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Available in English and Spanish!

 

Created by MCN, medical student Rachel Kelley of UCSF, and collaborators at East Tennessee State University, this guide is intended to be a reference for health care providers who work with people employed in the U.S. tomato industry. It aims to prepare providers with a more detailed understanding of hazards, health issues, and work processes associated with different tomato industry jobs.

This guide draws on published research, experienced health professionals’ advice, and information gathered from interviews and focus groups conducted with 36 tomato workers from diverse backgrounds and 14 community leaders familiar with tomato workers’ health in multiple states. It is important to note that health and safety conditions at any particular farm or company may vary from what is described here. Furthermore, individual workers may experience the same set of conditions differently.

The first section of the guide focuses on health hazards and health conditions commonly encountered in tomato production. The second section consists of detailed descriptions and illustrations of different tomato production tasks. The third section covers “human resources” information and policies that apply to U.S. agricultural workers generally. The appendices contain a Spanish-English glossary, further detail about different types of pesticides, information about agricultural occupational health policies and regulation, and a list of resources and readings.

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Substance Use Warmline
Peer-to-Peer Consultation and Decision Support
10 am – 6 pm EST Monday - Friday
855-300-3595

Free and confidential consultation for clinicians from the Clinician Consultation Center at San Francisco General Hospital focusing on substance use in primary care

 

Objectives of the Substance Use Warmline:

Support primary care providers in managing complex patients with addiction, chronic pain, and behavioral health issuesImprove the safety of medication regimens to decrease the risk of overdoseEnhance the treatment, care and support for people living with or at risk for HIVDiscuss useful strategies for clinicians in managing their patients living with substance use, addiction and chronic pain.

Consultation topics include:

Assessment and treatment of opioid, alcohol, and other substance use disordersApproaches to suspected misuse, abuse, or diversion of prescribed opioidsMethods to simplify opioid-based pain regimens to reduce risk of misuse and toxicityUrine toxicology testing- when to use it and what it meansUse of buprenorphine and the role of methadone maintenanceWithdrawal management for opioids, alcohol, and other CNS depressantsHarm reduction strategies and overdose preventionManaging substance use in special populations (pregnancy, HIV, hepatitis)Productive ways of discussing (known or suspected) addiction with patients.

The CCC’s multi-disciplinary team of expert physicians, clinical pharmacists and nurses provides consultation to help clinicians manage complex patient needs, medication safety, and a rapidly evolving regulatory environment.

Learn more at http://nccc.ucsf.edu/clinician-consultation/substance-use-management

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This 90-minute webinar was created for physicians, nurses, and other health professionals who treat and case manage patients with active TB.  The webinar introduced the 2016 Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.  This training highlighted the guidelines development process, the key changes in recommendations, and discussed the evidence supporting the changes.  The webinar was originally presented on November 4, 2016. This training was jointly sponsored by all 5 RTMCCs.

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Libro cómic educativo bilingüe sobre cómo prevenir las enfermedades zoonóticas. Desarrollado por MCN en colaboración con la Universidad Estatal de Ohio.

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DATE RECORDED: August 17, 2016 at 1 pm ET

PRESENTED BY: Amy Liebman, MPA, MA and Wilson Augustave, member of MCN’s Board of Directors and Senior HIV Case Manager at Finger Lakes Community Health

 

Recorded Webinar Participant Evaluation Presentation Slides (PDF)

 

Continuing Education Credit

To receive CME* or CNE credit after viewing this webinar, you must:

Complete the Participant Evaluation associated with this webinar Send an email with your first and last name stating which webinar you completed to contedu@migrantclinician.org Description

Milton “Tito” Rafael Barreto Hernandez was 22 years old when he died. He was killed when he was pulled into a machine at the concrete crushing facility where he worked.  This work-related death could have been prevented and would likely never have happened had the right safety procedures been followed.  Low-wage workers like Tito often work in dangerous jobs and immigrants are more likely to die or get hurt at work.  In spite of dangers on the job, all workers have the right to a safe and healthy workplace. This training for community health workers will equip you with the knowledge you need to empower people to advocate for their rights on the job. Additionally, participants will come to understand how to seek help in case of a dangerous work environment and to be familiar with resources to assist workers.   

