environmentally related diseases (e.g., lung cancer caused by exposure to asbestos is more likely to occur among people who smoke tobacco). Nevertheless, the link between adverse health effects and exposure to environmental hazards has been well established, and much can be done to prevent or minimize environmentally related illnesses.

While scientific understanding of the potential adverse health effects of most chemical compounds on humans is incomplete, reports concerning the adverse health affects associated with chemical exposures in other species are frequent. People's concerns about the impact of environmental conditions on their health are often voiced to nurses in the community and at the workplace. However, many nurses do not have the knowledge needed to identify environmental factors that may contribute to illness and injury among the populations they serve.

Environmental hazards may be encountered at home, work, or in the community via several pathways: contaminated air, soil, water, and food (see Figure 2.1). Routes of exposure include: inhalation, such as, of dust or fumes; ingestion, such as, of pesticide residues on fruits and vegetables; and dermal absorption, such as, of ultraviolet-B radiation from the sun or direct skin contact with caustic household cleansers.

FIGURE 2.1 Exposure pathways. SOURCE: ATSDR, 1992.



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