Thursday, June 19, 2008

THESIS

Health Related Problems and Living Conditions of the Residents of Barangay Mameltac along the Proximity of the City Sanitary Landfill

A Thesis Presented to
The Faculty of the College of Nursing
Lorma Colleges, City of San Fernando, La Union









In Partial Fulfillment
Of the Requirements for the
Degree Bachelor of Science in Nursing







By:
Almazan, Jeffrey M.
Araneta, Anthony Mark P.
Arquitola, Christian Glenn T.
Farrales, Jomar V.
Rimando, Ali John N.








March 2008





LORMA COLLEGES
COLLEGE OF NURSING
City of San Fernando, La Union



ENDORSEMENT


This thesis entitled “Health Related Problems and Living Conditions of the Residents of Barangay Mameltac along the Proximity of the City Sanitary Landfill”, in partial fulfillment of the requirements for the Degree Bachelor of Science in Nursing, has been examined and hereby recommended for Oral Defense.


This is to certify that Almazan, Jeffrey M., Araneta, Anthony Mark P., Arquitola, Christian Glenn T., Farrales, Jomar V., Rimando, Ali John N are ready for oral defense.


Charlie P. Cruz, RMT, MASE
Instructor



This is to certify that the thesis entitled “Health Related Problems and Living Conditions of the Residents of Barangay Mameltac” prepared and submitted by Almazan, Jeffrey M., Araneta, Anthony Mark P., Arquitola, Christian Glenn T., Farrales, Jomar V., Rimando, Ali John N. is recommended for oral defense.


PACITA G. APILADO, RN, MAN, ED.D

Chairperson

Charlie P. Cruz, RMT, MASE Christopher M. Jimenez

Member Member






APPROVAL SHEET

The thesis entitled HEALTH RELATED PROBLEMS AND LIVING CONDITIONS OF THE RESIDENTS OF BARABGAY MAMELTAC ALONG THE PROXIMITY OF THE CITY SANITARY LANDFILL, prepared and submitted by Jeffrey M. Almazan, Anthony Mark P. Araneta, Christian Glenn T. Arquitola, Jomar V. Farrales, Ali John N. Rimando in fulfillment of the requirements for the degree of Bachelor of Science in Nursing is hereby accepted




CHARLIE P. CRUZ, RMT, MASE
Instructor


Thesis Committee


PACITA G. APILADO, RN, MAN, Ed. D
Chairman


CHARLIE P. CRUZ, RMT, MASE CHRISTOPHER M. JIMENEZ
Member Member


Accepted and approved in fulfillment of the requirements for the degree of Bachelor of Science in Nursing.








LUDIVINA D. MAGPALI, RN, MAN
Dean, College of Nursing
Lorma Colleges



ACKNOWLEDGEMENT

“From the fruit of his words a man has his fill of good things, and the works of his hands come back to reward."(Proverbs 12:14)

Every good deed is surely rewarded, and without the contribution of certain people they would not have created a study like this, hence, they can only demonstrate their gratitude by listing their names here and their contributions.

Man cannot fulfill his ambition in life without the moral support of the people around him. But even with the support he gets, it cannot be fulfilled without the guidance of Almighty God. In fulfilling his humble works, the authors give thanks to Him, who guides them in surpassing all the hardship encountered in the design, construction and to the final test of the project.

The author wishes to extend their sincere o the following persons, who in one way or another have serve as constituents of their thesis to be one reality.


To Mr. Charlie P. Cruz, their thesis instructor, for his diligent assistance and support in contributing immensely for the success of this work;

To Dr. Pacita G. Apilado, for her keen desire of providing the researchers ample opportunities to widen their knowledge in the field they have chosen and for her approval and experties;

To Mrs. Ludivina D. Magpali, Dean, College of Nursing, for her generous support;

To Mr. Christopher Jimenez, their dear adviser, for the grateful advices and contributions he rendered during the completion of the thesis and unselfish guidance and supervision;

To Hon. Pablo C. Ortega, Mayor, City of San Fernando, for allowing the researchers to conduct their study;

To Engr. Pedro D. Balcita, Punong Barangay, Barangay Mameltac, for allowing the reseachers to gather and obtain data from the barangay;

To the respondents who have shared their knowledge and cooperation for the success of the project.

To their beloved parents to their untiring sacrifices and infinite love in bringing the authors to pursue their higher education and to live up to their expectation and giving them an unwavering belief in their ability.

Again, the authors acknowledge the Almighty God, for the courage and determination that led to the fulfillment of the project





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prince
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jomar
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THESIS ABSTRACT

This descriptive type of study aims to determine the Health Related Problems and the Living Conditions of the Residents of Barangay Mameltac along the proximity of the City Sanitary Landfill. Specifically, this study determines the profile of the repondents in terms of age, gender, height and weight; this study also determines the health related problems of the respondents along the Gastrointestinal System, Respiratory System, Cardiovascular System and the Reproductive System; and this study determines the Living Condition of the respondents along their Personal Hygiene, Health Maintenance, Household Chores, Rest and Sleep and Recreational Activities. The researchers gathered important adta through questionnaires, informal interview and analysis of data from the City Health Office of San Fernado. The gathered data showed that most of the respondents were early adult males with a proportional height in relation to their weights, this study also revealed that Respiratory illness as manifested sa cough and common colds are the most prevalent health related problems in the barangay, another finding of this study showed that the respondents have commendable living conditions wherein most of the respondents practiced hygienic activities to promote and restore health. Through these data, the researchers came up with the following conclusions: the distribution of the respondents in terms of gender is almost equal, though the number of early adult males were slightly higher compared with female respondents; Respiratory Diseases were the most health related problem in the barangay; and the respondents along the proximity of the City Sanitary Landfill have a healthy living conditions. Guided by these conclusions the researchers have came up with these following recommendations: the future researchers should maintain an equal distribution of the respondents in terms of their age and gender; the researchers would like to encourage the residents of Barangay Mameltac especially along the proximity of the City Sanitary Landfill to have regular check-up to the Health Centers to avoid further complications of problems especially in the Respiratory System which the most prevalent in the area, regular exercise, enough rest and sleep and adequate intake of nutritious food to prevent illnesses that may be brought about by the unconducive environment; in relation with their living condition, the residents should maintain their healthy lifestyle, good personal hygiene and maintaining a clean environment to promote and restore health.





















Table of Contents
Page
TITLE PAGE …………….……………………………………………………………… i
ENDOSEMENT ………………………………………………………………………... ii
APPROVAL SHEET …...……………………………………………………………… iii
ACKNOWLEDGEMENT ……………………………………………………………… iv
THESIS ABSTRACT ..……………………………………………………………….. vii
TABLE OF CONTENTS ...……………………………………………………………. ix
LIST OF FIGURES ….………………………………………………………………. xi

Chapter 1 INTRODUCTION
Background of the Study ........................................................................... 1
Theoretical Framework ............................................................................ 11
Conceptual Framework ........................................................................... 12
Statement of the Problem ........................................................................ 14
Research Hypotheses ............................................................................. 15
Research Paradigm ................................................................................ 16

Chapter 2: METHODS
Population and Locale ............................................................................. 17
Data Gathering Tools ............................................................................... 18
Data Gathering Procedures ..................................................................... 19
Treatment and Analysis of Data .............................................................. 20

