Public Health Nursing Vol. 31 No. 4, pp. 298–308 0737-1209/© 2014 Wiley Periodicals, Inc. doi: 10.1111/phn.12098
POPULATIONS
AT
RISK ACROSS
THE
LIFE SPAN: POPULATION STUDIES
Student Nurses’ Risk Perceptions of Home Environmental Hazards Barbara J. Polivka, Ph.D., R.N.1 and Celia Wills, Ph.D., R.N.2 1
University of Louisville School of Nursing, Louisville, KY; and 2The Ohio State University College of Nursing, Columbus, OH
Correspondence to: Dr. Barbara Polivka, University of Louisville School of Nursing, 555 S. Floyd St., Louisville, KY 40202. E-mail: [email protected]
ABSTRACT Objective: This study described nursing students perceptions of home health risks. Design and Sample: Nursing students (N = 254) at two large urban universities completed a cross-sectional survey during the 2011–2013 academic years. Measures: From a list of 22 common home health hazards, students identified what they perceived as the three: (a) most dangerous hazards, (b) most common hazards in their state, (c) hazards most likely to be present in their current home, and (d) hazards they would most afraid to find in their home. Students also rated perceived dangerousness of the hazards, how healthy they perceived their home to be, and the perceived effect of their home on their own health. Results: Tobacco smoke, asbestos, and cleaning products were the most commonly identified home hazards. Individual characteristics, hazard experiences in personal homes, and university geographic location (state) were associated with perceptions of home hazards. Students who identified hazards in their own homes were more likely to identify them as hazards in general and for their own state. Conclusions: These results fill a foundational knowledge gap by describing the risk perceptions of near-future health care providers about home environmental hazards. Key words: environmental health, home health hazards, nursing students, risk perception.
Background The perception of risk is inherently subjective and often shaped by one’s personal experiences. With regard to environmental hazards, risk perceptions are central to the accuracy of risk assessments. The perceived probability that an environmental exposure will have an adverse effect, concern over the severity of the effect, and the context of the exposure all impact risk assessment judgments. Assessment of risk is also influenced by factors such as familiarity with the source of the risk, ability to control the risk, awareness of danger, and reliability and clarity of information sources (Miller & Solomon, 2003; Renn, 2004; Slovic, 1987). Nurses’ knowledge and personal perceptions regarding environmental hazards influence their ability to educate, interpret information, advocate, and advice (Mujuru & Niezen, 2004). A large body of research over multiple decades supports the
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central role that clinician (and more generally, human) risk perceptions play in a wide range of interpreting and acting upon probabilistic risk information in health-related judgment and decision making (for illustrative reviews, see Brewer et al., 2007; Sox, Blatt, Higgins, & Marton, 1988; Trevena et al., 2012). Home environmental risks, which are often significantly detrimental to the health of inhabitants, can include lead, dust mites, mold/moisture, carbon monoxide, radon, pesticides, tobacco smoke, uncovered electrical outlets, overheating in the winter, and volatile organic compounds (VOCs). VOCs are chemicals in products such as air fresheners, cosmetics, and cleaning products that volatize and become gaseous at room temperature (Davis, 2007; Hynes et al., 2003). Over half of childhood deaths from unintentional injuries occurred in the home and were caused by fires, submersion/suffocation, poisonings, and falls
Polivka and Wills: Student Nurses’ Perceptions of Home Hazards (Nagaraja et al., 2005). Exposures to house dust mites, cockroach allergens, molds, fragrances, formaldehyde, and environmental tobacco smoke are associated with asthma in children (Institute of Medicine, 2000). Krieger and Higgins (2002) in their seminal paper “Housing and Health: Time again for Public Health Action” noted substandard housing is associated with infectious and chronic diseases from exposures to hazards such as unsafe drinking water, pests, crowding, cold, mold/moisture, environmental tobacco smoke, lead based paint, and radon. A healthy homes approach was encouraged for improving home environmental quality. A healthy home is one that is dry, clean, pest-free, well ventilated, safe, contaminant-free, and well-maintained (National Center for Healthy Housing, 2011, 2013). Assessment of a homes’ indoor air quality, asthma and allergen triggers, carbon monoxide, lead, water quality, chemicals, pesticides, and other poisons is advocated by the Healthy Homes Partnership (2012). The U.S. Environmental Protection Agency (2005) recommends assessment of children’s exposures to environmental hazards based on life-stage groupings (i.e., Birth to
