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What is environmental health?

Examining a massive influence on our health: the environment..

We've been reporting on environmental health for 20 years. But what is environmental health? You've got questions, and we have answers.

Environmental health is a branch of public health that monitors the relationship between human health and the environment, examining aspects of both our natural and human-made environment and their effect on human wellbeing.

What is an example of environmental health?

Living near factories or heavy traffic worsens air quality and leads to health impacts on the lungs and heart.

Credit: Kouji Tsuru / Unsplash

Environmental health is a broad area of study — everything from the climate to the food we eat to the air we breathe plays into environmental health. A few specific examples include:

Air pollution: Living near factories or heavy traffic worsens air quality and leads to health impacts on the lungs and heart such as asthma and increased risk of heart attacks or stroke.
Water contamination: Drinking lead-contaminated water can cause IQ loss, behavioral issues, learning disabilities and more. Infants and young children are most at risk.
Toxic chemicals in consumer products: Phthalates, a class of chemicals that are widely used in consumer products, are known endocrine-disruptors, meaning they hijack your body’s hormones and can cause a wide array of health impacts including increased risk of cancer and fertility issues.

What is the role of environmental health?

The role of environmental health research is to examine areas of the environment that impact our health so that we can make personal and policy changes to keep ourselves safe and improve human health and wellbeing.

Why is environmental health important?

Credit: Viki Mohamad / Unsplash

Environmental health impacts every one of us.

We reap the benefits of clean air, clean water, and healthy soil. If our environment is unhealthy, with toxic chemicals saturating our resources and pollution abundant, then our health also suffers.

It is also an important field of study because it looks at the “unseen” influences on your health.

Many individuals may not associate their health problems with air or water quality, or with what clothes they wear, makeup and household goods they use, or food they eat.

That’s because not every example of environmental health problems are obvious: some chemicals, for example, build up slowly over time in your body: a small dose may not seem to bring harm, but repeated small doses can lead to later impacts.

BPA absorbed through plastic containers, cans, receipts, etc. lingers in the body and the build-up over time increases risk of cancer, diabetes, liver failure, and more.
PFAS are known as ‘forever chemicals ’— they don’t break down and are widely used, so small exposures are frequent and contribute to immune system and reproductive damages, heightened cholesterol levels, and more.
Mercury from eating seafood and shellfish can impact neurological development of fetuses in the womb, and populations that regularly consume mercury-heavy seafood have shown mild cognitive impairment.

Also, individual susceptibility can differ: for example, one member of a household can experience illness, asthma, migraines, etc. from chemicals found in their water supply while another member of the same household is just fine, such as the case in a young girl’s reaction to benzene in her water from living near fracking wells.

Certain variables play a role in susceptibility and level of adverse health effects such as age, gender, pregnancy, and underlying health conditions. Studies suggest fetuses, infants and children are much more at risk to experience lifelong health problems from toxic chemical exposure.

Rate, duration, and frequency of exposure to toxic chemicals and other influences from our environment all factor into our health.

Good environmental health = good human health.

What environmental health problems affect our health?

Two women extracting from a well in Senegal.

Credit: JordiRamisa

There are many environmental health issues that affect human health. These include:

Air pollution — nine out of 10 people currently breathe air that exceeds the World Health Organization’s guideline limits for air pollution worldwide. This mainly affects people in low and middle-income countries, but in the United States, people that live in cities, or near refineries or factories, are often affected as well.

Air pollution also ramps up during wildfire season.

Read more: Breathless: Pittsburgh's asthma epidemic and the fight to stop it

Water pollution — as of 2014, every year more people die from unsafe water than from all forms of violence, including war. Water is the ‘universal solvent’, meaning it can dissolve more substances than any other liquid on Earth. Thus, it is too easy for toxic chemicals to enter our water supply.

Read more: Sacred Water: Environmental justice in Indian Country

Lack of access to health care — yes, this is an environmental health issue! Having an accessible health care system is part of one’s environment. Difficulty getting health care can further impact one’s health.

Poor infrastructure — from “food deserts” to lack of transportation services, living in an area with poor infrastructure can impact your health.

Read more: Agents of Change: Amplifying neglected voices in environmental justice

Climate change — climate change-induced heat waves, increased frequency and severity of large storms, droughts, flooding, etc. have resulted in health problems and even death.

Chemical pollution — chemical pollution can be sneaky: the chemicals in your everyday products, from shampoo to deodorant to your clothing to the food you eat, can directly affect your health. These chemicals are often not on the label or regulated at all.

Read more: Exposed: How willful blindness keeps BPA on shelves and contaminating our bodies

How can we improve our environmental health?

Credit: instaphotos

Educate yourself. Environmental health is a broad topic, so this can seem overwhelming. Start by taking stock of your own personal environment. Look up air pollution monitoring in your area. Get your water tested to see its chemical makeup. Evaluate the products you use in your life — personal products like shampoo and deodorant, household cleaners, air fresheners, the foods that you eat — and see what you’re bringing into your home.

Explore the Environmental Working Group's guides to check your products for toxic chemicals.

We have additional guides to help you learn more about environmental health. Find guides to plastic pollution , environmental justice , glyphosate , BPA , PFAS and more in the Resources tab at the top of our website.

As individuals we have the power to improve some of our environmental health, but there is a pressing need for systemic change and regulation on a policy level.

We’re actively working with scientists to share their research and knowledge with politicians to advocate for science-backed policy change. But we need your help. Contact your representatives to let them know that environmental health is important to you — whether it’s air pollution in your area, contaminated water, plastic pollution, food deserts in your area, or chemicals in consumer products.

Subscribe to Above the Fold , our daily newsletter keeping you up-to-date on environmental health news.

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Essay on Environment and Human Health for Students and Children

500+ words essay on environment and human health.

The environment is all that surrounds us. It can be a living or a non-living thing. It includes many forces that are physical, chemical and other natural forces. These living things live in their environment. They consistently react with it and adapt themselves according to the conditions in their environment. In the environment, there are various interactions between the animals, plants , water, soil and other living and many non-living things present in nature. Since everything is a part of this environment of something else, we use the term environment talking about various things. People in different fields use this term differently.

Importance of Environment

The environment is very important for every living being. No one can survive without the environment. It matters a lot because planet earth is the only home for human beings. It provides food, air, water and millions of other things. Humanity’s entire life-supporting system totally depends on the well-being of all the species living the earth.

We call it the biosphere. Biosphere means one global ecological system under which all living things are depending upon each other relatively. In the ecosystem or overall biosphere, there are some smaller ecosystems like the rainforests , deserts , oceans and the tundra.

An ecosystem has both living and non-living parts. It can be terrestrial or aquatic. It explains the valuing ecosystem services: towards better environmental decision making that is available through the National Academy Press. The non-living things are like soil , water, air, nutrients, and living elements are the plants, micro-organisms , animals and human beings.

A healthy ecosystem consists of all the chemical elements and nutrients that circulate in a cycle while supporting billions of species. The species helps in the process of cycling the elements when they produce any food. It also happens during their eating, going about their lives and even though their deaths. In this process creation of a variety of goods and services takes place that is very useful for human beings.

Get the huge list of more than 500 Essay Topics and Ideas

Human Health Issues

It is very rare for children to get seriously ill without any warning. According to the symptoms of your child, you should contact your children’s pediatrician for advice on a regular basis. Time to time treatment of symptoms or usual illness can prevent your child from getting seriously affected with any disease or making that worse or turning it into an emergency.

A true emergency occurs when you believe a severe injury or any sort of illness is threatening your child or his/her life is in danger, or it might cause any permanent harm. In this scenario, one needs emergency medical treatment immediately as soon as possible. Discuss it with the doctor about what should you do in case of a true emergency.

The use of vaccines is improving the health of the children at a huge level over a very short period. Much infectious illness one is having as a child. For example, chickenpox or polio no longer affects many children in today’s time.

FAQs on Environment and Human Health

Q.1. Name some needs that are fulfilled by the environment:

Ans. There are many needs that are fulfilled by the environment. We get food, shelter, oxygen, water, sunlight, air, and many more things. The most important thing we get from the environment is food. Because we cannot survive without food.

Q.2.What should be done in the case off health illness?

Ans. Firstly, we should diagnose the problem and then go to a doctor and do proper treatment of that particular disease or illness. And then we should cure that disease according to the guidelines of the doctor.

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What is Environmental Health and What Critical Issues Impact Our Health?

What is environmental health, areas of environmental health, global environmental health, how you can help protect and improve environmental health.

Water quality, safe housing, healthy food access, and pollution -free transportation all contribute to human health, along with many other factors. Where people live and how they're connecting to the world can affect their health. The environmental health field—with its professionals, policies, and programs—is focused on these factors.

Your health is determined by personal choices (like whether you exercise or get vaccinated ) but also factors like local industry, the age of your home, food deserts , green space in your community, and more. Environmental stressors and advantages help to shape your options.

This article explains what environmental health is and how it can affect you and your community. It describes the work done by professionals and what you can do, too, to improve environmental health.

Environmental health is the public health field that monitors and addresses physical, chemical, and biological factors that impact your health though they're not always within your direct control.

Simply put, environmental health is the area of public health that deals with all the different ways the world can impact physical and mental well-being. Examples of impacts include:

Lead toxicity (poisoning) from the paint or water pipes in older homes and neighborhoods
Obesity and type 2 diabetes risk in food deserts and food swamps (communities with limited access to grocery stores and healthy food options, but often home to fast food stops)
Cancer and the impacts of air pollution, heat, ultraviolet radiation, and other carcinogens and climate factors
Stress, sleep disruptions , hearing loss , and other impacts due to traffic and other environmental noise
Depression, cognition, and other brain health factors can be affected by green space

If you live in an urban heat island with few trees, it may be hotter than other neighborhoods— affecting a range of issues, from heat-related illness to asthma and heart disease. It's harder to get outside and exercise, too. When your home was built and the materials used, what insects live nearby, and what food you can access affect your health and the health of your family.

Environmental health is one of the largest fields within public health because of the myriad ways external forces can impact how people eat, live, and grow. These forces can be about addressing the natural environment (as in the case for clean water or sanitation), but they can also be the consequence of human beings' actions—including societal norms.

There are a number of initiatives focused on environmental health in the United States. Among them is the Healthy People 2030 agenda, which highlights six key areas that encompass the various ways environmental health is crucial to the health of communities.

Air Quality

Air is non-negotiable for humans. It's needed to survive and air quality can have a significant impact on health.

