The NIEHS-sponsored Town Meeting left several key issues inadequately addressed. Thus, the EHSRC applied for and received a supplemental award to host an international conference and workshop entitled, “Environmental Health Impacts of CAFOs: Anticipating Hazards – Searching for Solutions.” This was held March 29-31, 2004 with an open conference on the first day and an invited workshop on the second two days. The conference was attended by over 200 people and featured speakers from the U.S., Canada, Sweden, Denmark and The Netherlands. Conference attendees included scientists, agricultural extension employees, producer group representatives, environmental activists, community activists, rural residents, and government officials. The Workshop on March 30 and 31 was very productive with 50 invited scientists covering all the major issues associated with livestock confinements and environmental health. Five working groups drafted state-of-the art reports which are now in preparation for publication. The working groups covered Respiratory Health Effects; Modeling and Monitoring of Air Toxics; Water Quality Issues; Influenza Pandemics, Infectious Diseases and Antibiotic Resistance; and Community Health and Socioeconomic Issues. Importantly, this conference demonstrated that viable solutions to many of the environmental health problems associated with livestock production exist and can be implemented economically. This conference also raised the specter of dangerous influenza pandemics arising in the U.S. from siting industrialized poultry and swine production in close proximity.