Occupational and environmental health nursing is the specialty practice that provides for and delivers health and safety programs and services to workers, worker populations, and community groups. The practice focuses on promotion and restoration of health, prevention of illness and injury, and protection from work-related and environmental hazards. Occupational and environmental health nurses (OHNs) have a combined knowledge of health and business that they blend with healthcare expertise to balance the requirement for a safe and healthful work environment with a “healthy” bottom line.


The first record of occupational and environmental nursing in the United States dates back to 1888 when a nurse named Betty Moulder cared for Pennsylvania coal miners and their families. The profession evolved with the growth of industry around the beginning of the 20th century as factories employed nurses to combat the spread of infectious diseases like tuberculosis, address health-related problems resulting from labor shortages during World War I, and cut costs arising from new workers’ compensation legislation. Today, the scope of practice includes disease management, environmental health, and emergency preparedness and disaster planning in response to natural, technological, and human hazards to work and community environments.

Poor employee health costs business about $1 trillion annually, so business executives look to occupational and environmental health nurses to maximize employee productivity and reduce costs through lowered disability claims, fewer on-the-job injuries, and improved absentee rates. Through their recognized value as business partners, OHNs are both managers (implementing occupational health service programs and providing budgetary input for programs and staffing) and leaders (developing policies and procedures in alignment with company visions/mission, supervising and directing employees, and mentoring co-workers) in the effort to impact corporate improvement and workers, worker populations, and community group health and safety, thus contributing positively to the financial bottom line.

Occupational and Environmental Nurses Today

Modern roles of OHNs are as diverse as clinicians to educators, case managers to corporate directors and consultants. The OHN’s responsibilities have expanded immensely to encompass not only the responsibilities previously stated but also a wide range of job duties, including but not limited to:

Case management: OHNs routinely coordinate and manage the care of ill and injured workers. Their roles as case managers have grown more sophisticated with the coordination and management of work-related and non-work-related injuries and illnesses, which include aspects related to group health, workers’ compensation, and Family Medical Leave Act (FMLA) and short-term/long-term disability benefits.

Counseling and crisis intervention: Besides counseling workers about work-related illnesses and injuries, OHNs often counsel for issues such as substance abuse, psychosocial needs, wellness/health promotion concerns, and other health or work-related concerns. They may also assume primary responsibility for managing employee assistance programs or handling referrals to employee assistance programs and/or other community resources, and coordinate follow-up.

Health promotion and risk reduction: OHNs design programs that support positive lifestyle changes and individual efforts to lower risks of disease and injury and the creation of an environment that provides a sense of balance among work, family, personal, health, and psychosocial concerns. Immunization, smoking cessation, exercise/fitness, nutrition and weight control, stress management, monitoring of chronic diseases, and effective use of medical services are just a few of the preventive strategies to keep workers healthy and productive.

Legal and regulatory compliance: Whether it is the array of state and federal regulations put forward by the Occupational Safety and Health Administration (OSHA) or laws that affect the workplace, such as the Family and Medical Leave Act (FMLA) or the Health Insurance Portability and Accountability Act (HIPAA), OHNs work with employers on compliance with regulations and laws affecting workers and the workplace.

Worker and workplace hazard detection: Worker and Workplace Hazard Detection: OHNs recognize and identify hazards; monitor, evaluate, and analyze these hazards by conducting research on the effects of workplace exposures; and gather and use health and hazard data to select and implement preventive and control measures as a continual process. Examples include an analysis of the effects of toxic chemical exposure, development of plans to prevent work-related accidents, and an analysis of groups, not just individuals, to detect patterns, trends, changes, and commonalities as in pandemic situations.

Education Requirements

OHNs are nurses licensed to practice in the states in which they are employed. Typically, nurses entering the field have a baccalaureate degree in nursing and experience in community health, ambulatory care, critical care, or emergency nursing. Many OHNs have obtained Masters Degrees (e.g., in public health, advanced practice, business) to continue to build their professional competencies. Certification in occupational and environmental health nursing is highly recommended. In 2011, AAOHN voted to invite our nursing LPN/LVN colleagues to join the association as active members. We hope to represent their needs by providing guidance in setting scopes of practice, ethics, and education to enhance their practice of occupational health.


For more information about occupational and environmental health nurses, contact the American Association of Occupational Health Nurses, Inc. at 312-321-5173 or info@aaohn.org.

AAOHN is a professional association of more than 4,000 members dedicated to advancing the health, safety, and productivity of domestic and global workforces by providing education, research, public policy, and practice resources for occupational and environmental health nurses. These professionals are the largest group of health care providers serving the worksite.

Click here to download this OHN Fact Sheet.