This course is part of a series of short courses offered by the American College of Medical Toxicology on contemporary issues in environmental toxicology and environmental health developed by leading authorities in medical toxicology, under the direction of Drs. Michael Kosnett, Charles McKay and Paul Wax.

Developed By:

Learning Objectives:

1. Describe sources of particulate matter and how it affects air quality.
2. Appraise air quality trends and interpret their relevance for exposures and health effects.
3. Define and assess the health status of individuals and populations, including determinants of health and illness, factors contributing to health promotion and disease prevention, factors influencing the use of health services, and epidemiology (e.g., incidence, prevalence) of diseases.
4. Identify available resources to investigate and manage particulate matter exposures.

Funding for this web-based learning module was made possible (in part) by the cooperative agreement award number 1U61TS000117-05 from the Agency for Toxic Substances and Disease Registry (ATSDR). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Created: February 2011

Learning Objectives

• Define climate change.
• Explain the "Greenhouse Effect".
• Identify common health impacts associated with climate change.
• Explain the potential relationship of birth outcomes and climate change.
• Explain how health care providers can assist patients in addressing health effects due to climate change.
• Identify at least one way you can work as a team with your community to help residents deal with the effects of climate change.

Developed By

• Laura Anderko, Phd, RN, Professor, Endowed Chair, and Director Region 3 PEHSU, Georgetown University
• Jerome Paulson, MD, FAAP, Medical Director, Pediatric Environmental Health Specialty Units - East

Developed By:

Learning Objectives:

• Explain why clinicians should be knowledgeable about the exposure history process.
• Identify the possible sources of toxicants from indoor air pollution, in the home and environment.
• Describe the components of an exposure history.
• Identify specific questions asked in the occupational history.
• Identify specific questions asked in the environmental history.
• Evaluate a possible temporal relationship between patient’s symptoms and patient’s home and surrounding environment.
• Recognize resources available that help identify toxicants.

Funding for this web-based learning module was made possible (in part) by the cooperative agreement award number 1U61TS000117-05 from the Agency for Toxic Substances and Disease Registry (ATSDR). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Created: July 2013

This course qualifies for CME, CNE, CEU, and CECH provided by the Centers for Disease Control. 

This course is part of a series of short courses offered by the American College of Medical Toxicology on contemporary issues in environmental toxicology and environmental health developed by leading authorities in medical toxicology, under the direction of Drs. Michael Kosnett, Charles McKay and Paul Wax.

Developed By:

Learning Objectives:

• Describe initiating and exacerbating factors in environmentally-induced pediatric asthma.
• List 6 key components of modern pediatric asthma management.
• Identify relevant community and public health resources involved in asthma response.

Funding for this web-based learning module was made possible (in part) by the cooperative agreement award number 1U61TS000117-05 from the Agency for Toxic Substances and Disease Registry (ATSDR). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Created: October 2013

This course is part of a series of short courses offered by the American College of Medical Toxicology on contemporary issues in environmental toxicology and environmental health developed by leading authorities in medical toxicology under the direction of Drs. Michael Kosnett, Charles McKay and Paul Wax.  

Developed By:

• Describe the carcinogenicity classifications of various agencies (i.e. IARC, ACGIH, NTP, NIOSH), methods for determining the classification status of a given agent, nuances of individual definitions, and scientific uncertainty associated with classification
• Distinguish between exposure and dose and describe the importance of intensity, chronicity, route, and individual and population susceptibility on carcinogenicity
• Understand the fundamentals underlying various in vitro mutagenicity and carcinogenicity studies, laboratory animal studies, and human epidemiology or surveillance studies and the strength and limitations of each of these modalities
• Familiarity with EPA computational models for distribution of toxicants in various media, physical and chemical properties that affect distribution, the use of models in risk assessment, and their limitations
• Describe the four components of risk assessment, extrapolation and the use of protection factors, and the scientific uncertainties associated with risk assessment

Funding for this web-based learning module was made possible (in part) by the cooperative agreement award number 1U61TS000117-05 from the Agency for Toxic Substances and Disease Registry (ATSDR). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Created: September 2014

  

CE Origination Date – 04/19/17
CE Expiration Date – 04/19/19

The goal of this course is to enhance the knowledge of physicians and other healthcare providers about the health impacts of marijuana exposure among the pediatric population. By enhancing their knowledge, physicians and other healthcare providers can better assess pediatric patients who may suffer symptoms caused by marijuana exposure, provide informed guidance to their patients' caregivers, and advocate for stronger legislation to support exposure prevention. 

