This is the book I wish I had when I started practicing medicine in an agricultural community. During 22 years of researching, practicing, and teaching agricultural medicine, I have encountered bat bites, thorn punctures from citrus, grain harvester machine entrapments, and pesticide exposures. I have seen packing-house women who routinely got into fist fights, and a lawyer run over by a bull while visiting a dairy. I've treated farm laborers from Mexico who worked 12 hours a day, and millionaires dressed in mud-caked jeans and boots, looking not much different from the day laborers.

People in agriculture are a hearty and bull-headed group. You can tell a cowboy to wear a cast; the next day he will be riding a bull with the cast missing. He will tell you he "lost" it. Or the farmer will insist on working even though his finger was just cut off by a machine: "It's just bleeding a little, Doc. Can't you put a butterfly on it?"

This book cuts across several different medical disciplines to include those subjects of importance to a physician practicing in an agricultural area. As such, it is a reference and overview of those subjects that form the core of primary care in farming communities. Important topics include the broad field of farm chemicals, the nexus of food safety and employee health, common injuries seen in agriculture, and special topics including mental health, diseases and injuries of veterinarians, and zoonoses.

This book is intended for students, researchers, academicians, and, most important, physicians on the front lines of illness and disease among agricultural workers. It is designed to be as useful as a text to students new to the field and as a reference for those of us who have been in the field for decades.

The authors of this book are as diverse as the field of agriculture is broad. Professionals from around the world and representing multiple scientific disciplines have contributed. They come from academia, clinical practice, scientific institutions, and industry to present a broad-based introduction to the care of individuals in a diverse field.

I am indebted to Dr. Stan Schuman, editor emeritus of the Journal of Agromedicine, and Dr. Robert Taylor, editor of Family Medicine: Principles and Practice, for their guidance and help over the last decade.

I am grateful to Robert Albano for the opportunity to write this book. Developmental editor Merry Post was instrumental in bringing it to fruition. My son Ernest, now an MBA student at Rice University, helped me with all the computer setups. My wife, Leslie, who has a Ph.D. in psychology and keeps me sane, helped with research, reviewed manuscripts, and gave encouragement. My deepest thanks to all those involved in this project.

James E. Lessenger, MD, FAAFP, FACOEM Porterville, California

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