Military Hygiene and Hygiene in Emergency Situations - K.O. Pashka 2005

Introduction

Due to the establishment of departments of disaster medicine and military medicine in medical universities and academies of Ukraine, the discipline "Military Hygiene and Hygiene in Emergencies" has been introduced as a mandatory part of the student curriculum.

To date, Ukraine has lacked systematic educational and methodological Materials for studying the theoretical framework of this discipline. This gap prompted the creation of a textbook written in the state language, which synthesizes modern data on military hygiene and hygiene in emergencies. It reflects the activities of the sanitary-epidemiological service, which was newly established within the Armed Forces of Ukraine, detailing its mission, Structure, equipment, and other operational aspects. The textbook outlines the core principles of organizing sanitary surveillance and medical control to maintain the combat readiness (working capacity) of military personnel and affected populations during combat operations or in emergency zones, as well as to preserve and strengthen the health of service members performing their duties across various branches and arms of the Armed Forces of Ukraine in both peacetime and wartime.

It covers the fundamentals of organizing and implementing Sanitary and hygienic measures during the field deployment of military units and formations (or groups of the affected population), as well as Sanitary supervision and medical oversight of Nutrition, Water supply, bath and laundry services, clearance of emergency areas and battlefields, and the working conditions of military personnel and the general public.

Mastering the material presented in the textbook requires prior study of a sufficiently broad scope of fundamentals in general hygiene.

The textbook fully complies with the standard curriculum for the discipline "Military Hygiene and Hygiene in Emergencies" for the specialty "General Medicine", while the drafting of certain chapters maximally accounted for the specific requirements of standard curricula in other medical specialties. In addition to the Introduction, it features 5 chapters, illustrations, tables, a list of References, chapter Review Questions, situational problem Examples with answer keys for independent student work, and a subject index.

The authors faced certain challenges when selecting material from a vast array of diverse sources and independent academic disciplines, and condensing it to fit the curriculum's allocated hours. Therefore, they will gratefully accept any comments and suggestions for improving the textbook. The authors express their sincere gratitude to O.D. Pashko, H.V. Chernetska, and Ya.I. Horbova for their technical assistance in preparing the textbook.

Because the authors aimed to provide the most comprehensive Definitions of the concepts "military hygiene" and "hygiene in emergencies," they placed this material in the "Introduction" chapter.

Military hygiene is a specialized branch of hygiene and military medicine that studies The impact of various environmental factors, combat training conditions, military labor, and daily routines on the health and, consequently, the combat readiness (working capacity) of service members. It also develops measures to mitigate or eliminate the negative effects of these factors on the combat readiness of troops and forces. Its goal is to preserve and strengthen the health of military personnel by establishing scientifically grounded sanitary and hygienic standards and requirements for the Organization and conditions of military labor, billeting, nutrition, water supply, uniforms, laundry services, and Other forms of logistical support, enabling personnel to achieve high combat readiness in peacetime and maintain it during wartime. Military hygiene specialists develop and submit for approval lists of hygienic requirements and standards for all types of weaponry, military equipment, and the operational environments within them, both at the design and engineering stages and during actual operation. They also implement forms and Methods for organizing and conducting sanitary supervision over the hygienic support of military units and formations across various operational training and combat conditions. In carrying out these tasks, hygiene physicians utilize laboratory and instrumental Research Methods along with the following specific hygienic research methods:

- epidemiological method—used to study the patterns of spread of non-communicable and infectious diseases among military personnel under METABOLISM/18.html">The Influence of various harmful environmental factors, including physical, biological, and chemical hazards;

- method of sanitary inspection and description—where environmental conditions are assessed using specialized schemes (algorithms) or sanitary inspection maps (such as mapping the Sanitary and epidemiological reconnaissance of a water supply source or deployment site) containing specific questions,

the Answers to which provide a comprehensive Overview of the facility under inspection. Sanitary inspection and description are complemented by laboratory and instrumental studies employing physical, chemical, physicochemical, microbiological, and other methods that enable both Qualitative and quantitative assessment of environmental factors;

- method of hygienic experiment—divided into two categories: field (natural) experiments and laboratory experiments. An example of a field hygienic experiment is the assessment of service members' health status while operating inside a military-technical facility, whereas a laboratory experiment involves animal testing to establish hygienic standards such as maximum allowable levels and maximum allowable concentrations;

- method of sanitary and epidemiological expertise—typically applied during preventive sanitary supervision to determine the compliance of design developments with current hygienic standards and requirements;

- statistical method—used for Processing the obtained data.

When necessary, military hygiene may draw upon scientific data and research methods from other branches of hygiene and related disciplines.

The findings of military hygienists are essential for developing both preventive and therapeutic measures; hence, military hygiene is closely intertwined with military-field therapy, military-field surgery, military Epidemiology, space and aviation medicine, and other medical sciences.

The health of military personnel is continuously influenced by material environmental factors—physical, chemical, and biological—as well as psychogenic and social factors. Consequently, existing hygienic standards and recommendations are applied during the military service of personnel across all branches and arms of the forces to create favorable conditions for combat training, Physical Exercise and conditioning, national-patriotic education, billeting, rest, nutrition, water supply, and other daily needs. It follows from the above that military hygiene is closely connected to every aspect of life within the Armed Forces.

