How a Public Health Nurse Shares Environmental Health Knowledge

A public health nurse plays many roles when it comes to protecting the local population. One of the most important things a public health nurse can do is provide education about potential health risks related to the environment.

According to the World Health Organization (WHO), pollution is the world’s greatest environmental health risk, accounting for more than 7 million deaths per year, even exceeding the death toll of HIV/AIDS. Populations in underdeveloped areas generally are impacted the most by pollution – an estimated 98% of these cities fail to meet the air quality guidelines set by the WHO.

From 2011 to 2016, outdoor air pollution grew by 8%, according to data collected by the WHO on more than 3,000 cities. Areas in the Middle East, Southeast Asia and Western Pacific have pollution levels 5 to 10 times higher than recommended levels, and have the greatest potential for health risks.

Air pollutants can penetrate deep into the lungs and cardiovascular system, which can pose many health risks. To help address this problem, public health nurses have been leaders in advocating for and sharing environmental health awareness with patients.

In 2003, the American Nurses Association adopted the Precautionary Principle, which notes there is an ethical imperative in preventing disease and not just treating it. The principle instructs nurses to take the life cycle of chemicals, products or technologies into consideration and act accordingly to prevent exposure.

How to Protect Against Pollutants

Air pollution occurs indoors and outdoors. While the sources causing air pollution can vary, the negative health impact is the same.

The U.S. Environmental Protection Agency (EPA) currently tracks six major air pollutants that cause significant health effects. These pollutants include:

  • Ground-level ozone
  • Nitrogen oxides
  • Carbon monoxide
  • Lead
  • Sulfur oxides
  • Microscopic particles, or particulate matter

Both indoor and outdoor air can contain these pollutants. However, it is the amount of pollutants in the air and the length of time you are exposed to them that determines how they affect you.

When gases such as carbon monoxide or nitrogen dioxide are inhaled, the cells that line the airways to the lungs absorb them. Once they’re absorbed, the gases are able to pass into the bloodstream and travel to internal organs, where they can cause health problems. Even if the air pollutants aren’t absorbed into the bloodstream, they can damage the lungs.

The effects of air pollution can vary from person to person. For example, a healthy adult with limited exposure to these pollutants for a brief time might not develop any long-term problems. Yet, for a person with a heart or respiratory condition, even limited exposure could potentially make symptoms worse. In any case, longer exposure or a larger dose can lead to serious illness and in some cases death.

Some of the specific sources of outdoor pollution include:

  • Fine particles produced by burning fossil fuels
  • Noxious gases (chemical vapors, nitrogen oxide, carbon monoxide)
  • Urban smog
  • Tobacco smoke

Reducing exposure to outdoor air pollutants can be done by checking the Air Quality Index (AQI), avoiding heavy traffic when possible and avoiding second-hand tobacco smoke.

Some specific sources of indoor pollution include:

  • Gases (carbon monoxide)
  • Household products and chemicals
  • Tobacco smoke
  • Pollen and mold
  • Building materials (asbestos, formaldehyde, lead)
  • Indoor allergens (pet dander, dust)

To help reduce exposure to indoor pollutants, buildings should be well-ventilated and cleaned regularly to prevent the buildup of dust and mold.

Public Health Nursing and Environmental Health

The role of public health nurses in controlling the influence of environmental factors on health was first recognized by Florence Nightingale and Lillian Wald. Today, public health nurses’ roles remain much the same.

To further clarify the role of public health nurses when it comes to the environment’s effects on human health, the ANA developed 10 principles of environmental health for nursing practice. They are:

  1. Knowledge of health concepts related to the environment are essential.
  2. In practice, nurses are guided by the Precautionary Principle to use products and practices that do not harm health or the environment and to take preventative action when met with uncertainty.
  3. Nurses are entitled to work in a safe and healthy environment.
  4. Multi-disciplinary collaboration helps to sustain healthy environments.
  5. Nurses should leverage the best evidence available when selecting materials, products, technology and practices.
  6. Nurses must respect the diverse values, beliefs, cultures and circumstances of their patients and their families in their approach to promoting a healthy environment.
  7. Nurses need to regularly assess the quality of the environment in which they practice and live.
  8. Nurses, other health care workers, patients and communities possess the right to receive pertinent and timely information about the potentially harmful pollutants, chemicals and other hazards they are exposed to.
  9. Nurses need to actively research what the best practices are for promoting a safe and healthy environment.
  10. Nurses require support to advocate for and implement environment health principles in nursing practice.

Every working public health nurse can strive to follow these principles. However, some specializations provide better opportunities for nurses to advocate for environmental health. Rather than specializing in individualized care at a hospital or clinic, public health nurses and environmental health nurses focus on improving the health of an entire population.

Public health nursing pursues the broader goal of population health, one aspect of which is environmental health. Public health informatics nurses ensure health information is easy to understand so people can take greater control over their health and well-being. In low income and rural areas, nurses are often responsible for providing critical health care services, which makes it necessary for them to be able to recognize and respond to potential health crises.

A more specialized role solely focused on environmental health is a population health nurse. These nurses identify environmental issues that can have an impact on the health and wellbeing of those in the area. Environmental nurses typically have the option to focus on a variety of different environments. While their focus is typically more broad, some can choose to focus on specific issues within a particular building or facility and how it impacts employees.

Environmental health topics such as community focused nursing, global health promotion and information management in healthcare are featured prominently in the online RN to BSN program at Jacksonville University’s Keigwin School of Nursing.

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