4.

Adhere to established norms of conduct based on the

Philippine Nursing Law and other legal, regulatory and
STUDENT ACTIVITY SHEET
institutional requirements relevant to safe nursing practice.

LESSON PREVIEW/REVIEW (5 minutes)

Community Health Nursing 1 - Lecture BS NURSING /
SECOND YEAR

LESSON TITLE: Environmental Sanitation, Sanitation Session # 20

Code, Clean Air Act
LEARNING OUTCOMES: Materials:
Upon completion of this lesson, the nursing student can: 1. Pen, paper, index card, book, and class List
Provide, safe, appropriate and holistic care to individuals,
family, population groups and community utilizing nursing
process Reference:
2. Practice nursing in the community setting in accordance
with law, legal, ethical and moral principles. Famorca, Z. U., Nies, M. A., & McEwen, M. (2013).
3. Adhere to ethic-legal considerations when providing safe, Nursing Care of the Community. Elsevier
quality and professional nursing care. Gezondheidszorg.

Instruction: What are the four time-bound interventions of EINC? Explain each briefly.
1. _____________________, _______________________________________________________________________
2. _____________________, _______________________________________________________________________
3. _____________________, _______________________________________________________________________
4. _____________________, _______________________________________________________________________

MAIN LESSON (30 minutes)

Introduction: Water, sanitation and waste management are important driving forces for community health in India. A
clean environment, open defecation free areas, personal hygiene practices among the individuals, proper solid and
liquid waste management, and availability of adequate safe drinking water determine the health of individuals as well
as the community

Environmental sanitation is that branch of public health that is concerned with the control of all those factors in man’s
surrounding’s or physical environment which may have a bad effect on human health and well - being.

COMPONENTS OF ENVIRONMENT: The environment is consisting of different several factors which is responsible for
good health and environment.

The component which is consist of good environment is are as follows:

⎯ Physical environment.
⎯ Biological environment.
⎯ Social environment

ENVIRONMENTAL HEALTH: According to W.H.O, “the control of all those factors in man’s physical environment which
exercise or may exercise harmful effect on his physical development, health and survival.

IMPORTANCE OF ENVIRONMENTAL HEALTH:

Factors which influence sustainable growth in the of the community are:

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⎯ Migration (Masons). Human migration is the movement of individuals and families from one place to another in
search of employment, food, shelter and better living conditions. Members in certain occupations like masons, semi
skilled masons, laborers, painters, plumbing workers, carpenters and others migrate from one place to another.
Migration may be temporary or a permanent arrangement in search of jobs and better wages depending on the
individual’s interest. There are a number of economic activities related to sanitation which can result in the economic
growth of the local community, thus possibly reducing migration.

⎯ Organic Farming through urine and feces: Farming, with the use of natural fertilizers, has been practiced by our
ancestors for thousands of years. The developments after the 18th century have led to use of chemical fertilizers and
pesticides along with hybrid crop varieties and genetically modified crops, which have now become common
agricultural practice. Usage of chemical fertilizer and pesticide results in decreased crop production, loss of soil fertility,
water contamination due to chemicals, death of surface drinking water sources due to eutrophication, ground water
contamination from chemicals and loss of indigenous type of crop varieties all of which lead to environmental
degradation. All these factors at global level have diverted the interest of individuals, scientists, researchers and
practitioners to shift from chemical fertilizers to organic fertilizers. Human feces and urine have high levels of NPK
(Nitrogen, Phosphorus and Potassium).

⎯ Health Cost: Sustainable environmental sanitation practices, safe drinking water supplies and proper waste
management systems result in reducing money spent on ill health caused due to poor access to sanitation.

⎯ Clean Environment: The environment comprises of both living and non-living organisms. Our environment is
becoming increasingly polluted due to various reasons. An important cause for environmental contamination is poor
sanitation facilities. Ensuring a proper solid and liquid waste management system and ensuring a 100% open
defecation free status results in a sustained clean environment.

