Background: Pulmonary Tuberculosis has been a major health problem despite major efforts for its control. Quality assurance tools such as the clinical pathway may aid in promoting quality health care delivery to meet standards of care for PTB. Objectives: This study was conducted to determine the effectiveness of providing clinical pathway checklist for PTB in improving the appropriateness of care as compared to those without checklist and the issues with its use among residents at the Family Medicine Clinic of the Department of Family and Community Medicine at UP-PGH. Methodology: The Family Medicine Clinic was the setting of the study and the DFCM resident rotators for August-September, 2009 were the subjects. PTB cases seen during the 42 clinic days were randomized into groups with PTB clinical pathway checklist and without checklist. Chart audit was done based on the clinical pathway for PTB. The mean percentage scores served as a measure of the appropriateness of care. These were compared among the two groups based on the following parameters: clinical evaluation, assessment, health counseling, medications and monitoring and the overall appropriateness of care. A focus group discussion was done to identify issues with the use of the clinical pathway checklist. Results: The clinical pathway checklist significantly improved the appropriateness of care in the following parameters, clinical evaluation (86.40 versus 75.54) at P value 0.004; health counseling (71.98 versus 56.22) at P value 0.007; monitoring and follow-up (62.2 versus 37.98) at P value <0.01 and in the overall appropriateness of care (78.24 versus 71.05) at P value 0.0002. The parameters of care in terms of laboratory evaluation and diagnosis for both groups, and clinical evaluation in the group with clinical pathway checklist were able to meet the set standard of 80 percent. Issues identified with the use of PTB clinical pathway checklist were physician characteristics, clinician time commitment, applicability to setting and financial resources. Conclusion: The PTB clinical pathway checklist was effective in improving the appropriateness of care in all parameters and was significant in terms of clinical evaluation, laboratory evaluation, health counseling, monitoring and follow-up and the overall appropriateness of care. Issues identified with the use of clinical pathway should be considered prior to pathway development and implementation.
PULMONARY TUBERCULOSIS

The use of auto-LPG (Liquefied Petroleum Gas) has spread globally due to its economic and environmental advantages over gasoline and diesel. The growing popularity of auto-LPG in the country has been challenged by reported health complaints from its use instigating alarms among taxi drivers and passengers. This paper aims to review documented health outcomes of auto-LPG among drivers. Health outcomes of auto-LPG are classified to inhalation effects and burns. Auto-LPG is expected to have inhalational effects such as headache, dizziness, dry throat, nausea and dry cough during prolonged exposure caused by leakage from faulty conversions. Fire and explosion causing significant burns were documented in relation to auto-LPG use. Cases of cold burns or frostbite were also reported. Human factors and technical malfunctions causing leakage were implicated on the reported adverse health event. Limited studies on auto-LPG and health outcomes require the development and use of objective assessment of health outcomes and presence of auto-LPG in the driver's environment to make relevant correlations. Regulations governing auto-LPG should be reviewed to formulate strategic interventions to promote health and safety of drivers as well as the passengers.

Human ; Explosions ; Gasoline ; Dizziness ; Penicillin G Benzathine ; Cough ; Pharynx ; Vertigo ; Fires ; Petroleum ; Blast Injuries ; Burns ; Headache ; Frostbite ; Nausea

OBJECTIVES: This study was conducted to determine the cadmium (Cd) concentration in brown and polished rice collected from the 9 farms in Barangay Real, Calamba City. This study also assessed the non-cancer health risk to adults (?20 years old) of long-term consumption of rice with Cd using the non-cancer hazard quotient (NHQ).

METHODS: Rice grains with hull were collected in November-December 2013. Both rice types were analyzed for Cd using a graphite furnace atomic absorption spectrophotometer (GFAAS). The NHQ was calculated by dividing the estimated daily intake of Cd via rice consumption by the oral reference dose (RfD) for Cd.

RESULTS: Mean Cd concentrations in brown and polished rice collected from the 9 farms in Barangay Real ranged from 0.0062 to 0.0725 mg/kg and 0.0047 to 0.0778 mg/kg, respectively. The NHQ values of Cd in both rice types were less than 1.0 for adults (?20 years old).

