Ch04

Health Promotion StrategiesHealth Promotion Strategies
Through the Life SpanThrough the Life Span
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Health Promotion Strategies Through the Life Span, Eighth Edition
Ruth Beckman Murray, Judith Proctor Zentner, and Richard Yakimo
Chapter 4
Environmental Influences

Figure 4.1 Human
interrelationship
with the
environment.

Figure 4.2 Various
forms of life
effected by
pollution.

PollutionPollution
 One form of pollution can affect another
– Soil pollution can affect water when there is
runoff
– Air pollutants can cause soil pollution when
they fall to earth as particles or are dissolved
in rain

Air PollutionAir Pollution
 Causes
– Excessive use of greenhouse gases
 Effects
– Increase in greenhouse gases
– Depletion of upper atmosphere ozone layer
– Presence of photochemical ozone at ground
level
– Industrial chemical releases
– Presence of acid deposition

Effects of Greenhouse GasesEffects of Greenhouse Gases
 Increased heat-trapping capability of gases
 Problems with increased heat
– Diseases caused by insects and pests
– Heat strokes and heat-related deaths
– Myocardial infarction
– Respiratory diseases
– Bronchitis
– Asthma

Effects of Decreased OzoneEffects of Decreased Ozone
 Sunburn
 Compromised immune system
 Cataracts
 Nonmelanoma skin cancer
 Malignant melanoma
 Immune system diseases

Effects of Photochemical OzoneEffects of Photochemical Ozone
 Most harmful to very young, very old, or
persons with respiratory or cardiac
diseases
 Also creates respiratory difficulty in
healthy people working or exercising
outdoors
 Causes bronchitis, emphysema, asthma,
scarring of lung tissue, cardiac diseases
 Environmental Protection Agency created
Air Quality Index to measure air quality

Effects of Acid DepositionEffects of Acid Deposition
 Also called acid rain
 Effects on humans
– Cardiac and respiratory symptoms
– Cardiac diseases
– Respiratory diseases
– Death

Water PollutionWater Pollution
 Two origins
– Point sources
– Nonpoint sources
 Sources
– Municipal
– Industrial
– Agricultural

Soil PollutionSoil Pollution
 Causes
– Air pollutants
– Industrial wastes
– Fertilizers
– Toxic materials from sewage plants
– Heavy metals
– Landfills containing chemicals or
contaminated wastes

Food PollutionFood Pollution
 Causes
– Additives
– Pesticides
– Hormones
– Antibiotics
– Arsenics
– Mercury
– Other toxins
 Possible Effects
– Yellow 5: hyperactivity
in children
– Antibiotics in animals:
human resistance to
antibiotics
– Mercury: learning
problems or
retardation in children;
damage to developing
fetuses

Food-borne IllnessesFood-borne Illnesses
 Examples
– Campylocacter
– Salmonella
– E. Coli
– Calicivirus
– Shigellosis
– Hepatitis A
 Symptoms
– Fever
– Diarrhea
– Abdominal cramps
– Vomiting

Noise PollutionNoise Pollution
 Causes
– Urban development
– Road, air, and rail
transport
– Industrial noise
– Neighborhood
noise
– Recreational noise
 Effects
– Headaches
– Minor illness or
accidents
– Reliance on
sedatives and
sleeping pills
– General fatigue
– Noise-induced
hearing loss (NIHL)

Surface PollutionSurface Pollution
 Refers to dangers of open dumps
 Nonhazardous wastes can still be harmful
 Hazardous wastes
– Paints
– Cleaners
– Oils
– Batteries
– Pesticides
 EPA aims to protect health and
environment

AsbestosAsbestos
 Mineral fiber added to products in 1970s
 Effects
– Respiratory difficulty and diseases
– Asbestosis
– Lung cancer
– Mesothelioma
 Educate clients about what to do with
asbestos

Biological ContaminantsBiological Contaminants
 Examples include bacteria, mold, viruses, animal
dander, dust, mites, pollen
 Effects
– Allergic reactions on skin
– Respiratory difficulty
– Specific allergies
– Asthma
 Educate client
– Good housekeeping and maintenance
– Adequate ventilation and moisture control

Carbon MonoxideCarbon Monoxide
 Effects
– Fatigue
– Headaches
– Chest pain
– Nausea
– Vomiting
– Impaired vision
– Poor coordination
– Acute myocardial
injury
– Death
 Educate client to
check combustion
equipment
– Furnaces
– Water heaters
– Generators
 Buy or check carbon
monoxide detector

FormaldehydeFormaldehyde
 Effects
– Watery eyes
– Burning sensation in
eyes and throat
– Nausea
– Wheezing
– Coughing
– Allergic reactions
– Asthma attacks
– Lung cancer
 Educate clients
– Use exterior-grade
pressed wood
products
– Avoid formaldehyde
products
– Use air conditioners
and dehumidifiers
– Provide adequate
ventilation

LeadLead
 Effects
– Physical and mental
delays or retardation
– Behavioral disorder
– Lower IQ levels
– Red blood cell
damage
– Kidney disease
– Nervous system
damage
– Convulsions, coma, or
death
 Educate clients
– Federal funding
available for lead
removal
– Prevention
– Screening
– Children with elevated
lead need further
testing

