Ch #9: Environmental Health and Safety

Five things Florence Nightingale believed health depends on from the environment are…?

1. Clean air

2. Clean water

3. Safe food

4. Control of noise

5. Exposure to light

Occupational/Environmental Nurses - Original Role

• Assessment of workers

• Ensure worker safety

• Prevent adverse health effects

Occupational/Environmental Nurses - Current Role

• Certification available in the following areas via the OHN

  • Toxicology

  • Epidemiology

  • Workplace hazards

  • Regulations

  • Prevention strategies

Healthy People 2030 - Environment Objectives

Healthy People 2030 - Environment Objectives

Hazardous Materials - Definition

• Includes exposure from air, food, and soil

Disasters and Climate Change - Definition

• Natural and human-caused disasters, built environment, and climate change

Deforestation - Definition

• Rise in development leading to significant reduction in trees and forests

Synthetic Chemicals - Definition

• Use of chemicals that have not been well tested for safety in variety of products

Ecosystem - Definition

• Dynamic communities of plants, animals, microorganisms, and the nonliving environments in which they live

• CAN NOT EXIST OUTSIDE OF

What do ecosystems provide?

• Regulation of water, gases, waste, recycling, nutrient cycling, pollination, infectious disease, climate, and biology

• Recreational and cultural opportunities for human use

Sustainability - Definition

• Human beings and natural environment must coexist harmoniously for survival

With sustainability, humans have to consider the following needs?

• Food and fuel limitations

• Protection of environment

• Promotion of health characteristics in population

Sustainable Development Goals - Definition

• Global goals identifying need to care for natural and built environments

• Developed by the United Nations

Nurses role in the environment is …?

• “The registered nurse practices in an environmentally safe and healthy manner”

Nurses have the responsibility to …?

• Detect unusual health patterns

• Response to environmental emergencies

Upstream Focus

Health Disparities - Definition

• Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experience by socially disadvantages populations

Social Determinants of Health - Definition

• Conditions in which people are born, grown, live, work, and age

• Shaped by distribution of money, power, and resources at global, national, and local levels

• Address social factors that contribute to health disparities

Environmental Justice - Definition

• Fair treatment and meaningful involvement of all people regardless

• Addresses the inequities in distribution of environmental hazards and exposure risks

Health Risk Assessment - Definition

• Systematic evaluation of risk of specific exposure

Health Risk Assessment - Four Steps

1. Identification of hazard

2. Exposure assessment

3. Characterization of health risk

4. Risk management

Health Impact Assessment - Definition

• Systematic evaluation of a planned change to a community before the change occurs

Health Impact Assessment - Six Steps

1. Screening

2. Scoping

3. Assessment

4. Recommendations

5. Reporting

6. Monitoring and Evaluation

Health Impact Assessment - Purpose

• Inform decision-makers of the impacted a change will have on the health of population

Groups at Increased Risks from the Environment

• Pregnant women and fetus

• Infants and children

• Older adults

Epigenetics - Definition

• Examination of gene-environment interaction to study the processes in which genes are expressed differently as a result of environmental influences

Environmental Epidemiology - Definition

• Focuses on environmental exposures and risks that contribute to adverse health effects

Toxicology - Definition

• Study of how body processes toxicants and their ultimate effects in the body

Risk assessments involve … and …?

• Environmental epidemiology

• Toxicology

Core Functions of Public Health

1. Assessment

2. Policy Development

3. Assurance

Core Functions of Public Health - Assessment

• Investigation of health hazards, surveillance of health issues, examining causes, and assessing needs

Core Functions of Public Health - Policy Development

• Science based decision making and education of the community to create involvement to develop policies

Core Functions of Public Health - Assurance

• Seek innovative solutions to health issues, guarantee necessary services, and provide oversight to policy implementation

Superfund National Priorities List - Definition

• Developed by Congress in response to publicized hazardous waste dump sites

Superfund - Definition

• CERCLA → Comprehensive Environmental Response, Compensation and Liability Act

When assessing a site, what should be considered?

• Built environment

• Climate change

• Land use

• Toxic exposure

• Toxic waste

• Radiation

Built Environment - Definition

• Physical structures and features that contribute to social cohesiveness or disruption

  • Includes quality of housing

Climate Change

Land Use - Definition

• Decisions can impact a community’s access to health-promoting resources and environmental health

Toxic Exposure - Examples of How

• Air → Poor air quality = Increased rates of disease and adverse health effects

• Water → Safe lakes, rivers, streams, and waterways

• Food → Quality, quantity, and safety

Toxic Waste - Definition

• Need for sustainable practices at local, state, and federal level

How is toxic waste monitored and regulated?

• EPA Waste Management hierarchy

Radiation - Ionizing Definition

• Atomic particles (ions) break away from nucleus of atom

• Radiation of higher energy

Radiation - Ionizing Examples

• Radon gas

• Comic radiation from atmosphere

• X-rays

• Gamma rays

Radiation - Nonionizing Definition

• Radiation of less energy so can not remove electrons from atoms

Radiation - Nonionizing Examples

• Visible light

• UV radiation

• Infrared, microwave, and radio wave

Policy Development - Purpose

• Need for legislation to protect human health

• Opportunity for C/PHN to engage within community to address policies specific to their needs

Policy Development - Items to Consider as the RN

• Community hazards

• Existing legislation

• Governmental groups

• Nongovernmental groups

Policy Development - What RN Can Do

• Write letters to legislators and news media

• Advocate for health protective policies

• Inform community members about their risks

• Serve on committees or agencies

• Assist with implementation of programs

Assurance - Definition

• Guarantees policy and regulatory functions are followed through the provision of public health essential services