Karen Bowman.

What work do you do?

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I have the best job in the world! I’m president of Karen Bowman & Associates Inc., a nurse-owned firm that provides occupational- and environmental-health services to the global community.

How does it relate to the environment?

The company designs and implements cost-effective, sustainable solutions that enhance health and safety in the workplace. Companies love nurses! We are the most trusted profession — sharing that honor occasionally with firefighters — and people listen to us. When companies are in a pickle because they’ve been audited by the U.S. Occupational Safety and Health Administration or the Washington state Department of Labor’s WISHA, they call me. Nurses are great at kissing boo-boos, fixing things, and teaching clients how to improve their situations. That’s essentially what I do! It’s so fun, I can hardly stand it. What other profession lets you climb on a tanker to provide immunizations to a crew from Brazil, assess an injured worker’s knee at a construction site, instruct police officers on how to decontaminate a jail, and testify on banning persistent bioaccumulative toxins, all in a day’s work? Our services include wellness/health and safety programs, managed medical surveillance, immunizations, program development and education, compliance audits and environmental assessments, and first aid. We’re particularly interested in raising awareness of the shortfalls of occupational and environmental health in underserved populations.

My job as an occupational health nurse is to make sure workers are fully informed about the health hazards they work with — biological, chemical, physical, mechanical, and psychosocial. Because the majority of chemicals have little to no human- or environmental-health data, workers are poorly informed about the health hazards associated with the chemicals they work with. They must understand routes of exposure, how chemicals affect their bodies, and the recommended control measures to protect themselves. What’s most critical for them to understand is that they may also be exposing their families, including small children, to the same hazards if they don’t take precautionary measures such as showering, changing shoes, periodically cleaning the car, etc.

How do you get to work?

The firm is based in Seattle, right out of my home.

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What are you working on at the moment?

I have a continual project of informing immigrant populations about the hazards they work with, especially chemicals. Currently I’m working with Washington Toxics Coalition and the Toxic-Free Legacy Coalition on legislation to ban brominated flame retardants. Chemicals policy reform is the next big enchilada! People are very smart; once they learn about toxic chemicals, they’ll be right on board.

We also work with the serene town of Siem Reap, Cambodia, located 15 minutes from Angkor Wat, which has been identified as a major tourist destination for 2006. This has created a plethora of occupational- and environmental-health issues because of the rapid move from “underdeveloped” to “developed” status, with little regard to the environment, community, or workers. This, in addition to the ravages of war, land mines, poor nutrition, lack of clean water, and appropriate sanitation, have created almost insurmountable odds for the continuation of a healthy Khmer community. My company works with Professional Adventures (a company I cofounded) and others from across the globe to provide a floating village hospital on the Tonle Sap with generators, medical supplies, and money for medications such as antibiotics.

Nurses for environmental health.

In recent years, I’ve focused my attention on informing nurses, workers, and the public about environmental-health hazards such as persistent bioaccumulative toxins and their link to chronic health concerns in the U.S. and underdeveloped countries. I am currently the environmental health specialist for the Washington State Nurses Association, which provides an excellent opportunity to build capacity in nursing for environmental-health advocacy, educate the nursing profession on current environmental-health issues and their roles in prevention, and help direct policy toward a more appropriate way to deal with chemicals.

What long and winding road led you to your current position?

I was born right here in Seattle in 1953. I’ve been working in occupational health for over 20 years, health care for over 30 years, and in 2004 received a master’s degree in community health with a special focus in occupational and environmental health (OEH). I’m board certified as an occupational health nurse specialist. I think one of my biggest blessings is to have been the occupational and environmental-health nurse for a leading occupational medicine clinic in the greater Seattle area, which gave me experience in many industries, not just one. I currently teach part-time at the University of Washington’s School of Nursing and am the vice president and president-elect of the Washington chapter of the Association of Occupational Health Nurses.

What has been the worst moment in your professional life to date?

On the morning of a huge training presentation to a biotech firm in Seattle, I thought I was adding a copyright logo to each PowerPoint slide when in reality I deleted the whole program. Once I hit that button, there was no return. I had to spend the next eight hours recreating the presentation. It was a good but costly lesson on not doing anything before coffee.

What’s been the best?

Aside from saving lives, stamping out disease, and healing the sick, the best has been to recoup burned-out nurses and turn them into thriving, excited expert OEH nurses. I actually think everyone should become an OEH nurse. My students say so too!

What environmental offense has infuriated you the most?

