White House Climate and Nursing Roundtable

Wednesday, May 25th
by, Kimberly J. Angelini, WHNP-BC, RN

Today was a beautiful sunny day in D.C.

As part of Extreme Heat Week, the White House hosted representatives from leading national nursing organizations to discuss the critical importance of fighting climate change to protect public health.

Nurse leaders from across the country were convened by the Alliance of Nurses for Healthy Environments (ANHE) with hopes of establishing a relationship with decision and policy makers in Washington.

I was personally introduced to effects of environmental toxins on health through Stacy Malkan’s book Not Just a Pretty Face: The Ugly Side of the Beauty Industry. I was shocked to learn that the FDA does not regulate cosmetic products and that many contain chemicals and toxins that have been known to cause cancer and birth defects. In the book she mentions a study in which the cord blood of a newborn was found to have high levels of many of these toxins. Makes you think twice.

With this in mind I found the Skin Deep database by the Environmental Working Group (EWG.org) that lists chemicals in products and rates them as a consumer reference. I got involved and attended several lectures held by the EWG on environmental toxins as well as climate change and the effects on health. This area is critical yet remains out of the minds of the general population. The ANHE and other organizations are playing a fundamental role in bringing these health issues to the forefront and lobbying for policy change.

Nurses are on the front lines caring for America’s health.  In light of the current and predicted health threats from climate change, this historic event focused on how nursing organizations can address this public health threat through educating their members, leading research, incorporating climate change into their nursing practice, and participating at the local, state, and federal levels on climate policies like the Environmental Protection Agency (EPA)’s Clean Power Plan, which sets the first national limits on carbon pollution from power plants.

Nurses are health care professionals accustomed to looking at health holistically (telling someone to eat healthy is more complicated if the only food source in a town is fast food and gas stations.)  It is the nurse who looks at the environmental, social, and cultural aspects of an individual’s life to understand if a treatment plan will work. Nurses, as the most trusted profession, are at an opportune position to educate patients on the effects of climate change on health and anticipate the public health issues that will arise in a changing environment.

Although combustion of fossil fuel, agricultural practices, and forestry, are already causing harm and change can not be expected overnight, the harm will be less if we take prompt action. We need to both decrease the causative agents and increase our adaptations and resiliency.

Major health consequences include:

• Extreme Heat –
  • As temperatures rise, there will be an increase in heat related deaths and illnesses (particularly for vulnerable populations including pregnant women, children, elderly, and homeless)
• Air –
  • Increased temperatures decrease air quality
  • Wildfires have been increasing 5-6 fold and contribute to increased ozone and particulate matter resulting in increased cardiovascular and respiratory illnesses and death
  • Higher pollen counts contribute to longer and stronger allergy seasons
• Increased Precipitation—
  • Combination of rising sea level and increase in extreme precipitation in the form of hurricanes and storm surges can lead to flooding, alter infrastructure and result in negative health consequences before, during, and after the event, such as drowning, trauma and mental health consequences (eg PTSD)
• Water-related infections—
  • Flooding and increased water temperatures increasing contamination of water and toxic algaea growth (Vibrio vulnificus)
  • Contamination of water or shellfish
  • GI illnesses, sepsis
• Vectors –
  • Elevated temperatures and increased water breeding sites (lead to longer and larger populations)
  • Ticks and mosquitos will show earlier in season and expand northward geographically
  • Increased exposure to lyme, zika, malaria, west nile, etc.
• Food –
  • Increased temperature, humidity, and season length
  • Increased salmonella 
• Mental Health –
  • Traumatic events and natural disasters
  • Distress, grief, PTSD, social impacts, and increased stress

The impact on human health is a nonpartisan consequence of climate change that speaks to everyone globally and cannot be denied by opposition.

The need for nursing participation was clear and members of ANHE encouraged White House staff to consider electing nurses onto their committees. The role of developing committees and initiatives within each specialty nursing professional organization was addressed and the overarching importance of combining resources and efforts across nursing specialty organizations and interdisciplinary to accomplish optimal health for our nation.

Going forward, the EPA is voting on an alliance with ANHE to support continued collaboration and efforts to address this global and pressing issue.

Kimberly J. Angelini, WHNP-BC, RN is a PhD student at Boston College studying women’s health promotion. She is currently a board certified Women’s Health Nurse Practitioner and works at Dowd Medical Center Gynecology. Kim also works as a staff nurse on the in-patient transplantation unit at Massachusetts General Hospital.