Lesson 3 Non-communicable diseases

Non-communicable diseases are not transmitted.

Can occur due to the:

  • genetic background (eg. thalassemia)
  • environmental exposure (eg. lung cancer)
  • unhealthy behaviors (eg. obesity).

➔Genetic background plays a significant role in most non-communicable diseases. Your genetic background refers to your DNA.

➔Some other diseases are caused by substances in your surrounding environment will be briefly mentioned here, but if you want more information, you can visit module 1.

Daily behaviors can cause or increase risk of a non-communicable disease.

This disease might not have been developed otherwise or might have developed later in your life.

  • Inadequate sleep and rest
  • Physical inactivity
  • Unhealthy diet
  • Smoking
  • Substances abuse
  • Poor dental hygiene

In this unit, we are going to discuss the most common health behavior-resulted diseases that a municipal urban cleaner may face or may develop at some point of his/her life.

Cardiovascular diseases

Cardiovascular diseases (heart diseases), are conditions that affect the heart and blood vessels.

We will discuss conditions that may

  • increase the risk of suffering from more severe cardiovascular diseases
  • consist a severe immediate threat to your life

The conditions that can influence your health and increase the risk of suffering from cardiovascular diseases are:

high blood pressure


high blood sugar levels

Hypertension or high blood pressure

affects about one in three adults.

  • Hypertension is often referred to as the “silent killer,” as it may not present warning signs and symptoms.
  • Hypertension can be controlled with proper medication, a healthy diet, exercise, and other factors such as proper sleep, moderate alcohol consumption, and smoking cessation.

If hypertension remains untreated, it can increase the odds of suffering from:

  • heart attack
  • heart failure
  • chest pain
  • even non-heart-related diseases such as diabetes or obesity

Hyperlipidemia (or high blood lipids) refers to abnormally elevated levels of lipids in the blood (LDL, HDL, Cholesterol, Triglycerides – TG).

  • You should monitor these factors on a regular basis.
  • Hyperlipidemia can increase the odds of suffering from cardiovascular diseases and therefore can result in heart disease or stroke.
  • To prevent it, the most important behaviors are a healthy diet, exercise, tobacco cessation, medical consultation, and, when needed, following your medication plan.

Make healthy choices to help keep these indicators under control.

  • Elevated blood sugar levels, or hyperglycemia, is a risk factor for many cardiovascular diseases
  • Our blood contains sugar, which is distributed to all organs to provide energy.
  • Hyperglycemia is the main problem in diabetes, a disease that will be presented in detail later in this module.

Heart diseases

  • Main causes: unhealthy diet, physical inactivity, excess weight, tobacco use, and excess alcohol consumption
  • Heart diseases are no joke— about one in three deaths globally are caused by heart diseases.
  • 85% of these deaths are caused by a stroke or a heart attack.
  • A stroke occurs when the blood supply to a part of the brain is shut off
  • A heart attack occurs when a part of the heart does not get enough blood

Heart attack

  • Chest pain or discomfort
  • Feeling weak, light-headed, or faint
  • Pain or discomfort in the jaw, neck, or back
  • Pain or discomfort in one or both arms or shoulders
  • Shortness of breath


  • Sudden numbness/weakness in face, arm, or leg, especially on one side
  • Sudden confusion, trouble speaking, or difficulty understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, balance loss, or lack of coordination
  • Sudden severe headache with no known cause

If any of these symptoms appear, it is important to contact your personal physician or occupational physician, or visit a healthcare facility immediately


Anaemia has a set of common symptoms:

  • Weakness
  • Shortness of breath
  • Dizziness
  • Fast or irregular heartbeat
  • Pounding or “whooshing” in your ears
  • Headache
  • Cold hands or feet
  • Pale or yellow skin
  • Chest pain

The most common type of anaemia is caused by iron deficiency. This can occur if you do not consume enough iron.

To tackle iron deficiency, you should eat more iron-rich foods and take iron supplements, if your doctor advises you to do so (see unit 4).

An unjustifiably tired worker

  • Meet John!
  • He is a municipal urban cleaner. In the last three months, he is constantly feeling tired. He says that in the past, his work did not feel this tiring. He says that he feels too weak to do everyday tasks and needs to rest every 50 meters that he walks before continuing. But he still manages to do complete his work. Sometimes he says that he might feel shortness of breath and some dizziness or lightheadedness that did not happen in the past.
  • There may be times that you feel like John. And the causes of this fatigue might be numerous, ranging from concerns with your mental health or even some very serious conditions.
  • What should John do?
  • John should not self-diagnose! He might have anemia, or he might not. But he can find out…
  • Ideally, the first thing that should come to John’s mind is to visit a doctor!
  • At first, he should address to the occupational physician provided by his employer and/or seek advice by his family doctor.
  • Searching online for his symptoms is neither suggested nor prohibited, as long as the source is trusted. But… the doctor who will examine him will surely know best how to proceed (more than an online source)! After all the doctor is responsible for monitoring his health after any medical intervention.

Diabetes affects about 1 in 10 people.

  • Type 1 diabetes is attributed to your DNA and develops in childhood.
  • Type 2 diabetes is often caused by unhealthy diet (especially sugar), excess weight, inactivity, family history, and conditions that can influence blood sugar.

The common characteristic of diabetes is the inability of the body to control the levels of blood sugar. This can cause hyperglycemia (high blood sugar) or low blood sugar, which causes weakness, fainting, or more severe symptoms.

Uncontrolled or constantly high blood sugar levels can cause eye or foot problems, heart attack or stroke, kidney conditions, nerve damage, or cancer.

