Midwife Licensure Exam Community & Public Health — Environmental, Occupational & School Health NursingCheat Sheet
Environmental, Occupational & School Health Nursing cheat sheet for Midwife Licensure Exam aspirants. If you could only take one sheet of paper into your review session, this is what it would look like. Professional Regulation Commission (PRC) — Board of Midwifery's most-tested concepts, all in one place.
Exam context
For the Midwife Licensure Examination, Professional Regulation Commission (PRC) — Board of Midwifery tests Community & Public Health under a "Core" label, with Environmental, Occupational & School Health Nursing in the 5th slot across 6 chapters. Midwife Licensure Exam candidates must clear the 75% weighted average cut on the 2026 paper, which draws about a meaningful share of Community & Public Health questions. Date to watch: April and November 2026 (expected).
Environmental, Occupational & School Health Nursing - Cheat Sheet
Your last-minute revision companion for Environmental, Occupational & School Health Nursing. This condensed reference covers all exam-critical laws, water/sanitation levels, occupational hazards, school health programs, and nursing roles across all three environments. Master these 50+ key points in 30 minutes.
Sections
Section Title
1. ENVIRONMENTAL HEALTH & SANITATION — KEY LAWS
Important Facts
- PD 856 = PRIMARY sanitation law in the Philippines
- RA 9003 = Ecological Solid Waste Management Act (mandatory segregation at source; open dumpsites BANNED)
- RA 9275 = Clean Water Act (protects water quality)
- RA 8749 = Clean Air Act (protects air quality)
- RA 11223 = Universal Health Care (intersects with environmental health in primary care)
- RA 10121 = Disaster Risk Reduction & Management Act (environmental health during emergencies)
- Environmental sanitation is a CORE PRIMARY HEALTH CARE element
- Main diseases prevented by sanitation: diarrhoea, typhoid, cholera, hepatitis A, parasitism, leptospirosis
Key Definitions
Term
Environmental Health
Example
Safe water supply, sewage disposal, waste management prevent diarrhoea, typhoid, cholera, hepatitis A, parasitism.
Definition
Control of all physical, chemical, and biological factors external to a person that can affect health; sanitation is the control mechanism.
Term
PD 856 — Code on Sanitation of the Philippines
Example
Food handler health certificates, toilet facility standards, water source protection all mandated under PD 856.
Definition
PRIMARY LAW governing environmental sanitation (water supply, food establishments, sewage, refuse, markets, public places); enforced by DOH and LGU sanitation inspectors.
Diagrams To Know
- Hierarchy of Occupational Hazard Controls (Elimination → Engineering → Administrative → PPE)
- Water Supply Facility Levels (Level I, II, III progression)
Common Values
Value
2 minutes (rolling boil)
Symbol
t = 2 min
Quantity
Boiling time for safe drinking water
Value
0.3–1.5 mg/L (ppm)
Symbol
Cl residual
Quantity
Residual chlorine level in water systems
Value
25 metres
Symbol
d ≥ 25 m
Quantity
Minimum safe distance from water source to toilet
Value
~15 households
Symbol
n = 15
Quantity
Households served by Level I point source
Value
250 metres
Symbol
r = 250 m
Quantity
Service radius for Level I source
Section Title
2. WATER SUPPLY & WATER SAFETY
Important Facts
- BOILING: Bring water to a ROLLING BOIL for at least 2 MINUTES to make it potable (household level)
- CHLORINATION: Standard for community water systems; residual chlorine maintained at 0.3–1.5 mg/L (ppm) at point of use
- SAFE DISTANCE: Minimum 25 metres between water source and toilet/pollution source (PD 856)
- Water disinfection methods: boiling (household) and chlorination (community systems) are FIRST-LINE
- Level I requires no electricity or complex infrastructure (most sustainable in remote areas)
- Level II serves transitional/semi-urban areas efficiently
- Level III requires high maintenance and capital investment but maximizes convenience in cities
- Water quality parameters: pH, turbidity, bacteriological count, free chlorine residual are routinely tested
- Coliform bacteria = indicator of faecal contamination; MUST be absent in drinking water
Key Definitions
Term
Level I Water Supply — Point Source
Example
A protected dug well or developed spring in a remote barangay, households fetch water directly.
Definition
Protected well or developed spring WITHOUT a distribution system; serves ~15 households within 250 m radius; NO piped network.
