and oncology nurses need to understand that cancers and other diseases in older people may be due in whole or in part to toxic exposures that occurred years earlier in the workplace, home, or community. Nurses working in obstetrics and gynecology need to be aware that many environmental hazards are known to affect adversely reproductive health or are suspected of doing so (Paul, M., 1993). Emergency department and trauma nurses need to know how to isolate, decontaminate, and treat workers and emergency response personnel who are exposed to toxic chemicals through transportation spills, industrial accidents, or unsafe working conditions. Occupational health nurses, who already address health hazards in the work environment, need to be wary of workplace chemicals that can be carried into the community as effluent or into homes on the clothing of workers, putting additional populations at risk.

In particular, any nurse caring for economically disadvantaged patients should be aware that these populations often face an increased risk of exposure to hazardous environmental pollutants. For example, low-income and minority populations are more likely to live near or work in heavily polluting industries, hazardous waste dump sites, and incinerators (EPA, 1992). They are more likely to live in substandard houses with friable asbestos and deteriorating lead paint and to have yards with contaminated soil. They are also more likely to be exposed to toxic chemicals through diets that include seafood or fish taken from local waters designated unfit for swimming and fishing. Thus, the environmental burden is generally greater for minorities and the economically disadvantaged because they are exposed to a greater number and intensity of environmental pollutants in food, air, water, homes, and workplaces. Inequities of this kind have generated sharp controversies, often cast in terms of "environmental justice," about legislative and regulatory measures that can be used to decrease the burden of pollution on disadvantaged communities. The environmental justice issue has special relevance to this report, because for many disadvantaged populations, nurses represent the initial and most consistent point of contact with the health care system. Because of their close contact, nurses are well positioned to represent the environmental concerns of members of these communities in discussions of health policy.

Individuals and communities often lack adequate information about environmental hazards to enable them to act on their own behalf. There are a variety of reasons for this lack of access to information, such as the use of overly technical language in warning signs, illiteracy, and language inadequacies. Nurses are responsible for responding to an individual's or a community's lack of access to information.



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