Practice-based agromedicine: the need for client-centered research

During recent years, several client calls received from Clemson University Cooperative Extension Service office and private physicians have required client-oriented investigations. These have practical implications for preventive medicine and public service. The challenges for differential diagnosis across disciplines are not for the faint-of-heart or the narrow thinking specialist. Examples of incidents that have signaled a problem and resulting research projects are: 1) anaphylactic cardiovascular response to red imported fire ant venom (statewide morbidity survey); (2) unexplained contact dermatitis in tomato harvesters and floral designers (immunodermatologic study and statewide survey of florists); (3) concerns over two unexplained cancer deaths at an experimental agricultural research station (farmer's mortality study); (4) a household outbreak of organophosphate poisoning (statewide hospital morbidity survey); and (5) a woman in early pregnancy exposed to misapplication of chlordane in her house (literature review and update on trends in U.S. birth defects). These examples reflect a broad but responsive interdisciplinary approach to the needs of the clients of the South Carolina Agromedicine Program.