Term
Level II Water Supply — Communal Faucet/Stand-Post
Example
Rural water system with 4–5 communal faucets serving a barrio; households queue to fetch water.
Definition
Piped system with communal faucets (standpipes); serves clustered rural populations; has distribution but NOT individual house connections.
Term
Level III Water Supply — Waterworks/Individual House Connections
Example
Metropolitan Waterworks and Sewerage System (MWSS) in urban Manila; households have indoor taps.
Definition
Fully piped system with INDIVIDUAL household connections; appropriate for urban/densely populated areas; highest level of service.
Diagrams To Know
- Water Supply Facility Levels flowchart
- Chlorination residual maintenance curve over time
Section Title
3. EXCRETA & SEWAGE DISPOSAL
Important Facts
- Approved toilet facility = one that SAFELY CONFINES excreta (cannot contaminate water, food, hands, accessed by flies/vermin)
- Level I relies on soil absorption and anaerobic decomposition (pit)
- Level II (septic tank) removes 80–90% of pathogens; sludge disposal is critical safety issue
- Level III requires 24/7 treatment plant operation; most reliable but requires infrastructure investment
- Proper excreta disposal breaks the FAECAL-ORAL TRANSMISSION chain of disease
- Pit latrines must be located AWAY from water sources (same 25 m rule as water supply)
- VIP latrine = ventilated improved pit; vents reduce odour and allow flies to escape (fly control)
- Pour-flush toilets use small amounts of water (50–100 L/day) to flush waste into septic/holding tank
- Toilet facility SELECTION depends on water availability, population density, and soil permeability
- Diseases prevented by proper excreta disposal: diarrhoea, typhoid, cholera, hepatitis A, hookworm, ascaris
Key Definitions
Term
Level I Toilet Facility
Example
VIP latrine with sealed pit, fly screen vents; used in rural areas without sewage systems.
Definition
Non-water-carriage types (pit latrine, ventilated improved pit [VIP] latrine, sanitary pit privy) or pour-flush toilets; safely confines excreta WITHOUT running water.
Term
Level II Toilet Facility
Example
Residential homes with septic tank systems; sludge periodically emptied and treated.
Definition
Toilets connected to SEPTIC TANKS; excreta treated on-site and absorbed into soil (suitable for single homes or small clusters).
Term
Level III Toilet Facility
Example
Metropolitan Manila's sewage network with treatment plants; excreta piped to centralized facilities.
Definition
Water-carriage system connected to a public SEWERAGE SYSTEM with central treatment; highest standard; used in urban areas.
Diagrams To Know
- Pit Latrine cross-section diagram
- VIP Latrine components (sealed pit, vent pipe with fly screen)
- Septic tank treatment cycle (inflow → settling → absorption)
Section Title
4. SOLID WASTE MANAGEMENT — RA 9003
Important Facts
- SEGREGATION AT SOURCE = primary strategy under RA 9003 (must happen at household level)
- Biodegradable/Compostable Waste: food scraps, garden waste, paper (compost → soil amendment)
- Non-Biodegradable/Recyclable Waste: plastics, glass, metals, paper (recycled into new products)
- Special/Hazardous Waste: batteries, electronics, chemicals, medical supplies (handled separately; proper disposal required)
- Residual Waste: material that cannot be segregated; properly disposed in SANITARY LANDFILLS
- OPEN DUMPSITES ARE BANNED under RA 9003 (no longer legal in Philippines)
- Waste Hierarchy: REDUCE → REUSE → RECYCLE (in order of preference/sustainability)
- Healthcare/Infectious Waste: YELLOW containers (infectious waste), RED containers (sharps/pathological); segregated from general waste per DOH guidelines
- Barangay/Municipal level: responsible for implementing waste management and monitoring segregation
- Environmental impact: improper waste = contaminated groundwater, mosquito breeding, air pollution, health hazards
Key Definitions
Term
RA 9003 — Ecological Solid Waste Management Act of 2000
Example
All households must separate food waste (biodegradable), plastics/glass (recyclable), and batteries (hazardous) before collection.
Definition
PRIMARY LAW mandating waste segregation AT SOURCE into biodegradable, recyclable, and special/hazardous waste; bans open dumpsites; prioritises reduce-reuse-recycle hierarchy.
