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Description:
To comply with acute pesticide illness and injury surveillance requirements, in April of 2006, a mandatory public health reporting law was passed requiring all physicians report cases of acute pesticide-related illness and injury to the NC Division of Public Health. Reporting to a surveillance system ensures that incidents are recorded and enhances prevention of pesticide related illness. Reports trigger immediate patient education and investigation facts guide public health prevention efforts and help regulatory agencies review unanticipated health problems with products and make policy changes. No physician has ever directly reported a case to the NC Division of Public Health. They may call poison control instead but this case source typically captures only 56 percent of total poisoning incidents that occur. Reasons for under reporting may include lack of awareness of the rule and/or understanding of its significance. The proposed training would include information on how and why to report. Unfamiliarity with pesticide-related illness may be another reason. Education authorities, the literature and local NC survey data indicate that physicians may not be prepared to respond to pesticide-related illness. Physicians receive minimal amount of training in environmental health in early formal education and further once in practice, practitioners’ awareness and understanding of pesticide-related illness may or may not ever expand. Training would also include information on the basics regarding recognizing, diagnosing, and managing pesticide-related illness, resources to aid with clinical management, and resources to aid with patient counseling. Training will target physicians, physician assistants and nurses that work in rural settings as most pesticides are used in agriculture.

Learning Objectives:

- Describe what occurrences need to be reported and how you do it.

- Describe general aspects of pesticide toxicology and pesticide illness epidemiology.

- Describe the importance of taking an occupational and environmental history to aid
with diagnosis of a pesticide-related illness.

- Identify informational resources that can aid with clinical management of pesticide-
related illness and patient counseling.

Author(s):
Ann Chelminski MD MPH
Ann Chelminski MD MPH graduated from Duke University in 1985 with a BA, then completed post graduate work at the University of Pennsylvania from 1989 - 1990. Dr. Chelminski completed medical school in 1996 at Duke University and then residencies in both Family Medicine and Preventive Medicine at the University of North Carolina at Chapel Hill in 2001 and 2004 respectively. Dr. Chelminski is board certified in Family Medicine and Board Eligible in Preventive Medicine. She was awarded her Masters in Public Health in 2004 from UNC Chapel Hill. She has worked in family practice intermittently during the last eight years both in the urgent care setting and presently in a federally qualified CHC serving residents of the rural community and the uninsured. She practiced as a medical epidemiologist for the NC Division of Public Health, Occupational and Environment Epidemiology Branch, from 2004 – 2006, in the Medical Evaluation and Risk Assessment Unit, helping to conduct investigations relating to environmental and occupational exposures to include pesticides.

Disclosure: The North Carolina Medical Society adheres to ACCME Essential Areas and policies regarding industry support of continuing medical education. Any commercial support for the program and faculty relationships within the industry will be disclosed during the on-line registration of this activity. Speakers will also state when off-label or experimental use of drugs or devices is incorporated in their presentations.

Target Audience:
Physicians and Physician Assistants

Length: 1 Hour

Credit Type(s): 1.0 AMA PRA Category 1 Credit Hours

Cost: $0.00