Environmental Health and Nursing Practice

Environmental Health and

Nursing Practice

Barbara Saltier, RN, DrPH Dr. Barbara Sattler is the Director of the Environmental Health Education Center at the University of Maryland School of Nursing where she is an Associate Professor, The Environmental Health Education Center, a multi-disciplinary center in Baltimore, i engaged in training, education, and research related to environmental health. Dr. Sattler is the principle investigator and co-investigator on several projects including a new "Healthy Homes Initiative" funded by the U.S. Department of Housing and Urban Development and an EPA-funded, continuing education initiative with the American Nurses Association. Dr. Sattler is the PI for "Community Outreach" for the EPA Hazardous Substance Research Center at the Johns Hopkins University Department of Geography and Environmental Engineering in which the University of Maryland is a collaborator and she and staff are working with communities concerned about hazardous waste sites And, Dr. Sattler is the PI on a grant from Health Services Resource Administration within DHHS to create a graduate degree program in environmental health for nurses at the University of Maryland, the first in the country. This program is nested within the Master's Degree in Community/Public Health Nursing. Dr. Sattler is on the Education Committee of the Children's Environmental Health Network where she has helped to develop a train-the-trainer program for medical and nursing faculty on children's environmental health. During the summer, she organizes a summer institute for school-based nurses on environmental health. She is the manager of a Kellogg-funded project for nursing faculty development on environmental health, a project that spans the 16-state southern region and is also currently funded by the Bauman Foundation to improve knowledge and increase advocacy among health care professionals in the area of safe drinking water. Dr. Sattler's particular areas of interest are community-based environmental health assessments/ interventions, "right to know" issues, and risk communication. Dr. Sattler's past positions have included Director of the National Center for Hazard Communication, Health and Safety Staff to the United Steelworkers of America, and Director of the Maryland Committee on Occupational Safety and Health (COSH). She is a Registered Nurse with both a Masters and Doctorate in Public Health from the John Hopkins University School of Hygiene and Public Health. She holds joint appointments in the Department of Epidemiology at the University of Maryland School of Medicine and an Adjunct Appointment in the Department of Health Policy and Management at the Johns Hopkins University School of Public Health. Jane Lipscomb, RN, PhD, FAAN Dr. Jane Lipscomb is an Associate Professor at the University of Maryland at Baltimore (UMAB) School of Nursing. She has conducted research into the occupational hazards facing health care workers for the past twenty years. She was faculty for a Kellogg funded grant to conduct nursing faculty development in environmental health. She is active within the American Public Health Association leadership. Prior to joining the faculty at UMD, Dr. Lipscomb spent three years as a senior scientist in the Office of the Director of the National Institute for Occupational Safety and Health (NIOSH). At NIOSH, Dr. Lipscomb assisted in the development and implementation of the National Occupational Research Agenda (NORA). Prior to NIOSH, Dr. Lipscomb was an Assistant Professor at the University of California, at San Francisco (UCSF) School of Nursing and Director of their graduate Occupational Health Nursing program. While at UCSF, Dr. Lipscomb received federal research support to develop and implement a model for integrating occupational and environmental content into baccalaureate nursing curricula. Dr. Lipscomb earned a MS in Occupational Health Nursing from the Boston University/Harvard School of Public Health and PhD in Epidemiology from the University of California at Berkeley. Her dissertation examined the Epidemiology of Symptoms Reported by Persons Living Near Hazardous Waste Sites.

Environmental Health and

Nursing Practice

Barbara Sattler, RN, DrPH Jane Lipscomb, RN, PhD, FAAN Editors

Springer Publishing Company

Copyright © 2003 by Springer Publishing Company, Inc. All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Springer Publishing Company, Inc. Springer Publishing Company, Inc. 536 Broadway New York, NY 10012-3955 Acquisitions Editor: Ruth Chasek Production Editor: Janice Stangel Cover design by Joanne Honigman

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Library of Congress Cataloging-in-Publication Data Environmental health and nursing / Barbara Saltier, Jane Lipscomb, editors. p. ; cm. Includes bibliographical references and index. ISBN 0-8261-4282-6 1. Environmental health. 2. Nursing. 3. Industrial nursing. I. Sattler, Barbara, DrPH. II. Lipscomb, Jane. [DNLM: 1. Environmental Health. 2. Environmental Exposure. 3. Nursing Care. WA 30 E638706 2002] RA566 .E575 2002 615.9—dc21 2002017022 Printed in the United States of America by Maple-Vail Book Manufacturing Group

CONTENTS

Contributors

ix

Foreword

xi

Introduction

xiii

Part I The Environment and the Health Care Workplace 1.

Pollutants Produced by the Health Care Industry Barbara Sattler

2.

Occupational Health Risks in the Health Care I n d u s t Jane Lipscomb

11

3.

Latex Allergy in Health Care Susan Wilburn Ergonomics Pat Bertsche and Gary Orr Health Care Without Harm: A Case Study in Advocacy Charlotte Brody

27

4. 5.

