To the Editor: In their study of acute illnesses associated with pesticide exposure, Dr Alarcon and colleagues1 conclude that pesticide exposures at schools continue to produce symptoms of illness in people attending schools. However, we caution that the authors’ use of Toxic Exposure Surveillance System (TESS) data as an instrument to monitor disease frequency in this study may not be valid. The data recorded in TESS consist of signs and symptoms of illness as reported by the caller. Although callers might be skilled health professionals, more often they are concerned parents, caregivers, or in this case possibly teachers.2
Kirrane BM, Hoffman RS. Pesticide Exposure at Schools and Acute Illnesses. JAMA. 2005;294(19):2431. doi:10.1001/jama.294.19.2431-a
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