APPENDIX I-C: Pesticide Poisoning – Permethrin- What to Do?-Rapp, M.D.
This appendix is copied from:
(Insecticide Fact Sheet- Pyrethrins/Pyrethrums, National
Coalition of Alternative to Pesticides, Spring, Vol. 22. #1, 2002, 541
344 5044 and The Toxicology ...
Letter To Maricopa Doctors (page 1)
APPENDIX I-C: Pesticide Poisoning – Permethrin- What to Do?-Rapp, M.D.
Doris J. Rapp, M.D. Board Certified in:
Pediatrics, Allergy and Environmental Medicine
Former Clinical Assistant Prof. Pediatrics at SUNY at
From Dr Doris Rapp
Open Letter to
We have a crisis
are purported to plan to continue to inundate us with massive toxic pyrethroid chemicals until November. Forget the unnecessary expenditure of
millions of dollars. Forget the potential for law suits for breaking the Clean
Water (and Air?) Acts as they presently have in NYC. They are upset in
The following is what is important now.
Facts: How Dangerous Is The Infected Mosquito?
We do not have an epidemic. Three deaths per 6 million people is not a reason to pollute the air, water, food, wildlife and inhabitants of the Phoenix Area.
How Safe Is The Spray?
The reports vary as to how long the spray lasts. Some say 2 hours in sunlight. Germans report 60 hours and some say it can take a month or more for the chemical to fully dissipate. Other articles say it can last up to 3 months. (“Insecticides in ambient air following application of control for pests”. Env. Contam. Toxic. 26:548-553,l981). The pyrethroid chemicals do bioaccumulate.
We have dust
storms that can stir up the chemicals in the saturated soil. Swamp coolers and leaky roof air conditioners
can bring the chemicals into a home. The chemicals can collect in carpets for
about 10 weeks putting children and pets in special jeopardy. (J. of High
Resolution Chromatography, l997, Vol20 pg 284) In one study in half the homes studied
they found over 60% had permethrin and piperonyl butoxide, as well as
other toxic chemicals in the house dust and air. (Environmental Science and
Technology 9/2003). What will the indoor levels be after the massive nightly
county spraying in this area? Physicians should be recommending air purifiers,
such as the
Who Can Be Affected?
The subset of the
population that is most apt to be affected by either the
The spray, however, can cause those who have never had sensitivity to chemicals to develop this problem. You will see patients who suddenly complain that chemicals that never bothered them before are now developing symptoms from a whiff of perfume, lawn spray or putting gas in the car. They will begin to smell chemicals what others do not notice. They also may complain they have suddenly developed allergies that were never present before. You will also see other patients who already have chemical sensitivities because they will relapse and suddenly become immensely ill. Some will die. These are the ones who say they collapse when they go outside if the air is polluted with chemicals. These are the ones who leave the city and come back and are desperately ill in minutes, outside and inside their homes. (Read book by Ashford and Miller- entitled Chemical Exposures, Low Levels and High Stakes.)
The Acute Signs and Symptoms
The effects of the
spray can be acute and easily confused with other illnesses. We will know the
facts only if the records of school health officials and emergency rooms are
scrutinized. Look for headaches, weakness, lack of energy, nausea, dizziness,
swollen red eyes, a stuffy nose, chest congestion, salivation and rashes Of
course these symptoms are non-specific and easily confused with many other
illnesses but be suspicious if they become evident or worse in the morning
after spraying. Watch for numbness or burning of the skin, burning of the
throat, unexplained tender skin spots, sudden nosebleeds, twitches, seizures or
swollen glands. Some can have an immediate asthma attack. Infants, in
particular, will be prone to this. (Environmental Health
Perspectives, on line
Blood, urine and saliva pyrethroid tests are available. Until you can get a kit, collect urine in a clean glass bottle and refrigerate it. Call Accuchem or Immunoscience Lab. Some the above symptoms will last only a few days; for others it can be just the beginning of the illness called a chemical sensitivity, which can last for a lifetime.
Am I exaggerating? No. One woman died after using a pyrethroid flea shampoo on her dog. (Clinical Toxicology 32(4) pg 457, l994.) Some can expire quickly if they have a chemical sensitivity. Cindy Dheuring died suddenly when they did not warn her, as they were supposed to, and sprayed too close to her home.
