Community Nursing WK 4

Chapter 14

Environmental Health

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Environmental Health Is …

... all the physical, chemical, and biological factors external to a person and all the related factors impacting behaviors.

… encompasses the assessment and control of those environmental factors that can potentially affect health.

… targeted toward preventing disease and creating health-supportive environments.

– WHO (2013)

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Environmental Health

The purpose of environmental health is to ensure the conditions of human health and provide healthy environments for people to live, work, and play.

Accomplished through…

Risk assessment

Prevention

Intervention

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Using a Critical Theory Approach

Uses “thinking upstream” framework.

Raises questions about oppressive situations.

Involves community members in the definition and solution of problems.

Facilitates interventions that reduce health-damaging effects of environments.

Asks critical questions about clients’ work and home environments to help discern the contributions of specific hazards to health.

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Benefits of an Environmental Health History

Increased awareness of environmental/ occupational factors

Improved timelines and accuracy of diagnosis

Prevents disease and aggravation of conditions

Identifies potential work-related environmental hazards and/or environmental hazards in and around clients’ homes

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I PREPARE Environmental 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

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Figure 14-1

From U.S. Department of Health and Human Services: Healthy People 2010, ed 2, Washington, DC, U.S. Government Printing Office, 2000.

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Areas of Environmental Health

Built environment

Work-related exposures

Outdoor air quality

Healthy homes

Water quality

Food, safety, and waste management

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Built Environment

The connection between people, communities, and their surrounding environments that affects health behaviors and habits, interpersonal relationships, cultural values, and customs

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Built Environment: Examples

Drunk driving

Second-hand smoke

Noise exposure

Urban crowding

Technological hazards

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Work-Related Exposure

Poor working conditions that result in potential injury or illness

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Work-Related Exposure: Examples

Asbestosis

Asthma

Lung cancer

Agricultural accidents

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Outdoor Air Quality

The purity of the air and the presence of air pollution

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Outdoor Air Quality: Examples

Gaseous pollutants

Greenhouse effect

Destruction of the ozone layer

Aerial spraying of herbicides and pesticides

Acid rain

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Healthy Home

The availability, safety, structural strength, cleanliness, and location of shelter, and indoor air quality

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Healthy Home: Examples

Homelessness

Rodent and insect infestation

Poisoning from lead-based paint

Sick building syndrome

Unsafe neighborhoods

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Water Quality

The availability, volume, mineral content levels, toxic chemical pollution, and pathogenic microorganism levels

The balance between water contaminants and existing capabilities to purify water for human use and plant and wildlife sustenance

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Water Quality: 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

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Food Safety

Availability, accessibility, and relative costs of healthy food free from contamination of harmful herbicides, pesticides, and bacteria

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Food Safety: Examples

Malnutrition

Bacterial food poisoning

Food adulteration

Disrupted food chains by ecosystem destruction

Carcinogenic chemical food additives

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http://www.foodsafety.gov/

Figure 14-5

FDA food safety campaign:

http://www.fightbac.org/safe-food-handling

Waste Management

The handling of waste materials resulting from industry, municipal processes, and human consumption as well as efforts to minimize waste production

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Waste Management: Examples

Use of nonbiodegradable plastics

Poorly designed solid waste dumps

Inadequate sewage systems

Transport and storage of hazardous waste

Illegal industrial dumping

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Waste Management: Examples (Cont.)

Nuclear facility emissions

Radioactive hazardous wastes

Radon gas seepage in homes and schools

Nuclear testing

Excessive exposure to x-rays

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Effects of Environmental Hazards

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Figure 14-6 From Environmental Protection Agency: Air Pollution and Health Risk. http://www.epa.gov/ttnatw01/3_90_022.html. Retrieved March 27, 2013.

Emerging Issues in Environmental Health

Environmental public health infrastructure

Natural disasters

Global climate change

Ozone depletion

Fossil fuel burning

Marine dumping

Active land mine abandonment in war-torn areas

Destruction of tropical rain forests

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Critical Community Health Nursing Practice

Approach environmental health at the population level

Take a stand; advocate for change

Ask critical questions

Facilitate community involvement

Form coalitions

Using collective strategies

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