Poor air quality has been linked to a wide range of health issues, including SIDS, lung cancer , and chronic obstructive pulmonary disease ( COPD ). Air pollution is also linked to low birth weight.

One2019 study found that people exposed to high levels of air pollutants in the early and late states of pregnancy were more likely to have babies with lower birth weights, or with preterm births, than their non-exposed peers.

The Clean Air Act

The Clean Air Act of 1970 marked the first time the federal government took responsibility for protecting the air quality for all U.S. citizens by regulating harmful emissions from things like cars and factories. The act was later expanded in 1990 to address acid rain and ozone depletion.

Water and Sanitation

According to the Centers for Disease Control and Prevention, an estimated 780 million people worldwide don’t have access to safe drinking water, and a jaw-dropping 1.7 billion (or roughly a fifth of Earth’s population) lack adequate sanitation services like clean bathrooms.

The simple act of filtering and chlorinating water systems in the United States has resulted in significant declines in once-common diseases like typhoid . Historically, clean water is responsible for the bulk of the decline in childhood mortality in the country.

The environmental health impact of safe water can't be overstated. An estimated 2,200 children die every day worldwide of diarrheal diseases linked to improper water and sanitation. The United Nations estimates a return of $4.30 in medical and social costs for every dollar spent on clean water.

Toxic Substances and Hazardous Wastes

Toxicology—that is, the area of science devoted to understanding how chemicals and substances can affect people and their surroundings—is an important field in environmental health. Many of the materials needed to advance industries and technology, like heavy metals or even some plastics, can also hurt the human body and even lead to serious medical conditions.

The Flint, Michigan, water crisis is an example of lead poisoning effects in a community that can lead to long-term health complications, including brain damage in children. Economically disadvantaged kids are often most affected.

The Flint crisis, which exposed more than 100,000 people to unsafe lead levels in drinking water, was a prime example of how environmental health issues often hurt those whose health status is already most at risk.

Homes and Communities

Home and neighborhoods are at the core of environmental health. When a neighborhood has a lot of violence, for example, families or older people might not go outside to exercise. When roads aren't properly maintained, it can result in more car crashes. When sidewalks are in poor condition, people may avoid walking for fear of accidents.

An emerging field of environmental health is that of food access. In neighborhoods without full-service grocery stores, people rely on convenience stores, gas stations, and fast food restaurants. This limits fresh produce options—a vital part of a healthy diet. These food deserts contribute to health disparities for low-income and minority populations especially.

Environmental health professionals are urging communities to establish public gardens where residents can grow and harvest their own fresh produce, improve access to public transportation to full-service grocery stores and farmers markets, and change zoning laws to incentivize retailers to offer healthier food options.

Infrastructure and Surveillance

A primary piece of any public health strategy is information to identify risks and guide the resources and responses to prevent them. This includes investigating and responding to diseases—a field called epidemiology —as well as screening for hazards and establishing surveillance programs.

Surveillance activities involve either going out and looking for particular health concerns (active surveillance) or by asking professionals in other fields, such as medicine or agriculture, to alert environmental health agencies when they encounter them (passive surveillance).

An example of this in action is mosquito surveillance and abatement activities. These programs test mosquitoes for certain things, including the presence of dangerous infections like Zika virus , as well as monitor populations to ensure control measures are working. This information can help health officials know what to watch for in doctors' offices, direct local governments on where and how best to spray for mosquitoes, and alert the public if a mosquito-borne illness is spreading in the area.

In the coming decades, environmental health professionals are bracing for a warmer, wetter climate that will likely prompt or exacerbate threats to public health across the globe.

Disease-carrying mosquitoes can live in areas previously too cold for them to survive, upping the number of people impacted by vector-borne illnesses like dengue and malaria . As sea levels rise, whole coastal cities and island nations face flood risks and disease due to displacement.

Even though health outcomes have improved significantly over the past century—in wealthy nations like the United States in particular—environmental hazards and infectious diseases know no geopolitical boundaries. People today are traveling farther and more often than ever before, and conflicts in areas like Syria, Afghanistan, and South Sudan cause millions to flee their homes.

These increases in cross-border and cross-continental movements have the potential to threaten disease prevention efforts and overextend existing infrastructure. That's why it's crucial that countries look beyond their borders to improve the health of the global population overall.

Environmental health is supported by trained experts who assess nutrition and community health, test water for heavy metals, and do research on how rising heat might change where insects are likely to spread disease. They develop laws, policies, and programs at all levels of government.

And while environmental health doesn't focus on individual impacts and footprints, there's much you can do to help. Consider protecting environmental health and safety by:

Improving air quality. You can ride your bike, take mass transportation, or work from home instead of driving a car to and from work.
Testing for toxins. You can test for radon gas, lead paint, or heavy metal exposure in pipes to prevent toxicity. Don't forget your cooking stove, which can be a source of indoor air pollution.
Cooling your home. You can plant trees, install roofs designed for cooling, and make lifestyle choices (like closing off rooms or running certain appliances after dark) to limit heat impacts.
Promoting healthy food choices. Plant gardens, shop at local farmer's markets, join a food co-op, and consider eating less meat when opting for a diet that's friendlier to environmental health.

Keep in mind that visibility helps to drive environmental health policy. Talk with your government and local businesses about investing in environmental health to ensure every neighbor has the chance to live, work, and play in a healthy and safe community.

Environmental health professionals focus on factors like industrial air pollution, water quality, healthy food access, and safe housing that impact public health. In many cases, these factors (unlike the personal risk of genetics, for example) are preventable or can be changed to improve public health and overall health equity .

Most communities in the United States are served by environmental health agencies, whether at the local and state level or through federal authorities. You can help to improve environmental health by working closely with these professionals, local businesses, and other stakeholders.

But there's much you can do personally to make lifestyle changes, like limiting plastic waste and reducing energy use, that can limit environmental health risk both for you and the planet.

Neta G, Martin L, Collman G. Advancing environmental health sciences through implementation science . Environ Health . 2022 Dec 23;21(1):136. doi:10.1186/s12940-022-00933-0.

Centers for Disease Control and Prevention. Sources of lead exposure .

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American Academy of Pediatrics. New AAP policy, technical report offer advice on reducing harms from excessive noise exposures .

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By Robyn Correll, MPH Correll holds a master of public health degree and has over a decade of experience working in the prevention of infectious diseases.

January 28, 2011

The Link between the Environment and Our Health

Would people care more about the environment if they had a better understanding of how it affects them personally?

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Dear EarthTalk : Aren’t environmental issues primarily about health? Detractors like to trivialize environmentalists as “tree huggers,” but the bottom line is that pollution makes us sick, right? Wouldn’t people care more if they had a better understanding of that?— Tim Douglas, Stowe, Vt. No doubt many of the ways we harm our environment come back to haunt us in the form of sickness and death. The realization that the pesticide-laced foods we eat, the smokestack-befouled air we breathe and the petrochemical-based products we use negatively affect our quality of life is a big part of the reason so many people have “gone green” in recent years. Just following the news is enough to green anyone. Scientific American reported in 2009 that a joint U.S./Swedish study looking into the effects of household contaminants discovered that children who live in homes with vinyl floors—which can emit hazardous chemicals called phthalates—are twice as likely to develop signs of autism as kids in other homes. Other studies have shown that women exposed to high levels of polybrominated diphenyl ether (PBDE) flame retardants common in cushions, carpet padding and mattresses—97 percent of us have detectable levels of these chemicals in our bloodstreams—are more likely to have trouble getting pregnant and suffer from other fertility issues as a result. Cheaply produced drywall made in China can emit so much sulfur gas that it not only corrodes electrical wiring but also causes breathing problems, bloody noses and headaches for building occupants. The list goes on and on.... But perhaps trumping all of these examples is the potential disastrous health effects of global warming. Carbon dioxide emissions may not be directly responsible for health problems at or near their point of release, but in aggregate they can cause lots of distress. According to the Center for Health and the Global Environment at Harvard Medical School, climate change over the coming decades is likely to increase rates of allergies, asthma, heart disease and cancer, among other illnesses. Also, it is quite likely that, as global temperature rises, diseases that were previously found only in warmer areas of the world may show up increasingly in other, previously cooler areas, where people have not yet developed natural defenses against them. And the loss of rain forest that accompanies increases in temperature means less access to undiscovered medicines and degradation of the environment’s ability to sustain our species. Given the link between environmental problems and human health, more of us are realizing that what may seem like exorbitant up-front costs for environmental clean-up may well pay us dividends in the end when we see our overall health care costs go down and our loved ones living longer, healthier lives. To help bridge the understanding gap between environmental problems and human health, the nonprofit Environmental Health Sciences offers the free website, Environmental Health News , which features daily reports on research showing how man-made environmental problems correspond to a wide range of individual and public health problems. Even your local TV station or newspaper likely carries an occasional story about the health effects of environmental pollution. We don’t have to look very hard to find examples of environmental neglect leading to human suffering. But with newfound public awareness and the commitment of younger generations to a cleaner future, we are moving in a good direction. CONTACTS : Harvard Medical School Center for Health and the Global Environment, http://chge.med.harvard.edu ; Environmental Health News , www.environmentalhealthnews.org .

SEND YOUR ENVIRONMENTAL QUESTIONS TO: EarthTalk® , c/o E – The Environmental Magazine , P.O. Box 5098, Westport, CT 06881; [email protected] . E is a nonprofit publication. Subscribe : www.emagazine.com/subscribe ; Request a Free Trial Issue : www.emagazine.com/trial .

Essay on Environment And Health

Students are often asked to write an essay on Environment And Health in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Environment And Health

Our surroundings and our well-being.

The environment is everything around us – the air, water, and land. It is important for our health. Clean air is needed to breathe without getting sick. When the air is dirty, it can cause diseases like asthma.

Water and Health

Water is another part of the environment that affects our health. We need clean water to drink, cook, and wash. If water is polluted, it can carry germs and make us very ill. It is important to keep water sources clean.

Healthy Land, Healthy Food

The health of the land is also linked to our health. We grow food in the soil. If the soil is healthy, our food is more likely to be healthy too. But if the soil is polluted, the food might be harmful to eat.

What We Can Do

To stay healthy, we must take care of our environment. This means not littering, recycling, and using less plastic. By doing these things, we can help keep our air, water, and land clean for everyone.

