facilitate the transfer of new technologies and improvements in operation and maintenance of these new technologies. One of the project's goals is to improve living conditions in the targeted areas by installing drinking water and drainage systems. A socio-economic unit (SEU) in the project supports these technical interventions by encouraging the community to participate in project activities. The Occupational Health Programme in Mirzapur was conceived by the SEU to improve the health and living conditions of child and adult weavers. At the start of the programme, 200 weavers and 60 non-weaver workers from Mirzapur city, matched for age and socio-economic status, were interviewed and underwent a physical examination. The mean age of the weavers is 27 years, reflecting the relatively large percentage of child labour (13.5%). Illiteracy among them is 73%, whereas 14% have had only a primary education. 64.5% of the carpet weavers are Muslims and 35.6% are Hindus. 61% own a loom or work in a family owned loom shed. 95% of the weavers have a monthly income of less than 600 Rs. Complaints of a persistent cough and cough with expectoration, backache, the common cold and joint pains occurred more often in the weaver population than in the comparison group and have been identified as 'occupational hazards'. An intervention programme has been implemented based on the results of the occupational health survey. These interventions include awareness camps, installment of plexiglass tiles for light improvement in the loom sheds, training of community health volunteers and house-to-house health education. Another essential part of the programme is the provision of functional literacy classes for child and adult labourers in the carpet weaving industry. Occupational health as an entry point proved to be a successful approach in this segment of the informal sector, where child labour plays an important role.

Adolescent

Florence Nightingale and the India sanitary reforms.

After the Crimean War, Florence Nightingale persisted in researching the health conditions of British troops throughout the Empire. Undaunted by geographic limitations, she surveyed and publicized data that documented the mismanagement of living conditions and health care among the occupational forces on the Indian continent. Nightingale proposed widespread changes in the reporting of military health status and biostatistics, in sanitary engineering, and in self-care activities. With dogged persistence, she continued to gather follow-up data to measure the changing health status of soldiers in a land she never saw.

History, 19th Century

[Monitoring of indoor air of residential and public buildings].

The quality of the air medium of residential and public buildings has been studied; contaminants discharged from polymeric materials and contained in domestic dust have been identified. Due to a great medico-hygienic significance of this problem it is necessary, that joint studies be carried out by experts in the field of hygiene, builders, sanitary engineers, physicists and chemists with the aim of the assessment of buildings from the point of view of sources of pollution in them depending on the construction and contingent of the population. Indoor air monitoring will make it possible to develop the scientific basis of indoor air quality control.

Adult

[Quality of water in the marine environment. The history and application of microbiology standards].

The history and application of microbiological standards to measure the quality of seawater for primary-contact recreational use and for the harvesting of shellfish are reviewed. Recent research concludes that enterococci, as indicator organisms, provide the most accurate correlation with gastrointestinal disorders attributed to swimming in contaminated waters. Accordingly, a linear relation has been established between mean enterococcus density per 100 ml and swimming associated gastrointestinal disorders per 1,000 population, and in 1984 the U.S. Environmental Protection Agency (EPA) adopted these bacteria as the primary indicator organisms for recreational waters in lieu of the indicators applied up til then, mainly total and fecal coliforms. International, national, and local microbiological standards and guidelines are presented to provide the sanitary engineer with a water quality range for the marine environment. Before adaptation of particular set of standards, local and national circumstances as well as socioeconomic factors should be carefully reviewed. Moreover, the application of quantitative relationships between health risks and the level of indicator organisms should take into account the general health and immunity conditions of the local population.

Fisheries

[New measurements of noise from road traffic in Rome carried out during 24 hours (author's transl)].

A new series of noise measurements in 10 points of the central zone in Rome, corresponding to residential areas with commercial activity, to parks, to hospitals, and to a subway, have been carried out. Investigation has been protracted during 24 hours and each measure has lasted 20 minutes. For the survey a mobile acoustic unity of the Environmental Hygiene Laboratory, Department of Sanitary Engineering, of Istituto Superiore di Sanità has been employed. The unity is fitted with instruments for statistical analysis of noise in connection with a minicomputer. The used program has allowed to calculate L1, L10, L50, L90, standard deviation, Leq, LNP, TNI. On the basis of such measurements Leq 24, Ldn, CNEL, have been calculated. Collected data have been compared with limits of stated rules and with noise levels measured in other seven Italian towns.

Automobiles

Monitoring the bacteriological quality of potable waters in hospital.

We report a survey of the bacteriological quality of potable waters from hospitals. In the 12-month period February 1986 to January 1987, 646 samples were examined from 25 hospitals. Coliforms were isolated from eight (1.2%) samples, received from three hospitals. These hospitals did not, therefore, satisfy the European Community (EC) directive on potable water quality. Three hundred and four (47%) samples had total viable counts higher than the guidelines given in the EC directive on potable waters. Thirteen (52%) of hospitals surveyed submitted at least one unsatisfactory sample and six (24%) submitted more than 50% unsatisfactory samples. Water quality was generally poorer in the summer and autumn. Estimation of the total viable count is an inexpensive and simple method for monitoring the microbial quality of hospital waters.

Enterobacteriaceae

Legionella spp. in a hospital hot water system: effect of control measures.

Potential sources of Legionella spp. in a university hospital were investigated over 3 years in order to gain better understanding of the ecology and transmission of this organism to hospitalized patients. The survey highlighted the contamination of the hot water system with high concentrations of legionellas (up to 10(6) cfu 1(-1]. Legionella pneumophila serogroup 6 was predominant followed by L. pneumophila serogroup 10. Serogroup 1 and other species (L. longbeachae, L. micdadei) were rarely isolated. Serogroup 6 was also the predominant cause of nosocomial legionellosis in 15 sporadic cases in immunocompromised patients from 1981 to 1987. In light of this problem, several control measures were tried consecutively. A disinfection cycle with 6 ppm free chlorine failed to eradicate legionellas because of difficulties with the plumbing system. Raising the temperature in hot water tanks to 80 degrees C was effective locally, but mixer tanks where cold and hot water (60-65 degrees C) are mingled in order to achieve 45 degrees C became the principal reservoirs. Disconnecting the mixer tanks, maintaining a temperature of 60 degrees C in the heating tanks and accelerating the flow rate in the hot water system proved to be the most useful measures.

Belgium