Environmental health competence in Basque health workers. Analyzing the soil before sowing the seed

BACKGROUND AND AIM Modifiable environmental factors account for the 23% and 22% of mortality and morbidity respectively. However, it is unclear whether health practitioners – especially those in primary care – are sufficiently aware of the connections between environmental exposures and health and able to intervene in this domain. The objective of this study was to assess environmental health (EH) literacy and competences among health professionals working in the Basque Public Health System. METHODS We recruited a sample of 366 (85% females) including nurses, family doctors, paediatric doctors, gynaecological doctors and advanced university students of nursery and medicine. The online questionnaire measured 1) general and specific EH competences, 2) use of exposure clinical history, 3) perceived competence to deliver medical advice on several exposures, and, 4) perceptions of Basque Public Health Services. Data were analysed with descriptive statistics, chi-squared tests and ANOVA with post-hoc comparisons. RESULTS Overall, we found low to moderate general and specific EH competence and found that nurses and nursery students reported higher perceived general and specific competences than the rest of the profiles at the p < .001. These differences were small to large in size according to the Hedges’ g statistic. The sample was scarcely educated in the use of exposure clinical history and only 6 participants confirmed its use. The EH topics that more frequently appeared in the consultation room (e.g. passive smoke exposure or sun protection) were the ones for which the professionals reported a higher competence level and vice versa (least frequent topics were biomarkers and industrial emissions). Finally, even though Basque Public Health Services were highly regarded, participants rarely contacted them. CONCLUSIONS Interventions addressing environmental health knowledge and competences among health professionals in the Basque Health System are needed to improve population’s health. KEYWORDS: Environmental health competence, Health practitioners, Public health