Environmental and Occupational Health

Is your clinic prepared for an emergency?

This video describes a pesticides poisoning incident and how it affected a community health center.

Pesticide Exposure Comic Books Now Available!

MCN is pleased to announce the availability of two excellent environmental comic books. Lo Que Bien Empieza...Bien Acaba is a full color, educational comic book in Spanish that helps women of reproductive age and pregnant women understand the risks associated with pesticide exposure and ways to minimize exposure. The comic book targets women in rural and urban areas and women in various occupations. It also addresses various pesticide exposures: occupational, para-occupational exposures (take home) and in-home.

Aunque Cerca Sano educates parents about children's risks to pesticide exposure and ways to minimize these risks. Both of these comic book are available to you free of charge. Our only requirement is that you order a minimum of 100 comic books. To order send us an email with your full shipping address, a brief description of where you will be using the comic books, your name, and the quantity of each that you wish to order. We will respond within several days to your request. PLEASE HURRY AS SUPPLIES ARE LIMITED!

MCN's Environmental Health Program

Pesticide and other chemicals, contaminated drinking water, unsanitary and substandard living conditions and lack of hand washing facilities and toilets in the fields constitute serious health risks to hundreds of thousands of farmworkers and their families. Additionally, farmworkers suffer from thousands of agricultural related injuries each year. Farmworker children are particularly vulnerable to these hazards.

To address these occupational and environmental health issues, MCN has developed an environmental and occupational health education program for healthcare providers serving migrant and seasonal farmworkers and other mobile populations. Specifically, MCN is trying to:

1. Raise primary health care providers' index of suspicion regarding environmental and occupational causes of health problems, and
2. Provide health care providers with tools and resources to address these health problems.

In 2000, MCN conducted a needs assessment to determine specific environmental health training needs by profession and appropriate environmental health topics as well as educational and training methods to reach each professional group. According to the clinicians surveyed the three most important environmental and occupational problems facing farmworkers are:

1. exposure to pesticides,
2. water and sanitation problems and related diseases and
3. musculoskeletal or ergonomic problems.

However, the overwhelming majority (83 percent) of clinicians surveyed listed no courses/training or only one course/training pertaining to environmental or occupational health.

To systemically address environmental and occupational health in the primary care setting, MCN is developing a clinic-based effort to better recognize and manage environmental and occupation injury and illness. The project entitled, Saving Lives by Changing Practice, is supported through a five year cooperative agreement with the US Environmental Protection Agency. In this project MCN is partnering with Migrant and Community Health Centers to develop clinic based models that address the needs of each participating center. One of the outcomes we hope to establish is a better system for recognizing, treating and managing pesticide exposures. Lessons learned from these in-depth collaborations will provide helpful insight about how to better incorporate environmental and occupational health into primary care in other sties.

Farmworker Occupational Illness and Injury

Occupational injuries and illnesses are one of the most prevalent patient care issues for clinicians working with migrant workers. Migrant patients are a unique segment of the U.S. workforce and factors such as lack of training, poor safety precautions, over representation in dangerous industries, language barriers, piece-rate pay, undocumented worker status, and geographical and cultural isolation can put these workers at increased risk for work related injuries and illnesses. Health disparities in this population are starkly demonstrated by excess mortality and injury at work. Fatal occupational injuries among farmworkers occur at five times the rate for all workers in the U.S (USDOL, 1998).

Trapé-Cardoso and colleagues described migrant workers seeking medical care at Migrant/ Community Health Centers in Connecticut. Of the 331 workers seen during medical clinic visits, 41 percent reported a work-related injury or illness. Thirty-nine percent were musculoskeletal disorders (sprains/strains, tenosynovitis, and muscle spasm), 22 percent allergies, irritation, or rhinitis, and 22 percent dermatitis (2003). The New York Center for Agricultural Medicine and Health examined over 5,000 medical charts from 12 Migrant/Community Community Health Centers and found that approximately 20 percent of visits by migrants were for obvious occupational injuries. The rate of occupational injury was as high as 50 percent for migrant men in certain clinics. Moreover, 90 percent of farmworkers with documented occupational injuries chose not to file a claim for their work-related injuries(Sorensen, 2004; NYCAMH, 1997-1999). Twenty-four percent of California agricultural workers surveyed by the NAWS reported suffering from at least one musculoskeletal injury during the previous year (Aguirre International, 2005). In a recent study in North Carolina, it was found that 45 percent of occupational heat-related deaths were in farmworkers (Mirabelli and Richardson, 2005).