Chapter 3: RESULTS AND DISCUSSION
1. Profile of the Respondents in terms of:
Age ............................................................................................... 22
Gender …...................................................................................... 23
Weight …....................................................................................... 27
2. Health Related Problems along the:
Gastrointestinal System ............................................................... 25
Respiratory System ...................................................................... 27
Cardiovascular System................................................................. 30
Reproductive System ................................................................... 32
3. Living Condition of the Respondents along the:
Personal Hygiene ......................................................................... 34
Health Maintenance ..................................................................... 36
Household chores ........................................................................ 37
Rest and Sleep ............................................................................ 38
Recreational Activities ………………………………………………. 40
Chapter 4: CONCLUSION AND RECOMMENDATIONS
Summary of Findings .............................................................................. 41
Coclusion ................................................................................................ 42
Recommendations .................................................................................. 43
Bibliography ....................................................................................................... 44
Questionnaire .................................................................................................... 46
























List of Figures
Figures Page
1. Research Paradigm ……………………………………………………………… 16



Chapter 1
INTRODUCTION
Background of the Study
As countries continue to develop, generation of solid wastes has rapidly increased. Together with the enlargement of urbanized society is the lessening of the possible areas for disposal of wastes. Cities’ waste collection system cannot cope with the increasing volume of solid wastes. Because of this, the proper waste management is one of the major concerns both by developed and developing countries. One of their problem is how and where to dispose these garbage.
The disposal of wastes in landfill sites has increasingly caused concern about possible adverse health effects for populations living nearby, particularly in relation to those sites where hazardous waste is dumped. The majority of studies evaluating possible health effects in human populations living near landfill sites investigate communities near one specific waste disposal site, frequently in response to concerns from the public about reported contamination from the site or reported clusters of disease.
In 1937, the first modern sanitary landfill was built at , the “Fresno Municipal Sanitary Landfill”. Sanitary Landfills are engineered landfills, secured with physical barriers such as liners to save the public from exposure to the disposed wastes. Four basic conditions should be met before a site can be regarded as a sanitary landfill. First, the site must have formal engineering preparations. Designs should be developed from local geological and hydrogeological investigations. A waste disposal and a final restoration plan should also be developed. Second, the site must have a planned waste emplacement and covering. Waste are spread in layers and compacted which is then be covered daily to make the waste less accessible to pests. Third, the site must have a trained staff to supervise site preparation ad construction, the depositing of the waste and the regular operation and maintenance. And lastly, a sanitary landfill must have a full/partial hydro geological isolation. Additional lining materials should be used to help reduce breakage from the base of the site and help reduce contamination of ground water and surrounding soil with leachates. (Thurgood, 1999).
Leachates and landfill gas are two major contaminants in a landfill. Leachates is formed when water flows through the waste in the landfill. This water can be from rain or the waste itself. As the liquid moves through the landfill, many organic and inorganic compounds are transported in the leachate (, 2001). Leachates move to the base of the landfill and collects. To prevent this leachates from leaking out, and contaminates the ground water and surrounding soil, leachate collection and treatment must be stressed as a basic requirement. These leachate have potential health effects once leaked out in the landfill sites. Leachates from paints contains lead, phenols, cadmium compounds and xylene that can cause nausea, vomiting, diarrhea, abdominal pain, dyspnea, chest pain, pneumonia, skin irritation and dermatitis once exposed. Other leachates from the wastes such as batteries, glass, glues, and plastic contains elements such as mercury and nickel can cause health effects as stated above. Landfill gas is also major contaminants in landfills. These include carbon dioxide, nitrogen, volatile organic compounds, and hazardous air pollutants such as benzene, methane, vinyl chloride. Methane, primary content of landfill gas, is an odorless, colorless, flammable gas that can cause dizziness and headache once inhaled. It can also displace oxygen in an enclosed space which may result to asphyxia, a condition of severely deficient supply of oxygen to the body that leads to deprivation of oxygen supply to the brain tissue causing confusion, fainting and even death in extended periods (Brooks, 2005).
There is a correlation between landfill size and the amount of leachates produced. The largest landfill in the world located in Fresh Kills, StatenIsland, New York, produces 4 million gallons of leachate per day or 1.5 billion gallons per year. The study revealed a high concentrations of Volatile Organic Chemicals (VOCs) in the leachates. These volatile organic chemicals include Benzene, Choloroform, Ethylbenzene, Methylene Chloride, Tetrachloroethylene, Toulene, Trichloroethylene, and Vinyl Chloride which has been reported to have potential effects to Central Nervous System, Respiratory System, Gastrointestinal System, Kidney and Liver Damage, blood disorders, and eye and skin irritations.
Benzene and xylenes, both a human carcinogen, are highly mobile that it can travel with groundwater far beyond the borders of a landfill. A study conducted in Florida, USA found out that some benzenes had migrated with the groundwater 800 meters away from the landfill. Almost 90% of the people in Florida rely on groundwater for household consumption. (http://k3power.org/docs/LandfillManual.pdf)
Vinyl Chloride and Toulene, a component of leachates, once inhaled can cause Respiratory effects such as chest constriction, throat irritations and upper respiratory infections; neurological effects such as dizziness, fatigue, sleepiness, headache, loss of coordination, tremors and decreased brain size; cardiovascular effects such as irregular heartbeat; and other health related effects such as irritation of the eyes, involuntary eye movements, impaired speech, hearing and vision, difficulty sleeping, liver damage and some reproductive effects. (http://concernedcitizens.homestead.com/epa_on_hap_in_lfg.html)
Another hazardous component of leachtes are metals. A study conducted in Minnesota, USA reported that metals from leachates once ingested can cause potential effects to health. These hazardous metals include Cadmium, Lead, and Chromium. These metals, which are mainly from batteries, paints, ceramic glasses, mining wastes, medical equipments and plastics, can cause lower respiratory tract infections, irritability, poor attention span, headaches, muscular tremors, loss of memory, hallucinations, infertility, nausea, vomiting, oral ulcers, diarrhea, abdominal pain and indigestion; effects on major systems of the body such as the Nervous System, Circulatory System, and Cardiovascular System. (http://proteus.pca.state.mn.us.waste/listedmetals.html)
Another study was conducted at Municipality of Olavarria Sanitary Landfill. The study revealed that the gastrointestinal diseases resulting from contaminated water are the biggest health problem facing the village population, affecting particularly the young and the elderly.(http://www.cleanairnet.org/lac_en/1415/article-59485.html)
For people living in the vicinity of these sites, other routes of exposure may be of more concern. Landfill sites may be a source of airborne chemical contamination via the off-site migration of gases and via particles and chemicals adhered to dust, especially during the period of active operation of the site. Many people find the odors emitted from a landfill to be unpleasant. Landfill gas odors are produced by bacterial or chemical processes in both active or closed landfill. A study was conducted in Georgia, USA regarding the discomforts brought about by the landfill gas odors. These landfill odors may be coming from sulfides, ammonia and certain Non-Methane Organic Compounds (NMOCs). The study also suggest that the landfill gas odors were also produced by disposal of wastes such as manures and fermented grains. Exposure to landfill gas at extremely high concentrations can cause eye irritation, headaches, nausea and soreness of the throat and nose. (http://www.health.state.ga.vs/pdfs/hazards/LandfillGas.bro.pdf)
