Occupational and Environmental Respiratory Disease and Updates in - - PDF document

Department of Medicine, Division of Occupational and Environmental Medicine University of California, San Francisco School of Medicine presents

Occupational and Environmental Respiratory Disease and Updates in Occupational and Environmental Medicine

March 9-11, 2017 Holiday Inn Fisherman’s Wharf San Francisco, CA Course Chairs Paul D. Blanc, MD, MSPH Robert Kosnik, MD, DIH Timur Durrani, MD, MPH, MBA University of California, San Francisco

University of California, San Francisco School of Medicine

Acknowledgement of Commercial Support

This CME activity was supported in part by educational grants from the following: Sedgwick SL Environmental Law Group, PC

Exhibitors

Bayer Qiagen Sutter Health US Healthworks

University of California, San Francisco School of Medicine Presents

Occupational and Environmental Respiratory Disease and Updates in Occupational and Environmental Medicine

Educational Objectives An attendee completing this course will be able to:

• Improve their understanding of the role of inhalational exposures in occupational and

environmental health practice;

• Adopt new medical knowledge into preventive activities addressing emerging risk

factors and new diseases entities, in particular for respiratory conditions;

• Evaluate scientific data in the field of occupational and environmental medicine;
• Expand the differential diagnosis to incorporate a wider range of environmental and
• ccupational factors in respiratory disease processes and in other work-related

conditions;

• Improve their diagnostic methods and treatment recommendations for selected
• ccupational and environmental conditions, emphasizing but not limited to lung

processes;

• Improve their management in terms of required regulatory management of specific

work-related scenarios;

• Inform the prioritization of clinical care, research, and public health policy with state-of-

the-art updates. Accreditation The University of California, San Francisco School of Medicine (UCSF) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. UCSF designates this live activity for a maximum of 19.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This CME activity meets the requirements under California Assembly Bill 1195, Continuing Education and Cultural and Linguistic Competency. NURSES: For the purpose of recertification, the American Nurses Credentialing Center accepts AMA PRA Category 1 Credit™ issued by organizations accredited by the ACCME. PHYSICIAN ASSISTANTS: AAPA accepts category 1 credit from AOACCME, Prescribed credit from AAFP, and AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. PHARMACY: The California Board of Pharmacy accepts as continuing professional education those courses that meet the standard of relevance to pharmacy practice and have been approved for AMA PRA Category 1 Credit™. Pain Management and End-of-Life Care:

The approved credits shown above include a maximum of 5.00 credits toward meeting the requirement under California Assembly Bill 487, Pain Management and End-of-Life Care. Geriatric Medicine: The approved credits shown above include 4.50 credits toward meeting the requirement under California Assembly Bill 1820, Geriatric Medicine. California Division of Workers Compensation- Medical Unit (QME Credit) This course has been reviewed and approved for 18.00 hours of credit. The course number is 1200. American Board of Preventive Medicine The American Board of Preventive Medicine for Maintenance of Certification (MOC) has approved this course for a maximum of 18.00 MOC credits. The course ID for this module is 1047. American Academy of Family Physicians This Live activity, Occupational and Environmental Respiratory Disease and Updates in Occupational and Environmental Medicine, with a beginning date of 03/09/2017, has been reviewed and is acceptable for up to 19.25 Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

General Information

Attendance Verification/Sign-In Sheet / CME Certificates

Please remember to sign-in on the sign-in sheet when you check in at the UCSF Registration Desk on your first day. You only need to sign-in once for the course, when you first check in. After the meeting, you will receive an email from Qualtrics@ucsf.edu with a link to complete your online Course Evaluation/ Electronic CME Certificate. Please make sure that you add this email to your safe senders list. The Qualtrics system will send you reminders to complete your CME Certificate Claiming until you complete it. Upon completing the Electronic CME Certificate, your CME certificate will be automatically generated to print and/or email yourself a copy. For smartphone users, you may want to take a photo of your certificate as some settings prevent you from emailing the certificate. The link will be available for 30 days after the last day of the course. However, after that date the link will expire and you will no longer be able to claim your credits online. You must then contact the Office of CME at registration@ocme.ucsf.edu to receive your certificate and a $15 administrative fee may be applied. Speaker Survey Your opinion is important to us – we do listen! The speaker survey is the available

• nline here: http://www.ucsfcme.com/evaluation

We request you complete this evaluation within 30 days of the conference in order to receive your CME certificate through this format.

