Unit 5 Environmental Health and Safety PDF

Environmental Health and Safety Prepared By Dr. Fuad Abuadas PhD, MSN, CNS, RN  Introduction Our environment—the conditions within which we live and work, including the quality of our air, water, food, and working conditions—strongly influences our health st...

Environmental Health and Safety Prepared By Dr. Fuad Abuadas PhD, MSN, CNS, RN  Introduction Our environment—the conditions within which we live and work, including the quality of our air, water, food, and working conditions—strongly influences our health status. Consequently, the study of environmental health has tremendous meaning for community health nurses. Definition of Environmental Health Broadly defined, environmental health is concerned with assessing, controlling, and improving the impact people make on their environment and the impact of the environment on them. The field of environmental health is concerned with all elements of the environment that influence people’s health and well-being. The conditions of workplaces, homes, or communities, including the many chemical, physical, and psychological forces present in the environment that affect human health, are important considerations.  Ecologic Perspective  An ecosystem is a community of living organisms and their interrelated physical and chemical environment. Within an ecosystem, any manipulation of one element or organism may have hazardous effects on the rest of the system. Therefore, no one factor, whether organism or substance, can be viewed in isolation.  For example, in produce processing there are several points at which contamination can occur: at production and harvest (growing, picking, and bundling); during initial processing (washing, waxing, sorting, and boxing); during distribution (trucking); and during final processing (slicing, squeezing, shredding, and peeling). Several different pathogens are associated with a variety of food-borne diseases.  A triangle of human disease ecology  This model stresses the links between habitat, population, and behavior (Fig. 9.1).  Habitat includes aspects of the environment in which people live, including housing, workplaces, communication systems, flora, fauna, climate, topography, services, and economic and political structures of societies and local communities.  Population factors include the characteristics of the population (age, gender, and genetic predisposition), which help to determine health status and disease susceptibility.  Behavioral factors include health-related beliefs and behaviors, which are shaped by a range of social and economic factors. The triangular relationship among these factors suggests that no real boundaries exist between them and that the health of populations is a result of the interaction of all factors. It also indicates that action on one part of the system in isolation is unlikely to be effective without complementary action on other relevant factors.  A triangle of human disease ecology  The triangular relationship among these factors suggests that no real boundaries exist between them and that the health of populations is a result of the interaction of all factors. It also indicates that action on one part of the system in isolation is unlikely to be effective without complementary action on other relevant factors.  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 1. Overpopulation Human population took hundreds of thousands of years to reach 1 billion in the 1800s and until 1960 to reach 3 billion. Less than 50 years later, it has more than doubled to 6.7 billion. Every 11 years, the world gains 1 billion people. Assuming that overall fertility rates continue to decline as they have since the 1970s, by 2050 there may still be well in excess of 9.2 billion inhabitants of Earth. If however, the fertility rates remain constant, the population could reach 11.9 billion (Population Action International, 2007a, 2007b). The environmental impact of continued growth could translate into increasing food scarcity, water shortages, and depletion of other vital resources, ultimately threatening our very survival (Friis, 2007). Uncontrolled population growth is indisputably a public health issue. MAJOR GLOBAL ENVIRONMENTAL CONCERNS  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 1. Overpopulation  Nurse’s Role Public health professionals, including community health nurses, have a responsibility in the area of overpopulation, both globally and locally. Productive interventions include the following: (a) teaching families that birth spacing improves child and maternal survival and that a planned family is the best environment for a child’s development; (b) preventing high-risk pregnancies, such as those among teens and adult women who are infected with the human immunodeficiency virus (HIV) or have the acquired immunodeficiency syndrome (AIDS); (c) preventing the growing epidemic of HIV/AIDS;  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 1. Overpopulation  Nurse’s Role (a) providing family planning education to prevent worldwide deaths from unsafe abortions; and (b) providing prenatal care—because healthy mothers equal healthy children. These are key areas in which public health efforts can reap major rewards for families.  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 2. Air Pollution  Pollution refers to the act of contaminating or defiling the environment to the extent that it negatively affects people’s health. Air pollution is now recognized as one of the most hazardous sources of chemical contamination. It is especially prevalent in highly industrialized and urbanized areas where concentrations of motor vehicles and industry produce large volumes of gaseous pollutants.  Outdoor air pollution contributes to cardiovascular and respiratory diseases and is believed responsible for nearly 1 million lung cancer deaths yearly. With respect to children, infant mortality in the first year of life, bronchitis, asthma, and reduced lung development are additional health threats (Licari, Nemer, & Tamburlini, 2005).  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 2. Air Pollution  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 2. Air Pollution  Nurse’s Role  Community health nurses can influence air quality through detection, community education, and lobbying for appropriate legislation. People are exposed to numerous impurities in the air in their homes and workplaces. Nurses can promote health by helping to detect indoor pollutants and informing people of existing or potential dangers. Many household products and building materials emit vapors that can cause problems. Cigarette smoke and cigar smoke are common indoor pollutants that can have ill effects on nonsmokers as well as smokers. Infants and other vulnerable persons are at risk from such exposure (Friis, 2007; Wigle, 2003).  