1. 1 Role of Public Health Nursing in Environmental Health Presented by Marita Santos, RN, MSN Stella Fogleman, RN, MSN/MPH Los Angeles County Department of Public Health Environmental Health Services Toxics Epidemiology Program

2. Purpose & Objectives Describe the role of the Toxics Epidemiology Program in assessing and reducing adverse health effects associated with environmental exposures in Los Angeles County Explain various roles of Public Health Nurses in Environmental Health

3. Placement within L.A. County DPH, Environmental Health Division Bureau of Toxicology & Environmental Assessment Toxics Epidemiology Environmental Hygiene Lead Program 3

4. Toxics Epidemiology Program Vision: Safety from toxic agents in Los Angeles County so that all persons can live, work, and play in a non-hazardous environment. Mission: To assess and reduce toxic-related disease and injury, educate the public about toxic agents, and to advocate for solutions to toxic exposures to empower people to protect themselves, their families, and their communities in Los Angeles County.

5. Role of Toxics Epidemiology Program To better understand toxic potential: Study scientific literature Consult with medical and scientific experts Conduct epidemiological studies when necessary Conduct health risk assessment by identifying: Potential toxin Route of Exposure (inhalation, ingestion, and dermal) Pathway of exposure (air, soil, water, and food) Vulnerable populations Potential health effects

6. Mold Asbestos Industrial or Household chemicals Cancer clusters Fish contamination Air Pollution Heat Emergency Preparedness & Response (Chemical Terrorism) Examples of Environmental Concerns

7. Role of Public Health Nursing Respond to calls, emails, and formal referrals Collaborate on environmentally-related disease cluster investigations Assess possible connections between exposures and health effects Form health risk message –DPH External Relations and Communication Program

8. Role of Public Health Nursing Work with interdisciplinary team –Medical Toxicologist, Industrial Hygienists, Epidemiologists, Reseach Analysts, Health Educators Provide education and outreach –Trainings, community meetings, health fairs Track legislation regarding environmental health issues –Initiate or support policy statements or testimonies

9. Examples of Public Health Nursing in Environmental Health – 3 Levels Individual Level –Health consultation about indoor environment of the home (mold, household chemicals) Community Level –Public health messages about air quality during wildfires Systems Level –Advocating for improved policies to protect vulnerable populations

10. How to contact us: Toxics Epidemiology Program Website: http://www.lapublichealth.org/tox http://www.lapublichealth.org/tox Email: tox@ph.lacounty.gov Phone: (213) 738-3220

11. Other Resources Environmental Protection Agency (EPA) http://www.epa.gov/region09/index.html http://www.epa.gov/region09/waste/sfund/index.html Agency for Toxic Substances & Disease Registry (ATSDR) http://www.atsdr.cdc.gov/ California Department of Toxics Substances Control (DTSC) http://www.dtsc.ca.gov/http://www.dtsc.ca.gov/ South Coast Air Quality Management District (AQMD) http://www.aqmd.gov/http://www.aqmd.gov/

12. Q & A