Public Health, the Environment, and Nursing Practice: Health Promotion in a Toxic World

Purpose: Nurses are at the forefront of community and preventative health as educators and practitioners. It is imperative that they provide comprehensive, quality care as it relates to environmental health issues; acknowledging advances in research that are exposing the correlation between chemicals and our body burden. The incidence of many serious diseases and disorders are on the rise and understanding the link to environmental exposures is critical. There is growing consensus among the scientific and medical community that exposure to toxic chemicals in our every day environment including those found in building products, plastics, personal care products and household cleaners, are linked to the rise of many of these diseases. The President’s Cancer Panel Report (2010) noted the link between chemicals and cancer has actually been significantly underestimated, as over 80,000 chemicals in commerce have been largely unregulated and untested. The Panel wrote: “the American people—even before they are born—are bombarded continually with myriad combinations of these dangerous exposures…that needlessly increase health care costs, cripple our Nation’s productivity, and devastate American lives.” [1] Through review of research there is a knowledge gap within nursing as it relates to this body of knowledge; which impacts nursing care and population health.

Methods: Surveys are being created for distribution to nursing schools and hospitals, within the state of Connecticut (USA), that will assess for the need for inclusion of curriculum, annual education and continuing education offerings to assess for environmental health issues, and the nurse's role in assessment and care. An educational webinar is also being offered to provide information on environmental health issues and related nursing interventions, with a pre/post test to assess for competency.

Results: This project is in process, however based on current research it is apparent that there remains a needs gap. The gap shows enhanced education requirements to create competency and nursing leadership in public health.

Conclusion: Environmental factors often disproportionately affect vulnerable and underserved populations. Exposure to toxic, environmental chemicals during critical windows of development (even prenatally) are linked to adverse health outcomes that span a lifetime and also impact fertility and pregnancy. In addition to the health impacts of chemical exposure, the economic impacts are staggering. The NIH projects that cancer costs will reach at least $158 billion by 2020. [2] Nurses are well suited to be leaders in protecting the public through environmental health education, evaluation, and research to incorporate this expanded view of environmental health. Therefore it is imperative that this knowledge be interwoven into nursing curriculum and offered as continuing education in all practice areas within nursing to improve competency.