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MINISTERUL SNTII AL REPUBLICII MOLDOVAUNIVERSITATEA DE STAT DE MEDICIN I FARMACIE NICOLAE TESTEMIANU

CENTRUL DE SNTATE PUBLIC mun. CHIINUGrigore Friptuleac

Iurie PnzaruIgiena muncii lucrtorilor gospodriilor rnetiChiinu 2010CZU

Aprobat spre editare de Consiliul de experi al Ministerului Sntii al Republicii Moldova, proces verbal nr. 4 din 30 iunie 2010Refereni: Gheorghe Ostrofe dr. hab. n medicin, profesor universitar,

USMF Nicolae Testemianu

Elena-Ana Puncu dr. n medicin, profesor universitar, UMF Timioara (Romnia)

Autori: Grigore Friptuleac - dr. hab. n medicin, profesor universitar Iurie Pinzaru dr. n medicin DREPTURILE ASUPRA PREZENTEI MONOGRAFII APARIN N EXCLUSIVITATE AUTORILOR. rEPRODUCEREA MATERIALELOR SE PERMITE DOAR CU INDICAREA OBLIGATORIE A SURSEICuvnt nainte Monografia reflect problemele igienei muncii lucrtorilor gospodriilor rneti. Obiectivele cercetrii constau n estimarea particularitilor demografice a lucrtorilor gospodriilor rneti, accesului la asistena medical; studierii i evalurii strii de sntate a lucrtorilor gospodriilor rneti; studierii i evalurii igienice a particularitilor mediului ocupaional; evalurii interrelaiilor dintre indicii strii de sntate i factorii de risc; elaborrii msurilor profilactice.

Lucrarea aparine unei direcii noi de cercetri n igiena muncii, a relaiilor dintre factorii de risc i indicii strii de sntate. Se demonstreaz existena unor particulariti specifice pentru Republica Moldova n structura socio-demografic a membrilor gospodriilor rnei, condiiile de munc, a indicilor comportamentali, strii de sntate, asistenei medicale. Investigaiile clinico-igienice, fiind originale prin complexitatea lor, evideniaz formele morbide cronice caracteristice pentru aceast categorie de populaie, cuantific corelaia dintre particularitile condiiilor de munc, demografice, de comportament i formele morbide. Se evalueaz gradul de risc pentru sntatea ranilor n funcie de factorii ce o determin.

Rezultatele studiului actual se ncadreaz att n principiile de cercetare ale medicinii muncii, ct i n limitele unui concept original al igienei, evideniindu-se premisele teoretico - tiinifice ale corelaiei dintre morbiditatea ranilor i factorii de risc din mediul de munc, fapt care a permis estimarea riscului de mbolnvire a membrilor gospodriilor rneti n funcie de aceti factori.

S-au format premise concrete, eficace de argumentare i elaborare a unui complex de msuri profilactice n scopul prevenirii impactului nefavorabil al factorilor de risc asupra indicilor de sntate a lucrtorilor gospodriilor rneti. Prezenta carte este destinat specialitilor n sntatea public medicilor igieniti, medicilor de familie, managerilor n medicin etc. Ea va fi util, de asemenea, studenilor facultilor de medicin i sntate public, rezidenilor, doctoranzilor, cercettorilor tiinifici.PREFACE

The monograph is dedicated to occupational hygiene of peasant households workers. The subjects of investigations are the evaluation of demographic peculiarities of peasant households workers, their access to medical care, studies and evaluation of the state of health of peasant households workers, studies and hygienic evaluation of peculiarities of occupational environment, evaluation of interrelations between indices of the state of health and risk factors, elaboration of preventive measures.

The work belongs to a new direction of investigations in occupational hygiene, interrelation between risk factors and state of health. It is demonstrated the existence of some specific peculiarities for the Republic of Moldova in the socio demographic structure of the members of peasant households, occupational conditions, behavioral indices, state of health, medical care. Clinical hygienic investigations, being original by their complexity, reveal chronic morbid forms characteristic for this category of population, quantify correlation between peculiarities of occupational conditions, demographic, behavioral peculiarities and morbid forms. It is evaluated the degree of risk for peasants health in dependence of determined factors.

