Rationale: Nurses in every area of practice encounter environmentally induced illnesses, either knowingly or unknowingly. Nurses can address these situations if they are aware of the potential links between environmental conditions and disease.

Strategies for Achieving Recommendation 3.1:

1. Elicit an environmental health history during patient assessment (see Appendix G).

2. Interventions should include referrals to health agencies as well as to occupational and/or environmental specialists; education about prevention techniques; and site visits to the home, workplace, or community.

3. Licensure and certification examinations for all levels of nursing should include environmental health content.

4. Professional nursing associations should be encouraged to address environmental health through the development of policy recommendations, continuing education programs, codes of ethical conduct, and written standards of care.

Rationale: Environmental health issues are increasingly complex, and practicing nurses cannot be expected to be expert in all aspects of environmental health. Nurses need access to comprehensive resources for technical assistance in assessment, planning, intervention, and evaluation in the area of environmental health. Such resources may include nurse experts; professionals from other disciplines; written materials; and local, state, and federal public health and environmental protection agencies. Institutional policies that support access to and use of these resources will help nurses realize their potential in addressing environmentally related illnesses.

Strategies for Achieving Recommendation 3.2:

1. Enhance distribution of Agency for Toxic Substance and Disease