New and Emerging Research in Agricultural, Forestry, and Fishing Safety and Health - Agriculture Forestry and Fishing Research at NIOSH - page 165

their wives to explore the potential causes of cancer and other diseases—is a good
example of extensive collaboration among NIOSH, the National Cancer Institute,
the National Institute of Environmental Health Sciences, EPA, and various universi-
ties and institutes (National Cancer Institute, 2007). Clinician scientists would need
to collaborate with laboratory-based scientists and epidemiologists to facilitate
translation of knowledge into a form that can be communicated directly to AFF
workers and those who provide health and safety services to them. Representatives
of AFF communities need to play a large role in that dissemination process. Suc-
cessful knowledge translation and dissemination will require that ways be found
to overcome barriers of geography, economics, language, culture, and politics. A
rigorous evaluation plan needs to be in place for all efforts of this nature.
The focus of health effects research may need to change as the AFF Program
evolves. It may be wise to review priorities and accomplishments before the AFF
Program enters its next phase, with input from NIOSH intramural and extramural
researchers, scientists who are studying AFF issues through other funding streams,
AFF workers, and medical and safety professionals who serve the AFF sector. Scien-
tific information obtained through the efforts of all scientists working in AFF needs
to be considered as future directions are determined. AFF workers from all levels
of the workplace hierarchy need to be at the table when priorities and approaches
to problems are considered.
Health Services Research and Training
NIOSH can identify useful structures that might function in advising the Edu-
cation and Research Centers (ERCs) and the Centers for Agricultural Disease and
Injury Research, Education, and Prevention (Ag Centers) so that training materials
developed for occupational venues are clinically accurate, reflect current practice
standards, integrate contemporary scientific and clinical findings, and are formally
vetted before they are released for general use under the aegis of NIOSH.
Clinical science relative to occupational exposure assessment and intervention
is advancing rapidly, including tools to identify workers with specific combinations
of genetic variants and environmental stressors that put them at higher than normal
risks of disease. NIOSH will need a mechanism to quickly feed such science into
training curricula. AFF safety and health professionals need appropriate translation
of the findings because they deal directly with AFF workers. Such discovery leads to
specifically targeted therapies and intervention techniques for disease prevention
and control—the very reason for conducting health services research and training.
Telehealth is an emerging application used to expand access to healthcare services
and training, especially for practitioners in rural communities: it serves as a means
of providing AFF worker populations with access to medical specialist consultations