196111 Training Physicians to Work with Communities and on Environmental Justice Issues

Wednesday, November 11, 2009: 8:30 AM

Philip Lewis, MD, MPH , Occupational Medicine Silverstein, Ground Floor, University of Pennsylvania, Philadelphia, PA
Edward Emmett, MD, MS , Occupational Medicine Silverstein, Ground Floor, University of Pennsylvania, Philadelphia, PA
Judith Green-McKenzie, MD, MPH , Occupational Medicine Silverstein, Ground Floor, University of Pennsylvania, Philadelphia, PA
We describe a novel academic/community partnership model for training residents specializing in Occupational and Environmental Medicine. Our focus is on mid-career physicians who are already in their practice. The program allows physicians to remain in their community for most training, with periodic resident visits to Philadelphia and faculty visits to the resident's community. Training incorporates a two-month “rotation” experience in Environmental Health, Risk Assessment and Risk Communication. This includes approximately 20 hours of seminar and interactive discussions devoted to understanding various points of view, such as those of environmental justice, NGOs, industry, regulators and professionals, and development of various technical skills and tools. Residents view and discuss the videos Trade Secrets: A Bill Moyers Report”, and John Stossel's ” Junk Science”. Trainees participate in a mentored risk communication exercise in which they role-play physicians from community, research, government, and industry. Each resident completes a substantive project in risk assessment and risk communication, working in the resident's community with a community or occupational population. Working with diverse stakeholders is emphasized. Representative projects will be described. Criteria for tuition assistance through a NIOSH grant include service to underserved population(s), specific regional needs and service to special populations at risk including minority and disadvantaged workers. Before and after evaluation and superior performance in professional examinations demonstrate quality outcomes. A project arising from this program received the prestigious Campus-Community Partnerships for Health Award for 2008. Professional training programs can and should incorporate community and environmental justice elements.

Learning Objectives:
Describe an academic/community partnership model for training residents in Occupational and Environmental Medicine to work with communities and appreciate environmental justice Evaluate an academic/community partnership model for training residents in Occupational and Environmental Medicine to work with communities and appreciate environmental justice issues.

Keywords: Professional Training, Environmental Justice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Philip G. Lewis Principal, Carthage Investment Group Philip G. Lewis joined the Carthage Investment Group in June 2009 concentrating on work at the intersection of sustainability, medicine and metaphysics. Previously he was with Rohm and Haas Company for 25 years, the last sixteen as Vice President and Director of Environmental, Health Safety and Sustainable Development. Dr. Lewis received a bachelor of science degree in Chemistry from Widener University in 1972; a master of public health in epidemiology from the Johns Hopkins University Bloomberg School of Public Health, and a doctor of medicine from the Johns Hopkins University School of Medicine both in 1976. He finished his residency in general preventive medicine in 1978 at Walter Reed Army Institute of Research in Washington, D.C., and his clinical fellowship in dermatology, occupational and environmental medicine at Johns Hopkins Medical Institutions in 1983. Dr. Lewis is an adjunct faculty member in the Division of Occupational and Environmental Medicine at the University of Pennsylvania School Of Medicine. He was a Clinton Presidential appointee to the Board of Directors of the Mickey Leland Urban Air Toxics Research Center; and is a Fellow of both the American College of Preventive Medicine and the American College of Occupational and Environmental Medicine. Dr. Lewis has won many awards over the years, including the George M. Sternberg Medal for Excellence in Preventive Medicine and Epidemiology. He is widely published and has lectured extensively on preventive, occupational and environmental medicine, public health, risk assessment, risk management and sustainable development. Publications 1. Torrington, K.G., Lewis, P.G., Tellis, C.J., Swedarskey, R.H.: "Systemic Sarcoidosis presenting with a Testicular Nodule," Southern Medical Journal, Vol. p. 1001-1031, 1979. 