APPENDIX II-I: Permethrin Kills Asthmatics:
All pesticides are designed to kill living organisms and involve
some health risk to humans exposed to them. While
the health and environmental
effects of non-lindane pesticides may be less
significant than those posed by lindane,
these risks should
nonetheless be kept in mind when deciding whether to use chemical treatments
for lice (pediculicides)
or scabies (scabicides).
Before using any
pesticide treatments for lice and scabies, it is important to understand
the risks associated with the different
pesticide active ingredients.
Purchasing for Pollution Prevention
Lindane Alternatives: Health and Environmental Effects
Purchasing for Pollution Prevention Program Fact Sheet
©INFORM, Inc. September 2003
Strategies for a
better environment
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361-2412
www.informinc.org
What are the alternatives to lindane
for head
lice and scabies?
• Pyrethrins/Piperonyl butoxide. Several over-thecounter
head lice shampoos and
lotions have active
ingredients containing, or
derived from, the
pyrethrum extract of dried
chrysanthemum flower.*
Lice products contain pyrethrum extract in a 0.33%
solution combined with piperonyl butoxide (PBO), a
synergist that increases the
effect of the pesticide.
• Permethrin. This “synthetic pyrethroid”
mimics the
structure of pyrethrum.
Products with 1% and 5% permethrin
are used to treat lice and
scabies, respectively.
• Malathion. This broad-spectrum organophosphate
pesticide is the active
ingredient in some lice and scabies
lotions. It is not
commonly used, because it must
be left on the head for
approximately eight hours;
other lice treatments
work in about 10 minutes.
What are the human health risks of lindane
alternatives?
PERMETHRIN AND PYRETHRINS
At the recommended dosage:
• Side effects can include dry patches, swelling, itching,
rash, or redness.1
• People with hay fever, asthma, and sensitivities to
certain allergens have an
increased risk from
pyrethrins; people have died from heart or respiratory
failure after applying
animal insecticide shampoo
containing pyrethrins.2
Overexposure or misuse:
• Overexposure can cause nervous system effects
such as dizziness,
headache, nausea, muscle twitching,
convulsions, and loss of
consciousness.3
PIPERONYL BUTOXIDE (PBO)
At the recommended dosage:
• PBO inhibits the enzymes that help to break down
toxins in the body,
increasing the efficacy of pesticides
by slowing their elimination from
the body;
this can make patients
more vulnerable to their
toxic effects.4
Overexposure or misuse:
• Piperonyl butoxide
can cause irritation of the skin
and eyes.5
MALATHION
At the recommended dosage:
• Side effects include scalp tingling, dandruff, and
redness of the scalp and
eyes.
• Ovide, the malathion treatment for head lice, contains
highly flammable
ingredients and may pose a fire
risk. Patients should
be cautioned to avoid heating
the hair by using hair dryers or
other appliances
during treatment.
Appropriate storage of flammable
materials is required when
storing large amounts of
this product.6
* The whole extract of
chrysanthemum is known as pyrethrum, while its
component compounds are known as pyrethrins. In
this fact sheet,
pyrethrins refers to the whole class of natural extracts.
Overexposure:
• Overexposure can cause headache, dizziness,
nausea, difficulty
breathing, blurred vision, and
loss of consciousness.
No acute poisonings have
been reported for malathion used as a pediculicide,
only for agricultural
use.7
What are the environmental risks of lindane
alternatives?
PERMETHRIN AND PYRETHRINS
• Both of these pesticides are very toxic to bees, fish,
and other aquatic organisms.
• Pyrethrins can break down after only
a few hours
when exposed to air and
sunlight, but their residues
have been found to last
from two weeks to two
months indoors.
• Permethrin is more persistent than
natural
pyrethrins.8
PIPERONYL BUTOXIDE (PBO)
• PBO is moderately toxic to fish and highly toxic to
some other aquatic
organisms.
• Through its suppression of detoxification processes,
PBO can increase the toxicity of numerous pesticides.
• PBO has a half-life ranging from a few hours in air
to 3 days in soil. In aqueous
environments, its halflife
is less than two days. 9
MALATHION
• Malathion is highly toxic to bees,
and certain fish
species.
• This pesticide breaks down fairly readily in soils,
with a half-life of 1
to 25 days.
• It can persist up to six weeks in water, depending on
conditions.10
Notes
1 Jones, Kimberly N., and Joseph C.
English III, “Review of
Common
Therapeutic Options in the
Treatment
of Pediculosis Capitis,” Clinical Infectious
Diseases,
2003, Volume 36, 1355-1359.
2
Wax, P.M., and R.S. Hoffman, “Fatality Associated with the
Inhalation
of a Pyrethrin Shampoo,” Clinical Toxicology,
Volume
32, 457-460, 1994; Wagner, S.L., “Fatal Asthma in a
Child
After Use of an Animal Shampoo Containing Pyrethrin,”
West Journal of
Medicine, Volume 173, 86-87, 2000.
3
“ToxFAQs for Pyrethrins
and Pyrethroids,” http://www.atsdr.
cdc.gov/tfacts155.html.
4
Toxicological
Profile for Pyrethrins and Pyrethroids,
2001,
http://www.atsdr.cdc.gov/toxprofiles/tp155.html.
5
National Pesticide Information Center, “Piperonyl Butoxide,”
fact sheet,
http://ace.orst.edu/info/npic/factsheets/pbotech.pdf.
6 Jones, Kimberly N., and Joseph C.
English III, “Review of
Common
Therapeutic Options in the
Treatment
of Pediculosis Capitis,” Clinical Infectious
Diseases,
2003, Volume 36, 1355-1359.
7
“ToxFAQs for Malathion,” 2001,
http://www.atsdr.cdc.gov/
tfacts154.html;
Jones, Kimberly N., and Joseph C. English III,
“Review
of Common Therapeutic Options in the
for the Treatment of Pediculosis Capitis,” Clinical Infectious
Diseases,
2003, Volume 36, 1355-1359.
8
Toxicological
Profile for Pyrethrins and Pyrethroids,
2001,
http://www.atsdr.cdc.gov/toxprofiles/tp155.html.
9
National Pesticide Information Center, “Piperonyl Butoxide,”
fact sheet,”
http://ace.orst.edu/info/npic/factsheets/pbotech.pdf.
10
Extension Toxicology Network, Pesticide Information
Profiles,
Malathion, revised June
1996,
http://ace.ace.orst.edu/info/extoxnet/pips/malathio.htm.
Purchasing
for Pollution Prevention Program Fact Sheet ©INFORM, Inc. September 2003
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