WOEMA is a regional component of the American College of Occupational and Environmental Medicine (ACOEM), and is dedicated to high quality medical care and ethical principles governing the practice of occupational medicine.

575 Market St.
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San Francisco, CA
94105

415/764-4918
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CME Webinars

WOEMA's Education Committee offers CME Webinars on topics relevant to the practice of occupational and environmental medicine. These webinars can be accessed by calling a toll-free 800 number and viewing the Powerpoint presentation using your Internet browser from your own computer. WOEMA members will be notified in advance of the dial-in phone number and the URL link to access the slides. When the CME Webinar is offered live, members will have the opportunity to send questions to the presenter and have those answered in real-time on the live broadcast. 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.

WOEMA CME Webinar Registration Fees
WOEMA/ACOEM Member - Free
Non-Member Physician - $20
Non-Member, Non-Physician -$15

TOPIC: Occupational Dermatology

Speaker: Heather P. Lampel, MD MPH Assistant Professor of Dermatology at Duke University in Durham, North Carolina. To Air on Wednesday, June 27, 2012 - 12 noon (Pacific Time)

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.

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 Credit^TM. CME Certificates are issuedand 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?

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 Aired Wednesday, April 25, 2012 - 12 noon (Pacific Time)

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.

[Download Presentation]

TOPIC: Vaccinations in Health Care: Influenza and Other Current Issues

Speaker: Robert J. Harrison, MD, MPH, Clinical Professor of Medicine, UCSF; Chief, Occupational Health Surveillance and Evaluation Program, California Department of Public Health Aired Thursday, February 16, 2012 - 12 noon (Pacific Time)

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 (see http://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 Administration and 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.

TOPIC: Opioid Use Guidelines for Chronic Pain Treatment

Aired Thursday, October 20, 2011 - 12 noon (Pacific Time)

Speakers:

Steven Feinberg, MD, MPH, Adjunct Clinical Professor, Stanford University School of Medicine & Chief Medical Officer, American Pain Solutions

Scott C. Levy, MD, MPH, FACOEM, Assistant Medical Director of Regional Occupational Health Services, Chief of Physical Medicine and Rehabilitation, Chief of Chronic Pain, The Permanente Medical Group

Description:
According to the California Workers' Compensation Institute there is considerable variation in the prescribing patterns of physicians in the workers compensation arena. This variation leads to a significant burden on the workers' compensation system by driving the costs of medications, prolonging disability, and increasing the duration of claims. In the recent past there was a concerted effort to increase the use of narcotic medications and to avoid "under-treatment" of pain. The belief at the time was that the risk of addiction to narcotic medications was very low for all patients in pain. This has been shown to be incorrect as evidenced by the escalation in the numbers of people addicted to prescription pain medications and/or made dysfunctional due to use of these substances, as well as the increased numbers of related deaths. Despite this evidence, barriers to change still exist. These include the fear of litigation as well the fact that, until recently, there was a lack of evidence-based guidelines designed for primary care providers prescribing opioid prescription medications. This webinar is designed to help office-based providers best manage patients with work-related injuries who may require opioid medications.

Learning Objectives - Participants will be able to:

Recognize how current medical practice guidelines as well as state and federal laws affect prescribing patterns for opioid medications;
Understand appropriate opioid screening criteria and monitoring protocols for patients who are at low, medium and high risk for addiction;
Apply knowledge to create practice protocols for opioid prescribing, treatment, and weaning based on evidence-based guidelines, consistent with quality medical care, and current state and federal guidelines.

Speakers:

Steven Feinberg, MD

Dr. Steven Feinberg is a physiatrist and pain medicine specialist practicing in Palo Alto. He is an Adjunct Clincial Professor and teachers at the Stanford University Pain Service. Dr. Feinberg is the Chief Medical Officer of Amerian Pain Solutions, Inc. Dr. Feinberg is a past president (1996) of the American Academy of Pain Medicine and served as a California Society of Medicine & Surgery Year 2011 President. He serves on the Board of Directors of the American Chronic Pain Association and is lead author of the 2011 ACPA Consumer Guide to Pain Medicine & Treatment. He is the Medical Director of Cedaron AMA Guides Software. Additionally, Dr. Feinberg served on the ACOEM Chronic Pain Guidelines Panel Chapter Update and also as Associate Editor. Dr. Feinberg also serves as a consultant to the Official Disability Guidelines.

