RN No Harm Environmental Health September 21, 2005 Alexandria, Virginia

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 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. RN No Harm.

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

Nursing, health and the environment IOM Report 1995 published: Pope, Snyder, Mood published: Pope, Snyder, Mood. General environmental health competencies for nurses 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 Freedom from illness or injury related to exposure to toxic agents and other environmental conditions that are detrimental to human health

Significance: What we know Heritability estimates in 28 types of cancer examined in 45,000 twin pairs 0% heritability (100% for environmental) for cervical cancer 0% heritability (100% for environmental) for cervical cancer 27% (73%) for breast 27% (73%) for breast 42% (58%) for prostrate 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 Environmentally attributable fraction for 4 pediatric conditions 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 Louisiana known as “cancer alley” as a result of the petroleum and polyvinyl chloride manufacturing The ‘oily dog’ Louisiana known as “cancer alley” as a result of the petroleum and polyvinyl chloride manufacturing The ‘oily dog’

Foundations in Policy ANA Positions ( ANA Positions ( –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 AORN Recommended Practices for Environmental Responsibility ICN Position Statements ( ICN Position Statements ( –1986 Nursing and the Natural Environment –1998 Medical Waste: Role of Nurses and Nursing –2003 Access to Safe Water

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

Successes Get the lead out! Of gasoline resulted in decreased lead levels in children 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 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 DDT ban resulted in the Bald Eagle’s removal from endangered species list

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

“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.”

Resources rnnoharmrnnoharm or gova/state.htm rnnoharm d.edu d.edu d.edu d.edu Noharm.org Noharm.org H2e-online.org H2e-online.org Sustainablehospitals.or g Sustainablehospitals.or g Cheforhealth.org Cheforhealth.org