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39 51

Part II Environmental Health Basics 6.

Toxicology Barbara Sattler

61

1.

Environmental Epidemiology Jane Lipscomb

73

8.

Finding Information About Chemicals in Our Environment Barbara Sattler Risk Assessment and Risk Management of Environmental Exposures Jane Lipscomb

87

9.

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99

vi

Contents

10. Risk Communication Barbara Saltier 11. Water Pollution Barbara Saltier 12. Drinking Water Quality Brenda Afzal 13. Air Pollution Barbara Sattler 14. How Food Production Can Affect Safe Consumption Jackie Hunt Christensen 15. Environmental Tobacco Smoke and Smoking Cessation Sophie Balk

107

16. Hazardous and Municipal Waste Sites Cherryll Ranger and Ralph O'Connor 17. Pesticide Exposure Patricia Butterfield and Phillip Butterfield

169

18. 19. 20.

21.

Part III Environmental Health Risks in Specific Populations and Settings Environmental Hazards in the Home Barbara Sattler Children's Environmental Health Barbara Sattler Environmental Health Risks in the Work Setting: Recognizing Sentinel Events Kathleen McPhaul Environmental Health Risks in Schools Erin Balka, Marian Condon, Tonya McKee, and Barbara Sattler

22. Cross-Cultural Issues on the Mexican-U.S. Border Maria Alvarez Amaya

113 119 135 143 157

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Part IV Integrating Environmental Health into Nursing Practice 23. Occupational and Environmental Health History-Taking 287 Jane Lipscomb and Karen Sova 24. Understanding Environmental Health Policy 303 Barbara Sattler

Contents

vii

25. Environmental Health Education Barbara Saltier 26. Advocating for Environmental Justice: Protecting Vulnerable Communities from Pollution Dorothy Powell and Diann Slade 27. Conclusion Barbara Sattler

311

321

Appendix: Environment Health Resources

343

Index

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Contributors

Brenda Afzal, RN, MS Staff Behavioral/Community Health Nursing University of Maryland

Charlotte Brody, RN Executive Director Health Care Without Harm Patricia Butterfield, PhD, RN Associate Professor Montana State University

Maria Alvarez Amaya, PhD, WHNP-C Associate Professor of Nursing School of Nursing, University of Texas at El Paso

Phillip Butterfield, PhD, PE Assistant Research Professor, Center for Biofilm Engineering and Department of Civil Engineering Montana State UniversityBozeman

Sophie Balk, MD Associate Professor of Pediatrics Children's Hospital at Montefiore Albert Einstein College of Medicine

Jackie Hunt Christensen Administrative Director Food and Health Program Institute for Agricultural and Trade Policy

Erin Belka Vista Volunteer, Environmental Health Education Center at University of Maryland

Marian Condon, RN, MS, BA Research Assistant, Environmental Health Education Center at University of Maryland

Pat Bertsche, MPH, RN, COHN-S Manager, Corporate Occupational Health Services Abbot Laboratories

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X

Contributors

Tonya McKee Vista Volunteer, Environmental Health Education Center at University of Maryland Kathleen McPhaul, RN, MPH Doctoral Student, University of Maryland Lillian Mood, RN, MPH, FAAN Director of Risk Communication and Community Liaison (retired) South Carolina Department of Health and Environmental Control Ralph O'Connor, PhD Assistant Director for Science Division of Health Education and Promotion Agency for Toxic Substances and Disease Registry Gary Orr, PE, CPE Alexandria, VA Dorothy Powell, EdJX, RN, FAAN Associate Dean and Associate Professor Allied Health Sciences Pharmacy and Nursing Howard University Washington, D.C.

Cherryll Ranger, RN, BSN, GCPH Health Education Specialist/Nurse Health Educator for the Health Education Division for Health Education and Promotion Agency for Toxic Substances and Disease Registry Diann Slade, MSN, RN Instructor Allied Health Sciences Pharmacy and Nursing Howard University Washington, D.C. Karen Sova RN. MS Silver Spring, MD Susan Wilburn, RN, MPH Senior Specialist of Occupational Safety and Health American Nurses Associates

Foreword

In the report produced by the Institute of Medicine Committee on Nursing, Health and Environment in 1995, nurses are identified as key resource people on environmental issues affecting human health. The compelling arguments for nurses' involvement in environmental health include the facts that (1) nurses are the largest group of health professionals, (2) nurses are present in every health care setting in every community, and (3) environment is an integral part of nursing's heritage. Historic nursing figures like Florence Nightingale and Lillian Wald paved the way and set a high standard for nurses to follow as they compiled data, presented persuasive public policy initiatives, and involved themselves fully in affecting all the determinants of health for individuals and communities. It was clear to them, as it is today, that people cannot be healthy unless they have healthy places to live, work, and play. The publication of Nursing, Health