Protocol for Excellence in Public Health (NACHO, 1991) and ATSDR's Public Health Assessment process (Lybarger et at., 1993) involve identifying risk factors and exposures that affect the health of the community. Both processes also emphasize soliciting and incorporating community health concerns as part of the assessment. Nurses skilled in interviewing, active-listening, and group processes, as well as epidemiological methods, can be invaluable team members.
Nurses have long served as patient educators; they teach patients how to get out of bed following surgery, how to change a dressing, the possible side effects of medication, and the importance of diet and exercise in maintaining health. This role can be expanded to include educating patients, families, workers, and communities about the possible adverse effects of exposure to environmental hazards and how to reduce or eliminate such exposures. This type of education is commonly referred to by public agencies and environmental health specialists as hazard or risk communication.(1) Nurses can further develop this role by providing information to create environmentally safe homes, schools, day-care settings, workplaces, and communities. As role models, nurses can conduct their practice and lives in an environmentally safe manner, that is, by limiting unnecessary exposure to chemicals or by carrying out routine duties in a manner that minimizes injury due to ergonomic hazards. Nurses can act as educators by speaking at community gatherings and becoming involved in community-level activities related to the environment and human health. They may also participate in risk or hazard communication for public health agencies.
The original focus of risk communication was on developing and delivering a message from an expert or agency to the public, in order to help the public better understand a situation and its implications for their health and well-being. This definition is widening to incorporate a two-way dialogue between regulators or managers and the public (Cutter, 1993). The interactive process of exchanging information on technical hazards and the human response, both physiological and emotional, calls for professionals who can listen, interpret, clarify, and reframe questions and information in emotionally charged and sometimes hostile situations. The basic patient education role of nurses with individuals and families