Security

We urge caution with regard to your personal belongings and syllabus books. We are unable to replace these in the event of loss. Please do not leave any personal belongings unattended in the meeting room during lunch or breaks or overnight. Exhibits Industry exhibits will be available outside the ballroom during breakfasts and breaks, and lunches. Final Presentations PowerPoint presentations will be available on our website, www.cme.ucsf.edu, approximately 3 – 4 weeks post course. Only presentations that have been authorized for inclusion by the presenter will be included

Federal and State Law

Regarding Linguistic Access and Services for Limited English Proficient Persons I. Purpose. This document is intended to satisfy the requirements set forth in California Business and Professions code 2190.1. California law requires physicians to obtain training in cultural and linguistic competency as part of their continuing medical education programs. This document and the attachments are intended to provide physicians with an overview of federal and state laws regarding linguistic access and services for limited English proficient (“LEP”) persons. Other federal and state laws not reviewed below also may govern the manner in which physicians and healthcare providers render services for disabled, hearing impaired or other protected categories II. Federal Law – Federal Civil Rights Act of 1964, Executive Order 13166, August 11, 2000, and Department of Health and Human Services (“HHS”) Regulations and LEP Guidance. The Federal Civil Rights Act of 1964, as amended, and HHS regulations require recipients of federal financial assistance (“Recipients”) to take reasonable steps to ensure that LEP persons have meaningful access to federally funded programs and services. Failure to provide LEP individuals with access to federally funded programs and services may constitute national origin discrimination, which may be remedied by federal agency enforcement action. Recipients may include physicians, hospitals, universities and academic medical centers who receive grants, training, equipment, surplus property and other assistance from the federal government. HHS recently issued revised guidance documents for Recipients to ensure that they understand their obligations to provide language assistance services to LEP persons. A copy of HHS’s summary document entitled “Guidance for Federal Financial Assistance Recipients Regarding Title VI and the Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons – Summary” is available at HHS’s website at: http://www.hhs.gov/ocr/lep/ . As noted above, Recipients generally must provide meaningful access to their programs and services for LEP persons. The rule, however, is a flexible one and HHS recognizes that “reasonable steps” may differ depending on the Recipient’s size and scope of services. HHS advised that Recipients, in designing an LEP program, should conduct an individualized assessment balancing four factors, including: (i) the number or proportion of LEP persons eligible to be served or likely to be encountered by the Recipient; (ii) the frequency with which LEP individuals come into contact with the Recipient’s program; (iii) the nature and importance

• f the program, activity or service provided by the Recipient to its beneficiaries; and (iv) the

resources available to the Recipient and the costs of interpreting and translation services. Based on the Recipient’s analysis, the Recipient should then design an LEP plan based on five recommended steps, including: (i) identifying LEP individuals who may need assistance; (ii) identifying language assistance measures; (iii) training staff; (iv) providing notice to LEP persons; and (v) monitoring and updating the LEP plan. A Recipient’s LEP plan likely will include translating vital documents and providing either on-site interpreters or telephone interpreter services, or using shared interpreting services with other

• Recipients. Recipients may take other reasonable steps depending on the emergent or non-

emergent needs of the LEP individual, such as hiring bilingual staff who are competent in the skills required for medical translation, hiring staff interpreters, or contracting with outside public

• r private agencies that provide interpreter services. HHS’s guidance provides detailed

examples of the mix of services that a Recipient should consider and implement. HHS’s guidance also establishes a “safe harbor” that Recipients may elect to follow when determining whether vital documents must be translated into other languages. Compliance with the safe harbor will be strong evidence that the Recipient has satisfied its written translation obligations. In addition to reviewing HHS guidance documents, Recipients may contact HHS’s Office for Civil Rights for technical assistance in establishing a reasonable LEP plan.

