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MCN's Environmental and Occupational Health Program Initiatives

MCN's Environmental and Occupational Health Program Initiatives


Primary Care and Environmental and Worker Health

Clinicians Standing togetherMCN works with front-line providers to integrate a focus on environmental and occupational health into primary care. Our projects strengthen the quality of care and meet the unique healthcare needs of the migrant population. MCN recognizes that the majority of primary care clinicians, including those caring for migrants and immigrant workers, generally do not bring an environmental and occupational health perspective to the care they provide.  MCN focuses on feasible, simple changes in clinical practices to improve the recognition and management of occupational exposures and injuries.

MCN partners with community health centers across the US and Puerto Rico to establish Centers of Excellence in Environmental and Occupational Health. These partnerships include on-site clinical training, the provision of resources and technical assistance, and peer-to-peer networking between front-line providers and occupational and environmental medicine specialists.

MCN also conducts research to explore barriers to occupational health in primary care.

Download a description of MCN's Workers and Health Program


Heat-related Illness

Farmworkers in the field Heat related illness is a major and growing risk for all outdoor workers. Climate change is increasing the number of extreme-heat days throughout the world. Farmworkers’ risk of dying from heat exposure is 20 times higher than for workers in other industries. As the climate crisis intensifies and continues to increase the number of heat events, farmworkers’ health will be further jeopardized. But this is not a future concern; the number of extremely hot days has already increased, and workers are dying every year. It’s not just temperature, workers also come to work already dehydrated which increases their risk of heat-related illness. Once they arrive at work, many are paid piece-rate, which discourages workers from taking time for rest and bathroom breaks, which further discourages water consumption. Workers may be discouraged by employers or contractors to take time to rest in the heat, and workers may feel that issuing a complaint may jeopardize their job.

These are just a few examples of how heat stress is not simply a result of high temperatures, but a confluence of determinants that limit workers’ ability to avoid heat stress when state or federal regulations do not protect them. MCN works to provide clinicians and other front-line providers with tools to increase their own knowledge and skills around heat-related illness, as well as providing important worker education materials. Additionally, MCN experts serve as key advocates for heat-related standards in states as well as in advocacy for a national heat illness standard.

Visit MCN's Heat-related Illness page to view and download resources.

Dairy Worker Health and Safety

MCN EOH Dairy WorkerMigrant and immigrant agricultural workers and their families face unique environmental and occupational health risks. Work in agriculture is one of the most dangerous occupations in the US.

MCN and the National Farm Medicine Center are partnering to provide health and safety training to immigrant dairy workers in Wisconsin. The Seguridad en las lecherias project targets limited English proficient, hard-to-reach workers with culturally and linguistically appropriate safety messages. The project also tests the use of a promotor de salud model to reinforce the safety messages and support increased worker safety. The five module curriculum and accompanying resources are available to view and download via MCN's Seguridad en las lecherías webpage.  

This effort is part of the Upper Midwest Agricultural Safety and Health Center based out of the University of Minnesota. It is one of several dairy-focused projects targeting low-literate, limited English proficient, hard to reach immigrant workers.

Through the Susan Harwood Training Grant, MCN developed OSHA-approved training and educational materials for immigrant dairy workers. MCN's training modules incorporate English-as-a-Second-Language (ESL) learning activities with culturally and linguistically appropriate safety and health trainings. The bilingual picture dictionary, developed to compliment the training modules, includes important vocabulary and image-based safety messages to be utilized in agricultural work places and further adapted for other industries. Visit MCN's ESL Dairy Health & Safety page to view and download lesson plans and accompanying resources. 

Worker Safety and Health Train-the-Trainer

MCNEvery day, millions of workers face potentially life-threatening risks from hazards such as chemicals, machinery, ladders, and temperature extremes. For immigrant workers, challenges including language and cultural differences, immigration status and weak regulatory protections further their vulnerability and increase their risk of on-the-job injuries and even death. To help immigrant workers better protect themselves on the job, MCN strives to integrate environmental and occupational health into community settings through projects that utilize community health workers to spread education to people employed in high-risk occupations. These projects, many of which are funded by the Occupational Safety and Health Administration (OSHA) Susan Harwood Training program, partner with community organizations to facilitate health and safety training for vulnerable worker populations through a train-the-trainer model.  The target population for these projects include workers employed in agriculture, meat packing, construction, nail salons, cleaning, and restaurants.

MCN’s work in occupational health and safety also includes a Community Health Worker (CHW) webinar series which highlights best practices in worker training on various topics including chemical safety, work-related asthma, heat stress, ergonomics and injury prevention, and the Worker Protection Standard. Additionally, MCN offers webinars designed specifically for clinicians who treat individuals employed in high-risk occupations.

Children's Safety and Environmental Health

MCN EOH protecting childrenFarmworker children are uniquely vulnerable to environmental and other hazards as their homes are often located near agricultural fields. Pesticide drift is an important hazard along with paraoccupational exposure in which parents can unknowingly expose their children via their work clothing and shoes worn in their home. They many face further risks if they accompany their parents to work. MCN has a long-standing commitment to understanding and addressing the needs of farmworker children through community health and safety outreach efforts and has implemented clinical, research, policy and outreach projects to improve the environmental health needs of these children.

Since 2001, MCN has partnered with the National Children's Center for Rural Agricultural Health and Safety to further our work to improve the health safety of children of immigrant and migrant agricultural workers. We were also a core contributor to the 2012 Blue Print for Protecting Children Agriculture: A National Action Plan. We currently partner on a project to facilitate the access to and availability of off-farm childcare services. In this project, MCN researched barriers to off-farm childcare and brought together stakeholders to determine best practices for creating family services for farmworkers. With the help of their project partners, MCN worked to develop a Roadmap for Delivering child Care in Agricultural Communities.

MCN has also partnered with various community organizations to implement train-the-trainer programs in which parents are trained as community health workers to reach farmworker families with education on how to minimize children's exposure to environmental hazards, including pesticides, lead, and asthma triggers.

Educational Materials

MCN EOH Educational Materials

MCN's educational materials target workers and their families and utilize culturally appropriate formats to convey health and safety messages.


MCN’s efforts in environmental and occupational health include development and distribution of clinical and patient resources; training of clinicians and stakeholders through webinars, conferences and onsite workshops; research; and extensive partnerships with community health centers and with organizations with expertise in pesticides, occupational and environmental medicine, and worker safety. MCN has developed a number of patient education materials and training programs for community health workers to educate workers about their rights, workplace hazards, and ways to stay safe on the job.  MCN also implements community health worker programs to train farmworkers about the risks from pesticide exposure and ways to protect themselves and their families. MCN distributes thousands of resources each year.

Clinical Tools

In collaboration with partners and experts in occupational and environmental medicine and migrant health, MCN has developed tools for clinicians to translate need to practice.


**Many of MCN’s EOH efforts are supported through cooperative agreements with the US Environmental Protection Agency as part of their National Strategies for Health Care Providers: Pesticide Initiative. The conclusions and opinions expressed herein are those of MCN and do not necessarily reflect the positions and policies of the U.S. EPA.

Photos by Earl Dotter