2. Lemon, S.M., Lednar, W.M., Bancroft, W.H., Cannon, H.G., Benenson, M., Park, J.H., Churchill, F.E., Tezak, R.W., Erdtmann, F.J., Kirchdoerfer, R.G., Lewis, P.G., Janes, Miller, R.N.: "Etiology of Viral Hepatitis in American Soldiers," American Journal of Epidemiology, Vol. 116, No. 3, p. 438-450, 1982. . 3. Hymes, S.R., Farmer, E.R., Lewis, P.G., et al: "Cutaneous Graft Versus-Host Reaction: Prognostic features seen by light microscopy," JAAD, Vol. 12, No. 3, p. 468-474, 1985. 4. Emmett, E.A., Lewis, P.G., Tanaka, F., et al: "Industrial Exposure to Organophosphorus Compounds: Studies on a Group of Workers with a Decrease in Esterase Staining Monocytes and a Comparison Group," JOM, Vol. 27, No. 12, p. 905-914, 1985. 5. Cameron, L.L., Taylor, H.R., Lewis, P.G., Emmett, E.A.: "Methods of Measuring Cumulative Solar UVB Exposure in Epidemiologic Studies," Photochem. Photobiol, Vol. 4 3 (Suppl.) p. 225-230, 1986. 6. Lewis, P.G.: "Contact Allergy to the Preservative Kathon," Contact Dermatitis, Vol. 14, 198-200, 1986. 7. Lewis, P.G. and Emmett, E.A.: "Irritant Dermatitis From Tri-Butyl Tin Oxide and Contact Allergy From Chlorocresol," Contact Dermatitis 1987:17:129-132. 8. Cameron, L.L., Vitasa, B.C., Lewis, P.G., Taylor, R., Emmett, E.A.: "Visual Assessment of Facial Elastosis Using Photographs as a Measure of Cumulative Ultraviolet Exposure," Photodermatology 1988:277-282. 9. Lewis, P.G., Hood, A. F. et al: "Post Inflammatory Elastolysis and Cutis Laxa: A Case Report," Journal of the American Academy of Dermatology, 1990:22:40-48. 10. Lewis, P.G. and Moss, J.M.: "Isothiazolinone Preservatives: A Toxicological Evaluation," Cosmetic Dermatology, 1991:2:123-133. 11. Jayjock, M.A. and Lewis, P.G.: "Low-Applied-Dose Extrapolation of Induction and Elicitation of Contact Allergy in the Evaluation and Management of Sensitization Risk from Kathon® CG Isothiazolinone in Products," American Journal of Contact Dermatitis, 1992:3:86-91. 12. Lewis, P.G. and Jayjock, M.A.: "Risk Assessment Modeling: Allergic Contact Dermatitis Application,” American Journal of Contact Dermatology, 1994:5:143-149. 13. Rosenthal, I. and Lewis, P.G.: "The Real Cost of Risk Analysis," Process Safety Progress, 1994:13:92-94. 14. Jayjock, M.A., Hazelton, G.A., Lewis, P.G., Wooder, M.F.: “Formulations Effect on Dermal Bioavailability of Isothiazdone Biocide,” Fd. Chem. Toxic., 1996:34:277-282. 15. Myers, R.E., Vernon, S.W., Carpenter, A.S., Balsher, A.M., Lewis, P.G.: "Participation in a Worksite Colorectal Cancer Screening Program Among Employees at Increased Risk,” Cancer Detection and Prevention, 1997:21:380 389. 16. Weiler, E.D., Cherry, J, Lewis, P.G.: “Case Study: Management System Verification Using Responsible Care® at Rohm and Haas: Lessons Learned,” Environmental Quality Management, 1997:6:13-19. 17. Weiler, E.D., Lewis, P.G., Belonger, D.J.: “Building an Integrated Environmental, Health, and Safety Management System,” Environmental Quality Management, 1997:6:59-65. 18. Lewis, P.G.: “Occupational and Environmental Medicine: Moving the factory fence or hedging our bets?” Occupational Medicine, 2000:50:217-220. 19. Jayjock, M.A., Lewis, P.G., Lynch, J. R. : “Quantitative Level of Protection Offered to Workers by ACGIH Threshold Limit Values (TLV*) Occupational Exposure Limits” American Industrial Hygiene Journal, , 2001: 62: 4-11. 20. Weiler, E.D., Jayjock, M.A., Lewis, P.G. : “Responsible Care Programs for Hazardous Chemicals” Environmental Quality Management, Spring 2001: 41-52. 21. Lewis, P.G. : “A Cure for Preventive Medicine” American Journal of Preventive Medicine, 2002:22(4):324-325 22. Jayjock, M.A., Lewis, P.G. : “Implications of Hormesis for Industrial Hygiene” Biological Effects of Low Level Exposures (BELLE) Newsletter, 2002:10(3):2-7 23. Weiler, E.D., Johnson, L.D., Lewis, P.G. : “Environmental, Health, and Safety Considerations During Acquisitions" Environmental Quality Management, Summer 2003: 1-7. 24. Oktem, U., Lewis, P.G., Donovan, D., Hagan, J.R., Pace, T., ”EMS and Sustainable Development: A Model and Comparative Studies of Integration” Greener Management International, Summer 2004: 46: 11-28. 