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 2. Air Pollution  Nurse’s Role  Carbon monoxide poisoning may result from stove and furnace emissions or from car exhaust accumulating in a garage. Radon gas trapped in basements or tightly insulated homes is also a major concern. Nurses can assist with the prevention or elimination of these health hazards by ensuring that the indoor environment is well ventilated (oxygenated) and heating equipment properly maintained and by looking for possible sources of pollution. Installation and maintenance of residential carbon monoxide detectors outside the sleeping area in every home should also be encouraged (U.S. Consumer Product Safety Commission, n.d.).  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 3. Water Pollution  The major concern with regard to water is purity. Every time you turn on the faucet in your home, workplace, or in the community, the expectation is that the water is clean, clear, and free of contamination.  More concerning is that, in many parts of the world, access to safe sources does not exist. As much as 20% of the world’s population may not have access to safe sources of drinking water (Friis, 2007). Water can be contaminated and made unsafe for drinking in many different ways  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 3. Water Pollution  Water can be contaminated and made unsafe for drinking in many different ways: 1. Water may be infected with bacteria or parasites that cause disease. Giardia lamblia is a parasite that enters the water supply through contamination from human or wild animal feces. It can cause giardiasis, a gastrointestinal disease that results in diarrhea and malabsorption of nutrients. For example, beavers in the northern Cascade Mountains often contaminate water. Humans using the area for recreation must treat the water by boiling before drinking it. Water may also be contaminated with bacteria such as Vibrio cholerae, resulting in cholera, or with viruses leading to hepatitis A (Heymann, 2004).  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 3. Water Pollution  Water can be contaminated and made unsafe for drinking in many different ways: 2. Toxic substances, such as pesticides, are introduced by humans into water systems and constitute another form of water pollution. These substances may contaminate streams, lakes, and wells. Industrial pollutants may also enter drinking water through oil spills, careless dumping, or buried hazardous wastes that seep into underground water sources. Such wastes not only harm the quality of the water but also have been implicated in diseases such as leukemia. They can contaminate local fish and shellfish, making them unfit for consumption. One such example is mercury, which, through bioaccumulation has reached levels in some seafood (shark, swordfish, king mackerel, and tilefish) that make them unsafe for consumption, especially by pregnant women, nursing mothers, and young children.  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 3. Water Pollution  Water can be contaminated and made unsafe for drinking in many different ways: 3. Pollutants may upset the ecosystem, affecting natural organisms that help purify water systems. Power plants or other industries dissipate excess heat into lakes and streams and cause water temperatures to rise. This thermal pollution kills off beneficial organisms in the water.  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 3. Water Pollution  Nurse’s Role (What role can community health nurses play in the effort to keep water safe? )  As nurses work in a community, they can help by examining household or city drinking water. Is there a strange odor or discoloration? Are particles or sediment visible in the water? Being aware of drinking water quality and possible contaminants in a given locality alerts the nurse to consider a possible causal relationship if a problem exists.  Asking clients to observe and report changes in water quality further assists the nurse in the monitoring process. If such changes occur, the proper authorities, such as health department officials, should be notified and water samples tested.  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 3. Water Pollution  Nurse’s Role (What role can community health nurses play in the effort to keep water safe? )  Community health nurses can also be alert to increased incidence of illnesses that might be water related. For example, if several children exhibit similar symptoms, the nurse might inquire as to whether all have been swimming in the same pool or drinking from the same water fountain.  Although water quality monitoring is ultimately the responsibility of environmental health authorities, it is incumbent on the nurse, as a collaborating member of the health team, to observe and report any information that would further the goal of safe and healthy water for communities.  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 4. Hazardous Wastes  Disposal of toxic chemical and radioactive wastes produced by industry is another grave concern.  The threat is serious. Many of these wastes escape containment or accidentally leak into water systems and into the soil to contaminate drinking water and food.  Community laws and regulations for refuse:  Collection of refuse adequately  Adequate refuse disposal to prevent health hazards  MAJOR GLOBAL ENVIRONMENTAL CONCERNS 4. Hazardous Wastes Nurse’s Role  Community health nurses can encourage the positive actions described by educating the public and lobbying for enabling legislation.  Nurses can promote greater sensitivity among citizens to the problems of accumulating waste with its potential health hazards, Encourage clients to buy products that can be recycled.  Discourage use of aerosol spray containers, plastics, and other non-recyclable items.  STRATEGIES FOR NURSING ACTION IN ENVIRONMENTAL HEALTH  The following strategies for collaboration and participation provide a summary of the nurse’s role and can assist the nurse in addressing this two-part goal: 1. Learn about possible environmental health threats. The nurse has a responsibility to keep abreast of current environmental issues and to know the proper authorities to whom problems should be reported. 2. Assess clients’ environment and detect health hazards. Careful observation and an environmental checklist can assist in this assessment. 3. Plan collaboratively with citizens and other professionals to devise protective and preventive strategies. Remember that environmental health work is generally a team effort  STRATEGIES FOR NURSING ACTION IN ENVIRONMENTAL HEALTH 4. Assist with the implementation of programs to prevent health threats to clients and the environment. 5. Take action to correct situations in which health hazards exist. Nurses can use direct intervention (e.g., in an unsafe home situation), notify proper authorities. 6. Educate consumers and assist them to practice preventive measures. Examples of preventive measures include radon testing in homes and well water testing in rural communities. 7. Take action to promote the development of policies and legislation that enhance consumer protection and promote a healthier environment. 8. Assist with and promote program evaluation to determine the effectiveness of environmental health efforts. 9. Apply environmentally related research findings and participate in nursing research.