Column: Nurse urges upstream approach to clean water and health


Too often, health professionals are called upon to treat patients with diseases that could have been prevented – through quality primary care, lifestyle and environmental changes, or (especially now) vaccines.

Frustrated and exhausted, we sought “upstream” solutions to our hospital and waiting room problems.

That’s why nurses are speaking out on environmental issues. We know that clean air and water are the foundation of good health. When it comes to clean water, the solution we need – literally – is upstream. A new report from the Alliance of Healthy Environment Nurses highlights the threats to water quality in America today and shows how nurses across the country are taking action to address them.

Clean Water and Health

It is no exaggeration to say that water is life: without it, human beings would not survive for more than a few days. Clean water is also essential for safe healthcare — from washing hands to prevent infection to cleaning hospital sheets. In fact, U.S. healthcare facilities are very water-intensive, accounting for 7 percent of the nation’s industrial and commercial facilities.

In America, we mostly take water for granted. When we turn on the faucet, we assume the water is free of pollutants and pathogens; when we head to the beach, we assume it is safe to swim. But that’s not always the case. In the early 1970s, raw sewage and industrial waste were routinely dumped into waterways, and two-thirds of the nation’s lakes, rivers and coastal waters were declared unfit for fishing or swimming. Occasionally, oil-polluted rivers catch fire.

Beginning with the passage of the Clean Water Act in 1972, the EPA hit the worst sources of water pollution, and the federal government invested in water treatment plants across the country. As a result, most Americans have access to safe drinking water, and most of our waters are safe for fishing and swimming. But many sources of pollution remain unchecked. And, from Flint, Michigan, to the Navajo Nation, access to safe, clean water is far from guaranteed.

Today, aging infrastructure leach heavy metals such as lead and copper into drinking water. Combined sewer overflows continue to discharge raw sewage into waterways. Additionally, in 2015, approximately 27 million people in the United States were served by water systems that reported health-based violations under the Safe Drinking Water Act.

There are also new threats. Climate change is exacerbating droughts, floods and pathogen overgrowth – all of which affect water availability and quality. Per- and polyfluoroalkyl substances (PFAS)—a persistent pollutant associated with cancer and reproductive harm—now present in the drinking water of at least 10 million Americans.

Nurses in action for clean water

These threats are affecting our patients. About 7 million cases of water-borne illness occur in the United States each year, and many more get sick from drinking water contaminated with toxic metals and chemicals. Overall, waterborne diseases result in approximately 118,000 hospitalizations each year and cost $2.39 billion annually.

But while the threat is growing, there is also an opportunity to make a difference. City halls, state legislatures, courts and Congress are making critical decisions that affect our water supply. This year marks the 50th anniversary of the Clean Water Act, and implementing the original intent of this landmark bill is critical.

Nurses are seizing these opportunities, as detailed in the report by the Alliance of Nurses for Healthy Environments. Nurses, for example, have joined the debate on how to define “American waters,” with a more protective definition extending the Clean Water Act’s coverage to about 60 percent of the nation’s streams and wetlands — a third of upstream water sources One of the sources of drinking water for Americans. Last month, several coalition members testified before the EPA and the Army Corps of Engineers in support of the change. Emily Little, a registered nurse from Virginia, spoke on behalf of her children at the hearing: “We’re borrowing water from future generations,” Little said.

Nurses are also making an impact locally. People in Union, Alabama, contacted Dr. Azita Amiri, a nurse researcher and associate professor at the University of Alabama in Huntsville, because they were concerned that their water was making them sick. Dr. Amiri tested local drinking water with community members and found lead and arsenic in some samples. Dr. Amiri then conducted outreach to help residents limit contact while advocating for local and state officials to address the problem at the source.

Nurses play a vital role in the fight for clean water. We are trusted messengers: Nursing was recently named the most trusted profession in America for the 20th consecutive year.

“Our approach to education really looks at the whole person,” said Dr. Laura Anderko of Villanova University’s M. Louise Fitzpatrick School of Nursing. For many, this holistic view extends to the broader context of disease and health .

Nurses have learned an important lesson over the past two years: addressing “upstream” problems can prevent downstream crises. That’s true in pandemics, and it’s also true in protecting the clean water on which all life depends.

Katie Huffling DNP, RN, CNM, FAAN is a certified nurse midwife and executive director of the Alliance of Nurses in Healthy Environments (ANHE). Working with ANHE, Dr. Huffling works with nurses and nursing organizations to advance environmental health issues in the nursing profession, such as climate change, toxic chemicals, and healthcare sustainability.

Banner photo: SJ Objio/Unsplash

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