These hygienic standards, requirements, and recommendations are put into practice by commanders and leaders at all levels, as well as the medical and sanitary-epidemiological services of the Ministry of Defense of Ukraine.

The second half of the 20th century, particularly its final decade, and the early 21st century have been marked by major transport accidents and catastrophes, industrial fires, earthquakes, floods, typhoons, and other natural disasters that frequently result in emergencies (Es)¹.

The mitigation of emergency consequences in Ukraine is entrusted to a dedicated non-military service under the Ministry of Emergencies and Affairs of Population Protection from the Consequences of the Chornobyl Catastrophe.

However, As a result of natural disasters or technological catastrophes, complex sanitary, hygienic, and epidemic situations will arise in emergency zones, posing a threat to the health and often the lives of the affected population. This can also adversely affect the health of personnel from units deployed to handle emergency response operations and assist in restoring normal living conditions for those affected.

The healthcare infrastructure in emergency zones may be partially or completely disabled. Even if it remains intact, resources and personnel will often be insufficient to handle the extraordinarily large volume of work required within extremely tight deadlines during a given emergency.

Therefore, to address the tasks assigned to public health authorities in mitigating the medical and sanitary consequences of emergencies, virtually all developed nations have established a public medical protection system featuring appropriate organizational structures—namely, state central and territorial emergency medical services for populations in emergencies, later designated as disaster medicine services.

Such a service was first established in Ukraine by Resolution of the Council of Ministers No. 339 dated April 7, 1990, and Order of the Ministry of Health of the former USSR No. 193. These documents approved the mission, tasks and Functions, operational principles, organizational STRUCTURE OF THE emergency medical service in emergencies (disaster medicine), management systems for routine and emergency conditions, Procedures for deploying and utilizing medical forces and assets regardless of subordination, and the principles of logistical and financial support.

Driven by the need to guarantee the safety of the population and territory of Ukraine, the "Concept for Creating a Unified State System for Prevention and Response to Accidents, Catastrophes, and Other Emergencies" was developed in 1994 and approved by Resolution of the Cabinet of Ministers of Ukraine No. 501 on July 7, 1995.

¹ Emergency — a disruption of normal living and working conditions for people in a specific area, facility, or water body caused by an accident, disaster, natural calamity, or other hazardous event that has led (or may lead) to human casualties and/or significant material losses.

Later, other relevant documents were prepared and adopted, such as the Resolution of the Cabinet of Ministers of Ukraine No. 343 dated April 14, 1997, "On the ESTABLISHMENT OF THE State Disaster Medicine Service," which approved the Regulations on the State Disaster Medicine Service and the Regulations on the Coordination Commissions of the State Disaster Medicine Service (SDMS).

Consequently, there arose a need to initiate and develop a new distinct branch of hygiene—emergency hygiene—which studies the impact of various environmental factors resulting from natural disasters or technological catastrophes, as well as the working and living conditions of emergency responders and the affected population during rescue operations and while staying in emergency zones, on their health and performance. The goal of emergency hygiene is to develop sanitary and hygienic standards and requirements that help eliminate or reduce the NEGATIVE IMPACT OF harmful and hazardous factors on the health of emergency responders and affected residents, and to preserve and strengthen their health. This is achieved by studying environmental factors that arise in emergency areas, and by developing and implementing scientifically grounded measures to ensure appropriate sanitary and hygienic conditions in primary life-support locations. Primary life-support measures include temporary accommodation for the affected population and arriving emergency responders, providing them with food and safe drinking water, public utilities, medical, social, and legal support.

In the event of a threat to the lives of the affected population, their evacuation to safe locations may be carried out for a certain period or for permanent resettlement without returning to their previous place of residence, such as relocation from the exclusion zone following the Chornobyl NPP accident.

In this case, primary life-support measures are supplemented by the reception of affected residents in areas of temporary (permanent) accommodation.

To carry out sanitary-hygienic and anti-epidemic measures in emergency areas within the framework of the State Disaster Medicine Service, forces and resources of the state sanitary and epidemiological service subordinated to the Ministry of Health of Ukraine are engaged, along with the sanitary-epidemiological and medical services of the Ministry of Defense, the Ministry of Emergencies, the Ministry of Internal Affairs, and other ministries and agencies. Formations that are part of the SDMS are established on their basis. To ensure the effectiveness of sanitary and hygienic measures, it is necessary to forecast in advance the sanitary and epidemiological situation that may arise as a result of a natural disaster or technological catastrophe, identify potential risk factors that will negatively affect human health and the environment, and resolve A number of other urgent issues.

Self-Control Questions

1. Define and state the purpose of a distinct branch of hygiene—military hygiene.

2. Name the Main methods of hygienic research in military hygiene.

3. Define and state the purpose of the branch of hygiene known as emergency hygiene.

4. Name the primary life-support measures for the affected population and emergency responders.

5. The forces and resources of which ministries and agencies carry out sanitary-hygienic and anti-epidemic measures in emergency areas?