Learning Objectives

1. Describe how marijuana legislation has affected the incidence of marijuana exposures in pediatric populations.
2. Recognize the basic pharmacology, pharmacokinetics, and methods of marijuana use.
3. Explain marijuana urine testing.
4. Describe the clinical effects of marijuana exposure in children and treatment for pediatric marijuana intoxication.
5. Identify strategies to prevent unintentional pediatric exposures

Developed By

George Sam Wang, MD, FAAP
Assistant Professor of Pediatrics
Section of Emergency Medicine, Medical Toxicology
Department of Pediatrics
University of Colorado Anschutz Medical Campus, Children's Hospital Colorado
Aurora, CO
 
Dr. Wang, completed his pediatric residency and pediatric emergency medicine fellowship at Children's Hospital Colorado/Anschutz Medical Campus, and his medical toxicology fellowship at the Rocky Mountain Poison and Drug Center at Denver Health. He is an Assistant Professor of Pediatrics at Children's Hospital Colorado/Anschutz Medical Campus where he is a PEM and toxicology attending.  

This course qualifies for CME, CNE, CEU, and CECH provided by the Centers for Disease Control. 

This is a two-part course developed by the Pediatric Environmental Health Specialty Unit Program. The course will focus on the impact of acute and chronic pesticide exposures on human health at vulnerable stages of in utero and pediatric development, with consideration of risk reduction. 

Part I: Acute Exposures and Recognition

Part II: Chronic Exposures and Prevention

Learning Objectives

1. Implement strategies that aid in overcoming diagnostic challenges associated with both acute and chronic pesticide exposures.
2. Describe the signs and symptoms of acute organophosphate, carbamate, and pyrethroid poisoning in children given a set of pediatric case facts.
3. Discuss the pediatric morbidities associated with early life pesticide exposure based on current toxicological and epidemiological data.
4. Identify the appropriate anticipatory guidance that enables patients to limit childhood pesticide exposures given relevant case information

Developed By

Catherine Karr, MD, PhD, MS
University of Washington, Seattle
PEHSU Region 10 

Dr. Catherine Karr is a board-certified pediatrician with specialty training in environmental medicine. She received her M.D., M.S. in Toxicology/Environmental Health, and Ph.D. in Epidemiology at the University of Washington. She practices primary care general pediatrics and specialty environmental medicine consultation at UW Physicians Pediatric Care Center – Roosevelt in Seattle. She is also Co-Director of Northwest PEHSU (Region 10).

Margaret Willis, MPH, BSN
University of Washington Medical Center, Seattle

Margaret Willis received her MPH in Environmental and Occupational Health from the University of Washington, with a a special focus on pediatric environmental health issues. In addition to working as a clinical nurse in acute and community care settings for over a decade, she has worked as an educational assistant for the Northwest PEHSU, and completed a fellowship on policy issues in reproductive health from the University of California, San Francisco.

Learning Objectives

• Identify common sources of plasticizers.
• Describe the populations most at risk for exposure to plasticizers.
• Identify at least two questions you can ask to assess your patients' risk for exposure to plasticizers.
• Select at least two appropriate recommendations for your the at-risk patient.

Developed By

• Charles McKay, MD, FACMT, FACEP; Immediate Past President, American College of Medical Toxicology; Pediatric Environmental Health Specialty Units 
• Marya Zlatnik, MD, MMS; Professor of OB/GYN and MFM, University of California San Francisco

Learning Objectives

• Identify common sources of organic solvents.
• Describe the populations most at risk for exposure to organic solvents.
• Identify at least two questions you can ask to assess your patients' risk for organic solvent exposure.
• Select at least two appropriate recommendations for the at-risk patient.

