Environmental and Occupational Health Fellowships for Medical Students

Emory University - Rollins School of Public Health
Atlanta, Georgia
Instructor(s): Frumkin, Howard
Subject area: Health / Medicine
Department: Public Health
Level: Undergraduate Medical
Learning objective: Provide Information, Provide Multidisciplinary Thinking, Provide Real-World Experience
Teaching style: Active Learning, Out-of-class Activity

Please note that the copyright for this course project is retained by the instructor.

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This fellowship is offered at Emory University for medical students. The six-week fellowship provides students with the opportunity to explore the relationship between human health and the environment, the political and social context of Environmental Medicine, epidemiology and toxicology, and other environmental health topics. Field trips are incorporated extensively.


Emory University - 1998

Reading List

Friday, May 22

TOPIC: The big picture: the relationship between human health and the environment
READING: T. Williams, Refuge: An Unnatural History of Family and Place

Friday, May 29

TOPIC: Introduction to EOM (political and social context, history-taking, data sources)
READING: LaDou, Chaps 1-2
Levy and Wegman, Chaps 1-2
Environmental Medicine, pp 61-96

Friday, June 5

TOPIC: Evidence and information in EOM: an introduction to epidemiology and toxicology
READING: LaDou Chap 13, pp 794-804 (Note: you may prefer Levy and Wegman, Chaps 5 and 13)

Friday. June 12

(Dr. Frumkin will be out on vacation; Dr. Ramana Dhara will lead discussion.)
TOPICS: Reproductive toxicity and persistent organic pollutants; the Bhopal disaster
READING: LaDou Chaps 25 and 26
Michal F et al. Impact of the environment on reproductive health: executive summary. EnvironHealthPersp 1993; 101 Suppl 1: 159-67.
Colborn T et al. Developmental effects of endocrine-disrupting chemicals in wildlife and humans. Environ Health Persp 1993; 101(5): 378-84.
Stevens W. Pesticides may leave legacy of hormonal chaos. New York Times, August 23, 1994.
Steon R. Environmental estrogens stir debate. Science 1994; 265: 308-10.
Hileman B. Environmental estrogens linked to reproductive abnormalities, cancer. Chem Engin News 1994; Jan 31: 19-23.
Brandt I et al. Developmental and reproductive toxicity of persistent environmental pollutants. Arch Toxicol 1998 Suppl: 20; 111-9.
Dhara R. Dhara VR. Bhopal: A case study of international disaster. ant J Occup Env Health 1995; 1: 58-69.

Friday June 19

TOPIC: Cancer
READING: LaDou Chap 17

Friday June 26

TOPIC: The nervous system
READING: LaDou Chap 24


Rotation Schedule
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Week #1	Week #2	Week #3	Week #4	Week #5	Week #6
Field Trip Week	Choice Care (Ramana Dhara)	OSHA	Gwinnett County Health Dept	GM	EPA Week
Field Trip Week	Gwinnett County Health Dept	Atlantic Health Group (Fred Glass)	OSHA	GM	EPA Week
Field Trip Week	Gwinnett County Health Dept	OSHA	GM	Emory Cigna Healthcare Center (Tom Faulkner	EPA Week
Field Trip Week	Emory Healthcare - Lawrenceville (Jonathan Mittelman)	Gwinnett County Health Dept	GM	OSHA	EPA Week
Field Trip Week	GM	Gwinnett County Health Dept	OSHA	Atlantic Health Group (Fred Glass)	EPA Week
Field Trip Week	GM	Choice Care (Ramana Dhara)	Gwinnett County Health Dept	OSHA	EPA Week
Field Trip Week	Project	GM	Project	Project	EPA Week
Field Trip Week	Project	GM	Project	Project	EPA Week

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Rotation Descriptions:

1. 4 Clinical Rotation Sites (each student goes to one of the following)

• Atlantic Health Group is a multiclient private practice of occupational medicine. The Atlantic Health Group provides occupational medicine services to a variety of companies. Thus, you will experience occupational medicine as practiced in a stand-alone clinic setting.
• Choice Care is another multiclient private practice of occupational medicine. Choice Care provides occupational medicine services to a variety of companies. Thus, you will experience occupational medicine as practiced in a stand-alone clinic setting.
• The Emory Clinic - Lawrenceville is a general family practice clinic. However, they also provide occupational medicine services to a variety of companies. Dr. Jonathan Mittelman is an occupational medicine physician on staff there.. Thus, you will experience occupational medicine as practiced in a stand-alone clinic setting.
• Emory Cigna Healthcare Center is another general family practice clinic. However, they also provide occupational medicine services to a variety of companies, most notably Delta Airlines. Dr. Tom Faulkner is an occupational medicine physician on staff there. Thus, you will experience occupational medicine as practiced in a stand-alone clinic setting.