CONCLUSION: Cd concentrations in brown and polished rice from the 9 farms did not exceed the 0.4 mg/kg maximum allowable Cd concentration in rice set by FAO/WHO. Since the NHQ did not exceed 1.0, long-term exposure to Cd through consumption of brown and polished rice from these farms is unlikely to cause non-cancer health effects in adults (?20 years old). It is unlikely for adults to develop kidney diseases such as tubular proteinuria, decreased glomerular filtration rates, and itai-itai disease.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Oryza ; Cadmium ; Neoplasms

OBJECTIVES: The aim of the project is to develop water safety plan (WSP) guidelines specific for water refilling station (WRS) operators. The guidelines will serve as model for future formulation of WSP among WRS across the country.
METHODS: A criteria was developed for selecting WRS. Site visits were initially done along with the selection of eight (8) water refilling stations from pre-identified areas across the country. The operators of the selected WRS together wih their respective local sanitary inspectors underwent a workshop where they were trained and guided on the step-by-step process of devising a WSP. Coaching and mentoring was then conducted for the improvement of the draft WSPs. A guideline manual on how to develop WSPs for WRS was drafted to serve as reference for other WRS in the country.
RESULTS: The study developed a WSP model specifically made for WRS setting. Eight (8) final drafts of WSP were also accomplished. WRS operators and local sanitary inspectors were trained on how to develop WSP which will support and facilitate appropriate implementation of these functional WSPs.
CONCLUSION: The formulation of WSPs among WRS ensures delivery of safe drinking-water among its consumers. It serves as an initial step in realizing the vision of DOH of institutionalizing WSPs among all water utilities in the country. The guidelines developed will be a useful tool for other WRS in the country for preparing their own WSPs.

Human ; Male ; Female ; Diarrhea ; Gastroenteritis ; Safety ; Models, Theoretical ; Motor Vehicles ; Water ; Water Supply ; Risk Management

The Sixth Environmental and Occupational Health Forum, conducted virtually on November 23 to 24, 2023, focused on "Accelerating the Development of Healthy and climate-smart Hospitals in the Southeast Asian Region." This forum, a collaborative effort of the University of the Philippines Manila and Health Care Without Harm Southeast Asia, aimed to explore and exchange strategies, challenges, and innovative practices for integrating environmental sustainability in healthcare settings across Southeast Asia. The event gathered healthcare professionals, policymakers, and environmental experts to discuss the transformation of hospitals into health and climate-smart institutions. Keynote speakers from various countries presented case studies and research findings, emphasizing the need for holistic approaches that include policy development, stakeholder engagement, and continuous education. Significant outcomes highlighted were the identification of effective policies for sustainable hospitals, understanding the impact of healthcare facilities on climate change, and the necessity for political acumen in promoting environmental stewardship in healthcare. The forum concluded with a consensus on the critical need for ongoing collaboration and innovation in environmental and occupational health, underscoring the importance of transforming healthcare facilities into entities that prioritize both patient care and planetary health.
Delivery of Health Care ; Occupational Health

Environmental and occupational health are interconnected disciplines of public health that are concerned in maintaining a symbiotic relationship between the ecosystem and humans. This relationship is under threat by the continuous and alarming increase of the Earth's temperature causing climate change that impacts not just health but also the economy and the safety of the population. The First National Environmental and Occupational Health Forum was organized by the Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila to address and discuss the complex issues that the Philippines is currently experiencing when it comes to environmental and occupational health by providing a space where stakeholders from different sectors can actively participate in mapping out challenges and opportunities. The organizer's long-term vision is to catalyze and build a network of collaboration that is geared towards the improvement of health and safety in the workplace that involves mitigating the effects of climate change. The discussions in the forum gave a comprehensive insight into the different challenges we face for being one of the most vulnerable countries to natural disasters: how this affects health, workplace, and environment. These challenges created new opportunities for the country to build resilience and formulate adaptive strategies to decrease the vulnerability of the population especially the workforce who are constantly exposed to different hazards that are exacerbated by changes in the environment.

Climate Change ; One Health ; Agriculture

Even after two years, the COVID-19 pandemic still disrupts public activities and services as it exposes vulnerabilities among the population and negatively impacts environmental conditions. The crisis also impeded global progress toward achieving Sustainable Development Goals (SDG). The Fourth Environmental and Occupational Health (EOH) Forum held virtually on November 25 to 26, 2021 provided a venue for learning about local and international COVID-19 responses to help prepare for the next global crisis. Through the systems thinking approach, the discussions prioritized analyses of leadership and governance, financing, human resource, technologies, information management, and service delivery. These analyses focused on community and/or workplace programs and services linked to air quality, waste management, psychosocial wellness, and COVID-19 vaccination. The forum amplified calls for climate actions and public health improvement and emphasized the significance of a collaborative, evidence-based, integrated public health response to a crisis underscoring the apparent interdependence of the SDGs.
Environmental Health ; Occupational Health ; Sustainable Development Goals ; Covid-19 ; air quality