Diagrams To Know
- Waste Segregation Categories and disposal pathways
- Waste Management Hierarchy flowchart
Common Values
Value
4–60°C
Symbol
TDZ
Quantity
Temperature danger zone (Celsius)
Value
40–140°F
Symbol
TDZ
Quantity
Temperature danger zone (Fahrenheit)
Value
≥63°C (145°F)
Symbol
Thot
Quantity
Safe hot food temperature
Value
≤4°C (40°F)
Symbol
Tcold
Quantity
Safe cold food temperature
Value
2 hours
Symbol
t = 2 h
Quantity
Maximum time in danger zone
Section Title
5. FOOD SAFETY & SANITATION
Important Facts
- FOOD HANDLER HEALTH CERTIFICATE = mandatory (PD 856); required before working in food establishment
- COMMUNICABLE DISEASE & FOOD HANDLING = INCOMPATIBLE; persons with diarrhoea, typhoid, hepatitis A, TB must NOT handle food
- HOT FOOD = keep HOT (≥63°C / 145°F); COLD FOOD = keep COLD (≤4°C / 40°F); AVOID danger zone (4–60°C)
- HANDWASHING: Before food prep, after toilet, after touching hair/nose; key intervention for faecal-oral transmission prevention
- SAFE WATER for food prep and cleaning utensils (treated/chlorinated water required)
- PROTECTION FROM FLIES AND VERMIN: Screens, lids, proper storage; flies = fomites for pathogenic bacteria
- WHO FIVE KEYS TO SAFER FOOD: (1) Keep clean, (2) Separate raw and cooked, (3) Cook thoroughly, (4) Keep food at safe temperatures, (5) Use safe water and raw materials
- CROSS-CONTAMINATION: Raw meat juices on cutting board → cooked food = HIGH RISK; use separate utensils/boards
- COOKING TEMPERATURES: Poultry 74°C, ground meat 71°C, whole cuts 63°C (minimum internal temp for safety)
- Food establishments are graded/inspected by DOH/LGU under PD 856 (Grade A–D; Grade A = safest)
Key Definitions
Term
Temperature Danger Zone
Example
Cooked chicken left at room temperature for 3 hours = UNSAFE (entered danger zone; bacteria multiplied).
Definition
Temperature range (typically 40–140°F or 4–60°C) where bacteria multiply RAPIDLY; food must NOT be held in this range for >2 hours.
Diagrams To Know
- Temperature danger zone chart with safe holding temperatures
- Cross-contamination prevention flowchart
Section Title
6. OCCUPATIONAL HEALTH NURSING — HAZARDS & PREVENTION
Important Facts
- OCCUPATIONAL HAZARD CLASSIFICATION — 5 TYPES:
- • PHYSICAL: noise, extreme temperatures, vibration, radiation (UV, ionizing), poor illumination, pressure extremes
- • CHEMICAL: dusts (silica, asbestos), fumes (welding), gases (CO, chlorine), solvents, heavy metals (lead, mercury), pesticides
- • BIOLOGICAL: bacteria, viruses, fungi, parasites; HIGH RISK in healthcare, agriculture, sanitation workers
- • ERGONOMIC: poor posture, repetitive motion, heavy lifting, poorly designed workstations, awkward work positions
- • PSYCHOSOCIAL: stress, shift work, harassment, excessive workload, job insecurity, lack of control
- HIERARCHY OF CONTROLS (order of preference — MOST to LEAST effective):
- 1. ELIMINATION/SUBSTITUTION: Remove or replace the hazard (BEST; eliminates risk at source)
- 2. ENGINEERING CONTROLS: Enclose/isolate hazard, ventilation, machine guards, noise barriers
- 3. ADMINISTRATIVE CONTROLS: Safe work procedures, job rotation, training, limiting exposure time, scheduling breaks
- 4. PPE (PERSONAL PROTECTIVE EQUIPMENT): Respirators, gloves, ear protection, goggles (LAST LINE OF DEFENCE)
- PPE alone is NOT sufficient (must be combined with other controls); relied upon only when other measures fail or insufficient
- OCCUPATIONAL HEALTH NURSE ROLES: Pre-employment/periodic/return-to-work health assessments, health surveillance, first aid/emergency care, health promotion, hazard identification/reporting, record-keeping
- RA 11058 = Occupational Safety and Health (OSH) Law; strengthens employer duty to provide safe workplace
- EMPLOYEES' COMPENSATION PROGRAM (ECP) covers workers for work-related injury/illness (medical, rehabilitation, income replacement)
- WORK-RELATED ILLNESS EXAMPLES: Silicosis (silica dust), asbestosis (asbestos), lead poisoning, occupational asthma, occupational dermatitis, hearing loss
Key Definitions
Term
Occupational Health Nursing
Example
Occupational health nurse in a factory monitors noise levels, conducts pre-employment medicals, teaches ergonomics, and provides first aid.