OK, now you’re getting into my idiosyncrasies. I hate it when people throw cigarette butts out their car windows, and when people pour oil and other solvents down the storm drain! Excuse me — fish are trying to live here!

Who is your environmental hero?

My personal environmental heroes are my grandfather and his daughter, my mother. My grandfather taught me that everything had spirit — animals, trees, rocks, water, the sky, etc. — and my mother was the original “tree hugger.” Really! We’d walk around the woods of the Pacific Northwest and she would walk up to a tree and hug it for the longest time and talk to it. She died from an organic brain disease that melted her memory away. She worked for an aerospace company for over 30 years, bent over wire bundles and circuit boards, and, while welding, inhaled the fumes. She was my champion. Now I champion for the environment in her name and will not stop, ever! I don’t want another daughter to lose a mother this way.

My environmental organization hero is easy — the Washington Toxics Coalition. They are tireless in advocating for the environment and creating a legacy of clean water, air, soil, and food for our most priceless resource, our children. They have taught me so much.

What’s your environmental vice?

I’m embarrassed to say: my PT Cruiser. I promise, my next car will be more earth-friendly. OK, OK, my Clinique lipstick too!

How do you spend your free time (if you have any)? Read any good books lately?

Free time? What’s that? I’ve gotten into physical fitness lately, and bought myself a trainer. I like to play with my rabbits Marty and Stella, read OEH nursing books (yes, I’m a geek), and travel. I volunteer with the Cambodian Community Center.

What’s your favorite meal?

Everything short of meat and cilantro — ick!

What’s your favorite place or ecosystem?

Other than my home, Cambodia.

If you could institute by fiat one environmental reform, what would it be?

Phase out the top 10 most persistent bioaccumulative toxins and substitute earth-friendly alternatives.

What’s your favorite TV show?

Heroes or CSI.

Which actor would play you in the story of your life?

I think Meryl Streep should play me. Will you contact her please?

If you could have every InterActivist reader do one thing, what would it be?

Call your legislator and get involved in chemicals policy reform. If you’re too shy, swap out toxic household cleaners for safer, cheaper alternatives, and tell all your friends to do the same.

Karen Bowman, president of Karen Bowman & Associates Inc.

I’m intrigued by environmental-health nursing as a career path — I’d never heard of it until now! How did you become an environmental-health nurse, and how does the average person do so?    — Marta Lindsey, San Francisco, Calif.

I am so glad you asked — and if I can do it, you can do it too! As you learned from my initial bio, I’ve been in occupational health for quite some time and had quite an interest in reducing chemical exposures, injuries, and illnesses in my worker populations. Well, the thing about us nurses is that we totally know how to network. I was in the right place at the right time. One of my professors in my graduate nursing program recommended me for an environmental-health specialist position being created within the Washington State Nurses Association. Needless to say, and glory to the gods and goddesses, I got the position and have been working to help nurses remember that the foundation of nursing practice is firmly rooted in environmental-health principles. Florence Nightingale’s tenets of nursing called for clean air, water, and food in order to put the patient in the best environment for health and healing.

If you have an interest in environmental-health nursing, I would start by reading Nursing, Health, & the Environment. It discusses the history of environmental health and nursing and suggests environmental-health concepts every nurse must incorporate into his or her practice. Also read “Thinking Upstream” and “Upstream Reflections on Environmental Health” by Patricia Butterfield, or Rachel Carson’s Silent Spring. Check out your local university’s nursing school to see if they are a National Institute for Occupational Safety and Health educational resource center. If they are, you can get a master’s degree or doctorate of clinical practice with a special focus in occupational and environmental health and NIOSH will pay for your tuition. If there are extra monies, they’ll also give a monthly stipend. I had full medical and dental too. It’s quite a deal. Did I mention it was free? Also check out the American Nurses Association or your local association for information. Nurses are the change agents to improve human and environmental health.

How did you and your company get involved with the efforts in Cambodia?    — Ryan Healey, Mansfield, Mass.

Well, my friend and I were turning 50 a few years back, and we wanted to celebrate by going to an exotic place. After a bottle of great wine and a spin of the globe, we chose Siem Reap, Cambodia, to go check out Angkor Wat, the 1,100-year-old temples that are spread out over 500 acres. As a community-health nurse with a specialty in occupational- and environmental-health nursing, it’s hard to just stand around when there’s so much work to be done. We just jumped in and started doing what nurses do.