The good news is that in mammals, the acute signs of toxicity are usually temporary and diminish.
Potential and Definite Chronic Heath Effects
Common unsuspected effects could include loss of memory. If the behavioral, or memory changes are severe, or prolonged, SPECT or other brain imaging might help make a definitive diagnosis. (Read articles by Gunnar Heuser, MD, PhD and Theodore Simon, MD.)
Women exposed to
organic solvents have a 13 fold increased chance of having a child with birth
defects and developmental delay. (JAMA 1999) Solvents make up a large part of
Anvil or Kontol. How many of the “inerts”
in this spray will pass into the placenta and breast milk? Studies have shown
exposed cows have pyrethroids in their milk. Low-
level chemical exposures are thought to affect one in six children in the
Pyrethrins are considered by the EPA to be “likely human
carcinogens”. Farmers who use pyrethrins have a 3.7
fold increased risk of leukemia. If the
pesticide sprayers in
What about the children? Under the age of 5
years, there has been a 53% increase in brain cancer, and an 18% increase in
leukemia. Other reports state there is a 25% increase in the past 25 years of
brain tumors in children. (The Politics of Cancer Revisited
by Dr. Samuel Epstein.) Simply using garden pesticides can increase by
six fold the chances of a child developing leukemia. Flea preparations can
increase the chances of a brain cancer in children by fold. (National Cancer Institute 1987) Can we
really afford to wait and see what the pyrethroid
spray does to the children in the
Some will have a decreased sperm count. Will infertile couples consider this when they cannot conceive during the next few months or years? In NYC some of the pesticide applicators are complaining of impotence. Chemicals have definitely caused penises to be deformed and other sexual problems in animals and man. (Chapter 5 of my book, Our Toxic World-1 800 787 8780). It is known that pyrethroids alter the normal functioning of sex hormones. One report tells of the estrogenic potential of pyrethroid compounds in human breast carcinoma cell lines. (Env. Health Perspectives, Vol. 107, #3, March 1999) One report states miscarriages and preterm babies can be caused by pyrethroid-like compounds. Liver tumors are more evident in exposed female rats and kidney disease such as degenerated tubules are also reported. (see Fact Sheet on pyrethrums for specific references) They also cause thyroid tumors in animals. Exposed mice have more lung cancer and parathyroid tumors. Will you wonder about the 2004 spray exposures when you see patients with these problems in the next few years?
You might want to do chemical blood/urine studies on all ADHD, developmentally delayed children, cancer, and sex related problem patients. (See Chapter 13 of Is This Your Childs World? by Doris J. Rapp, M.D., for diagnostic tests to detect chemicals. 1 800 787 8780)
What about Your Pets and Wildlife?
Cats are particularly sensitive to pyrethrins because of detoxification weaknesses. If exposed they can salivate more, act depressed, have a change in behavior, anorexia and high temperatures. Dogs have developed atrophied testicles.
Fish and bees are exceedingly sensitive. (The ants in my front lawn were dead the morning after the spray was used in my area.)
Are Officials Advising Correctly about Use of DEET?
To complicate the
issue some Maricopa decision makers are pushing the use of DEET preparations by
adults and children to prevent mosquito bites. Most doctors are aware the 30%
DEET has led to deaths in children. Less well know is the fact it is absorbed
more readily on sunburned or broken skin.
We must ask if lower concentrations really are that safe for children.
In addition, Dr. Abou- Donia
Safer more effective topical preparations are available. See my web site: drrapp.com
I sincerely hope
you will consider the above facts and help to increase the
Doris J. Rapp is a retired M.D., board- certified in pediatrics, allergy and environmental medicine.
*In relation to
some treatment options that appear to help, refer to www.drrapp.com under “Are
You Sick from the West Nile Virus or Chemical Sprays?” or in Chapter 8 of
book Our Toxic World, A Wake Up Call,
800 787 8780) or see Special Reports on Chemicals and Pregnancy and “Why and How to Protect Your Home and Town.”
(Little did I know.)
HOW CAN CHEMICAL SPRAYS HURT YOU?
