Community health news article

Air Pollution

Although one would presume that air toxins would increase an elderly person's risk of contracting a respiratory ailment, a recent health study reported by the Associated Press in the New York Times revealed that fine grit in polluted air also increases the risk of heart disease in older women ("Study Finds Gritty Air Raises Heart Disease Risk in Older Women," 2006, the Associated Press). Breathing in grit from the environment can create inflammation in the lungs which also leads to an increased risk of heart attacks and strokes. A federally financed study of 65,893 postmenopausal women between the ages of 59 and 79 found that for every increase of 10 millionths exposure to grit in the air, the woman's risk of developing fatal cardiovascular disease increased by 75% ("Study Finds Gritty Air Raises Heart Disease Risk in Older Women," 2006, the Associated Press).

The average exposure of the subjects to air pollutants was 13 millionths. This meant that, of the patients that developed ailments, two-thirds of the subjects fell beneath the Environmental Protection Agency's national standard of 15 millionths of every cubic meter of air. Thus, the study found that exposure to air particles within federal limits could still make a significant contribution to women's development of lung and heart diseases. Women are more susceptible than men to heart problems because of their smaller blood vessels and other biological differences. Unlike earlier studies, this new study looked not only at deaths, but also at heart attacks, coronary disease, strokes and clogged arteries that were not fatal. A shocking 3% of the women had some kind of cardiovascular problem, and the researchers tried to adjust for variances in income and other health problems and lifestyle choice that might affect the statistics. Still, "the risk varied along with the varying levels of these particles in different neighborhoods in the same city" ("Study Finds Gritty Air Raises Heart Disease Risk in Older Women," 2006, the Associated Press).

The study found that current federal standards were not strict enough regarding air particles and grit in the environment. But what can elderly women, like the women do to improve their immediate health environment? Self-care is critical, even for the elderly, according to Orem's model of nursing which maintains: "a requirement for nursing exists when a person is unable to maintain for him/herself self-care action which is therapeutic in sustaining life and health," such as recovering from disease and injury or coping with the effects of an illness (Goodwin, 1990, citing Orem, 197 1: 1). In Orem's model, the nurse-patient relationship is unbalanced in the sense that the patient has a need for the nurse and the nurse must step in with her ability and meet that need but the relationship between nurse and patient is always complimentary. The nurse must act to help the patient assume responsibility for health-related self-care to the maximum degree possible (Goodwin, 1990).

For example, a nurse can first of all make a patient aware about the possibilities of environmental risks in the form of dust and grit. The patient can monitor the patient for the signs of heart disease, and be aware of the fact that women may be more at risk, and have different symptoms than men. The nurse can make the patient aware of the signs of heart-related ailments caused by the environment. Of course, the patient's increased efficacy in such self-care will not change federal environmental regulations, nor improve the quality of the air in the city block where the patient lives. But the nurse can provide knowledge, and if the patient is unable to do so, improve the indoor air quality of the patient's immediate environment by adjusting ventilation systems to decrease the exposure emissions, and advise the patient to eliminate sources of asbestos, dust, and other toxins within the home. "In many cases, source control is also a more cost-efficient approach to protecting indoor air quality than increasing ventilation because increasing ventilation can increase energy costs," which can be of concern to elderly patients living on a fixed income, and also because levels of pollutants may be high outside as well as inside the home ("An Introduction to Indoor Air Quality," 2006, EPA).