Assisting communities to adapt to climate change is a challenge we face.
1. Pick a community near you and determine what climate change impacts they may face.
2. What vulnerabilities they may have.
Remember to consider especially vulnerable populations within those communities and identify their specific challenges. (Websites such as CDC’s Climate and Health or EPA’s Climate Change Adaption Resource Center might be helpful.)
Chapter 19: Environmental
Health
Chapter Highlights #1
❖ Human health and the environment
❖ Assessing contaminants in the environment
❖ Exposure pathways
❖ Assessing the environment of a community
❖ Planning interventions to make communities healthier
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Chapter Highlights #2
❖ Evaluating interventions
❖ Environmental epidemiology
❖ Working toward healthy communities
❖ Environmental justice
❖ Global environmental health issues
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #1
Is the following statement true or false?
Environmental health is the branch of public health science
that focuses on how the environment influences chronic
disease.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #1
False
Rationale: Environmental health is the branch of public
health science that focuses on how the environment
influences human health, not chronic disease.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Human Health and the Environment #1
❖ History of environment health
o How do certain contaminants affect human health?
o How do we assess exposures to contaminants?
o How does the environment influence health?
o How do we live as a population while maintaining a
healthy environment?
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Human Health and the Environment #2
❖ Community environment
❖ Genetic and behavioral factors
❖ Nursing and environmental health
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Assessment
❖ Assessing contaminants in the environment
❖ Exposure pathway
o Source of contamination
o Environmental media and transport mechanisms
o Point of exposure
o Route of exposure
o Receptor population
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Exposure History
❖ Present work
❖ Past work
❖ Home/residence
❖ Activities/hobbies
❖ Concerns
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #2
What is bioavailability?
A. Study of the adverse effects of chemical, physical,
or biologic agents on people, animals, and the
environment
B. An estimate that determines a person’s level
of exposure to a contaminant
C. Amount of a contaminant that actually ends up in the
systemic circulation
D. Process of using medical tests such as blood or urine
collection to determine if a person has been exposed
to a contaminant and how much exposure he or she has
received
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #2
C. Amount of a contaminant that actually ends up in
the systemic circulation
Rationale: Bioavailability is the amount of a contaminant
that actually ends up in the systemic circulation. Toxicology
is the study of the adverse effects of chemical, physical, or
biologic agents on people, animals, and the environment.
An exposure estimate determines a person’s level of
exposure to a contaminant. Biomonitoring is the process of
using medical tests such as blood or urine collection to
determine if a person has been exposed to a contaminant
and how much exposure he or she has received.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Determining the Health Impact of a
Completed Exposure Pathway
❖ Toxicology is the study of the adverse effects of
chemical, physical, or biologic agents on people, animals,
and the environment.
❖ An exposure estimate determines a person’s level of
exposure to a contaminant.
❖ Bioavailability is the amount of a contaminant that
actually ends up in the systemic circulation.
❖ Biomonitoring is the process of using medical tests such
as blood or urine collection to determine if a person has
been exposed to a contaminant and how much exposure
he or she has received.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Proximity
❖ Proximity to a contaminant or hazard
is not the only factor in determining whether there is a
risk to human health.
❖ For a contaminant to pose a risk, there must be a
completed exposure pathway.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Assessing the Environment of a
Community
❖ When assessing a community’s environment, it is helpful
to think about the whole environment to determine what
components are influencing human health.
❖ Environmental justice is important to consider when
looking at the impact of the environment on a
community.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Assessment of Individuals: Taking an
Exposure History
❖ Identify current or past exposures.
❖ Eliminate exposures.
❖ Try to mitigate or reduce a client’s adverse health effects
from exposures.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Interventions
❖ Most often something designed to interrupt or break the
exposure pathway
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Evaluation
❖ Has the exposure pathway been interrupted?
❖ What does the community think about the intervention—
are people satisfied?
❖ How has health improved?
❖ How many people did the intervention affect?
❖ Can the intervention demonstrate any cost savings?
❖ Is the intervention sustainable?
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Environmental Epidemiology
❖ Epidemiology is a field of public health science that
focuses on the incidence and prevalence of disease or
illness in a population
❖ Environmental epidemiology
o Field of public health science that focuses on the
incidence and prevalence of disease or illness in a
population from exposures in their environments
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Major Challenges to Environmental
Epidemiology
❖ Limited availability of data on many contaminants and
their effect on health
❖ Limited understanding about how exposures to multiple
contaminants may sicken people
❖ Latency between exposure and illness can be very long.
❖ Time‐consuming to perform
❖ Resource intensive in terms of personnel and money
❖ Inconclusive in determining if X contaminant caused
Y illness
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Working Toward Healthy Environments
❖ Healthy communities
❖ Healthy homes
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Children’s Health and the Environment
❖ Vulnerability
o Body systems are still rapidly developing
o Eat, drink, and breathe more in proportion to their
body size than do adults
o Breathing zone is closer to the ground compared with
adults
o Bodies may be less able to break down and excrete
contaminants
o Behaviors can expose them to more contaminants
o Spending time outside home where environmental
hazards may be present
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Question #3
Is the following statement true or false?
Environmental justice is the belief that no group of people
should bear a disproportionate share of negative
environmental health consequences regardless of race
alone.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Answer to Question #3
False
Rationale: Environmental justice is the belief that no group
of people should bear a disproportionate share of negative
environmental health consequences regardless of race,
culture, or income.
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Environmental Justice
Environmental justice is the belief that no group of people
should bear a disproportionate share of negative
environmental health consequences regardless of the
following:
❖ Race
❖ Culture
❖ Income
Copyright © 2020 Wolters Kluwer · All Rights Reserved
Global Environmental Health Challenges
❖ Clean water and sanitation
❖ Air quality
❖ Chemical and contaminant exposure
❖ Climate change
Copyright © 2020 Wolters Kluwer · All Rights Reserved