2. General Motors - General Motors Corporation is a large automobile manufacturing company located in Doraville. They have their own medical clinic on-site. The Medical Director, Dr. Sharon Stewart, sees patients, visits parts of the plant, and performs many other corporate medical duties. Thus, you will experience occupational medicine as practiced in a corporate setting.

3. Gwinnett County Health Department - The Georgia Department of Human Resources, Division of Public Health, has an Environmental Health Section. The District Environmentalists who work in the Environmental Health Section are responsible for a wide range of activities, including restaurant inspections, lead poisoning prevention, radon exposure assessments, disaster preparation, and others. The state Environmental Health Section in turn has a close relationship with the environmental health personnel in the county health departments, offering assistance and expertise when needed. You will be assigned to the Gwinnett County Health Department. The Environmental Health Division in Gwinnett County is divided into three operational areas: Food Services, Land Use (mainly involving the permitting and inspection of septic tank systems), and Technical (involving swimming pool inspections, tourist facilities, nuisance complaints, etc.) You will have an opportunity to accompany environmentalists into the field to observe their activities in each of these three areas.

4. OSHA - OSHA is the federal agency that sets and enforces workplace health and safety standards. OSHA inspectors perform workplace inspections in response to employee complaints, whenever a fatal accident occurs on the job, and also at random. Their primary responsibility is to check for regulatory compliance. You will help the inspectors prepare for worksite visits, and then accompany them into the field.

5. EPA Week - You will spend a week at the Region 4 office of the EPA, located here in Atlanta. Each of 3 days will be spent with a different division: the Water Division, the Environmental Accountability Division, and the Air Pollution and Pesticides Division. The intent is to learn about the activities that take place in each area, and then (whenever possible) accompany EPA officials into the field. On the fourth day, you will visit the Science and Ecosystems Support Division Laboratory in Athens, GA. This facility is a state-of-the-art environmental research laboratory.


Schedule for Field Trip Week (5/18/98 through 5/22/98):

Monday, May 18:

8:00 a.m.: Fellowship orientation meeting with Dr. Frumkin and Amanda Sanders.
Room 222, Rollins School of Public Health

9:30 a.m.: Meeting at Emory University Hospital's Safety Management Office
Contact: Jim Speelman, Hospital Safety Manager
Description: This will be an opportunity to learn about the occupational and environmental health and safety issues faced by hospitals and other health care providers.

11:30 a.m.: Project Safe Georgia Meeting (luncheon included) ** Only 3 students can go!
Meet Dr. Frumkin here at the School of Public Health at 11:30. He will escort you to the Project Safe Georgia meeting that is scheduled from 12:00 - 2:00. Project Safe Georgia is a coalition of business leaders and health and safety professionals from the Atlanta area. The group meets to develop initiatives to improve the health and safety of workplaces across a variety of industries.

2:30 p.m.: Legal Deposition given by Dr. Frumkin for a Worker's Compensation Case
Room 222, Rollins School of Public Health Dr. Frumkin is frequently called upon to give depositions for worker's compensation cases involving his clinic patients. You will be exposed to some of the legal issues you encounter in the practice of EOM.

4:30 p.m.: Emily and Ashley to meet with Dr. Frumkin to discuss their projects. Everyone else is free to go!
Room 222, Rollins School of Public Health

Tuesday, May 19:

7:30 a.m. - All day trip to North Georgia
Meet here at the School of Public Health at 7:30 a.m. We have 3 different activities planned:

9:00 a.m.: Visit to Purina Feed Mill plant
Gainesville, GA
Contact: Joe Markert, Plant Manager
Description: This will be an opportunity to see an industrial facility involved with the production of various animal feed products. Ask about the occupational/environmental health and safety issues they have encountered, and what steps they have taken to address them.

