Topic outline

  • Welcome to the 2015-2016 Agricultural Medicine Course

    Welcome to the online portion of Agricultural Medicine: Occupational Health for Rural Professionals.  This training is a blended course designed for medical practitioners, agricultural professionals, first responders and others with responsibility for the health and safety of farmers and rural citizens.

    **  REVISED COURSE COMPLETION TIMELINE (published 10-28-15)  **

    1.  November - December, 2015:  Current trainees finish up webinars and ​quizzes.  First of 4 newsletters will be sent out to trainees planning to complete the full Agricultural Medicine Course at the end of April 2016.  Each newsletter will have information giving access to a National AgriSafe Network webinar about an important agricultural health and safety issue, as well as other pertinent material.

    2.  January - March, 2016:  Monthly newsletters continue

    3.  Tuesday, April 26, 2016 - Friday noon, April 29, 2016:  Final on-site training days at Middlebury Inn for 2015 training enrollees.

    4.  New participants:  Will be required to watch the 6 recorded webinars (refer to links in sections below) AND attend on-site training at the Middlebury Inn from 12 p.m. on Monday, April 25 through 12 p.m. on Friday, April 29, 2016.

    5.  Friday, May 27, 2016:  Half-day Review Day in preparation for the University of Iowa online Certification Test.

    6.  Wednesday, June 1 through Thursday, 30, 2016:  Participants take Iowa Certification Test during this period.  Moodle course website will close at 11:59 p.m.

    **  The following course information was published prior to 10-28-15 for 2015 training enrollees  **

    This course takes place in three distinct environments -- webinars, Moodle course website, in-person sessions -- so please read this section carefully.

    1. Webinars

      • There are six (6) consecutive Wednesday afternoon weekly webinars:  September 16-23-30 and October 7-14-21.  
      • The first five are from 3 to 4:30 p.m. and the last session (Oct. 21) is from 3 to 5 p.m.  
      • These webinars are presented over Blackboard Collaborate.
      • Each week's webinar is reached through a unique link provided on this site.
      • To be sure that your computer is ready to run the webinars please go to AND run the diagnostics.
      • Visit UVM Extension "Getting Started: Blackboard Collaborate" ( for more information.
      • The webinars are an important part of the class -- plan to attend as many as possible live.
      • We understand that sometimes things come up and it may not be possible for you to attend every presentation. The webinars will be recorded and links to recordings will be posted in the appropriate section after the program.

    2. Moodle Course Website

      • The second part of the the course -- Moodle -- is this website where you are reading this message.
      • On this site, you will be able to: download presentation materials, review the recordings of the webinar presentations, get to know the presenters and other participants, and review for and take the weekly quizzes.
      • The course will have more meaning for you if you try to log in several times each week rather than trying to do everything at a single sitting.
      • You may want to bookmark the site to make finding it easier. 

    3. In-person Sessions

      • The in-person part of the course takes place in-person from 12:00 p.m. on Monday, April 25 to 12:00 p.m. on Friday, April 29, 2016 at the Middlebury Inn (Middlebury, Vermont).
      • This section of the course provides 39 hours of instruction and CME credit.


    Information & Acknowledgements

    Agricultural Medicine: Occupational Health for Rural Health Professionals - The Core Course. 

    A Building Capacity course. 

    Funded by NIOSH ​Grant #5U54OH007548.

    University of Iowa Center for Agricultural Safety and Health (I-CASH) and the Great Plains Center for Agricultural Health

    We are grateful for the sponsorship and substantial assistance by the staff of the University of Iowa’s Center for Agricultural Safety and Health (I-CASH) and the Great Plains Center for Agricultural Health in developing and presenting this training for Vermont and other New England states.  Having been trained and mentored by the Iowa Center for Agricultural Safety and Health (I-CASH) program staff, Vermont is now the New England regional training sponsor and presenter of the Core Course. This Course has been modified to include some New England regional differences in agricultural processes and exposures, cultural and climatic variations, and differences in availability and type of health services.  

    great plains center for agricultural health

    AgriSafe Network

    Although this training is aimed at a broad audience of health and agricultural professionals, it is also designed to specifically train rural practitioners and the agricultural partners needed to provide necessary farm occupational health and safety services. The shared goal for both these groups is that trained professionals become certified as AgriSafe Network Providers.  AgriSafe originated in Iowa and has now expanded to a national program. AgriSafe providers are trained in the recognition, diagnosis, treatment and the prevention of occupational and environmental illnesses and injuries within the rural and agricultural communities. Vermont is the only New England state that is an official AgriSafe Affiliate and qualified to present the Agricultural Medicine course. 