25. Lewis, P.G. : Book Review of Hazardous Chemicals: Control and Regulation in the European Market by Herbert F. Bender, Philipp Eisenbarth. 397 pp. 2007. Wiley-VCH Verlag Gmbh & Co. KGaA, Weinheim. ISBN: 978-527-31541-3., Journal of Occupational and Environmental Medicine, Vol 51, No 1., Jan 2009: 112-113. Seminars and Lectures 1. Johns Hopkins University School of Hygiene and Public Health, "Dermatophysiology, " for the General Physiology course, October 31, 1983 . 2. Rutgers University School of Medicine, "Allergic vs. Irritant Contact Dermatitis," for the Department of Occupational Medicine, December 13, 1983. 3. Johns Hopkins University School of Medicine, ''Statistics for the Dermatologist," for the Department of Dermatology, December 21, 1983 . 4. Prairie View A&M University, "Dermatophysiology and the Occupational Environment," for the Department of Biology, April 14, 1984 . 5. MeHarry Medical College, "Occupational Skin Disease - The Changing Field, " for the Department of Community and Occupational Medicine, June 27, 1984. 6. American Osteopathic College of Preventive Medicine, "The Corporate Role in Rehabilitation," at the November 11, 19 Atlanta Convention of the American Osteopathic Association. 7. Poster session at the 44th Meeting of the American Academy of Dermatology, "The Development of Methyl and Methylchloroisothiazlinone," December 7-12, 1985. 8. Rutgers University School of Medicine; "Policy Development for Control of Reproductive Hazards in the Workplace, " for the Department of Occupational Medicine, January 28, 1986. 9. Merck Company: "Practical Aspects of Embryo-Fetotoxin Protection in the Workplace, " for the Corporate Medical Department, April 1, 1986. 10. Yale University School of Public Health: "Opportunities in Industry for Biologic Professionals," for the Department of Environmental Sciences, April 15, 1986. 11. Johns Hopkins University School of Hygiene and Public Health: "Occupational Medicine (Clinical )," a course for the Division of Occupational Medicine, Jan 21-Mar 18, 1987; Jan 20-Mar 16, 1988; Jan 18-Mar 22, 1989; Mar 20, 1990; Feb 13, 1991. 12. American Occupational Health Conference 1987: "Basic Course in Occupational Dermatology," Philadelphia, PA. 13. National Cancer Advisory Board, NCI: "Preventive Activities and Screening in Cancer Management,” at the Public Participation Hearings, April 19, 1988. 14. National Society of Black Engineers, MIT Chapter: "Explaining Scientific Problems to a Non Scientific Public," November 27, 1990. 15. Johns Hopkins University School of Hygiene and Public Health: "The Future of Occupational Medicine," for the Division of Occupational Medicine, March 1992, April 1993. 16. Medical Society of Eastern Pennsylvania, "OSHA and the Private Practitioner" June 1992. 17. American Industrial Hygiene Association Regional Meeting, “What Management Wants from the SH&E Professional” December 1997 18. Plenary Session Closing Remarks: “Capitalism, Green Chemistry and the Promise of the Future”, Presidential Green Chemistry Award, Green Chemistry Conference, Washington, DC., August 1998 19. Middle Atlantic Regional Conference on Occupational Medicine: “Environmental Health and Risk Communication”, Philadelphia, PA, September 1999 20. Mickey Leland National Urban Air Toxics Research Center, Keynote Address at the Symposium “Environmental Air Toxics: Role in Asthma Occurrence” M.D. Anderson Cancer Center, May 2001. 21. American Industrial Hygiene Conference, Roundtable "The U. S. Chemical Safety and Hazard Investigation Board: Making a Difference in Workplace Safety and Health" New Orleans, LA, June 2001 22. Asia Pacific Regional Responsible Care Conference “Business, Community and Sustainable Development” Seoul, Korea, November 2003 23. Yale University Department of Occupational and Environmental Medicine “Sustainable Development and the Physician”, New Haven, CT, April 2004 24. Russian Chemists Union, Russian Chemical Workers´ Union, Chemical Industry Federation of Finland and Chemical Workers´ Union of Finland, the International Conference Social Responsibility of Chemical Industry. Chemical Industry and International Program Responsible Care, “Global Responsible Care Programme” Moscow, May 14-15, 2007
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.