IMPORTANCE OF ENVIRONMENTAL HEALTH:

⎯ Importance the individual and community health status.
⎯ Protection against diseases.
⎯ Controlling the environment pollution and protecting the environment.
⎯ Providing healthful environment.
⎯ Encouraging the environmental condition.
⎯ Coordination with the efforts of environmental health team.

ELEMENTS CONTRIBUTING TO ENVIRONMENTAL HEALTH:

⎯ Attention should be paid to the following elements for good environmental health:
⎯ Controlling the air pollution.
⎯ Supplying clean and safe water.
⎯ Health housing.
⎯ Checking the sound pollution.
⎯ Protecting the person from diseases caused by arthropods
⎯ Proper light, appropriate temperature and humidity, and protection against radiation.
⎯ Proper disposal of excreta, sewage, solid, refuse, E-refuse, and other waste products.

DISASTERS AND SANITATION:

⎯ Disasters are caused mainly due to natural and man-made causes.
⎯ Disasters cause serious health hazards to individuals as well as to community members. During a disaster the
climate and weather condition in the area change and the change of conditions directly affects the water and sanitation
situation and favors the growth of harmful microbes and vectors.

LEVEL OF ENVIRONMENTAL SANITATION:

1. Sanitation at house hold:
⎯ Good quality housing is a key element for ensuring a healthy community.
⎯ Poor housing can lead to many health problems and is associated with infectious diseases as-TB etc. ⎯ Everyone
should therefore have associated to good quality housing and home environment.

2. Sanitation Community Level:

⎯ Good health is not merely the absence of disease.

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⎯ Take proper waste disposal.
⎯ Avoid waste from water source.
⎯ Avoid the high noise and remove the source of pollutants.

Sanitation and waste management are important driving forces for community health. A clean environment, open
defecation free areas, personal hygiene practices among the individuals, proper solid and liquid waste management,
and availability of adequate safe drinking water determine the health of individuals as well as the community. Good
quality housing is a key element for ensuring a healthy community. Poor housing can lead to many health problems
and is associated with infectious diseases as-TB etc.

Sanitation Code

Code on Sanitation of the Philippines (Presidential Decree 856) – Empower the Department of Health with the
following powers and functions: Undertake the promotion and preservation of the health of the people and raise the
health standards of individuals and communities throughout the Philippines.

Sanitation Code of 1976 (Presidential Decree 856) define as the hygienic and proper management, collection, disposal,
or reuse of human excreta (feces and urine) and community liquid waste to safeguard the health of individuals and
communities.

Sanitation refers to public health conditions related to clean drinking water and adequate treatment and disposal of
human excreta and sewage.

Objective:
⎯ Directing public health services towards protection and promotion of the health of the Filipinos.

Environmental Sanitation Code Composition:

The study of all factors in man’s physical environment, which may exercise a deleterious effect on his health, well-being
and survival.
Includes:
⎯ Water sanitation
⎯ Food sanitation
⎯ Refuse and garbage disposal
⎯ Excreta disposal
⎯ Insect vector and rodent control
⎯ Housing
⎯ Air pollution
⎯ Noise
⎯ Radiological Protection
⎯ Institutional sanitation
⎯ Stream pollution
6Fs proposed by Sanitation and Hygiene Promotion Programing Guidelines that form part of the means to transmit
microorganism in fecal materials to a new host namely:
1. Fingers
2. Fluids
3. Flies
4. Fields/Floors
5. Food

Department of Health Functions:

⎯ Promotion and preservation of health and health standards
⎯ Extend maximum health services in rural areas and provide medical care to people who cannot afford due to poverty
⎯ Develop, administer and coordinate health activities and services
⎯ Upgrade the standards of medical practice and quality of health services
⎯ Assist local health agencies in developing public health programs
⎯ Issue permits to establish and operate hospitals, clinics, etc.

