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02.02 Environmental Health

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Overview

We will discuss environmental risks to health and the assessments utilized for adequate education in the community.

Nursing Points

General

  1. Environmental health
    1. Environment
      1. External surroundings
    2. Seeks to
      1. Identify hazards
      2. Limit exposure
    3. Factors determining community health
    4. Natural and man-made
    5. Hazards
      1. Chemical
        1. Gases
        2. Metals
        3. Pesticides
        4. Air pollutants
      2. Physical
        1. Fall hazards
        2. Pollution
        3. Temperature
        4. Radiation
      3. Biological
        1. Bacteria
        2. Parasites
        3. Fungi
        4. Viruses
      4. Psychosocial
        1. Violence
        2. Stress
  2. Exposure pathways
    1. How contact occurs
      1. Inhalation
      2. Contact
      3. Ingestion

Assessment

  1. Community health assessments
    1. Purpose
      1. Identify health concerns/risks
      2. Act on problems
      3. Improve health
      4. Improve quality of life
    2. Individual and population risk
      1. Assess for
        1. Potential exposure
        2. Actual exposure
        3. Outcomes
    3. Windshield survey
      1. Assesses whole community
      2. To understand potential risks
    4. I PREPARE environmental exposure
      1. Investigate potential exposure
      2. Present work
      3. Residence
      4. Environmental concerns
      5. Past work
      6. Activities
      7. Referrals/resources
      8. Educate

Therapeutic Management

  1. Nursing Role
    1. Identify risks
    2. Analyze risks
    3. Educate community
      1. Preventative strategies

Nursing Concepts

  1. Safety
  2. Patient Education

Patient Education

n/a

Reference Links

Study Tools

Video Transcript

Video Transcript

Hi guys. Welcome to the environmental health lesson. So we’re finally at that point we can talk about how environment is a determinant of health for a community. In this lesson we will talk about the types of hazards and how we address them in the community. Let’s get started.

So the environment is our external surroundings. Environmental health focuses on the natural and man-made hazards that affect our health, and also the factors that benefit it.  What I mean by natural is it’s already present and maybe created by the atmosphere, and we can’t really control them. Think natural disasters and what we call normal bacteria here. Pollution, toxic chemicals and waste, these are things we put into the environment, which makes it man-made and controllable to a point. The purpose of environmental health is to identify hazards and limit the exposure a community may have those hazards. Now, as I’ve said a few times now, the environment can help or hurt our health. It’s what we do to ensure it helps.

So let’s identify some hazards. Now we talked about these in the introduction lesson but we’re going to go into a little more detail. So the hazards are broken down into four separate categories. Chemical, which includes harmful gases and other air pollutants like pesticides, and metals like lead or mercury. Then we have physical hazards. These are your fall hazards and other types of pollution, radiation and temperature is one we don’t think about as a hazard but if it gets too hot or too cold, we see negative effects if we’re not careful. Now the biological hazards come from living microorganisms like your bacteria, viruses, fungi. Parasites fall into this category as well. And finally, psychosocial hazards. These are typically from workplace stress, family stress, violence and things of that nature.

So now that we’ve identified the hazards, you’re probably questioning how we can be exposed to certain ones. Exposure pathways give us that answer. The three paths of exposure are inhalation, contact and ingestion. So let’s think about this for a second. An example I’ll use is Hurricane Katrina, which by the way is considered a physical hazard. So here we had this natural disaster with effects that pretty much wiped out a community or attempted to. We’ve all seen pictures of the destruction right? How many chemicals and microorganisms were stirred up and flooded the area? Now you have people walking in that water. It definitely wouldn’t be safe to drink even years later I’m sure. So now we’ve revealed at least two pathways of exposure and a few hazards as well.

So we performed our own little assessment in the last slide but I want to be clear. The whole point of community health assessments is to identify the risks and act on the problems you see to improve the health and quality of life of the community members. In the last slide, didn’t we identify some of the environmental risks stemming from Hurricane Katrina? Sure did. But we try to perform these assessments BEFORE a catastrophe or emergency occurs if we can. How do we do that?

Well here’s a comparison of two assessments. The risk assessment and the windshield survey. So the risk assessment we use to assess either an individual or a population to determine potential and actual exposure to environmental hazards. This is the more formal approach because we are asking questions. Now, when you’re driving do you tend to look straight ahead or do you look around and take note of the things in front of you that could potentially go wrong? I look around. That’s exactly what the windshield survey does. It’s someone literally driving around the community looking at the potential for environmental risks. There’s no interviews involved, barely any interaction and it’s completely informal because of that. 

So then there’s the I PREPARE environmental exposure assessment. “I PREPARE” is a reference tool designed to remind you of the questions you should be asking a client in the community. And these are categories guys, not the specific question. But you are looking for a client’s exposure history in each category. Now, it helps guide your assessment so you’re not jumping around and skipping questions and it also makes sure you remember to provide the right education and resources based on the answers you get.  It should go faster that way too.

So as community nurses, what do we do about environmental health? It’s really very simple. We work to identify the risks of the community’s exposure to specific hazards and we analyze those risks so we can provide the best education to prevent exposure. In emergencies, it works the same, but we are adding to that by acting on the effects of the exposure itself, not addressing preventative strategies.

So, let’s review. Environmental hazards can be natural or man-made. We work very hard to minimize the effects of man-made hazards and our exposure risks to them. We are exposed to environmental hazards through contact, inhalation or ingestion. Be sure to know what risks you are educating the community on so you know how to educate. Health assessments work by identifying risks and acting on them to improve health and quality of life. The I PREPARE mnemonic guides your assessment by reminding you what questions to ask. Be sure to remember this so your assessment flows smoothly. And as with most topics, our role in environmental health is to identify and analyze risks and educate on avoiding and preventing exposure.

So that’s it for the environmental health lesson. Make sure you check out all of the resources attached to this lesson. Now, go out and be your best self today! And, as always, happy nursing!
 

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