POPULATIONS
AT
RISK ACROSS
THE
LIFE SPAN: POPULATION STUDIES
Student Nurses’ Risk Perceptions of Home Environmental Hazards Barbara J. Polivka, Ph.D., R.N.1 and Celia Wills, Ph.D., R.N.2 1
University of Louisville School of Nursing, Louisville, KY; and 2The Ohio State University College of Nursing, Columbus, OH
Correspondence to: Dr. Barbara Polivka, University of Louisville School of Nursing, 555 S. Floyd St., Louisville, KY 40202. E-mail: [email protected]
ABSTRACT Objective: This study described nursing students perceptions of home health risks. Design and Sample: Nursing students (N = 254) at two large urban universities completed a cross-sectional survey during the 2011–2013 academic years. Measures: From a list of 22 common home health hazards, students identified what they perceived as the three: (a) most dangerous hazards, (b) most common hazards in their state, (c) hazards most likely to be present in their current home, and (d) hazards they would most afraid to find in their home. Students also rated perceived dangerousness of the hazards, how healthy they perceived their home to be, and the perceived effect of their home on their own health. Results: Tobacco smoke, asbestos, and cleaning products were the most commonly identified home hazards. Individual characteristics, hazard experiences in personal homes, and university geographic location (state) were associated with perceptions of home hazards. Students who identified hazards in their own homes were more likely to identify them as hazards in general and for their own state. Conclusions: These results fill a foundational knowledge gap by describing the risk perceptions of near-future health care providers about home environmental hazards. Key words: environmental health, home health hazards, nursing students, risk perception.
Background The perception of risk is inherently subjective and often shaped by one’s personal experiences. With regard to environmental hazards, risk perceptions are central to the accuracy of risk assessments. The perceived probability that an environmental exposure will have an adverse effect, concern over the severity of the effect, and the context of the exposure all impact risk assessment judgments. Assessment of risk is also influenced by factors such as familiarity with the source of the risk, ability to control the risk, awareness of danger, and reliability and clarity of information sources (Miller & Solomon, 2003; Renn, 2004; Slovic, 1987). Nurses’ knowledge and personal perceptions regarding environmental hazards influence their ability to educate, interpret information, advocate, and advice (Mujuru & Niezen, 2004). A large body of research over multiple decades supports the
298
central role that clinician (and more generally, human) risk perceptions play in a wide range of interpreting and acting upon probabilistic risk information in health-related judgment and decision making (for illustrative reviews, see Brewer et al., 2007; Sox, Blatt, Higgins, & Marton, 1988; Trevena et al., 2012). Home environmental risks, which are often significantly detrimental to the health of inhabitants, can include lead, dust mites, mold/moisture, carbon monoxide, radon, pesticides, tobacco smoke, uncovered electrical outlets, overheating in the winter, and volatile organic compounds (VOCs). VOCs are chemicals in products such as air fresheners, cosmetics, and cleaning products that volatize and become gaseous at room temperature (Davis, 2007; Hynes et al., 2003). Over half of childhood deaths from unintentional injuries occurred in the home and were caused by fires, submersion/suffocation, poisonings, and falls
Polivka and Wills: Student Nurses’ Perceptions of Home Hazards (Nagaraja et al., 2005). Exposures to house dust mites, cockroach allergens, molds, fragrances, formaldehyde, and environmental tobacco smoke are associated with asthma in children (Institute of Medicine, 2000). Krieger and Higgins (2002) in their seminal paper “Housing and Health: Time again for Public Health Action” noted substandard housing is associated with infectious and chronic diseases from exposures to hazards such as unsafe drinking water, pests, crowding, cold, mold/moisture, environmental tobacco smoke, lead based paint, and radon. A healthy homes approach was encouraged for improving home environmental quality. A healthy home is one that is dry, clean, pest-free, well ventilated, safe, contaminant-free, and well-maintained (National Center for Healthy Housing, 2011, 2013). Assessment of a homes’ indoor air quality, asthma and allergen triggers, carbon monoxide, lead, water quality, chemicals, pesticides, and other poisons is advocated by the Healthy Homes Partnership (2012). The U.S. Environmental Protection Agency (2005) recommends assessment of children’s exposures to environmental hazards based on life-stage groupings (i.e., Birth to