A similar problem was being encountered at Danbury, Connecticut. The study revealed that the air near the landfill contains Sulfides, Ammonia, Vinyl Chloride and hydrocarbons. People may experience nausea or headaches in reaction to the odor. Although such responses are undesirable, medical attention is usually not required . Often, symptoms such as headaches and nausea fade away when odor goes away. However, the effects on the living conditions can be more lasting. Families living in the proximity of the landfill described frequent odor events as overwhelmingly disruptive. One family reported being awakened during predawn hours by a flood of nauseating air the persisted for 2 or more hours. The loss of sleep and the frustrations from the frequent odor events greatly added to the level of stress in the family's life. Although landfill odors may not be associated with long-term adverse health effects for most people, the added disruptions and stress to their daily living conditions can greatly affect the quality of life. (http://www.atsdr.cdc.gov/HAC/landfill/PDFs/Landfill/2001_ch3.pdf)
Other contaminants from sanitary landfill are dust and vapors. Inhalation of these contaminants can cause headaches, dizziness, nausea and diarrhea. It can also irritate the eyes, nose and mouth that could lead to respiratory diseases. Extreme exposures can cause coma and death. The effect of sanitary landfill to the respiratory system can be attributed to the periodic volume reduction that is accomplished by an open burn that often leads to short-term effects such as wheezing, watery eyes, “cold” symptoms, pneumonia and bronchitis and long-term effects that include allergies, sinus infections, asthma and emphysema.
Dump sites for toxic waste have become a public health concern in both developed and developing countries. People living in the proximity of landfill sites believe that these toxic waste to be serious threats to their health and demand public health assessments and thorough clean up. One epidemiologic study have shown a high prevalence of subjective symptoms, such as headache, vertigo, insomnia, skin rash and upper airway irritation, although it has not been possible to demonstrate whether these symptoms are related to a direct toxilogical effect. (Boucharlout, 1994).
In the Philippines , solid wastes are disposed in open dumpsites. This type of waste management would cause environmental and health problems. Samples gathered from Carmona and Payatas, dumpsites in , showed high levels of toxic metals which includes lead, nickel, copper, and chromium which as discussed above, has an effect to health. In , an average of 2, 500 cubic meters of garbage is generalized daily which can fill up 120 garbage trucks. The country is having a hard time treating and handling this garbage, in fact, there are 13 billion kilos of solid waste generated from its 89 million residents. There are 718 open dumpsites and 376 controlled dump sites, which should be closed under Republic Act 9003, The Solid Waste Management Law.
(http://www.gmanews.tv/story/63908/Garbage-crisis-in-Metro-looms-MMDA-urged-to-find-new-dumpsite-soon).
Health dangers posed by open landfills to the Filipino community include the proliferation of organic waste and damage to the human respiratory system. Organisms such as mosquitoes and rats are drawn to food sources at dumps in search of either reproduction sites, mosquitoes, or food sources, these organisms then pass on germs as unwitting carriers. The effect to the respiratory system can be attributed to the fact that open dumps require a periodic volume reduction that is usually accomplished by an open burn. These burn often lead to such short-term effects as wheezing, watery eyes, “cold” symptoms, pneumonia, and bronchitis and long-term effects that include allergies, sinus infections, asthma, heart disease, and even cancer. Adverse effects also include nervous system disorder, integumentary diseases, bone disorders and anemia. Inhaled dust can irritate nose, mouth, and eyes, which may lead to dizziness, diarrhea, and nausea and vomiting. Eventually may lead to death. The most commonly reported effect of living near a landfill is low birth weight and small size among children.
(http://www.state.ak.us/dec/dsps/compass/7pdf).
(http://www.gaia.com/Greenpeace/Manila.htm).
In , La Union, an engineered sanitary landfill was constructed in 2005 and situated at Barangay Mameltac with a contract to last for 10 years. There are about 1, 300 metric tons of garbage being dumped coming from different barangays of every month. Garbage from city establishments, public and private sectors are also collected and being delivered at the city sanitary landfill. Last January, 2008, 1, 226 metric tons of garbage has been collected. Before the collection of garbage, the dumping site is being prepared. It is done by placing a very large high density poly ethylene plastic (HDPE) above the soil so that the secretions coming from the garbage will not contaminate the soil. Above this is a filter cloth and gravel which filters and slows down the fluid and the movement of dirt from the garbage. From here, they will suction all filtered fluid and dirt using the HDPE pipe and will be brought at the pumping station and being filtered again in the leachate pond thus, being released at the rice field.
A previous study was conducted in this barangay with regards to the effects of sanitary landfill to the health of the residents. Study shows that in general, residents sometimes experience symptoms of gastrointestinal problems such as diarrhea, nausea and vomiting, abdominal pain, constipation, and boating. They also sometimes experience symptoms of respiratory infections like tonsillitis, bronchitis, asthma, etc.; and as for the integumentary system, they sometimes experience manifestations of skin infections like boils, warts, hives, and others (Uy, et. al. 2006).
As to statistics, the leading cause of morbidity is said to be Acute Respiratory Infection with 53 number of cases in the year 2007, followed by Urinary Tract Infection with 15 cases and Acute Toncillo Pharyngitis with 10 cases. On the other hand, the leading causes of mortality are Cardio Pulmonary Arrest, Respiratory Failure, Heart Failure, Chronic Organ Failure, and Pneumonia with the same number of cases. They have 23% crude birth rate, 4% crude death rate, and 0% infant mortality rate, maternal death, and fetal death.
In the health effects discussed above, residents along the proximity of a sanitary landfill a healthy living conditions should be imposed. To protect ourselves from illness especially from the hazardous substance brought upon by the toxic wastes, good personal hygiene must be sustained. it includes hand washing, bathing, oral care and simple but effective things like covering your mouth with a clean tissue when sneezing. Infections are acquired easily when we are off-guard. Unknowingly, a dirty hand touches food we eat that may bed us up in a hospital suffering from gastroenteritis. To ensure you don’t carry bacteria to other parts of your body or to other individual, you should wash your hands as needed.
Health maintenance such as exercises, eating nutritious foods at least 3x a day, taking vitamins, and having regular check up is also important to prevent occurrence of diseases, studies shows that a healthy body is a disease free body. Sleep and Rest is essential for the restoration and repair of the body’s normal function. At the end of the day, the body has worn out from the strenuous activity and the only remedy is proper rest and sleep, it is like resetting a machine or computer, after a tough day, it needs to take a time out. However, environment is one of the factors that affect the sleeping pattern of people.
Since a sanitary landfill has a hazardous effect to the health of the people once the four conditions discussed above are unmet, the researchers wants to investigate the health related problems of the city sanitary landfills to the residents of Barangay Mameltac and their living conditions, Furthermore, to fulfill their duty as student-nurses in improving the over-all health status of their target communities by identifying particular health concern as influenced by environmental factors. The result of this study will provide the barangay residents near the landfill area substantial information regarding the advantages and probable health risks of the sanitary landfill. The Department of Health, together with the City Government of San Fernando, the City Health Office, and community health nurse can also use the results of this study as guidelines in identifying and developing the plan of care and interventions for environmental health related problems.



