Western Occupational & Environmental Medical Association
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CME Webinars – 2012

Following the live broadcast, WOEMA members may view and listen to the webinar on-line and then complete the questionnaire in order to receive credit.


TOPIC: What to Watch for in Traumatic Brain Injury
Aired on December 19, 2012, noon PST

Speaker: Jordan A Firestone, MD, PhD, MPH Clinical Associate Professor of Medicine, Medical Director of Occupational Health, Stanford University

Description: Traumatic Brain Injury (TBI) is an important problem in OEM. It may affect workers of any age and in any profession.  In this webinar, Dr. Firestone will review the newest information related to the prevention, evaluation, and management of TBI.

Learning Objectives – Participants will be able to:

  • Learn about the epidemiology of Traumatic Brain Injury (TBI) and controls to mitigate risk of TBI.
  • Describe the pathophysiology of concussion and Chronic Traumatic Encephalopathy (CTE).
  • Develop an approach to the evaluation of TBI, including indications for diagnostic testing.
  • Develop a plan to manage the sequelae of TBI, including triggers for escalation of care.
  • Know the steps in a recommended process of Return-to-Work/Return-to-Play following TBI.

Speaker: Jordan A Firestone, MD, PhD, MPH

Dr. Firestone is board-certified in both neurology and occupational medicine. He has extensive training and experience in evaluating and managing patients with traumatic brain injury.  After attending the University of Colorado School of Medicine, MD/PhD program (completing a PhD in neuropharmacology, 1993; MD, 1995), he went to the University of Washington, where he did a medicine internship (1995-96), neurology residency (1996-99), and occupational & environmental medicine fellowship (1999-2001). He then joined the UW faculty, where he became medical director of the UW-Harborview OEM Clinic and Center of Excellence for Chemically Related Illness, and UW Center of Occupational Health & Education. While in Seattle, he served on the board and as President of the NW component of ACOEM. He recently moved to California, joining Stanford University as a Clinical Associate Professor of Medicine and Medical Director of the Stanford University Occupational Health Center. His professional interests are naturally focused on occupational & environmental neurology. He has an active clinical practice, he has conducted research related to occupational risks for neurodegenerative disease, and he enjoys teaching on various topics related to neuropsychological health in the workplace.

Dr. Firestone has no conflict of interest to disclose.

[Download Presentation]

CREDIT: WOEMA is accredited bythe Institute of Medical Quality/California Medical Association to provide continuing medical education for physicians. WOEMA takes responsibility for the content, quality, and scientific integrity of this CME activity.

WOEMA designates this educational activity when combined with completion and submission of the on-line questionnaire, for a maximum of 1.0 AMA PRA Category 1 CreditTM. CME Certificates are issued and e-mailed to those who successfully participate and complete the webinar.


TOPIC: SB 863: New California Workers’ Comp Regulations for January 1, 2013 That You Need to Know!
Aired on Wednesday, December 12, 2012

Presenters: 
– Rupali Das, MD, MPH, FACOEM 
Executive Medical Director, Division of Workers’ Compensation, Department of Industrial Relations
– Destie Overpeck, 
Acting Administrative Director, Division of Workers’ Compensation
– Constantine J. Gean, MD, MBA, MS, FACOEM, 
Regional Medical Director, Liberty Mutual Insurance
– Bernyce Peplowski, DO, MS, 
Vice President, USHW CA & Chief Medical Officer, California Clinical Operations, US HealthWorks
– Cathryn Pine, Assistant Vice President and Director of Operations, California Claims Legal Department, Zenith

Description:  Join this important webinar featuring the acting Administrative Director and the Medical Director of California’s Division of Workers’ Compensation as well as other experts.

As of January 1, 2013, California physicians must adjust to major reforms in the Workers’ Compensation system due to newly enacted SB 863. Changes include new methods for settling treatment disputes (Independent Medical Review – IMR) and billing (Independent Bill Review – IBR), as well as changes in permanent disability compensation to injured workers, MPN rules, and many other issues. In 2014, major changes will affect how physician services are paid.

Presenters will provide up-to-the minute information on the development of SB 863’s numerous regulations.  We hope you can join us for this timely, essential, and unique WOEMA presentation.

[Presentation- Log in Is Required] 

This is a non-CME Webinar.


