The U.S. Environmental Protection Agency’s (EPA) Worker Protection Standard (WPS) provides basic workplace protections to farmworkers and pesticide handlers to minimize the adverse effects of pesticide exposure. EPA announced major revisions to the WPS in September 2015. MCN and FJ's fact sheet provides a summary of the revised regulation.
- WPS-2015.pdf (981.69 KB)
In 2015, for the first time in over 20 years, the Environmental Protection Agency updated the Worker Protection Standard (WPS). The WPS provides basic workplace protections for agricultural workers to reduce the risk of pesticide exposre. This issue brief overviews the major revisions that are particularly relevant for clinicians caring for agricultural workers.
- WPS_MCN_FJ_IssuesBrief2016.pdf (3.02 MB)
ACA Toolkit:
Available in English and Spanish
Health Insurance Guide:
Available in English and Spanish and Haitian Creole
Older Guides:
Available in English, Spanish, and Haitian Creole for workers on employer-provided health insurance
Created by Farmworker Justice.
- http://www.farmworkerjustice.org/sites/default/files/FJ_ACA_Fact_Sheet_Employer_Provided_Health_Insurance_FINAL.pdf
- http://www.farmworkerjustice.org/sites/default/files/FJ_ACA_Fact_Sheet_Employer_Provided_Health_Insurance_SPANISH_FINAL.pdf
- http://www.farmworkerjustice.org/sites/default/files/FJ_ACA_Fact_Sheet_Employer_Provided_Health_Insurance_CREOLE_FINAL.pdf
The National LGBT Health Education Center provides educational programs, resources, and consultation to health care organizations with the goal of optimizing quality, cost-effective health care for lesbian, gay, bisexual, and transgender (LGBT) people.
http://www.asbestosdiseaseawareness.org/
ADAO is the largest independent nonprofit in the U.S. dedicated to preventing asbestos exposure, eliminating asbestos-related diseases, and protecting asbestos victims' civil rights through education, advocacy, and community initiatives.
http://www.cdph.ca.gov/programs/cosmetics/Pages/default.aspx
An online, searchable database that allows salon workers and others to learn about and report toxic chemicals found in nail salon products and other cosmetics.
Migrant Clinicians Network, Inc. (MCN) will work during the next two years to engage members of our clinical network and all relevant stakeholders to advance health justice for the mobile poor. Our advocacy and education priorities focus on safe and legal entry into the United States, as well as strong and equal protection for workers in all occupations. Advancement in these areas creates the greatest opportunity for all to access high-quality, affordable healthcare.
- Comprehensive Immigration Reform
- Access to Health Care
- MCNAdcovacyAgendaFinal.pdf (148.62 KB)
This new guide from the National Center for Medical-Legal Partnership is intended to help civil legal aid practitioners message their work to health care audiences in order to build stronger cross sector medical-legal partnerships and to encourage investment in that work.
- Framing Legal Care as Health Care.docx (72.27 KB)
On Monday August 18, 2014 MCN submitted technical comments to the EPA regarding the proposed changes to the Worker Protection Standard. View MCN's recommendations for advancing stronger safeguards to protect farmworkers from pesticide exposure.
- MCN_WPS_FinalComments_2014.pdf (164.74 KB)
This proposal will I) provide a profile of the agricultural industry and Farmworkers in Washington State II) propose a theoretical framework to understand farmworker housing accessibility III) describe prior legislative actions to address farmworker housing IV) and propose a set of recommendations to address farmworker housing.
Published July 15, 2014
MCN holds the position that immigrant children fleeing violence in their home countries must receive priority consideration for their safety and health. We have provided several links with additional resources on this issue.
http://umash.umn.edu/needlestick-prevention/ This webpage features factsheets and videos developed by the Upper Midwest Agricultural Safety and Health Center (UMASH) to educate farmworkers, producers, and veterinarians about needlestick prevention. Resources are available in both English and Spanish.
Este diccionario ilustrado bilingüe de MCN, "Seguridad en Palabras/ Safety in Words", muestra los peligros que hay en el lugar de trabajo y las mejores prácticas para la salud y la seguridad en la agricultura. Desarrollado con el apoyo del Programa de Subvenciones Susan Harwood de OSHA, este recurso refuerza el vocabulario en inglés de los trabajadores que hablan español lo que ayudará a prevenir lesiones en la agricultura.
