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*** This podcast is provided by NECOEM and ACOEM solely for professional educational purposes and is not offered as a substitute for the personal care of a licensed medical professional.  The views expressed herein are those of the presenters and do not necessarily reflect a presenter's recommended practices nor NECOEM or ACOEM policy. NECOEM and ACOEM hereby disclaim any liability resulting from any action you may take, or choose not to take, in reliance on the content of this podcast, under any theory of liability or indemnity. *** The content of this podcast is proprietary and may not be repurposed or redistributed in any medium for any reason without the express, written consent of NECOEM or ACOEM.

Category: Instructions -- posted at: 10:52 AM

Nelson Haas, MD, MPH, FACOEM reviews the basic approaches to the evaluation of ankle and foot complaints in the occupational medicine setting. He also elaborates on the level of evidence and effectiveness of the treatment of various ankle and foot disorders. Dr. Haas is currently the  chairman of the Ankle-Foot Panel of the American College of Occupational Medicine Evidence Based Practice Committee. He serves as medical director of the occupational medicine clinic of North County Hospital in Newport, VT. You may refer to the handout as you listen to his lecture.


Glenn Pransky, MD, MOcch was selected to deliver the 2009 William B. Patterson Memorial Lecture for Excellence. In his lecture, he discusses three essential characteristics that distinguish program leadership from program development. He also elaborates on three important charectersitics linked to provider satisfaction in outpatient practice in Occupational Medicine. Dr. Pransky is the director of the Center for Disability Reserach at the Liberty Mutual  Reserach Institute in Hopkinton, MA. The Center is dedicated to scientific research on the return to work process, includes over a dozen active studies and has produced over seventy five scientific publications in the past eight years. Dr. Pransky is the author of numerous scientific articles on disability, measures of work related outcomes in occupational injuries and illnesses, treatment interventions, and screening for occupational disease. He is board certfied in both occupational medicine and internal medicine and holds faculty appointments as an Associate Professor in the Department of Family Medicine and Community Health at the University of Massachsetts Medical School in Worcester, MA and the Harvard School of Public Health.  You may follow Dr. Pransky's handout as you listen to his lecture.


Bill Ravanesi, MPH discusses events that have led to the acceleration of the revolution in "green and healthy" healthcare infrastructure and operations, both regionally and nationally. Furthermore, he identifies what the changes look like "on the ground", and how they may result in inproved patient outcomes and staff effectiveness, such as a reduction in fatigue, slips and falls, toxic exposures, etc. Bill Ravanesi is in his thirteenth year as Boston's regional director for Health Care Without Harm. He has a background in both public health and photojournalism, holding a master's degree in both fields. He is known nationally for his work in greening health care construction and operations. He has been awarded fellowships at the Ford foundation, Amherst College, Drexel University, and the National Endowment for the Arts. In addition to producing the award winning documentary Breath Taken: The Landscape and Biography of Asbestos, his latest video, A Healing Garden Grows in Bhopal was screend in Chicago in Spring 2009 at the Cleanmed Global Conference on Environmentally Sustainable Health Care. You may listen to his lecture while following his handout.


John Brusch, MD reviews the clinical presentation and treatment of the current flu virus and what we may expect for the disease in 2010. Dr. Brusch is board certified in Internal Medicine, Infectious Diseases and Geriatric Medicine. He serves as Associate Chief of Medicine for Cambridge Health Alliance and is Assistant Professor of Medicine at Harvard Medical School. You may refer to Dr. Brusch's handouts as you listen to his lecture.

Direct download: Seasonal_Influenza_Update_What_to_Expect_for_2010.mp3
Category: Occupational Medicine -- posted at: 8:13 PM

Stefanos Kales, MD, MPH discusses the relationship between obesity and obstructive sleep apnea as well as the relationship between obesity and motor vehicle crashes. You may listen to Dr. Kale's lecture while following his handouts. Dr. Kales is Associate Professor at Harvard Medical School and Director of the Occupational and Environmental Medicine residency program. He currently serves as Medical Director of Employee and Industrial Medicine at Cambridge Health Alliance. Dr. Kales focuses his research primarily on cardiovascular and metabolic factors such as obesity, their evolution over time and their effects in various working populations like emergency responders and drivers.


