Barbara Sattler

Pesticides and Health Risks

Pesticides are a category of chemicals formulated to kill or repel a pest or halt its reproduction. In this article we review the toxicological and epidemiological literature; describe common potential pesticide exposures; and focus on the associated health risks to fetal development. Clinical implications are reviewed, and recommendations are made regarding the integration of this environmental health concern into nursing education, practice, research, and policy/advocacy work. Recommendations for pesticide elimination and reduction in health care settings are included.

Environmental health of children

Pediatric primary health care providers are responsible for providing comprehensive care to children. This includes assessing for and identifying the effect of environmental hazards on childrens health and managing conditions that may result from exposure to environmental toxins. This article begins by reviewing the unique developmental, biologic, and behavioral characteristics of children and age-specific issues that make them particularly vulnerable to toxins. It then provides the reader with general assessment and management strategies related to environmental toxins, including an assessment tool that can be used in a pediatric primary care office. The qualities of selected toxins that have been implicated in childhood illnesses are discussed. Routes of exposure, signs and symptoms of toxicity, and assessment and management approaches are presented specifically for lead, mercury, environmental tobacco smoke, particulate matter, asbestos, radon, molds, and pesticides. Because prevention is the best intervention in environmental health, the article emphasizes ways pediatric providers can work with caregivers to prevent or minimize exposure.

Association between ozone and emergency department visits: an ecological study

The objective of this study was to examine the association between the levels of ozone concentration and emergency department (ED) visits for respiratory and cardiovascular conditions in Maryland in the United States by considering temporal and spatial characteristics, including socioeconomic status (SES), as a covariate. This study used multiple large datasets derived from government agencies for data of ozone, weather, census, and ED visits to represent Maryland in the summer of 2002. Block kriging was used to estimate the daily ozone and weather factors by ZIP code-day level. Results from a negative binomial regression showed that a 10-ppb increment of the 8-hr ozone level as a three-day average was associated with increased respiratory ED visits by 2.4%, after adjusting for weather factors, SES, and day of the week. For cardiovascular ED visits, an increment of 10 ppb of the 8-hr ozone level as a five-day average increased by 3.5%.

Infusing environmental health concepts into an existing nursing course.

The updated American Nurses Association Nursing: Scope and Standards of Practice’s 16th standard delineates that the practice of RNs be environmentally healthy. This makes explicit the need to incorporate learning activities about environmental health into nursing education courses. The authors describe a simple yet very rewarding undergraduate educational intervention that helped nursing students explore environmental health concepts and related nursing implications.

Starting a Health Care System Green Team

The health care industry is often overlooked as a major source of industrial pollution, but as this becomes more recognized, many health care facilities are beginning to pursue green efforts. The OR is a prime example of an area of health care that is working to lessen its environmental impact. Nurses can play key roles in identifying areas of waste and presenting ideas about recovering secondary materials. For instance, although infection prevention measures encourage one-time use of some products, nurses can investigate how to reprocess these items so they can be reused. This article examines how the efforts of a Green Team can affect a hospitals waste stream. A health care Green Team can facilitate a medical facilitys quest for knowledge and awareness of its effect on the waste stream and environment.

The Greening of Health Care: Environmental Policy and Advocacy in the Health Care Industry

The health care industry has been creating a number of health risks through many of its policies, practices, and processes. Many of the risks are preventable. This article focuses on the environmental health risks posed by the health care industry and the solutions that have been forged by both individuals and organizations through policy work at the local, state, federal, and international levels. A brief description is presented of two of the key environmental health threats: mercury pollution and dioxins, an unintentional by-product created by the manufacture and incineration of polyvinyl chloride plastics. This is the science underpinning the policy work. A chronology of the past decade’s activities, policies, and partnerships to reduce environmental health threats in the health care industry is discussed. Nurses have taken a critical leadership role in much of this work.

Developing curriculum recommendations for environmental health in nursing.

In 2010, the American Nurses Association (ANA) added an environmental health standard to the ANA Scope and Standards of Practice requiring that nurses implement environmental health strategies in nursing practice. To prepare nurse educators to integrate environmental health at all educational levels, nursing faculty members from the Alliance of Nurses for Healthy Environments developed environmental health competencies and curricular recommendations that address this need. Internet URLs are included for environmental health curricula for each level of nursing education.