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 |
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PATIENT EDUCATION MATERIALS |
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ARCHIVED WEBINARS & TRAINING RESOURCES |
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LOCAL PESTICIDE RESOURCES |
The following will provide information regarding the pesticides used in your areas:
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- http://migrantclinician.adobeconnect.com/p77irjl7cvq/
- http://www.marshfieldclinic.org/nfmc/
- http://www.agrisafe.org/
- http://1.usa.gov/1aF9rHY
- http://www2.epa.gov/pesticide-worker-safety/recognition-and-management-pesticide-poisonings
- http://1.usa.gov/1fFUSZm
- http://bit.ly/1imO43V
- http://npic.orst.edu/
- http://www.aapcc.org/
- http://extoxnet.orst.edu/
- http://www.pesticidemededucation.com/
- http://www.extension.umn.edu/agriculture/pesticide-safety/program-team/
- http://www3.extension.umn.edu/county
- http://web.extension.illinois.edu/psep/about/psepteam.cfm
- http://web.extension.illinois.edu/state/findoffice.cfm
Part 5 of the 6 webinar series: Essential Clinical Issues in Migration Health
DATE RECORDED: June 5, 2014
PRESENTED BY: Katherine Brieger, RD and Elizabeth Magenheimer
To receive CME* or CNE credit after viewing any of these webinars you must do the following:
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Diabetes continues to be one of the most common and challenging health condition confronting migrants and other underserved populations. It is clear that a healthy lifestyle is critical to mitigating the impact of diabetes on individuals and the population, however effective and appropriate interventions can be difficult to design. Fairhaven Community Health Center in Connecticut and Hudson River Healthcare in New York, are two health centers that have long led the way in creating culturally appropriate lifestyle programs for migrants and other underserved patients. In this session the presenters will discuss lessons learned from the development of a variety of programs for diabetics and other patients including a community garden, nutrition classes, cooking classes, weight management and strategies to encourage exercise. The session will address the clinical core measures related to nutrition and BMI and will also discuss current research test second line drug effectiveness in Type 2 DM. Available in English
Learning Objectives:
- Describe culturally appropriate diabetes intervention strategies
- Identify strategies to address clinical core competencies related to nutrition and BMI to improve quality care.
- Receive “take home” examples of how to incorporate effective nutrition, weight loss, exercise and other health lifestyle strategies.
FURTHER READING |
Download the Spanish Toolkit Materials
National Diabetes Information Clearinghouse, http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram Bright Bodies, http://brightbodies.org |
- https://youtu.be/s9tdKcyE5OE
- http://www.cdc.gov/diabetes/ndep/pdfs/16-road-to-health-user-guide-spanish.pdf
- http://www.cdc.gov/diabetes/ndep/pdfs/17-road-to-health-activities-guide-spanish.pdf
- http://www.cdc.gov/diabetes/ndep/pdfs/18-road-to-health-resource-guide-spanish.pdf
- http://www.cdc.gov/diabetes/ndep/pdfs/19-road-to-health-flipchart-spanish.pdf
- http://www.cdc.gov/diabetes/ndep/pdfs/20-road-to-health-physical-activity-quiz-spanish-508.pdf
- http://www.cdc.gov/diabetes/ndep/pdfs/21-road-to-health-city-of-excuses-spanish.pdf
- http://www.cdc.gov/diabetes/ndep/pdfs/22-road-to-health-future-poster-spanish.pdf
- http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram/
- http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram
- http://brightbodies.org/
- http://brightbodies.org
Part 4 of the 6 webinar series: Essential Clinical Issues in Migration Health
DATE RECORDED: May 14, 2014
PRESENTED BY: Candace Kugel, FNP, CNM and Megan Danielson, CNM
To receive CME* or CNE credit after viewing any of these webinars you must do the following:
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Migrant women face significant disparities with an additional layer of complexity and require different intervention strategies. Among them are reproductive health, pregnancy and childbirth, sexual and intimate partner violence, and cancers that disproportionately affect women, including cervical and breast cancer. Women often face environmental and occupational health exposures both in the home and in the workplace that heighten health risks. This session will provide a follow-up to the July 2013 presentation “Women’s Health at the Intersection of Poverty and Migration” that was part of our Clinician Orientation to Migration Health webinar series. During this presentation Candace Kugel, FNP, CNM, and Meagan Danielson, CNM will discuss quality improvement and health care services for migrant women. The HRSA clinical performance measures related to women’s health will be reviewed as well as resources and best practices for improving the health of migrant women.
Learning Objectives:
- Describe strategies to address clinical core measures that relate to women’s health .
- Discuss case studies that assist participants in understanding how creative collaborations and models of care can improve health outcomes for migrant women.
- Participants will be able to access clinical resources for working with female migrant patients.