III. California Law – Dymally-Alatorre Bilingual Services Act. The California legislature enacted the California’s Dymally-Alatorre Bilingual Services Act (Govt. Code 7290 et seq.) in order to ensure that California residents would appropriately receive services from public agencies regardless of the person’s English language skills. California Government Code section 7291 recites this legislative intent as follows: “The Legislature hereby finds and declares that the effective maintenance and development of a free and democratic society depends

• n the right and ability of its citizens and residents to communicate

with their government and the right and ability of the government to communicate with them. The Legislature further finds and declares that substantial numbers of persons who live, work and pay taxes in this state are unable, either because they do not speak or write English at all, or because their primary language is other than English, effectively to communicate with their government. The Legislature further finds and declares that state and local agency employees frequently are unable to communicate with persons requiring their services because of this language barrier. As a consequence, substantial numbers of persons presently are being denied rights and benefits to which they would

• therwise be entitled.

It is the intention of the Legislature in enacting this chapter to provide for effective communication between all levels of government in this state and the people of this state who are precluded from utilizing public services because of language barriers.” The Act generally requires state and local public agencies to provide interpreter and written document translation services in a manner that will ensure that LEP individuals have access to important government services. Agencies may employ bilingual staff, and translate documents into additional languages representing the clientele served by the agency. Public agencies also must conduct a needs assessment survey every two years documenting the items listed in Government Code section 7299.4, and develop an implementation plan every year that documents compliance with the Act. You may access a copy of this law at the following url: http://www.spb.ca.gov/bilingual/dymallyact.htm

Faculty List

Course Chairs

Paul D. Blanc, MD, MSPH Professor of Medicine, Endowed Chair and Division Chief, Occupational and Environmental Medicine University of California, San Francisco Robert Kosnik, MD, DIH Professor of Medicine, Medical Director, Occupational Health Services, Division of Occupational and Environmental Medicine University of California, San Francisco Timur Durrani, MD, MPH, MBA Assistant Professor of Medicine Division of Occupational and Environmental Medicine University of California, San Francisco

Course Faculty (University of California, San Francisco unless indicated)

Carisa Adamson-Harris, PhD Assistant Professor of Medicine, University of California, San Francisco Mehrdad Arjomandi, MD Associate Professor of Medicine, Director, UCSF Human Exposure Laboratory University of California, San Francisco John Balmes, MD Professor of Medicine, University of California, San Francisco; Professor of Environmental Health Sciences, School of Public Health, UC Berkeley Bruce Bernard, MD, MPH Captain, United States Public Health Service ; Chief Medical Officer; Health Hazard Evaluations ,CDC, National Institute for Occupational Safety and Health, Cincinnati, Ohio Julia Buss, RN, PhD Deputy Director, COEH, University of California, Berkeley Robert A. Cohen, MD Clinical Professor of Environmental and Occupational Health Sciences University of Illinois, School of Public Health James Cushman, MD Associate Professor of Surgery, Assistant Director of Trauma Services, UCSF-East Bay; Highland Hospital, Oakland, CA Giorgia Garrett, MD Physician, Kaiser Permanente, San Francisco Samuel Goldman, MD, MPH Associate Adjunct Professor of Neurology, University of California, San Francisco Robert Harrison, MD, MPH Clinical Professor of Medicine, University of California, San Francisco

Course Faculty (continued) (University of California, San Francisco unless indicated)

Roman Kownacki, MD, MPH Regional Medical Director for Occupational Health, The Permanente Medical Group,

• Inc. Oakland, CA

Roberto Lucchini, MD Professor of Medicine ; Director, Division of Occupational Medicine, Mount Sinai School