Definition
Application of nursing principles to the WORKING POPULATION to protect and promote worker health and prevent work-related illness and injury.
Term
Occupational Hazard
Example
Loud machinery (physical), silica dust (chemical), hepatitis B virus (biological), repetitive strain (ergonomic), shift work stress (psychosocial).
Definition
Any factor in the workplace that has potential to cause harm (injury, illness, disease) to worker; classified as physical, chemical, biological, ergonomic, or psychosocial.
Diagrams To Know
- Hierarchy of Occupational Hazard Controls pyramid
- Occupational Health Assessment flowchart
- Worker health surveillance cycle
Common Values
Value
Twice per year
Symbol
n = 2/year
Quantity
Frequency of national deworming program
Value
February and August (or June and December per region)
Symbol
Semester-based
Quantity
Typical deworming schedule months
Section Title
7. SCHOOL HEALTH NURSING & PROGRAMS
Important Facts
- SCHOOL HEALTH PROGRAM HAS 3 CORE COMPONENTS:
- (1) HEALTH SERVICES: health and nutritional assessment, screening (vision, hearing, oral), first aid/emergency care, referral, immunisation, management of common conditions
- (2) HEALTHFUL SCHOOL ENVIRONMENT: safe water, sanitation, clean canteen, ventilation, safety from hazards
- (3) HEALTH EDUCATION: integration of health lessons into curriculum, reinforcing healthy behaviours
- ANNUAL HEALTH & NUTRITIONAL ASSESSMENT: Height, weight, BMI calculation, anthropometric screening; identifies malnutrition and over-nutrition
- NATIONAL DEWORMING PROGRAM: Twice yearly (mass chemotherapy); targets soil-transmitted helminths; improves nutrition absorption and school attendance
- SCHOOL-BASED IMMUNISATION: MR (measles-rubella), Td (tetanus-diphtheria), HPV (human papillomavirus for eligible female pupils); catch-up doses for non-immunised children
- ORAL HEALTH / DENTAL SERVICES: Screening, health education, referral for cavities/gingivitis, fluoride application; school dentist or dental health worker conducts services
- FEEDING PROGRAMS: School meals/snacks for undernourished children; improves nutrition, concentration, school attendance; coordinated with DepEd nutrition program
- HEALTH SCREENING & REFERRAL: Case-finding for vision problems, hearing loss, dental caries, malnutrition; referral to RHU/hospital for management; follow-up and home visits by school nurse
- SCHOOL NURSE ROLES:
- • Case-finding and screening (vision, hearing, oral, nutritional status)
- • Health teaching to pupils, teachers, parents
- • First aid and emergency response at school
- • Maintaining school health records (individual pupil health files)
- • Monitoring healthful school environment (water, sanitation, safety)
- • Coordinating between school, home (home visits), and health center (RHU)
- • Referral and follow-up of identified health problems
- SCHOOL HEALTH RECORD: Individual pupil health file includes immunisation status, screening results, medical history, referred conditions, follow-up outcomes
- HOME VISIT by school nurse: Bridges school–home–community; assesses home environment, educates families, facilitates follow-up of referred conditions
- DepEd and DOH coordination: Joint implementation of school health programs; DOH provides technical support, vaccines, deworming tablets; DepEd provides infrastructure, teachers as health educators
Key Definitions
Term
School Health Nursing
Example
School nurse conducts vision screening, coordinates deworming campaigns, provides first aid, teaches health lessons to pupils.
Definition
Promotion of health for school-age population and school personnel, supporting learning by keeping children healthy; delivered in coordination with DepEd and DOH.
Term
National Deworming / Integrated Helminth Control Program
Example
Every semester (typically February and August), all school pupils receive anthelminthic tablets as part of national program.
Definition
Mass deworming of school children TWICE a year against soil-transmitted helminths (ascaris, hookworm, trichuris); implemented by DOH via schools.
