Dr. Rautiainen Focuses on Agricultural Health and Safety

Spotlight on Research at COPH

“Farmer run over and pinned under rear wheel of a tractor,” “Rancher knocked down by a cow while moving cattle on ranch,” “Two workers overcome by toxic gases when pumping manure between lagoons.” These are examples of serious agricultural injuries in Nebraska last year. Agriculture is the most hazardous industry in the nation, yet we rarely hear about it in the news. If there is a major mining incident, it is front-page news worldwide—and rightly so. But while in 2010 there were 172 mining fatalities in the US, agriculture had 596 fatalities and a fatality rate eight times higher than all industries on average. Dr. Risto Rautiainen, associate professor in the Department of Environmental, Agricultural, and Occupational Health, states that “one reason that farm incidents are under-reported in the media is that they typically involve just one victim.” Injuries such as those listed above may be reported locally, but they are not newsworthy beyond the local TV viewing area. “And this is just the tip of the iceberg,” says Dr. Rautiainen. “From surveys and studies, we know that non-fatal injuries and work-related illnesses are frequent on farms, but data on these outcomes are not collected systematically. We don’t have a clear picture of their frequency, risk factors, and causes, or if are we making progress in prevention.”

source: cdc.gov

Even from the limited data available, it is clear agricultural injuries and illnesses are a major public health problem in Nebraska and the nation—but is there a solution? The UNMC College of Public Health recently established a new center with funding from the National Institute of Occupational Safety and Health, part of the Centers for Disease Control and Prevention. The new Central States Center for Agricultural Safety and Health (PI Dr. Rautiainen) started operation in October, joining a national network of nine similar centers. “This is a significant new resource for Nebraska and the region,” states Dr. Rautiainen. “Our center will investigate asthma in animal confinement workers, and we will conduct annual surveys to establish injury rates and risk factors for our seven-state region, including Nebraska. We will collaborate with partners reaching out to farm audiences, including traditional family farms, and non-traditional farm operations, including organic farms and part-time farms. We will collaborate with the media in getting the word out about prevention. This is an exciting new opportunity for us, and we hope that with this new resource, we can make a difference, reducing injury and illness among farmers, family members, and workers on farms and ranches in Nebraska and the region.”

Exchange Students from National Taiwan University

From left to right: Kuan-Han Lin, Tsai-Shu Chu, and Cynthia Tzu-Hui Wu

Student Highlight – In January of 2011, the UNMC College of Public Health signed agreements with the College of Public Health of National Taiwan University (NTU) to promote collaboration in education and academic research. The NTU College of Public Health is a top public health academic institution in Asia. Based on the agreement, the two colleges will exchange up to three graduate or professional students each year. This fall, the first three NTU students (introduced below) are visiting and studying at UNMC. Building on the student exchange program, we hope to further strengthen the faculty collaboration between the two colleges and expand our global health initiatives through NTU’s network in Asia.

Kuan-Han Lin
Kuan-Han Lin is a second year PhD student in the Institute of Occupational Medicine and Industrial Hygiene at National Taiwan University. Her research interests are psychiatric disorders after occupational injury, environmental and occupational epidemiology, and occupational stress. Kuan-Han was inspired to pursue a PhD degree after learning about international perspectives on occupational and environmental health issues in an International Environmental and Occupational Health course she took as a master’s degree student. As a graduate student, she has attended many international conferences to broaden her perspectives on occupational and environmental health. Kuan-Han believes an occupational and environmental health professional should be able to communicate and work effectively with both domestic and international colleagues in occupational and environmental health. Kuan-Han’s future career goals are to obtain a PhD degree and become a researcher in the field of occupational and environmental health.

Through the NTU student exchange program with UNMC, Kuan-Han plans to further explore the occupational and environmental issues she encountered during her graduate years and to enhance her English-language proficiency. Kuan-Han is taking a course, “Special Topics – Occupational Biomechanics,” with Dr. Joseph Siu in the Department of Environmental, Agricultural and Occupational Health. She is also working on a research project with Dr. Dana Loomis (Department of Epidemiology) and Dr. Risto Rautiainen (Department of Environmental, Agricultural and Occupational Health) focused on the data analysis of injuries in farming. She believes that a PhD student should have independent and innovative research capabilities and a global perspective on the field of occupational medicine and occupational hygiene and health. She intends to use this opportunity as an exchange student in the COPH at UNMC to achieve this vision.

Tsai-Shu Chu
Tsai-Shu Chu comes from Taipei City, Taiwan. Her undergraduate concentration was in public health. As a sophomore, she became interested in environmental health and after graduation, decided to pursue a master’s degree in environmental health. Tsai-Shu received the Shane S. Que Hee Fellowship in graduate school. Her master’s thesis was on trichlormine exposure at indoor swimming pools. The study was accepted for poster presentation at the American Industrial Hygiene Conference & Expo in May 2011 and was awarded Best Professional Poster in the sampling and laboratory analysis field.

