september 5, 2007jemh van bronswijk 1 preventing disease (7y900) (incidence, prevalence, building...

September 5, 2007 JEMH van Bronswijk www.phe.bwk.tue.nl

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Preventing diseasePreventing disease

(7y900)(7y900)

(incidence, prevalence, building determinants, DALY)(incidence, prevalence, building determinants, DALY)


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Indicators Indicators for Public Healthfor Public Health

1. Incidence of disease or infliction1. Incidence of disease or infliction= number of cases diagnosed in a certain year= number of cases diagnosed in a certain year

2. Prevalence of disease or infliction2. Prevalence of disease or infliction= number of cases known to be present in a certain year= number of cases known to be present in a certain year

3. Prevalence of increased risk3. Prevalence of increased risk= number of persons with increased risk in a certain = number of persons with increased risk in a certain

yearyear

4. Lost Years of Life4. Lost Years of Life= extra years of life that could have been expected, = extra years of life that could have been expected, had the deadly condition not occurredhad the deadly condition not occurred

5. Disability Adjusted Life Years (DALY’s)5. Disability Adjusted Life Years (DALY’s)= healthy years in a life span = healthy years in a life span


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Incidence Prevalence Lost Years Upper Airways Infection Back Problems Coronary Heart Disease Accident in Private Domain Hearing Disorder Lung Cancer Back Problems Anxiety Disorder Stroke Sport Accident Arthrosis of Limbs Breast Cancer Pneumonia / acute bronchi(oli)tis Asthma & COPD Heart Failure Acute Urinary Tract Infection Contact Dermatitis Suicide Contact Dermatitis Diabetes Asthma & COPD Gastro-Intestinal Tract Infection Depression Intestinal Cancer Influenza Atopic Dermatitis Traffic Accident Accident at Work Osteoporosis Diabetes

Top-10 DiseasesTop-10 DiseasesThe Netherlands 1994The Netherlands 1994

Cause(s) in built environment characteristics

Built environment may compensate / support


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Atopic Disease


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Indoor Air Suitability (NL)Indoor Air Suitability (NL)

After MCL Snijders. PhD Thesis, TU/e, September 5, 2001

User Group

With Chronic Lung Disease

Children, Elderly, Non-sensitized Atopics

Healthy, non-atopic Adults

None

CO2 in ppm <= 680 680 < CO2 =< 865 865 < CO2 =< 1085 > 1085

Moisture: % of time in Humidity Class I or II

95 95 < 95 < 95

Room Ventilation Rate (RVR) in l s-1 m-

2

>= 2.4 2.4 > RVR >= 1.5 1.5 > RVR >= 1.05 < 1.05

Suitable Living Rooms in Heating Season

0 0 4 32


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AtopyAtopy

• Inherited constitution (Inherited constitution (40% of the population40% of the population))• Disease process is IgE mediatedDisease process is IgE mediated• 11stst phase: Sensitization ( phase: Sensitization (skin- and laboratory testsskin- and laboratory tests))• 22ndnd phase: Disease symptoms phase: Disease symptoms• 85% of symptoms building related85% of symptoms building related• Affected organs: eyes, nose, lungs, skin, Affected organs: eyes, nose, lungs, skin,

alimentary canalalimentary canal


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House Dust MitesHouse Dust Mites


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The 6 Global The 6 Global Risk AreasRisk Areas

for mite growth and survival for mite growth and survival in carpeting of well in carpeting of well ventilated and heated roomsventilated and heated rooms

1. No survival

2. Survival on poorly insulated ground floors

3. Survival on all floors

4. Growth on poorly insulated ground floors

5. Growth on most floors

6. Growth on all floors

1.2.3.4.5.6.


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Temperature and House Dust Temperature and House Dust Mites in CarpetingMites in Carpeting

Mean January outdoor temperature (oC) in Europe

Poorly insulated

ground floor

Well insulated ground floor or

floor of higher storeyMite condition

floor 15oC floor 16oC floor 17oC floor 18oC floor 19oC

No survival

(RH =<45%)

=< -12

dark-green

=< -10 =< -8

middle-green

=< -6 =< -3

light-green

No populationdevelopment

(RH =<60%)

=< -3

light-green

=< +1 =< +4

yellow

=< +5 =< +7

orange

Source: JEMH van Bronswijk, G Pauli (eds) 1996. An update on long-lasting mite

avoidance. GuT, Aachen. ISBN 3-00-000896-9


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The 6 Global The 6 Global Risk AreasRisk Areas

for mite growth and survival for mite growth and survival in carpeting of well in carpeting of well ventilated and heated roomsventilated and heated rooms

1. No survival

2. Survival on poorly insulated ground floors

3. Survival on all floors

4. Growth on poorly insulated ground floors

5. Growth on most floors

6. Growth on all floors

1.2.3.4.5.6.


