The impact of environmental exposures on women’s health

This interview features Katie Huffling, DNP, RN, CNM, FAAN, executive director of the Nursing Alliance for Healthy Environments in Mount Rainier, Maryland.

KH: We are the only national nursing organization that focuses primarily on the intersection of health and the environment. I’m also a nurse midwife and my interest in environmental health was really born out of a greater recognition of how the environment can affect reproductive health. It’s kind of woven throughout my career as a nurse-midwife.

Q: What are some of the key points that providers need to know regarding environmental exposures and women’s health?

KH: No matter what area of ​​healthcare you are in, [or] what is your profession, whether you are a nurse, advanced practice, nurse practitioner, most of us have not had much environmental health education. It’s a really underutilized area of ​​healthcare where we have such an incredible opportunity to help prevent disease and help our patients have much better outcomes. When we look at environmental exposure and the things that our patients can be exposed to, whether they’re at home or at work or just out in the environment, we can make such an incredible impact on their health.

Q: What are the most prevalent environmental issues currently related to women’s health?

KH: I would say that one of my main areas of interest right now is around climate change. There is a growing consensus that climate change is the most pressing public health issue facing us today. But on the contrary, it is also the biggest opportunity. Because when we talk about climate change, there are so many different aspects of health that we can affect. Within climate change, things that are related to this are things like air pollution, extreme heat, larger areas for vector-borne diseases, issues around water – like floods and drought, wildfires – there are so many different components and depending on the age of your patient, whether it is newborns, elderly, [or women of] reproductive age, they have different health impacts depending on [not only] their age, but also if they have chronic diseases. For example, with air pollution, we know that when the temperature goes up, air quality goes down. When we have more days with high temperature, we have more days with poor air quality. So [for] patients who have respiratory or heart problems, if they are outside on these poor air quality days or don’t have access to…good indoor air quality, are more likely to end up in the emergency room [with] breathing or heart problems.

As healthcare professionals, I believe we have a moral obligation to talk to our patients about ways to reduce exposures. Using air pollution as an example, there’s a tool called airnow.gov where they can sign up and get alerts on their phone or in their emails so the day before a bad air quality day tells them you’re going to be bad air tomorrow and here are some things to do depending on the type of pre-existing condition you have.

We also need to get involved in advocacy because climate change is a huge problem. While individual action is really important, we really need to talk to our elected officials and to politicians and help them make that connection between health and climate change and [let them know that] when they take these climate actions, they really improve the health of their constituents.

Q: What are some important findings from the Body Burden benchmark studies?

KH: About 15 years ago, the first comprehensive body burden studies began to take shape, testing various body fluids such as blood, urine, breast milk for a wide range of industrial chemicals. The reason it first started at that time was [because] then for the first time we had laboratory tests that could actually be run and be able to assess whether [those chemicals were] into body fluids and then into the human body. So when they first did a pilot test on about 15 adults, they found a variety of different chemicals in them in measurable amounts. They then partnered with the American Red Cross and did cord blood tests on about 20 babies right after birth and found about 285 different chemicals in the cord blood right after birth. So this shows that these babies during pregnancy — we don’t know exactly when during pregnancy they may have been exposed to these different chemicals — were exposed to measurable amounts of chemicals. A lot of them have to do with health impacts, like neurological issues like autism and ADHD, developmental issues, things that we’re seeing on the rise. I don’t think that’s the whole picture of why some of these different diseases and ailments occur, but I think it’s part of why we’re seeing this.

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