Cambodia is one of the poorest countries in the world. Fifty percent of the population is 15 years old and under. Seventy percent of the country has no access to clean water, and 80 percent lack effective sanitation systems. Compound that with the dismantled health-care system caused by the social and economic impact of more than 50 years of war, and the people of Siem Reap Province face overwhelming community, occupational, and environmental health-care challenges. Siem Reap is in a precarious position as the gateway to Angkor Wat. Many multimillion-dollar hotel complexes are being constructed between the town and the temples, increasing the potential for worker injury and illness. Workers are exposed to workplace hazards such as dust, noise, and toxic chemicals. New hazards found with new technology, like prolonged periods of sitting in front of a computer or driving heavy construction equipment, and psychosocial stressors, such as long work hours and informal labor contracts with multinational corporations, will inevitably increase on-the-job injuries and illnesses. The environment also becomes contaminated due to inadequate hazardous-waste management systems. Many live where they work, resulting in continued exposure to occupational health hazards.

So, back to the story. We hooked up with a driver, John Teng, who has since become our great friend. During one of our day trips, John took us to the Chong Kneas Floating Village Hospital, which serves close to 6,000 villagers. The hospital is a one-room barge. We became friends with the locals there and wouldn’t leave until they let us help. Without John Teng’s help we couldn’t do what we’re able to do, like providing a generator, medical supplies, and money for medicines. I’m currently working on a grant in collaboration with Angkor Hospital for Children, researching ways to reduce incidence of diarrhea from exposure to the rotavirus, including wells to get toxin- and bacteria-free water to the villagers.

Just jump in, Ryan, come with me! You can also volunteer at Angkor Hospital for Children. They’ll put you up, feed you, give you a bicycle, and teach you some Khmer to get by. It’s the hardest job you’ll ever love.

You say that the majority of chemicals have little to no human- or environmental-health data. Are there any organizations or programs out there to gather the appropriate data and make it available to the public?    — Sarah Bronstein, Seattle, Wash.

There are over 86,000 chemicals on the market now. When the Toxic Substance Control Act was established in the early 1970s, they grandfathered in over 80,000 chemicals so they weren’t tested for human- and environmental-health effects. From 2,000 to 3,000 new chemicals come onto the market every year. NIOSH certainly has some data on the health effects of some chemical exposures; the Centers for Disease Control and the Occupational Safety and Health Department should also provide some data. The U.S. EPA might be a resource, along with local departments of ecology and health. And, of course, environmental-health advocacy groups like the Environmental Working Group, U.S. Public Interest Research Group, Washington Toxics Coalition, and the Collaborative on Health and the Environment are excellent sources of information.

You have to kind of piece together the little data we have. Remember, we haven’t studied how synergy or multiple exposures play on human health, and we just now understand that death isn’t necessarily the worst end point either. Chronic diseases like asthma, cancer, autism, Alzheimer’s, and other neurobehavioral diseases are rapidly increasing. Washington state has the highest breast cancer rates in the United States and also the highest rates of multiple sclerosis in the world. We’ve got to be diligent in pushing for a chemical policy that phases out the highly toxic, highly persistent, and highly accumulative chemicals first, supports green chemistry research, confirms chemicals are safe to humans and the environment prior to release, and provides better data on chemicals already in the environment. We can do this. We’ve got to, for a healthier tomorrow and to save our most precious resource — our children.

What are your favorite organizations working on environmental-health issues?    — Marta Lindsey, San Francisco, Calif.

I’m so glad you asked, Marta. Here’s my list: Washington Toxics Coalition, Toxic-Free Legacy Coalition, Health Care Without Harm, Collaborative on Health and the Environment, American Nurses Association and the Washington State Nurses Association, the Breast Cancer Fund, People for Puget Sound, Physicians for Social Responsibility, and the Washington State Public Interest Research Group.

I’m working on a project which aims to assess the health effects of changing from a more processed diet to a sustainable, locally sourced one. I’m trying to test as many of the health effects as I can, in an organized way. Do you know of any organizations similar to your own that carry out tests on humans for nutrient levels, contaminants such as mercury, or, ideally, pesticide residues?    — Eliza Mutino, Pound Ridge, N.Y.

I am so impressed with your ideas, and you are definitely heading in the right direction. Health Care Without Harm is researching using local organic produce in hospitals to improve nutritional support and decrease health effects of pesticides and other contaminants while supporting local sustainable farming methods. You might also try your local health department for mercury research. I’m not aware of any organizations that are doing human research on nutrient levels, but you might also check with the Collaborative on Health and the Environment on contaminants in foods, etc.