250 Words Essay on Environment And Health

The environment is everything around us: the air we breathe, the water we drink, and the land we live on. It’s like a big house where we all live together. Our health is closely linked to this house. If our environment is clean, we tend to be healthy. If it’s dirty, we can get sick.

Air and Breathing

Think about the air outside. When it’s fresh, taking deep breaths feels great. But when the air is polluted with smoke or chemicals, breathing can be hard. Dirty air can cause coughing, asthma, and other breathing problems. So, keeping our air clean is important for our lungs to stay healthy.

Water is Life

Water is another part of the environment that affects our health. We need clean water to drink, cook, and wash. When water gets dirty with germs or harmful chemicals, it can make us very sick. That’s why it’s important to keep our rivers, lakes, and oceans free from pollution.

Safe Land, Safe Food

The land is where our food comes from. If the soil is healthy, our fruits and vegetables will be healthy too. But if the soil has dangerous chemicals or waste, the food grown in it can harm us. We must take care of the land to ensure our food is safe to eat.

Working Together

Keeping our environment clean is a job for everyone. By doing simple things like recycling, saving water, and not littering, we can help make our environment a healthier place. When our environment is healthy, we are more likely to be healthy too. Let’s work together to keep our big house clean!

500 Words Essay on Environment And Health

Introduction to environment and health.

Our health is like a treasure that we need to protect. One big thing that affects our health is the environment around us. The environment is everything that surrounds us, including the air we breathe, the water we drink, and the ground where plants grow. Just like friends can influence us, the environment can change our health in good or bad ways.

The Air We Breathe

Think about the air outside. When it’s clean, it’s like a fresh breath that makes us feel good. But when it’s dirty, with smoke from cars and factories, it can make us cough and feel sick. Breathing dirty air can lead to asthma or other lung problems, especially in kids and old people. That’s why it’s important to keep the air clean by doing things like riding bikes instead of cars when we can.

The Water We Drink

Water is life. Our bodies need it to work properly. But if the water we drink is not clean, it can carry germs that make us ill. Sometimes, harmful chemicals from factories can get into rivers and lakes, which is where our drinking water comes from. To stay healthy, we need to make sure our water is not polluted and is treated to remove germs.

The Food We Eat

The health of our environment also touches the food we eat. Fruits and vegetables grow in soil, but if that soil has harmful chemicals, those can get into the food. Eating such food can make us unwell. It’s like when you draw with markers, and the color gets on your hands. Similarly, the bad stuff from dirty soil can get into our food. We need to take care of the ground by not using too many chemicals and by farming in ways that keep the soil healthy.

Our Changing Climate

Our world’s weather is changing, and this can also affect our health. Hotter summers can lead to heat strokes, and new kinds of bugs that carry diseases can come to places where it used to be too cold for them. We need to work together to slow down these changes by doing things like planting more trees and using less energy.

There are simple things we can do every day to help our environment and our health. Walking or biking instead of asking for a car ride, turning off lights when we leave a room, and recycling paper and plastic are small steps that make a big difference. We can also plant trees and clean up trash in our neighborhoods.

To sum it up, the environment plays a big part in our health. Clean air, water, and soil help us stay healthy. We also need to think about how the changing weather affects our health. By taking care of our planet, we take care of ourselves. It’s like being on a team – when we work together to protect our environment, we all win by being healthier and happier.

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Environment and health: an overview

In the 1980s biologists began to observe startling declines in frog populations around the world, even in isolated and relatively pristine environments. It appears that no single factor is responsible. Rather, the health and reproductive success of amphibians is being damaged by an increase in the intensity of ultraviolet (UV) light (because of thinning of stratospheric ozone), traces of globally distributed toxic chemicals, competition from introduced predator species and infections caused by virulent fungi and bacteria. 1 , 2 The declining health of frogs, birds and thousands of other organisms may be one of the clearest indications of environmental threats to human health. Although local environmental tragedies of climate change, species extinction and deforestation have marked every period of human history, today's environmental degradation is rapidly creating an unprecedented global crisis driven by population growth and industrialization. 3 , 4 , 5 , 6 , 7

For the first time, human beings are altering the basic operations of the Earth's atmosphere, geosphere and biosphere. In a recent essay, 4 prominent biologists noted with concern that "human alteration of Earth is substantial and growing. Between one-third and one-half of the land surface has been transformed by human action; the carbon dioxide concentration in the atmosphere has increased nearly 30% since the beginning of the Industrial Revolution; more atmospheric nitrogen is fixed by humanity than by all natural terrestrial sources combined; more than half of all accessible surface fresh water is put to use by humanity, and about one-quarter of bird species on Earth have been driven to extinction." 8 In 1992 the World Scientists' Warning to Humanity 9 was endorsed by more than 1600 scientists from 70 countries, among them 104 Nobel laureates, including most of the science prize recipients. The warning cited clear evidence of a growing environmental crisis. 9

Ten years ago Alexander Leaf wrote about the potential effects of global environmental change on human health. 10 This essay in CMAJ introduces a series of articles that continue Leaf's initial exploration. In each article, the authors will present a brief state-of-the-science review of their topic, an interpretation of the problem, and suggestions for medical and public health responses. The intent of the series is to examine the links between environmental change and human health and to suggest programs and policies that will protect both health and the environment. These essays do not address environmental hazards for which the association with disease is well understood, such as environmental lead poisoning, particulate and ozone air pollution, radon and tobacco smoke. Instead, these papers will focus on global environmental changes precipitated by human activity and their likely role in emerging health problems.

From a biomedical standpoint health is viewed as an attribute of the individual. The fields of medicine and public health acknowledge environmental causes of illness and assign risk to specific exposures. In the past decade, biologists, ecologists and physicians have developed the concept of ecosystem health. This idea recognizes that humans are participants in complex ecosystems and that their potential for health is proportional to the health of the ecosystem. 11 An ecosystem-based health perspective takes into account the health-related services that the natural environment provides (e.g., soil production, pollination and water cleansing) and acknowledges the fundamental connection between an intact environment and human health. 12

Environmental degradation exaggerates the imbalance between population and resources, increases the costs of development, and worsens the extent and severity of poverty. Population growth and the "corporatization" of agriculture and forestry have forced poor people onto land that is the least productive and ecologically the most fragile. In crowded or poor countrysides, people often abandon traditional and sustainable land use practices in favor of short-term survival strategies such as farming on steep slopes and living in areas threatened by flood or drought. The need for farmland, fuel wood and timber for export results in deforestation, which in turn increases soil erosion, flooding and mud slides and reduces agricultural productivity. In short, interactions between poverty, population growth and environmental degradation impede sustainable economic development and worsen population health. 13

The problems resulting from environmental change pose new challenges for traditional public health science. 14 The health effects of global change are often indirect and difficult to assess, and the quality of evidence for the health- related outcomes of global environmental change varies widely. 7 For example, the prevalence of malaria has increased worldwide, but no clear relation to climate change has been established. Similarly, exposure to UV light (especially UVB) increases skin cancer and cataract formation, but large studies across geographical areas with different levels of UV exposure have not been performed. Furthermore, the health science necessary to understand global environmental change is increasingly interdisciplinary and requires collaboration among meteorologists, chemists, biologists, agronomists, biologists and health scientists, over long periods. Organizing and funding such science is difficult. Finally, the science of global change frequently relies on computer models to suggest the direction of change, but politicians and policy-makers are loath to commit resources to predicted but unproven future outcomes.

It is important for scientists to anticipate the potential consequences of environmental change. 15 Serious environmental problems are often unknown or unrecognized. The stratospheric ozone hole produced by chloroflurocarbons, although anticipated, was discovered by accident. 16 At the time of the first major international conference on the environment, held in Stockholm in 1972, global warming, acid rain and tropical deforestation were not recognized as major problems. Explanations of the decline in amphibian populations, cancer outbreaks in fish and the bleaching of coral reefs are still inadequate today. Furthermore, change in natural systems may be sudden and nonlinear. For example, fish populations that have remained stable during long periods of intense harvesting may suddenly collapse.

Global environmental issues at this special moment in history are unique in their scope and consequences, and discussion of them may be emotionally and politically charged. 17 Global change may seem so remote from our daily lives that we become indifferent to the litany of environmental apocalypse. We may not perceive the actual degradation of the Earth. 18 Some of us distance may ourselves from the discussion because we find it frightening or overwhelming As a result, policy-makers and politicians are not pressed to confront the consequences of the continuing expansion of human enterprise. For example, climate change produced by the accumulation of greenhouse gases, primarily carbon dioxide, seems increasingly certain. The 1995 second report of the Intergovernmental Panel on Climate Change concluded that "man's impact on climate is discernible," and many climate scientists believe that we are already experiencing global warming effects. 19 But it is difficult for us to acknowledge that industrial carbon dioxide — invisible, odourless and nontoxic — is a pollutant. International political leadership has only recently begun to seek solutions to the global issues of climate change, toxic pollution, species loss and deforestation.

Two recent developments have drawn renewed attention to the health risks of persistent organic pollutants (also known as POPs): the identification of medical waste as a significant source of toxic pollution and the emergence of the new toxicological field of endocrine disruption. Medical waste incineration is a major source of the dioxin and mercury released into the environment. Almost all humans have measurable residues in their tissues of chlorinated hydrocarbon chemicals, including pesticides, polychlorinated biphenyls (PCBs) and dioxin. In some cases these levels approach the threshold of public health concern. 20 Pressured by advocacy organizations, the health care industry has begun efforts to better manage medical materials and waste. The second development is the emerging toxicological field of endocrine disruption. Endocrine disruptors are a class of chemicals, including many of the persistent organic pollutants, that imitate or block hormones. These chemicals produce a variety of reproductive and neurodevelopmental disturbances in wildlife, laboratory animals and humans, often at very low doses. Endocrine disruption, currently the object of renewed study by government, industry and academia, offers a new toxicological paradigm that may supplement carcinogenesis as the outcome of concern. 21 , 22

Public concern about environmental degradation in both rich and poor nations is developing into a broad environmental health movement. 23 But to argue, as some do, that the quality of human existence is improving because life expectancy is increasing and child mortality is decreasing in many parts of the world is to miss what McMichael has called the "essential newness" of environmental change. 14 The carrying capacity of the Earth may appear adequate at this moment in history, particularly for those of us in affluent countries. Economic development and improved access to public health programs have produced expected improvements in less developed countries. Although the world's population has increased fourfold in the last 150 years, the food supply has kept pace. But can we support another approximate doubling of the population by 2050, from 6 billion to 10 or 12 billion, the high-fertility forecast by the United Nations? 24 Will the food supply remain adequate? What are the health consequences of global warming and climate change? 25 What are the consequences of loss of biodiversity, forests and marine life? 26 Science has only begun to address these questions.