Diagrams To Know
- School Health Program 3-Component model
- School Health Nursing assessment flowchart
- Annual school health calendar with key activities
Section Title
8. VECTOR & PEST CONTROL
Important Facts
- VECTOR & PEST CONTROL HIERARCHY (in order of preference):
- 1. SOURCE REDUCTION (MOST SUSTAINABLE): Eliminate breeding sites — drain stagnant water (mosquitoes), remove garbage (flies/rats), eliminate snail habitats (schistosomiasis)
- 2. BIOLOGICAL CONTROL: Natural predators (e.g., larvivorous fish Gambusia for mosquito larvae); eco-friendly, long-term
- 3. CHEMICAL CONTROL: Larvicides, insecticides; RESERVED FOR OUTBREAKS; NOT first-line (breeds resistance, environmental impact)
- 4. PERSONAL/HOUSEHOLD PROTECTION: Screens, insecticide-treated bed nets (ITNs), repellents, proper food/waste storage
- KEY MESSAGE FOR COMMUNITY EDUCATION: 'Environmental source reduction, NOT FOGGING, is the mainstay of sustainable vector control.'
- FOGGING/SPRAYING: Used ONLY during outbreaks (dengue epidemic, malaria spike); NOT routine practice; indiscriminate use breeds insecticide resistance
- DENGUE PREVENTION: Eliminate water containers, use bed nets, wear protective clothing; source reduction = remove Aedes breeding sites (flower pots, clogged gutters, tyres)
- MALARIA PREVENTION: Insecticide-treated bed nets (ITNs), indoor residual spraying in endemic areas, antimalarial chemoprophylaxis for travelers
- LEPTOSPIROSIS: Prevent rat contact/contamination, avoid flood water, boil water for drinking, use protective footwear in flooded areas
- FLY CONTROL: Proper refuse storage, screens, sanitation facilities away from food, sanitary landfill for waste
- RAT CONTROL: Remove food sources, seal building crevices, traps, rodenticide (with caution around children/pets)
Key Definitions
Term
Vector-Borne Disease
Example
Malaria (mosquito), dengue (Aedes mosquito), schistosomiasis (freshwater snails), leptospirosis (rat urine in flood water).
Definition
Disease transmitted by arthropod vectors (mosquitoes, flies, snails, ticks); prevention requires environmental and personal protection measures.
Diagrams To Know
- Vector Control Hierarchy pyramid (Source Reduction → Biological → Chemical → Personal Protection)
- Aedes mosquito lifecycle and breeding sites flowchart
Section Title
9. DISASTER & EMERGENCY ENVIRONMENTAL HEALTH
Important Facts
- DISASTER ENVIRONMENTS shift focus to IMMEDIATE ENVIRONMENTAL HEALTH PRIORITIES:
- 1. SAFE WATER SUPPLY: Provide potable water (boiling, chlorination, bottled water); prevent cholera, diarrhoea outbreaks
- 2. EMERGENCY SANITATION: Portable toilets, hand-washing stations, excreta containment (prevent disease spread in crowded shelters)
- 3. SAFE FOOD: Food safety protocols, prevention of spoilage in evacuation centres
- 4. DISEASE SURVEILLANCE: Monitor for diarrhoeal disease, respiratory infections, leptospirosis (post-flood); early outbreak detection
- POST-FLOOD DISEASES: Leptospirosis (rat urine in flood water), diarrhoea (contaminated water), skin infections (prolonged dampness), respiratory disease (crowded shelters)
- POST-EARTHQUAKE DISEASES: Communicable diseases from overcrowding (tuberculosis, measles, respiratory infections), waterborne disease (broken water lines)
- NURSE ROLE IN DISASTER: Rapid health assessment, water-safety messaging, infection control education, case-finding, referral, first aid, mental health support
- EVACUATION CENTER HEALTH: Crowded conditions = HIGH TRANSMISSION RISK; prioritise ventilation, sanitation, vaccination, isolation of suspected cases
- RA 10121 IMPLEMENTATION: DOH and LGUs coordinate disaster health response; Red Cross, NGOs provide support; integrated into UHC (RA 11223) framework
Key Definitions
Term
RA 10121 — Philippine Disaster Risk Reduction and Management Act
Example
During typhoon flooding, RA 10121 activates disaster response chain; DOH ensures safe water supply, sanitation, disease surveillance in evacuation centres.
Definition
PRIMARY LAW governing disaster preparedness, response, and recovery; mandates risk reduction, early warning, rescue, relief, rehabilitation; coordinates health response through DOH and LGUs.
