ABSTRACT

Purpose: Agricultural workers, especially those who farm full-time, are at substantial risk for developing long-term health problems related to occupational dust, chemical, and vibratory noise exposures. There is clear evidence of risk factors for acute agricultural injury; however, literature regarding risk factors for long-term occupational health problems, including noise-induced hearing loss (NIHL), agricultural chemical exposure (ACE), and inhalation injury, is more limited. The literature poses conflicting information on agricultural workers and personal protective equipment (PPE); agricultural workers understand the importance of PPE use, yet the lack of PPE use is pervasive in agricultural workers across numerous studies. Education of agricultural workers on the role of PPE in chronic disease prevention has shown promise.

Methods: Our research seeks to identify a replicable model of Physician Assistant (PA) student education on agricultural worker health and safety, including patient education and disease prevention. This model will equip future health-care providers with the knowledge and skills to provide patient education on farming-associated, preventable chronic diseases, as it is a documented tool for increasing PPE use. Didactic curriculum objectives include agriculturally related respiratory health issues, chemical exposure, and noise-induced hearing loss. Curricular content delivery includes traditional classroom learning as well as adjunctive small group and simulation activities. Upon completion of the didactic phase, students complete a 15-month clinical learning phase, including a 12-week primary care rotation in a rural setting, serving many agricultural workers throughout the Midwest. Student logs of patient encounters track diagnoses related to agricultural exposure, as well as monitor agricultural patient treatment modalities, including patient education on PPE use. Distribution of patient education and PPE materials occurs through clinical site visits to primary care rotation sites.

Practical Application: Our educational model intends to improve health outcomes of patients in the rural Midwest. Our ongoing research will collect data on agriculturally related diagnoses in the Midwest and patient-provider communication, ideally enhancing patient awareness of risk factors and compliance with treatment plans, as well as decreasing chronic disease severity. The measured effects of this educational intervention will serve as a basis for future research and health-care provider education.

摘要

目的：农业工人，尤其是专职农场的农业工人，面临与职业粉尘，化学和振动噪声暴露有关的长期健康问题的严重风险。有明确证据表明急性农业伤害的危险因素；然而，有关长期职业健康问题的风险因素的文献更为有限，包括噪声引起的听力损失（NIHL），农药暴露（ACE）和吸入伤害。文献中有关农业工人和个人防护设备（PPE）的信息相互矛盾。农业工人了解使用PPE的重要性，但是在众多研究中，缺乏PPE的使用在农业工人中普遍存在。关于PPE在慢性病预防中的作用的农业工人教育已显示出希望。

方法：我们的研究旨在确定可重复的Physician Assistant（PA）学生教育模式，涉及农业工作者的健康和安全，包括患者教育和疾病预防。该模型将为未来的卫生保健提供者提供知识和技能，以为他们提供与农业有关的可预防的慢性病的患者教育，因为它是增加PPE使用的有据可查的工具。有说服力的课程目标包括与农业有关的呼吸系统健康问题，化学物质暴露和噪音引起的听力损失。课程内容的交付包括传统的课堂学习以及辅助小组和模拟活动。在完成教学阶段后，学生将完成为期15个月的临床学习阶段，包括在农村地区进行为期12周的初级保健轮换，为整个中西部的许多农业工人服务。病人遇到的学生日志会跟踪与农业暴露相关的诊断，并监视农业病人的治疗方式，包括对PPE使用的病人教育。患者教育和PPE材料的分发通过临床现场访问基层医疗轮换站点进行。

实际应用：我们的教育模式旨在改善中西部农村地区患者的健康状况。我们正在进行的研究将在中西部地区收集有关农业相关诊断的数据，并与患者-提供者进行交流，从而理想地增强患者对危险因素的认识和对治疗计划的依从性，并降低慢性病的严重程度。这种教育干预措施的实际效果将作为未来研究和医疗保健提供者教育的基础。