    agri safe network

    University of Vermont Extension  

    UVM Extension has again graciously given the Farm Health Task Force access to their Blackboard Collaborate webinar platform and the Moodle course site for their 2015 Agricultural Medicine and Occupational Safety Course.   Extension communication staff have been generous with their time updating and reformatting the existing course website, and providing consultation to faculty and students. We have greatly benefited from this support and collaboration as will our course students and faculty. 


    uvm extension

    Continuing Education Credits

    1. Continuing Medical Education Credits (CMEs): This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of Vermont and the Vermont Farm Health Task Force.  CMEs are currently available only for the on-site portion of the course.   The University of Vermont designates this live activity for a maximum of 38.5 AMA PRC Category 1 Credits TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.
    2. Participants are hereby notified that there is no commercial support or sponsorship for any portion of this training; no conflicts of interest of any kind by planners or faculty to disclose or resolve; no products will be displayed or advertised in conjunction with this activity; and, there will be no discussion of any off-label usage of any products.
    3. Social Workers: This program has not received prior approval for Social Work CEUs, but social workers who attend may apply individually for Continuing Education units by contacting NASW-VT at or calling (888) 260-7398.
    • 1. Zoonotic Diseases - September 16, 2015

      julie smith

      Julie Smith, DVM, PhD, UVM Extension Dairy Specialist

      Dr. Julia M. Smith is an Extension Associate Professor at the University of Vermont. Julie received her B.S., D.V.M., and Ph.D. degrees at Cornell University. Her research interests include the interactions among nutrition, growth and immune system development in young dairy calves. She also promotes the improvement and protection of herd health through biosecurity. Julie has conducted trainings for Extension educators, livestock producers and community members on the risks posed by the introduction of a highly contagious animal disease and the importance of preparedness in all sectors of the livestock industry. She currently serves as Vermont’s point-of-contact for the national Extension Disaster Education Network and co-chairs that organization’s Agrosecurity committee. As a veterinarian and spouse of a dairy farmer, Julie is well aware of the animal health and wellbeing concerns of dairy animals. 

      Educational Objectives - At the end of this session, participants will be able to:  

      • Identify exposure to agricultural animals or environments as a risk factor for zoonoses.  

      • Identify particular conditions which predispose agricultural workers to infection by zoonotic agents.  

      • Discuss potential risks and ways to mitigate these risks.  

      • Describe examples of zoonotic diseases which either have a relatively high prevalence or which have generated recent interest in the media.

    • 2. The Pharmacist's Role in Rural Communities - September 23, 2015

      catherine friend
      Catherine Friend, RPh, Supervising Pharmacist, Middlebury Marbleworks Pharmacy Michael Biddle, Jr., Pharm.D., BCPS, Assistant Professor, Albany College of Pharmacy - Vermont Campus

      Catherine Friend has been a practicing pharmacist for the past 26 years and worked in various pharmacy settings. The majority of her practice has been in retail pharmacy, but she has also worked in long-term care and hospital settings.  Currently, she manages three independent retail stores in central Vermont. Catherine is a certified Medication Management Therapy provider and also certified in Immunizations and Diabetes management. Over the years, she has witnessed the changing environment in the healthcare fields and was excited to partner with Porter Hospital in their patient discharge program.  

      Michael Biddle is an assistant professor in the Department of Pharmacy Practice at Albany College of Pharmacy and Health Sciences – Vermont Campus. After receiving his Bachelor of Arts degree at Marshall University in secondary education, Dr. Biddle went on to earn his Doctor of Pharmacy degree at West Virginia University School of Pharmacy in 2009. Dr. Biddle completed a 2-year pharmacotherapy residency at Idaho State University’s Department of Family Medicine in Pocatello, Idaho specializing in both inpatient and outpatient family medicine in 2011.  Dr. Biddle is currently responsible for teaching Pharmacy Sills Lab 5: Patient Assessment, Pharmacists as Immunizers and Medication Therapy Management.  His practice interests include anticoagulation, diabetes, medication therapy management and motivational interviewing.  Dr. Biddle currently practices at Richmond Family Medicine in Richmond, Vt.