FURTHER READING |
Low Birth Weight Resources
Cervical Cancer Resources
Other Resources
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- WomenWebinar2014May12.pdf (999.83 KB)
- https://youtu.be/AJe7SVQxWTA
- http://www.healthcare.gov/
- http://www.healthcare.gov
- http://www.text4baby.org/
- http://www.text4baby.org
- http://www.migranthealth.org/
- http://www.migranthealth.org
- http://www.acog.org
- http://www.cdc.gov
- http://www.cancer.org
- http://www.rwhp.org
- http://cdc.gov/cancer/nbccedp
- http://bphc.hrsa.gov/policiesregulations/performancemeasures/index.html
- http://www.nashp.org/
- http://www.nashp.org
- http://bphc.hrsa.gov/spotlight/eriefamilyhc/index.html
- http://transform.childbirthconnection.org/
Part 6 of the 7 webinar series: Clinician Orientation to Migration Health
DATE: presented live on July 17th, 2013
PRESENTED BY: Candace Kugel, FNP, CNM, Specialist in Clinical Systems & Women's Health and Melissa Bailey, Executive Director of North Carolina Field, Inc.
Additional Resources: |
MCN Women's Health page MCN Health Network: Any prenatal patient who may move out of your area before giving birth is eligible to be enrolled in the Health Network. MCN will provide care coordination throughout the course of her pregnancy, until her postpartum visit is completed, to help ensure that there are no gaps in her health care. 512-327-2017 or 800-825-8205.
MCN Environmental Health/Pesticides Resources
MCN Family Violence Resources
MCN Streamline articles
Other Women’s Health Resources for Migrant/Immigrant Care
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Historically, the field of women's health consisted of issues surrounding reproduction and childbirth. However, increasingly, the health care community has come to see women as a distinct patient group that has unique health concerns over a lifetime. Migrant farmworker women experience unique risks during pregnancy and otherwise, due to the physical demands, environmental exposures and other circumstances of their lives. The provision of healthcare services to migrant women presents distinctive challenges for both clinicians and organizations. MCN’s Candace Kugel, CRNP, CNM, and Melissa Bailey, Executive Director of NC FIELD, Inc., both with many years of experience with this population will discuss the problems, solutions and rewards of working with migrant women, through case illustrations and review of resources.
After taking this webinar:
- Participants will be able to identify at least 2 health risks unique to women farmworkers and the impact of those challenges on work, nutrition and health.
- Participants will be able to describe environmental and occupational health exposures relevant to farmworker women of reproductive age.
- Case studies will assist participants in understanding how creative collaborations and models of care can improve health outcomes for migrant women.
- Participants will be able to access clinical resources for working with female migrant patients.
PRESENTER BIOS:
Candace Kugel, FNP, CNM, Specialist in Clinical Systems & Women's Health, Migrant Clinicians Network |
Candace Kugel is a Family Nurse Practitioner and Certified Nurse-Midwife with over twenty years of experience in health care for the underserved. She has worked in various clinical settings, including family planning, migrant health, community health center, and private practice. She has worked almost exclusively in rural settings. Candace has also been active in aspects of health care other than direct patient services. She has served as a clinical instructor for nurse practitioner, nurse-midwife, nursing, and medical students, and currently has faculty appointments with the University of Cincinnati and Penn State University’s Schools of Nursing. She has worked in program development in various arenas, including co-founding a “Stork’s Store” prenatal incentive program, initiating a natural family planning education program, and teaching childbirth education classes. |
Melissa Bailey, Executive Director of North Carolina Field, Inc. |
Melissa Bailey is a native of southern West Virginia. She has worked in North Carolina migrant education programs since 2001. In 2010 AFOP’s Children in the Fields Campaign assisted community workers with forming the nonprofit NC FIELD. This effort aimed to establish an organizational empowerment and advocacy model to build capacity in farmworker communities, particularly among child laborers in agriculture. In 2012 Melissa became the Executive Director of NC FIELD. She has presented to local, state, and national stakeholders; assisted media; has worked as a research assistant on farmworker studies; assisted with organizational development and the leadership training of child farmworkers, and is a successful field organizer, consultant, and project manager. Melissa holds a certificate in Nonprofit Management from Duke University, among other certifications related to the delivery of supplemental education services and data. In her spare time Melissa enjoys reading, writing, gardening, and spending time with loved ones. |
- http://migrantclinician.adobeconnect.com/p17n4u7kxek/
- http://252Fwww.migrantclinician.org/toolsource/resource/aunque-cerca...sano-pesticide-comic-book.html
- http://www.text4baby.org
- http://www.nccc.ucsf.edu/about_nccc/perinatal_hotline/
- http://www.centeringhealthcare.org
- http://www.rwhp.org
- http://www.augercommunications.com
- http://www.wakehealth.edu/Research/Family-Medicine/Educational-Materials.htm
- http://www.migranthealth.org
- http://www.womenshealth.gov
- http://www.marchofdimes.com/professionals/professionals.asp
- http://www.cdc.gov/spanish/mujer.htm
- http://www.nationalperinatal.org/trans.php
- http://www.cdph.ca.gov/programs/cdapp
- http://www.effectivehealthcare.ahrq.gov/ehc/products/107/510/Diabetes%20Spanish.pdf
- http://afop.org/wp-content/uploads/2010/07/The-Fields-PDF-2.13-version.pdf
- http://www.hrw.org
- http://www.legalmomentum.org/
- http://www.acf.hhs.gov/trafficking
New bilingual resource available April 2014!
