Patients with a cancer or respiratory disease and parents of children with a congenital abnormality often ask nurses: 'What caused this? Was it pollution or my job, or something I've done?' Often there is no clear answer. Media coverage - of such issues as Sellafield and childhood leukaemias, mobile phones and brain cancers, or waste sites and congenital abnormalities - may prompt a rash of questions from anxious patients. This article discusses environmental issues so that nurses are in a position to answer some of these questions

I REMEMBER little mention of environmental causes of ill health during my training. Now interest in environmental issues is growing. We know that the environment can affect health, both positively and negatively, although much depends on the definition of environment used. Albert Einstein gave a wide and simple definition: 'Everything which isn't me' (Grant and Hawkins 1995).