Who Is Most Apt to Develop Illness from the Chemical Exposures?
Chemicals, such as pesticides, are most apt to harm the unborn fetus of a pregnant mother, infants, the elderly, those who have allergies such as asthma, other allergies or autoimmune diseases (fibromyalgia, lupus, multiple sclerosis etc).
Anyone with a weakened immune system from cancer treatment or radiation is more at risk.
Those who have never had symptoms from pesticides can possibly develop these either immediately or in a few days after a chemical exposure. Once this happens they can be what doctors call “chemically sensitized”. From then on, whenever they are exposed to even the most minute amount of any chemical in the future, it is possible for the original symptoms to recur. Those who already have a known chemical sensitivity can become mildly or very seriously ill. Some can be totally incapacitated and their symptoms can last for weeks to years. They often tend to flare repeatedly with each additional chemical exposure and this exquisite sensitivity can last for many years. The rare person with an inordinate chemical sensitivity can die from one single unavoidable miniscule chemical exposure.
What Symptoms Do Chemicals Typically Cause?
The typical acute or chronic symptoms from chemicals can include burning in the nose or throat and burning or numbness on the face or extremities, nose bleeds, weakness, extreme fatigue, dizziness, headaches, muscle aches, tender skin spots, problems walking, seizures, sudden rages or unexplained episodes of crying, depression, irritability or aggression. It is not uncommon to notice an inability to think clearly or write normally because the brain can be so severely affected.
What Are the Characteristic Symptoms from Pesticides Such as Pyrethroids, Pyrethrums with Piperonyl Butoxide ( Anvil)?
In minutes, but maybe in a few days, pyrethroid-like pesticides have been reported to cause some combination of the following: a respiratory illness, sudden severe asthma, dizziness, headaches, fatigue, hay fever, extreme weakness and skin problems (burning, numbness, rashes and hives), eye irritation, an increased sensitivity to sound and touch, depression, heart failure, a lowered sperm count (in animals the testis also shrink), reproductive sex hormone problems, thyroid disease, tremors, miscarriages, preterm deliveries, and kidney, liver, intestinal and nervous system damage and circulatory difficulties, such as an irregular heart beat. It is possible for pregnant women (or animals), to have a brain-damaged or developmentally-delayed offspring. This can occur if the unborn are exposed to a most minute amount of toxic chemicals. especially early in their pregnancy. The EPA has reported that pyrethrins can be likely carcinogens because in animal tests they can cause thyroid tumors and farmers who use them have a higher risk of leukemia than normal.
What Are the Characteristic Symptoms from a Malathion or an Organophosphate Pesticide Exposure?
Organophosphates can extensively hurt the human body, potentially damaging the lungs, intestines, bladder, heart, muscles, nerves and brain. They also affect the behavior of both humans and animals. Malathion is admittedly a low level cause of cancer. Studies indicate farmers develop lymphomas, apple growers, leukemia and flour mill workers using organophosphate chemicals develop cancer, cotton workers have defective infants and exposed children can develop myopia or eye defects. It is most alarming to learn recently that Maricopa country has been spraying toxic malathion for some time and most of the community did not seem to be aware of it.
Examples of Organophosphate Dangers:
It has been reported that mothers who use an organophosphate flea shampoo (dichlorvos) on their pet during their pregnancy double the chances of a brain tumor developing in the baby they are carrying by the age of five years. Prenatal or infant exposure to organophosphate pest strips unquestionably increases the risk of leukemia in young children. Could this or other chemicals be related to the 30% increase of brain cancer and the 10% increase in leukemia that is unfortunately evident in today’s children? We must start to ask such questions.
How Can the Diagnosis of a Chemical Sensitivity Be Confirmed Medically and Legally?
1.) You can check your breathing with a Peak Flow Meter (Call 1 800 787 8780). Simply blow into this tube with a gauge on it and record your usual level of expiration. If after exposure to a spray, the level falls significantly, this suggests something has affected your breathing. Your physician can use a more complicated procedure to document such changes more scientifically.
2.) You can check your pulse. The usual pulse range is typically around 70-85 if you are rest. If your pulse suddenly goes over 100 or falls below 55, or the pulse becomes irregular, document this with your physician.
