CHAPTER 4: ENVIRONMENT AND

THE HEALTH OF COMMUNITIES

INTRODUCTION

The environment influences health through indirect pathways

Florence Nightingale: emphasis on pure air, pure water, efficient drainage,
cleanliness, and light
Wider Web of Life: good health lies in recognizing that each of us is part of
a wider web of life
o No one person or community is an independent entity
o Each is linked to the environment

POLLUTION

Pollutants: residues of things human make, use, and throw away

o Nondegradable pollutants: do not degrade or degrade very slowly
o Biodegradable pollutants: can be rapidly decomposed by natural
processes
MAJOR POLLUTANT MECHANISMS

Transport: wind patterns or aquatic systems

Transformation: harmful substances can be turned unharmful or a
relatively harmless substance can be transformed into a noxious form
Bioaccumulation: the introduction of substances into ecologic food webs
Biomagnification: when the accumulation of a pollutant greatly exceeds the
rate at which an organism eliminates it
Synergism: the simultaneous action of separate substances or agencies that
produce a greater total effect than the sum of their individual effects

TOXIC SUBSTANCES

Any chemical or mixture of chemicals poisonous to humans, plants, or

animals under expected conditions of use and exposure
Four major categories of toxic substances:
o Pesticides: lethal chemical specifically designed to kill weeds, fungi,
insects, mites, rodents, and other pests
o Industrial chemicals: asbestos, benzene, PCBs
o Metals: arsenic, lead, cadmium, mercury
o Substances with radiation-emitting isotopes: strontium, cesium,
iodine

ECOLOGIC PRINCIPLES

Law of Gravity: everything that goes up must come down

Everything is connected to everything else:
Everything has to go somewhere
Everything is constantly changing

ENVIRONMENTAL ISSUES AFFECTING HEALTH

Deforestation: the clearing of forests to create crop lands

Desertification: fertile land becomes desert because of hotter and not
wetter conditions
Global warming: the greenhouse effect; increased temps increase of
vector borne diseases
UV light: excess radiation penetration contributes to cataracts and
immunosuppression
Ozone: pollutant found in ambient air; but not a pollutant in stratosphere
protects against excess UV penetration
Physical hazards: radiation, lead, heavy metals, noise
Biologic hazards: infectious agents, insects, animals, and plants
Chemical hazards: poisons and pollution
Climate change: global air and ocean temps increased; glaciers and ice
caps melting; sea levels rising

NURSING INTERVENTIONS TO DECREASE ENVIRONMENTAL INFLUENCES ON

HEALTH

Primary:
o Reduce/eliminate environmental hazards
o Education community residents on how to avoid environmental
hazards
o Become involved with political actions that provide strategies to
minimize environmental exposure
o Promote routine immunizations
Secondary:
o Monitor for signs of hazardous environmental conditions
o Assess for signs of illness related to environmental hazards
o Decrease environmental pollution
o Treat and monitor disorders caused by environmental conditions
Tertiary:
o Eliminate environmental hazards to prevent re-exposure
o Help communities manage long term effects of conditions caused by
environmental hazards
o Participate in political activity that reduces environmental hazards
Healthy air
o Exercise in early morning
o Less intense outdoor activity
Healthy water

THE COMPLEX HUMAN ENVIRONMENT

Ecologic model: Includes individuals, physical, sociocultural, biologic, and

politico-economic factors that affect the individuals health