RN No Harm Environmental Health

1. RN No HarmEnvironmental Health September 21, 2005 Alexandria, Virginia

2. Introduction to the Project • In July, 2002, the Beldon Fund Foundation awarded a grant to the American Nurses Association (ANA) through American Nurses Foundation (ANF) for an exciting new environmental health project called • RN No Harm.

3. Nurses as Environmental Health Advocates • The RN No Harm project seeks toactivate nurses as environmental health advocates. • Nurses are already patient advocates • ANA views nurses as potentially powerful voices for the environment • Environmental Advocacy - community as patient

4. 1995 published: Pope, Snyder, Mood. General environmental health competencies for nurses Basic knowledge & concepts Assess and refer Advocacy, ethics, and risk communication Legislation & regulation Freedom from illness or injury related to exposure to toxic agents and other environmental conditions that are detrimental to human health Nursing, health and the environment IOM Report

5. Heritability estimates in 28 types of cancer examined in 45,000 twin pairs 0% heritability (100% for environmental) for cervical cancer 27% (73%) for breast 42% (58%) for prostrate “ . . .the overwhelming contribution to the causation of cancer in the populations we studied was the environment” Lichtenstein et al. NEJM, 2000:343 (20). Significance: What we know

6. Environmentally attributable fraction for 4 pediatric conditions Lead poisoning = 100% Asthma =~ 30% Cancer = ~ 5% Neurobehavioral =10% Annual cost = $54.9 billion Landrigan et al. “Children’s health and the environment” Environmental Health Perspectives, 2004. Significance: what we know

7. Significance • Louisiana known as “cancer alley” as a result of the petroleum and polyvinyl chloride manufacturing The ‘oily dog’

8. Foundations in Policy • ANA Positions (www.nursingworld.org) • 1997 HOD Report: Reduction of Health Care Production of Toxic Pollution • 2003 Precautionary Principle • 2004 Environmental Health Principles in Nursing • AORN Recommended Practices for Environmental Responsibility • ICN Position Statements (www.icn.ch) • 1986 Nursing and the Natural Environment • 1998 Medical Waste: Role of Nurses and Nursing • 2003 Access to Safe Water

9. ANA Actions • 1997 Joined HCWH: Campaign for Environmentally responsible health care • 1998 Participate in negotiation of MOU between AHA and EPA creating H2E • Minimize waste volume & toxicity • Eliminate mercury use by 2005 • 2002 RN No Harm project launched • 2005 Lawsuit against EPA over mercury emission

10. Successes • Get the lead out! Of gasoline resulted in decreased lead levels in children • Closure of 700 medical waste incinerators led to reductions in dioxin emissions • DDT ban resulted in the Bald Eagle’s removal from endangered species list

11. Beldon Fund Vision & Mission • Our vision for the future is a planet with healthy people living in healthy ecosystems. • By supporting effective, nonprofit advocacy organizations, the Beldon Fund seeks to build a national consensus to achieve and sustain a healthy planet.

12. “No amount of medical knowledge will lessen the accountability for nurses to do what nurses do, that is, manage the environment to promote positive life processes.”

13. Resources • www.Nursingworld.org/ rnnoharm or gova/state.htm • www.enviRN.umaryland.edu • Noharm.org • H2e-online.org • Sustainablehospitals.org • Cheforhealth.org