To protect the health of populations we must develop systems of food, energy and industrial production that can be sustained over generations. We also need value systems of stewardship, precaution and prevention to guide environmental protection and health promotion. Finding solutions to the threats posed by environmental change is the major health challenge of the next century. 27 , 28

Dr. McCally is with the Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY.

Organization of the series "Environment and Health" was supported by a grant from the Jennifer Altman Foundation.

Correspondence to: Dr. Michael McCally, Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York NY 10029; fax 212 360-6965; [email protected]

Environmental Issues and Human Health

Introduction.

With the 2020 COVID-19 pandemic having affected all countries and millions of people around the globe, environmental threats to human health are now given the utmost attention by governments worldwide. It is internationally acknowledged that we are now facing an environmental crisis caused by rapid economic growth and industrialization, overpopulation, and the overuse of fuel and natural resources. Environmental changes resulting from human activities pose a global threat to human health and development, being a cause of many diseases, injuries, and deaths worldwide. The most important environmental concerns include climate change, air pollution, and waste management. The purpose of this paper is to discuss the impact of these environmental threats on human health and the strategies developed to address them.

While humans have always had an impact on their local environment, the rapid economic growth of the last several decades has resulted in increasingly harmful consequences, with environmental degradation being the most serious of them. Industrialization, urbanization, population and economic growth, intensification of agriculture, increase in transportation and energy use are the most important factors that contribute to environmental degradation (United Nations Environment Programme, 2019). The main challenges that we now face include climate change, extinction of species, unprecedented pressure on terrestrial and marine ecosystems, pollution, and over-exploitation of natural resources.

There is a direct relationship between the state of the environment and human health, with environmental risks affecting mankind either directly by exposing people to harmful agents, or indirectly, by disrupting life-sustaining ecosystems. Although the exact contribution of environmental factors to disease and death rates is hard to determine, the World Health Organization (WHO) has estimated that around 13 million deaths annually are related to preventable environmental causes ( Encyclopedia of environmental health, 2019). The 6th Global Environment Outlook report, published by the United Nations Environmental Programme (UNEP), identifies a range of the most serious environmental health challenges. They include air, water, and land pollution; heatwaves, flooding, and other weather extremes; toxic chemicals; pathogens; ultraviolet and other radiation; reduced biodiversity; melting of polar ice; and destruction of coral reefs (United Nations Environment Programme, 2019). Environmental pressures are addressed by multiple organizations all over the world, united by the belief that immediate and consistent efforts are required to prevent the environmental health crisis.

Literature Review

Environmental issues began to be acknowledged and discussed only at the end of the 20th century, with the most extensive research conducted in the last two decades. The current literature on the problem of environmental health includes encyclopedias and collections of articles on the current environmental concerns, scholarly articles published in specialized journals, and reports put together by international organizations. Statistical data is provided by the WHO, UNEP, Greenpeace, and local governments.

For this research, two publications provide the most valuable sources of information: Encyclopedia of environmental health, and Global environment outlook 6, published by the UNEP. Encyclopedia of environmental health is a comprehensive collection of articles on all current environmental health threats. It provides a detailed overview of the whole scope of environmental problems, supported by factual data, and discusses the policies and strategies developed and implemented on local, national, and international levels. Global environment outlook 6 is the sixth UNEP’s report on pressing environmental issues put together by hundreds of scientists, peer reviewers, and collaborating institutions and partners. It outlines the current state of the environment, illustrates future environmental trends, and analyses the effectiveness of the implemented policies. This research also uses statistical data from the WHO’s website and the book Environmental health science: Recognition, evaluation, and control of chemical health hazards that discusses the issues of pollution and waste management.

Global Warming and Climate Change

The terms “global warming” and “climate change” are used to denote the same problem connected to the enhancement of the Earth’s greenhouse effect as a result of increasing gas emissions from human activities. The most significant threats include the increase of average global temperature, changes in cloud cover and precipitation, melting of glaciers and ice caps, the rise of sea level, and extreme weather events ( Encyclopedia of environmental health, 2019). The scope of climate change impacts on individual countries is different; however, as the changes progress, their effects become increasingly widespread.

Climate change affects human health and development in all countries worldwide, threatening all social and environmental determinants: clean air and water, sufficient food, and secure homes. Its main health impacts include water shortages, flooding, drought, shortages of food and crop production, the rise of sea level, and the spread of infectious diseases (World Health Organization, 2018). Many of the threats are hard to predict or model with a high level of accuracy. The most affected groups of population include children, elderly people, the population of poor countries, coastal regions, megapolises, mountains, and polar regions.

Given the complexity of the challenge, the strategies of addressing global climate change have gone through various transformations over a period of close to two decades. The current international objectives include reducing gas emissions through the design of better transport systems, the development of new production technologies and cleaner energy systems, and the implementation of safer food and energy-use choices (United Nations Environment Programme, 2019). In 2015, the WHO endorsed a new plan on climate change and health. It includes partnerships with governments and national health agencies, awareness-raising, research and development, and support of the public health responses to climate change (World Health Organization, 2018). The current international initiatives are focused on assisting less developed countries in building capacity to reduce health vulnerability to climate change, providing information on existing threats, and developing a global research agenda.

Air Pollution

Air pollution is considered by the WHO as the greatest environmental risk to health. The air we breathe contains emissions deriving from both natural and anthropomorphic sources, including motor vehicles, power plants, construction sites, fires, and industries. Nine out of ten people breathe polluted air every day, and every year almost 7 million people die prematurely from diseases caused by air pollution, such as cancer, stroke, heart and lung diseases ( Encyclopedia of environmental health, 2019). Air pollution particularly harms vulnerable population groups: elderly people, children, and people with existing respiratory problems. The problem is especially acute in less developed countries, where the volumes of emission from transport and industry are high and unregulated.

Air pollution is one of the major contributors to climate change, affecting the amount of sunlight that is reflected or absorbed by the atmosphere, temperature, and energy balance. Some pollutants, such as black carbon, lead to warming of temperatures by absorbing heat from the sun, while others, such as sulfates, bring about cooling effects by reflecting sunlight (Lippmann & Schlesinger, 2017). The problem of pollution was recognized in the 1970s, and several strategies and legislative initiatives have been developed to minimize its effects. The third session of the United Nations Environment Assembly, held in 2017, adopted the most current resolution on air quality that lists a range of measures to be taken to address the issue. They include taking action to decrease all forms of air pollution, establishing systems to monitor air quality and emissions, setting ambitious air quality standards, and integrating air pollution management into national development planning (United Nations Environment Programme, 2019). The resolution also calls for strengthened cooperation to address the problem at the local, national, regional, and global levels.

Waste Management

With the rapid growth of the world’s population, the amount of waste we produce is increasing at an unprecedented rate. Poor waste management is a major threat that has an enormous impact on both environment and human health. Poorly collected or improperly disposed waste can contaminate surface and groundwater and cause air pollution from burning waste. Solid waste that is not managed properly can become a breeding ground for insects and vermin, contributing to the development and spread of air- and water-borne diseases (Lippmann & Schlesinger, 2017). The issue is particularly critical in low- and middle-income countries that have insufficient funding for adequate waste management and where waste disposal is still dominated by landfills, which represents a serious health hazard (United Nations Environment Programme, 2019). Surveys conducted by UN-Habitat show that in areas where waste collection is not performed timely and properly, the cases of diarrhea are twice as high, and the cases of acute respiratory infections are six times higher than in areas where waste collection is frequent (Lippmann & Schlesinger, 2017). The other common issues include uncontrolled dumping, open burning, inadequate access to waste services, and increasing distribution and impact of marine litter.

The current waste disposal strategies are based on three main principles: waste reduction, recycling and materials recovery, and improving the efficiency of waste collection and disposal. Waste reduction and recycling initiatives seek to reduce the quantity of waste and the return of materials to the economy. Aerobic composting, anaerobic digestion, and incineration are waste disposal methods that allow to generate energy during waste disposal and reduce the volume of disposed waste (United Nations Environment Programme, 2019). Basic waste disposal methods, such as landfills, should be engineered and operated properly to protect the environment and public health.

Environmental issues are a major source of damage to both human well-being and the health of the planet. The most significant threats include climate change, air pollution, and waste management. The risks are systematic and wide-ranging, with climate change threatening to destroy multiple ecosystems and natural habitats, and water and air pollution consistently deteriorating the quality of human lives and the natural environment. With some of the problems, such as waste management, mostly affecting less developed countries, the others, such as climate change, provide a global threat. Since the problems have been recognized at the end of the 20th century, multiple studies have been conducted and numerous strategies developed to tackle the crisis. The current initiatives are focused on the collaborative efforts of local communities, national governments, and international organizations. They include the introduction of new environmental legislation, research and development, raising public awareness, and minimizing the damage to the environment.

Encyclopedia of environmental health (2nd ed.). (2019). Elsevier.

Lippmann, M., & Schlesinger, R. (2017). Environmental health science: Recognition, evaluation, and control of chemical health hazards. Oxford University Press.

United Nations Environment Programme. (2019). Global environment outlook 6. Cambridge University Press.

World Health Organization. (2018). Climate change and health. Web.

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COVID-19 Pandemic and Environmental Health: Effects and the Immediate Need for a Concise Risk Analysis

Affiliations.

1 Master Program "Environment and Health. Management of Environmental Health Effects," Medical School, National and Kapodistrian University of Athens, Athens, Greece.
2 1st Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens General Hospital "Laikon," Athens, Greece.
3 2nd Department of Pathology, "Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
4 4th Department of Internal Medicine, "Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
PMID: 33642862
PMCID: PMC7894687
DOI: 10.1177/1178630221996352

COVID-19 pandemic, as another disease emerging in the interface between animals and humans, has revealed the importance of interdisciplinary collaborations such as the One Health initiative. Environmental Health, whose role in the One Health concept is well established, has been associated with COVID-19 pandemic via various direct and indirect pathways. Modern lifestyle, climate change, environmental degradation, exposure to chemicals such as endocrine disruptors, and exposure to psychological stress factors impact human health negatively. As a result, many people are in the disadvantageous position to face the pandemic with an already impaired immune system due to their exposure to environmental health hazards. Moreover, the ongoing pandemic has been associated with outdoor and indoor air pollution, water and noise pollution, food security, and plastic pollution issues. Also, the inadequate infrastructure, the lack of proper waste and wastewater management, and the unequal social vulnerability reveal more linkages between Environmental Health and COVID-19 pandemic. The significant emerging ecological risk and its subsequent health implications require immediate risk analysis and risk communication strategies.