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Prevalence of Sensitisation Prevalence of Sensitisation to mite allergen in atopic patientsto mite allergen in atopic patients

Prevalence in %

Allergen source Scandinavia UnitedKingdom

Netherlands Mediterranean

House dustmites

2 - 30 80 80 15 - 50

Storage mites 40 - 45 > 30 65 - 70 10

Source: JEMH van Bronswijk, G Pauli (eds) 1996. An update on long-lasting mite

avoidance. GuT, Aachen. ISBN 3-00-000896-9


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Infectious disease


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Important Infections Important Infections in Architecture, Building & Planningin Architecture, Building & Planning

InfectionTransmitted through

Air Water Surfaces Outdoor

Influenza AInfluenza A x x x (x)

Lyme diseaseLyme disease - - - x

SARSSARS x x x (x)

Tuberculosis x - - -

Veteran’s diseaseVeteran’s disease - x - -

Weil’s diseaseWeil’s disease - - - x

In green: diseases associated with pneumoniaIn green: diseases associated with pneumoniaIn red: zoonosesIn red: zoonoses


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Pneumonia:Pneumonia:

Influenza A: bird fluInfluenza A: bird flu

Virus particles are spherical (diameter of 80-120 nm) Virus particles are spherical (diameter of 80-120 nm) or filamentous (length 1 mu m)or filamentous (length 1 mu m)

Source: http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/I/Influenza.html


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Pneumonia:Pneumonia:

SARSSARS


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SARSSARS- Severe Acute Respiratory SyndromeSevere Acute Respiratory Syndrome- Coronavirus, person to person transmissionCoronavirus, person to person transmission- 2003: 908 dead among 8.422 patients2003: 908 dead among 8.422 patients- Survivors: medication caused osteoporosisSurvivors: medication caused osteoporosis- Damage to the economyDamage to the economy

Influenza AInfluenza A- Orthomyxovirus, Orthomyxovirus, person to person transmission ?person to person transmission ?- Some death did occurSome death did occur- Pandemic: after person to person transmissionPandemic: after person to person transmission


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ZoonosisZoonosis

• DefinitionDefinition: Disease of animals that : Disease of animals that may be transmitted to humansmay be transmitted to humans

• SeveritySeverity: Expect severe disease: Expect severe disease

• UseUse: Some zoonoses are used in : Some zoonoses are used in biowarbiowar

• Currently abundant in NLCurrently abundant in NL: Diseases of : Diseases of Lyme and WeilLyme and Weil


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Technology to enlarge vitality?Technology to enlarge vitality?

• 93% of NL-elderly (2.2 mil of 65+) live independently

• 33% of the elderly with a severe physical disorder live in an unsuitable dwelling (not fully accessible, limited support)

Source: Lectoraat Vraaggestuurde Zorg (dr. H.S.M. Kort), Utrecht 2005


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A Smart Home EnvironmentA Smart Home Environment(2(2ndnd semester 7y910) semester 7y910)

is a home environment that adapts itself to the is a home environment that adapts itself to the dweller. A SHE forms an invisible, intelligent, dweller. A SHE forms an invisible, intelligent, self-learning part of our daily life, combining self-learning part of our daily life, combining functions pertaining to demand-driven functions pertaining to demand-driven comfort, domestic tasks, personal care, quality comfort, domestic tasks, personal care, quality of life, and professional careof life, and professional care

Source: Bronswijk et al. 2005: De Intelligente Thuisomgeving. In: Handboek Zorg Thuis. Amsterdam: Elsevier


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Next classNext class

September 12:September 12: No class, consultation on requestNo class, consultation on request

September 19:September 19: The DALY construct (Disability The DALY construct (Disability Adjusted Life Years) to evaluate Adjusted Life Years) to evaluate

building servicesbuilding services

september 5, 2007jemh van bronswijk 1 preventing disease (7y900) (incidence, prevalence, building...

Documents

jemh van bronswijk

support slide

daly slide

life span slide

insulated ground floors

prevalence of disease

alimentary canal slide

incidence of disease