Ronald Eisenberg, MD discusses the benefits of eliminating the lateral view of chest xray testing in the routine pre-employment evaluation. Dr. Eisenberg is a practicing radiologist at the Beth Israel Medical Center and on the faculty of Harvard Medical School. He is the author of 100 articles and twenty books on radiology, including "Clinical Imaging: An Atlas of Differential Diagnosis" and "Radiology: An Illustrated History". Dr. Eisenberg is a non-practicing lawyer, a member of the California bar and author of five books on Jewish studies. You may listen to the lecture while following Dr. Eisenberg's handouts.


Dr. Ajay Wassan discusses the transition between acute/subacute pain to chronic pain and how to appropriately manage the use of opioids for these periods. Dr. Wassan is Assistant Professor of Anesthesiology and Psychitary at Harvard Medical School and is the Director of the Section of Clinical Pain Research at Brigham and Women's Hospital in Boston. He is board certfied in Pain Medicine and completed a fellowship training in Interventional Pain Medicine in addition to being board certficied in Psychiatry. He currently directs a clinical research program which includes clinical trials, quailitative studies and neuroimaging studies. He has particular expertise in the phsyciatric co-morbities of chronic pain and the use of opiods, neuropathic pain medications and psychotropic medications. You may follow Dr. Wassan's handouts while listening to his lecture.


John Spengler, PhD and Richard Donahue, MD, MPH identify human health impacts of fossil fuel combustion through summarizing the scientific data. They also discuss the importance of the physician's voice in the health policy arena to advocate for transitioning from fossil fuels to healthier energy systems. Dr. Donnahue practices for the Harvard University Health Services and is a member of the Massachusetts Medical Society Committee on Environmental Health. Dr. Spengler is the Akira Yamaguchi Professor of Environmental Health and Human Habitation in the Exposure, Epidemiology and Risk Program of the Department of Environmental Health at the Harvard University School for Public Health. Please refer to the handouts as you listen to their lecture.


Terrence Doorly, MD identifies the recent advances in surgical technology for low back pain and the currently available evidence based clinical guidelines for the role of surgery. Dr. Doorly is the Medical Director of Neurosurgery and Spine, The Musculoskeletal Center in Peabody, MA. He is also Associate Chief of Neurosurgery at the North Shore Medical Center in Salem, MA. Dr. Doorly has had a long standing interest in the nonsurgical management of musculoskeletal and spine disorders, the injured worker, and minimally invasive spine surgery. You may listen to Dr. Doorly's lecture while following his handouts. Enclosed also are his references.


Rose Goldman, MD/MPH discusses the health and safety regulations concerning adolescent workers in the US and provides an analysis of child labor and slavery abroad, potential health impacts and implications for the US. Dr. Goldman is currently Chief of the Division of Occupational and Envrionmental Health at the Cambridge Health Alliance. She is Associate Professor of Medicine at Harvard Medical School and Associate Professor in the Department of Environmental Health at the Harvard School of Public Health. You may also follow this lecture while referring to Dr. Goldman's handouts.

Direct download: Adolescent_and_Child_Labor_At_Home_and_Abroad.mp3
Category: Occupational Medicine -- posted at: 10:07 AM

Adam Forman Esq interprets the Family and Medical Leave Act from the employer's perspective in order to assist patients navigate the system. He also interprets the "legal bermuda triangle": the intersection of the FMLA, ADA and worker's compensation system. Mr. Forman advises and represents employers in a broad range of employment law matters, including discrimination, harassment and wrongful discharge litigation, non-competition and trade secret litigation, and litigation avoidance training. He has been recognized as one of the leading employment attorneys in Massachusetts by Chambers USA, The Guide of the World's Leading Labor and employment Lawyers and Boston Magazine. You may also listen to the podcast while following Mr. Forman's handouts.

