230034 Saving lives by changing practices: Protecting workers by integrating occupational and environmental medicine into the primary care setting

Monday, November 8, 2010

Amy K. Liebman, MA, MPA , Migrant Clinicians Network, Quantico, MD
Steve Manock, MD MS , Migrant Health Program, Rural Medical Services, Parrottsville, TN
Karin Hoffman , Migrant Outreach, Rural Medical Services, Inc., Parrottsville, TN
Alexis Andino , Outreach, Rural Medical Services, Inc., Parrottsville, TN
This presentation will examine a five year initiative that successfully integrated an occupational and environmental medicine (OEM) program into eight select Migrant and Community Health Centers throughout the country, resulting in changes in clinical systems and provider practices. The centers received on-site OEM and pesticide trainings designed for the primary care provider and training for outreach staff. At each center the clinician champion developed a flexible program tailored to the unique needs of the center and incorporated key elements of the National Pesticide Practice Skills Guidelines for Medical & Nursing Practice. Centers were introduced to OEM specialists who served as faculty and offered consults. Centers also received patient education materials and clinical tools such as screening questions and reference books. The partner clinics have integrated screening processes to better recognize work related injuries and exposures and have incorporated into their practice patient education regarding the prevention of work related injuries and exposures. The project trained more than 2,000 clinicians and distributed more than 60,000 environmental and occupational health resources to assist clinicians. Primary care clinicians are interested in OEM and welcomed the training and program. Some projects fostered new relationships between local growers and health centers. This model offers potential entrée to further involve health centers and primary care clinicians in worker health and safety training programs, surveillance and cholinesterase monitoring. This presentation will include a case study from one of the eight partner centers to highlight their efforts in Eastern Tennessee.

Learning Areas:
Administer health education strategies, interventions and programs
Advocacy for health and health education
Diversity and culture
Implementation of health education strategies, interventions and programs
Occupational health and safety

Learning Objectives:
Identify the tangible benefits to quality care in migrant health through the integration of occupational and environmental medicine in the primary care setting. Discuss the role of a “champion” in the success or failure of clinical programs. List environmental and occupational health tools specifically for the frontline provider. Identify ways to access tools and resources.

Keywords: Occupational Health Care, Immigrants

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Ms. Liebman has devoted her professional career to improving the environmental and occupational health of disenfranchised populations. As Director of Environmental and Occupational Health at Migrant Clinicians Network (MCN), she has established a nationally recognized initiative to integrate occupational and environmental medicine into the primary care setting. This initiative aims to reduce risks associated with occupational and environmental hazards by improving clinical knowledge and practice as well as community outreach and education. Ms. Liebman has been a national leader in bringing culturally appropriate approaches such as promotores de salud (lay health workers) to environmental and occupational health efforts in order to educate vulnerable communities about pesticides and ways to reduce their risks from pesticide exposure. MCN and Ms. Liebman received the EPA Regional Children’s Environmental Health Champion Award for their innovate programs to help farmworker families minimize exposures to environmental hazards. Ms. Liebman serves on the Pesticide Program Dialogue Committee (Federal Advisory Committee to the EPA Office of Pesticide Programs). Prior to her current position, she was the Director of Outreach and Policy for the Center for Environmental Resource Management in El Paso, Texas, where she directed several programs on both sides of the US-Mexico Border. Her most noted program was Agua Para Beber or Water to Drink was the first program to successfully utilize the promotera de salud model in a community-based environmental health initiative in the United States. Ms. Liebman has authored articles, bilingual training manuals and other educational materials dealing with environmental/occupational health and migrants. Ms. Liebman has a Master’s degree from the LBJ School of Public Affairs at the University of Texas at Austin, and a Master of Arts from the Institute of Latin American Studies at the University of Texas at Austin.
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.