Keywords: COVID-19; Environmental Health; One Health; pandemic; risk analysis; risk communication.

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Open access
Published: 03 April 2024

The environmental awareness of nurses as environmentally sustainable health care leaders: a mixed method analysis

Olga María Luque-Alcaraz ORCID: orcid.org/0000-0003-1598-1422 1 , 2 , 3 , 5 ,
Pilar Aparicio-Martínez ORCID: orcid.org/0000-0002-2940-8697 3 , 4 ,
Antonio Gomera ORCID: orcid.org/0000-0003-0603-3017 2 &
Manuel Vaquero-Abellán ORCID: orcid.org/0000-0002-0602-317X 2 , 3 , 4

BMC Nursing volume 23 , Article number: 229 ( 2024 ) Cite this article

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People worldwide are concerned with the possibility of climate change, microplastics, air pollution, and extreme weather affecting human health. Countries are implementing measures to reduce environmental impacts. Nurses play a vital role, primarily through Green Teams, in the process of promoting sustainable practices and minimizing the environmental footprint of health care facilities. Despite existing knowledge on this topic, assessing nurses’ environmental awareness and behavior, including the barriers they face, is crucial with regard to improving sustainable health care practices.

To analyze the environmental awareness and behavior of nurses, especially nurse leaders, as members of the Green Team and to identify areas for improvement with regard to the creation of a sustainable environment.

A sequential mixed-method study was conducted to investigate Spanish nurses. The study utilized an online survey and interviews, including participant observation. An online survey was administered to collect quantitative data regarding environmental awareness and behavior. Qualitative interviews were conducted with environmental nurses in specific regions, with a focus on Andalusia, Spain.

Most of the surveyed nurses ( N = 314) exhibited moderate environmental awareness (70.4%), but their environmental behavior and activities in the workplace were limited (52.23% of participants rarely performed relevant actions, and 35.03% indicated that doing so was difficult). Nurses who exhibited higher levels of environmental awareness were more likely to engage in sustainable behaviors such as waste reduction, energy conservation, and environmentally conscious purchasing decisions ( p < 0.05). Additionally, the adjusted model indicated that nurses’ environmental behavior and activities in the workplace depend on the frequency of their environmental behaviors outside work as well as their sustainable knowledge ( p < 0.01). The results of the qualitative study ( N = 10) highlighted certain limitations in their daily practices related to environmental sustainability, including a lack of time, a lack of bins and the pandemic. Additionally, sustainable environmental behavior on the part of nursing leadership and the Green Team must be improved.

Conclusions

This study revealed that most nurses have adequate knowledge, attitudes, and behaviors related to environmental sustainability both inside and outside the workplace. Limitations were associated with their knowledge and behaviors outside of work. This study also highlighted the barriers and difficulties that nurses face in their attempts to engage in adequate environmental behaviors in the workplace. Based on these findings, interventions led by nurses and the Green Team should be developed to promote sustainable behaviors among nurses and address the barriers and limitations identified in this research.

Graphical Abstract

Peer Review reports

Introduction

The impact of climate change on human society is a global concern, especially with regard to microplastics, resource shortages, air pollution, droughts, and extreme weather. Such consequences affect human health both directly and indirectly, resulting in an increase in pathologies and a deterioration in medical attention [ 1 , 2 ]. In this context, diverse measures aimed at reducing the environmental impact of daily activities and minimizing the ecological footprint thereof [ 3 ] have been implemented by multiple countries [ 4 , 5 , 6 , 7 ]; these activities have been framed as environmental regulations in line with the Sustainable Development Goals (SDGs) [ 8 ].

The SDGs are being integrated into governments and a variety of other contexts, including the health care system. Spain is dedicated to such a goal, i.e., that of promoting a greener and more democratic health care transition. To achieve this goal, strategic plans have been developed to mitigate the effects of climate change [ 9 , 10 ]. One specific such program is the Strategic Health and Environment Plan (PESMA) [ 11 ], whose aim is to enhance the synergy between health and the environment innovatively by assessing the impact of the population in terms of 14 environmental indicators [ 12 ].

One such indicator focuses on the resources and support needed for sustainable practices, especially for nurses, due to the impact of the environment on their work [ 13 , 14 ]. The PESMA highlights the fact that health care providers should be included in strategies to reduce carbon footprints, build resilience to address the challenges associated with climate change and embrace a leadership role in the task of promoting sustainable health care practices [ 13 , 14 , 15 , 16 ]. Another critical aspect of PESMA focuses on education, training, and incentives that can promote sustainable behavior among health care workers, especially nurses [ 17 , 18 ]. As frontline health care workers, nurses have a unique opportunity to advocate for sustainable practices and reduce the environmental impact of the health care system. Nurses’ knowledge and behavior are limited despite the fact that nurses have positive attitudes toward environmental sustainability [ 19 ].

This situation stands in contrast to the role of nurses in the creation of more sustainable hospitals via the “Green Team” [ 20 ]. The Green Team, which originated in the United States of America a decade ago, is a committee that is responsible for finding and implementing sustainability projects to decrease the environmental impacts of daily operations. Members of various departments collaborate with sustainability staff to detect opportunities, spread awareness, and promote staff involvement in line with the Committee’s mission [ 21 ]. The team, which typically consists of and is led by nurses, aims to increase awareness of the health care industry’s effect on the environment and to develop tactics to mitigate the adverse environmental effects of hospitals.

In Spain, Green Teams, which span multiple disciplines and usually led by nursing professionals, are committed to sustainable change in health care [ 22 ]. Environmental nursing leaders on Green Teams control environmental sustainability in health care settings and provide education, resources, and support to other professionals with regard to the implementation of sustainable practices [ 23 ]. Accordingly, all nurses can contribute to the tasks of mitigating the impact of climate change on public health outcomes and promoting sustainable health for all [ 24 ]. These actions improve nurses’ knowledge, attitudes, and behavior in terms of sustainability and promote sustainable practices in health care settings, thus leading to a better understanding of the barriers faced by nurses in this context [ 24 , 25 , 26 ].

However, measuring and identifying nurses’ environmental awareness is essential for the promotion of sustainable hospitals [ 27 , 28 ]. Multidimensional indicators have been proposed for this purpose [ 16 ], the responsibility for which lies with nurse leaders on Green Teams. Nurses are responsible for promoting sustainability in health care organizations, as discussed by Kallio et al. (2018) [ 29 ], as well as for promoting nursing competencies related to environmental sustainability [ 30 ]. Several studies, including Harris et al. (2009) and Phiri et al. (2022), have examined nurses’ roles in environmental health and the effects of their leadership on the promotion of sustainability, especially during the COVID-19 pandemic, thereby emphasizing the importance of leadership [ 31 , 32 ].

As Ojemeni et al. (2019) discussed, leadership effectiveness in Green Teams, nursing teams and health care organizations must prioritize quality control and health care improvement to ensure sustainable development [ 33 ].

The topic of environmental management in health care organizations has been studied extensively, and an environmental or ecological model of care for promoting sustainability has been proposed [ 34 ]. As environmental creators and leaders on Green Teams, nurses are vital for minimizing hazardous waste in health care settings and improving awareness [ 35 ].

Although nurses have some degree of existing knowledge and awareness of sustainability, it is crucial to assess their proficiency in environmental matters and to gauge their environmental awareness. Such an evaluation can help identify areas for improvement within clinical management units [ 20 , 33 , 36 ]. Education and training programs can effectively promote sustainable behavior among nurses, but interventions should also address the barriers they face in their attempts to implement sustainable practices [ 37 ]. Therefore, it is imperative to examine the factors that foster sustainable behavior among nurses and to identify effective interventions that can promote sustainable health care practices and minimize the environmental footprint of health care facilities. Accordingly, this study aimed to analyze the environmental awareness and behavior of nurses, especially nurse leaders, as members of the Green Team and to identify areas for improvement with regard to creating a sustainable environment.

Study design

A sequential mixed-method study was conducted based on an online survey and interviews with a representative sample of Spanish nurses, including participant observation.

The study was divided into two phases. In the first phase, a cross-sectional, descriptive exploratory analysis was performed; this analysis relied on the results revealed using the Nurse’s Environmental Awareness Tool in Spanish (NEAT-es) [ 38 ], which was divided into three subscales: nursing awareness scale (NAS), environmental behaviors outside the workplace (PEB) and sustainable behaviors in the workplace (NPEB). In the second phase, qualitative interviews with environmental nurses (see Supplementary file 1 ) were conducted in regions featuring specific environmental units that were available in person (Andalusia).

Participants

The participants were recruited from public and private institutions associated with the National Health System, particularly from the nursing staff. The scope of the study focused on Spain, and the sample included all the nursing staff who completed the questionnaire and met the inclusion criteria.

The sampling process focused on the population of nurses in Spain in 2020, which was estimated to consist of 388,153 nurses. Therefore, a random sample of 314 participating individuals was sufficient to estimate the population with 95% confidence and an accuracy of +/- 2% units, which was expected to account for approximately 90% of the overall population. The inclusion and exclusion criteria used for the sample focused on nursing staff, nursing care auxiliary technicians, and students with relevant degrees, as this members of this group have the most significant presence in the health system and engage in direct and daily contact with environmental management in health centers (hospitals, primary care centers, sociosanitary centers and others). The remaining health and nonhealth personnel were excluded.

Additionally, the person from each unit who served as the environmental coordinator and other nurses from the ward who were members of the Green Team were asked to participate in the interviews and observations. The environmental coordinators, most of who were nursing supervisors, were determined based on the number of members of the Green Team and the sampling calculation used for the observational study. The interviews took place after various sessions, talks, or courses pertaining to environmental sustainability at the clinical management units.

Data collection

An intentional sampling process was implemented, and the data collection period spanned from November 2019 to March 2021. The observational data were collected in Spain via messages and posts on social media with the goal of quantifying nurses’ environmental awareness.