Direct download: FMLA_A_Corner_of_the_Bermuda_Triangle.mp3
Category: Risk Management -- posted at: 9:25 AM

Stephen Wintermeyer, MD, MPH reviews important respiratory characteristics in selecting the optimum respirators for workers and the information obtained from PFT's in the evaluation of respirator safety. Dr. Wintermeyer is Associate Professor of Clinical Medicine in the Division of Pulmonary, Allergy, Critical Care and Occupational Medicine at Indiana University School of Medicine. He is board certified in Internal Medicine, Occupational Medicine, Pulmonary Medicine and Critical Care Medicine. His primary areas of interest include occupational asthma, hypersensitivity pneumonitis, indoor air quaility, tuberculosis and disaster preparedness. Please refer to Dr. Wintermeyer's handouts as you listen to his lecture.
Direct download: Respirator_Safety_in_Workers_with_COPD_and_Asthma.mp3
Category: Occupational Medicine -- posted at: 1:40 PM

David Lombardi, PhD describes the adverse implications of long working hours and how they increase the risk for occupational related injuries and errors. Dr. Lombardi is a senior research scientist at the Center for Injury Epidemiology at the Liberty Mutual Research Institute for Safety. He is also an Instructor of Injury Epidemiology and Prevention at the Harvard School for Public Health. He has published a number of articles in journals and textbooks in the area of long working hours and the prevention of occupational injuries. You may follow this podcast  with Dr. Lombardi's handouts.

Don Milton, MD, DrPH is the 2009 Harriet Hardy Award recipient, an annual award given by the board of directors of NECOEM. In his lecture, he discusses the three important causes of airborne transmitted infections and where influenza likely fits in this spectrum. He also elaborates on the currently available scientific data on the value of source control startegies. Since the fall of 2009, he assumed a new post as Director of the Maryland Institute for Applied Environmental Health at the University of Maryland School of Public Health. He is board certified in Internal and Occupational Medicine and has twenty years experience in an occupational medicine referral practice in central Massachusetts. He teaches courses on aerobiology, toxicology, indoor air quaility, respiratory epidemiology, physiology, pathology and pathophysiology.You may follow this lecture with Dr. Milton's handouts.

Thomas Gill, MD discusses the various maneuvers and tests used in the physical management of the shoulder joint. He also explains the initial management and treatment recommendations as well as the rationale behind return to work guidelines. Dr. Gill is Chief of the Sports Medicine Service of Massachusetts General Hospital and is Associate Professor of Orthopedic Surgery at Harvard Medical School.  He serves as the Medical Director of the Boston Red Sox and the head team physician for the New England Patriots. You may follow the podcast with Dr. Gill's handouts.

David Ring, MD, PhD reviews the differences between nociception and pain, disease and illness, impairment and disability, particularly as they relate to hand and arm injuries. He discusses a collaborative approach to occupational hand injuries that includes both mental and physical aspects of illness. Dr. Ring is Associate Professor of Orthopedic Surgery at Harvard Medical School and Medical Director of Research at the Orthopaedic Hand and Upper Extremity Service of Massachusetts General Hospital. He is an expert on trauma and post-traumatic reconstruction of the arm as well as the psychosocial aspects of arm illness. You may also listen to this podcast while following Dr. Ring's handouts.

Debra Lerner, MS, PhD explains the principles of health and productivity management and measurement and how to apply health and productivity principles to reducing the burden of depression. She also covers measurement methods using the Work Limitations Questionnaire (WLQ) and a new program to prevent the adverse impact of depression in the workplace. Dr. Lerner is a Senior Scientist within The Health Institute, a division of The Institute for Clinical Research and Health Policy Studies (ICRHPS), Tufts Medical Center in Boston. She is a national leader in research concerning the work and productivity impact of health problems and has served in an advisory capacity to a  wide range of public and private sector organizations.