Pesticides and other chemical exposures are a significant environmental hazard for farmworkers and their families. The absence of a national system for reporting pesticide poisonings makes it difficult to estimate the number of pesticide poisoning incidents in workers nationwide and estimates differ widely (Blondell, 1997; Calvert, 2004). There are a number of studies, however, that document the existence of pesticide exposures among farmworkers and their families (Arcury et. al., 2005; Arcury and Quandt, 2003; Curl, et. al., 2003, Calvert, 2004; CDC, 1997; Coronado et al., 2004).

For further resources, click here.

MCN Environmental and Occupational Health Projects

Saving Lives by Changing Practice: Pesticide-Related Health Conditions Prevention Change Concept, EPA's "Office of Pesticide Programs" 5 year Cooperative Agreement: The purpose of this program is to develop and test a model to change of practice behaviors in the clinical setting in regard to pesticide-related health conditions. The specific objectives are as follow.

1. Organize strategic meetings with primary health care providers, health care clinics, and other health care delivery systems to communicate the need to incorporate pesticide education and awareness into the practice settings.
2. Design and implement methods of integration of the key practice skills required for health care providers to deal effectively with pesticide related health conditions in the practice settings.
3. Develop and provide access (through training, continuing ed, website) to relevant resources and tools that health care providers need to deal effectively with pesticide-related health conditions.
4. Develop and test a training model for primary health care providers that incorporate key practice skills for the recognition and treatment of pesticide poisonings.
5. Evaluate and promote the use of a training model for health care providers across a wide-range of practice settings.

Pesticide Education Program for the Paso del Norte Region, Paso Del Norte Health Foundation, 22 month grant: As part of the Paso del Norte Health Foundation's Healthy Homes Initiative, MCN works with organizations in the border region of El Paso, Texas and Cd. Juárez to implement effective community based interventions that reduce risks to area residents from exposure to pesticides. MCN serves as the technical assistance arm of the pesticide program for the Foundation.

Mi Casa Es Su Casa: Healthy Homes for Migrant and Seasonal Farmworkers EPA's Region III, 2 year grant: This program will educate migrants about environmental health issues in order to strengthen the capacity of migrant farmworker households to control and minimize in-home environmental risks. The project includes a partnership with Migrant Head Start (Rural Family Development) and utilizes the promotora de salud model to offer migrants an overview of the environmental hazards, the reasons migrants should be concerned (e.g. the potential health effects of environmental exposures) and simple behavioral changes to minimize such exposures is achievable. The project also includes environmental health training for clinicians.

National Children's Center for Rural Agricultural Health and Safety, 5 year partnership: MCN continues to serves as internal a external advisor in order to keep NCC informed of migrant related health and safety issues and to assist NCC in addressing migrant related health and safety issues.

More resources...

With funding from the EPA Region III, MCN partnered with Rural Family Development of the Virginia Council of Churches to produce five radio novellas (Las Historias de Melesio) in Spanish to promote environmental health information.

1) Getting Rid of Pests /Acabando con las plagas (Inhome Pest Control)
2) Protecting Yourself from Pesticides/Protegiéndose de los pesticidas
3) Be Careful with Water and Lead/Cuidado con el agua y el plomo (Water, Sanitation, Hygiene and Lead)
4) Protecting Kids from Pesticides/Protegiendo a sus niños de los pesticidas
5) Respiratory Problems/Los problemas respiratorios (Improving Indoor Air Quality)

Note: All files are .mp3 type. To download and then listen, right-click and select "Save target as..." on the desired link above. To listen inside of the browser without downloading, simply click the desired link.

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  • A Migrant Farmworker Occupational Health Reference Manual for Clinicians