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⎯ Prescribe standard rates of fees • Performed other functions provided by law
⎯ Recognizes international treaties agreements and conventions on public health.
⎯ Proceedings and rights commenced and accrued upon the effectivity of this code should not be affected by its
provisions but those arising after the date of effectivity should conform to the provisions.
⎯ Power delegated and duty assigned to a public health officer may be exercised by an agent of the official pursuant to
law.
⎯ Notice, report, statement, or record should be written in English or Pilipino and sent through postal service. ⎯ No
compensation for the owner whose property is officially condemned or seized by government for the purpose of public
health
⎯ Duty expressly vested in a health officer is the concern of the superiors of health office (command responsibility)

Nursing Responsibilities and Activities

⎯ Health Education. Educating patients, families and communities about environmental health and how to address key
environmental health issues.
⎯ Showing leadership in personal practices that support and reduce harm to the environment. ⎯ Collaborating with
interdisciplinary colleagues to identify and mitigate environmental health risks in practice environments
⎯ Advocating for policies that protect health by preventing exposure to those hazards and promoting sustainability. ⎯
Assessing and communicating risks of environmental hazards to individuals, families and communities. ⎯ Actively
participate in the training component of the service like in Food Handler’s Class, and attend training/workshops related
to environmental health.
⎯ Assist in the deworming activities for the school children and targeted groups.
⎯ Effectively and efficiently coordinate programs/projects/activities with other government and non-government
agencies.
⎯ Act as an advocate or facilitator to families in the community in matters of program/projects/activities on
environmental health in coordination with other members of Rural Health Unit (RHU) especially the Rural Sanitary
Inspectors. ⎯ Actively participate in environmental sanitation campaigns and projects in the community. Ex. Sanitary
toilet campaign drive for proper garbage disposal, beautification of home garden, parks drainage and other projects. ⎯
Be a role model for others in the community to emulate terms of cleanliness in the home and surrounding.

Implemented barriers to prevent the spread of pathogens:

A. Primary barriers are structures and facilities that prevent the fecal contaminations of 6Fs B. Secondary barriers
are practices that prevent 6Fs from coming in contact with food or the new host. ✔ It includes but are not limited to,
handwashing practices, insects and vermin control, water treatment, and proper food handling.

Clean Air Act

Clean Air Act (R.A.8749) the government's measures to reduce air pollution and incorporate environmental protection
into its development plans.

Air Pollutant is defined by DENR, as any matter in the atmosphere other than the natural concentrations of oxygen,
nitrogen, water vapor, carbon dioxide, and inert gases that may be detrimental to health or the environment.

Two major sources of air pollution identified by Clean Air Act

1. Mobile source
⎯ Any vehicle /machine propelled by or through oxidation or reduction reactions.
⎯ Constructed or operated conveyance of persons.
⎯ Transportation of property or goods that emit air pollutants as a reaction product.
2. Stationary source refers to any building or fixed structure, facility, or installation that emit air pollutants as a reaction
product.

Programs to address air pollution:

⎯ BantayTsimineya Program
⎯ BantayTambutso Program and Standard Setting
⎯ Improved Fuel Quality Program
⎯ National Research and Development Program for the Prevention and Control of Air Pollution

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Rights of Citizens on this law:
⎯ The right to breathe clean air
⎯ The right to utilize and enjoy all-natural resources according to the principles of sustainable development. ⎯ The
right to participate in the formulation, planning, implementation, and monitoring of environmental policies and programs
and in the decision-making process.
⎯ The right to participate in the decision- making process concerning development policies, plans, and program
projects or activities that may have adverse impact on the environment and public health.
⎯ The right to be informed of the nature and extent of the potential hazard of any activity, undertaking, or project and to
be served timely notice of any significant rise in the level of pollution and the accidental or deliberate release into the
atmosphere of harmful or hazardous substances.
⎯ The right to access public records which a citizen may need to exercise his/her right effectively under this Act. ⎯
The right to bring in court or quasi-judicial bodies to enjoin all activities in violation of environmental laws and
regulations, to compel the rehabilitation and cleaned up of affected area, and to seek the imposition of penal sanctions
against violators of environmental laws.
⎯ The right to bring action in court for compensation of personal damages resulting from the adverse environmental
and public health impact of a project or activity.