Diagrams To Know
- Disaster Health Response phases and environmental health priorities
- Outbreak risk timeline after disaster (immediate vs delayed)
Section Title
10. NURSING ROLES ACROSS ALL THREE ENVIRONMENTS
Important Facts
- CONSISTENT NURSING ROLES across environmental, occupational, and school settings:
- 1. HEALTH EDUCATOR: Teach safe water practices, food safety, ergonomics, vector control, immunisation importance; community/individual/family level
- 2. CASE-FINDER/SCREENER: Identify health problems (malnutrition, vision loss, occupational illness); referral pathway initiation
- 3. FIRST-AID PROVIDER: Emergency response, immediate care at workplace, school, community setting
- 4. COORDINATOR/REFERRER: Bridge between community, health centre, hospital; ensure follow-up; liaison with schools, employers, families
- 5. ADVOCATE: Promote safe environment, worker rights (RA 11058), child health (school programs); voice concerns about hazards/violations
- 6. RECORD-KEEPER: Maintain health records (worker health files, school health records, individual community records); data for surveillance
- LEVELS OF PREVENTION APPLICATION:
- • PRIMARY: Environmental sanitation, hazard elimination, health education, immunisation — PREVENTS DISEASE
- • SECONDARY: Screening (vision, hearing, nutritional), case-finding, early treatment — EARLY DETECTION & TREATMENT
- • TERTIARY: Rehabilitation, management of chronic occupational disease, referral for advanced care — PREVENTS COMPLICATIONS
- PRIMARY PREVENTION IS MOST COST-EFFECTIVE — emphasised in all three settings
- NURSING PRACTICE LAW (RA 9173): Nurses in community settings practice nursing autonomously per nursing process, within scope of PHC
- HEALTH PROMOTION STRATEGIES: Community mobilization, intersectoral collaboration (DOH, DepEd, DOLE, LGUs), capacity building of health workers, use of local resources
Key Definitions
Term
Primary Prevention in Community Nursing
Example
Handwashing education (environmental health), ergonomics training (occupational), immunisation (school health) — all primary prevention.
Definition
Actions taken to PREVENT DISEASE/INJURY BEFORE IT OCCURS by promoting health and protecting against environmental/occupational hazards; most cost-effective approach.
Diagrams To Know
- Nursing Process in Community Health (Assessment → Diagnosis → Planning → Implementation → Evaluation)
- Levels of Prevention pyramid with examples from environmental, occupational, school settings
Must Remember
- 1. PD 856 = PRIMARY LAW for environmental sanitation (water, food, sewage, waste, markets); RA 9003 = Solid Waste (segregation at source, ban dumpsites); RA 9275 = Clean Water; RA 8749 = Clean Air; RA 11058 = Occupational Safety & Health.
- 2. WATER SUPPLY LEVELS: Level I = point source (no distribution, ~15 households, 250 m range); Level II = communal faucets (piped, rural clusters); Level III = individual house connections (urban, waterworks). Safe distance from water source to toilet = ≥25 METRES.
- 3. WATER DISINFECTION: Boil at ROLLING BOIL for ≥2 MINUTES (household); chlorinate at 0.3–1.5 mg/L (ppm) for community systems.
- 4. TOILET LEVELS: Level I = pit/VIP/pour-flush (no water); Level II = septic tank; Level III = sewerage with treatment. All must SAFELY CONFINE excreta (prevent contamination of water, food, hands; prevent fly access).
- 5. SOLID WASTE: RA 9003 mandates SEGREGATION AT SOURCE (biodegradable, recyclable, hazardous). OPEN DUMPSITES ARE BANNED. Hierarchy = Reduce → Reuse → Recycle.
- 6. FOOD SAFETY: TEMPERATURE DANGER ZONE = 4–60°C (40–140°F); do NOT hold food in this range >2 hours. Keep hot food ≥63°C, cold food ≤4°C. WHO Five Keys = Keep clean, Separate raw/cooked, Cook thoroughly, Keep at safe temps, Use safe water/materials.
- 7. OCCUPATIONAL HAZARDS = 5 TYPES: Physical (noise, temp), Chemical (dust, fumes), Biological (bacteria, viruses), Ergonomic (posture, lifting), Psychosocial (stress, shift work). HIERARCHY OF CONTROLS = Elimination → Engineering → Administrative → PPE (PPE is LAST resort).