TOPIC: Therapeutic Use and Misuse of Metal Chelation Therapy
Aired on October 31, 2012, 12 noon // Reviewed November 1, 2012

Available until November 1, 2015

Speaker: Michael Kosnett, MD, MPH Associate Clinical Professor in the Division of Clinical Pharmacology and Toxicology at the University of Colorado School of Medicine and Associate Adjunct Professor in the Department of Environmental and Occupational Health at the Colorado School of Public Health. 

Description:
 The prompt use of chelating agents to treat, acute, life-threatening intoxication is an indication that is largely supported by experimental animal data and limited clinical research. Although chelating agents administered for chronic intoxication may accelerate the excretion of heavy metals, their therapeutic efficacy in terms of decreased morbidity and mortality is largely unestablished. Recent investigations suggest that their use in such settings might be associated with deleterious effects. The use of post-chelation challenge urinary metal excretion as a basis to identify patients who will derive therapeutic benefit from chelation has not been validated.

Learning Objectives – Participants will be able to:

  • Identify key studies that constitute the scientific basis for the use of chelation therapy
  • Recognize adverse effects of chelation displayed in animal experiments and clinical experience
  • Understand the limitations and pitfalls of chelation challenge tests that measure urinary metal concentration in the clinical evaluation of patients

Speaker: Michael Kosnett, MD, MPH

Dr. Kosnett is an Associate Clinical Professor in the Division of Clinical Pharmacology and Toxicology at the University of Colorado School of Medicine, and an Associate Adjunct Profession in the Department of Environmental and Occupational Health at the Colorado School of Public Health. Dr. Kosnett has a clinical and research interest in the human toxicology of heavy metals, particularly arsenic, lead, and mercury. He is the Chair of the Work Group on Lead Consumer Products of the CDC Advisory Committee on Childhood Lead Poisoning Prevention. He currently serves on several EPA Science Advisory Board panels pertaining to lead in air, dust, and water. He is a current member of the NIOSH Board of Scientific Counselors. He is a longstanding advisor the the Occupational Lead Poisoning Prevention Program of the California Department of Public Health. He has served on an advisor on heavy metal chelation to the World Health Organization International Program on Chemical Safety, and to the nongovernmental agency Medecins Sans Frontieres.

Dr. Kosnett has no conflict of interest to disclose.

[Download Presentation]

CREDIT: WOEMA is accredited bythe Institute of Medical Quality/California Medical Association to provide continuing medical education for physicians. WOEMA takes responsibility for the content, quality, and scientific integrity of this CME activity.

WOEMA designates this educational activity when combined with completion and submission of the on-line questionnaire, for a maximum of 1.0 AMA PRA Category 1 CreditTM. CME Certificates are issued and e-mailed to those who successfully participate and complete the webinar.


TOPIC: Occupational Ophthalmology: How to Fulfill the Visual Requirements of the ADA and ADAA Disability Act And Amendments
Aired on Wednesday, August 29, 2012

Speaker: Bernard R. Blais, MD, FACOEM, FAAO, FACS 
 President of Blais Consulting, Ltd. In Clifton Park, New York. 

Description:
 The Occupational Medicine Provider encounters vision screenings as part of numerous occupational health examinations. It is important to understand the regulatory requirements and ADA/ADAAA considerations involved with vision screenings. This webinar is intended to increase awareness of the medical-legal and regulatory complexities relating to vision qualifications for occupational positions, and to help Occupational Medicine Providers become more familiar with the wide array of tools used in visual acuity testing and color vision testing, while maintaining compliance with ADA/ADAAA.

Learning Objectives – Participants will be able to:

  • Discussion of the requirements of the ADA and ADAAC 2009
  • Discussion of how does one answer the question of how do you fulfill the visual requirements under ADA.

Speaker: Bernard R. Blais, MD, FACOEM, FAAO, FACS

Dr. Blais has 20 years’ experience practicing ophthalmology and 18 years of occupational medicine as Medical Director. He has more than 9 years’ experience as an expert in occupational ophthalmology. His latest publications are Color Vision in the Occupational Setting: Analysis and Testing and AMA Guides™ to the Evaluation of Ophthalmic Impairment and Disability – Measuring the Impact of Visual Impairment on Activities of Daily Life.