The Clean Air Act provides that the State shall:

⎯ Protect and advance the right of the people to a balanced and healthful ecology in accord with the rhythm and
harmony of nature.
⎯ Promote and protect the global environment to attain sustainable development while recognizing the primary
responsibility of local government units to deal with environmental problems.
⎯ Recognizes that the responsibility of cleaning the habitat and environment is primarily area-based. ⎯ Recognizes
the principle that “polluters must pay”.
⎯ Recognizes that a clean and healthy environment is for the good of all and should, therefore, be the concern of all.

What are covered by the Clean Air Act?

⎯ All potential sources of air pollution (mobile, point and area sources) must comply with the provisions of the law. All
emissions must be within the air quality standards.
⎯ Mobile sources refer to vehicle like cars, trucks, buses, jeepneys, tricycles, motorcycles and vans. ⎯ Point sources
refer to stationary sources such as industrial firms and smokestacks of power plants, hotels and other establishments.
⎯ Area sources refer to sources of emission other than the above. These include smoking, burning of garbage, and
dust from construction, unpaved grounds, etc.

What can you do to help clean the air?

For vehicle owners/motorists:

⎯ Maintain your vehicle by changing oil regularly (every 5,000 kilometers)
⎯ Keep the engine well-tuned following the owner’s manual
⎯ Keep tires properly inflated
⎯ Plan trips and observe proper driving habits •

Remove unnecessary things from the trunk. Don’t overload and travel only at speed required by traffic regulations and
road conditions

For commuters:
⎯ Try talking to the jeep/bus/tricycle driver about the high health risks of poor vehicle maintenance and improper
driving practices.
⎯ Patronize mass railway transit

At home:
⎯ Use low watt bulbs or energy saving lights
⎯ Limit the use of air conditioning units and keep the temperature a few degrees higher
⎯ Don’t burn garbage
⎯ Avoid using aerosols
⎯ Properly dispose of refrigerant, refrigeration equipment and used coolant

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Education (Department of Nursing) 5 of 9
For everyone:
⎯ Report smoke belchers to LTO, MMDA and/or appropriate local government units.
⎯ Walk or ride your bike to places
⎯ Work with residential association to stop burning of garbage
⎯ Spread the word about the ban of smoking in public places.
⎯ Plant trees.

CHECK FOR UNDERSTANDING (20 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 20 minutes for this activity:

Multiple Choice

1. A foodborne outbreak of salmonellosis has twice occurred at a day-treatment program. The environmental health
worker has requested that an advanced public health nurse be included in the next inspection of the program's kitchen.
During the visit, the nurse’s primary concern is to:
A. Educate kitchen workers about safe and food preparation.
B. Ensure the workers understanding of various microorganism.
C. Identify other resources for providing various microorganism.
D. Promote the health of clients affected by the previous outbreak.
ANSWER: ________
RATIO:_________________________________________________________________________________________
_
_______________________________________________________________________________________________
__ ______________________________________________________________

2. A resident in one of the communities complained of unacceptable smell on their areas which lead to lots of fleas on
their surroundings. To whom does the rural health nurse approach?
A. Municipal health officer
B. Rural health midwife
C. Rural sanitation inspector
D. Barangay health workers.
ANSWER: ________
RATIO:_________________________________________________________________________________________
_
_______________________________________________________________________________________________
__ ______________________________________________________________

3. Clean Air Act has been clearly defined in what Republic Act?
A. R.A. 8749
B. R.A. 9003
C. R.A. 8746
D. All of the above
ANSWER: ________
RATIO:_________________________________________________________________________________________
_
_______________________________________________________________________________________________
__ ______________________________________________________________