Current study results fall within the investigations principles of occupational medicine and they are in the limits of one original concept of hygiene being revealed theoretical scientific premises of the correlation between peasants morbidity and risk factors from occupational environment, the fact which allowed estimation of disease risk to members of peasant households according to these factors.

It has formed concrete and efficient premises for argumentation and elaboration of complex of prophylactic measures to prevent unfavorable impact of risk factors upon indices of health of peasant households employees.

This book is intended for public health professionals: hygienists, family doctors, medical managers, etc.. It will be useful also for students of medicine and public health faculties, residents, doctoral students, scientific workers.cuprinsINTRODUCERE .......................................................................................................Capitolul 1. Particularitile socio-demografice ale populaiei rurale ....................1.1. Evaluarea particularitilor socio-demografice ale populaiei rurale .......1.2. Caracteristica socio-demografic a lucrtorilor gospodriilor rneti inclui n studiu ...................................................................................................Capitolul 2. Caracteristica i evaluarea igienic a mediului ocupaional din gospodriile rneti ..................................................................................................2.1. Evaluarea igienic a fluxului tehnologic .....................................................2.2. Particularitile cronometrice ale muncii i comportamentului lucrtorilor gospodriilor rneti .........................................................................................2.3. Particularitile factorilor fizici i chimici ai muncii n cmp .....................Capitolul 3. Caracteristica strii de sntate a lucrtorilor gospodriilor rneti ......................................................................................................................3.1. Modificrile fiziologice ale organismului n procesul de munc ...............3.2. Caracteristica morbiditii populaiei din localitile rurale ........................3.3. Caracteristica examenelor medicale a lucrtorilor gospodriilor rneti (de fermier) .........................................................................................................Capitolul 4. Morbiditatea profesional a ranilor .....................................................Capitolul 5. Calitatea serviciilor de asisten medical n sectorul rural ..................Capitolul 6. Evaluarea integral a strii de sntate a lucrtorilor gospodriilor rneti n relaie cu factorii determinani .................................................................Capitolul 7. Msurile de promovare a sntii i de profilaxie a maladiilor pentru lucrtorii gospodriilor rneti ................................................................................

7.1.Noiuni i principii de promovare a sntii..............................................

7.2. Particulariti ale profilaxiei maladiilor.....................................................

7.3.Msurile profilactice generale.....................................................................

7.4. Msurile profilactice speciale.....................................................................Capitolul 8. Activiti de promovare a sntii i de profilaxie a maladiilor la lucrtorii gospodriilor rneti .................................................................................8.1. Activiti ale Serviciului de Supraveghere de Stat a Sntii Publice ........8.2. Activiti ale serviciului de asisten medical curativ ..............................8.3. Activiti ale administraiei publice centrale i locale .................................8.4. Activiti ale reprezentanilor altor Ministere i Departamente ...................8.5. Activiti ale membrilor de familie ..............................................................ncheiere Bibliografie Anexe ..CONTENTS

Introduction..............................................................................................Chapter 1. Socio-demographic peculiarities of the rural population.................... 1.1. Assessment of some socio-demographic peculiarities of the rural population ....... 1.2. Socio-demographic characteristics of peasant households workers included in the study .................................... .................................................. .......... Chapter 2. Characteristics and hygienic evaluation of occupational environment health of the peasant households ........................... ..................................................

2.1. Hygienic assessment of the technological flow ..................................... 2.2. Labors chronometric and behavioral peculiarities of peasant households workers.................................................................................... 2.3. Peculiarities of physical and chemical factors in field work ................ Chapter 3. Characteristics of the state of health of peasant households workers 3.1.Body's physiological changes during the working process ............... 3.2.Characteristic of morbidity of population from rural localities......... 3.3.Characteristic of medical examinations of peasant households workers (farmers) ........................................................................................ Chapter 4. Occupational morbidity of