Dr. Joel Stein discusses new insights in neurorecovery to stroke survivors, treatment modalities to maximize recovery and the concepts of physical impairment and recovery models as they relate to work. Dr. Stein is Physiatrist-in-Chief at the Department of Rehabilitation Medicine, New York Presbyterian Hospital, the Simon Baruch Professor and Chair at the Department of Rehabilitation Medicine, Columbia University College of Physicians and Surgeons, and Chief of the Division of Rehabilitation Medicine at Weill Cornell Medical College. Dr. Stein's clinical and research interests are in the area of stroke rehabilitation, with a particular on the use of robotic and other technologies to facilitate recovery after stroke. He has extensively published in the area of stroke rehabilitation, including scientific papers, review articles and books.

Direct download: Maximizing_Outcomes_in_Young_Stroke_Survivors.mp3
Category: Occupational Medicine -- posted at: 10:31 PM

Dr. Mel Glenn reviews the various clinical presentations for mild closed head injuries,  and pharmacotherapy and rehabilitation strategies for post concussive syndromes. Dr. Glenn is the Director of  Outpatient and Community Brain Injury Rehabilitation Medicine at Spaulding Rehabilitation Hospital in Boston and is also Associate Professor of Physical Medicine and Rehabilitation at Harvard Medical School. Dr. Glenn has been Project Director of the Spaulding/Partners Traumatic Brain Injury Model System at Harvard Medical School, a project funded by the National Institute on Disability and Rehabilitaion Research since 1998. Dr. Glenn has also been editor for the Update of Pharmacology column of Journal of Head Trauma Rehabilitation since its inception.



In 2008 NECOEM began to dedicate an annual conference lecture in honor of the late Dr. William B. Patterson, focusing on excellence in occupational health. NECOEM was pleased to select Kurt T. Hegmann, MD, MPH to deliver the first William B. Patterson Memorial Lecture of Excellence. In this presentation, he discusses principles for treatment approaches to evidence based medicine and the place for the art of medicine. Dr. Hegmann is Associate Professor and Center Director for the Rocky Mountain Center for Occupational Health at the University of Utah. He is current chair of ACOEM's Practice Guidelines Committee and has served as chair for the Ergonomics Committee for five years. He is lead physician and epidemiologist of two of the most extensive cohort studies funded to date on these subjects, one for the distal upper extremity and the other on the lower back. Dr. Hegmann teaches Occupational Injuries and Diseases, Occupational Epidemiology and Clinical Prevention.



Dr. Thomas Gill reviews basic clinical concepts in the examination and diagnosis of common shoulder and knee injuries seen by the occupational medicine provider.  His presentation is accompanied by colorful slides which may be found in the library section of necoem.org. Dr. Gill is currently  Associate Professor of Orthopedic Surgery at Harvard where he is also serving as Sports Medicine Fellowship Director. He serves as Associate Team Physician for the New England Patriots (NFL) and the Boston Bruins (NHL). He has authored numerous articles in peer reviewed journals, has lectured at many local and international conferences and has been invited faculty at numerous symposia.





In this panel, Dr. Edward Zuroweste and Attorney Channing Migner discuss the importance of cultural competence in dealing with immigrant workers. Understanding immigrant reporting of workplace injury claims and literacy effects on immigrant medical choices will also be reviewed.

Dr. Zuroweste is Assistant Professor of Medicine at Johns Hopkins School of Medicine and is Chief Medical Officer of the Migrant Clinicians Network, Inc., a national clinical network of providers who care for the mobile poor. He has given over 100 invited presentations on topics such as immigration and human rights, rural maternity care and underserved women, cultural competence, immunizations, HIV and tuberculosis.

