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Testing a PHN environmental risk reduction intervention: Household and biomarker data from rural low-income families

Patricia Butterfield, PhD, RN, School of Nursing, Dept of Psychosocial and Community Health, University of Washington, Box 357263, Seattle, WA 98195, 206-543-4436, pbutter@u.washington.edu, Wade Hill, PhD, RN, College of Nursing, Montana State University, Sherrick Hall, Bozeman, MT 59717, and Phillip Butterfield, PhD, PE, Department of Occupational and Environmental Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Box 354695, Seattle, WA 98105.

The Environmental Risk Reduction through Nursing Interventions and Education (ERRNIE) study involves a university/health department partnership and the collection of household data from low-income Montana families. Families that are currently receiving public health services and have homes with a private well (vs. a municipal system) are eligible for participation. The goal of this phase of the research is to obtain prevalence estimates for putative exposures from well water, radon gas, carbon monoxide, lead (blood), and environmental tobacco smoke (i.e., urinary cotinine). Data are collected by PHN personnel who have been trained to collect specimens using a standardized research protocol. Household and biomarker data (n=24) to date include 33% of wells testing positive for total coliforms, 31% of homes exceeding the action level for airborne radon (4.0pCi/L), and 1 home exceeding the carbon monoxide threshold of 9ppm (range=0=24pCi/L). In addition, well water from 3 homes (12.5%) had elevated nitrate levels (but less that the health standard), 1 (4.2%) was high in fluoride, 3 (12.5%) contained volatile or synthetic organic compound contaminants, 3 (12.5%) contained high sodium levels, and 2 (8.3%) contained high levels of sulfate. Six children (23%) had lead levels exceeding 5µg/dl, with the highest value being 7.6µg/dl (and 3.2µg/dl at one-month repeat testing), and four children (15%) tested positive for urinary cotinine (range=0-43 µg/ml, with 5 µg/ml used as the threshold indicating exposure). Together these data provide evidence of the prevalence of household risks as well as opportunities for targeted PHN risk reduction interventions in the home.

Learning Objectives:

Keywords: Environmental Exposures, Public Health Nursing, Outcomes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Environmental Health

The 132nd Annual Meeting (November 6-10, 2004) of APHA