Effect of Environmental Temperature and Humidity on Permethrin Biomarkers of Exposure in U.S. Soldiers Wearing Permethrin-Treated Uniforms.

Environmental factors, including high temperature and humidity, can influence dermal absorption of chemicals. Soldiers can be dermally exposed to permethrin while wearing permethrin-treated uniforms. This study aimed at examining the effects of high temperature and a combined high temperature and humid environment on permethrin absorption compared with ambient conditions when wearing a permethrin-treated uniform. Twenty-seven male enlisted soldiers wore study-issued permethrin-treated army uniforms for 33 consecutive hours in three different environments: 1) simulated high temperature (35°C, 40% relative humidity [rh]) (n = 10), 2) simulated high temperature and humidity (30°C, 70% rh) (n = 10), and 3) ambient conditions (13°C, 60% rh) (n = 7). Spot urine samples, collected at 21 scheduled time points before, during, and after wearing the study uniforms, were analyzed for permethrin exposure biomarkers (3-phenoxybenzoic acid, cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid) and creatinine. Biomarker concentrations were 60-90% higher in the heat and combined heat/humidity groups (P < 0.001-0.022) than the ambient group. Also, the average daily permethrin dose, calculated 12 hours after removing the treated uniforms, was significantly higher in the heat (P = 0.01) and the heat/humidity (P = 0.03) groups than the ambient group. There were no significant differences in biomarker concentrations or computed average daily dose between the heat and the heat/humidity groups. Both hot and combined hot and humid environmental conditions significantly increased permethrin absorption in soldiers wearing permethrin-treated uniforms.

Urinary concentrations of permethrin metabolites in US Army personnel in comparison with the US adult population, occupationally exposed cohorts, and other general populations.

Permethrin is used to treat clothing as a personal protective measure against insect bites in military and recreational settings, and along with other pyrethroid insecticides, is sprayed in agricultural and residential sites for pest control. The widespread use of permethrin and other pyrethroid insecticides creates a potential for human exposure in occupational and non-occupational populations. This study aims to compare urinary biomarkers of pyrethroid exposure in two US military cohorts to the general US adult population from the 2009-2010 Nutritional Health and Nutrition Examination Survey (NHANES). Additional comparisons are made to previously published biomonitoring data from occupational and population cohort studies. Urine samples from two US military cohorts were analyzed for 3 permethrin metabolites: 3-phenoxybenzoic acid (3-PBA), and cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (DCCA). Biomarker concentrations were adjusted for creatinine. Geometric means were calculated and then compared to creatinine-adjusted concentrations of 3-PBA and trans-DCCA in US adults (aged 20-59) using data collected as part of the 2009-2010 NHANES. Sex- and race-standardized geometric means were calculated separately for each of the US military groups using the demographic distributions from NHANES 2009-2010. Data from other military, occupational, and non-occupational population studies were extracted from the literature for further comparison. The two US military cohorts' geometric mean values, non-standardized and standardized, were markedly higher than what was observed in the general US adult population. Biomarkers of permethrin exposure were detected at a high frequency in military personnel wearing treated uniforms (90-100%). Detection rates of these biomarkers were similarly high in other studies of occupational exposure (67-100%) to pyrethroid insecticides. Adjusting for creatinine, the concentrations observed in the military groups were generally higher than levels seen in the general US adult population (NHANES, 2009-2010), other occupational groups (e.g., farmworkers, flight attendants, and pest control workers), and population cohorts from other countries.

Role of body composition and physical activity on permethrin urinary biomarker concentrations while wearing treated military uniforms.

Wearing of permethrin treated clothing is becoming more prevalent in military and outdoor occupational and recreational settings, as a personal protection measure against vector borne diseases transmitted through arthropods (e.g., malaria, Lyme disease). The goal of the study was to prospectively examine permethrin exposure among new U.S. Army recruits who had just been issued permethrin-treated uniforms over a 10-week military training period and whether individual body composition (percent body fat, %BF) and physical workload (total energy expenditure, TEE) influenced the exposure. Exposure was assessed by quantification in urine of three permethrin metabolites, 3-phenoxybenzoic acid (3-PBA), and cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid. Although there was individual variability, urinary concentrations and estimated dose levels decreased over the 10-week period. Mixed models demonstrated that 10% higher %BF was significantly associated with 4.42% higher 3-PBA concentrations and a 10% higher daily TEE was significantly associated with a 10.57% higher 3-PBA concentrations. Additional factors influencing exposure included sex, number of uniform launderings, and wear- time (hours per previous day).

