Occupational and Environmental Health, ch 6/20
Americans with Disabilities Act
Employers must make "reasonable accommodations" to enhance opportunities for individuals with disabilities; prohibits discrimination on the bases of disability
I-PREPARE
Environmental exposure history mnemonic •I- investigate potential exposures •P- present work •R- residence •E- environmental concerns •P- past work •A- activities •R- Referrals and resources •E-educate
hazard communication standard
employers and employees must know about hazards to protect themselves from illness/injury
Environmental Protection Agency (EPA)
formed with the mission to protect human health and to safeguard the natural environment Key issues: built environment, toxic materials, air/water quality, environmental stability
ergonomics
incorporates the science of biomechanics to design work that is less demanding of a worker's joints, back and muscles to prevent injury
environmental justice
refers to fair distribution of environmental burdens and fair application of environmental laws, policies, and regulations regardless of race, color, national origin and income
Ambient Air Standard
refers to the highest level of a pollutant in a specific place over a specific period of time that is not hazardous to humans
4 aspects of climate change
rising temperatures, increased extreme weather events, rising CO2 levels and rising sea levels
green jobs
the effort to create employment in the field of renewable and efficient energy production Addresses 2 main concerns: need to rebuild the economy after the economic crisis, and the need to develop strategies that will respond to the threat of global climate change
environmental health
the study and management of environmental conditions that affect the health and well-being of humans
2 key components of environmental exposure to hazardous substances
time and location
built environment
-man-made surroundings •includes housing, street conditions, neighborhood deterioration, parks, and playgrounds •Neighborhood SES is greater mediator of childhood obesity than racial or ethnic disparities •People live in areas with almost daily exposure to health risk such as impaired drivers, second-hand smoke, noise exposure, etc.
OSH program
A systematic process that: •Evaluates the workplace •Recognizes the exposures and hazards found in each area of the worksite •Provides a plan to control these exposures and hazards •Evaluates the effectiveness of these controls through routine environmental monitoring of the worksite and routine medical screening
Occupational Safety and Health Act (OSHA)
Created to protect worker and health. Its main aim was to ensure that employers provide their workers with an environment free from dangers to their safety and health, such as exposure to toxic chemicals, excessive noise levels, mechanical dangers, heat or cold stress, or unsanitary conditions.
exposure-risk assessment
Hazard identification Dose-response assessment: Based on experiments that look for a correlation between an increase in harmful effects and an increase in quantity of a substance Exposure assessment Risk characterization
3 routes of entry
Ingestion, inhalation, and dermal absorption
probability a toxin will affect humans
Its inherent toxicity (ability to cause harm to humans) Whether it enters the body and reaches susceptible organs Amount that is present
workers compensation acts
Provide income replacement and health care for employees who sustain a work-related injury or death
Key components of occupational/environmental histories
Review of systems Personal and family health history Psychosocial history Past medical history List of hobbies
hierarchy of controls
Systematic process to control workplace hazards 5 levels: Eliminating a substance or substitution Engineering controls Warning Administrative controls PPE
vulnerable populations in the workforce
•Adolescents •Aging workers •Female •Disabled •Immigrant/foreign-born •Minority
epidemiological triangle for workers
•Agent (exposure in workplace) •Host (worker/employee) •Environment (workplace) ie back injury, chemical exposure, virus, stress
high risk occupations
•Agriculture/forestry •Fishing •Construction •Health care •Manufacturing •Mining •Public safety •Transportation
water quality
•Availability, volume, mineral content levels, toxic chemical pollution, and pathogenic microorganism levels •Balance between water contaminants and existing capabilities to purify water for human use and plant & wildlife sustenance
areas of environmental health
•Built environment •Work-related exposures •Outdoor air quality •Water quality •Food safety •Waste management
effects of environmental hazards
•Environmental health effects can be immediate, long-term, or intergenerational •Some environmental exposures have a direct relationship to the development of cancers, chronic disease, and other health-related problems •Effects of environmental risks may also be indirect, such as global warming
benefits of taking pt environmental health history
•Increased awareness of environmental health concerns •Improved timeliness and accuracy of diagnosis •Prevents disease and aggravation of conditions •Identifies potential environmental hazards
food safety concerns
•Malnutrition •Bacterial food poisoning •Food adulteration •Disrupted food chains •Carcinogenic chemical food additives •Genetic alteration of food growing despite unknown long-term health risks
Occupational Safety and Health Administration (OSHA)
•Mission is development & enforcement of safety & health standards to ensure safe & healthy working conditions •Protects coworkers, family members, employers, customers, suppliers, communities, and other public members affected by workplace environment •Part of the Department of Labor •Role is regulation and enforcement of OSHA Act •Safety and health standards in workplace
nursing actions for environmental health
•Must work with public to promote more stringent and actively enforced environmental legislation and regulations •Must include worldwide along with national environmental policies •Approach environmental health at the population level: •Take a stand, advocate for change •Ask critical questions •Facilitate community involvement •Form coalition •Use collaborative strategies
waste management problems
•Nonbiodegradable plastics •Inefficient recycling programs •Unlicensed waste dumps •Inadequate sewage systems for growing populations •Unsafe dumping of industrial toxins •Exportation of radioactive medical wastes
types of exposure in the workplace
•Physical-heat, cold, noise, vibrations •Chemical-affect various body systems, may be carcinogenic •Biological-bacterial, viral, etc •Psychological-job stress
occupational health nursing
•Prevention of adverse health effects from occupational hazards •Provides occupational health and safety programs and services to clients, usually at their place of employment •Provide health care and making nursing decisions within the scope of practice determined by state law must understand business/costs and legality/ethics
levels of prevention in occupational health
•Primary prevention: •Personal protective equipment (PPE) •Secondary Prevention: •Screening and monitoring •Tertiary Prevention: •Diagnosis of an occupational illness and alteration of the work assignment as needed
health promotion in the workplace
•Reduces absenteeism •Increases productivity •Sustains/increases level of well-being •Captive audience (workers) for health promotion programs
occupational health
•Systems approach •Promote safety and healthy work environments •Priority is prevention •Develop work cultures to support health and safety at work •Prevent and control hazards, risks •Promote positive social climate that enhances productivity usually involved in healthcare and manufacturing
outdoor air quality
•The purity of the air and presence/absence of air pollution •EPA has classifies 6 common air pollutants: Carbon monoxide, nitrogen oxides, sulfur dioxide, ozone, lead, & particulate matter •1968: Nat'l Air Pollution Control Administration developed air quality index (AQI) to increase public awareness of air pollution •(nurses need to consider the AQI when making recommendations for physical activity, especially for children, elderly, and asthmatic clients)
walk-through safety assessment
•Walk through to observe operations •Workers performing skills •Identify the use of equipment •Physical layout •Cleanliness •Locker rooms •Lunch/break rooms
purpose of environmental health
•to assure the conditions of human health and provide healthy environments for people to live, work, play. Accomplished through... •Risk assessment •Prevention Intervention