Chemicals can unquestionably do this.
3.) You can monitor your blood pressure before, during and after a chemical exposure and in some patients there will be a significant change. Again, have your suspicions documented by a physician. If you can find and eliminate the cause, you may have nothing to treat.
4.) To confirm the diagnosis of a specific chemical exposure, the blood and/or urine can be examined You can immediately collect a urine sample in a clean well-rinsed glass bottle when you have symptoms shortly after an exposure. Do not allow the urine to touch the bottle cap. It might help to save the next morning’s sample of urine in a second bottle. If your symptoms persist, your urine will probably reveal the type and level of chemical to which you were exposed. This sample can then be sent in the proper container to the appropriate laboratory for analysis. If your symptoms have already subsided, check with the laboratories listed below.
5.) You can have your blood, urine, breast milk or semen checked for chemicals contact AccuChem, 972 234 5412 for pyrethroid or other pesticide tests or Immunoscience, 800 950 4686, for the Immunotoxicology Panel . ( Check on fee for urine test and kit ; the fees range from $150 to $950. Insurance may or may not pay so check with your provider). If you know the cause of symptoms, talk to the laboratory about which test would be best. This results of this type of testing might be essential for legal documentation.
(The average American has 91 chemicals in his/her blood and some have up to 500. Chemicals unquestionably can damage the immune, nervous, endocrine and reproductive systems in animals, children, men and women. Many studies document repeatedly these types of health effects in both animals and humans.)
6.) There are also a number of other blood studies that can be ordered that strongly suggest a toxic chemical exposure and would be helpful both medically and legally. (These tests are specified in Chapter 3 of Our Toxic World and in Chapter 13 of Is This Your Child’s World? by Dr. Rapp.)
7.) You can have
an environmental health engineer determine which chemicals are in the air, near
or in your home. (See Phone Book. In the
8.) You can expose mice to a suspect chemical
used in your home or area and obtain videos and scientific documentation of
what happens from such contact. (
They can also examine items that may have accumulated chemicals in them, such as a fabric left outside during aerial spraying or an indoor carpet after indoor pesticide application. These tests provide insight concerning how safe such exposures might be for infants, young children and adults. ( See Video "Environmentally Sick Schools", 716 875 0398)
9.) You can find
an environmental medical specialist who can sometimes do allergy testing for
certain chemicals and clinically document a chemical sensitivity. They, and many specialists in alternative medicine can also
advise you how to detox or eliminate chemicals. (Call
- 316 684 5500, AAEM (American
10.) Chemicals can
cause documented changes in the brain. Check with Gunnar
Heuser, M.D., PhD, a remarkably well-trained
11.) Consider a brain image test (i.e. SPECT, Dr. Theodore Simon, 972 566 471) to verify these changes. The brain changes often can be improved or reversed with proper treatment. If your nervous system and brain have been changed after some exposure, this test might document the damage.
Where Can You Find a Doctor?
The diagnosis and
treatment of a chemical sensitivity, however, is not as easy as you might
imagine. Initially the symptoms can be confused with many other illnesses,
Which Doctors Might Be Most Helpful?
Environmental, Occupational and Alternative medical physicians are among those who would most quickly recognize this disease. Check with your personal physician prior to trying any of the following suggestions because each person can have different physical symptoms and requires individualized consideration.
Ask about fees prior to any visit to either an environmental or alternative physician. Your insurance may not reimburse for anything or may cover only a portion of the fees or laboratory charges.
Medical Physicians in the
Dr. Alan Ketover 602-381-0800
Dr. Stuart Lanson 480-994-9512
For the nearest
environmental medical specialist in other areas of the
Medical Specialists in
What Is the
The basic concept is to prevent further chemicals from entering your body and to take specific measures to help eliminate the many chemicals that are already stored in your body.
To Stop More Chemicals from Entering Your Body:
1 . Do not go outside when the spraying is taking place or for several hours.
2. Keep the doors and windows tightly closed and turn off your air-conditioner. This means if they are spraying in your neighborhood at night, the air conditioner must be off.