Tsai-Shu is interested in how the environment affects human health and how humans can live healthier lives through a better environment. When she was doing field sampling in Taipei City, she learned the importance of expressing professional knowledge in lay people’s terms so they understand that environmental health is crucial.

As an exchange student, Tsai-Shu is in the Department of Environmental, Agricultural and Occupational Health, and her advisor is Dr. Chandran Achutan. During the six-month exchange program, she wants to experience the difference between academic life in the US and Taiwan and to enhance her language skills. While studying at UNMC, she will do research on the potential hazards of exposure to wind turbine noise. Tsai-Chu believes that “no man is an island” and that the worldwide environment is interconnected. “It is important to broaden our perception of the world and how people think.” Helping people achieve a better life through her work as an environmental health professional is Tsai-Shu’s career goal.

Tzu-Hui Wu
Tzu-Hui Wu, also known as “Cynthia,” is from Kaohsiung, Taiwan. She is a master’s degree student majoring in health policy and management at National Taiwan University (NTU). Tzu-Hui wanted to study abroad, and the NTU/UNMC student exchange program was an ideal opportunity. As an undergraduate, she majored in adult and continuing education, pursuing an interest in gerontology education and interaction with elders. After noticing the change in population structure, she decided to undertake further study of the health system and aging issues, and entered the field of public health. Tzu-Hui hopes that one day elders will live in a better world.

During her time at NTU, she took courses such as Principles of Health Care Organization and Management, Health Care System, Geriatrics and Long-Term Care, and Organizational Research Methods and Applications in Health Care. As an exchange student at UNMC, she wanted to expand her knowledge base, so she chose to join a health behavior class. She would like to apply theoretical foundations and theories of health behavior in her career in the future. Dr. Li-Wu Chen (Department of Health Services Research and Administration), Dr. Terry Huang (Department of Health Promotion, Social and Behavioral Health), and Dr. Jungyoon Kim (Department of Health Services Research and Administration) are her advisors during the exchange period. Dr. Kim is assisting Tzu-Hui with her research regarding how the experience of home health aides in the United States might inform the experience the experience of home health aides in Taiwan.

Though Tzu-Hui is still getting used to learning in a foreign language environment, and is working hard to complete her reading assignments, she is enjoying her study at UNMC and hopes she will succeed in both academia and life!

Spotlight on COPH Research

Dr. Joshi Uses Health Informatics to Address Public Health Issues

Blood glucose and pressure monitoring in Orissa, India, using portable technology in chronic disease surveillance.

Dr. Ashish Joshi is an assistant professor in the COPH Department of Health Services Research and Administration and the Center for Global Health and Development. Dr. Joshi’s research interests include global health; multifaceted technology-mediated interventions to support chronic care; and computer-mediated health education, geovisualization, and health outcomes.

Dr. Joshi blends his clinical medicine training with biomedical research, public health research, and computer science and engineering research. He uses technology-mediated, multifaceted interventions to support chronic care. For example, Dr. Joshi designs and evaluates interventions that support disease prevention, monitoring, and management through technologies that are multifaceted, cost-effective, and accessible. He creates models that can be adopted in practice-based settings through effective collaborations among different stakeholders for improving health outcomes. His expertise is especially geared toward interactive health information platforms such as touch-screen computers placed in kiosks for the purpose of recording demographic information, knowledge, attitudes, and practice information; self-reported clinical assessments; and risk assessment information and health education for lifestyle modification.

Since joining UNMC in 2010, Dr. Joshi has developed a program called MetaPhor (Mobile Emerging Technologies and Population Health Outcomes Research) that aims to develop and implement meaningful, cost-effective, and accessible health Informatics solutions by establishing strong public-private partnerships. He has initiated several research projects in the areas of chronic diseases, sexually transmitted infections, and child health nutrition. Dr. Joshi, in collaboration with the North Central District Health Department in O’Neil, Nebraska, designed and developed an innovative web-based community health assessment system to better assess needs of individuals living in rural Nebraska.

In addition, Dr. Joshi is developing research and teaching opportunities in Brazil, Nigeria, and India. His ongoing project to evaluate a telehealth program in Brazil was supported by a grant from Brazil’s Ministry of Health and the U.S. Department of Education. His research work involving computers to improve chronic disease surveillance in rural and tribal areas of India was recently presented at the American Medical Informatics Association-Public Health Informatics 2011 conference, for which he was awarded a travel grant by the Robert Wood Johnson Foundation.

Dr. Joshi will be teaching Introduction to Biomedical Informatics (BIINFO 810) in the fall semester 2011 in collaboration with other faculty from the UNMC College of Medicine and College of Nursing and from UNO. Prior to joining UNMC, he developed an online certificate program in public health informatics specifically geared toward addressing public health informatics needs in developing countries. Dr. Joshi will use his academic and research expertise to expand similar public health informatics programs at UNMC.