title: Case report: three farmworkers who gave birth to infants with birth defects closely grouped in time and place-Florida and North Carolina, 2004-2005.
abstract: BACKGROUND
  There is little evidence linking adverse reproductive effects to exposure to specific pesticides during pregnancy.
  
  
  METHODS
  In February 2005, three infants with congenital anomalies were identified in Collier County, Florida, who were born within 8 weeks of one another and whose mothers worked for the same tomato grower. The mothers worked on the grower's Florida farms in 2004 before transferring to its North Carolina farms. All three worked during the period of organogenesis in fields recently treated with several pesticides. The Florida and North Carolina farms were inspected by regulatory agencies, and in each state a large number of violations were identified and record fines were levied.
  
  
  CONCLUSIONS
  Despite the suggestive evidence, a causal link could not be established between pesticide exposures and the birth defects in the three infants. Nonetheless, the prenatal pesticide exposures experienced by the mothers of the three infants is cause for concern. Farmworkers need greater protections against pesticides. These include increased efforts to publicize and comply with both the U.S. Environmental Protections Agency's Worker Protection Standard and pesticide label requirements, enhanced procedures to ensure pesticide applicator competency, and recommendations to growers to adopt work practices to reduce pesticide exposures. RELEVANCE TO PROFESSIONAL PRACTICE: The findings from this report reinforce the need to reduce pesticide exposures among farmworkers. In addition, they support the need for epidemiologic studies to examine the role of pesticide exposure in the etiology of congenital anomalies.
authors.affiliation: Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio 45226, USA. jac6@CDC.GOV
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Calvert
authors.forename: Walter A
authors.initials: WA
authors.lastname: Alarcon
authors.forename: Ann
authors.initials: A
authors.lastname: Chelminski
authors.forename: Mark S
authors.initials: MS
authors.lastname: Crowley
authors.forename: Rosanna
authors.initials: R
authors.lastname: Barrett
authors.forename: Adolfo
authors.initials: A
authors.lastname: Correa
authors.forename: Sheila
authors.initials: S
authors.lastname: Higgins
authors.forename: Hugo L
authors.initials: HL
authors.lastname: Leon
authors.forename: Jane
authors.initials: J
authors.lastname: Correia
authors.forename: Alan
authors.initials: A
authors.lastname: Becker
authors.forename: Ruth H
authors.initials: RH
authors.lastname: Allen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Evans
mesh_terms: D000383:Agriculture / Q000331:legislation & jurisprudence* / Q000379:methods; D016000:Cluster Analysis; D000013:Congenital Abnormalities / Q000209:etiology*; D005260:Female; D005431:Florida; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009657:North Carolina; D016273:Occupational Exposure / Q000009:adverse effects*; D010575:Pesticides / Q000633:toxicity*
chemical_list: D010575:Pesticides