Learning Objectives Identify worker safety and health rights and responsibilities in the United States Describe the role of government agencies in protecting workers Recognize resources to assist workers in addressing workplace hazards Identify worker safety and health rights and responsibilities in the United States Describe the role of government agencies in protecting workers Recognize resources to assist workers in addressing workplace hazards Further Reading Workers' Comp Hub.org Workers' Comp Hub- Navigating the System MCN's Pesticide Reporting and Workers' Compensation in Agriculture Map Comic Book- Safety and Health on the Farm- It's your Right and it's the Law MCN's Immigrant Dairy Worker Health and Safety webpage OSHA's Workers' Rights Webpage NCOSH - Know Your Rights to a Safe and Healthy Workplace Hesperian Foundation's "Workers Guide to Health and Safety"

This material will be produced under grant number SH-27640-15-60-F-48-SH5 from the Occupational Safety and Health Administration, U.S. Department of Labor. It will not necessarily reflect the views or policies of the U.S. Department of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

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DATE RECORDED: Wednesday, June 17, 2014
PRESENTED BY: Matthew Keifer, MD, MPH, Dean Emanuel Endowed Chair/Director National Farm Medicine Center

MCN’s Environmental and Occupational Health Programs

Learn more about MCN’s training and technical assistance programs to help clinicians and health centers improve the recognition and management of pesticide exposures and other environmental/occupational health conditions.

 

Mistakes can be dangerous. Accurate identification of pesticides responsible for a patient's illness is important to avoid iatrogenic errors with respect to acute treatment.  Join us for an important webinar that will focus on key decision points in the diagnosis of pesticide exposures and emphasize the usefulness of the newly revised resource for clinicians - The Recognition and Management of Pesticide Poisonings, 6th ed.  Through interactive case studies, this webinar will illustrate effective recognition and treatment of patients over exposed to pesticides. 


The webinar, sponsored by Migrant Clinicians Network, the National Farm Medicine Center and AgriSafe Network features Dr. Keifer, a board certified occupational medicine specialist and internationally renowned researcher regarding pesticides and agricultural health and safety. For over 30 years, Dr. Keifer has focused his clinical practice and research largely on farmworkers. 

SPONSORED BY: AgriSafe Network, Migrant Clinicians Network, and the National Farm Medicine Center

OBJECTIVES: Participants will be able to:

Better recognize the signs and symptoms of pesticide overexposure Identify key decision points in diagnosing pesticide exposures Demonstrate an understanding of how to use The Recognition and Management of Pesticide Poisonings, 6th ed. in a clinical setting

We encourage all participants to order The Recognition and Management of Pesticide Poisonings, 6th ed. prior to attending this webinar. Order here. PDF versions are also available at http://www2.epa.gov/pesticide-worker-safety/recognition-and-management-pesticide-poisonings
If you have experienced any trouble ordering your copy please contact: kbrennan@migrantclinician.org 

 

 

  CLINICAL TOOLS & RESOURCES   Recognition and Management of Pesticide Poisonings 6th Edition
An essential clinical reference for recognizing and managing pesticide overexposures. Pesticide Reporting and Workers’ Compensation Map
This interactive map provides state-specific pesticide reporting requirements and contact information to facilitate reporting.  It also includes state-specific Workers’ Compensation criteria and agencies responsible for enforcing the Worker Protection Standard. Cholinesterase Testing Protocols for Healthcare Providers and Cholinesterase Testing Protocol Algorithm
These clinical tools provide a concise and simple guide for clinicians in managing care for patients working with Class I and Class II organophosphates (OP) and N-methyl-carbamates. Acute Pesticide Exposures Clinical Guidelines
Important guidelines for health centers outlining how to handle acute pesticide exposures, emergencies and decontamination. Pesticide Exposure Assessment
A user-friendly form and check list for data collection on the acute pesticide exposed patient. EOH Screening Questions for the Primary Care Setting
Three screening questions in both English and Spanish to quickly ascertain work-related and environmental exposures and injuries.   National Pesticide Information Center
Supports a toll-free telephone service and extensive website providing impartial information about pesticides across the United States. Phone: 1-800-858-7378  Email: npic@ace.orst.edu American Association of Poison Control Centers
Offers a listing of regional Poison Control Centers. Poison Control Centers provide information regarding possible or actual environmental or occupational exposures and recommended treatments EXTOXNET
Objective, science-based information about pesticides - written for the non-expert   PATIENT EDUCATION MATERIALS   Aunque Cerca Sano (Comic Book)
Educational comic book targeting farmworker parents to address children’s risks to pesticide exposure and ways to minimize these risks. Lo Que Bien Empieza… Bien Acaba (Comic Book)
Educational comic book addressing pesticide exposure in women of reproductive age. Poco Veneno… ¿No Mata? (Comic Book)
Educational comic book with a story and messages about risks from pesticide exposure and ways to minimize these risks in the home.   ARCHIVED WEBINARS & TRAINING RESOURCES   Pesticide Health Effects Medical Education Database 
A diverse collection of training materials useful in the training of physicians, nurses, physician assistants, and nurse practitioners. The Nuts & Bolts of Cholinesterase Monitoring for Farmers, Ranchers, and Agricultural Workers
Webinar addressing the importance of recognizing and managing certain pesticide exposures with a specific focus on the ways in which cholinesterase monitoring is a key component in clinical care for individuals working in agriculture.
  Workers and Health- How Frontline Providers Make a Difference in the Protection of Migrant Farmworkers and their Families
Webinar focusing on the factors that put migrant workers at increased risk for occupationally related injuries and illnesses and chronic diseases.  Emphasized exposure to pesticides and other contaminants as a particular concern to migrants and their families.
  Caring for the Injured Worker: Effective Partnerships between Clinicians, Health Centers and Lawyers
Webinar offering practical information for using the workers’ compensation system as well as legal avenues available to injured workers through a series of case studies.  Explores how clinicians can work collaboratively with legal advocates to help their patients secure these benefits.
    LOCAL PESTICIDE RESOURCES  