• f Medicine, New York and University of Brescia, Italy

Jeffrey H. McClellen ,CAPT, MC, USN Branch Head, Undersea Medicine and Radiation Health; Bureau of Medicine and Surgery; Falls Church, VA Stephen A. McCurdy, MD, MPH Director, Master of Public Health (MPH) Program Vice Chair and Professor Department of Public Health, University of California, Davis David Rempel, MD, MPH Emeritus Professor of Medicine, UCSF and Professor of Bioengineering, University of California, Berkeley Carl J. Reynolds, MD Honorary Clinical Research Fellow Imperial College, London United Kingdom Marc B. Schenker, MD, MPH Distinguished Professor of Public Health Sciences and Medicine ; Founding Director / Migration and Health Research Center; Center for Occupational and Environmental Health; Western Center for Agricultural Health and Safety, University of California, Davis Dennis Shusterman, MD MPH Professor of Clinical Medicine, Emeritus, Division of Occupational and Environmental Medicine, University of California, San Francisco Jonathan Singer, MD Assistant Professor of Medicine , Associate Medical Director, UCSF Lung Transplant Research Program, University of California, San Francisco Gina Solomon, MD, MPH Deputy Secretary for Science and Health, California EPA / Clinical Professor of Medicine, University of California, San Francisco Kjell Torén, MD Professor, Occupational and environmental medicine / Sahlgrenska Academy, university of Gothenburg, Sweden

Disclosures

The following faculty speakers, moderators, and planning committee members have disclosed they have no financial interest/arrangement or affiliation with any commercial companies who have provided products or services relating to their presentation(s) or commercial support for this continuing medical education activity: Mehrdad Arjomandi, MD John R Balmes, MD Bruce P Bernard, MD, MPH Paul D. Blanc, MD MSPH Julia Buss, RN, PhD Robert A Cohen, MD James Cushman, MD Timur Shah Durrani, MD Giorgia Louise Garrett, MD Samuel M Goldman, MD, MPH Robert Harrison, MD, MPH Robert Kosnik, MD DIH Roman P Kownacki, MD Roberto Lucchini, M.D. Jeffrey H. McClellen, BS, MD Stephen A. McCurdy David Rempel, MD, MPH Carl Jonathan Reynolds, MD Marc B Schenker, MD, MPH Dennis J Shusterman, MD, MPH Jon Singer, MD MS Gina M Solomon, MD, MPH Kjell Toren, MD, PhD The following faculty speakers have disclosed a financial interest/arrangement or affiliation with a commercial company who has provided products or services relating to their presentation(s) or commercial support for this continuing medical education activity. All conflicts of interest have been resolved in accordance with the ACCME Standards for Commercial Support: Carisa Harris Adamson, PhD, PT Stock Shareholder (Sold all shares 2/1/17) Briotix This UCSF CME educational activity was planned and developed to: uphold academic standards to ensure balance, independence, objectivity, and scientific rigor; adhere to requirements to protect health information under the Health Insurance Portability and Accountability Act of 1996 (HIPAA); and, include a mechanism to inform learners when unapproved or unlabeled uses of therapeutic products or agents are discussed or referenced. This activity has been reviewed and approved by members of the UCSF CME Governing Board in accordance with UCSF CME accreditation policies. Office of CME staff, planners, reviewers, and all

• thers in control of content have disclosed no relevant financial relationships.

Wednesday, March 8, 2017

6:30pm-8:00pm Evening Poster Session on Occupational and Environmental Respiratory Disease

Thursday, March 9, 2017

7:00 am Registration and Continental Breakfast Occupational and Environmental Respiratory Disease 7:45 Introductions Course Leaders 8:00 am Air Pollution and Health: Research to Bedside John Balmes, MD 8:50 Upper Airway Responses to Occupational and Environmental Exposures Dennis Shusterman,MD 9:40 Coffee Break 10:10 G Occupation and Pneumonia Kjell Torén, MD 11:00 Occupational COPD and Chronic Bronchitis Paul Blanc, MD, MSPH 11:50am Lunch on your own 1:20 Work-related Interstitial Lung Disease: Beyond Pneumoconiosis Carl Reynolds,MD 2:10 Work-Related Asthma - New Onset and Exacerbation Robert Harrison, MD, MPH 3:00 P Lung Transplantation: Occupational and Environmental Aspects Jonathan Singer, MD 3:50 Coffee Break 4:10 Mineral Dust Exposure, Disease and Prevention: Old and New Robert Cohen, MD 5:00 P Respiratory Hazards of Military Service Mehrdad Arjomandi,MD 5:50 Closing Panel: What’s Old and What’s New in Occupational Respiratory Disease Paul Blanc, John Balmes, & Robert Cohen 6:30 pm Adjourn

