Western Integrated Pest Management Center

 

A municipal groundskeeper walks into an urgent care clinic with nausea and dizziness. Her heartbeat is also irregular.

There are dozens of potential causes for the woman’s symptoms. So how quickly will the provider on duty – who will potentially see 50 patients that shift – consider pesticide exposure as a contributing factor for her condition?

If a group called PERC-med is successful with its outreach, the clinician asks the woman about her environmental exposures, including pesticides, as part of the diagnosis process. 

PERC-med is short for Pesticide Educational Resources Collaborative-Medical, a sister project of PERC. Both projects are cooperative agreements with the U.S. Environmental Protection Agency and the University of California, Davis in collaboration with Oregon State University. Both projects produce educational materials and resources on pesticides, but PERC-med specifically targets health care providers so they can recognize, treat and report pesticide-related illnesses.

“Our intended audience are clinicians, whether they are students or practicing nurses, physicians, physician assistants or other providers,” said Diana Simmes, the pesticide medical education director of the program. “We produce fact sheets and case studies and provide access to free continuing medical education courses, often through webinars, but also present at in-person at conferences.” 

 

The need for the ongoing education is clear, Simmes said.

“We recently collaborated on a webinar for the American Academy of Physician Assistants and the comments afterward included, ‘This is more information than we got in PA school and so important to know for our patients.’”

And that can be an issue for two reasons. First, pesticides are more ubiquitous than many people realize, and second, pesticide-related illness can be confused with other health conditions such as heat illness or the flu. 

So the challenge for PERC-med is to get very busy health care providers to consider pesticides as a possible cause when they encounter a patient, especially those working in high-risk occupations.

“What we aim to do in all of our educational efforts is basically start with what a pesticide is and get medical providers to consider where patients might have been exposed, including at home,” Simmes said. “We also help providers recognize the many occupational groups at risk such as agricultural workers and hospitality workers, forestry and even in health care.”

One method the group uses to reach clinicians is writing brief articles and case studies for medical professionals’ newsletters and other health care organizations like the American Academy of Family Physicians.

“We leverage where health care providers get their trusted sources of information,” Simmes said, “because they’re most likely to go to these sources first.”

Is it working?

“We look closely at how many providers engage with our educational materials on our collaborators websites and we have qualitative data as well,” she said. “It’s great to see when participants have those ah-ha moments, when someone after a webinar says, ‘Oh wow, disinfectants are pesticides. I never knew that.’  Or when a group like the Association of Public Health Nurses adds PERC-med information to its residency training program.”

And just maybe that training, or a PERC-med article or infographic or webinar, will prompt a busy clinician to consider pesticide exposure when making a diagnosis. 

For more information, visit the PERC-med website at pesticideresources.org/med/index.html