NR443 Week 6 Discussion, Environmental Health

NR443 Week 6 Discussion, Environmental Health For this week’s discussion I chose to look at the My Health tab on the EPA (2018) website. The 2014 risk for cancer due to inhalation of toxins in the air in Williamson County, Texas is 32 per million. One surprising thing I learned is that the largest contributor to toxic air in my county are secondary sources at 67.3% and that is a measure of ambient concentrations of formaldehyde, acetaldehyde, and acrolein. This is important information to have as Nies & McEwen (2019) state that exposure to toxins in the air have been found to have “a direct relationship with the development of some cancers, chronic diseases, and other health-related problems” (p. 264). Doing further research, I found that formaldehyde is found in resins in composite wood products such as plywood and particleboard. It’s in building materials and insulation. It can be caused by poorly vented gas stoves or kerosene space heaters, and it is in cigarette smoke and worse when it’s indoors (EPA, 2018). Fortunately, the EPA has set limits on how much formaldehyde can be released from composite wood products. It is also used in the production of fertilizer and given all the farming that is done in a state as large as Texas, I can see how that could contribute to our number of air toxins and could possibly affect migrant or farm workers (ATSDR, 2015). Acrolein is a toxin that can occur as a by-product of heating fats; I’m thinking that vulnerable populations could be employees in food prep, industrial kitchens or line chefs in restaurants. It can also be elevated in areas with heavy traffic or in parking garages. Lastly, it is a by-product of tobacco smoke (ATSDR, 2015). People with respiratory illness could suffer an exacerbation of their symptoms when exposed to this gas and children are particularly respiratory sensitive to this toxin when exposed to indoor tobacco smoke. Acetaldehyde is the most abundant carcinogen in tobacco smoke, and a leading cause of hangovers according to NCBI (2019). “It has been shown to increase the risk of developing cirrhosis of the liver, multiple forms of cancer, and alcoholism” (NCBI, 2019). Given that tobacco smoke is a leading cause of toxic air related to formaldehyde, acrolein, and acetaldehyde exposure and can be particularly harmful to children, as a community health nurse I sought more information on the Healthy People 2020 website I found objective TU-11.1 “which is to reduce the proportion of children aged 3 to 11 years exposed to secondhand smoke (USHSS, ODPHP, 2018). In this circumstance, the stakeholders will be the parents/caregivers of children. A home health nurse (HHN) should always assess the environment of each home she visits no matter who the client is. If there is suspicion of indoor tobacco use in the presence of children, the HHN should verify her concern, teach why the behavior is dangerous to children in the home, educate as to the health risks adults and children can suffer when exposed to the aforementioned toxic chemicals in the air, and explore with the client/family ways to mitigate the risk and/or stop the behavior entirely. Mak, Loke, & Wong (2018) state that adequate knowledge and active participation in cessation of tobacco can improve outcomes and enhance the nurses’ teaching. Nurses should coach, counsel, and assist in the effort to end second-hand smoke risks to children. Liz Agency for Toxic Substance and Disease Registry (ATSDR). (2015). Acrolein. Retrieved from Agency for Toxic Substances and Disease Registry (ATSDR). (2015). Tox FAQs for formaldehyde. Retrieved from Mak, Y. W., Loke, A. Y., & Wong, F. (2018). Nursing intervention practices for smoking cessation: A large survey in Hong Kong. International Journal of Environmental Research and Public Health, 15(5), 1046. doi:10.3390/ijerph National Center for Biotechnology Information (NCBI). (2019). Acetaldehyde, CID=177. PubChem Database. Retrieved from Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier, 264. United States Environmental Protection Agency (EPA). (2018). My environment. Retrieved from U.S. Department of Health and Human Services (USHHS), Office of Disease Prevention and Health Promotion (ODPHP). (2018). Healthy People 2020: About Determinants of Health. Retrieved from