      Educational Objectives At the end of this session, participants will be able to:

      • List and describe the types of services community pharmacists can provide to optimize patient care.

      • Explain the role and impact of community pharmacists providing immunizations.

      • Describe the role of the community pharmacist as a member of the patient care team.


    • 3. Agricultural Toxicology: Pesticides and Health Risks - September 30, 2015

      sarah vose anne macmillan
      Sarah Vose, PhD, State Toxicologist, Vt. Department of Health Anne MacMillan, MS, Agrichemical Toxicologist, Vt. Agency of Agriculture, Food & Markets

      Sarah Vose received her undergraduate degree in Molecular Biology from Vanderbilt University in Nashville, Tennessee. After working in biotechnology and academia, Sarah enrolled in graduate school at the University of Berkeley in California. She received her Ph.D. in Molecular Toxicology in 2008. Her research focused on pesticide metabolism and chemistry, and potential biomarkers for neurotoxicity. She went on to complete post-doctoral training at Harvard School of Public Health in Boston, Massachusetts, in the Genetics and Complex Diseases Department. Sarah studied Cockayne Syndrome, a progeria caused by defective DNA repair. In 2012, Sarah accepted the State Toxicologist position at the Vermont Department of Health, in Burlington. Sarah oversees risk assessments, cyanobacteria monitoring, private drinking water, chemical emergency response and the Chemical Disclosure Program for Children’s Products.

      Annie MacMillan is the Vermont Agency of Agriculture’s Agrichemical Toxicologist, where she wears many hats. She coordinates the federal Worker Protection Program, a comprehensive farm worker safety program; manages the Agency’s Agricultural Plastic Film Recycling Program and the Obsolete Pesticide Disposal Program. Annie develops and maintains a toxicological and regulatory database and reference library pertinent to agrichemicals. She conducts both qualitative and quantitative human health and environmental risk assessments on pesticides and other agricultural chemicals and practices. Annie also responds to specific health and environmental concerns communicated to the Agency through risk assessments and recommendations for appropriate actions to eliminate or minimize impacts. 

      Educational ObjectivesAt the end of this session, participants will be able to:

      • Identify the uses and hazards of pesticides, how people are exposed, symptoms of poisoning, diagnosis and treatment of pesticide poisoning.  

      • Describe four classes of agricultural insecticides.

      • Understand the key issues in addressing pesticide exposure in children.
      • Be able to discuss the purpose of the proposed federal Worker Protection Standards (WPS).


    • 4. Oral Health in Rural Vermont - October 7, 2015

      doctor jim cossaart
      James Cossaart, DDS, Community Dentist, Bristol Park Dental

      Dr. Jim Cossaart was a farmer in Northern Kansas for twenty years.  In 1999, at the age of 42, he received his DDS degree from the University of Nebraska College of Dentistry.  Upon graduation, Dr. Jim practiced for eight years in Middlebury.  In 2007, Dr. Cossaart and his wife Deb moved back to his family’s six-generation homestead in Kansas.  During a seven-year period of upgrading their 384-acre farm into a grass-fed cattle ranch, Jim and Deb established two separate rural dental practices in adjacent southern Nebraska.  Both practices were sold to younger dentists, and they continue to serve the two communities.  In July of 2015, Dr. Jim and Deb returned to Vermont and established a new dental practice in Bristol.  With an open schedule and accepting all new patients, they opened their doors October 1 of last year.

      Educational Objectives - At the end of this session, participants will be able to:

        • Identify the number one problem in dental health.
        • List measures used to treat dental abscess and manage dental pain.
        • Discuss barriers to ​obtaining dental ​care for rural populations.


    • 5. Vector Borne Diseases - October 14, 2015

      christopher grace jeff heath

      Christopher Grace, MD, Director, Infectious Diseases Unit, UVM Medical Center

      Jeffrey Heath, RN, Public Health Nurse Supervisor, Middlebury District Office, Vt. Department of Health

      Christopher Grace, MD graduated from the University of Notre Dame with a BS in Biology.  He received his MD from New York Medical College.  He did an internship in internal medicine at St. Vincent's Hospital in New York, N.Y., followed by two fellowships; critical care at University Health Center in Pittsburgh, Pa. and infectious disease at St. Francis Hospital in Hartford, Conn.  Since 1987, he has been an attending physician in infectious disease at the University of Vermont Medical Center (UVMMC) and Director of the Infectious Disease Unit at UVMMC since 1992.  Since 1994, he has been the Director of the HRSA grant for HIV Care.  Dr. Grace received the UVM College of Medicine Clinical Teacher of the Year Award four times.  He is the author of 16 refereed journal articles and editor of Medical Management of Infectious Diseases (2003).