Theoretical Framework
The following health and legal theories were adopted by the researchers as their bases for conducting the study.
According to Florence Nightingale’s Environmental Theory, nursing is an act of utilizing the environment of the client to assist him in his recovery (Kozier, 2004). It involves the nurses’ initiative to configure the environmental settings appropriate for the restoration and promotion of the client’s health. External factors that are associated with the patient’s surroundings affect life or biologic and physiologic processes and his development. In this study, we will investigate the effect of the sanitary landfill (environment) to the health of the residents.
The Ecological Belief Model or the Agent-Host-Environment Model states that there are three dynamic interactive elements of health and illness. First are the agents which are any environmental factors or stressors which by its presence or absence could affect the health status of an individual. In this study, the potential environmental hazards posed by the sanitary landfill are agents which may cause negative effects to the resident’s health status. Second is the host which refers to the person who my or may not be at risk of acquiring a disease based on inherent variables like age, sex, and lifestyle which influence the host’s reaction. And third is the environment which may include external factors that may predisposes the host to the development of the disease. The resident’s proximity to the sanitary landfill also increases their vulnerability or risk of acquiring diseases brought about by the possible pollutants of the sanitary landfill (http://msucares.com/health/health /appa1.htm).
Conceptual Framework
Under Republic Act 9003, or the Comprehensive Solid Waste Management, certain criteria should be followed for sitting a sanitary landfill. With regards to people sensitivity, the site chosen must be accessible from major road ways. The site should have an adequate quantity of earth cover materials that is easily handled and compacted. The site where the landfill operates should not affect environmentally sensitive resources such as ground water reservoir or water shed area. This will prevent the contamination of the environment by hazardous wastes. After sitting and choosing the location, these following criteria should be met in the establishment of the sanitary landfill. The presence of covers and liners should be considered. Liners are a system of clay layers or geosynthetic membrane use to contain leachate and reduce/prevent contaminant flow to ground water. Leachate should be collected through installed pipes of the low areas of the liver. These pipes serve as a storage and eventually treatment and discharge for collected leachates. Landfill gas should also be collected through a gas control recovery system. It is a series of vertical wells/horizontal trenches containing permeable materials and perforated piping placed in the landfill for treatment and productive use of landfill gas as an energy source. Also present in the criteria is the ground water monitoring well system, this will be use to monitor the quality of the ground water.
In relation to RA # 9003 (Comprehensive Solid Waste Management), the government also ensure the maintenance of a pollutant free atmosphere through the establishment of RA 8794 (The Clean Air Act). This act defines air pollutants means any matter found in atmosphere other than oxygen, carbon dioxide, nitrogen, water vapor, and the inert gases in their normal concentration, that is detrimental to health or environment. These air pollutants can be found in sanitary landfill along with the other hazardous substances. The Clean Air Act defines hazardous substances as those substances with present either short-term acute hazards such as acute toxicity or long-term toxicity upon repeated exposure, carcinogenicity.
The government recognizes the right of the people to a healthy environment. The City Government of San Fernando, La Union, contribute to the preservation and enhancement of the Philippine environment through its ordinances. These ordinances includes 2006-012, an ordinance amending City Ordinance No. 2003-007 otherwise known as an Ordinance providing for a Comprehensive Solid Waste Management in the City of San Fernando and for other purposes, and 2006-013, an ordinance enacting the environment code of the City of San Fernando, Province of La Union.
External and internal variables affects individual’s health and wellness, it may or may not predispose him to a developing disease. Those favorable or positive factors can lead somebody’s health to high level of wellness; on the contrary, those unfavorable factors could result to poor health.
In this study, the researchers considered the profile of the respondents of Barangay Mameltac in terms of their age, gender, occupation, and body mass index. The researchers also considered the effects of City Sanitary Landfill to the health of the respondents along with gastrointestinal, respiratory, and integumentary systems so as with their live conditions for the past five years. On the other hand, the health status of the residents of Barangay Mameltac and their present live conditions are considered as the dependent variables.

Statement of the Problem
This study aims to determine the Health Related Problems and the Living Conditions of the Residents of Barangay Mameltac along the proximity of the City Sanitary Landfill
Specifically, it seeks to answer the following questions:
1. What is the profile of the respondents in terms of:
1.1 Age
1.2 Gender
1.3 Weight
2. What is the prevalence of the Health Related Problems along the:
2.1 Gastrointestinal System
2.2 Respiratory System
2.3 Cardiovascular System
2.4 Reproductive System
3. What are the living conditions of the respondents in terms of:
3.1 Personal Hygiene
3.2 Health Maintenance
3.3 Household Chores
3.4 Rest and Sleep
3.5 Recreational Activities
Research Hypotheses
1. There are varying profiles among the respondents of Barangay Mameltac in terms of their age, gender, and weight.
2. Health related problems along the Respiratory System are the most prevalent.
3. The respondents has a healthy living conditions along the:
3.1 Personal Hygiene
3.2 Health Maintenance
3.3 Household Chores
3.4 Rest and Sleep
3.5 Recreational Activities






















Figure 1
Research Paradigm

Chapter 2
METHODS
Population and Locale of Study
The respondents for this study are the 43 selected households in Barangay Mameltac along the proximity of the City Sanitary Landfill. The respondents were chosen through some criteria. The proximity of the households to the City Sanitary Landfill is the following: the respondents are within 600 meters proximity North, within 150 meters proximity west, and 150 meters proximity east. These proximities were used since the researchers believed that respondents within this specified proximity may experience more accurately the health related problems that are related to the Sanitary landfill than those who reside far from the site. The researchers used the Slovin’s Formula to get the number of samples. Within the specified proximity to the Sanitary Landfill, the population is approximately 215 people. Using the Slovin’s Formula the researchers come up with 139 people as the respondents.

The Slovin's Formula (Pagoso, 1995) is:
n = N / (1 + Ne2 )
Where:
N = # of population
n = sample size
e = margin of error
Barangay Mameltac is 4.5 km away from the city proper. It is bounded on the north by Barangay Bato, on the east by Barangay Dallangayan Este, on the south by Barangay Dallangayan Oeste, and on the west by Barangay Biday. It has a land area of 94, 3132 hectares. Based on the latest census, the barangay is composed of 211 households with a total population of 1171. there are two schools situated at the barangay, the Barangay Mameltac Community School and Dr. Quintin Balcita National Highschool and a Day Care. They also have one Barangay Health Center .
Data Gathering Tools
In gathering data for this study, the researchers made used of a questionnaire that was validated and confirmed by the adviser and the defense panel as their main data gathering tool. In constructing the questionnaire, the researchers based it from books, and Internet sources related to the topic to come up with a supported and well understood questionnaire. The questionnaire comes in English version and was supported with an informal interview with the respondents to substantiate gathered data from the questionnaire. It was composed of 3 parts. The first part dealt with the profile of the residents along with their age, gender, and weight. The second part dealt with the prevalence of health related problems along the proximity of the City Sanitary Landfill. And the last part dealt with the living conditions of the respondents.
Data Gathering Procedures
This study focused on identifying the prevalence of health related problems and living conditions of the residents of Barangay Mameltac. These health problems will be limited only to the Gastrointestinal, Respiratory, Cardiovascular systems, and Reproductive System since these were the areas most commonly affected during an infectious process.
After the approval of the City Mayor, the researchers proceed to CENRO, then immediately advanced to the Local Government of Barangay Mameltac and asked permission to conduct a research in their barangay. After that, the researchers asked for the approval of the Dean of College of Nursing and finally pushed through to the target place and got acquainted with the respondents.
The respondents were initially briefed on the purpose of the study, they were interviewed and were given the questionnaire to fill up. The researchers guided and assisted the respondents on answering the questions.
Unfortunately, the researchers did not retrieved one hundred percent of their target but still proceed with the analysis and interpretation of the gathered results.
The researchers also gathered some data from the their Barangay Health Center about the incidence of commonly occurring disease in the barangay and these documents served as a basis in analyzing the actual effect of the City Sanitary Landfill to the health of the respondents.

