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We collected indoor dust samples from homes in the Salinas Valley of California. Of 22 pesticides measured in 504 samples, permethrins and the organophosphate chlorpyrifos were present in highest amounts. In multivariate Tobit regression models among samples from 197 separate residences, reported agricultural uses of chlorpyrifos, a herbicide (2,3,5,6-tetrachloroterephthalate (DCPA)), and a fungicide (iprodione) on agricultural fields were significantly (p < 0.01) associated, with 83%, 19%, and 49% increases, respectively, in dust concentrations for each kg applied per day, near participant homes, in the month or season prior to sample collection. However, agricultural use of diazinon, which was 2.2 times that of chlorpyrifos, and of permethrin were not significantly associated with dust levels. Other variables independently associated with dust levels included temperature and rainfall, farmworkers storing work shoes in the home, storing a diazinon product in the home, housing density, having a home less clean, and having an air conditioner. Permethrins, chlorpyrifos, DCPA, and iprodione have either a log octanol-water partition coefficient (K(ow)) greater than 4.0, a very low vapor pressure, or both. Health risk assessments for pesticides that have these properties may need to include evaluation of exposures to house dust.

We evaluated a community-based participatory research worksite intervention intended to improve farmworkers' behaviors at work and after work to reduce occupational and take-home pesticide exposures. The workers received warm water and soap for hand washing, gloves, coveralls, and education. Self-reported assessments before and after the intervention revealed that glove use, wearing clean work clothes, and hand washing at the midday break and before going home improved significantly. Some behaviors, such as hand washing before eating and many targeted after-work behaviors, did not improve, indicating a need for additional intervention.

The purpose of this study was to investigate the quality of evaluation and management of children requiring timely orthopaedic surgery before admission to a tertiary pediatric facility. A retrospective chart review was performed on 372 consecutive children who underwent orthopaedic surgery for a diagnosis of fracture, infection, slipped capital femoral epiphysis (SCFE), or compartment syndrome during a 22-month period at the authors' facility. Of the 372 children, 142 children (38%) first received medical care elsewhere; these are the subjects of this study. Before being seen at the authors' institution, 27 children (19%) had a problem in treatment or diagnosis and 18 (13%) had a delay in diagnosis or treatment of greater than 48 hours. Problems in diagnosis included five children with unrecognized open fractures, four of whom did not receive antibiotics; six children with missed SCFE, five of whom were not made non-weight-bearing; and six missed closed fractures. Delay in treatment occurred for 15 fractures, with a mean delay of >7 days until surgical treatment. Insurance status and primary language of the family were not associated with problems or delays in treatment. Overall, 32% of children undergoing time-sensitive orthopaedic surgery at a tertiary pediatric center had problems or delays in the medical care they received before transfer.