      Jeffrey Heath is a Public Health Nurse with the Vermont Department of Health in the Middlebury District Office serving Addison County.  He is the Epidemiology Designee for the district and investigates cases of reportable diseases, partnering with the local hospital and medical providers to protect and promote public health for the Addison County service area.  Jeff began his career in serving adults with developmental disabilities in community residential facilities. He provided medical case coordination to individuals with complex medical, educational, and behavioral needs.  Concurrently, Jeff became a professional home provider and provided care to a developmentally disabled man in his home for 14 years.  One of Jeff’s most cherished accomplishments was the adoption of his son who had been in protective custody after being removed from an extremely abusive home.  Jeff raised his son as a single parent, helped his son overcome many of the challenges of his adverse childhood experiences, and ultimately enjoyed his son’s many successes in life.  Jeff has worked as a nurse for the Vermont Department of Health for 15 years.  Through a strong determination to promote health and prevent disease, he has become a trusted and reliable public health resource for his community. 

      Educational Objectives At the end of this session, participants will be able to:

        • Participants will be able to recognize, diagnose and treat Lyme disease and other arbovirus infections.

        • Participants will understand the epidemiology and surveillance of Lyme disease and other arboviruses.  

        • Participants will understand the current recommendations to prevent infection with Lyme disease and other arboviruses.

    • 6. Physical Environmental Factors (Vibrations, Heat, Cold, Noise) - October 21, 2015


      kelley donham john may

      Kelley Donham, MS, DVM

      John May, MD

      Kelley J. Donham, MS, DVM, DACVPM is Emeritus Professor, Occupational and Environmental Health, College of Public Health, University of Iowa, serving as a faculty member and professor from 1973–2013.  During his time there and among his many achievements, he accomplished the following: 

      • Lead the Agriculture at Risk Policy Process, leading to the NIOSH National Agricultural Health and Safety Program (1987-1990);
      • Held the Pioneer Endowed Chair in Rural Health and Safety from 2009–2013;
      • Founded and directed both the Agricultural Health and Safety Training Program at the University of Iowa, and the NIOSH-funded Building Capacity Training Program in Agricultural Medicine (1974–2013);
      • Founded and directed Iowa’s Center for Agricultural Safety and Health (I-CASH) 1990-2013);
      • Founded and directed the Iowa Health and Safety Service Network (1987-2003; now the AgriSafe Network);
      • Founded and directed the Certified Safe Farm Program (1997-2007);
      • Served as Deputy Director of The Great Plains Center for Agricultural Health (GPCAH; 1990–2013). 
      • Published 3 books, 24 book chapters, and 150 peer-reviewed research papers in the field of Agricultural Medicine. 

      John May, MD is a graduate of the University of Notre Dame and Case Western Reserve School of Medicine.  He is the Jane Forbes Clark Chair of the Research Institute at the Bassett Healthcare Network, CooperstownNew York.  He is a Professor of Clinical Medicine and Epidemiology at the College of Physicians & Surgeons, Columbia University and the Director of the New York Center for Agricultural Medicine and Health.  Dr. May practices pulmonary and occupational medicine at Bassett Healthcare with a particular interest in agricultural injury and illness, a field he has worked in for the past 30 years.  Research interests include the epidemiology of migrant farmworker injury; social marketing and community-based initiatives aimed at reducing agricultural injury and death.  Dr. May directs the Northeast Center for Agricultural Health, one of the centers designated nationally by the National Institute for Occupational Safety and Health.  Northeast Center projects extend from Maine to Delaware and focus upon health and safety issues affecting migrant farmworkers and traditional family farmers. 

      Educational Objectives - At the end of this session, participants will be able to:  

        • Recognize the effects of farm activities on noise-induced hearing loss.

        • Understand the impact of mechanical vibrations on agricultural workers.  

        • Be aware of the positive and negative role that temperature extremes (especially cold) play in New England farming.