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Pesticide Exposure Presentation


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Part 2 of the Environmental and Occupational Health Risks Clinical Training.

Part 2 of the Environmental and Occupational Health Risks Clinical Training.

Published in: Health & Medicine, Technology

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  • 1. Pesticide Exposure Implications for Migrant and Community Health Centers Judith Fitzgerald, B.S.N., R.N. Special Programs Manager InterCare Community Health Network May 20, 2009
  • 2. Significance for Health Centers  Most Migrant and Community Health Center staff did not receive any pesticide-related instruction during medical or nursing education.  Many have had little or no continuing education on this topic.  Few have experienced identifying pesticide induced conditions and making appropriate reports and/or referrals.
  • 3. National Strategies for Health Care Providers: Pesticides Initiative  The National  U. S. Department of Environmental Labor (DOL) Education & Training  U.S. Department of Foundation (NEETF) Agriculture (USDA)  U.S. Environmental  U.S. Department of Protection Agency Health and Human (EPA) Services (DHHS)
  • 4. Why should CHC staff be especially alert to pesticide exposure?  Hundreds of millions of pounds of pesticides are used in the U.S. annually (most are herbicides applied to agricultural crops).  Many other applications are made in homes, lawns, businesses, schools, on pets, and on human skin  Opportunities for over-exposure abound in our environment  Effects of pesticide poisoning are often misdiagnosed, yet can be devastating
  • 5. Occupational and Environmental Risk for Pesticide Exposure  Ranch and farm workers  People employed in  Gardeners pesticide production,  Groundskeepers mixing and application  Florists  Family members of those  Structural pest control at occupational risk workers  Treated foods and plants  Hunting and fishing  Ground- +/- well-water guides contamination  Health care workers who  Breast milk deal with decontamination  Placental transfer
  • 6. 6 Essential Practice Skills  Taking an Environmental History  Awareness of Community and Individual Pesticide Risk Factors  Knowledge of Key Health Principles  Clinical Management of Pesticide Exposure  Reporting Pesticide Exposure and Supporting Surveillance Efforts  Providing Prevention Guidance and Education to Patients
  • 7. Environmental History: Agricultural Workers and Their Families  Is their spraying going on  Were Restricted Entry while you are in the field? Interval (Danger/Peligro) signs with dates posted in  Do you feel sick while in the fields? the fields?  How close do you live to  Were the fields wet while the fields? you were picking? (Dry  Do your children play or fields can be sources of work in the fields? residues also)  Do you have lunch in the  Does anyone else have the fields?(Do you eat what same sickness as you? you pick?)
  • 8. Barriers to successful medical interventions with MSFWs  Fear of job loss if any incident is reported  Lack of awareness of the dangers of pesticides  Lack of knowledge about the specific pesticides being used  Substandard housing conditions; lack of hot water and indoor plumbing  Shared, antiquated or no in-camp laundry facilities  Poverty; few clothes, lack of laundromat money; poor diet  Language barriers  Culturally learned explanations for health problems
  • 9. Barriers to successful medical interventions with MSFWs  Symptoms resemble other medical conditions  Environmental history not taken  Explanatory model approach not explored  Poor integration of clinic and outreach operations  Failure to follow through with a report MTSD-51ODreporting.pdf
  • 10. Eliciting MSFW Patients’ Explanatory Models  What is the name of your problem?  What caused it?  Why did it start when it did?  What will this problem do to your body?  How has this illness affected your life?  What worries you most about this problem?  What are your expectations?  What kind of treatment do you think you need?  Are there other things you want (support, reassurance, or explanations)? Guidelines for the Care of Migrant Farmworkers’ Children, AAP, MCN, p. 21