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Occupational Health and Environmental Nurses Shift Focus Towards Sustainability

April 2013

According to the National Student Nurses’ Association, the specialty of occupational health and environmental nursing began in the 1880s when nurses were caring for coal miners, but vastly expanded in the early 1900s in the wake of the industrial revolution when factories employed nurses to combat the spread of infectious diseases. Today, the specialty mainly focuses on health promotion and emergency preparedness, but is growing into the area of environmental and sustainability issues.

“When I first graduated from nursing school in the early 1970s, there was no such thing as environmental nursing. However, over time, I’ve seen hospitals and the community become more proactive regarding issues of sustainability, and nurses have played a large role in providing a unique and valuable health perspective to these conversations,” said Jacqueline Agnew, RN, Ph.D., MPH, professor in the department of Environmental Health Sciences, and director of the Education and Research Center for Occupational Safety and Health at Johns Hopkins Bloomberg School of Public Health in Baltimore, Md.

With the plethora of environmental issues that exist today – such as food, water and air quality concerns – occupational and environmental health nurses have the opportunity to work in a variety of settings and use a multitude of interdisciplinary skills. A new graduate may work as an epidemiologist, injury and safety specialist, or environmental specialist for organizations such as the Occupational Safety and Health Administration or the Centers for Disease Control and Prevention. Additionally, nurses in this field may consult with executives about the health of employees and safety conditions in the workplace, coordinate employee disability requests or administer inoculations for hepatitis, to name a few responsibilities.

“Occupational health and environmental nursing is a great specialty for those who are interested in health and disease prevention from a population perspective. Nurses in this field are problem solvers and independent thinkers who must take a step back to understand how environmental issues could affect our entire population, not just one patient,” said Agnew.

Many occupational health nurses are beginning to integrate environmental health into their practice settings. For example, many nurses in the field conduct occupational and environmental health histories, determine actual and potential environmental hazards, control disease exposures, or educate the working community about these hazards.

“A lot of my students start at the local level and become involved with environmentally-focused organizations as a side project, but for some students, it truly starts to become their passion,” said Agnew.

While most nursing schools at the undergraduate level do not currently offer environmentally-focused specialty courses, some universities and organizations are starting to provide nurses with online courses and supplemental resources to stretch their education into health and global sustainability issues. For example, the University of Maryland School of Nursing (UMSON) offers a master’s degree in environmental health nursing, and Johns Hopkins Bloomberg School of Public Health has an Occupational and Environmental Health Nursing (OEHN) program and a Master of Public Health and Nursing (MSN/MPH) degree program.

Additionally, organizations like the Environmental Health Nursing Education Collaborative, a project organized by the Boston University Superfund Research Program (BU SRP) and the Harvard School of Public Health, provides lectures, case studies, presentations and reports to contribute to the education and training of nurses by helping their faculty integrate environmental health into the nursing curriculum.

“Right now the focus is shifting – despite this being a new area of concern, people are coming together and bringing the knowledge they have to the table. I foresee great promise and opportunity for this specialty in the future,” said Agnew.

For more information about occupational health and environmental nursing, including appropriate certification, visit

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