1 / 23

Deval L. Patrick, Governor Timothy P. Murray, Lieutenant Governor Suzanne M. Bump, Secretary

COMMUNITY HEALTH CENTERS and BLOOD LEAD TESTING of IMMIGRANT HOUSE PAINTERS Richard Rabin Occupational Lead Poisoning Registry Division of Occupational Safety. Deval L. Patrick, Governor Timothy P. Murray, Lieutenant Governor

zelenia-lewis
Download Presentation

Deval L. Patrick, Governor Timothy P. Murray, Lieutenant Governor Suzanne M. Bump, Secretary

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. COMMUNITY HEALTH CENTERS and BLOOD LEAD TESTING of IMMIGRANT HOUSE PAINTERS Richard Rabin Occupational Lead Poisoning Registry Division of Occupational Safety Deval L. Patrick, Governor Timothy P. Murray, Lieutenant Governor Suzanne M. Bump, Secretary Laura Marlin, Commissioner, Division of Occupational Safety

  2. INTRODUCTION • Lead Exposure of House Painters • Community Health Center (CHC) Blood Lead Testing • Blood Lead Data Outreach to Community Health Centers

  3. MASSACHUSETTS OCCUPATIONAL LEAD POISONING REGISTRYLaboratory blood lead reports of adultsFollow-up with workers, physicians, employersData analysis, reportsOne of almost 40 state lead registries in US

  4. PAINTERS’ BLOOD LEADSMASSACHUSETTS OCCUPATIONAL LEAD REGISTRY=> 25 mcg/dl (2001 – 2007) • Painters 306 (37%) • Others 524 (63%) • Total 830 (100%)

  5. BLL SCREENING OF BRAZILIAN PAINTERS (N=61) BLL (µg/dl) Freq. % < 10 39 64 10 – 14 7 12 15 – 24 5 8 25 – 39 5 8 >= 40 5 8 Adapted from: COBWEB, “A Report on Brazilian Immigrant Workers in Massachusetts,” 2009

  6. OSHA LEAD STANDARD, CONSTRUCTION Blood lead testing Medical exams Lead exposure monitoring Lead exposure controls Respirators, PPE Training

  7. Difficulties of Surveillance (BL testing) Small size of employers – lack of knowledge of, and ability & desire to comply with, regulations Immigrants - language - lack of knowledge of rights (ex: OSHA) - fear of retaliation - immigration authorities

  8. House Painters • Low income • Uninsured • Immigrant • Limited English-speaking • Irregular employment

  9. Community Health Centers • Primary medical care • Auxiliary health services Sliding fee scale 90 – 100 in Massachusetts • Patients Low income Non-English speakers No health insurance Don’t know workplace rights

  10. COMMUNITY HEALTH CTR PATIENTS Percentage of patients unaware of OSHA by place of origin Place of Origin Never Heard of OSHA United States (471) 41% Puerto Rico (101) 68% Other Country (834) 75% All patients (1,406) 63% Source, Occupational Health and CHC Patients, MDPH, 2007

  11. COMMUNITY HEALTH CTR PATIENTS Percentage of patients unaware of Workers’ Compensation, by place of origin • United States (483) 15% • Puerto Rico (101) 42% • Other country (838) 52% • All patients (1,422) 39% Source, Occupational Health and CHC Patients, MDPH, 2007

  12. COMMUNITY HEALTH CENTER SERVICES • “Our providers offer a wide variety of services for the whole family including prenatal care and deliveries. “ • Primary Services: • Pediatric, Adult and Senior Primary • Care • Obstetrics and Gynecology including • prenatal care

  13. COMMUNITY HEALTH CENTER SERVICES • Multiple languages, incl. Portuguese • Other Services: • HIV testing and counseling • Family planning • •Nutrition services • Mental Health services • (from clinic network’s website)

  14. COMMUNITY HEALTH CENTERS ANDHOUSE PAINTERS:A PERFECT FIT?

  15. Community Health Center Blood Lead Testing • Minimal • Except, one network of ~ 15 CHCs

  16. OBSTACLES TO DEALING WITH OCCUPATIONAL HAZARDS Worker’s compensation Dealing with employer Other personal, social issues Lack of training in medical school

  17. REASONS FOR BLOOD LEAD TESTS2001 – 2007 (%) • ReasonCS NetworkOther All Others Painters • Symptoms 18 (20) 53 (24) 19 (4) • Pt. Request 21 (24) 80 (37) 54 (10) • Med. Mon. 1 (1) 45 (21) 432 (82) • Doctor 43 (48) 27 (12) 11 (2) • Unknown 6 (7) 12 (6) 8 (2) • Total 89 (100) 217 (100) 524 (100)

  18. WHAT’S DIFFERENT ABOUT CHC¹ NETWORK? • Occupational med. doctors – outreach • If house painter, order blood lead (BL) test • If BL elevated, refer to occupational medicine clinic 1 - network of chc in greater Boston area

  19. PRESENTATIONS TO COMMUNITY HEALTH CENTERS TOPICS • Sources of lead exp. – esp. painters • Health effects • OSHA lead standard • Lead Registry data • Need for BLL testing

  20. PRESENTATIONS TO COMMUNITY HEALTH CENTERS REACTIONS • CHCs have painters, other Pb-exposed • Were not thinking about lead exposure • How to follow-up if BLL elevated

  21. KEYS TO SUCCESS • Raise awareness • Information/training • Easy to deal with individual cases • Specifics of each case • Workers’ compensation • Contact with employer

More Related