Dr. Blais has no conflict of interest to disclose.

[Download presentation]

CREDIT: WOEMA is accredited bythe Institute of Medical Quality/California Medical Association to provide continuing medical education for physicians. WOEMA takes responsibility for the content, quality, and scientific integrity of this CME activity.

WOEMA designates this educational activity when combined with completion and submission of the on-line questionnaire, for a maximum of 1.0 AMA PRA Category 1 CreditTM. CME Certificates are issued and e-mailed to those who successfully participate and complete the webinar.


TOPIC: Occupational Dermatology
Aired on Wednesday, June 27, 2012

Speaker: Heather P. Lampel, MD MPH 
Assistant Professor of Dermatology at Duke University in Durham, North Carolina. 

Description:
 The Occupational Medicine Provider may encounter unique occupational skin conditions.  It is important to be able to identify these conditions and provide proper diagnosis and treatment.  This lecture is intended to help the Occupational Medicine Provider become more comfortable with diagnosing and treating occupational contact dermatitis, and will become familiar with common allergens in the workplace.  Patch testing will be discussed and treatment options will be explored.

Learning Objectives – Participants will be able to:

  • Become familiar with the difference between irritant and allergic contact dermatitis
  • Understand the role of patch testing in occupational allergic contact dermatitis
  • Explore common allergens in the workplace
  • Review treatment options for occupational dermatitis

Speaker: Heather P. Lampel, MD MPH

Dr. Lampel is an Assistant Professor of Dermatology at Duke University in Durham, North Carolina. She specializes in general and occupational contact dermatitis, and performs extensive patch testing at Duke. She also provides skin cancer screening, surgical treatment, general dermatological care and facial rejuvenation. She is board-certified in both Occupational and Environmental Medicine and in Dermatology.

Dr. Lampel has no conflict of interest to disclose.

[Download presentation]

CREDIT: WOEMA is accredited bythe Institute of Medical Quality/California Medical Association to provide continuing medical education for physicians. WOEMA takes responsibility for the content, quality, and scientific integrity of this CME activity.

WOEMA designates this educational activity when combined with completion and submission of the on-line questionnaire, for a maximum of 1.0 AMA PRA Category 1 CreditTM. CME Certificates are issued and e-mailed to those who successfully participate and complete the webinar.


TOPIC: Lumbar Spinal Fusion in Workers Compensation: Can We Help Patients to Make Better Decision?
Aired Wednesday, April 25, 2012

Speaker: Michael Erdil, MD, FACOEM 
Medical Director for Occupational and environmental Health Network Occupational Disability Solutions, Medical Director for Health Direct Inc., Associate Occupational Medical Staff at Johnson Memorial Medical Center, Assistant Professor at the University of Connecticut Health Center 

Description:
 Low back pain is one of the most common conditions evaluated by occupational medicine physicians. Approximately 80-90% of the adult population will experience an episode of low back pain temporarily limiting activities during their lifetime, and perhaps 7% of the population note chronic low back pain. Low back pain is a major factor contributing to health care costs, lost work productivity and disability. Recent studies have noted a significant rise in complex lumbar spine fusion surgery to treat chronic pain from degenerative disc disease. Surgeons and patients often overestimate expected benefit from spinal surgery. Despite the proliferation of lumbar fusion and instrumentation, rates of low back disability have not declined. Surgical complications, hardware issues, repeat surgeries contribute to post-fusion disability and cost. Of concern, approximately 2/3 of patients treated with lumbar fusion may continue to be disabled at 2 years post surgery, and opioids prescribed post-fusion pose a considerable risk for subsequent mortality. Recent randomized trials have suggested equivalent outcomes for non-operative treatment of lumbar spine degenerative disc disease vs. fusion without these significant post-operative risks. Therefore, occupational medicine physicians must play a more prominent role in patient education before and after spine surgery referral to assist patients with making informed choices. This session will overview the supportive scientific evidence and guidelines including Cochrane, ACOEM, ODG for lumbar spine fusion vs. non-operative care for the treatment of degenerative disc disease, explain potential adverse outcomes from lumbar fusion, and discuss strategies to assist occupational medicine physicians with patient education and decision making when faced with treatment recommendations for lumbar fusion.