Dr. Feinberg has no conflict of interest to disclose.

Scott Levy, MD

Dr. Scott Levy is the Assistant Medical Director of Regional Occupational Health Services for the Permanente Medical Group in northern California where he has practiced since 2005. He also serves as the Chief of Physical Medicine and Rehabilitation as well as Chronic Pain. Dr. Levy serves on the Board of Directors of WOEMA where he Co-Chairs the Legislative Committee. He is also the Chair of the ACOEM Membership Committee. Dr. Levy serves on the Executive Committee of the Speciality Delegation of the California Medical Association and sits on the Board of Directors for the Marin Medical Society. He is Board Certified in both Internal Medicine and Occupational and Environmental Medicine.

Dr. Levy 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.

TOPIC: Fibromyalgia

Aired Thursday, August 18, 2011 - 12 noon (Pacific Time)

Speaker: Sheetal Desai, MD, MSEd, Assitant Clinical Professor of Medicine, Division of Rheumatology, University of California Irvine

Description:
Fibromyalgia is a condition that is difficult for many to understand. Many physicians do not believe it is a true condition, and most patients feel that "it is in their head". These beliefs are due to a poor understanding of Fibromyalgia, which in turn results in inappropriate diagnosis and treatment of the condition. It is a cause of considerable morbidity to patients, and has high indirect costs to healthcare. Dr. Desai will give an overview of the 21st century understanding of Fibromyalgia and the significant research that has been done on this condition, which shows that Fibromyalgia truly is a condition that is literally "in the patient's head"!

Learning Objectives - Participants will be able to:

Increase awareness of the current understanding of the pathophysiology of Fibromyalgia;
Know how to make a diagnosis of Fibromyalgia;
Be aware of disease masqueraders that can present as Fibromyalgia;
Understand the various treatment options that exist for Fibromyalgia, and the need for a multidisciplinary approach.

Speaker Information:
Dr. Sheetal Desai is a board-certified rheumatologist and is Assistant Professor of Medicine at University of California, Irvine. Dr. Desai specializes in the diagnosis and treatment of rehuamtic disorders such as osteoarthritis, rheumatoid arthritis, polymyalgia rheumatica, fibromylagia, scleroderma, and lupus.

Dr. Desai 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.

TOPIC: Obstructive Sleep Apnea and the Commercial Driver: Understanding the Controversy and Applying Screening Criteria

Aired Thursday, June 16, 2011 - 12 noon (Pacific Time)

Speaker: Scott Levy, MD, MPH, FACOEM

Description:
There is a high prevalence of Obstructive Sleep Apnea (OSA) in commercial drivers and screening for this medical condition is important to insure safety. OSA increases the risk of crashes and effective treatment is available. However, many practitioners do not regularly screen for OSA, and there is considerable controversy amongst the medical community on the criteria for sleep apnea screening. The controversy exists for several reasons but most importantly is the absence of a set of screening criteria which both the medical community adopts as the "gold standard" and the Department of Transportation and/or Federal Motor Carrier Safety Administration embraces.

In order to make an educated decision regarding screening for OSA in the commercial driver population, practitioners need to have a good understanding of the pathophysiology of the condition, as well as a firm grasp of the associated health consequences, including the risk of motor vehicle accidents.

Learning Objectives - Participants will be able to:

Understand the pathophysiology of Obstructive Sleep Apnea (OSA);
Understand the health consequences of OSA;
Become familiar with the current screening criteria OSA and understand controversies;
Implement appropriate screening criteria in clinical practice;
Improve ability to manage commercial drivers who are diagnosed with OSA.

Speaker Information:
Dr. Scott Levy is the Medical Director of Occupational Health and Safety Services for the Permanente Medical Group where he has practiced since 2005. In his time with Kaiser Permamente he has either performed and/or taught others to perform, examinations on thousands of commercial drivers. Dr. Levy serves on the Board of Directors for WOEMA where he Co-Chairs the Legislative Committee. He also serves as Chair of the ACOEM membership committee. Dr. Levy is Board Certified in both Internal Medicine as well as Occupational Medicine.