Friday, March 10, 2017

7:30 am Registration and Continental Breakfast Updates in Occupational and Environmental Health 7:50am Introductions 8:10 G,P Ultraviolet Radiation Exposure in Work and Life Giorgia Garrett, MD 9:00 Historical Development of Submarine Atmosphere Controls Jeffrey H. McClellen, CAPT, MC, USN 9:50 Coffee Break 10:20 G Insights on Work-Related Neurodegenerative Disease Samuel Goldman, MD, MPH 11:10 What’s New in Hazardous Technologies and Exposures? Gina Solomon MD MPH 12:00pm Lunch on your own 1:30 G Keynote: Occupationally Associated Male Genitourinary Conditions Bruce Bernard, MD, MPH 2:30 P Opiates and Chronic Pain Management in Occupational Health Practice Roman Kownacki, MD, MPH 3:20 Coffee Break 3:40 To Sit or Stand: What Is Good for the Heart? David Rempel, MD 4:30 P Thinking About Vulnerable Workers Stephen McCurdy, MD, MPH 5:20 The Skinny on Work: Obesity on the Job Julia Buss, DNS 6:10pm Adjourn

Saturday, March 10, 2017

7:45am Continental Breakfast Updates in Occupational and Environmental Health 8:15 Introductions Speaker Name 8:30 G Manganese Toxicity: Recent Research Advances Robert Lucchini, MD 9:20 Weightless Environments and Health James Cushman, MD 10:10 Coffee Break 10:30 Agricultural Workers’ at Risk Marc Schenker, MD 11:20 P The Neck and Upper Extremities: Ergonomics 101 Carisa Adamson‐Harris, PhD 12:10 Closing Panel: Occupational and Environmental Health in 2017 Bruce Bernard, Samuel Goldman, Carisa Harris- Adamson 12:40 Adjourn Speaker Name P = Pain Credit G = Geriatric Credit T = Trauma Credit

MDM17N01: OEM 2017

3/1/2017 University of California San Francisco City, State Name

Registrant List

UCSF OCME Page 1 of 3 1 MD San Francisco, CA Agarwal Shuchi 2 MD, MPH San Francisco, CA Allems Thomas S. 3 MD Wilmington, DE Allen James W. 4 MD Rocky Hill, CT Allen Teresa 5 MD New York, NY Aqua Offiong Offiong 6 DO Emeryville, CA Balogun Rahmat 7 MD Gothenburg, Sweden Brisman Jonas 8 MD Menlo Park, CA Brown Joanna G. 9 JD San Rafael, CA Brown Linda J. 10 MD Reno, NV Brown Steve T. 11 DO Gardnerville, NV Bryce Louise Michelle 12 MD Seattle, WA Bryson Jiho 13 MD Zoeterwoude, Netherlands Bunschoten Gerard 14 MD Salt Lake City, UT Cahill Barbara 15 MD Oakland, CA Calvo Donald A. 16 MD, MPH, FACP Toronto, ON, Canada Chernin Jeffrey M. 17 MD Burlingame, CA Cole Sophie Winefred 18 MD Salt Lake City, UT Cope Myles 19 MD Novato, CA Danse Ilene R. 20 RN, FNP, COHN- Larkspur, CA Domeracki Sandra 21 MD, MPH Morris Plains, NJ D'Souza David 22 MD Portland, OR Fischer Rachel C 23 MD San Diego, CA Fishman Ira B. 24 MD Berkeley, CA Forest Catherine 25 MD, DrPH Teaneck, NJ Friedman-Jimene George 26 MD Petaluma, CA George Christopher 27 Physician San Ramon, CA Goncalves Carlos 28 MD San Francisco, CA Guntur Sandeep 29 MD Pacifica, CA Hall John L. 30 MD Victoria, BC, Canada Hamm

• R. Douglas

31 MD, MPH Bellevue, WA Haq Abid 32 MD Fife, WA Harmon Kirk 33 Basking Ridge, NJ Harrison Denise 34 MD Inglewood, CA Hawkins Randy W. 35 MD River Forest, IL Herrera Patricia 36 MD, MPH Half Moon Bay, CA Hollblad-Fadiman Katerina 37 MSN El Cerrito, CA Hollinger Barbara 38 MD Oakland, CA Holm Stephanie M.

