Research by WHEN

The Women's Health & Environmental Network (WHEN) has conducted pilot research projects as well as translated research findings into public practices. WHEN takes research published in peer-reviewed journal articles and uses the information to teach people about toxic substances. The pilot research projects include assessment tools and survey development, used for program implementation. The results from these efforts have been presented
at the College of Physicians of Philadelphia, Public Health Section Poster Session, American Public Health Association International Conferences, and numerous public venues. Listed below are a brief summary of some of WHEN's research efforts:

WHEN at Amercian Public Health Association 2006
in Boston, MA!

Environmental health nursing: Fostering future leaders

Laurie Ann Colborn, MSN, RN1, Teresa Méndez-Quigley, MSW, LSW2, Mary T. Bouchaud, MSN, RN, PhD-c3, Ramona Salotti, BS, RN2, and Julie Becker, PhD, MPH2. (1) Guest Lecturer - Community Health Nursing, Thomas Jefferson University, Jefferson College of Health Professionals, P.O. Box 101, Woodbury, NJ 08096, 856-384-1545, Lauria@operamail.com, (2) Women's Health & Environmental Network (WHEN), 704 North 23rd Street, Philadelphia, PA 19130, (3) Department of Nursing, Thomas Jefferson University, Jefferson College of Health Professionals, 130 South 9th Street - Suite 1202, Philadelphia, PA 19107-5233

In 1995, the Institute of Medicine1 noted a lack of knowledge related to environmental health (EH) and nursing. In October 2003, the American Nurses Association adopted a Precautionary Principle2 related to EH. The awareness that the field of nursing lacks a general environmental knowledge base has encouraged the authors to create a pilot program that will help to educate student nurses on the basics of EH and its importance within the field of nursing.

The one-year pilot program expands the current EH curriculum. The goal is to educate 75-100 student nurses about EH nursing and engage them in EH issues within their communities. Integral to the project will be the development of a student community project specific to an EH issue which will result in submission of written pieces to selected nursing publications, newspapers, letters to the editor, legislators or presentation at a community health event. This project will culminate in students, as health care advocates, the opportunity to interact with local legislators to discuss their selected issues during a session arranged by the EH advocacy group in the final class.

This collaborative effort between an EH group and a local nursing school demonstrates an innovative partnership in reaching health care professionals early in their careers to provide leadership and advocacy skills in the growing EH arena. With this pilot, students should enhance their understanding of the important role that nursing plays within EH and continue to build on their skills throughout their nursing profession.

Determining pesticide and cleaning agent usages in childcare centers
Christa L. Smolenski1, Julie Becker, PhD, MPH2, Teresa Méndez-Quigley, MSW, LSW2, and Andrea Crivelli-Kovach, PhD, CHES3. (1) Arcadia University, 450 Easton Road, Philadelphia, PA 19130, 215-763-0298, ja.becker@verizon.net, (2) Women's Health & Environmental Network (WHEN), 704 N. 23rd Street, Philadelphia, PA 19130, (3) Department of Community Health, Arcadia University, 450 Easton Road, Glenside, PA 19038

Growing children need safe, secure educational environments in which they can learn and socialize. Specific environmental factors and practices, such as the use of conventional pesticides and commercial cleaning products can adversely affect normal development in infants and young children. This group is especially vulnerable to environmental exposures because of their body weight and immature immune and endocrine systems. Presently, there are few regulations regarding the use of conventional pesticides and commercial cleaning products in and around child care facilities. The purpose of this project was to assess a) the awareness level concerning the pesticide and disinfectant use among directors and mangers of child care centers in Philadelphia County, and b) their knowledge of Integrated Pest Management (IPM) and Green Cleaning. More than 20 childcare centers in 45 zip codes were surveyed via the telephone through a collaboration of childcare credentialing agencies. The researchers examined the type and use of commercial cleaning products among childcare staff, awareness of IPM and parental notification prior to pesticide application, and practice of IPM and Green Cleaning considering the location of the facility. Preliminary results from this study suggest there is little awareness of either Green Cleaning practices or IPM. The results from this study will be used to structure new interventions to educate childcare providers and parents about these issues. The ultimate aim of this project is to encourage and/or establish a mandate in the state of Pennsylvania requiring all childcare centers to practice IPM and Green Cleaning.

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I-PREPARE Environmental Assessment: WHEN, in conjunction with the Agency for Toxic Substances and Disease Registry (ATSDR) of the CDC, Drexel University, and Montana State University developed and pilot tested a pneumonic to remind health care providers to ask patients and their families about exposure to environmental conditions and chemicals. WHEN subsequently has distributed this card to several hundred healthcare professionals. A short follow-up survey was administered to some of these professionals that showed a heightened awareness of environmental exposures but little impact was made from the use of these cards. WHEN is considering other venues such as medical schools and residency programs with formal program to accompany the
distribution of the assessment cards.

"Christmas in April" House Renovation Project: WHEN took the lead in creating the first environmentally friendly house renovation project for the local group, "Christmas in April," a voluntary group that helps people stay in their homes by renovating them. Working in West Philadelphia, WHEN applied research about off gassing from paints and building materials as well as trained all volunteers (including building and trades people) about lead paint. As a result, WHEN used low-VOC paints, low VOC building compounds, and safe lead paint practices to rebuild a child's bed room, the dining room, and the bathroom. Because of WHEN's efforts, "Christmas in April" changed their national policy to educate all volunteers about lead paint and about the use of low VOC materials in building.

Environmental Education Survey: WHEN conducted a survey of 5 medical schools, 7 nursing schools and programs, and 4 physician assistant programs regarding the teaching of environmental health. It was not surprising to learn, that besides asthma and infectious disease, less than 5% of the curriculum presented information about environmental health. This is consistent with national data and suggests that there is a significant dearth of information regarding the links between environment and health taught in health professional schools.

Environmental Stewardship: Using translational research techniques, WHEN has worked with 50 healthcare facilities and public health departments around mercury removal and elimination. WHEN is broadening its efforts to
include a regional (5+ counties) computer recycling cooperative to reduce and eliminate harmful heavy metals like mercury and lead from the waste stream that are generated by computers. WHEN conducted a survey on computer
disposal practices in hospitals and found: 22% of responding facilities recycle, 33% do a combination of recycling and trashing, and 44% disposed of computer equipment, of which 62.5% placed them in regular waste and only
37.5% handled them as universal waste. The number of obsolete components replaced yearly, are as follows for those respondents who completed this section: over 755 CPUs, over 1300 monitors, 135 keyboards, 143 printers,
with over 50 other peripheral, networking and communications units removed from the facilities. Hospitals expended approximately $18,000 to dispose of these components in 2002, according to respondents. Only 22% of facilities
had Take-Back provisions in their contracts. Those who reported trashing components expressed interest in recycling or donating. Many expressed concerns about costs of disposal, amount of staff hours to handle disposal
and deleting patient information as per the new Health Insurance Portability and Accountability Act (HIPAA) guidelines.

Hospital Environmental Practices Survey – Spring 2004 WHEN developed a survey to assess environmental best practices among health care facilities in the Philadelphia Region. The Delaware Valley Healthcare Council (DVHC) disseminated the survey to its member hospitals. Respondents were invited to share their information with DVHC via the survey. DVHC CEO gave highlights of the best practices at CleanMed 2004 in Philadelphia.