The initial sample of qualitative study included five environmental nursing leaders (NLs), 14 registered nurses (RNs), and ten nursing undergraduates. The final sample was reduced when the interviews reached data saturation ( N = 10, five NLs, and five RNs). Before the interviews, a focal group composed of one nurse, one physician, two engineers and a psychologist was tested using the questions included in this research as part of a pilot study ( Supplementary file 1 ). These interviews were conducted at the beginning of the participant’s shift, usually in the morning, and they featured a median time of 30 min, a minimum of 20 min and a maximum of one hour per participant.

One researcher (O.A.L.) also observed nurses during their daily work after the interview from a position within the ward as an added team member or staff member. Nevertheless, the observer did not highlight mistakes or sustainability issues during the observation process. No other researcher was involved in this step of the ethnographic analysis to avoid bias with regard to observing a variety of tasks ranging from preparing medication to implementing treatments.

The data collected through the interviews were recorded on a Samsung Galaxy 31 A, and observations were collected in a field notebook based on the Google Keep and Evernote mobile applications from November 2019 to mid-March 2021. This study was conducted at a regional level 1 hospital in southern Spain, particularly in various clinical management units (neurosurgery, internal medicine, cardiology, traumatology, and COVID-19 units, among others), and it focused on nursing supervisors, who are the leaders who bear responsibility for environmental awareness (NLs), and registered nurses (RNs) who were members of the Green Team.

Data analysis

The quantitative data were analyzed by reference to descriptive statistics, including the mean, standard deviation (SD), and 95% confidence interval (CI); the relative frequencies of the variables were also analyzed. Normalization tests, Kolmogorov‒Smirnov tests with Lilliefors correction, and Q‒Q tests were used to compare the goodness-of-fit to an average data distribution with regard to continuous or discrete quantitative variables. The comparison of two or three independent means was performed using Student’s t test and analyses of variance for each variable. The Χ 2 test with Yates’ correction was used to compare percentages and Pearson’s correlation (r) coefficients across the quantitative variables. Finally, associations among the NPEB and the other variables were studied through multiple linear regression. Participant observation was used to support the qualitative study of the reflective ethnographic type [ 39 , 40 ], and this process ended when the data reached saturation. Two researchers developed transcripts for the interviews based on the recorded interviews and added descriptions based on the notes from the field notebook. The identification of themes and patrons was based on a process of triangulation among the researchers and by cross-checking the results. The interviews with nurses were analyzed to summarize the content analysis and identify keywords and concurrency among the terms. The themes thus identified included Green Teams, sustainable environmental behaviors, environment awareness, leadership barriers and limitations and areas for improvement.

EPIDAT (version 4.2) and SPSS (version 25) software were used to support the quantitative analysis. The computer program ATLAS.ti (version 22) and the Office Package with Microsoft Word Excel (version 2019) were used for the interviews and the visualization of the keywords based on the themes identified based on the records, observations and field notebooks.

Nurses’ awareness, knowledge, attitudes and skills.

The ages of the Spanish staff, mainly nurses, included in this study ( N = 314) ranged from 19 to 68, with a mean age of 37.02 ± 12.7, CI = 95%, 35.6–38.4 years); in addition, 76.4% of these participants were women with more than 20 years of working experience (35.1%), and the majority were registered nurses (70.4%). Moreover, 113 (36%) participants worked at a local or regional hospital (30%) and were employees of a public institution (85.3%). Half of the nurses (157) worked only a morning shift (Table 1 ) in Andalusia, Madrid, or Catalonia (62.4%). The diverse autonomous regions on which this research focused were homogenously distributed and structured in line with the population. The analysis of these areas was also based on the specific inclusion of environmental units led by nurses (Andalusia, Madrid, and Catalonia), in contrast with regions featuring undetermined units or leaders related to this topic (such as Valencia) (37.5%).

Regarding nursing awareness, nurses scored higher on the PEB (31.83 ± 8.02 CI 95% 30.94–32.72 with regard to frequency vs. 32.36 ± 7.15 CI 95% 31.57–33.15 with respect to difficulty) than on the NAS (26.13 ± 9.91 CI 95% 25.03–27.23 with regard to knowledge vs. 47.39 ± 5.97 CI 95% 46.73–48.05 with respect to impact) and the NPEB (23.82 ± 6.45 CI 95% 23.10-24.53 with regard to frequency vs. 25.71 ± 6.31 CI 95% 25.01–26.41 with respect to difficulty). These results indicated that environmental knowledge among the Spanish population was limited (55.7%), although the nurses included in this research were aware of their potential impact on the environment (70.4%). The PEB subscale focused mostly on following environmental guidelines in their homes (57.3%) because these sustainable domestic tasks are easier for them (63.1%) than tasks in the professional field. The second subscale, NPEB, indicated that sustainable activities such as recycling were easy for the participants (57.6%), but sometimes they engaged in such activities less frequently than they would like (52.2%) (Fig. 1 and Fig. 2 ).

Representation of the frequency of nursing environmental behavior

Difficulty of engaging in adequate environmental behaviors

The sociodemographic variables indicated differences among the NEAT subscales (Table 2 ). Gender, working experience (with a median value of 10 years), and the position held in the institution and region were relevant with regard to environmental knowledge ( p < 0.01), environmental behavior outside the workplace ( p < 0.01), and environmental behavior in the workplace ( p < 0.01).

The NPEB was associated with the worst scores, thereby reflecting the nurses’ environmental behavior and activities in the workplace (52.23% rarely performed relevant activities, and 35.03% indicated that doing so was difficult) (Fig. 1 and Fig. 2 ). The NPEB values pertaining to environmental behavior were positively linked to age ( r = 0.412; p < 0.001), NAS knowledge ( r = 0.526; p < 0.001), PEB frequency ( r = 0. 57; p < 0.001), PEB difficulty ( r = 0.329; p < 0.001), and finally, difficulty performing adequate environmental behaviors ( r = 0.499; p < 0.001). Additionally, the value of the NPEB with regard to the difficulty of performing adequate environmental behaviors was positively associated with age ( r = 0.149; p = 0.008), NAS knowledge ( r = 0.249; p < 0.001), PEB frequency ( r = 0. 244; p < 0.001) and PEB difficulty ( r = 0.442; p < 0.001).

Based on the relevance of certain sociodemographic variables, the nurses’ environmental awareness (NAS) and their behavior outside the workplace (PEB), linear multiple regression was performed to investigate nursing behavior in the workplace (NPEB). The initial model (square sum = 488.655; p < 0.0001) indicated that age, the impact of nursing awareness (NAS), and the frequency of sustainable behaviors outside the workplace (PEB) were not relevant to nursing behavior in the workplace (NPEB) in terms of the frequency of performing adequate behavior or the difficulties experienced ( p > 0.05). Based on these results, the adjusted model was calculated (Table 3 ), indicating that NPEB depends on PEB frequency and NAS knowledge ( p < 0.01).

Nursing environmental behavior in the context of Green Teams: Barriers and areas for improvement.

The participants in the qualitative study ( N = 10) included nine women and one man; their median age was 49 years; they exhibited an interval quartile range of 35–60; they had levels of working experience ranging between 20 and 30 years, and they worked only in the mornings (7/10). Furthermore, the group including nurses and nursing supervisors (5/10) exhibited higher levels of education (see Supplementary file 2 ). The themes identified via repetition and associations during the interviews and observations indicated links among nurses’ responsibilities on the Green Team since they conformed to the nature of such teams (i). This team and nursing leaders identified sustainable environmental behavior (ii) that could improve environmental awareness (iii), knowledge, aptitude, and skills. The nurses who are responsible for sustainable changes should be the leaders (iv), and the relevant barriers and limitations (v) and areas for improvement (vi) in diverse areas should be identified simultaneously.

Green teams were linked to nursing responsibilities in the context of environmental sustainability.

In the interviews, the Green Teams, led by environmental leader nurses and comprising various staff members, were identified as crucial committees dedicated to enhancing environmental awareness and knowledge among hospital staff. Participants indicated that these teams facilitated regular meetings to discuss sustainable practices and played a pivotal role in testing behaviors and knowledge related to environmental sustainability. The Green Teams were highlighted as platforms for fostering collaboration and discussion surrounding sustainable practices. Participants noted that these teams facilitated the main purpose of the team and its members to improve the hospital staff’s knowledge and attitudes via meetings (RN 2,3 and NL 1,3). Subsequently, the NL also indicated a key role of the team in the testing of behaviors and knowledge. The behavior of registered nurses should be tested using questions according to the NLs. Also, the NLs are included in disponibility of of proper disposal methods for medical waste:

“So, where is the rubbish bin for medicines, that white one that you showed in the session that is used for the remains of medicines that we do not give to patients?” [(NL5)]

By such comments, it can be inferred that the Green Team not only disseminates information, manages the training and measures knowledge but also ensures that staff members understand and adhere to best practices in waste management. These tasks of the NLs and other RNs in the Green Team contribute to the overall efficiency and effectiveness of environmental sustainability efforts within the hospital.

Sustainable environmental behaviors were emerged by Green Teams.

The results of the analysis indicated some degree of resistance among the nurses working at the clinical management units with regard to their lack of competencies, especially those pertaining to knowledge, skills and attitudes. The comments from the interviews highlighted potential factors contributing to this resistance, including age-related differences, varying levels of awareness, and challenges in applying the principles of reduce, reuse, and recycle (the three Rs). For instance, one repetitive comment expressed a sentiment of uncertainty, stating “It is what is, but we don’t know it or what to do with it” (RN 3,4,5, and NL 2,3).

“We know what the light packing is, and they (maintenance people) installed it to reduce the lights and reduce the expense and cost, but we don’t know what to do with the rubbish bins” [(NL 4)]

This comment highlights a disconnect between awareness of specific sustainable initiatives and the practical knowledge to implement them effectively. All comments reflect the importance of addressing knowledge gaps and providing practical guidance to support nurses in adopting sustainable environmental behaviours. By acknowledging and addressing these challenges, healthcare facilities can enhance their environmental stewardship efforts and promote a culture of sustainability among staff members.

Environmental awareness were drawn from the nursing responsibilities that led to the creation of the Green Team.

The comments indicated that environmental awareness among nurses was influenced by training sessions and courses on environmental sustainability. After receiving training featuring lectures and courses on environmental sustainability, the leaders also reflected on the ways in which nurses put the recommendations made during the environmental sustainability courses into practice. Moreover, the leaders indicated that education should be beyond formal training sessions. The environmental leaders were interested in supplementing these courses with environmental education practices for the general population, as noted, for example, in reports of discharge from patient care or cycling on the ward. These activities indicated the ideal of including a holistic approach to sustainability within the healthcare setting.