Dr. Levy 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.

TOPIC: Visual Ergonomics in the Workplace
Aired Thursday, April 21, 2011 - 12 noon (Pacific Time)

Speaker: Jeffrey Anshel, OD, FAAO, Corporate Vision Consulting

Description:
The visual symptoms that computer workers experience are the most obvious expression of the shortcomings in the ergonomics and visual characteristics of the worker. Because of the high visual demands of the computer task and the visual shortcomings of many operators, vision problems and symptoms are very frequent among computer workers. Most studies indicate that visual symptoms occur in 75-90% of computer workers^1-3; by comparison a study released by the National Institute of Occupational Safety and Health (NIOSH)⁴ showed that 22% of computer workers have musculoskeletal disorders. A large survey of optometrists⁵ indicated that 10 million primary care eye examinations are annually given in this country primarily because of visual problems at computers- not a small public health issue! (references click here)

Learning Objectives -

To educate about the critical role good vision maintains in being able to work productively at a computer;
To show how vision and lighting interact to create a challenging visual environment in the workplace;
To inform attendees on how to troubleshoot computer workplaces regarding visual stress areas so that they can reduce risk of eyestrain and decreased productivity.

Speaker Information:

Dr. Anshel is a 1975 graduate from the Illinois College of Optometry. He has written numerous articles and books regarding nutritional influences on vision and computer vision concerns. Dr. Ansehl is the principal of Corporate Vision Consulting, where he addresses the issues surrounding visual demands while working with computers. He also offers on-site consultations and seminars to corporations related to visual stress and productivity in the workplace. He lectures nationally to eyecare providers on nutrition topics. Dr. Anshel is a Fellow of the Americal Academy of Optometry and President of the Ocular Nutrition Society. He maintains a private practice in Carlsbad, CA.

Dr. Anshel has no conflict of interest to disclose.

[Download Powerpoint 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.

TOPIC: Public and Worker Health from the Fukushima Nuclear Plant Accident
Aired Wednesday, April 6, 2011 - 12 noon (Pacific Time)

Speakers:

Thomas McKone, PhD, Senior Scientist, Lawrence Berkeley National Laboratory
James Seward, MD, Medical Director, Lawrence Livermore National Laboratory

Description:

The speakers will provide a basis for understanding the radioactive releases at the Fukushima Daiichi nuclear plants and discuss the types of radionuclide exposures involved. They will cover the accident sequence, emissions inventories, actual releases, potential health effects, expsoure limits, and protective responses, including the use of prophylactic potassium iodide. There will be ample time for audience questions.

Learning Objectives - Participants will be able to:

Understand the need for and principles of nuclear safety systems and what failed in Fukushima;
Understand the types, origins,and potential health effects of the radioactivity released into a reactor incident;
Describe the different routes of exposure to radioactivity and the approaches used to managing them;
Explain the indications, limitations, and contraindications for the use of potassium iodide as a prophylactic agent.

Speaker Information:

Thomas McKone, PhD
Dr. McKone is a senior staff scientist at the Lawrence Berkeley National Laboratory (LBNL) and a Professor at the University of California, Berkeley School of Public Health. His research focuses on the development, use, and evaluation of models and data for human-health and ecological risk assessments and the health and environmental impacts of energy, industrial, and agricultural systems. Dr. McKone has served on the US EPA Science Advisory Board, been a member of numerous National Academy of Sciences committees, and worked with the World Health Organization. He is a fellow of the Society for Risk Analysis and a former president of the International Society of Exposure Science (ISES). Dr. McKone earned his PhD in nuclear engineering from the University of California, Los Angeles.

Dr. McKone has no conflict of interest to disclose.

James Seward, MD, MPP
Dr. Seward is the Medical Director for the Lawrence Livermore National Laboratory (LLNL) which is a research and development facility of the US Department of Energy. He holds appointments as a Clinical Professor at the University of California, Berkeley School of Public Health and the University of California, San Francisco School of Medicine. He is Co-Director of the UCSF Preventive Medicine Residency Program.
Dr. Seward is a former WOEMA President and currently serves as a member of the ACOEM Board.

Dr. Seward has no conflict of interest to disclose.

[Download Powerpoint 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.

TOPIC: Occupational Medicine Practice in the New Era of Health Care Reform
Aired Thursday, February 17, 2011 - 12 noon (Pacific Time)

Speaker: Paul Papanek, MD, MPH, FACOEM, Occupational Health Service, Kaiser Permanente, Los Angeles, CA

Description:
The next three years will see implementation of the new health care reform bill, the Patient Protection and Affordable Care Act of 2010 (PP-ACA). As a result, the practice of Occupational Medicine is likely to change. Parallels can be drawn from the changes that occurred in Occupational Medicine when national health care was implemented in many countries of the European Union. Specific provisions in the PP-ACA bill, especially those related to employer-sponsored Health Plans may predict practice changes. Other aspects for Occupational Medicine are also likely to occur as a result of other anticipated regulatory changes related to the Medical Home and OSHA regulations. These changes are likely to include reimbursement for preventive services in Occupational Medicine.

Learning Objectives - Participants will be able to:

Identify two important trends in Occupational Medicine that occurred in several European Union countries at the time of their national health care implementation;
State two interventions related to genetic information that can be implemented for employer sponsored plans;
Identify two opportunities for clinical preventive services in the workplace, likely to improve both public health indicators and worker productivity.

Dr. Papanek received his MD degree in 1977 from UC San Diego and took his residency in Family Medicine at UCLA. He received a Masters of Public Health degree from UCLA in the field of Occupational and Environmental Health Science, and is Board certified in Occupational Medicine. Dr. Papanek was Chief of the Occupational Health Service/Kaiser on the Job Program in the Metro Los Angeles area, was the Assistant Program Director for the UCLA Occupational Medicine residency, and has served on the Workers' Compensation Committee of the California Medical Association.

Dr. Papanek has no conflict of interest to disclose.

[Download Powerpoint 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.

TOPIC: Exercise as Medicine
Aired Thursday, December 16, 2010 - 12 noon (Pacific Time)

Speaker: Dennis Pocekay, MD, MPH retired from The Kaiser Permanente Medical Group, Inc.

Description:
Exercise benefits both employees and employers. "Exercise as Medicine" is intended to update providers on the multiple beneficial effects of exercise on health, disease, and mortality. We will also explore how exercise might best be incorporated into employer wellness programs. Most importantly, the presentation will emphasize exercise history as a vital sign.

Learning Objectives - Participants will be able to:

Define "physical activity" (PA) vs "fitness".
List the US Dept. of Health and Human Services (USDHHS) 2008 Physical Activity Recommendations.
Discuss the relationship of these factors to health care costs and to overall mortality, as well as to work injury and delayed recovery.
Describe how this information impacts worksite health promotion.

Dr. Pocekay retired from The Permanente Medical Group, Inc. (TPMG) after a 27-career in 2009. Prior to his retirement, he was Chief of Occupational Medicine for San Rafael and Petaluma, as well as TPMG Physician Lead for Occupational Health and Safety Services and Disability Management. He just completed a term on the WOEMA Board, and continues to serve on the WOEMA Education Committee. In his retirement, he is also teaching high school science, cooking for charities, and serving on the Board of a non-profit mentoring organization. He is a life-long exerciser, and recently began regular "hill walking" following a trip to Scotland.

[Webinar, Powerpoint Presentation, Evaluation for CME Credit - WOEMA Members Only] [Download References]

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.

TOPIC: Occupational Contact Dermatitis
Aired Thursday, October 21, 2010 - 12 noon (Pacific Time)

Speaker: Vincent A. DeLeo, MD, Chairman, Department of Dermatology, St. Luke's Roosevelt & Beth Israel Medical Centers, New York City

Description:
Contact Dermatitis is one of the most common occupational diseases. I will discuss irritant and allergic forms of the disease. This will include the diagnosis and treatment of the disease.

Learning Objectives:

To recognize the morphology of Contact Dermatitis.
To discern differences between irritant and Allergic Contact Dermatitis.
To understand the methods for diagnosing Contact Dermatitis.
To learn the common allergens in Contact Dermatitis.
To recognize the setting for various allergens in the workplace.

[Webinar, Powerpoint Presentation, Evaluation for CME Credit - WOEMA Members Only]

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.

TOPIC: Mild Traumatic Brain Injury
Aired Thursday, August 19, 2010 - 12 noon PT

Speaker: Lorne K. Direnfeld, MD, FRCP, Neurologist, Diplomate, American Board of Psychiatry and Neurology

Description:
According to the CDC, there are about 1.5 million people with a traumatic brain injury (TBI) each year in the US. Approximately 90% of these cases are mild injuries. Almost half were seen only in the clinic, physician office, or not at all. TBI is a leading cause of disability, especially among young adults. Additionally, it is an important concern to the occupational health care pratitioner. Work-related TBIs constitute an estimated 45-50% of all TBIs, with the incident varying by specific occupation.
Participants in this webinar will learn the criteria for the diagnosis of TBI and will gain heightened awareness of the importance of physician/healthcare provider interaction and the outcome of patients with mild TBI including avoiding iatrogenic disability. A case example will be presented to illustrate this and other issues.

Learning Objectives:

The definition of mild traumatic brain injury (TBI).
Symptoms of mild TBI.
Important points in the history of patients with mild TBI.
Using strategies to strengthen the partnership with TBI patients and building a therapeutic alliance.
Avoiding iatrogenic disability.

[Webinar, Powerpoint Presentation, Evaluation for CME Credit - WOEMA Members Only]

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.

TOPIC: "To Work or Not to Work: The Costs of Absenteeism and Presenteeism"
Aired Thursday, June 17, 2010 - 12 noon PT

Speaker: Constantine Gean, MD, MBA, MS, FACOEM, Regional Medical Director, Liberty Mutual Insurance Company

Description:
Determining appropriate return to work status is a complex issue that must be addressed by all physicians, regardless of specialty. Not only must the timing of the return to work be addressed, but ancillary issues such as modified duty, part time work, or necessary accommodations need to be examined. OEM Physicians are often called upon by patients and employers for their expertise in this arena.

The complexity is increased by the number of stakeholders in the return-to-work process: patient, physician, managers, supervisors, human resources (if the absence from employment is work related), then adjuster and insurance company.

We will discuss and suggest practice improvements on this critical topic during this WOEMA Webinar Series.

Learning Objectives: At the end of this presentation, attendees will be able to:

Understand absenteeism, presenteeism, and the difference between the two.
Describe why absenteeism and presenteeism are important concepts for occupational health practice.
Obtain a general concept of the origins of presenteeism.
Appreciate absenteeism and presenteeism as they relate to the Workers Compensation and Group Health arenas.
Review the economic consequences of absenteeism and presenteeism.
Obtain an understanding of program approaches to monitoring and limiting costs from absenteeism and presenteeism.

[Webinar, Powerpoint Presentation, Evaluation for CME Credit - WOEMA Members Only]

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.

TOPIC: Occupational Lead Poisoning: New Guidelines for Clinical Management

Aired Thursday, April 15, 2010 - 12 noon PT -

Speaker: Paul J. Papanek, Jr., MD, MPH, Occupational Health Service, Los Angeles Medical Center, Kaiser on the Job

Description:
1) The California Dept. of Public Health published a new Guidance Document in 2008 on acceptable blood lead levels, which occupational physicians should be familiar with. Its key changes are:
(a) Blood lead levels should be kept below 20 mcg/dl
(b) Physicians can use Medical Removal Protections to accomplish this
2) Brief overview of lead toxicity and clinical presentation.
3) Epidemiology of lead poisoning in California, using Southern California data.
4) Other clinical approaches founded in the OSHA Lead Standard.
5) Pedictions for changes to the OSHA Lead Standard.