Learning Objectives – Participants will be able to:

  • Identify evidence based medicine regarding lumbar spine fusion for degenerative disc disease
  • Understand evidence regarding lumbar spine fusion vs. non-operative care
  • Recognize potential adverse outcomes
  • Improve provider confidence and knowledge in providing patient information when considering lumbar fusion

Speaker: Michael Erdil, MD, FACOEM

Dr. Erdil is the Medical Director for Occupational and Environmental Health Network Occupational Disability Solutions in Marlborough MA. Dr. Erdil also serves as the Medical Director for Health Direct Inc., in Farmington, CT, and for Johnson Occupational Medicine Center. Dr. Erdil is on the Associate Occupational Medical Staff at Johnson Memorial Medical Center in CT, on the Courtesy Occupational Medical Staff at New England Baptist Hospital in MA, on the Active Medical Staff at Hartford Hospital in CT, and is an Assistant Professor at the University of Connecticut Health Center. Dr. Erdil is Board Certified in Occupational and Environmental Medicine, and is a Fellow of the American College of Occupational and Environmental Medicine.

Dr. Erdil has no conflict of interest to disclose.

CREDIT: WOEMA is accredited bythe Institute of Medical Quality/California Medical Association to provide continuing medical education for physicians. WOEMA takes responsibility for the content, quality, and scientific integrity of this CME activity.

WOEMA designates this educational activity when combined with completion and submission of the on-line questionnaire, for a maximum of 1.0 AMA PRA Category 1 CreditTM. CME Certificates are issuedand e-mailed to those who successfully participate and complete the webinar.


TOPIC: Vaccinations in Health Care: Influenza and Other Current Issues
Aired Thursday, February 16, 2012

Speaker: Robert J. Harrison, MD, MPH, Clinical Professor of Medicine, UCSF; Chief, Occupational Health Surveillance and Evaluation Program, California Department of Public Health

Description:
A work group of the National Vaccine Advisory Committee (NVAC) has recommended in a draft report announced December 15, 2011 that health care facilities should require health care personnel to receive influenza vaccination to ensure patient safety (seehttp://www.hhs.gov/nvpo/nvac/subgroups/nvac_adult_immunization_work_group.pdf). The report recommends that if a facility or an employer cannot achieve the Healthy People 2020 vaccination coverage rate of 90% or better, the most effective mechanism to rapidly reach and maintain this goal is to institute a mandatory vaccination policy. The Federal Occupational Safety and Health Administrationand the Service Employees International Union have noted their opposition to a universal mandate in comments on the draft report. The full NVAC committee will meet to review and vote on the draft report on February 7-8, 2012. In addition, beginning in 2013 the Centers for Medicare and Medicaid Services (CMS) will require reporting of aggregate influenza vaccination data through the National Healthcare Safety Network as a quality measure for hospital reimbursement. Occupational health practitioners should be aware of these developments in light of their current institutional policies regarding influenza vaccination, and consider making decisions about programs based on currently available data on efficacy. Legal and ethical implications should also be considered in formulating policies and procedures.

Learning Objectives – Participants will be able to:

  • Become familiar with the evidence basis for workplace influenza vaccination programs;
  • Consider the legal and ethical implications of mandatory vaccination policies;
  • Understand the forthcoming requirements for hospital reporting of influenza vaccination of health care personnel.

Speaker: Robert Harrison, MD, MPH

Dr. Robert Harrison is a Clinical Professor of Medicine at UC San Francisco, and Chief of the Occupational Health Surveillance and Evaluation Program at the California Department of Public Health. He has collaborated with the CDC on a multi-state pilot study of influenza vaccination reporting in health care facilities. He has extensive experience with developing and implementing occupational health surveillance and monitoring programs at UCSF, and has investigated numerous injury and disease outbreaks in California.

Dr. Harrison has no conflict of interest to disclose.

[Download Presentation]

CREDIT:WOEMA is accredited bythe Institute of Medical Quality/California Medical Association to provide continuing medical education for physicians. WOEMA takes responsibility for the content, quality, and scientific integrity of this CME activity.

WOEMA designates this educational activity when combined with completion and submission of the on-line questionnaire, for a maximum of 1.0 AMA PRA Category 1 CreditTM. CME Certificates are issuedand e-mailed to those who successfully participate and complete the webinar.


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