There is no cure for diabetes, but there are actions that you can take to control your blood sugar.

A healthy lifestyle (including healthy diet and sleep) and sticking to your advised medication (insulin for type 1, and other medication for type 2), are the first course of action to control diabetes.

By controlling your blood sugar, you can not only prevent the unfavorable consequences of diabetes, but can also prevent type 2 diabetes from occurring in the first place. Your doctor is responsible for guiding you and should be trusted!

Having excess weight may not have significant effects on your health at first, but it can certainly be a concern for the future.

Excess weight can negatively impact your daily work and your social life.

Having excess weight for your height is characterized as being overweight. If this weight is significantly higher, it is called obesity.

In Europe, about half of adults have excess body weight!

BMI (Body Mass Index) is a great tool to check if you are overweight or obese. You just need to know your weight and height. You can calculate your BMI using this online based tool: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi-m.htm

Obesity can increase the risk of a variety of diseases and conditions, namely:

High blood pressure, high cholesterol, LDL and triglycerides with low HDL, type 2 diabetes, stroke, heart disease, sleep apnea, mental illness, many types of cancer, and more.

Obesity can interfere with your daily activities and impact your social life.

While the consequences of obesity are numerous, you should remember that, in most cases, obesity is preventable with a proper diet and frequent physical activity.

Cancer, tumors, or neoplasms simply refer to diseases that can affect parts of your body (breast, lung, colon or rectum, skin,stomach, etc.) due to rapid abnormal growth and multiplication of your own cells. These growths can affect many bodily functions and potentially spread to other organs in your body. This spread is called metastasis, a common cause of death from cancer.

You might ask: how does your own cells lose control?

  • Carcinogens. Carcinogens are factors that can increase the chance of developing cancer. They can be categorized into three groups: physical carcinogens (ultraviolet and ionizing radiation), chemicals (substances found in tobacco, alcohol, food contaminants, arsenic, etc.), and biological (infections caused by microorganisms).

Minimizing exposure to this factors can reduce the chances of cancer!

How can we prevent or delay cancer?

A healthy lifestyle! This includes a healthy diet, exercising, avoiding abusing alcohol, avoiding exposure to pollution and radiation, getting immunized, and, most importantly, avoiding smoking.

What happens if I do get cancer?

An early diagnosis can not only prevent metastasis and save many years of your life, but can also allow you to treat this disease and live as long as everyone else! Treating the disease in later stages is more difficult. So, make sure to attend the regular check ups that the doctor advises you to do. Sreening tests for cancer are very important and some of them are: Pap test, mammography, colonoscopy, etc. Your doctor will advise you which you need to do and when.

Lung cancer affects your lungs and can eventually spread to other organs. It is the second most common cancer after breast cancer, and it is the leading cause of cancer-related death.

Although this disease mostly appears in older age, early cigarette exposure can increase the chance of lung cancer appearing earlier in life.

For MUCs, occupational exposure (i.e. asbestos, diesel engine exhausts and air pollution) can also cause lung cancer.

Respiratory diseases are conditions that affect the organs that are involved in breathing. For more information on respiratory diseases visit page 23 of the supporting document.

For information regarding chronic kidney disease, visit page 24 of the supporting document.

For information regarding liver diseases visit page 24 of the supporting word document.

Remember that both chronic kidney disease and liver diseases can be prevented maintaining proper hygiene around your workplace, having a healthy lifestyle and doing regular screening!

  • Includes “injuries to the bones, muscles, nerves, tendons, joints, cartilage, and spinal discs”
  • To put it simply, they are conditions that affect your muscles, bones, and movement
  • They can significantly hinder your mobility and dexterity and may lead to early retirement.
  • Musculoskeletal disorders caused or worsened by working conditions are called work-related musculoskeletal disorders
  • To prevent these disorders, avoid or minimize doing the movement that may cause it. Practices such as job rotation (changing your tasks regularly), teamwork, and use of ergonomically friendly equipment can help avoid them.

Back pain is the most common musculoskeletal pain and can be caused by lifting, carrying, pushing, pulling, or dragging heavy loads, doing repetitive tasks, crouching, remaining in a certain position for a while, and poor posture.

Other musculoskeletal disorders include:

  • Carpal tunnel syndrome (pain on wrist, numbness, burning sensation, and swelling)
  • Cramps on upper limbs (shoulders, arms, wrists, hands, fingers, and neck)
  • Upper limb disorders (limit your movements)
  • Osteoporosis (poor bone health)
  • Osteoarthritis (severe joint pain, stiffness, and problems in moving your joints)

For more information on musculoskeletal disorders please visit page 24 of the supporting document.

  • Contact dermatitis
    Contact dermatitis (or allergic dermatitis) is an infection of the skin, caused by the frequent use of hand hygiene products, exposure to chemicals and glove use.
  • This is a condition you might encounter— it is more common among Municipal Urban Cleaners than other professions.
  • Irritant dermatitis causes dry, irritated, and itchy areas of skin around the point of contact.
  • Allergic dermatitis has more severe symptoms, visible as a rash developed hours after the contact with the chemical, accompanied with the symptoms of irritant dermatitis.
  • To prevent contact dermatitis, use basic protective and hygiene related measures.
  • If you get contact dermatitis, avoiding contact with an allergen and in some cases pharmaceutical therapy can fight the symptoms.

Mental health refers to our emotional, physiological, and social well-being.

Is speaking about your mental health at your workplace a taboo? NO!

You should never underestimate mental health’s importance.

  • If you find mental health interesting as a topic, please visit module 5.