Dose reconstruction in workers exposed to two major pyrethroid pesticides and determination of biological reference values using a toxicokinetic model.

A toxicokinetic model has been optimized to describe the time profiles of common biomarkers of exposure to permethrin and cypermethrin: trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acids (trans-DCCA) and 3-phenoxybenzoic acid (3-PBA). The model then served to reproduce urinary time courses in exposed agricultural workers and predict corresponding absorbed doses. It allowed for the prediction of the main routes of exposure in workers during the study period. Modeling showed that simulating exposure mostly by the oral route, during the 3-day biomonitoring period, provided best-fits to the urinary time courses of most workers. This is compatible with an inadvertent oral exposure during work. According to best-fit scenarios, absorbed doses in workers reconstructed with the model reached a maximum of 2.4 µg/kg bw/day and were below the absorbed dose limits associated with an exposure to the reference dose values established by the U.S. Environmental Protection Agency (0.06 and 0.25 mg/kg bw/day for cypermethrin and permethrin, respectively) and the Acceptable Operator Exposure Level set by the European Commission (0.06 mg/kg bw/day for cypermethrin). Modeling was further used to derive biological reference values for cypermethrin and permethrin exposure. Respective values of 7 and 29 nmol/kg bw/day of trans-DCCA, and 3 and 13 nmol/kg bw/day of 3-PBA were obtained. None of the workers presented values above these biological reference values.

PBPK modeling of the cis- and trans-permethrin isomers and their major urinary metabolites in rats.

Permethrin, a pyrethroid insecticide, is suspected to induce neuronal and hormonal disturbances in humans. The widespread exposure of the populations has been confirmed by the detection of the urinary metabolites of permethrin in biomonitoring studies. Permethrin is a chiral molecule presenting two forms, the cis and the trans isomers. Because in vitro studies indicated a metabolic interaction between the trans and cis isomers of permethrin, we adapted and calibrated a PBPK model for trans- and cis-permethrin separately in rats. The model also describes the toxicokinetics of three urinary metabolites, cis- and trans-3-(2,2 dichlorovinyl)-2,2-dimethyl-(1-cyclopropane) carboxylic acid (cis- and trans-DCCA), 3-phenoxybenzoic acid (3-PBA) and 4'OH-phenoxybenzoic acid (4'-OH-PBA). In vivo experiments performed in Sprague-Dawley rats were used to calibrate the PBPK model in a Bayesian framework. The model captured well the toxicokinetics of permethrin isomers and their metabolites including the rapid absorption, the accumulation in fat, the extensive metabolism of the parent compounds, and the rapid elimination of metabolites in urine. Average hepatic clearances in rats were estimated to be 2.4 and 5.7 L/h/kg for cis- and trans-permethrin, respectively. High concentrations of the metabolite 4'-OH-PBA were measured in urine compared to cis- and trans-DCCA and 3-PBA. The confidence in the extended PBPK model was then confirmed by good predictions of published experimental data obtained using the isomers mixture. The extended PBPK model could be extrapolated to humans to predict the internal dose of exposure to permethrin from biomonitoring data in urine.

In vivo dermal absorption of pyrethroid pesticides in the rat.

Exposure to pyrethroid pesticides is a potential cause for concern. The objective of this study was to examine the in vivo dermal absorption of bifenthrin, deltamethrin, and permethrin in the rat. Dorsal hair on adult male Long-Evans rats was removed. The next day, the skin was dosed with 1750 nmol (312.5 nmol/cm(2)) of radiolabeled (5 µCi) bifenthrin, deltamethrin, or permethrin in acetone. A nonoccluding plastic cover was glued over the dosing site. The animals were placed in metabolism cages to collect excreta. At 24 h postdosing, the skin was washed with soap and water, and rats in one group were euthanized and their tissues were collected. The skin was removed and tape stripped. The remaining animals were returned to the metabolism cages after the wash for 4 d. These rats were then euthanized and handled as already described. Excreta, wash, tape strips, tissues, and carcass were analyzed for pyrethroid-derived radioactivity. The wash and tape strips removed >50% of the dose and skin retained 9-24%. Cumulative radioactivity in excreta was 0.5-7% at 24 h and 3-26% at 120 h. Radioactivity in tissues was <0.3% of the dose, while carcass retained 2 to 5%. Assuming absorption equals cumulative recovery in skin (washed and tape stripped), excreta, tissues, and carcass, absorption was permethrin ~ bifenthrin > deltamethrin at 24 h and permethrin > deltamethrin > bifenthrin at 120 h. Using the parallelogram approach with published in vitro data, human dermal absorption of these pyrethroids was estimated to be <10% of the dose.