Attorney Migner has practiced Massachusetts worker's compensation law since 1985. He is vice-chair of the ABA Workers Compensation Group of the Trial Insurance Practice Section and is member of the Board of Directors of WILG (Workers Injury Law and Advocacy Group). He is co-chair of the Massachusetts Bar Association Workers Compensation Section and is also a member of the Massachusetts Academy of Trial Attorneys.




Dr. Stefanos Kales reviews the major risk factors for obstructive sleep apnea and how these can be best utilized in screening DOT-regulated drivers. Dr. Kales is Assistant Professor of Medicine at Harvard Medical School and Assistant Professor of Occupational Medicine at the Harvard School of Public Health where he also directs the Harvard Occupational and Environmental Medicine Residency Program. He has participated in a wide range of research, advisory and teaching activities in three continents resulting in over 55 scientific publications and numerous invited presentations. He is on the editorial boards of Environmental Health Perspectives and the Archives of Environmental and Occupational Health.




Dr. George Theodore reviews the most prevalent foot and ankle disorders which occur in the work setting and factors which may affect return to work. He also reviews both operative and nonoperative forms of treatment. Dr. Theodore is board certified by the American Board of Orthopedic Surgery and is a fellow of the American Academy of Orthopedic Surgeons. He practices in Massachusetts General Hospital and teaches in Harvard Medical School. He serves as Assistant Team Physician for the Boston Red Sox and is a consultant to the New England Patriots and Boston Bruins. In 2005, he was named a top orthopedic foot and ankle specialist by Boston Magazine.





Dr. Howard Frumkin is the 2008 recipient of the Harriet Hardy Award, an annual award given by the board of directors of NECOEM. In his lecture given during the recent NECOEM/MaAOHN conference, he discusses the health impacts of climate change as well as the varied roles of public health. In particular, he explains how the essential services of public health policy apply to climate change. Dr. Frumkin is the Director of the National Center for Environmental Health/Agency for Toxic Substances and Disease Registry (NCEH/ATSDR) at the U.S. Center for Disease Control and Prevention. Dr. Frumkin is an internist, environmental and occupational medicine specialist, and epidemiologist.




Marc Weisskopf, PhD, ScD reviews the clinical and pathological hallmarks of Parkinson's Disease in addition to the most recent research data on the role of environmental agents, particularly chemical toxicants linked to the disease. Dr. Weisskopf currently serves as Assistant Professor for the Department of Environmental Health and Epidemiology at the Harvard School of Public Health. His epidemiologic expertise and research focuses on environmental influences on neurological function including risk factors for ALS, parkinson's disease, and autism in addition to environmental influences on cognitive function and basic neural functioning.




Jack Dennerlein, PhD describes the most common computer related musculoskeletal disorders (MSD's) and explains the recent findings of epidemiologic studies identifying relevant physical risk factors. He also mentions the available ergonomic programs, approaches and interventions needed to reduce  computer related MSD's. Dr. Dennerlein is Associate Professor of Ergonomics and Safety at the Harvard School of Public Health and co-director for the Occupational Injury Prevention Research Training Program. His research interests include neuromuscular biomechanics, office ergonomics, exposure assessment for work related MSD's and injury epidemiology.




Dr. John Brusch discusses the latest data on the epidemiology, diagnosis and treatment of community acquired MRSA. He also includes a discussion of  the control of MRSA in health care facilities in addition to the general community at large. Dr. Brusch is board certified in Internal Medicine, Infectious Diseases and Geriatric Medicine. He currently Assistant Professor of Medicine at Harvard Medical School and Associate Chief of Medicine at Cambridge Health Alliance in Boston.




Dr. Robert Swotinsky discusses the latest federal drug testing regulations during the NECOEM/MaAOHN conference in December 2008. Dr. Swotinsky is board certified in Occupational Medicine, a certified Medical Review Officer (MRO), Substance Abuse Professional (SAP), and is an Aviation Medical Examiner. Dr. Swotinsky has written four books on workplace drug and alcohol drug testing, is founding editor of the MRO Update newsletter, is cofounder of the MRO certification exam, and teaches national courses for MRO's.


