Pesticide Exposure Presentation


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

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Pesticide Exposure Presentation

  1. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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