William J. Meggs – författare

Untoward reactions to environmental chemicals, particularly when a subject reports difficulties with exposures to chemicals of diverse classes involving more than one organ system, have been poorly understood and an area of great controversy. Studies of airway inflammation induced by respiratory irritants have established neurogenic inflammation as the mechanism for irritant asthma and rhinitis. Remodeling of the airway after an acute irritant exposure can lead to a heightened sensitivity to irritants that persists. Recognition that rhinitis, while sometimes regarded as a trivial disease, is associated with extra-airway manifestations such as fatigue and disturbances of sleep, mood, and cognition, further elucidates how chemical exposures can be serious for susceptible individuals.This book reviews current scientific understanding of irritant airway inflammation and related conditions, including cardiovascular effects of particulate exposures, airborne contact dermatitis and irritant dermatitis, and the brain as a target organ for both allergic and irritant reactions. It is essential reading for physicians and other healthcare workers caring for patients with environmental intolerances. Allergists, toxicologists, occupational and environmental physicians, and pulmonologists will find the materials particularly valuable. Patients and advocates for those with chemical intolerances will also find the book of interest.

This book provides healthcare workers practicing in rural areas with the practical knowledge necessary to diagnose and treat farm workers who develop an acute or chronic illness. In rural settings, distances and travel times may be prolonged, leading to delays in assessment and definitive treatment. Healthcare providers must be prepared to rapidly assess the ill farm worker, formulate a differential diagnosis, and initiate treatment.

The volume begins by teaching the reader to formulate a comprehensive differential diagnosis of farm worker illnesses, including stings and bites, green tobacco syndrome, infections, and heat and weather-related events, as well as exposures to the numerous chemicals found on the farm. The toxicity of various farm products, such as insecticides, herbicides, rodenticides, and petroleum products, are each discussed in their own chapter, enabling the reader to rapidly obtain vital information on their mechanism, clinical signs and symptoms, and differential diagnosis. The reader will learn to utilize information on pesticide labels and safety data sheets, including proper use of personal protective equipment. Chapter authors discuss a variety of other topics, including toxic gas exposures on the farm, disease associations with chronic chemical exposures, illicit drug use, and miscellaneous conditions that a rural practitioner should be familiar with that may occur on the farm, such as heat and cold injuries, lightning strikes, allergies, and asthma.

Farm Toxicology: A Primer for Rural Healthcare Practitioners will be an invaluable resource for rural healthcare providers, including paramedics, triage nurses, physician assistants, nurse practitioners, and physicians, who need to quickly evaluate and treat ill farm workers.