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Focus of Presentation Pesticides are chemicals, synthetic or natural, used to mitigate damage caused by pests. They play an important role in agriculture and public health. For a pesticide to be put on the market it must undergo a series of tests required by regulatory agencies to show with reasonable certainty that human exposures will not result in harm. Randomized trials are considered the gold standard for epidemiological study design. It is not ethical to conduct such studies to investigate human health outcomes of pesticide exposure. With increasing abundance of observational epidemiological literature there is an opportunity to leverage these studies for regulatory decision making. This presentation will describe a hypothetical randomized trial design to identify opportunities to adapt elements of experimental epidemiology to address some of the challenges unique to studies of health outcomes following pesticide exposure. Findings Elements warranting further development include analytic methods mimicking randomization, blinding, defining control groups, and introducing increased precision to outcome and exposure classifications. Efforts should aim to define generalizability and determine ways to report findings appropriate for regulatory use. Conclusions/Implications Epidemiologists must leverage analytic techniques, and increase dialogue among academics, industry stakeholders and regulators to adapt experimental epidemiology methods to ensure safety of agricultural pesticides. Key messages Work is needed to adapt experimental epidemiological methods to investigate human health outcomes of pesticide exposure. Focus areas for adaptation include randomization, blinding, control selection, exposure and outcome definitions, generalizability, and reporting.

1291Adapting a randomized trial design to develop epidemiology studies for pesticide exposure