Nursing Leadership in Environmental Health: Starting with our own workplaces

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Nursing Leadership in Environmental
HealthStarting with our own workplaces

• H2E Conference Call
• October 7th, 2005
• 1pm EST
• Barbara Sattler, RN, DrPH, FAAN
• University of Maryland School of Nursing

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Evidence of Failed Environmental Protection
Policies

• CDC Body Burden studies (NHANES)
• http//www.cdc.gov/nchs/nhanes.htm
• The Egg Study
• http//www.oztoxics.org/ipepweb/egg/egg20reports
  /GLOBAL_eggseport20FINAL.pdf
• EWG Cord Study http//www.ewg.org/reports/bodyb
  urden2/execsumm.php
• New biomonitoring initiatives
• http//www.oztoxics.org/ipepweb/egg/egg20reports
  /GLOBAL_eggsreport20FINAL.pdf
• Stupid Fish, stupid children

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Hazardous Chemicals

• Glutaraldehyde
• Ethylene Oxide (EtO)
• Solvents alcohols, xylene
• Toxic Cleaning Chemicals
• Antineoplastic Drugs

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Whos in charge of chemical policies?

• Environmental air, water, toxic chemicals
  (pesticides) - EPA
• Food FDA and Dept of Agriculture
• Transportation of hazardous materials - DOT
• Lead-based paint, radon, carbon monoxide in
  buildings federal, state, and local policies
• Workplace exposures OSHA

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Regulatory ProcessesPre-market testing

• The regulatory process by which a drug comes to
  market includes several stages of testing,
  including both animal and human testing.

• There is no requirement for pre-market testing of
  chemical products that are not foods, cosmetics,
  or pesticides. No original testing is required.

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Governmental Chemical Policies

• Statutes
• Regulations
• Standards
• Permits / Zoning
• Voluntary programs

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Non-governmental policy opportunities

• Institutional / Company policies (Kaiser
  Permanentes new chemical policies)
• Collective bargaining / Contract language
• JCAHO
• H2E (Hospitals for a Healthy Environment)
• EPP

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Environmentally Preferable Products EPP)

• Less Toxic (mercury-free)
• Fewer Allergens (latex-free)
• Less Packaging (buy in bulk)
• Recycled content (paper supplies)
• Reusable (bedpans, mattresses)
• Energy Efficient (appliances)
• Many more...

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Health Care Without Harms Mission

• To transform the health care industry worldwide,
  without compromising patient safety or care, so
  that it is ecologically sustainable and no longer
  a source of harm to public health and the
  environment.

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HCWH Food Work Group

• Food procurement policies
• Nutritionally improved food
• Food systems that are ecologically sound,
  economically viable, and socially responsible

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Group Purchasing Organizations (GPO) Work Group

• Implementing Environmentally Preferable
  Purchasing (EPP)
• Working with group purchasing organizations
  (GPOs) and Product Evaluation Committees

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Medical Waste Treatment Work Group

• Promotes policies, practices and laws that
  eliminate incineration of medical waste
• Advocates for safer waste alternative
• Provides organizing and technical assistance to
  local groups in closing medical waste
  incinerators in their communities.

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Global Projects and International Outreach (GPIO)

• Works internationally to develop collaborative
  strategies
• Provides technical assistance, training and
  international networking opportunities, public
  education, and media work
• Influences international organizations and
  financial institutions to cease the funding of
  medical waste incineration

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Strategic Healthcare Initiatives (SHI)

• Implements Health Care Without Harm's goals in
  health care facilities through the Hospitals for
  a Healthy Environment (H2E) program.
• Provides educational materials, technical
  assistance and opportunities for collaboration

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Regional Organizers Work Group (ROW) 

• Supports local organizing efforts for HCWH.
  (Philadelphia, Boston, Chicago, Washington DC,
  California, Michigan, Montana and Alaska.) 
• Promotes specific HCWH issues such as mercury,
  PVC, and PBT reduction/elimination, medical waste
  issues, and health care justice. 

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Safer Materials Work Group

• Moving the US and European markets toward safer
  materials and helping define the characteristics
  of those materials. 
• Focus on PVC, brominated flame retardants (BFRs),
  and other Persistent Bioaccumulative Toxins
  (PBTs)

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Green Building (GBH)Work Group

• Green design/materials for construction,
  operation, and maintenance of health care
  facilities.
• By extension of its leadership and the Green
  Guidelines for Health Care (GGHC), is
  advocating/promoting comprehensive approaches for
  greening all buildings

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NursesWork Group

• Developing the role of nurses in environmental
  health with a priority focus on Health Care
  Without Harm issues.
• Engages in educational and advocacy efforts
• Works with a wide range of nursing leaders and
  nursing organizations.
• Attempts to coordinate efforts

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Nurses Work Group Activities

• RN No Harm
• The Luminary Project
• Writers Workshop
• Speakers Bureau
• Nurse Lobbyist development
• Outreach to Nursing Unions (UAN, SEIU)
• Outreach/development with state nurses
  associations
• Working with Nursing Subspecialty organizations
• Technical Assistance

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The Good News

• Popular media is raising awareness
• Green is marketable (organic foods, green
  cleaners)
• Hospitals are taking leadership
• Nurses participation makes a real difference (in
  hospitals, in the legislature, in chemical
  policies)
• Ready, willing, and able collaborators
  environmentalist, health-effected groups, and the
  public health community
• Health Care Without Harm
• Hospitals for a Healthy Environment (H2E)

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Strategic Next Steps

• Stronger engagement with direct care nurses
• Better integration of nurses into existing
  advocacy activities
• Improved communication
• Within the greater nursing community
• Within HCWH and H2E efforts
• With the environmentalist community

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Next Steps

• Contract language
• Health and Safety Committee Work
• Purchasing and Product Selection Committees
• Coalition building (H2E, ROW)
• Legislative / Regulatory involvement
• Technical assistance
• And.

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And along the way, dont forget to

• Mentor newbies
• Celebrate victories
• Honor our champions