- 8. SCHOOL HEALTH PROGRAM = 3 COMPONENTS: (1) Health services (screening, immunisation, first aid), (2) Healthful environment (water, sanitation, safety), (3) Health education. NATIONAL DEWORMING = TWICE yearly. School nurse roles = screener, educator, case-finder, coordinator, advocate.
- 9. VECTOR CONTROL: Source reduction (eliminate breeding sites) = MOST SUSTAINABLE. Biological control, admin control, then chemical (reserved for outbreaks). FOGGING is NOT routine; used only during epidemics. Key message = 'Environmental source reduction, NOT FOGGING, is mainstay.'
- 10. NURSING ROLES across all environments = Health educator, case-finder, first-aid provider, coordinator/referrer, advocate, record-keeper. PRIORITIZE PRIMARY PREVENTION (most cost-effective). RA 9173 = Philippine Nursing Practice Law; nurses practice autonomously per nursing process in PHC.
Last Minute Tips
- TIP 1: Remember the '25-METRE RULE' — minimum safe distance from water source to toilet/pollution source. This appears in EVERY water-sanitation question; write it on your scratchpad.
- TIP 2: HIERARCHY OF CONTROLS for occupational hazards is a classic NLE question. Order is ELIMINATION/SUBSTITUTION → ENGINEERING → ADMINISTRATIVE → PPE. PPE ALONE is NEVER acceptable as primary control; always identify the preferred level.
- TIP 3: WATER SUPPLY LEVELS and TOILET FACILITY LEVELS often appear as paired questions. Level I = simplest/no infrastructure; Level III = most sophisticated/urban. Match them to population density and resources: remote = Level I; urban = Level III.
- TIP 4: SCHOOL HEALTH PROGRAM questions test the 3-component model AND deworming frequency (TWICE yearly). If you see a question about school programs, check whether it mentions services, environment, education — or ask 'How often is deworming?' (Answer = 2×/year).
- TIP 5: In occupational health, DO NOT confuse PPE with engineering controls. If a question says 'The factory provides hearing protection to workers in a loud area' — that is PPE (last resort), NOT ideal. The ideal is engineering (noise barriers, better machine design, or moving the worker away from the noise).
Comparison Tables
Rows
Values
- Protected well/spring, NO distribution
- Piped system with communal faucets
- Fully piped system with individual house taps
Property
Infrastructure
Values
- ~15 households within 250 m
- Clustered rural/semi-urban population
- Urban/densely populated areas
Property
Service Area
Values
- Manual fetch by household
- Public queue at communal faucet
- Individual household tap (in-home)
Property
Water Fetching
Values
- NONE
- YES, with communal outlets
- YES, with individual household connections
Property
Distribution System
Values
- LOW (no pumps/treatment needed)
- MEDIUM (gravity-fed or small pump)
- HIGH (treatment plants, pumping, maintenance)
Property
Technology Level
Values
- LOWEST (sustainable for remote areas)
- MODERATE
- HIGHEST (requires capital investment)
Property
Cost
Values
- Remote, low-population-density areas
- Rural barrios, semi-urban clusters
- Cities, urban centers, high-density areas
Property
Appropriate Area
Columns
- Feature
- Level I — Point Source
- Level II — Communal Faucet
- Level III — Waterworks/Individual Connections
Table Title
Water Supply Facility Levels — Quick Comparison
Rows
Values
- Non-water-carriage (pit), pour-flush
- Septic tank treatment on-site
- Water-carriage to centralized treatment
Property
Type
Values
- NONE (pit) or minimal (pour-flush)
- MODERATE (for flushing)
- HIGH (continuous water supply)
Property
Water Required
Values
- On-site decomposition in pit
- On-site septic tank; sludge disposal
- Centralized treatment plant
Property
Waste Management
Values
- LOW (periodic emptying)
- MODERATE (sludge removal every 3–5 yrs)
- HIGH (24/7 treatment plant operation)
Property
Maintenance
Values
- Single households/small clusters in rural areas
- Individual homes or small communities
- Urban areas, densely populated cities
Property
Appropriate Population
Values
- PARTIAL (natural die-off in pit)
- 80–90% removal (septic treatment)
- 90%+ removal (professional treatment)
Property
Pathogen Removal
Values
- LOWEST
- MODERATE
- HIGHEST
Property
Cost
Columns
- Feature
- Level I — Pit Latrine/VIP
- Level II — Septic Tank
- Level III — Sewerage System
Table Title
Toilet Facility Levels — Quick Comparison
Rows
Values