City, State Name

Registrant List

UCSF OCME Page 2 of 3 39 MD Boise, ID Jackson Keri 40 MD Salt Lake City, UT Jarvis Joseph 41 MD Morristown, NJ Jennison Elizabeth 42 Troy, MI Jones Palma 43 MD, PhD Oakland, CA Jourgensen David 44 MD Monte Sereno, CA Kaitz Monica 45 MD Berkeley, CA Khafagy Abdullah 46 MbChb, CCFP Nanaimo, BC, Canada Kotze Charlene 47 JD San Rafael, CA Kowler Karina 48 MMS, RD, PA-C San Jose, CA Kumar Vijayasree 49 DO, MPH Ponte Vedra Beach, FL Lance James M. 50 MD Oakland, CA Landman Zachary 51 MD, MPH Spokane, WA Lantsberger Paula 52 MD, PhD Boden, Sweden Larsson Lars-Gunnar 53 MD, MSPH Redwood City, CA Lin Yi 54 MD Boden, Sweden Lindberg Ann 55 MD, MPH Tiburon, CA Liu Diane 56 New York, NY Luo Honghong 57 PA-C Aurora, CO Maas Jordan 58 MD San Ramon, CA Manlapaz Perla 59 MD San Francisco, CA McLaughlin Erin 60 MD Oakland, CA Meade Jeff 61 Md , Mph Eden Prairie, MN Mollner Sue 62 DO Joshua Tree, CA Montoya Miguel A. 63 MSN, APN Reno, NV Morrison Michelle T. 64 MD, MPH, FACO Berkeley, CA Morse Linda H. 65 MD Vacaville, CA Murphy Craig 66 MD Aiea, HI Nguyen Lan T. 67 RN, MPH, NP Livermore, CA Noonan Kathleen 68 NP San Francisco, CA O'Connor Catherine Mary 69 MD Saint Paul, MN Olson Shawn 70 DO Bellevue, WA Penix Brendan 71 MD, MS, MPH El Cerrito, CA Petersen Scott J. 72 MD San Diego, CA Poon Henry 73 Waimanalo, HI Potocko Joshua 74 MPH San Francisco, CA Quinlan Patricia J. 75 MSN-ANP Daly City, CA Ramos Alan M. 76 MD, MSC New York, NY Richman Susan 77 Md, Mph Highland Park, NJ Ritch De Herrera Thaddeus David 78 Md New York, NY Salme Navarro Acran 79 MD El Cerrito, CA Schwilk Erika 80 MD, MPH San Bernardino, CA Sharip Akbar

City, State Name

Registrant List

UCSF OCME Page 3 of 3 81 MD Perugia, Italy Siracusa Andrea 82 New York, NY Skerrette Latoya S 83 MD, MPH Olalla, WA Snead Thomas A. 84 MD San Anselmo, CA Specht Janet A. 85 Oakland, CA Stern Arlie 86 MD Santa Rosa, CA Suchard David P. 87 BSN, MA New York, NY Thompson Andrea 88 Troy, MI Ting Sue 89 MD San Francisco, CA Tran Lien (TJ) 90 MSN-NP San Francisco, CA Vigilante Corinne L. 91 MD San Francisco, CA Vo Kathy Trang 92 MD Oakland, CA Walters Samuel J. 93 MD, MPH San Francisco, CA Wang Christina Y. 94 MD Lodi, CA Whitmore Ron 95 DO San Francisco, CA Wiese Nancy Kay 96 MD, MPH Davis, CA Wiggins Patricia L 97 MD, MPH Stanford, CA Wittman Richard 98 MD Graz, Austria Wultsch Georg 99 MSN, ACNP-BC Reno, NV Yamamoto Carrie 100 MD Los Altos, CA Young Cary 101 MD, MPH Palo Alto, CA Zhao Yu 101 Total Number of Attendees for MDM17N01: