Total release foggers (TRFs), sometimes called "bug bombs," are pesticide products designed to fill an area with insecticide and often are used in homes and workplaces to kill cockroaches, fleas, and flying insects. Most TRFs contain pyrethroid, pyrethrin, or both as active ingredients. TRFs also contain flammable aerosol propellants that can cause fires or explosions. The magnitude and range of acute health problems associated with TRF usage has not been described previously. This report summarizes illnesses and injuries that were associated with exposures to TRFs during 2001-2006 in eight states (California, Florida, Louisiana, Michigan, New York, Oregon, Texas, and Washington) and were investigated by the California Department of Pesticide Regulation (CDPR) and state health departments participating in the SENSOR-Pesticides program.* During 2001-2006, a total of 466 TRF-related illnesses or injuries were identified. These illnesses or injuries often resulted from inability or failure to vacate before the TRF discharged, reentry into the treated space too soon after the TRF was discharged, excessive use of TRFs for the space being treated, and failure to notify others nearby. The findings indicate that TRFs pose a risk for acute, usually temporary health effects among users and bystanders. To reduce the risk for TRF-related health effects, integrated pest management control strategies that prevent pestsí access to food, water, and shelter need to be promoted and adopted. In addition, awareness of the hazards and proper use of TRFs need to be better communicated on TRF labels and in public media campaigns.