Student Action with Farmworkers (SAF) has been using theater as an educational tool with farmworkers for over twenty years. By drawing on techniques of popular theater, SAF performs culturally appropriate, lively skits and facilitates theater workshops at farm labor camps. These performances spur conversations about mental and physical health, living and working conditions, and farmworker movements for social justice.
Many of SAF’s performances have focused on health issues, and they aim for this guide to offer dynamic tools for health care providers, educators, outreach workers, and public health innovators. Practitioners can also use these techniques with other populations across the social justice spectrum. For both organizers and educators, SAF hopes that popular theater can bolster the messages and information that you so readily share and provide a dynamic approach to outreach. Resources include songs, scripts, theater games and icebreakers. Printed copies are free, but SAF accepts small contributions to cover shipping and handling ($5-10/copy).
Available in print and online
Contact: Laxmi Haynes , 919-660-3660
Limited data document the multiple and repeated pesticide absorption experienced by farmworkers in an agricultural season or their risk factors.
Laboratory studies and case reports of accidental exposure to large amounts of chemicals indicate that there are immediate and long‐term negative health consequences of exposure to agricultural chemicals.
The goal of this study was to describe acute occupational pesticide-related illnesses among youths and to provide prevention recommendations. Survey data from 8 states and from poison control center data were analyzed.
Concern about the adverse public health and environmental effects of pesticide use is persistent. Recognizing the importance of surveillance for acute occupational pesticide-related illness, we report on surveillance for this condition across multiple states. Between 1998 and 1999, a total of 1,009 individuals with acute occupational pesticide-related illness were identified by states participating in the SENSOR-pesticides program.
In response to limitations in state-based occupational disease surveillance, the California Department of Health Services developed a model for surveillance of acute, work-related pesticide illness. The objectives were to enhance case reporting and link case reports to preventive interventions. Risk factors for pesticide illness were prevalent.
The California Pesticide Illness Surveillance Program (PISP) is a major resource for pesticide illness epidemiology. This work attempts to improve characterization of pesticide illness in California, evaluate case ascertainment of the PISP and identify PISP’s limitations and biases for studying the incidence and epidemiology of pesticide-related illness.
Public health surveillance for acute pesticide intoxications is discussed. Explanation of the goals, components and functions of population-based surveillance is provided with reference to key informational sources.
Pesticide Action Network, United Farmworkers of America, and California Rural Legal Assistance Foundation analyzed California government data on agricultural poisonings and enforcement of worker safety standards. Nearly 500 pesticide poisonings were reported for California farmworkers every year. The actual number of pesticide-related illnesses is unknown, since many poisonings go unreported.
Surveillance data show that pesticide-related illness is an important cause of acute morbidity among migrant farm workers in California. Exposures occur in various ways (e.g., residues, drift), suggesting that the use of pesticides creates a hazardous work environment for all farm workers Improved education for health care providers should be a priority. Growers should be educated about alternative forms of pest control and incentives should be provided to encourage their use.
Describes the growth from 1987 through 1996 of the Occupational Pesticide Poisoning Surveillance Program at the Texas Department of Health. The program was initially based on a Sentinel Event Notification System for Occupational Risks (SENSOR) model, using sentinel providers to report cases, supplementing the passive reporting by physicians that was required by law.
The CHAMACOS study is a longitudinal birth cohort study examining chemicals and other factors in the environment and children's health.
In 1999-2000, CHAMACOS enrolled 601 pregnant women living in the agircultural Salinas Valley. They are following their children through age 12 to measure their exposures to pesticides and other chemicals and to determine if this exposure impacts their growth, health, and development.