Treatment and Analysis of Data
The following statistical treatments will be used to answer the specific problems of the study.
1. Frequency Distribution
This was used in the study to determine the responses of each category of the respondents, using a matrix table consisting of rows and column, frequency counts can be tabulated for the purpose of analysis and interpretation.
2. Percentage
Percentage was use to measure central tendencies in the study using the following formula:

P=___F___x 100
N
Where: P= Percentage
F= Frequency of Responses
N= Total of Respondents
For problem one, the filled up questionnaire about the profile of the respondents along with their age, gender and weight were treated with frequency counts and percentage distribution. For problems two and three, the researchers also made used of frequency counts and percentage distribution to show the prevalence health related problems of the respondents and the extent of their activities of daily living.


Chapter 3
Results and Discussions

This chapter presents the results, analysis and interpretation of data. Only 86% of the questionnaires were retrieved. Out of 139 population only 100 people respond to our interview and questionnaire. This is due to time constraints, lack of understanding about the purpose of the study and their fear of sharing information to the researchers. According to the respondents this will not help their lifestyles and personal problems. Though only 100 questionnaires were retrieved, the data collected were analyzed and given with interpretation.












Profile of the Residents of Barangay Mameltac along the Proximity of the City Sanitary Landfill

Table 1.1 Profile of the Respondents in terms of AgeTable1. Ages

Age
Frequency (f) Percentage (%)
60 y.o. above 5 5%
35-60 y.o. 23 23%
19-34 y.o. 42 42%
13-18 y.o. 24 24%
7-12 y.o. 6 6%
n=100


Table 1 shows that 42% of the respondents from Mameltac along the proximity of City Sanitary Landfill were aging 19-34 years old. This implies that most og the respondents were early adult(http://www.answers.com/topic/psychosocial-development?cat=health)








Table 1.2 Profile of the Respondents in terms of Gender
Gender Frequency (f) Percentage (%)
Male 58 58%
Female 42 42%
n = 100 100%

Table 1.2 presents the profile of the respondents in terms of their gender. It shows that the respondents have more males than females. It also shows that the distribution of respondents in terms of gender is slightly more males than females.













Table 1.3 Profile of the Respondents in terms of Weight
Weight (kg) Frequency Relative Frequency
70-91 1 1%
45-68 69 69%
Below 45 30 30%
n=100

Table 2 shows that 69% of the respondents' weight were ranging from 46-68 kg. This implies that majority of them have normal weight in relation to each height (http://www.weightcontroldoctor.com.au/uploads/Image/BMI.jpg)















Health Related Problems of the Residents of Barangay Mameltac along the Proximity of the City Sanitary Landfill.

Table 2.1 Prevalence of the Health Related Problems of the Respondents along the Gastrointestinal System
Frequency (f) Percentage (%)
1. Gastrointestinal System
1.1 Dry Mouth 31 31%
1.2 Vomiting 60 60%
1.3 Loss of Appetite 59 59%
1.4 Abdominal Pain 80 80%
1.5 Watery Stool 65 65%
1.6 Blood in the Stool 11 11%

Table 2.1 presents the prevalence of the Health Related Problems Respondents along the Gastrointestinal System. Abdominal pain got the highest percentage of 80% while Blood in the Stool got the lowest with 11% of the total respondents. These conditions presented in the table may indicate Gastritis which is one of the causes of morbidity in the barangay. As of 2007, 3 cases of Gastritis is reported. One study conducted in Vancouver, Canada revealed that garbage serves as a habitat for pathogens such as Shigella, E. coli and Salmonella that can cause gastrointestinal illnesses. Diarrhea, as manifested by watery stool and abdominal pain, is mainly caused by these microorganisms. (Pablo,2007)
Another study conducted in the Sanitary Landfill of Fresh Kills, in StatenIsland, New York revealed that 4 million gallons of leachate was being produced in the landfill per day. This leachate is one of the contaminants in a landfill. Groundwater samples were taken and the study showed that it is contaminated with leachates that contain Volatile Organic Chemicals (VOC). These chemicals include Benzene and Chloroform, both a human carcinogen, that has an effect to the gastrointestinal system. The study revealed that the groundwater near the landfill was contaminated by various Volatile Organic Chemicals. (http://k3power.org/docs/LandfillManual.pdf)
A study was conducted at Municipality of Olavarria Sanitary Landfill. The study revealed that the gastrointestinal diseases resulting from contaminated water are the biggest health problem facing the village population, affecting particularly the young and the elderly.(http://www.cleanairnet.org/lac_en/1415/article-59485.html)







Table 2.2 Prevalence of the Health Related Problems of the Respondents along the Respiratory System
Frequency (f) Percentage (%)
2. Respiratory System
2.1 Common Colds 96 96%
2.2 Shortness of Breath 35 35%
2.3 Cough 94 94%
2.4 Sore Throat 34 34%
2.5 Chest Pain 39 39%
2.6 Fever 74 74%

Table 2.2 presents the prevalence of the Health Related Problems Respondents along the Respiratory System. Colds ranks first followed by cough. These conditions may indicate Acute Respiratory Infections which has morbidity rate at Barangay Mameltac. According to the data of the Barangay Health Center of Mameltac, 53 cases of Acute Respiratory Infections is reported as of 2007.
The Respiratory tract is the most common entry and exit of pathologic agents. These infectious agents may be transmitted through droplets. Coughing as commonly experience by the respondents facilitates the discharge of secretions and foreign bodies that infect the Respiratory tract. (Reyala, et al.)
Leachates from the Sanitary Landfill once leaked out can cause health effects to the Respiratory System. Leachates from paints contains, lead, phenols, cadmium compounds and xylene that can cause respiratory disease such as pneumonia, dyspnea, cough and common colds. (Brooks, 2005)
Volatile Organic Chemicals from leachates such as Ethylbenzene, Tetrachloroethylene, Toulene, Tricholoroethylene has an effect to the respiratory system. (http://k3power.org/docs/LandfillManual.pdf)
Metals from leachates can also have a hazardous effect to the respiratory sytem, these toxic metals include Arsenic, Cadmium, Chromium, Lead and Nickel.(http://www.crtk.org/detail.cfm?docID=28&cat=industrial%20toxics) A study conducted in Minnesota revealed that inhalation of Lead and hexavalent chromium, such as chromate and chromate pigment production and chrome plating, are associated with respiratory disease and lung cancer. Nasal septum perforation and other respiratory effects have been reported among workers chronically exposed to hexavalent chromium compounds. (http://proteus.pca.state.mn.us/waste/listedmetals.html)
In some areas of the Philippines where their Sanitary Landfill is not properly maintained, the presence of respiratory tract infections is common. Conditions such as common colds, bronchitis, pneumonia, influenza and asthma affect the most vulnerable groups like the infants, young children and the elderly. (http://www.gaia.com)
According to some of the respondents, they usually smell foul odor from the Sanitary Landfill during rainy season. These maybe due to the fresh garbage collected and dumped to the Sanitary Landfill. Many people in Georgia, USA find the odors emitted from a landfill to be unpleasant. The landfill odors may be coming from sulfides, ammonia and certain NMOC's(Non-Methane Organic Compounds). This odor may also be produced by the disposal of waste such as manures and fermented grains. At extremely high concentrations, landfill gas exposure can cause eye irritation, headaches, nausea and soreness of the throat and nose. (http://health.state.ga.us/pdfs/hazards/LandfillGas.bro.pdf)



















Table 2.3 Prevalence of the Health Related Problems of the Respondents along the Cardiovascular System
Frequency (f) Percentage (%)
3. Cardiovascular System
3.1 Headache 91 91%
3.2 Dizziness 70 70%
3.3 Blurred Vision 30 30%
3.4 Nape Pain 28 28%
3.5 Facial Flushing 12 12%
3.6 Fatigue 46 46%

Table 2.3 presents the prevalence of the Health Related Problems Respondents along the Cardiovascular System. It shows that headache is the most prevalent among the six conditions presented. Headache together with dizziness may be related to some conditions such as cardiovascular disorders. One study revealed that Sanitary Landfill contaminants such as dust, vapors and toxic wastes can cause headache, dizziness and fatigue once ingested or inhaled. (Boucharlout, 1996) Another study revealed that inhaled Methane, a component of landfill gas can also cause headache and dizziness. (Brooks, 2005)
Lead has been shown to affect virtually every major organ in the body. The most sensitive organs appear to be the nervous system (particularly in children), the circulatory system and the cardiovascular system. http://proteus.pca.state.mn.us/waste/listedmetals.html
Volatile Organic Chemical such as Methylene Chloride has cardiovascular effects as well as blood disorders as shown in the study conducted at the Sanitary Landfill of Fresh Kills, in StatenIsland, New York. (http://k3power.org/docs/LandfillManual.pdf)
Data gathered from the Barangay Health Center of Mameltac showed that the leading cause of mortality is Cardiopulmonary Arrest.
















Table 2.4 Prevalence of the Health Related Problems of the Respondents along the Reproductive System
Frequency (f) Percentage (%)
4. Reproductive System
4.1 Strong Urge to Urinate 17 17%
4.2 Burning Sensation when Urinating 29 29%
4.3 Blood in the Urine 2 2%
4.4 Foul Smell in the Urine 4 4%
4.5 Dark/ Cloudy Urine 15 15%
4.6 Swelling in the Perineal Area 0 0%

Table 2.4 presents the prevalence of the Health Related Problems Respondents along the Reproductive System. Among the six conditions presented, 29% of the respondents experienced Burning Sensation when urinating. These conditions may indicate a more serious reproductive system problems such as Urinary Tract Infection. UTI is caused by microorganism that infects the urinary tract such as Escherichia coli and Staphylococcus saprophyticus. Barangay Mameltac has 15 cases of UTI as of 2007. This UTI can be due to some risk factors such as unhealthy lifestyle, aging and gender. Women have higher risk to acquire UTI because of short urethra. (Lemone and Burke, 2004)
Chromium a metal found in leachates also has an effect to reproductive system as revealed in the study conducted at Minnesota, USA. (http://k3power.org/docs/LandfillManual.pdf.). One chemical that is found on leachate is the lead. Lead can cause serious problem regarding with the reproductive system and the developmental growth of a fetus. Maternal lead stored readily cross the placenta, placing the fetus at risk. Lead affects not only the viability of the fetus, but development as well. Developmental consequences of prenatal exposure to low levels of lead include reduced birth weight and premature birth. On the other hand the effects of lead on the male reproductive system in humans have not been well characterized. The available data support a tentative conclusion that testicular effects, including reduced sperm counts and motility. (http://wonder.cdc.gov/wonder/prevguid/p0000017/p0000017.asp)







Living Condition of the Residents of Barangay Mameltac along the Proximity of the City Sanitary Landfill

Table 3.1 Living Condition of the Respondents in terms of Personal Hygiene
Frequency (f) Percentage (%)
1. Personal Hygiene
1.1Handwashing before and after eating meals 97 97%
1.2 Brushing the teeth 94 94%
1.3 Wearing of foot wears 94 94%
1.4 Taking a bath everyday 94 94%
1.5 Wearing of Clean Clothes 97 97%
n = 100 100%

Table 3.1 presents the living conditions of the respondents in terms of personal hygiene. This shows that 97% of the respondents are washing before and after eating meals and wearing clean clothes. Hand washing is the single most effective way to prevent spread of disease and infection. Frequent hand washing takes away germs that are picked up from other people, from contaminated surfaces, from waste materials and from animals. (http://environmentalhealthandsafetyoffice.dal.ca/radiatio_5324.html). While brushing teeth after eating meals, wearing of foot wears and taking a bath has a 94% which means that most of all the respondents are aware on importance of proper personal hygiene and the benefits that it can brought to the health of the respondents. Like in brushing the teeth it is the single best way to remove harmful plaque, a thin, sticky film of bacteria from teeth and gums. (http://www.hopkinshospital.org/health_info/ENT/Reading_Room/brushing.html)














Table 3.2 Living Condition of the Respondents in terms of Health Maintenance
Frequency (f) Percentage (%)
2. Health Maintenance
2.1 Eating meals three times a day 73 73%
2.2 Eating Nutritious food 86 86%
2.3 Taking Vitamins 62 62%
2.4 Regular Exercise 44 44%
2.5 Regular Check-up to the Health Center 65 65%
n = 100 100%
Table 3.2 presents the living conditions of the respondents in terms of the health maintenance. It reveals that 86% of the respondents eat nutritious food whereas 73% of the respondents eat meals 3 times a day. It implies that the respondents give importance to the daily food intake to restore used energy and prevent the occurrence of any illness. Eating nutritious foods can also help reduce the risk for chronic diseases, such as heart disease, certain cancers, diabetes, stroke, and osteoporosis. Eating right can also reduce the risk of obesity, high blood pressure, and high blood cholesterol, which increase the rate of acquiring such diseases. (http://www.cfs.purdue.edu/safefood/nutrition/importance.html)
Table 3.3 Living Condition of the Respondents in terms of Household Chores
Frequency (f) Percentage (%)
3. Household Chores
3.1 Cleaning the house and the backyard 54 54%
3.2 Washing of clothes 54 54%
3.3 Cooking of food 60 60%
3.4 Washing of Dishes 48 48%
3.5 Going to work or job 54 54%
n = 100 100%

Table 3.3 presents the living condition of the respondents under household chores. The table shows that 60% of total respondents prioritize cooking foods. Foods contain essential nutrients needed by the body which is converted to as energy. 54% of the total respondents clean the house and the backyard. Cleanliness reduce risk for the spread of microorganisms that may cause health related problems such as cough and colds. Clean environment can help the fast recovery of a sick person.



Table 3.4 Living Condition of the Respondents in terms of Rest and Sleep
Frequency (f) Percentage (%)
4. Rest and Sleep
4.1 Sleeping at least 8 hours per day 49 49%
4.2 Taking a nap 88 88%
4.3 Watching TV 88 88%
4.4 Listening to radio 87 87%
4.5 Reading newspapers, magazines etc 85 85%
n = 100 100%

Table 3.4 presents the living conditions of the respondents in terms of rest and sleep. It shows that only 49% of the respondents have at least 8 hours of sleep a day. Adequate rest and sleep helps the body to repair and restore the bodies normal function. However, almost half of the respondents have difficulty sleeping. This condition may be referred to as Insomnia. Predisposing factor such as their lifestyles, as shown in the table, 88% of the respondents during the interview stated that they stay up late at night watching television thus affecting their sleeping pattern. Difficulty of sleeping can also be related to their environment. Since the respondents are within the proximity of the Sanitary Landfill, the continuous dumping of garbage of garbage trucks making the environment too noisy and not conducive for sleep and rest. Medical research confirms that adequate rest and sleep are absolutely required for the heart, arteries, blood sugar, immune system, skin to have a normal functioning. During the day, the bodies are in a breakdown mode. This means that, as a general rule, we are using up our energy and our bodies faster than they are rebuilding. This reverses at night, when our bodies are able to rebuild during rest and sleep. If we do not allow enough time to rest and sleep, the rebuilding process is impaired until it will eventually cause premature aging, disease and early death. Research found out that not getting enough sleep and rest increased accidents, problems concentrating, poor performance on the job and in school, and possibly, increased sickness and weight gain.(http://www.mormonchic.com/healthy/sleep.asp)











Table 3.5 Living Condition of the Respondents in terms of Recreational Activities
Frequency (f) Percentage (%)
5. Recreational Activities
5.1 Quality time with family members 79 79%
5.2 Playing basketball or any sports 46 46%
5.3 Going out with friends or other relatives 53 53%
n = 100 100%

Table 3.5 presents the living conditions of the respondents in term of recreational activities. Quality time with family members have the 79% of the total number of respondents which signifies that most of the respondents want to spend a quality time together with there family members despite of an illness. This shows how important the ties between families are. Almost half of the respondents want to hang out with friends or going out with other relatives and some of the respondents engaged there selves in playing basketball which is a very good example of a recreational activity.



Chapter 4
CONCLUSION AND RECOMMENDATION
This chapter presents the general summary of findings, conclusions and recommendations.

Summary of Findings
The pertinent findings of this study are the following:
1. The findings with regard to the resident’s profile are as follows: in terms of age most of the respondents are adolescents and early adults. The respondents are within the active years of their life; in terms of their gender the difference between male and female respondents is not that significant which implies that the respondents are equally distributed with regards to gender; in terms of height most of the respondents have heights that are within normal in relation with their age and weight; and in terms of weight the respondents have normal weights in relation to their age and height.
2. The health related problems of the residents of Barangay Mameltac along with the gastrointestinal system; most of the residents within the proximity experienced abdominal pain. Under Respiratory System, almost all of the residents had experienced cough and colds. However, under Cardiovascular System, majority of them suffered from headache. Lastly, under Reproductive System, it revealed that burning sensation when urinating was the most prevalent condition.
3. The living conditions of the residents of Barangay Mameltac along the proximity of the City Sanitary landfill are as follows; along with the personal hygiene, almost all of the respondents wash their hands before and after eating meals and also wear clean clothes; along with the health maintenance, eating nutritious food is the priority in sustaining a healthy condition of living; along with the house hold chores, more than half of the respondents are able to cook there food; along with the rest and sleep almost all of the respondents able to take a nap, watching television, listening to radio, reading newspapers and magazines, but some of them are not able to sleep at least 8 hours per day; along with recreational activities spending quality time with family members was given the highest consideration.

Conclusions
Based on the findings of this study, the following conclusions were drawn:
1. The profile of the respondents in terms of weight and height are within the normal range in relation to their age. With regards to their gender, the males and females are equally distributed.
2. The most prevalent health related problems experienced by the residents of Barangay Mameltac along the proximity of the City Sanitary Landfill is along the Respiratory System. It supports the high morbidity rate of Acute Respiratory Infections in the barangay.
3. The respondents have commendable living conditions. They are aware of the importance of maintaining and performing a healthy lifestyle.

Recommendations
The following recommendations are given based from the study’s findings and conclusions.
1. For the future researchers, the same range in terms of the age, gender, height and weight of the respondents should be taken in order to have an accurate comparative view of present and future researches.
2. Educate the residents as well as the barangay health worker with regards to the importance of hygienic practices. It contribute much to the prevention of the disease occurrence especially with the extreme prevalence of respiratory diseases.
3. The respondents of Barangay Mameltac should maintain a healthy conditions along with their personal hygiene,health maintenance,etc .by instructing them not to neglect the said practices.









Bibliography
BOOK SOURCES:
Lemone, Priscilla and Burke, Karen M. Medical Surgical Nursing Vol. 1 and 2
INTERNET SOURCES:
http://www.answers.com/topic/psychosocial-development?cat=health
http://www.atsdr.cdc.gov/HAC/landfill/PDFs/Landfill/2001_ch3.pdf
http://www.cfs.purdue.edu/safefood/nutrition/importance.html
http://www.cleanairnet.org/lac_en/1415/article-59485.html
http://concernedcitizens.homestead.com/epa_on_hap_in_lfg.html
http://www.crtk.org/detail.cfm?docID=28&cat=industrial
http://environmentalhealthandsafetyoffice.dal.ca/radiatio_5324.html
http://www.gaia.com/Greenpeace/Manila.htm
http://www.gmanews.tv/story/63908/Garbage-crisis-in-Metro-looms-MMDA-urged-to-find-new-dumpsite-soon
http://health.state.ga.us/pdfs/hazards/LandfillGas.bro.pdf
http://www.hopkinshospital.org/health_info/ENT/Reading_Room/brushing.html
http://k3power.org/docs/LandfillManual.pdf
http://www.mormonchic.com/healthy/sleep.asp
http://msucares.com/health/health /appa1.htm
http://www.nhlbisupport.com/bmi/
http://www.panna.org/resources/gpc/gpc_200212.12.3.13.dv.html
http://proteus.pca.state.mn.us/waste/listedmetals.html
http://seagrant.uaf.edu/nosb/papers/2004/selawik-landfills.html
http://www.state.ak.us/dec/deh/POPs.htm
http://www.state.ak.us/dec/dsps/compass/7pdf
http://www.state.ak.us/dec/dsps/compasst/7generations/09p133-136.pdf
http://www.weightcontroldoctor.com.au/uploads/Image/BMI.jpg
http://wonder.cdc.gov/wonder/prevguid/p0000017/p0000017.asp


























QUESTIONNAIRE


Health Related Problems Affecting
the Living Conditions of the Residents of
Barangay Mameltac along the Proximity of the City Sanitary Landfill


I. Profile of the Respondents
Name (Optional):
Gender:
Age:
Weight: kg.



II. Prevalence of the Health Related Problems of the Respondents
Instruction: Check (√) the disease that you have encountered or experienced in terms of the following:

1. Gastrointestinal System: (√)
1.1 Dry Mouth
1.2 Vomiting
1.3 Loss of Appetite
1.4 Abdominal Pain
1.5 Watery Stool
1.6 Blood in the Stool

2. Respiratory System:
2.1 Common Colds
2.2 Shortness of Breath
2.3 Cough
2.4 Sore Throat
2.5 Chest Pain
2.6 Fever

3. Cardiovascular System
3.1 Headache
3.2 Dizziness
3.3 Blurred Vision
3.4 Nape Pain
3.5 Facial Flushing
3.6 Fatigue

4. Reproductive System:
4.1 Strong Urge to Urinate
4.2 Burning Sensation when Urinating
4.3 Blood in the Urine
4.4 Foul Smelling Urine
4.5 Dark / Cloudy Urine
4.6 Swelling in the Perineal area


III. Living Conditions of the Respondents

Instruction: Check (√) those activities that you are doing regularly.

