Environmental health concepts and applications

Because any nurse dedicated to evidence-based practice should be wary of jumping to conclusions and presuming a causal relationship between the workplace environment and the client’s health, it is recommended to perform thorough risk assessments and ideally collaborate with environmental health specialists who may be able to perform actual analyses of potential contaminants, irritants, or anything measurable. “Risk assessors should have a basic grounding in epidemiology, toxicology and chemistry,” which is why the scope of this risk assessment may be beyond the role of a nurse practitioner (“Environmental Health Risk Assessment,” 2012). Actual environmental health risk assessments are systematic and rigorous, including “the process of estimating the potential impact of a chemical, physical, microbiological or psychosocial hazard on a specified human population or ecological system under a specific set of conditions and for a certain time frame,” (“Environmental Health Risk Assessment,” 2012, p. 3). There are two main components to the risk assessment: assaying the environmental conditions of the workplace and also assessing exposure pathways. It would also be helpful to acquire detailed medical records for the client.
Exposure pathways include inhalation, ingestion, and dermal exposure (Frumkin, 2016, p. 191). Because the client and her coworkers are complaining of respiratory problems in particular, the most likely exposure pathway is going to be inhalation. To properly assess the client’s risk, I would first need to find out the legal ramifications of testing the workplace environment, and then team with trained environmental health specialists who could measure the presence of suspected contaminants in the 100 year-old building. As the EPA (2017) points out, hazard identification would be the first step, followed by exposure assessment and risk characterization. In other words, we need to know what toxins may be present, in what quantities, and how harmful that level of exposure has been determined to be in the research.
References
“Environmental Health Risk Assessment,” (2012). Retrieved online: http://ww2.health.wa.gov.au/~/media/Files/Corporate/general%20documents/Environmental%20health/Health%20risk%20assesment/Guidelines-for-Assessing-Human-Health.ashx
Environmental Protection Agency (2017). Human health risk assessment. Retrieved online: https://www.epa.gov/risk/human-health-risk-assessment
Frumkin, H. (2016). Environmental Health. John Wiley.