Direct download: MRO_New_Developments.mp3
Category: Occupational Medicine -- posted at: 10:42 PM

Dr. Pamela Scheinman reviews the main allergens causing occupational contact dermatitis, their typical clinical presentations and best treatment approaches. Dr. Scheinman is Associate Clinical Professor of Dermatology and Director of The Contact Dermatitis and Occupational Dermatology Unit at Tufts Medical Center in Boston. She has been actively involved in the American Contact Dermatitis Society (ACDS) for years and is currently serving on their board of directors. She conducts a busy tertiary referral clinical practice consisting mainly of dermatitis patients and has been an invited speaker for numerous national and international dermatology conferences.

Direct download: Occupational_Contact_Dermatitis.mp3
Category: Occupational Medicine -- posted at: 9:22 PM

For the past 10 years, Dr. Stefanos Kales and his team have been performing research on cardiovascular issues in firefighters, including hypertension, obesity, dyslipidemia, disability retirement, and on-duty cardiovascular disease events. They have published landmark studies describing the occupational and medical risk factors that contribute to on-duty coronary heart disease. Dr. Kales will review the current state of the science with respect to the progression of undetected or inadequately managed CVD risk factors into subclinical and clinical disease. He also discusses the contribution and interaction of occupational hazards and pre-existing pathology on the development of on-duty heart disease events. A supplementary list of references is available by going to the library section of the NECOEM homepage.


Dr. Thomas Hales discusses the most recent NFPA Guidelines in relation to cardiac fitness. Dr. Hales currently serves with the NIOSH Fire Fighter Fatality Investigation and Prevention Program, Cardiovascular Disease Component located in Cincinnati, OH. He is a member of the NFPA Fire Service Occupational Safety and Health Committee and is board certified in both Internal Medicine and Occupational Medicine. A copy of his handouts may be found in the library section of the NECOEM homepage.


Curt Varone, Director for the National Fire Protection Association, interviews Dr. Jonathan Mittelman and Dr. Thomas Gassert on various medical issues confronting today's firefighters. Both occupational medicine physicians have been consulting and managing firefighter related health conditions for many years. Dr. Mittelman himself began his career as a firefighter. Dr. Gassert has served as president of the New England College of Occupational and Environmental Medicine.

Direct download: F545D101A32648C0835D24030EC301C3.mp3
Category: Occupational Medicine -- posted at: 9:09 PM

Lecture given by Dr. Mark Cullen during the 2007 annual conference for NECOEM / MaAOHN held in Bedford, MA. Dr.Cullen is Professor of Medicine and Public Health in addition to being Director of Occupational and Environmental Medicine at Yale University. Dr. Cullen also received the 2007 Harriet Hardy Award given by the Board Of Directors of NECOEM.

Direct download: 5C616BB022264EB18BA54FA99A6A4761.mp3
Category: Occupational Medicine -- posted at: 7:57 PM

Lecture given by Allison Rogers during the 2007 annual conference on NECOEM / MaAOHN held in Bedford, MA. Ms. Rogers is an educational and outreach coordinator at "The Green The Capitol" Office in the US House of Representatives in Washington, DC.

Direct download: 26B29CBCF3714CEFA57D136D1B7AFB5C.mp3
Category: Environmental Medicine -- posted at: 8:42 PM

Lecture given by Mike Ellenbecher, CIH, PhD during the 2007 annual conference for NECOEM / MaAOHN in Bedford, MA. Dr. Ellenbecher is director of the Toxic Use Reduction Institute from the University of Lowell, MA. Handouts to this presentation are also available from the library section of the NECOEM homepage.


Direct download: 30FC1C48026747C08198A4F4FC62EEF6.mp3
Category: Environmental Medicine -- posted at: 8:32 PM



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