Common Toxic Exposures in Health Care: What every nurse should know
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1 Common Toxic Exposures in Health Care: What every nurse should know Barbara Sattler, RN, DrPH, FAAN Professor, MPH Program University of San Francisco
2 Sign up for envirn listserve By nurses for nurses New research Resources Funding opportunities Policy / Advocacy
3 The quality of the ENVIRONMENT is a major determinant of human health. Yet most nurses do not learn about air, water, food, soil, waste, and products in terms of their impacts on human health. not to mention climate change, radiation (other than medically-related)
4 Institute of Medicine Report: Nursing Health and the Environment (1995) Integration of EH into Nursing; Education Nursing education CE Patient Research Clinical Practice EH in Patient Care Greening our work settings Policy / Advocacy In our institutions Locally, state, national
5 ANA Scope and Standards of Professional Practice: NEW! ENVIRONMENTAL HEALTH STANDARD Standard 16
6 Biomonitoring: New Tool for Environmental Health
7 Charlotte Brody, RN Body Burden Studies Chemicals found in Charlotte: 214 tested 87 found
8 Charlotte Brody, RN Body Burden Chemicals found in Charlotte number: associated with: 54 Birth defects and dev delays 53 Immune toxicants 52 Cancer 37 Brain and nervous system 23 Reproduction and fertility 16 Hormone activity 10 Gastrointestinal (including liver)
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15 Hazardous Chemicals in Health Care: A Snapshot of Chemicals in Doctors and Nurses 62 Chemicals (including congeners) 12 Doctors 8 Nurses BPA Perfluorinated compounds Phthalates PBDEs Triclosan
16 BPA EDC, repro toxicant, breast and prostate Ca, brain fx, obesity, thyroid disfx Perflourinated compounds EDC, Immunotoxicant, liver/pancreatic tumors (animal) Phthalates reproductive development PBDE neurotoxicant (brain fx, memory, behavioral problems) Triclosan thyroid disfx, EDC, cardiotoxic At least 24 chemicals were found in any given person studied.
17 OSHA has left us alone
18 National Nurses Survey Exposures to 11 chemicals or hazardous agents, including Glutaraldehyde Ethylene Oxide Medications Medical devices such as mercury and ionizing radiation Anesthetic Gases Natural Rubber Latex Hand and Skin Disinfection Products Housekeeping Chemicals
19 Survey Findings ~ Housekeeping Chemicals 92% reported exposures 47% higher rates of asthma
20 Survey Findings ~ Personal Care Products 97% reported on-the-job exposures 1/3 of all products contain one or more ingredients linked to cancer 40% contain fragrances (associated with allergic reactions and cancer risks)
21 Survey Findings ~ Latex 64% percent of more than 1,500 nurses reported high (at least twice per week) exposure for five years or more. Nurses with frequent, longterm exposures to latex (at least weekly for at least ten years) reported 39 percent higher rates of asthma than other nurses.
22 Survey Findings ~ Hand & Skin Disinfection 96% reported exposures 39% higher rates of asthma
23 Nurses Survey Finding ~ Sterilization & Disinfectant Agents 52% reported on-the-job exposures 46% higher rates of asthma in those most highly exposed
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27 Survey Finding ~ Anesthetic Gases 36% reported exposures Up to seven times higher rates of birth defects in their children (central nervous system, cardiovascular, genitourinary, and musculoskeletal)
28 Survey Findings ~ Medications 95% reported exposures 14% higher rates of cancer
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30 Asthmagens: - Antibiotics, - Laxatives, - Antihypertensives, - Antituberculars, - H2 blockers
31 Survey Findings ~ Medications Antiretroviral Meds: Suppress HIV virus 47% 19% higher rates of difficulty conceiving
32 Survey Findings ~ Medications Chemotherapeutic Agents 41% reported exposures 42 percent higher rates of cancer than other nurses.
33 Survey Findings ~ Housekeeping Chemicals 92% reported exposures 47% higher rates of asthma
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35 Perfumes and Fragrances Go Fragrance-free
36 Over 70% of all antibiotics in the US are used in animal feed
37 Antibiotics Cattle Hogs Chickens Farmed Fish
38 Many the same as those for human use Virginiamycin Tetracyclines Penicillin Streptomycin Bactrican Salinomycin Lasalocid Monensin Bambermycin Arsenicals
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40 Arsenic in poultry Used for: Growth promotion Pigmentation > 70% of broiler chickens are fed arsenic. Prophylaxis - compensate for growing conditions 55% of raw, supermarket chicken had detectable arsenic. Banned in Europe
41 Antimicrobials in furniture
42 Conserving our armament of antibiotics Purchasinig Decisions: Meats and poultry raised without ABX Furnishings without antimicrobials Judicious use of antimicrobials at home and in the hospital (soap versus antimicrobials)
43 PBDEs (flame retardants) = neurotoxicants Choose PBDE-free Movie: Toxic Hot Seat
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45 DEHP in IV bags and tubing (di-ethylhexyl phthalates)
46 DEHP Leaches into IV fluids
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48 Choose DEHP-free products
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50 PVC Plastics
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55 Green Team Logos
56 Close the loop prevent exposures in the community
57 Blue Wrap Recycling?
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59 Alliance of Nurses for Healthy Environments (ANHE) Bringing Science and Passion to the Environmental Health Movement
60 Alliance of Nurses for Healthy Environments Bringing Science and Passion to the Environmental Health Movement Work Groups: Education Practice Research Policy/Advocacy Committees Climate Change Fracking
61 Welcome to A Virtual Community of Nurses Educating [curriculum / e-text] Resources Practice recommendations Advocacy A power-tool for the nursing community and healthy environments
62 iphone App RN
63 What do we want to tell pregnant women about preventing unnecessary exposures?
64 Prenatal Environmental Health Questionnaire go to assessment
65 ANHE: Free Monthly Calls Talk with Nurses from around the Country Practice Workgroup Calls: 3 rd Tues of the month at 12noon PST (240) (No ID/password necessary) Check the homepage of envirn.org for updates and for all other workgroups
66 Safe Chemical Act
67 Where s the Evidence National Library of Medicine Tox Town - Interactive guide to environmental health risks and potentially toxic substances for the public; explore a city, town, port, or the US-Mexico border for potential environmental health hazards and how to manage them Household Products Database Health and safety information on over 7,000 brand name products including personal care, cleaning, gardening, auto care, pests, crafts, etc. household.nih.nlm.gov ToxNet suite of programs:
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69 ToxTown s CITY
70 ToxTown s Hospital
71 householdproducts.nlm.nih.gov
72 Skin Deep
73 IMAGINE Cancer treatment centers built without materials linked to cancer Pediatric clinics free of chemicals that trigger asthma Hospitals with healthy food, fresh air, sunlight Imagine a hospital that is carbon neutral.
74 QUESTIONS?
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