11:00 a.m.: "Toxic Tour" and luncheon with the Newtown Florist Club
Gainesville, GA
Contact: Faye Bush, President of the Newtown Florist Club
Description: Newtown is a neighborhood of Gainesville, located in the industrial section of town. The population here is 100% African-American. The Newtown Florist Club was founded in 1940 as a social club dedicated to bringing flowers to recent widows. Over the years, the florist club members observed what they believed to be an excessive number of deaths attributable to certain causes, including cancer, renal failure, and lupus. The members began to question whether nearby sources of pollution might account for their observations. In recent years, the focus of the Newtown Florist Club has become raising awareness about environmental pollution within their community.

2:45 p.m.: Visit to Levi Strauss plant
Blue Ridge, GA
Contact: Cecilia Golightly, RN
Description: This will be an opportunity to see a different kind of industrial facility involved with the production of men's and boy's blue jeans. Ask about the occupational/environmental health and safety issues they have encountered, and what steps they have taken to address them.

Wednesday, May 20:

9:00 a.m.: All day visit to the National Center for Environmental Health/CDC

Tentative agenda is as follows:
9:00 a.m. - 9:15 a.m: Welcome and Overview
9: 15 a.m. - 10:00 a.m.: Division/Program/OD Staff Meeting
10:00 a.m. - 10:30 a.m.: Break
10:30 a.m. - 11:30 a.m.: Division of Birth Defects and Developmental Disabilities/Rounds
11:45 a.m. - 1:15 p.m.: Lunch
1:30 p.m. - 2:30 p.m.: Division of Environmental Hazards and Health Effects: Overview
2:30 p.m. - 3:30 p.m.: Division of Environmental Health Laboratory Sciences: Overview and tour
3:30 p.m. - 4:15 p.m.: Program wrap up with Dr. Richard Jackson, MD, MPH, Director, NCEH

Thursday May 21:

** Please note: For the field trip today, please carpool in American-made vehicles!! The folks at the Ford plant do not appreciate it when visitors arrive in foreign-made vehicles!!

8:30 a.m.: Visit to Construction Site at the Ford Plant *** TENTATIVE ***
Contact: Charlie Key, North Georgia Building Trades Council Business Manager
Description: At the Ford plant in Hapeville, there is a plant expansion in progress. A new building is being built to house part of the manufacturing process. You will have an opportunity to tour the job site and see the kinds of health and safety issues encountered in the construction industry. There are many different trade unions represented on the construction site, and Charlie Key can explain the union's perspective on things you might encounter.

l0:00 a.m.: Visit to the Ford Plant
Contact: Charlie Key, North Georgia Building Trades Council Business Manager
Description: You will meet with several representatives of the United Auto Workers (UAW) union, and also several representatives from Ford. They will talk with you about their joint health and safety program at the plant, then take you on a plant tour. This will be a great opportunity to explore the role unions play in the occupational health and safety of their members. At the Ford plant, management and the union have a good, cooperative working relationship. Unfortunately, this is not the case everywhere.

2:00 p.m.: Visit to the Southern Organizing Committee (SOC)
Contact: Connie Tucker
Description: The Southern Organizing Committee (SOC) assists community groups and activists in organizing themselves to address their common concerns. Environmental justice or environmental equity is an issue they deal with every day. You will have the opportunity to experience the community perspective on environmental health issues.

Friday May 22:

8:30 a.m. - Field trip to the National Institute for Occupational Safety and Health (NIOSH) Regional Office
Contact: Max Keeper
Description: The industrial hygienists in the NIOSH regional office are assigned projects out of the national office in Morgantown, WV. Workers who are concerned about the exposures at their jobs can contact NIOSH and request a Health Hazard Evaluation (HHE). These HHE requests are sent through the national office and assigned to one of the regional offices, depending upon location, expertise of regional staff, etc. In addition to the HHE program, NIOSH also conducts/sponsors a lot of occupational health research.




This document was last modified on 06/14/2000 03:07:54 PM

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This resource was acquired by CEEM (Consortium for Environmental Education in Medicine), a program of Second Nature, under the auspices of a NIEHS grant to gather and disseminate environmental health educational resources over the internet in order to help medical and allied health sciences faculty identify, locate and use resources for incorporating environment and health perspectives into their curricula. CEEM has authorized the use of these materials on this website for archival purposes. Please note that the copyright for this material is retained by the instructor and/or contributing institution.