4. Barangay health workers called for a barangay assembly meeting. The topic mentioned about ‘Clean Air Act’. One of
the citizens asked about, what are some of their Rights in accordance to Clean Air Act. The RHU staff enumerated the
rights except:
A. Right to breath
B. Right to utilize and enjoy all-natural resources according to principles of sustainable development. C. Right to
discard non- hazardous household, commercial, institutional waste.
D. Right to access to public records which a citizen may need to exercise his/her rights effective under this act.
ANSWER: ________

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Education (Department of Nursing) 6 of 9
RATIO:_________________________________________________________________________________________
_
_______________________________________________________________________________________________
__ ______________________________________________________________

5. A newly hired midwife assigned in a remote rural health unit as new RHM. The following are the functions of the RHM
except:
A. Manages BHS and supervises, trains BHW
B. Conducts patient’s assessment and diagnosis for referral or further management
C. Check healthy physical environment
D. Organizes community and facilitates barangay planning and community health services
ANSWER: ________
RATIO:_________________________________________________________________________________________
_
_______________________________________________________________________________________________
__ ______________________________________________________________

6. Which of the following is the mission of the Department of Health?

A. Health for all Filipinos
B. Ensure the accessibility and quality of health
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020
ANSWER: ________
RATIO:_________________________________________________________________________________________
_
_______________________________________________________________________________________________
__ ______________________________________________________________

7. A 4-year-old client was brought to the health center with chief complaint of severe diarrhea and the passage of “rice
water”. The client is most probably suffering from which condition?
A. Giardiasis
B. Cholera
C. Amoeba
D. Dysentery
ANSWER: ________
RATIO:_________________________________________________________________________________________
_
_______________________________________________________________________________________________
__ ______________________________________________________________

8. What is the act of cleaning one’s hands with the use of any liquid with or without soap for the purpose of removing
dirt or microorganisms?
A. Aseptic technique
B. Handwashing
C. Medical Asepsis
D. Surgical Asepsis
ANSWER: ________
RATIO:_________________________________________________________________________________________
_
_______________________________________________________________________________________________
__ ______________________________________________________________

9. The clinical instructor asks her students the rationale for handwashing. The students are correct if they answered that
handwashing is expected to remove:
A. Transient flora from the skin.
B. Resident flora from the skin.
C. All microorganisms from the skin.
D. Media for bacterial growth.
ANSWER: ________

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Education (Department of Nursing) 7 of 9
RATIO:_________________________________________________________________________________________
_
_______________________________________________________________________________________________
__ ______________________________________________________________

10. Nurses should review which of the following reports to determine what pollutants have been found in the drinking
water in a community?
A. Point source report
B. Consumer confidence report
C. Material Safety Data Sheet
D. Environmental standards report
ANSWER: ________
RATIO:_________________________________________________________________________________________
_
_______________________________________________________________________________________________
__ ______________________________________________________________

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE-TO-FACE INTERACTION) The instructor
will now rationalize the answers to the students. You can now ask questions and debate among yourselves. Write the
correct answer and correct/additional ratio in the space provided.

1. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

2. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

3. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

4. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

5. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

6. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

7. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

8. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

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Education (Department of Nursing) 8 of 9
9. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

10. ANSWER: ________

RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

LESSON WRAP-UP (5 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23AL Activity: CAT: 3-2-1

Instructions:
1. As an exit ticket at the end of the class period
2. Record three things you learned from the lesson.
3. Next, two things that you found interesting and that you’d like to learn more about.
4. Then, record one question you still have about the lesson.

Three things you learned:

1. __________________________________________________________________________________ 2.
__________________________________________________________________________________ 3.
__________________________________________________________________________________

Two things that you’d like to learn more about:

1. __________________________________________________________________________________ 2.
__________________________________________________________________________________
One question you still have:
1.___________________________________________________________________________________

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