Detailed Urinary Excretion Time Courses of Biomarkers of Exposure to Permethrin and Estimated Exposure in Workers of a Corn Production Farm in Quebec, Canada.

Permethrin is a synthetic pyrethroid insecticide widely used in agriculture. Farm workers are thus regularly exposed during spraying season. To help interpret routine biomonitoring results, a proper knowledge of the time courses of biomarkers of exposure is necessary. The kinetics of biomarkers of exposure to permethrin has recently been documented in volunteers exposed to permethrin under controlled conditions but there is a lack of detailed time profiles following real exposure conditions. This study aimed at obtaining data on the excretion time courses of permethrin metabolites in agricultural workers following typical exposure conditions in the field. Twelve workers exposed to permethrin were recruited from a corn production farm in the Montérégie, Quebec, Canada. They provided all their urine voided over a period of 3 days following the onset of a spraying episode of permethrin or work in a treated area. Three major metabolites of permethrin, trans- and cis- 3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-l-carboxylic acid metabolites (trans-DCCA, cis-DCCA), and 3-phenoxybenzoic acid (3-PBA), were analyzed. For the applicator, a progressive rise in excretion values was observed with a single peak being reached 29h following the onset of the 3.5h exposure and ensuing elimination with a half-life of 6.4h for trans-DCCA and 8.7h for 3-PBA. In the other workers (supervisor and corn pickers), excretion profiles were generally more compatible with multiple entries in the treated area during the 3-day sampling period and rapid elimination between exposure episodes. In general, 3-PBA was found in slightly higher levels than trans-DCCA, except for the applicator and a harvester. For both trans-DCCA and 3-PBA in a given worker, excretion values expressed as creatinine-normalized concentrations were less variable than those expressed as excretion rates per kilogram body weight. Time-dependent variability in excretion values of workers confirms the need for serial urine sampling of at least two biomarkers of exposure, with minimally pre-exposure, end-of-shift sample the day of onset of exposure, and following morning void.

Time profiles and toxicokinetic parameters of key biomarkers of exposure to cypermethrin in orally exposed volunteers compared with previously available kinetic data following permethrin exposure.

Biomonitoring of pyrethroid exposure is largely conducted but human toxicokinetics has not been fully documented. This is essential for a proper interpretation of biomonitoring data. Time profiles and toxicokinetic parameters of key biomarkers of exposure to cypermethrin in orally exposed volunteers have been documented and compared with previously available kinetic data following permethrin dosing. Six volunteers ingested 0.1 mg kg(-1) bodyweight of cypermethrin acutely. The same volunteers were exposed to permethrin earlier. Blood samples were taken over 72 h after treatment and complete timed urine voids were collected over 84 h postdosing. Cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acids (trans- and cis-DCCA) and 3-phenoxybenzoic acid (3-PBA) metabolites, common to both cypermethrin and permethrin, were quantified. Blood and urinary time courses of all three metabolites were similar following cypermethrin and permethrin exposure. Plasma levels of metabolites reached peak values on average ≈ 5-7 h post-dosing; the elimination phase showed mean apparent half-lives (t½ ) for trans-DCCA, cis-DCCA and 3-PBA of 5.1, 6.9 and 9.2 h, respectively, following cypermethrin treatment as compared to 7.1, 6.2 and 6.5 h after permethrin dosing. Corresponding mean values obtained from urinary rate time courses were peak values at ≈ 9 h post-dosing and apparent elimination t½ of 6.3, 6.4 and 6.4 h for trans-DCCA, cis-DCCA and 3-PBA, respectively, following cypermethrin treatment as compared to 5.4, 4.5 and 5.7 h after permethrin dosing. These data confirm that the kinetics of cypermethrin is similar to that of permethrin in humans and that their common biomarkers of exposure may be used for an overall assessment of exposure.

Evaluation of pyrethroid exposures in pregnant women from 10 Caribbean countries.

