Chapter 6

Environmental Health

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 Objectives
 Explain how the environment influences human
health and disease.
 Know which disciplines work most closely with
nurses in environmental health.
 Describe legislative and regulatory policies that
have influenced the effect of the environment on
health and disease patterns.
 Describe the skills needed by nurses practicing
in environmental health and apply the nursing
process to the practice of environmental health.

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 Introduction
 Healthy environment is essential for optimal
health and health care.
 We often take the environment for granted and
may fail to see the hazards in front of us.
 We get chemical, biological, and radiological
exposures that affect our health in the air we
breathe, the water we drink, the food we eat,
and the products we use.
 ANA Scope and Standards for Environmental
Health (2007)

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 Historical Context
 Florence Nightingale: Crimean War
 Mary Brewster: Henry Street neighborhood
 Environmental contamination
 Poverty and exposure to environmental hazards

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 Environmental Health Sciences
 Toxicology
 Epidemiology
 Epidemiology triangle
 Geographic information systems (GIS)
 Competencies

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Environmental Health Assessment
 Air (indoor/outdoor), water, land, or food
 Chemical, biological, or radiological
 Environmental health assessment
 “I PREPARE”
 Windshield survey
 Environmental databases
 Environmental health assessment form
 Inquire/observe about unintended environmental
exposures

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Environmental Health Assessment
 The Right to Know Laws
 Consumer confidence report (CCR)
 Material Safety Data Sheet (MSDS)

 Risk Assessment
 Point source
 Nonpoint source
 Assessing Risks in Children
 Children
 Pregnant women

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 Reducing Environmental
Health Risks
 Apply the basic principles of disease prevention
 Risk Communication
 Ethics
 Governmental Environmental Protection

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 Advocacy
 Nurses have responsibilities to be informed
consumers and to be advocates for citizens in
their community regarding environmental health
issues

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 Environmental Justice and
Environmental Health Disparities
 Environmental Health disparities
 Environmental Justice:
 1993 Environmental Justice Act
 1994 Executive Order 12898, Federal Actions to
Address Environmental Justice in Minority
Populations
 2012 Environmental Justice Strategy and
Implementation Plan

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 Unique Environmental Health
Threats in the Health Care Industry
 Mercury
 Synthetic chemicals
 Persistent bioaccumulate toxins (PBTs)
 Persistent organic pollutants (POPs)
 Dioxin

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 Unique Environmental Health Threats
in the Health Care Industry and
Advocacy
 Health Care Without Harm campaign
 ANA

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 Referral Resources
 No single source of information about environmental
health is available, nor is there a single resource to
which individuals or a community can be referred if
they suspect an environmental problem.
 Starting points
 The environmental epidemiology unit or toxicology unit of
your state health department or environmental agency
 Environmental health experts in nursing or medical
schools, or schools of public health
 Association of Occupational and Environmental Clinics

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 Roles for Nurses in
Environmental Health
 Assessment
 Referral
 Community involvement and public participation
 Risk communication
 Epidemiologic investigations
 Policy development

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