- Noise, temperature, vibration, radiation, illumination
- Loud machinery (>90 dB), extreme heat/cold, UV radiation, poor lighting
- Factory workers, outdoor laborers, welders, construction
- Elimination/Engineering (noise barriers, ventilation)
Property
Physical
Values
- Dusts, fumes, gases, solvents, heavy metals
- Silica dust, lead, mercury, pesticides, organic solvents, welding fumes
- Factory workers, painters, agricultural workers, miners
- Engineering (ventilation, extraction); PPE (respirators)
Property
Chemical
Values
- Bacteria, viruses, fungi, parasites
- Hepatitis B, TB, HIV (healthcare workers), brucellosis (farm workers), parasites
- Healthcare workers, waste handlers, farm workers, sanitation workers
- Universal precautions; immunisation; PPE (gloves, masks)
Property
Biological
Values
- Poor posture, repetitive motion, heavy lifting, awkward positioning
- Computer work (RSI), warehouse lifting, manual labor, assembly line
- Office workers, warehouse staff, construction, manufacturing
- Workstation design; job rotation; proper lifting techniques; breaks
Property
Ergonomic
Values
- Stress, shift work, harassment, job insecurity, excessive workload
- Shift work, long hours, tight deadlines, harassment, lack of job control
- Healthcare workers, call centers, police, transport drivers
- Admin controls (flexible scheduling, workload management); support programs
Property
Psychosocial
Columns
- Hazard Type
- Definition
- Examples
- At-Risk Workers
- Prevention Hierarchy Priority
Table Title
Occupational Hazard Types & Examples
Rows
Values
- Direct care and assessment of pupils
- Annual health/nutritional assessment, vision/hearing screening, first aid, immunisation, referral, management of common conditions
- School nurse, school doctor (if available), health worker
- Early detection of health problems, referral for advanced care, maintained student health
Property
Health Services
Values
- Safe, clean school setting that supports learning
- Safe water supply, sanitation facilities, clean canteen, ventilation, safety from hazards (no exposed nails, electric wires, etc.)
- School administrators, facilities manager, sanitation workers, DepEd/DOH inspectors
- Reduced disease transmission, safe learning environment, improved attendance
Property
Healthful Environment
Values
- Curriculum integration and behavioral change
- Health lessons in classes (nutrition, sanitation, disease prevention, personal hygiene), health campaigns, teacher training
- Teachers (primary educators), school nurse (support/reinforcement), health educators, DepEd curriculum specialists
- Knowledge of healthy behaviors, adoption of safe practices, improved health literacy
Property
Health Education
Columns
- Component
- Definition
- Key Activities
- Responsible Personnel
- Target Outcomes
Table Title
School Health Program Components & Implementation
Rows
Values
- Remove/replace hazard at source
- HIGHEST (prevents exposure entirely)
- DIFFICULT (may require process redesign)
- HIGH (capital investment upfront)
- Replace toxic solvent with less toxic; remove asbestos insulation; eliminate noise-generating process
Property
1. Elimination/Substitution
Values
- Enclose/isolate/modify process
- VERY HIGH (eliminates/reduces hazard exposure)
- MODERATE (technical expertise needed)
- MODERATE-HIGH (equipment, installation)
- Ventilation systems, machine guards, noise barriers, fume hoods, automated conveyors
Property
2. Engineering Controls
Values
- Modify work practices/procedures
- MODERATE-HIGH (reduces exposure, not eliminates)
- EASY (training, scheduling, procedures)
- LOW-MODERATE (training cost)
- Job rotation, limiting exposure time, safe work procedures, breaks, scheduling
Property
3. Administrative Controls
Values
- Personal protective equipment
- VARIABLE (depends on compliance, proper use)
- EASY (distribute, train)
- LOW (recurring cost)
- Respirators, gloves, safety goggles, hard hats, hearing protection (LAST resort)
Property
4. PPE
Columns
- Control Level
- Strategy
- Effectiveness
- Implementation Ease
- Cost
- Examples
Table Title
Hierarchy of Occupational Hazard Controls — Effectiveness & Implementation
Previous chapter
Communicable Disease Control & Immunization
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Health Promotion & Primary Health Care
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