Pyrethroid pesticides are commonly used in tropical regions such as the Caribbean as household insecticides, pet sprays, and where malaria is endemic, impregnated into mosquito-repellent nets. Of particular concern is exposure during pregnancy, as these compounds have the potential to cross the placental barrier and interfere with fetal development, as was shown in limited animal studies. The objective of this study was to evaluate exposure to pyrethroids to pregnant women residing in 10 English-speaking Caribbean countries. Pyrethroid exposures were determined by analyzing five pyrethroid metabolites in urine samples from 295 pregnant women: cis-DBCA, cis-DCCA, trans-DCCA, 3-PBA, and 4-F-3-PBA. Pyrethroid metabolite concentrations in Caribbean pregnant women were generally higher in the 10 Caribbean countries than levels reported for Canadian and U.S. women. In Antigua & Barbuda and Jamaica participants the geometric mean concentrations of cis-DBCA was significantly higher than in the other nine countries together (p<0.0001 and <0.0012 respectively). For cis- and trans-DCCA, only Antigua & Barbuda women differed significantly from participants of the other nine Caribbean countries (p<0.0001). Urinary 4-F-3-PBA and 3-PBA levels were significantly higher in Antigua & Barbuda (p<0.0028 and p<0.0001 respectively) as well as in Grenada (p<0.0001 and p<0.007 respectively). These results indicate extensive use of pyrethroid compounds such as permethrin and cypermethrin in Caribbean households. In Antigua & Barbuda, the data reveals a greater use of deltamethrin. This study underscores the need for Caribbean public health authorities to encourage their populations, and in particular pregnant women, to utilize this class of pesticides more judiciously given the potentially adverse effects of exposure on fetuses and infants.

Biomonitoring in wearers of permethrin impregnated battle dress uniforms in Afghanistan and Germany.

OBJECTIVES: To analyse differences in uptake of the insecticide permethrin in wearers of non-impregnated and permethrin impregnated battle dress uniforms (BDU) in Afghanistan and Germany. METHODS: In two separate studies, in April 2003-January 2004 (study I, n=549) and in February-April 2005 (study II, n=195), healthy female and male members of the German Federal Armed Forces were equipped with permethrin impregnated BDU (two sub-cohorts in Germany and one in Afghanistan) while members equipped with non-impregnated uniforms served as a control group. Human biomonitoring was conducted before, during and after wearing the uniforms by measuring permethrin metabolites in urine samples via GC-MS. RESULTS: Subjects of the Afghan and German control groups had permethrin levels in the range of the German general population. In contrast, subjects wearing impregnated BDU had about 200-fold higher exposure levels. Within this group, subjects located in Afghanistan and smokers had significantly higher exposure levels. Internal exposure decreased with increasing duration of use of impregnated BDU. CONCLUSIONS: There is no evidence for a higher background permethrin contamination in military bases located in Afghanistan compared to Germany. Daily use of permethrin impregnated BDU is associated with significantly higher permethrin uptake compared to the general population. Hand-mouth contact by smoking can increase uptake which also seems to be influenced by the duration of use of impregnated BDU.

Permethrin exposure from fabric-treated military uniforms under different wear-time scenarios.

The objective of the project was to ascertain whether urinary biomarkers of permethrin exposure are detected after wearing post-tailored, fabric-treated military uniforms under two different wear-time exposure scenarios. Study A occurred over 3.5 days and involved six participants wearing treated uniforms continuously for 30-32 h. Urine collection occurred at scheduled time points before, during, and after wearing the uniform. Study B, conducted over 19 days, included 11 participants wearing treated uniforms for 3 consecutive days, 8 h each day (with urine collection before, during, and after wear). Urinary biomarkers of permethrin (3-phenoxybenzoic acid (3PBA), cis- 2,2-(dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (cDCCA), trans- 2,2-(dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (tDCCA)) were detected during and after wear. Biomarker detection generally occurred over the 10- to 12-h period after putting on the uniform and subsided 24 h following uniform removal (in both Study A and B scenarios). Those wearing permethrin-treated uniforms under the longer wear-time scenario (Study A) excreted significantly higher cumulative mean levels compared with those in Study B (3.29 times higher for 3PBA and 2.23 times higher for the sum of c/tDCCA (P≤0.001)). Findings suggest that wearing permethrin-treated clothing does increase absorbed, internal dose levels of permethrin above population levels and is significantly related to wear-time duration.