Developed By

• Charles McKay, MD, FACMT, FACEP; President, American College of Medical Toxicology; American College of Medical Toxicology; Pediatric Environmental Health Specialty Units
• Erica Burt, MPH, Freelance Environmental Health Consultant; Chicago IL.

Learning Objectives

• Describe the pathways of radon gas exposure.
• Identify the populations most at risk for radon gas exposure.
• Assess your patients' risk for radon gas exposure.
• Select appropriate recommendations for the at-risk patient.

Developed By

• Charles McKay, MD, FACMT, FACEP; President, American College of Medical Toxicology; American College of Medical Toxicology; Pediatric Environmental Health Specialty Units

Learning Objectives

• Describe the pathways of environmental tobacco smoke exposure. 
• Identify the populations most at risk for environmental tobacco smoke exposure.
• Assess your patients' risk for environmental tobacco smoke exposure.
• Select appropriate recommendations for the at-risk patient.

Developed By

• Charles McKay, MD, FACMT, FACEP; President, American College of Medical Toxicology
• Carrie Dickenson, MA, Senior Program Manager, ACMT
• Acknowledgement: Debra Goniwicha, LMSW; Case Manager, Northside General Hospital

Learning Objectives

• Describe the pathways of chemical flame retardant exposure.
• Identify the populations most at risk for chemical flame retardant exposure.
• Assess your patients' risk for chemical flame retardant exposure.
• Select at least two appropriate recommendations for the at-risk patient.

Developed By

• Charles McKay, MD, FACMT, FACEP; President, American College of Medical Toxicology
• Laura Distelhorst, MSN, PNP, RN; Assistant Professor, Case Western Reserve University

Learning Objectives

• Identify differences between organic and inorganic lead (Pb).
• Describe the pathways of lead exposure.
• Identify the populations most at risk for lead exposure.
• Assess your patients' risk for lead exposure.
• Select appropriate recommendations for the at-risk patient.

Developed By

• Charles McKay, MD, FACMT, FACEP; President, American College of Medical Toxicology
• Anna Engstrom, PhD Candidate, University of Washington School of Public Health
• Michaella Ann Pain, MPH, Project Manager, University of California San Francisco Medical Center

Learning Objectives

• Identify at least three common sources of methylmercury.
• Describe the four steps of formation of methylmercury.
• Identify at least two populations most at risk for exposure to methylmercury.
• List four risks for patients for methylmercury exposure.
• Recognize the appropriate recommendations for at -risk patients exposed to methylmercury.

Developed By

• Charles McKay, MD, FACMT, FACEP; President, American College of Medical Toxicology
• Anna Engstrom, PhD Candidate, University of Washington School of Public Health
• Michaella Ann Pain, MPH, Project Manager, University of California San Francisco Medical Center

Learning Objectives

• Identify common sources of pesticide residues.
• Describe the populations most at risk for exposure to pesticide residues.
• Assess your patients’ risk for pesticide residue exposure.
• Select appropriate recommendations for your at -risk patient.

Developed By

• Charles McKay, MD, FACMT, FACEP; President, American College of Medical Toxicology
• Michaella Ann Pain, MPH, Project Manager, University of California San Francisco Medical Center
• Acknowledgement: Megan Cartwright, PhD Candidate, University of Washington

Learning Objectives

• Identify three common sources of carbon monoxide
• Describe two populations most at risk for carbon monoxide poisoning
• Identify three effects of carbon monoxide poisoning
• Identify two appropriate methods for treatment of carbon monoxide poisoning
• Recognize three patients’ risk for carbon monoxide exposure
• Identify two appropriate methods for detecting and preventing carbon monoxide exposure

Developed By

• Charles McKay, MD, FACMT, FACEP; President, American College of Medical Toxicology
• Anna Engstrom, PhD Candidate, University of Washington School of Public Health
• Michaella Ann Pain, MPH, Project Manager, University of California San Francisco Medical Center

Learning Objectives:

• How toxic agents can affect male or female reproduction
• How reproductive hazardous can influence the developing embryo and fetus
• Describe the FDA Pregnancy Risk categories
• Describe the risk due to contaminants in breast milk

Funding for this web-based learning module was made possible (in part) by the cooperative agreement award number 1U61TS000117-05 from the Agency for Toxic Substances and Disease Registry (ATSDR). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Created: August 2013

CE Origination Date – 03/07/16
CE Expiration Date – 03/07/20

This course will focus on environmental exposures and pollutants within the school setting and their impact on human health at vulnerable stages of pediatric development, with consideration of risk reduction. 

