Environmental Health

1. Environmental Health Environmental Health

2. Environmental Health is … • “… those aspects of human disease and injury that are determined or influenced by factors in the environment. This includes the study of both direct pathological effects of various chemical, physical, and biological agents, as well as the effects on health of the broad physical and social environment, which includes housing, urban development, land use and transportation, industry, and agriculture.” – USDHHS (2000)

3. Using a Critical Theory Approach • Uses “thinking upstream” framework. • Raises questions about oppressive situation. • Involves community members in the definition and solution of problems. • Facilitates interventions that reduce health-damaging effects of environments. • Ask critical questions about clients’ work and home environments to help discern the contributions of specific hazards to health.

4. Environmental Health History • Environmental screening questions to ask an adult: • What kind of work do you do? How long on the job? Types of work exposures? • Do you notice health problems you are having while you are at work? at home? in the community? in specific locations? • What is the age of your home? Characteristics of heating and ventilation? Do you live near an industrial site or landfill? • Have you recently used pesticides, solvents, insecticides, or weed killers? • What kinds of hobbies do you have? • Has your workplace been treated recently for insects, weeds, or other pest problems?

5. Environmental Health History for a Child(cont’d) • Environmental screening questions to ask the parents or guardian of a child: • Where does your child go to school or daycare? Any playgrounds? • Have any of these places been treated recently (e.g., sprayed) for insects, weeds, or other pest problems? Does your child help with gardening activities? • Have you recently used pesticides, solvents, insecticides, or weed killers? • What are child’s sources of food, water (e.g., well water)? Is someone in the household breast-feeding an infant? • Do you have any occupational exposure to potential health threats (lead, pesticides, x-rays)?

6. I PREPAREEnvironmental Exposure History • I – Investigate potential exposures • P – Present work • R – Residence • E – Environmental concerns • P – Past work • A – Activities • R – Referrals and RESOURCES • E – Educate

7. Benefits of an Environmental Health History • Increased awareness of environmental/ occupational factors • Improved timelines and accuracy of diagnosis • Prevent disease and aggravation of conditions • Identify potential work-related environmental hazards and/or environmental hazards in and around clients’ homes

8. Areas of Environmental Health • Living patterns • Work risks • Atmospheric quality • Water quality • Housing • Food quality • Waste control • Radiation risks

9. Living Patterns • The relationships among people, communities, and their surrounding environments that depend on habits, interpersonal ties, cultural values, and customs • Examples: • Drunk driving • Second-hand smoke • Noise exposure • Urban crowding • Technological hazards

10. Work Risks • The quality of the employment environment and the potential for injury or illness posed by working conditions • Examples: • Occupational toxic poisoning • Machine-operation hazards • Sexual harassment • Repetitive motion injuries • Carcinogenic work sites

11. Atmospheric Quality • The protectiveness of the atmospheric layers, the risks for severe weather, and the purity of the air for breathing purposes • Examples: • Gaseous pollutants • Greenhouse effect • Destruction of the ozone layer • Aerial spraying of herbicides and pesticides • Acid rain

12. Water Quality • The availability and volume of the water supply and the mineral content levels, pollution by toxic chemicals, and the presence of pathogenic microorganisms. • Water quality consists of the balance between water contaminants and existing capabilities to purify water for human use and plant and wildlife sustenance. • Examples: • Contamination of drinking supply by human waste • Oil spills in the world’s waterways • Pesticide or herbicide infiltration of ground water • Aquifer contamination by industrial pollutants • Heavy metal poisoning of fish

13. Housing • The availability, safety, structural strength, cleanliness, and location of shelter, including public facilities and family dwellings • Examples: • Homelessness • Rodent and insect infestation • Poisoning from lead-based paint • Sick building syndrome • Unsafe neighborhoods

14. Food Quality • The availability, relative costs, variety, and safety of foods and the health of animal and plant food sources • Examples: • Malnutrition • Bacterial food poisoning • Food adulteration • Disrupted food chains by ecosystem destruction • Carcinogenic chemical food additives

15. Waste Control • The management of waste materials resulting from industrial and municipal processes, human consumption, and efforts to minimize waste production • Examples: • Use of nonbiodegradable plastics • Poorly designed solid waste dumps • Inadequate sewage systems • Transport and storage of hazardous waste • Illegal industrial dumping

16. Radiation Risks • Health dangers posed by the various forms of ionizing radiation relative to barriers preventing exposure of humans and other life forms • Examples • Nuclear facility emissions • Radioactive hazardous wastes • Radon gas seepage in homes and schools • Nuclear testing • Excessive exposure to x-rays

17. Violence Risks • The potential for victimization through the violence of particular individuals • The general level of aggression in psychosocial climates

18. Effects of Environmental Hazards • Environmental hazards can be • General – smog over community • Specific- lead expose to a family • Direct- illegal dumping • Indirect- global warning • Immediate- GI disturbances • Long term- black lung of coal miner

19. Global Environmental Health • Environmental health addresses all physical, chemical, and biological factors external to a person and related factors affecting behaviors. It encompasses the assessment and control of those environmental factors that can potentially affect health. • The goals of environmental health are disease prevention and the creation of environments that support health. – WHO (2009)

20. Emerging Illnesses and Threats • Global climate change • International commerce and travel • New diseases create environmental challenges • Environmental public health infrastructure • Risk of terrorist attacks • Threat of natural disasters

21. Critical Community Health Nursing Practice • Take a stand; advocate for change • Ask critical questions • Facilitate community involvement • Form coalitions • Using collective strategies