You mention swapping out household products — what are the top five that you’d recommend getting rid of?    — Name not provided

First, ditch the drain cleaners and oven cleaners — eww! These chemicals are very caustic and can burn the skin, cause permanent damage to the respiratory tract, and, if splashed in the eyes, cause blindness. To clean drains you can use a snake or do routine cleaning maintenance by placing one-quarter of a cup of baking soda down the drain followed by half a cup of white vinegar. Wait 10 to 15 minutes, then flush with boiling water. I learned this from my 87-year-old neighbor. The chemical reaction of a base (baking soda) and an acid (vinegar) creates a bubbling effect that can clean the drain and remove small clogs of hair, grease, etc. I have a self-cleaning oven, which is a great engineering control. If you don’t have one, there are safer alternative oven-cleaning products by Seventh Generation.

Swap out that blue window cleaner for one cup white vinegar mixed in with one gallon of water. Clean the window with newspaper. Streak-free every time — even for me, and I’m the worst window cleaner. The blue cleaner can contain ammonia, which is caustic to lungs, skin, and eyes. If you don’t want to make it, I suggest Seventh Generation window cleaner.

Swap out the powdered cleaners with bleach for a baking soda, lemon, and water mixture, or Bon Ami. Still, though, be cautious when pouring any cleaning powder onto a surface. We want to reduce the amount of particulates released into the air to reduce exposure through inhalation.

Try to cut your bleach use to minimal or none. I know, I struggle with this too. I understand bleach is a household word synonymous with “clean, sterilized, and white,” but because of its “commonness,” people overuse it and do not treat it with the respect it deserves. It’s very toxic to human and environmental health; I’ve treated many people for sodium hypochlorite (bleach) exposure. Health and safety measures should be taken for the use of bleach in the workplace; insist employees wear a respirator, safety face shield, rubber gloves, and apron. Mix small amounts using a dilution of 1 to 100, which will still clean and sterilize effectively. For home laundry, you can use a non-chlorine bleach. Seventh Generation’s non-chlorine bleach, all-purpose cleaner, and toilet cleaner remove stains pretty well. If you want to sanitize, use isopropyl alcohol 70 percent or a good soap. Murphy’s soap is great, nontoxic to the lungs and skin, and smells clean and fresh. Dr. Bronner’s soap is another stock item in my house.

Do we need to have our houses smell like “meadow mist,” “evening at the beach,” or “springtime in the Rockies?” No. It would be nice to have fresh, clean air every so often, but I don’t think we need a fake chemical smell in the house. Research is now showing that household air can be more contaminated with environmental toxicants than outside air, from PBDE-contaminated house dust and fumes from carpets, paint, cleaners, etc. Periodically open the house up for an hour or so. Also, make sure plenty of sunlight gets in. UV light kills bacteria, which can also create funky smells. I think it’s good for the spirit too! If you must have some “smelly smell,” try organic essential oils like lavender, lemon, or rosemary. Ask others first though — just because they’re organic essential oils doesn’t mean people can’t be sensitive to them.

I think it is critical to remember that even though cleaning alternatives may be green or made with common household items, you still need to protect yourself from exposure. Wear protective eyewear and gloves. Because I have severe asthma, I sometimes wear a dust mask or N-95 respirator when using powders, or use a squirty bottle. Please, read instructions on store-bought products thoroughly, and know what to do in case of emergency. Know your poison control telephone number too.

How hard was it to get your business up and running?    — Andrew B., Seattle, Wash.

Well, it was very hard, but it has been the most rewarding enterprise I’ve ever committed to. One of the smartest things I did to improve my odds at being successful was to do a business plan for an occupational-health nurse consulting business as my scholarly project. The research was invaluable. I must say, though, having a stellar reputation in the community from being the chief nurse at the only occupational medicine clinic system in the Pacific Northwest didn’t hurt either. Here’s the CliffsNotes version on what I found.

Barriers to a successful environmental-health business: not having the necessary expertise or credentials; not having the positive “people person” personality of an entrepreneur; not being used to taking risks or failing; and not having a business plan. Also, remember that there’s no health insurance, vacation, or sick leave pay, and if you don’t know how to do finance management, accounting, marketing, business law, etc., you must hire out to get these services. Without them, you will fail. Nurses typically do not have business training; I don’t even balance my personal checkbook. I love my accountant. I’m also probably the only person who loves their attorney.

Facilitators to a successful environmental-health business: networking; developing support; having a mentor; taking a finance or business class; establishing your reputation in the community; having money and a passion for what you do; having fun; and knowing your competitors.

Feel free to contact me personally if you want a mentor.