National Pesticide Practice Skills Guidelines for Medical ...

National Pesticide Practice Skills Guidelines for

Medical & Nursing

Practice

A Project of the National Strategies for Health Care Providers: Pesticides Initiative

National Pesticide Practice Skills Guidelines for

Medical & Nursing Practice

A Project of the National Strategies for Health Care Providers: Pesticides Initiative

January 2003

For more information: Tel: 202-833-2933 x535

Fax: 202-261-6464 Email: pesticides@ Web: health/providers/index.shtm The National Environmental Education & Training Foundation 1707 H Street, NW, Suite 900 Washington, DC 20006-3915

Support for this project was made possible through Cooperative Agreement CR 827026-01-0 between the Office of Pesticide Programs of the U.S. Environmental Protection Agency and The National

Environmental Education & Training Foundation. The conclusions and opinions expressed herein are those of the authors and do not necessarily represent the views and policies of the U.S. EPA.

Extensive resources on pesticides can be found at Health/Resources/healthcare.htm

Reviewers

This document has been reviewed in draft form by individuals chosen for their unique perspectives and technical expertise. The purpose of this independent review was to elicit candid and critical comments that would assist in making this published document as sound and effective as possible. We thank the following individuals for their review of this document:

John Balbus, MD, MPH ..........................................George Washington University, School of Medicine

Patricia Bauman ......................................................The Bauman Foundation

Geoffrey M. Calvert, MD, MPH, FACP ................National Institute for Occupational Safety & Health

Kerry Hoffman-Richards, PhD ............................Pennsylvania State University, Pesticide Education Program

Ruth Kahn, DNSc.....................................................Health Resources and Services Administration, Bureau of Health

Professions, Division of Medicine

Philip J. Landrigan, MD, MSc ...............................Mount Sinai School of Medicine

Ann Linden CNM, MSN, MPH..............................Liaison for American College of Nurse-Midwives

Paul Locke, JD, DrPH ..............................................Trust for America's Health

Edward Master, RN, MPH......................................U.S. Environmental Protection Agency, Region 5

Robert K. McLellan, MD, MPH .............................Institute and Center for Human Development and Environmental

Health Service

Ameesha Mehta-Sampath, MPH.......................U.S. Environmental Protection Agency, Region 2

Melissa Melum RN, BSN........................................University of Maryland, School of Nursing, Environmental Health

Education Center

Claudia Miller, MD, MS...........................................The University of Texas, Department of Family and Community

Medicine; South Texas Environmental Education & Research

Program

Lillian Mood, RN, MPH, FAAN..............................Retired Public Health Nurse & Community Liaison

Patrick O'Connor-Marer, PhD .............................University of California, IPM Education and Publications

Donna Orti, MS, MPH.............................................Agency for Toxic Substances & Disease Registry

Dorothy Powell, EdD, RN, FAAN .........................Howard University, College of Pharmacy, Nursing & Allied Health

Science

Mark Robson, PhD, MPH.......................................University of New Jersey, School of Public Health

Elaine Rubin, PhD ...................................................Center for Interdisciplinary, Community-Based Learning and

Association of Academic Health Centers

Barbara Sattler RN, PhD........................................University of Maryland, School of Nursing

Gina Solomon, MD, MPH......................................Natural Resources Defense Council

David Stevens, MD .................................................Association of American Medical Colleges

2

Michael Stimmann, PhD.......................................University of California, Davis, Center for Pest Management

Daniel Sudakin, MD, MPH ....................................Oregon State University, Department of Environmental &

Molecular Toxicology

David Wallinga, MD, MPA .....................................Institute for Agriculture and Trade Policy

Although the reviewers listed above have provided constructive comments and suggestions, they were not asked to endorse the content nor did they see the final draft of the document before its release. Responsibility for the final content rests with the authors and The National Environmental Education & Training Foundation.

Reviewers

Extensive resources on pesticides can be found at Health/Resources/healthcare.htm

Authors

Project Coordinators:

Practice Team:

Andrea R. Lindell, DNSc Past President, American Association

of Colleges of Nursing Dean, College of Nursing Senior Associate Vice President University of Cincinnati Cincinnati, Ohio

George M. Bernier, Jr., MD Professor of Medicine and Emeritus Dean University of Texas Medical Branch Galveston, Texas

Education Team:

Candace Burns, PhD, ARNP Representative, National Organization of Nurse

Practitioner Faculties University of South Florida College of Nursing Tampa, Florida

Bonnie Rogers, Dr.PH, COHN-S, LNCC, FAAN Past President, American Association of

Occupational Health Nurses University of North Carolina School of Public

Health Chapel Hill, North Carolina

Cathy Simpson, MD, MPH Wayne State University School of Medicine Detroit, Michigan

Pesticide Extension Representative:

Amy E. Brown, PhD President, American Association of Pesticide

Safety Educators Associate Professor, Department of Entomology University of Maryland College Park, Maryland

James R. Roberts, MD, MPH

Assistant Professor, Department of Pediatrics

Medical University of South Carolina

Charleston, South Carolina

3

The participants gratefully acknowledge the contributions of the staff of the U.S. Environmental Protection Agency and The National Environmental Education & Training Foundation for their dedication and support of the project.

Authors

Extensive resources on pesticides can be found at Health/Resources/healthcare.htm

Table of Contents

Foreword _______________________________________________________________________5

Introduction _____________________________________________________________________6

A Pesticide Primer _______________________________________________________________10

Literature Review _______________________________________________________________ 18

Incorporating Pesticides into Practice Skills __________________________________________ 22

Points of Contact for Training/Refreshing Practitioners______________________________ 22

Adult Education Principles ____________________________________________________ 23

Pesticide Practice Skills Guidelines for Medical & Nursing Practice: Content and Resources for Practice Settings__________________________________________ 27

Practice Skill I: Taking an Environmental History ___________________________________ 30

Practice Skill II: Awareness of Community and Individual Pesticide Risk Factors _________ 36

Practice Skill III: Knowledge of Key Health Principles _______________________________ 40

Practice Skill IV: Clinical Management of Pesticide Exposure _________________________ 43

4

Practice Skill V: Reporting Pesticide Exposure and Supporting Surveillance Efforts _______ 69

Practice Skill VI: Providing Prevention Guidance and Education to Patients _____________ 72

Table of Contents

Extensive resources on pesticides can be found at Health/Resources/healthcare.htm

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