Florence Nightingale saw the environment as a fundamental cause of illness and disease.
She practiced a wholistic approach to environmental health, which included understanding
and recognizing the effects of social, economic and political forces on the health
of her patient.
The Institute of Medicine (IOM) defines environmental health as “Freedom from
illness or injury related to exposure to toxic agents and other environmental conditions
that are potentially detrimental to human health” (Pope, Snyder, & Mood,
1995)
The International Labor Union (ILO) and World Health Organization (WHO) define occupational
health as “The promotion and maintenance of the highest degree of physical, mental
and social well being of workers in all occupations, the prevention among workers
of departures from health caused by their working conditions, the protection of
workers in their employment from risks resulting from factors adverse to health,
[and] the placing and maintenance of the workers in an occupational environment
adapted to [their] physiological and psychological equipment."
The IOM (1995) has published general environmental health competencies for nursing
practice identified below. In combination with the Agency for Toxic Substances
and Disease Registry’s (ATSDR) IPREPARE card, will assist nurses incorporate
environmental health concepts into everyday practice.
- Basic knowledge and concepts
All nurses should understand the scientific principles and underpinnings of the
relationship between individuals or populations, and the environment (including
the work environment). This understanding includes the basic mechanisms and
pathways of exposure to environmental health hazards, basic prevention and control
strategies, the interdisciplinary nature of effective interventions, and the role
of research.
- Assessment and referral
All nurses should be able to successfully complete an environmental health history,
recognize potential environmental hazards and sentinel illnesses, and make appropriate
referrals for conditions with probable environmental etiologies. An essential
component of this is the ability to access and provide information to patients and
communities, and to locate referral sources.
- Advocacy, ethics, and risk communication
All nurses should be able to demonstrate knowledge of the role of advocacy (case
and class), ethics, and risk communication in patient care and community intervention
with respect to the potential adverse effects of the environment on health.
- Legislation and regulation
All nurses should understand the policy framework and major pieces of legislation
and regulations related to environmental health.
Pope, A. M., Snyder, M. A., & Mood, L. H. (1995). Nursing, health, &
the environment: strengthening the relationship to improve the public’s
health. Institute of Medicine. National Academy
Press, Washington, D.C.