Relevant statements included, “We have to separate residues according to the material… light plastic goes to… it is important for the unit and all of us” (NL 2,5). One key point that the referees and registered nurses highlighted pertained to the climate, particularly the lack of water (NL 1–5 and RN 1,2).

“The drought is getting worse; I don’t know how we are going to keep up… we hope it rains soon” [(RN1)]

Overall, the interviews shed light on the efforts to foster environmental awareness among nurses through formal training and practical integration into everyday practices. These observations emphasize the importance of ongoing education and action in addressing environmental concerns within healthcare settings.

Leadership, which was linked by comments to the Green Teams.

The interviews revealed that leadership, particularly within the context of Green Teams, is crucial in promoting environmental awareness and fostering a culture of sustainability among nursing staff. All the participants ( n = 10) indicated that the presence of adequate knowledge, meetings and awareness among nursing staff were the most important factors. These factors were identified as key drivers in promoting sustainable practices within the healthcare environment. NLs indicated the importance of creating a supportive working environment where nurses feel comfortable asking questions and seeking clarification without fear of negative feedback. Relevant statements included, “It is key to receive feedback from the nurses and provide a good working environment so that they can ask questions and reflect without negative comments” (NL 1,2,4, and RN 1,2). This working environment allowed the registered nurses to ask for help regarding the three Rs:

“Could you remind me (referring to the environmental coordinator) how the sustainable guidelines were included in the discharge report for the continuity of care; I remember some things from the course you gave us, but I want to convey it completely to my patient” [(RN2)]

Barriers and limitations, were drawn from nurses’ responsibilities.

Several nurses indicated that the difficulties they encountered with regard to performing environmental behaviors pertained to the lack of time, adequate bins, and space as well as the limited number of nurses per patient in the wards. Despite these challenges, participants noted a positive outcome in the form of increased awareness of sustainability issues among nurses, indicating a growing recognition of the importance of environmental stewardship within the healthcare setting. One factor that increased the barriers to environmental adequacy was the pandemic, which increased waste and rubbish. Despite these challenges, participants noted a positive outcome in the form of increased awareness of sustainability issues among nurses, indicating a growing recognition of the importance of environmental stewardship within the healthcare setting. Relevant statements included “There are not enough green rubbish bins for COVID waste” (EL 1,4,5 and RN1,2) and “How are we going to recycle if we don’t even have time to care for patients?” (RN 1,2 and NL 3).

All these comments indicated the barriers the nurses faced, but they also suggested possibilities for improvement. The pandemic, despite overloading nurses, also improved their awareness.

Areas subject to improvement emerged from nursing responsibilities, limitations and leadership.

Nurses indicated that despite their general levels of environmental awareness and the courses they had received, participants performed better regarding their recycling behaviors at home than at the hospital. Participants acknowledged performing better in recycling practices within their personal spaces, suggesting a potential gap in translating theoretical knowledge into practical action within the healthcare environment. Relevant statements included “It’s just that I recycle almost everything in my house, especially glass…, but here, there is no time…” (RN 1,4,5).

Moreover, time constraints emerged as a significant barrier impeding nurses’ ability to engage fully in environmental sustainability efforts. Participants cited the demanding nature of their work, particularly in the context of patient care responsibilities, as limiting their capacity to prioritize sustainability initiatives. This highlights the need for strategies to streamline environmental practices and integrate them seamlessly into nurses’ daily routines without adding undue burden.

Some statements also highlighted nurses’ willingness to improve paperwork and records. Nurses recognized the importance of incorporating environmental considerations into patient discharge reports and other documentation processes but sought further guidance on how to effectively implement these practices. Relevant statements included “Can you tell me how the patient’s continuity care report upon discharge was included in the recommendations for environmental sustainability… I want to do the report well with what you gave us in the clinical session the other day…” [(NL4)]

These comments indicated the opportunities for improvement in fostering a culture of environmental sustainability within the hospital setting. By addressing the identified challenges and providing targeted support and guidance, especially the lack of time, nurses can contribute to environmental stewardship efforts more effectively.

The current research highlights the relevance of nurses as promoters of environmentally sustainable behaviors in their roles as members of Green Teams and important leaders. The findings suggest that nurses exhibit acceptable knowledge, attitudes, and behaviors with regard to environmental sustainability both inside and outside the workplace. These results are complemented by a qualitative analysis indicating that such behaviors originate from nursing responsibility, Green Teams, leadership identification of barriers and areas of improvement. Both analyses highlight the fact that environmental nursing behavior in the workplace depends on sustainable behaviors outside the workplace. The qualitative analysis also identifies diverse barriers to the task of promoting sustainable behavior within the workplace, such as the COVID-19 pandemic and the need for more time to be allocated to this process. One key point identified by both analyses is that nurses have acceptable levels of knowledge; however, their attitudes, although as yet imperfect, are improving.

Several studies of nurses’ awareness of environmental sustainability have revealed that nurses exhibit moderate levels of awareness and a considerable degree of concern regarding the health impacts of climate change [ 37 , 42 , 43 ], as reflected in the NEAT-es results.

Interestingly, the participants exhibited a tendency to perform environmentally sustainable behaviors more consistently in their personal lives than in professional settings. These results are consistent with previous research on registered nurse and nursing students [ 36 , 41 , 42 ]. According to Swedish research, nurses generally recognize environmental issues but may lack awareness of the environmental impact of health care [ 43 ]. Polivka Barbara J. et al. (2012) highlighted the gap between nurses’ knowledge of sustainability and workplace behaviors, thereby emphasizing the need for education and training programs to promote sustainable practices [ 44 ]. These issues were also observed in a study conducted in Taiwan, which revealed that while nursing students exhibit positive attitudes toward sustainability, their knowledge and behaviors are inadequate [ 45 ].

By conducting qualitative analysis, this research also identified multiple barriers to the adoption of sustainable practices among nurses, including time constraints, disruptions caused by the COVID-19 pandemic, a lack of bins, and a lack of health care personnel. These findings are in line with those reported in other research, but certain barriers (in terms of resources, time, and support) to the implementation of sustainable practices in the workplace remain [ 29 ]. This study suggests that interventions should be designed to address these barriers and promote sustainable behavior among nurses, a suggestion which is consistent with the current research. These findings highlight the importance of comprehending nurses’ perspectives on environmental sustainability in health care contexts as well as the necessity for targeted interventions and support mechanisms [ 46 ]. The tasks assigned to nursing leaders and the Green Team involved addressing these barriers and promoting sustainable practices among nurses in the context of their professional roles. Environmental nursing leaders seem to be crucial with regard to establishing a more environmentally conscious health care environment, which is in line with recommendations to create a greener health care system [ 21 , 31 ]. Despite the results of the interviews, some global qualitative studies of nurses’ views on environmental issues have exhibited variations across countries [ 47 , 48 ]. In Sweden, nurses already exhibit pro-sustainability attitudes before the introduction of the 2030 SDGs [ 16 ]. However, the integration of environmental sustainability education into nursing programs can prepare future nurses more effectively to address the challenges associated with climate change and promote sustainable health outcomes [ 49 ].

Limitations

Although this investigation provides valuable insights, it is important to acknowledge its limitations. First, the study was conducted during the COVID-19 pandemic in Spain, which may have influenced the results due to the unique circumstances and stressors faced by health care workers during this period. Additionally, the assessment of nurses’ environmental awareness was performed on a larger scale, i.e., across multiple regions, and therefore may not accurately reflect individual attitudes and behaviors since the qualitative investigations focused on a specific region. However, this approach was adopted to minimize the risk of the ecological fallacy. Future studies could explore individual perspectives and experiences by reference to more diverse and representative samples.

Despite these limitations, this research is highly relevant because it sheds light on the role of nurses in the task of promoting environmental sustainability in health care settings. The research also emphasized the role of nursing leadership in the tasks of promoting environmental sustainability and providing nurses with the necessary resources and support to implement sustainable practices.

In conclusion, while nurses generally exhibit acceptable levels of knowledge, attitudes, and behaviors regarding environmental sustainability, a notable gap persists in terms of the frequency of sustainable actions within the professional settings in which they operate. This finding highlights the importance of closely aligning nurses’ personal and professional sustainability practices.

The qualitative analysis conducted as part of this study identified several barriers to the adoption of sustainable practices among nurses, including time constraints, disruptions resulting from the COVID-19 pandemic, issues with waste disposal, and challenges related to health care personnel. Despite the fact that these findings are in line with those reported in previous research, persistent barriers such as limited resources, time, and support hinder the implementation of sustainable practices in the workplace. Therefore, interventions aimed at addressing these barriers and promoting sustainable behavior among nurses are essential, as highlighted by both current research and the corresponding qualitative insights. Therefore, nursing leaders and Green Teams are pivotal with regard to overcoming these barriers and fostering sustainable practices within health care environments. Environmental nursing leaders in particular are instrumental to the cultivation of a more environmentally conscious health care system, thereby aligning with recommendations for greener health care practices.

Data availability

The datasets used and/or analyzed as part of the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to thank the Excellent Official Nursing School and all the professionals who participated in this research for their support.

This research received no external funding; however, the project did receive an award from the Excellent Official Nursing School in Cordoba, Spain, in 2020.

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Olga María Luque-Alcaraz

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Olga María Luque-Alcaraz, Antonio Gomera & Manuel Vaquero-Abellán

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Olga María Luque-Alcaraz, Pilar Aparicio-Martínez & Manuel Vaquero-Abellán

Nursing, Pharmacology and Physiotherapy Department, Faculty of Medicine and Nursing, University of Cordoba, 14071, Cordoba, Spain

Pilar Aparicio-Martínez & Manuel Vaquero-Abellán

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A.G. and M. V-A. conceived and designed the study, and O.M. L. and P.A-M. acquired the data, analyzed and interpreted the data, and drafted the article. The publication and supervision of the article were the responsibility of A.G. and M. V-A. All authors contributed equally to the writing and preparation of the final manuscript.

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Ethical approval was obtained from the Ethics Committee of Reina Sofia Hospital of Cordoba, which is part of the Andalusian Health Care System in Spain (Act No. 267, ref.3605). This research was in line with the Organic Law 3/2018 of December 5 on the Protection of Personal Data and Guarantee of Digital Rights as well as the Nursing Ethics Code and the 1964 Declaration of Helsinki. The participants were informed of the study’s purpose before participation; their informed consent was obtained, and they were informed that they were able to withdraw from the study at any stage. All the data were obtained after informed consent was collected; in addition, the data were anonymized and saved securely in a database, thereby maintaining all stipulations of the Personal Data Law.