3. Keep your car ventilation system on “ recirculate” if that is available in your automobile.
4. Keep your pets and children indoors and off sprayed lawns for several days.
5. Wash off all outdoor toys and furniture if they were exposed to chemical sprays.
6. Wash your pet, especially the feet and legs.
7. Have your children and visitors remove their shoes or wear special shoes when inside your home.
8. If you are near a bad chemical, hold your breath as long as possible and run in the opposite direction.
9. Get an air purifier, such as an Austin Air, to help clean the air in your bedroom and family room (call 1 800 787 8780). It can remove dust, molds and pollen and some chemicals.
10. Eat mainly organic food to decrease the amount of chemicals entering and accumulating in your body. If your organic garden was sprayed, the food is no longer organic.
11. Be sure your bowels move regularly each day. Silymarin, psyllium husks, and chlorophyll can temporarily aid bowel function. Chemicals in your feces can leak back into your body so you must have daily bowel movements. Organic coffee enemas or a total colonic cleanse might also be indicated. email@example.com. Check with your physician.
12. Avoid long showers, baths or swimming in chlorinated or fluorinated water. You can absorb the chemicals.
To Help the Body Excrete More Toxic Chemicals:
1. Drink eight large glasses of purified water, in glass, not in plastic or styrofoam. This will help to eliminate chemicals in your urine.
2. Exercise in clean air (not next to a highway or sprayed lawns) to help excrete chemicals from your lungs and move them out of your muscles.
3.Take glutathione (about 10-100 mg/day) Obtain at a health food store. Glutathione helps to gather up the chemicals in the body so you to can excrete them more easily.
4. Consider improved lymphatic drainage. (See Phone Book under massage) This helps to move chemicals through the lymph channels and out of the body.
5. If the problem is severe, consider obtaining an oxygen tank and inhale 4 liters per minute every 15 -30 minutes until you feel better and are thinking more clearly. This can help quickly. You might also want to have a small oxygen tank in your car and at home for emergency treatment of chemical exposures. Check with your doctor or emergency room for a prescription and your personal instructions.
6. Take a colonic irrigation to cleanse the bowels and learn how to do an organic coffee enema to cleanse the liver. Check with a naturopathic or alternative physician.
7. Consider naturopathic detoxification baths using Epsom salts, apple cider, baking soda, sea salt, clay, ginger root, etc.
8. If you are seriously ill consider a far infra red or a heavenly heat sauna- every day for a long while. This increases perspiration and the excretion of both chemicals and trace metals. This also helps if done regularly to diminish the chemicals that accumulate in your body on a daily basis.
To Strengthen the Body’s Immune System
1. Take a quality antioxidant that contains some of the following: Vitamin A in form of beta carotene, Vitamins B, C and E, selenium, zinc, manganese, magnesium, methionine CoQ10, pynogenol, bioflavinoids, alpha lipoic acid, taurine and cysteine. Activated charcoal and chlorella also are said to be helpful.
2. Extra vitamin C can be often most helpful. Take 500mg, two to four times a day. You can take up to 3000 mg. or more but when you develop diarrhea, lower the dose a bit and then stay on a smaller amount that does not cause diarrhea. If you are seriously ill, this can be given intravenously along with other vitamins, trace metals and minerals.
There are also a number of other homeopathic, herbal remedies, organic vitamins, intravenous nutrients, oxygen or ozone therapies, photoplasmaphoresis, and colloidal silver preparations that can be used as adjuncts with traditional therapies or tried when the more typical therapies are not completely effective. These might help a
1. One homeopathic remedy, such as Arsenicum album, is thought to decrease congestion in organs and promote drainage. Other remedies are also available.
For example, Dr. Bruce Shelton, 601 504 1000, is a specialist in the use of homotoxicology remedies. This entails the use of a special combination of Heel remedies as outlined in the Heel Handbook of homotoxic therapy. You or your physician can contact him or AHIMA at www.arizonahomeopathic.org.
2. Consider herbal remedies for supplementing traditional treatment or if the latter does not help.
3. Consider Acupuncture. For
In April, 2001, The United Nations declared that “Everyone has the right to live in a world free from toxic pollution and environmental degradation.” This was declared to be a human right. They felt strongly that, universally, the air and water should not be polluted. It is unfortunate that the clean air and water acts in the