Nitrogen OxideNitrogen Oxide
 Found in aerosols, gas stoves, and
tobacco smoke
 Used as anesthetic
 Effects
– Irritation to eyes, nose, throat, and respiratory
tract mucosa
– Respiratory infections
– Decreased lung capacity
 Educate clients to check combustion
equipment

PesticidesPesticides
 Effects
– Headache
– Dizziness
– Weakness
– Nausea
– Liver and kidney
disease
– Endocrine and
nervous system
damage
 Educate clients
– Choose pest
control companies
carefully (organic)
– Follow
manufacturer’s
directions
ventilation
– Dispose carefully

Volatile Organic CompoundsVolatile Organic Compounds
 Effects
– Eye, nose, and
throat irritation
– Headache and
dizziness
– Memory
impairment
– Liver, kidney, and
nervous system
damage
 Educate clients
– Discard unneeded
chemicals
ventilation
– Minimize exposure
to methylene
chloride, benzene,
and
perchloreothylene

RadonRadon
 Serious indoor pollutant caused by natural
decay of uranium in soil and rocks
 Causes respiratory difficulty and lung
cancer within 2 to 5 years after exposure
 Educate clients that do-it-yourself tests
can be purchased for a qualified tester can
be hired

Respiratory ParticlesRespiratory Particles
 Examples include soot, dust, and ash
 Effects
– Eye, nose, and throat irritation
– Respiratory infections and bronchitis
– Lung cancer
 Educate clients
– Adequate ventilation
– Perform proper maintenance on heating and
air conditioning and fireplaces

Second- and Third-hand SmokeSecond- and Third-hand Smoke
 Effects
– Irritation of eyes, nose, and throat
– Ear infections
– Asthma attacks
– Bronchitis
– Pneumonia
– Lung cancer
– Aggressive or defiant behavior in children
 Educate clients to not allow smoking in home or
car

Federal Government and WorkFederal Government and Work
EnvironmentEnvironment
 Acts
– Occupational Safety and Health Act of 1970
– Coal Mine Health and Safety Act of 1969
– Toxic Substances Control Act of 1976
 Occupational Safety and Health
Administration
– Setting and enforcing standards
– Provides training, outreach, and education

In the WorkplaceIn the Workplace
 Educate about Healthy People 2010
 Assess workplace hazards
 Advocate for enforcement of preventative
measures for known hazards and
continued environmental research
 Support professional or societal
organizations that advocate safety and a
healthy environment

Workplace HazardsWorkplace Hazards
 Threats
– Physical, chemical, and biological
 Emotional stress, noise, lighting, comfort,
or ergonomic stressors
 Air pollution
– Fumes from disinfectants, surgical smoke or
laser plume
cause respiratory symptoms, burning and watery
eyes, nausea, and viral contamination and
regrowth

Reducing PollutionReducing Pollution
 Properly disposing of agents that can
affect water, soil, and surface
 Supporting legislation to protect
environment
 Staying abreast of information from
agencies such as EPA
 Following directions on items such as food
 Staying aware of potential hazards in local
environment and taking action

Professional ResponsibilityProfessional Responsibility
 Help to control pollution worldwide through
conservative solutions
 Work with professional organizations
 Establish environmental task forces
 Restructure national and state
organizations to better address
environment
 Educate clients about environmental
pollutants

BioterrorismBioterrorism
 HAZMAT event
– Materials disseminated through inhalation,
skin absorption, or ingestion
– Examples
Biotoxins
Blister agents
Blood agents
Nerve agents
Toxic alcohols

Bioterrorism, contBioterrorism, cont
 Biological agents
– Category A: most devastating
Examples: smallpox, anthrax, plague
– Category B: lower mortality potential
Example: Q fever, ricin toxin, salmonella
– Category C: not believed to be present risk
Example: yellow fever, multi-drug resistant
tuberculosis

Bioterrorism, contBioterrorism, cont
 Radiological/nuclear agents
– Alpha particles are the least penetrating
– Beta particles can penetrate skin
– Gamma particles can pass through the
human body and be absorbed by tissues

Explosive AgentsExplosive Agents
 70% of all terrorist attacks in the U.S.
 Common blast injuries
– Liquid in lungs moves into gas area of the
alveoli and causes hemorrhage
– Implosion, compression, and decompression
causes rupture of tympanic membranes
– Blast waves can drive fluids from their
spaces, causing pulmonary hemorrhage

Disaster ResponseDisaster Response
 Activation Phase
– Survey damage and casualties
– Establish communication and information
facilities
 Implementation Phase
– Search and rescue
 Recovering Phrase
– Reassess scene for missed victims
– Debrief

Emergency Organizations and PlansEmergency Organizations and Plans
 Department of Homeland Security
– Federal Emergency Management Agency
(FEMA)
National Response Plan (NRP)
National Incident Management System (NIMS)
 Joint Commission
– Requires creation and testing of hospital
disaster plan
4 phases: mitigation, preparedness, response,
recovery

Family Plan for DisastersFamily Plan for Disasters
 Where to seek shelter
 How to contact family
 List of medications and emergency
numbers
 Tote bag with supplies
– Examples: ID, flashlight, portable radio,
batteries, bottled water, important family
documents, first aid and hygiene products

Community Disaster PlansCommunity Disaster Plans
 Include physical, emotional health, and
cultural considerations
 International Nursing Coalition for Mass
Casualty Education (INCMCE)
recommends nurses be prepared for
responding to disaster
 References and sources of information in
community can educate health care
workers

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