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Luque-Alcaraz, O.M., Aparicio-Martínez, P., Gomera, A. et al. The environmental awareness of nurses as environmentally sustainable health care leaders: a mixed method analysis. BMC Nurs 23 , 229 (2024). https://doi.org/10.1186/s12912-024-01895-z

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Environmental Health Humanities: Microbes, Plagues, and Healing

Concentric: Literary and Cultural Studies

Vol. 51 No. 2 | September 2025

Call for Papers

Environmental Health Humanities:

Microbes, Plagues, and Healing

Guest Editors

Pin-chia Feng (National Yang Ming Chiao Tung University)

Robin Chen-Hsing Tsai ( Tamkang University )

Deadline for Submissions: December 31, 2024

In 2015, the Rockefeller Foundation–Lancet Report introduced “Planetary Health,” highlighting the profound impact of environmental changes, including climate change, on global well-being, food security, and the proliferation of diseases caused by various microorganisms. Fast forward to 2019, the COVID-19 pandemic, caused by the SARS-CoV-2 virus, emerged, underscoring the interconnectedness of human health and the environment. Works such as Samuel Myers and Howard Frumkin’s Planetary Health: Protecting Nature to Protect Ourselves , Richard Horton and Selina Lo’s “Planetary Health: A New Science for Exceptional Action,” and Pierre Horwitz and Margot W. Parkes’s “Intertwined Strands for Ecology in Planetary Health” offer comprehensive frameworks melding environmental concerns with health, politics, and well-being. Schrödinger’s definition of life is systemic, and his envisioning of a life in interaction with “its environment” seems congruent with Georges Canguilhem’s conception of “life” and other philosophers such as René Dubos, Claude Bernard, and Bernard Stiegler. From these critical trajectories we hope to redefine the possibility of future medical and environmental humanities research.

While we are still struggling to grapple with the ongoing repercussions of COVID-19, society increasingly recognizes the importance of biomedical advancements and medical technologies. Addressing the psychological impacts of infectious diseases, the anguish of separation, and related healthcare challenges is paramount. Consequently, discussions surrounding environmental health humanities research and practice have gained unprecedented significance.

For this special issue of Concentric , entitled “Environmental Health Humanities: Microbes, Plagues, and Healing,” we aim to delve into the imaginaries of diseases and viruses, as well as revisit discussions on healing within literature and culture. We invite submissions that are devoted to the interactions with nature and wildlife, food system, and changes in demography and technology. Additionally, the issue hopes to scrutinize the environmental and societal factors contributing to medical and environmental racism, alongside the erosion of social structures due to industrial technologies. We welcome analyses of mindful approaches such as dietary practices, gardening therapy, and activism, which can present alternative paths to healing within modern medicine. Furthermore, we encourage investigations into the spiritual dimensions as pivotal components of human and environmental health that may catalyze change in the Anthropocene era.

Environmental health humanities, as an interdisciplinary field, offer a platform to tackle complex issues at the intersection of medicine, humanities, ethics, and beyond, thereby fostering critical inquiry and dialogue. Contributions examining various facets of this overarching theme are warmly welcomed. Possible topics include (but are not limited to) the following:

(1) Medical humanities and the Anthropocene

(2) Through the lens of pandemic

(3) Narrative of outbreaks

(4) Plague and pandemic writing

(5) Contagion and contagious disease

(6) Quarantine, security, society of control

(7) Health, disease, and poverty

(8) Graphic medicine and its discontents

(9) Plagues, ageing, and gerontology

(10) The normal and the pathological

(11) Odors, smells, and health

(12) Biopolitics, necropolitics, and immunopolitics

(13) Resonances and entanglements

(14) Immunity, community, and state of exception

(15) The posthuman and the medical imagination

(16) Mindfulness and spirituality

Please send complete papers of 6,000-10,000 words, 5–8 keywords, and a brief biography to [email protected] by December 31, 2024. Manuscripts should follow the latest edition of the MLA Handbook for Writers of Research Papers . Except for footnotes, which should be single-spaced, manuscripts must be double-spaced in 12-point Times New Roman. Please consult our style guide at http://www.concentric-literature.url.tw .

Concentric: Literary and Cultural Studie s, indexed in Arts and Humanities Citation Index, is a peer-reviewed journal published two times per year by the Department of English, National Taiwan Normal University, Taipei, Taiwan. Concentric is devoted to offering innovative perspectives on literary and cultural issues and advancing the transcultural exchange of ideas. While committed to bringing Asian-based scholarship to the world academic community, Concentric welcomes original contributions from diverse national and cultural backgrounds. In each issue of Concentric we publish groups of essays on a special topic as well as papers on more general issues. http://www.concentric-literature.url.tw/ .

For submissions or general inquiries, please contact us at: [email protected] .

Environmental Pollution and Its Effect on Health

Environmental pollution is one of the fundamental factors directly affecting climate change. Due to the active production and human use of fossil fuel products, industrial enterprises’ activities exert intense pressure on the environment. Air pollution has a direct negative impact not only on the climatic situation but also on people’s health throughout the country. The most vulnerable category of the population to climate change is adults over 65 since external factors most strongly influence their health.

Industrial enterprises for the extraction and processing of fossil fuels are located throughout the United States of America. Moreover, agricultural activities and natural disasters, such as seasonal forest fires, substantially impact the ecological situation. Moreover, given the air masses’ movement and the cyclical nature of many biological processes, it is fair to conclude that air pollution problems are national. First of all, the increased content of heavy particles such as CO2, N2O, and NH3 has a severe impact on the human respiratory system. The lungs receive additional stress due to respiratory diseases such as asthma and chronic objective pulmonary illness.

Furthermore, the lack of pure oxygen in the body harms other human organs: the brain, heart, and digestive system. According to new data from the World Health Organization (WHO) (2018), 9 out of 10 people breathe air with an increased concentration of pollutants. The WHO estimates that 7 million people die each year from the effects of inhaling air-containing particulate matter causing diseases such as stroke, heart disease, lung cancer, and pneumonia (World Health Organization, 2018). Older people are most vulnerable to environmental pollution, as their level of immunity weakens with age.

The negative impact of human-made pollution sources is actively affecting climate change. First of all, the above factors affect the increase in temperature in the atmosphere. According to the Lancet Countdown, temperature-related deaths in people over 65 have increased by 50% in the past twenty years (Watts et al., 2020). In the southern regions, there is an increased risk associated with an increase in atmospheric temperature, which in the long term will lead to droughts, floods, and, as a result, food crises. In addition, high temperatures increase the rate at which infectious diseases such as malaria spread, which also poses additional risks in some countries (Fairweather, 2020). Thus, the problem of climate change is not only national but also goes to the global level.

To solve this problem, a systematic and comprehensive approach is required, the application of which will take a relatively long period. In climate change, due to air pollution, the main force to prevent environmental disasters need to change the approach to the production of substances from fossil fuels. First of all, increased taxation and legislative acts limiting the number of harmful products will reduce the burden on the environment. Recent technological solutions allow the use of renewable energy sources with increasing efficiency. Large companies gradually lose the need to use coal or petroleum products. Conglomerates continue to use them due to low prices. Therefore, government intervention is needed, aimed not to adjusting the market as a harmful environmental consequence.

Due to the rapid development and massive use of modern technologies by the population, people’s way of life has changed. In the twenty-first century, the world community is ready to actively assist the government by applying the principles of conscious consumption and reducing the emissions of solid and gaseous waste into nature. People are beginning to use public transport, bicycles, and other transportation, emitting several times fewer emissions than cars.

Moreover, the environmental agenda is growing: citizens choose special packaging of products, strive to sort waste into categories, and the state needs to support private initiatives at the federal and local levels (Akhtar & Palagiano, 2018). First of all, it is necessary to create all the conditions to make it easier for people to choose environmentally friendly products, create additional waste sorting centers, and raise citizens’ education in environmental matters. This can be done both by legislative acts, there and by local decisions.

The problem of climate change and air pollution is global. Accordingly, a considerable number of people are subject to changes that affect their daily life. Consequently, there is an additional burden on the health care system. If the current trend continues, the situation runs the risk of spiraling out of control due to medical institutions’ limited capacity. The pandemic of the COVID-19 virus, which has spread worldwide, has demonstrated the existence of vulnerabilities in the healthcare system (Richardson, 2020). In cases where many people need the qualified help, medical institutions may not cope with the load. In the event of critical climate changes, implying global cataclysms, the healthcare system will not be able to cope with the task.

To sum up, climate change is primarily due to the high level of harmful substances emissions into the atmosphere. According to statistics, every year, more and more people over 65 years old directly feel the consequences of the changes. First of all, to reduce environmental change, it is necessary to introduce stringent measures for large industrial enterprises and agricultural centers. Increasing ecological awareness of the population also favorably contributes to curbing global warming and, as a result, reduces people’s vulnerability to disease.

Akhtar, R., & Palagiano, C. (2018). Climate change and air pollution . Switzerland: Springer International Publishing.

Watts, N., Amann, M., Arnell, N., Ayeb-Karlsson, S., Beagley, J., Belesova, K.,… & Capstick, S. (2020). The 2020 report of The Lancet Countdown on health and climate change: Responding to converging crises. The Lancet . Web.

World Health Organization. (2018). Air pollution and child health: Prescribing clean air: Summary (WHO Reference Number WHO/CED/PHE/18.01). Web.

Richardson, S. J., et al. (2020). Research with older people in a world with COVID-19: identification of current and future priorities, challenges and opportunities. Age and Ageing, 49 (6), 901-906.

Fairweather, V., Hertig, E., and Traidl‐Hoffmann, C. (2020). A brief introduction to climate change and health. Allergy, 75(9), 2352-2354. Web.

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"Environmental Pollution and Its Effect on Health." IvyPanda , 23 Nov. 2023, ivypanda.com/essays/environmental-pollution-and-its-effect-on-health/.

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IvyPanda . 2023. "Environmental Pollution and Its Effect on Health." November 23, 2023. https://ivypanda.com/essays/environmental-pollution-and-its-effect-on-health/.

1. IvyPanda . "Environmental Pollution and Its Effect on Health." November 23, 2023. https://ivypanda.com/essays/environmental-pollution-and-its-effect-on-health/.