Pesticides: Health and Safety

The National Strategies for Health Care Providers Pesticide Initiative was established in 1998 by EPA and the U.S. Departments of Health and Human Service, Agriculture, and Labor.  The initiative is aimed at improving the training of health care providers in the recognition, diagnosis, treatment, and prevention of pesticide poisonings among those who work with pesticides. 

• Cooperative Agreements Under the Initiative
• Implementing the Initiative
• The Initiative's Driving Force

Cooperative Agreements Under the Initiative

As part of this initiative, EPA has entered into two five-year cooperative agreements to create institutional change through education, professional training, and the development of new resources and tools on pesticide-related health conditions.
The first is a grant with University of Washington Pacific Northwest Agricultural Safety and Health Center (PNASH) to fund a project entitled, Pesticide Effects: Integration Into Health Care Provider Curricula.

The goal of the project is to incorporate the recognition and management of pesticide poisonings into the education of future health care providers. The project intends to integrate the Initiative's core competencies, including the diagnosis and treatment of pesticide-related illnesses, into the educational curricula of medical, nursing, and physician's assistant programs in the Pacific Northwest. The project will enlist key faculty and students in these schools to serve as "champions" and assist in the dissemination of these competencies into the institutions. For more information please visit the PNASH Web site.

The second cooperative agreement is with the Migrant Clinicians Network (MCN) for a project entitled, Saving Lives by Changing Practice: Pesticide Related Health Conditions Prevention Change Concept.

This project works directly with the health care community to improve pesticide education and awareness and to train health care providers to recognize and treat pesticide-related health conditions. MCN plans to design and implement methods to integrate the key skills required for health care providers to deal effectively with pesticide-related health conditions in their practices. MCN will test a training model for primary health care providers that incorporates key skills for the recognition and treatment of pesticide poisonings within health care clinics. The use of a training model for health care providers will then be evaluated and promoted across a wide angle of practice settings.

In addition, the project includes the development of relevant resources and tools that health care providers need to deal effectively with pesticide-related health conditions, and provide access to these products, such as through training, the Internet, and continuing education opportunities. For more information please visit the MCN Web site.

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Implementing the Initiative

This initiative is considered a long-term effort.  The projects under the two five-year cooperative agreements with PNASH and MCN build on the Initiative’s Implementation Plan and the National Pesticide Competency and Practice Skills Guidelines.

The Implementation Plan

In March 2002, EPA and the National Environmental Education and Training Foundation (NEETF) in collaboration with the U.S. Departments of Health and Human Services, Agriculture, and Labor released the Implementation Plan (149 pp, 150 MB, About PDF) for the National Strategies for Health Care Providers: Pesticide Initiative.  The Implementation Plan presents a three-pronged approach for meeting the initiative’s goals that includes specific strategies for effectively reaching primary care providers who are educated and trained in different settings.

The first prong targets a provider’s formal professional education, such as medical or nursing school; the second prong targets the practice setting in which a provider works and participates in professional development, and the third prong is to create linkages to resources and tools that providers need to deal effectively with pesticide-related health conditions in their practices and communities.    

National Pesticide Competency and Practice Skills Guidelines

In 2003, EPA, in partnership with NEETF, developed the National Pesticide Competency and Practice Skills Guidelines to serve as tools for focusing schools and practicum programs on pesticide health education, provide guidance directly to nurses and physicians to advance their awareness and skill in recognizing and managing pesticide-related illness, and act as a model for faculty and administrators in integrating specific pesticide issues into education and training.

National Forum

In June 2003, a National Forum (95 pp, 6.25MB, About PDF) was held to launch the National Strategies for Health Care Providers: Pesticide Initiative.  The goal of the Forum and subsequent activities was to build upon support for the Initiative from key stakeholders, create a national vision for environmental health outreach to health care providers, and develop a nationwide network of health care providers committed to incorporating environmental health into primary care education and practice. Forum participants included representatives of leading health care provider organizations, credentialing bodies and academic institutions, government agencies involved in the education and practice of health care providers, practicing primary care providers, and opinion leaders.

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The Initiative's Driving Forces

• EPA's Worker Protection Standard (WPS).   WPS is designed to reduce pesticide exposure to agricultural workers, mitigate exposures that occur, and inform agricultural employees of the hazards of pesticides. The regulation, implemented in 1995, mandates that millions of farmers, pesticide applicators, and farm workers be educated about the health effects of pesticide exposure and the need to get medical treatment for such effects. This in turn is expected to create additional demand for services from health care providers.
• A National Dialogue.   After the first year of full implementation of the Worker Protection Standard, EPA held nine public meetings to evaluate the progress of implementation and hear the experiences of the people most affected by the regulation. One clear message from the public meetings was the need to improve the recognition, diagnosis, and management of pesticide poisonings on the part of all primary members of the health care community.
• Children's Health Protection.  Protecting children from the effects of pesticides is an important concern at EPA.
• The American Medical Association (AMA) and the Institute of Medicine (IOM) Resolutions.  The need for improvements in health care provider training has been expressed by health provider groups as well as government and community organizations. In 1994, the American Medical Association adopted a resolution urging Congress, government agencies, and private organizations to support improved strategies for the assessment and prevention of pesticide risks. These strategies included systems for reporting pesticide usage and illness, as well as educational programs about pesticide risks and benefits.   In addition, two Institute of Medicine committees have dealt with the general issue of environmental health education, focusing on nurses and physicians.  Both committees recommended an integration of environmental health concerns throughout the various stages of training and clinical practice for health care providers.

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