Learning Objectives: At the end of this presentation, attendees will be able to:

State the target blood lead levels that are now supported by clinical research and recommended by health departments.
State a strategy for achieving such blood levels within the constraints of the OSHA lead standard.

[Webinar, Powerpoint Presentation, Evaluation for CME Credit]

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.

TOPIC: Overuse of Narcotics in California's Workers' Comp System: A Payer's Perspective and Suggested Interventions
Aired Thursday, February 18, 2010 - 12 noon PT

Speaker: Gideon Letz, MD, MPH, Medical Director, State Compensation Insurance Fund

Description: It is well known that a small percentage of Workers' Comp claims are responsible for a disproportionate percentage of the overall costs in the system. Surprisingly, most of these high cost cases are not severe injuries. They are mostly minor strain/sprain diagnoses with disability duration greater than expected - so called "delayed recovery" cases.

The cause of the unexpected disability and failure to recover is related to various psycho-social issues that involve the patient, his/her employer, treating physician and claims administrator. Most of these patients develop some form of chronic musculoskeletal pain that is often mis-managed because the treatment fails to address the non-medical context of the injured worker's claim. Typically, these patients are treated with chronic opiate medications, often in continually escalating does without any sign of functional improvement. Return to work is delayed and they become more and more isolated from their employer, co-workers and even family and friends. The results are disastrous both in terms of cost and human suffering.

A first step in turning these cases around is detoxification from narcotic and other CNS depressant medications, combined with cognitive behavioral therapy and daily exercise, particularly aerobic activity. But a more effective strategy involves early identification of patients at high risk for delayed recovery and specifically intervening with proven multidisciplinary treatment.

Learning Objectives:

To explain why use of opioid medications in the management of common soft-tissue musculoskeletal strain/sprain injuries is contrainidcated and prolongs disability.
To offer suggestions for the clinician on how to avoid the pitfalls of chronic opioid use:

a. Early identification of patients at risk for delayed recovery
b. Referral for effective alternative therapies with a focus on active care.

To outline a stratgey for how clinicians can work cooperatively with claims administrators and employers to facilitate recovery.

[Webinar, Powerpoint Presentation, Evaluation for CME Credit - WOEMA Members Only]

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 0.66 AMA PRA Category 1 Credit^TM. CME Certificates are issuedand e-mailed to those who successfully participate and complete the webinar.

TOPIC: Cal-OSHA ATD Standard
Aired Thursday, January 21, 2010 - 12 noon PT

Speaker: Deborah Gold, MPH, CIH
Senior Safety Engineer, Cal/OSHA

Description: California recently enacted the first occupational safety and health standard to protect employees against aerosol transmissible diseases. This presentation will include the background of the standard and how it relates to other infection control and occupational safety and health guidelines. The presentation will also discuss requirements relevant to medical practices, and the role of physicians in providing medical services under the standard.

Learn how to:

Describe how aerosol transmissible diseases are classified.
Apply common control measures to prevent the risks of aerosol transmissible diseases in medical practices.
Identify specific control measures applicable to airborne infectious diseases such as tuberculosis.
Interpret and report the exposure incidents and medical follow-up requirements under the ATD Standard.

[Webinar, Powerpoint Presentation, Evaluation for CME Credit - WOEMA Members Only]

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.

TOPIC: Pyrethroid Pesticides: Hidden Hazard
Aired Thursday, December 10, 2009 - 12 noon PT

Speaker: Rupali Das, MD, MPH, FACOEM
California Department of Public Health (CDPH)

Description: Pyrethroid pesticides are widely used for pest control in both occupational and residential settings. Often marketed as safe, the adverse effects of pyrethroid pesticides are under-appreciated. Occupational and environmental health practitioners are likely to encounter patients exposed to pyrethroids. This webinar provided critical information to guide practice.

Report pesticide illness
Describe why occupational illness due to pyrethroids is a concern
Recognize settings where exposure to pyrethroid pesticides may occur
Identify potential health consequences of exposure to pyrethroid pesticides
Manage workers exposed to pyrethroid pesticides

[Webinar, Powerpoint Presentation, Evaluation for CME Credit - WOEMA Members Only]

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Western Occupational & Environmental Medical Association

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