The following will provide information regarding the pesticides used in your areas:

Minnesota’s Agricultural Extension offices
Program team and Extension County Offices Illinois’s Agricultural Extension offices
Program team and Extension County Offices
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Haz-Map® is an occupational health database designed for health and safety professionals and for consumers seeking information about the adverse effects of workplace exposures to chemical and biological agents. The main links in Haz-Map are between chemicals and occupational diseases. These links have been established using current scientific evidence.

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Children encounter pesticides daily and have unique susceptibilities to their potential toxicity. Acute poisoning risks are clear, and understanding of chronic health implications from both acute and chronic exposure are emerging. Epidemiologic evidence demonstrates associations between early life exposure to pesticides and pediatric cancers, decreased cognitive function, and behavioral problems.
In this policy statement, the American Association of Pediatrics outlines the symptoms and suggested course of treatment for acute exposure pesticides belonging to the eight most predominant classes of pesticides. The policy statement also makes recommendations for both pediatricians and government to take measures to improve pesticide safety.
© AAP - 2012; This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors.

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This issue of Forced Migration Review, features an article about the Strengthening What Works initiative called "Preventing partner violence in refugee and immigrant communities." The article provides an overview of the Robert Wood Johnson Foundation initiative for readers in the humanitarian and public health sectors and features information about MCN's program Hombres Unidos.

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The importance of clinical diagnostic tools and biomonitoring of exposures to pesticides as well the role of clinicians in pesticide reporting and the challenges clinicians face in accurately diagnosing patients exposed to pesticides are described in a presentation by Matthew Keifer, MD, MPH and Amy K. Liebman, MPA. Click on the link for an APHA policy resolution underscoring the need for clinical diagnostic tools and biomomitoring of exposures to pesticides. This policy supports the information outlined by in the presentation.

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This resource helps you address stigmatization by providing best practices for inhibiting and the actions to take when you encounter stigmatization when new infectious diseases and illness emerge.

Early in an outbreak, such as the 2009 H1N1 outbreak, groups of people, places, and animals can be singled out and will be at risk of being stigmatized by association with the threat this virus poses. Groups are stigmatized by an infectious disease when the risk of infection to others is not present or remote but the association of the risk is magnified by others for that population group, or place or animal.

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The Toolkit is a combination of easy-to-use reference guides for health providers and user friendly health education materials on preventing exposures to toxic chemicals and other substances that affect infant and child health.

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Beyond Pesticides/National Coalition Against the Misuse of Pesticides provides pesticide fact sheets, action alerts and information on what to do in a pesticide emergency.

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Northwest Coalition for Alternatives to Pesticides - promotes healthy solutions to pest problems and publishes the Journal on Pesticide Reform.

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Pesticide Action Network of North America - promotes healthier, more effective pest management and houses the Pesticide Action Network Pesticide Database - a database of pesticide toxicity and regulatory information. The reference section provides general information about pesticides and their health effects.

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