Farmers, their spouses and children are exposed to numerous potential hazards. Farmers have been shown to be at increased risk for some cancers. Experimental and human studies of acute or high-dose exposures suggest that farmers may also be at increased risk of other adverse health effects. We are examining a variety of health endpoints in a prospective study of licensed pesticide applicators, spouses and children from NC and IA. Over a 3-year period, we enrolled more than 57,000 licensed applicators, representing 82% of eligible private pesticide applicators (largely farmers) in IA and NC and 43% of commercial applicators from Iowa. About 40% of the private applicators also completed a more detailed take-home questionnaire covering farming practices and health. Nearly 32,000 spouses of farmer applicators enrolled and 2/3 of these also provided data on reproductive health, including information on all children under age 21. We are conducting descriptive analyses of baseline characteristics as well as associations between self-reported exposures and selected health outcomes. We identified work practices associated with high pesticide exposure events which are in turn associated with visits to health care professionals. Fungicide and organochlorine pesticide use was associated with increased risk for macular degeneration. Associations with other eye diseases and visual dysfunction are being explored. Current analyses focus on infertility, menstrual cycle abnormalities, and the potential for selection bias among persons who returned the detailed supplemental take-home questionnaires. We have begun computer- assisted telephone follow-up interviews with applicators and spouses who enrolled five years ago. Preliminary response rates are above 70% and efforts are underway to increase the response rate further. Persons who complete the phone interview are asked to provide a buccal cell sample for DNA analysis using a rinse-and-spit kit mailed to their home and a dietary questionnaire. A follow-up study of a subcohort of African American farmers and farmworkers includes health questionnaires, collection of a blood sample to measure DDE, lipids, and steroid hormones, and measures of adiposity and hair loss. Preliminary analysis of 5-year cancer incidence will begin in the Fall. Non-cancer outcomes of particular interest in this follow-up period include diabetes in children, Parkinsons Disease, autoimmune diseases, and premature ovarian failure. Pilot studies are assessing the feasibility of linking cohort members to birth records and the IA birth defects registry and measuring nitrates and other contaminants in well water. Future nested case-control studies of diseases of interest will include validation of both diagnosis and exposure. Specific exposure scenarios (defined by type of chemical and application technique) are being evaluated by EPA; measured exposure levels under various farm conditions will be used to validate the questionnaire-based exposure assessment and help in the development of an exposure index that incorporates work practices and application methods. - agricultural exposure, pesticides, farm workers, African American, - Human Subjects & Human Subjects: Interview, Questionaires, or Surveys Only