Introduction

Human health can be heavily impacted by the environment. Spread of infectious diseases, exposure to hazardous materials, lack of food supplies, growth of bacteria resistant to antibiotics, as well as numerous other factors can be harmful to health and lead to death, while the definition of this exposure has been unclear until recent times, and the attention to the issue of the environment lacked until the 1990s.

Human Health and the Environment

The reasons for the creation of a hazardous environment are varied. Energy producing technology combined with great consumption of natural resources can lead to exhaustion of these resources and reduction in the ability of the environment to absorb the waste generated by the technology. If an area relies on agriculture for its food supply, overpopulation could lead to widespread malnutrition. Water supply infrastructure and poor sanitation could also be reasons for high levels of water-borne disease. Although economic growth can improve access to medical supplies and health care, it could have a much deeper impact on the environment and health of its occupants (Birley et al., 2013).

Pollution of the environment can often extend outside the borders of the area that is generating it. The Chernobyl incident occurred in Ukraine, yet its effect spread over multiple countries. Irradiated dust was sent up into the atmosphere and resulted in toxic rain falling in multiple countries. Effects of the Fukushima disaster were felt as far as the shores of California. Rising levels of production also led to a new problem of global climate change. Humanity only recently encountered this type of global environmental issue and while we have experience of dealing with localized pollution global issues still do not have a solution. Furthermore, these global issues can have a cumulative effect, synergizing two or more already present issues into a much greater one (Birley et al., 2013).

Concept of Exposure

Exposure can be considered the linking factor of the effect of the environment on human health. This term should be clearly defined to create better nursing literature. Although nursing has considered the environment to be a major source of illness for more than a hundred years, the exposure to it did not have a clear definition until recent times. Florence Nightingale believed the environment to be the main cause of infection, describing it like a miasma that brings disease to the people. To combat it she promoted cleanliness and proper sanitation of living and work spaces. In the 1900s the importance of the environment was downplayed due to the invention of the germ theory. The revelation of bacterial agents being the cause of the disease in the host created an idea that an environment is merely a place where both the agents and the host reside (Thompson & Schwartz Barcott, 2016).

During that time nursing focused only on adapting the response of the patient to the environment, without changing the environment itself. The environment had a very limited definition of places and objects that surrounded a person, making their home and the hospital two main points of attention. A global view on the issue of the environment did not appear in the medical and public community until the mid-1990s. However, by then multiple environmental disasters with global effects were already infamous and well-documented. Disasters such as the Chernobyl incident of 1986, the Love Canal disaster of 1978, and the Bhopal gas leak of 1984 had to be addressed in a broader manner. Finally, environmental health was recognized as an important area of nursing practice (Thompson & Schwartz Barcott, 2016).

With time, exposure came to be defined as a variety of things. In environmental health nursing exposure can refer to the presence of hazards in the environment, it can be classified by time and even refer to consequences of being in a hazardous environment. This is why it is important to define exposure clearly. A modern definition of exposure was presented by Thompson and Schwartz Barcott describing it as “a process involving three phases: 1. contact is made between a target and one or more agents in the same environment; 2. the agent accesses the target by one or more routes of entry; and 3. the agent enters the target by crossing a barrier or boundary (2016 p. 13).” This definition was the result of extensive research of medical literature and hopefully would help create a more cohesive language for the environmental health literature (Thompson & Schwartz Barcott, 2016).

Cleaning and Disinfecting

Medical workers have to deal with possible exposure to hazardous materials on a daily basis. Every surface and instrument in a hospital could be a possible vector of infection for its employees. Therefore, a lot of different and highly effective cleaning and disinfecting substances are used every day. Unfortunately, this practice has two serious downsides to it. To combat the most resilient of bacteria hospitals can utilize products containing chemicals unsafe for use to people who have asthma. This issue creates a real barrier for employees who need those instruments disinfected to provide health care to the patients. In some situations, a safer product just does not eliminate the bacteria leading to an unacceptable risk of infection to the patient (Quinn et al., 2015).

Another issue of this excessive use of disinfectants is a possible creation of organisms resistant to multiple types of drugs. These multidrug-resistant pathogens can be a danger to both the patient and the health care worker. The increasing need for disinfectants in modern medicine has made the goal of elimination of these pathogens unfeasible. New antimicrobials are created to deal with multidrug-resistant pathogens, but there is a chance of the bacteria developing faster than new antibiotics can be introduced. New and innovative strategies to fight them should be researched as well as a more personalized approach to patients to avoid inappropriate prescriptions to antibiotics. The release of antibiotics into the environment should be more controlled overall (Medina & Pieper, 2016).

At the moment these issues are handled by separate organizations and lack the thorough examination required to access the issues presented properly. Perhaps a more integrated approach to infection is required to find solutions. Nurses and other medical staff should be trained to use cleaning and disinfecting products in a safe manner to avoid excessive use. These products should be clearly labeled with accurate safety data sheets. In addition, research is needed in the use of antimicrobials in a hospital environment as well as the development of guidelines for cleaning and disinfecting. Gloves, goggles, face shields, aprons and other apparel should be selected in accordance with the methods used to disinfect the workspace. Concurrently stakeholders should also be informed on this issue to make smart purchasing and administrative decisions. Ultimately, the search for safer alternatives should receive more attention before the problem reaches a critical level (Quinn et al., 2015).

Conclusion

Environmental health is a crucial aspect of nursing both on the local and the global scale. Although the issue of the environment has only recently started to gain attention from the medical community, it was seen as a possible cause of illness over a hundred years ago. This lack of attention led to a narrow perspective on health care that possibly caused various issues for both health care workers and patients, while environmental disasters have only become more global with the time.

References

Birley, M., Boland, A., Davies, L., Edwards, R., Glanville, H., Ison, E., Millstone, E., Osborn, D, Scott-Samuel, A., Treweek, J. (2013). Health and environmental impact assessment: An integrated approach (Abingdon-on-Thames, UK: Routledge.

Medina, E. & Pieper, D. (2016). Tackling threats and future problems of multidrug-resistant bacteria. Current Topics In Microbiology And Immunology, 398, 3-33. Web.

Quinn, M., Henneberger, P., Braun, B., Delclos, G., Fagan, K., Huang, V. Knaak, J., Kusek, L., Lee S., Le Moual, N., Maher, K., McCrone, S., Mitchell, A., Pechter, E., Rosenman, K., Sehulster, L., Stephens, A., Wilburn, S., Zock, J. (2015). Cleaning and disinfecting environmental surfaces in health care: Toward an integrated framework for infection and occupational illness prevention. American Journal Of Infection Control, 43(5), 424-434. Web.

Thompson, M. & Schwartz Barcott, D. (2016). The concept of exposure in environmental health for nursing. Journal Of Advanced Nursing, 73, 3-43. Web.