title: Using surveillance data to promote occupational health and safety policies and practice at the state level: a case study.
abstract: BACKGROUND
  Following the investigation of a birth defects cluster involving migrant farmworkers employed in North Carolina and Florida, it became clear that greater efforts were needed to protect agricultural workers from pesticide exposure.
  
  
  METHODS
  Documentation is drawn from peer-reviewed published articles, government reports and news accounts.
  
  
  RESULTS
  The birth defects cluster was identified and investigated by state and federal pesticide poisoning surveillance system staff. Following the investigation, efforts were initiated to highlight pesticides as an important public health issue needing more attention. A series of subsequent events led to the creation and passage of important legislation recently enacted in North Carolina. The legislation resulted in funding to promote various activities to prevent harm from pesticides including strengthening surveillance, improving the quality of pesticide compliance inspections, and increasing and improving pesticide safety training. The legislation also broadened the coverage of anti-retaliation rules to include agricultural workers, and increased recordkeeping requirements pertaining to pesticide applications.
  
  
  CONCLUSIONS
  The important and positive impacts that can occur through surveillance activities are highlighted. As such, it is important to continue to support and improve occupational illness and injury surveillance programs.
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: Sheila A
authors.initials: SA
authors.lastname: Higgins
mesh_terms: D000015:Abnormalities, Multiple / Q000139:chemically induced* / Q000453:epidemiology*; D000383:Agriculture; D016000:Cluster Analysis; D005431:Florida / Q000453:epidemiology; D006801:Humans; D009657:North Carolina / Q000453:epidemiology; D016273:Occupational Exposure / Q000331:legislation & jurisprudence / Q000517:prevention & control* / Q000592:standards; D016272:Occupational Health / Q000331:legislation & jurisprudence; D010575:Pesticides / Q000009:adverse effects*; D018571:Sentinel Surveillance
chemical_list: D010575:Pesticides