community health lecture notes, Exams of Community Health

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Environmental Health

Leah D. Richardson MSN, RN Some slides adapted from Dr. Jay Gandy’s previous presentation

Objectives

• (^) Explain how the environment influences human health and disease.
• (^) Describe legislative and regulatory policies that have influenced the effect of the environment on health and disease pattern.

Historical Context

• (^) Florence Nightingale
  • (^) Environment influences health and recover from illness.
• (^) Lillian Wald
  • (^) Coined the term ‘Public Health Nurse’
  • (^) Moved into the ‘Henry Street Settlement’, lived and worked among the industrial poor, she and her colleagues offered health care to area residents in their homes on a sliding fee scale
  • (^) http://www.henrystreet.org/about/history/
• (^) What is different about today’s environment compared to a century ago?— clean water, clean air, we are more regulated in our industries etc.
• (^) The Food Quality Protection Act of 1996
  • (^) added new provisions related to protection of infants and children from pesticide exposure from multiple sources. The law established a health-based standard of reasonable certainty of "no harm" that prohibits taking into account economic considerations when children are at risk.

Environmental Influences to Health

• (^) Biological
  • (^) Disease organisms in water and food
  • (^) Insect and animal allergens—if you are allergic to cockroach

dandruff, you are more likely to have asthma

• (^) Chemical
  • (^) Air pollutants, industrial chemicals, agricultural chemicals, toxic

wastes, VOCs (volatile organic compounds), food additives

• (^) Physical
  • (^) Noise, radiation exposure
• (^) Socioeconomic
  • (^) Safe neighborhoods, adequate health care

Fields of Study in Environmental Health:

• (^) Epidemiology
• (^) Toxicology
• (^) Workplace safety/Industrial Hygiene
• (^) Air quality control/Indoor Air Quality
• (^) Nutrition and food safety
• (^) Drinking water quality
• (^) Liquid and solid waste disposal
• (^) Rodent and insect vector control
• (^) Radiation safety
• (^) Disaster Preparedness and Response
• (^) Risk Assessment

Environmental Health Sciences

• (^) Book includes:
  • (^) Toxicology
  • (^) Epidemiology (refer to Dr. D’s presentation)
  • (^) Multidisciplinary Approaches

The most basic tenant of toxicology:

The dose makes the poison.

• (^) All substances are poisons; there is none which is not a poison. The right dose differentiates a poison and a remedy.” Paracelsus (1493-
• (^) Example:
  • (^) Is Tylenol toxic?
  • (^) Is exposure to pesticides toxic?
    • What if exposed throughout your lifetime?

IF the video does not work, here is the link to the video on You Tube https://youtu.be/j10L6rLjM8U

Multidisciplinary Approaches

• (^) Geologists—study and/or dig in the earth, Chemists, Meteorologists— air pollution/toxic rain/daily UV index/heat index, Nurses
• (^) Team based approach is needed to assess and decrease environmental health exposure.

Environmental Health Assessment

• (^) See How to box on page 94-95 GREEN BOX.
  • (^) Assessment (Have you ever been exposed to radiation?)
  • (^) Diagnosis
  • (^) Goal Setting
  • (^) Planning
  • (^) Interventions
  • (^) Evaluation
• (^) AIR (point-fixed sites vs nonpoint sources-nonfixed)
• (^) Water
• (^) Land
• (^) Food

THE RIGHT TO KNOW

• (^) Right to know reports
  • (^) Must inform members of community
• (^) What about Hazards that you work with?
• (^) What is MSDS?—MATERIAL SAFETY DATA SHEETS
  • (^) Where can you find them in a hospital?—ER, NURSES STATIONS, ONLINE

Environmental (In)Justice

• (^) Environmental risks often borne disproportionately by poor

or minority communities

• (^) May have greater exposures in food, air, water, homes,

and workplaces

• (^) Proximity to hazardous waste sites, industrial releases,

etc. and more likely to live in substandard housing (e.g.,

lead paint, asbestos, water intrusion/mold)

**Proportion of cancer deaths attributed to environmental factors****