预防医学教学课件：绪论

1、Preventive MedicineWhole populationCharacteristic(1) Subject:(2) Model:(3) Method:(4) Strategy:IndividualPopulation Bio-psycho-socialEpidemiology StatisticsPrevention Control Example: case-control study 实例：吸烟与肺癌关系的病例对照研究附表 吸烟与肺癌的关系暴露史病例对照合计吸烟1100(a)850(b)1950(N1)不吸烟460(c)1600(d)2060(N0)合计1560(M1)245

2、0(M0)4010(T)1.两组暴露率的统计学显著性检验：2(ad-bc)2TM1M0N1N0(11001600-850460)240101560245019502060 489.51 p1，吸烟与肺癌呈正相关，吸烟者发生肺癌的危险性是不吸烟者的4.5倍。Characteristic(1) Subject:(2) Model:(3) Method:(4) Strategy:IndividualPopulation Bio-psycho-socialEpidemiology StatisticsPrevention Control Phylogeny of preventive medicine

3、Ancient public healthIndustrial revolution age1st health revolution 2nd health revolutionSpiritualism medical modelNature philosophical medical model Mechanistic medical modelBiomedical model Bio-psycho-social medicalThree levels of prevention Primary prevention: etiological factor prevention(2) Sec

4、ondary prevention: pre-clinical prevention (3) Tertiary prevention: clinical prevention Emergency public health eventsSevere acute respiratory syndromes, SARSOccupational HealthPreventive HealthEnvironmental HealthNutritional and food HealthNatural environmentSocial environmentEnvironmental HealthAi

5、rCoal smog, 1952，LondonPhotochemical smog,1955，Los AngelesFrog and haze,2014，Beijing Frog and haze,2014，Shanghai Environmental Health1. Biological pollution 2. Chemical pollution WaterWater borne infectionCholeraTyphoid DysenteriaViral hepatitis type ASchistosomiasismethyl mercury: Minamata disease

6、(水俣病) (mercurywatermethyl mercuryfishhuman)Minamata disease (水俣病) 対照例 右大脳水平断脳重量1380水俣病 右大脳水平断 脳重量775 全体的強萎縮示、視力中枢（印）、 聴力中枢（印）、水俣病患者共通傷害部位。 水俣病（ ，Minamata disease ）Environmental Health1. Biogeochemical disease2. Soil pollution Soil(1) Iodine deficiency disorders, IDD(2) Endemic fluorosis(3) Endemic a

7、rsenicosisCadmium: itai-itai disease (痛痛病)Skeletal fluorosisDental fluorosisEndemic fluorosisEndemic arsenicosishyperkeratosisPigment disorderSkin cancerEnvironmental Health1. Biogeochemical disease2. Soil pollution Soil(1) Iodine deficiency disorders, IDD(2) Endemic fluorosis(3) Endemic arsenicosis

8、Cadmium: itai-itai disease (痛痛病)写真病患者小松原告。1971.6.30,富山地裁勝訴喜、骨異常、身長縮。痛痛病病影響背骨曲患者毎日痛 痛痛病Occupational HealthPreventive HealthEnvironmental HealthNutritional and food HealthNatural environmentSocial environmentOccupational hazardsOccupational diseaseOccupational HealthOccupational hazardsOccupational di

9、seaseOccupational Health中国职业病危害人数过2亿我国职业危害以生产性粉尘为主，其次为生产性毒物。尘肺患者占全部职业病的71%，中毒占20%。每年因职业病、工伤事故产生的直接经济损失达1000亿元，间接经济损失2000亿元。职业卫生机构和队伍数量少、质量不高、素质偏低、后备力量不足。Occupational HealthPreventive HealthEnvironmental HealthNutritional and food HealthNatural environmentSocial environmentNutritional and food Health(1) Nutrition and health(2) Food safety(3) Food borne disease“大头婴儿”事件“苏丹红”