Learning Objectives

1. Identify areas of exposure in the school environment and the special susceptibilities of school populations
2. Discuss the connections between a school’s indoor environment to both student health and academic performance
3. Identify methods for creating a healthy indoor school environment
4. Identify strategies to overcome barriers to maintaining a healthy indoor environment

Developed By

Larry Lowry, PhD
University of Texas Health Science Center at Tyler
Tyler, Texas
Professor, Occupational Health Sciences
Senior Program Consultant, Southwest Center for Pediatric Environmental Health
Pediatric Environmental Health Specialty Unit, Region 6

Dr. Larry Lowry served as the Director of the Southwest Center for Pediatric Health (SWCPH) from 2001-2014. He is the current Senior Program Consultant to the SWCPEH/PEHSU Region 6 sited at Texas Tech School of Medicine, El Paso. He has extensive experience in health risk communication with schools and school nurses. 

Endocrine Disrupting Chemicals in Consumer Products is a three-part series of interactive, self-paced eLearning modules. The goal of this series is to enhance the knowledge of physicians and other healthcare providers about endocrine disrupting chemicals (EDCs) including populations who may be vulnerable to exposure, identification of EDCs in consumer products, potential health effects of exposure, and exposure prevention strategies. By enhancing their knowledge, physicians and other healthcare providers can better assess patients who may be exposed to EDCs in consumer products. This series includes the following courses:

Endocrine Disrupting Chemicals in Consumer Products: Introduction

• Define endocrine disrupting chemicals (EDCs)
• Identify critical periods of life when humans are most vulnerable to EDCs 

Endocrine Disrupting Chemicals in Consumer Products: Identification and Health Effects

• Identify consumer products that have been found to contain EDCs
• Describe the health effects of EDCs commonly found in consumer products

Endocrine Disrupting Chemicals in Consumer Products: Prevention

• Recognize prevention strategies to minimize EDC exposure in vulnerable populations
• Apply prevention strategies and risk communication to a patient scenario

Developed By

Timur Durrani, MD, MPH

Medical Director, Health Services, Lawrence National Laboratory, Berkeley, CA
Pediatric Environmental Health Specialty Units, Region 9

Dr. Durrani an Associate Clinical Professor of Medicine at the University of California San Francisco, where he holds appointments in the Department of Medicine, Division of Occupational and Environmental Medicine and Department of Family Medicine. Dr. Durrani earned his Medical Degree from the University of Arizona, where he also earned his Master of Public Health. He holds quadruple board certifications in Family Medicine, Preventive Medicine, Occupational Medicine and Medical Toxicology. His academic responsibilities include teaching medical and pharmacy students, as well as graduate medical trainees including Emergency Medicine, Occupational and Environmental Medicine residents, and Medical Toxicology Fellows. As a consultant for the Medical Toxicology Service, he provides clinical care for acutely poisoned patients at the San Francisco General Hospital, as well as outpatient Medical Toxicology consultations through the UCSF Occupational and Environmental Medicine Faculty Practice. He serves as Medical Toxicology consultant for the Agency for Toxic Substances and Disease Registry, Region 9, and the Environmental Protection Agency, Region 9. Dr. Durrani has publications in basic science and public health disciplines, and has presented abstracts in neurotoxicology.

Katelyn Wong
University of Connecticut School of Medicine
Pediatric Environmental Health Specialty Unit, Region 9

Katelyn is currently a third-year medical student with prior experience with literature review and research previously in undergraduate studies and medical school