By Lisiane Pruinelli
Imagine if nurses could anticipate environmental risks people face, not after symptoms appear, but before.
This is the promise of precision environmental health — an emerging field that integrates environmental exposure data with personal health characteristics to generate real-time, individualized insights. It moves us from vague public health alerts to targeted, actionable risk information, enabling earlier, more tailored nursing interventions.
Is it not better to know that a patient living in a high-heat area with limited access to cooling is at elevated risk for cardiovascular stress today? Or that a combination of poor air quality, high allergen levels and a patient’s asthma may soon push them into respiratory distress. Or that, in the days following a hurricane, a coastal community faces an increased threat of contaminated water, injury and worsening chronic illness due to disrupted access to care.
As a nurse in Florida, these risks are anything but abstract. The rise in ocean temperatures, stronger hurricane intensity, coastal flooding and prolonged heat waves are already reshaping the health landscape. These exposures intersect with chronic conditions, exacerbate inequities and stretch our systems beyond capacity. Yet most clinical tools do not account for these risks in any meaningful or real-time way.
But what if that changed?
With connected platforms, wearable technologies and AI-enhanced environmental analytics, we can now begin to interpret exposure data — temperature, humidity, air and water quality or storm surge risk — as clinically meaningful inputs. These technologies can help pinpoint who is most vulnerable today, the exposures that could tip them into crisis and what can be done now to prevent harm.
The value of these tools is not in the data alone, but in how that data is understood, contextualized and acted upon by nurses. Our profession is often the first to recognize when something is wrong, the one who follows up, explains, advocates and adjusts. In the context of environmental health, nurses have the opportunity to lead — not only in response, but in design.
From Awareness to Action: Building a Nursing-Ready Future
The health impacts of environmental exposures are growing — and so is our capacity to address them. Across research, public health and clinical innovation, real efforts are underway to translate precision environmental health into nursing-relevant tools and knowledge.
For example, the NIH-funded Environmental Influences on Child Health Outcomes (ECHO) program is exploring how early-life exposures affect lifelong health, including outcomes like asthma, neurodevelopment and obesity — conditions nurses frequently manage.
The National Institute of Environmental Health Sciences (NIEHS) is advancing resources that combine climate, geographic and biological data to assess risks for heat illness, air pollution sensitivity and chemical exposures — laying a foundation for clinical integration.
Promising wearable technologies now track individual exposure to heat, pollutants and hydration loss — tools that could guide nursing triage during climate emergencies or improve monitoring of vulnerable populations in real-time.
In education, environmental health is gaining traction in community health, disaster preparedness and population-based care curricula. This shift empowers future nurses to think as advocates and systems-level problem solvers, not just clinicians at the point of care.
Resources for Nurses Ready to Engage:
For those looking to explore this space further, several organizations are leading the way:
- Alliance of Nurses for Healthy Environments (ANHE) – Practical tools, policy briefs and education
- NIEHS Nursing Resources – Research, webinars and clinical guidance
- CDC Heat & Health Tracker – A public tool for mapping heat vulnerability by location
- Florida Climate Institute – Regional data on health impacts of climate change
The Nursing Imperative
As a member of the 2025 Environmental Health Research Institute for Nurse and Clinician Scientists (EHRI-NCS), I have had the opportunity to engage deeply in discussions around these challenges and innovations. What is clear is that precision environmental health is not optional — it is necessary. Nurses have always met people where they are. Now, we must also understand where they live, what they breathe and how their environment shapes their health — even before symptoms arise.
The nursing profession has what it takes: deep clinical insight, strong community trust, and a systems-oriented perspective. But we need tools built with nurses in mind, designed not only to inform but to act — early, equitably and effectively.
The risks are real. But so is the opportunity.