Other Programmatic Elements Identified by the Committee - Agriculture Forestry and Fishing Research at NIOSH - page 134

extramural projects that revolve around health services research or training and
numerous extramural projects of which health services research or training is an
important part. From 1990-2006, NIOSH funded up to 16 Education and Research
Centers (ERCs) across the United States. Many ERCs offer education and training
for medical providers, safety professionals, and others who work with agricultural
health and safety issues. NIOSH describes the emphasis as follows: “The core areas
of programming are industrial hygiene, occupational health nursing, occupational
medicine, and occupational safety. Programs are developed to meet the educational
needs of these groups as well as other professionals working in the field of occu-
pational safety and health” (ERC, 2007). In addition, NIOSH has funded at least
one program to train lay health advisers, also called promotoras. The ERCs provide
training programs in agriculture, forestry, and fishing.
Inputs
The main inputs to health services research, education, and training have
been NIOSH funds distributed to the agricultural research centers (ARCs) and
the ERCs, although the committee is aware that NIOSH clinicians and scientists
have provided faculty expertise to the centers. University-affiliated centers have
also been major contributors to the programs that have been developed with
faculty and staff outside the centers as well as those hired with ERC funds. The
documentation provided by NIOSH is unclear on the role of the private sector.
For example, the Mary Imogene Bassett Hospital—affiliated with the New York
Center for Agricultural Medicine and Health—has been instrumental in launching
studies of respiratory, auditory, and musculoskeletal problems faced by farmers;
the study results have been used in the design of new outreach capacity and in
clinical training. The Marshfield Clinic of Wisconsin fielded similar outreach and
training activity. NIOSH documentation, however, does not mention such efforts.
Collaborations with and contributions from other local and regional community
medical facilities are likely to have been critical for the success of such initiatives.
Documentation of them was difficult to find in the materials provided by NIOSH
for use by the committee.
Activities
Most of the health services research and training activities were reported for
the agricultural sector; very few could be found for forestry and fishing. A number
of the health services research and training programs in agriculture are specifically
designed to offer health or safety training directly to farmers or farm workers in
addition to educating medical or safety professionals. That dual approach to edu-
cation is desirable for the entire sector.