1. Personal Hygiene
1.1 Washing Hands before and after eating meals.
1.2 Brushing your teeth after eating meals.
1.3 Wearing of foot wears.
1.4 Taking a bath everyday.
1.5 Wearing of clean clothes.
Others (Please Specify)
2. Health Maintenance
2.1 Eating meals 3 times a day.
2.2 Eating nutritious food.
2.3 Taking vitamins.
2.4 Regular Exercise.
2.5 Regular Check-up to the Health Center.
Others (Please Specify)
3. Household Chores
3.1 Cleaning of the house and backyard.
3.2 Washing of clothes.
3.3 Cooking of foods.
3.4 Washing of Dishes.
3.5 Going to work or job.
Others (Please Specify)
4. Rest and Sleep
4.1 Sleeping at least 8 hours per day.
4.2 Taking a nap.
4.3 Watching television.
4.4 Listening to radio.
4.5 Reading Newspapers, magazines etc.
Others (Please Specify)
5. Recreational Activities
5.1 Quality time with the family members.
5.2 Playing basketball or any sports.
5.3 Going out with friends or other relatives.
Others (Please Specify)

Wednesday, June 11, 2008

NEPHROLITHIASIS

NEPHROLITHIASIS
Nephrolithiasis is another name for kidney stones. Kidney stones are also called renal calculi. These are rock-like pieces that are about the size of a grain of sand. They form most often in the kidneys and get stuck in the ureter. It is caused when water and waste crystals in the urine are out of balance. They can form when the urine contains too much of certain substances namely uric acid, calcium, or phosphate which eventually separate from the urine. Instead of going out of the body in the urine, the crystals build up. These small crystals later become stones and block the flow of urine and cause pain. A person with such condition may have more than one stone.
Kidney stones may not produce symptoms until they begin to move down the ureter, causing pain. Pain is its most common sign which basically comes on suddenly. It may come and go and is usually severe and often starts in the flank region, then moves down to the groin. Blood in the urine may also be seen, which will look pink or red accompanying difficult and painful urination. Other manifestations include feeling sick to the stomach (nausea) and throwing up (vomiting). Fever and chills may also be present once the stones have already caused an infection.
Oftentimes, nephrolithiasis can be treated at home and the stone will pass on its own. If the stone does not pass, then hospitalization may be sought and it may need to have surgery to remove it. Among the surgical procedures used in the removal of kidney stones were Ureteroscopy, Percutaneous Nephrostolithotomy, Ureteroscopic Stone Removal and Open Surgery. Or in some cases, lithotripsy (a medical procedure that uses shock waves to break up stones that form in the kidney, bladder, ureters, or gallbladder) may be performed to break it apart. Urine and probably, blood will then need to be tested. Other diagnostic tests may include x-ray, called an IVP (Intravenous Pyelogram), and ultrasound to look for the stone.
Men get kidney stones more often than women. Kidney stones occur mostly in people 20 to 60 years old. But they can happen to anyone at any age.
The prevalence of nephrolithiasis varies according to its form as determined by the waste crystal that has precipitated such condition. Calcium stone disease is the most common form of nephrolithiasis and represents about 70% of all stone-forming disease. It occurs most often in the third to fifth decade of life, more often in men than women. Uric acid stone disease is found in about 5% to 10% of stone formers. It is more common in patients with chronic diarrheal disorders and in those with hyperuricosuria (excretion of excessive amounts of uric acid in the urine). Infection stones, also known as struvite or magnesium ammonium phosphate stones occur in about 10% to 12% of patients, more often in women. They occur more often also in patients with spinal cord injury, neurogenic bladder, vesicoureteral reflux, chronic indwelling Foley catheters, and recurrent urinary infections, and in those with chronic obstruction of the upper urinary tracts.
The overall probability of forming stones differs in various parts of the world: 1-5% in Asia, 5-9% in Europe, 13% in North America, 20% in Saudi Arabia. The composition of stones and their location in the urinary tract, bladder or kidneys may also significantly differ in different countries. Moreover, in the same region, the clinical and metabolic patterns of stone disease can change over time. Some epidemiological evidence about the main risk factors for stone formation, both individual and environmental has been examined. And it has been found out that a slightly higher rate of renal stone disease emerged in males than in females, and in white Caucasians than in Blacks. Stones in the upper urinary tract appear to be related to the lifestyle, being more frequent among affluent people, living in developed countries, with high animal protein consumption. Bladder stones are nowadays mainly seen in the Third World, on account of very poor socio-economic conditions. A high frequency of stone formation among hypertensive patients has been reported, and among those with high body mass as well. There is no evidence of any rise in the risk of stone formation in relation to dietary calcium intake.
Older data estimated that 12 percent of men and 5 percent of women will have at least one symptomatic stone by the age of 70; over 80 percent of these stones will contain calcium, usually as calcium oxalate. The prevalence of kidney stones, however, appears to be increasing in the United States. In a report from the Third National Health and Nutritional Examination Survey, the prevalence increased from 3.8 to 5.2 percent in the period 1976 to 1980 compared with 1988 to 1994, respectively. Furthermore, the male to female ratio has changed over the past 25 years, from 3:1 (male:female) to now less than 2:1. Whether this represents an actual increase in incidence or an increase in detection is uncertain.
The prevalence of nephrolithiasis varies regionally. In one study of over 40,000 men between the ages of 45 and 70, the risk of having a history of kidney stones was 13 and 31 percent lower in the mid-Atlantic and northwestern regions compared to the southeastern United States. A second study confirmed this regional variation, but found that differences were greatly reduced after adjustment for temperature, sunlight, and beverage consumption.
The rate of nephrolithiasis increases with age, is slightly higher in men compared to women, and in whites compared to blacks. Hispanics and Asians are at intermediate risk. It has been estimated that 7 to 10 of every 1,000 hospital admissions are due to stones.


Nephrolithiasis Treatment and Management
Treatment should consist of high fluid intake and dietary sodium restriction. Remaining well-hydrated and keeping the urine dilute will help prevent kidney stones from forming.
Besides advising patients to avoid excessive salt and protein intake and to increase fluid intake, base medical therapy for the chronic chemoprophylaxis of urinary calculi on the results of a 24-hour urinalysis for chemical constituents.
Dietary calcium restriction is not advised because of the potential for negative calcium balance and because a low calcium diet increases gastrointestinal absorption of oxalate and increased oxaluria (presence of oxalic acid in the urine).
Since the solubility of uric acid is greatly increased when urine pH is raised, treatment should consist of alkalinization of urine to pH >6.5 with potassium citrate solution, 30 to 90 mEq per day in divided doses, and by hydration. This treatment has been shown to reduce uric acid stones by 90%. Such treatment, given to a patient with small stones in the kidneys, may also result in dissolution of the stones.
Uric acid and cystine calculi can be dissolved with medical therapy. Patients with uric acid stones who do not require urgent surgical intervention for reasons of pain, obstruction, or infection can often have their stones dissolved with alkalinization of the urine.
Alkalinization of the urine with sodium bicarbonate or sodium citrate is not recommended because the sodium salts will increase calcium excretion and increase the tendency to form calcium oxalate stones.
Therapy must eradicate the urinary infection. Since the stones themselves are frequently infected with bacteria, the urinary infection cannot be eradicated without removing the stones as well. Thus, surgical removal of the stones accompanied by appropriate antibiotic therapy is necessary.
Obstruction in the absence of infection can be initially managed with analgesics and with other medical measures to facilitate passage of the stone. Infection in the absence of obstruction can be initially managed with antimicrobial therapy.
If both obstruction and infection are present, emergent decompression of the upper urinary collecting system is required.
Ibuprofen can be used as an anti-inflammatory agent, and if further pain medication is needed, contacting the primary care provider may allow stronger narcotic pain medication to be prescribed.
The calcium channel blocker nifedipine relaxes ureteral smooth muscle and enhances stone passage.
Urinary calculi composed predominantly of calcium cannot be dissolved with current medical therapy; however, medical therapy is important in the long-term chemoprophylaxis of further calculus growth or formation.