Applying biofluid metabonomic techniques to analyze the combined subchronic toxicity of propoxur and permethrin in rats.

BACKGROUND: NMR combined with pattern recognition was recently introduced as a new technique for rapid xenobiotic toxicity evaluation. In this article, metabolic changes in the biofluid of rats after 90-day oral treatment with propoxur, permethrin and a combination of these two pesticides were investigated. RESULTS: Propoxur dosing induced increased urinary taurine, creatinine and glucose, whereas urinary lactate and acetate were increased in the highest permethrin dose group. Urinary acetate, alanine, lactate and trimethylamine levels were increased in the mixture group, accompanied by decreased urinary tricarboxylic acid cycle intermediates. In addition, the highest dose of the mixture displayed raised 3-D-hydroxybutyrate, acetate and lactate levels in the serum sample. CONCLUSION: Chronic exposure to a combination of propoxur and permethrin may induce hepatotoxicity and nephrotoxicity. An increase in acetate, alanine and formate in the urine could be a potentially sensitive biomarker of the chronic, combined effects of permethrin and propoxur.

Effect of DDVP on urinary excretion levels of pyrethroid metabolite 3-phenoxybenzoic acid in rats.

Pyrethroid insecticide (PYR) is used worldwide in agriculture and for indoor extermination of harmful insects. Urinary PYR metabolites (e.g. 3-phenoxybenzoic acid, 3PBA) have been used as the most sensitive biomarker for environmental PYR exposure since the late 1990s. In this study, we examined the effect of organophosphorus insecticide (OP) dichlorvos (DDVP) on excretion levels of urinary cis-permethrin-derived 3PBA in rats. Concentration of urinary 3PBA and cis-permethrin in plasma was monitored using gas chromatography-mass spectrometry and high-performance liquid chromatography after cis-permethrin injection (20 mg/kg) via the tail vein of rats pretreated intraperitoneally with DDVP (low dose, 0.3 mg/kg; high dose, 1.5 mg/kg). The amount of urinary 3PBA excretion over 48 h after cis-permethrin administration in control was 21.5±5.1 µg (mean±S.D.). In the low- and high-dose DDVP groups, the amounts of urinary 3PBA excretion were decreased to 81.1% (17.4±2.7 µg) and 70.3% (15.1±2.6 µg) of control, respectively. The plasma concentrations of cis-permethrin-derived 3-phenoxybenzyl alcohol (3PBAlc), which is a metabolite derived following hydrolysis of cis-permethrin, in high-dose DDVP group (0.18±0.01 µg) were significantly lower than in control (0.23±0.03 µg) 1h after cis-permethrin injection. Both in the control and high-dose DDVP group, no differences were observed in the excretion levels of urinary 3PBA after injection of 3PBAlc (25mg/kg, i.v.). These results suggested that the effect of DDVP on the amount of urinary 3PBA excretion was caused by the DDVP-induced modification of the cis-permethrin metabolic pathway. In conclusion, the possible decrease in urinary excretion level of 3PBA due to co-exposure to OPs should be considered in the biological monitoring of PYR exposure.

Experimental methods for determining permethrin dermal absorption.

The objectives of this study were to (1) determine the percutaneous absorption of radiolabeled permethrin and piperonyl butoxide (PBO) in vivo in rats and in vitro to permit a calculation of the ratio of in vitro to in vivo values, and (2) test a method of estimating in vivo human absorption. Carbon-14 labeled permethrin in ethanol solution was applied to the clipped skin of rats in vivo at doses of 2.25, 20, or 200 µg/cm2. As a reference compound, 14C-labeled PBO in isopropanol solution was applied to rat skin in vivo at a dose of 100 µg/cm2. All applications were washed at 24 h postapplication, and rats were sacrificed either at 24 h for permethrin or 5 d for both compounds. The radiolabel recovered from carcass, urine including cage wash, and feces was summed to determine percent absorption. For the 24-h time point, at doses of 2.25, 20, and 200 µg/cm2 of permethrin, values of 22, 22, and 28%, respectively, were obtained for in vivo rat percutaneous absorption (n=6 per dose). For the 5-d time point, at doses of 2.25, 20, and 200 µg/cm2 of permethrin, values of 38, 38, and 30%, respectively, were obtained for in vivo rat percutaneous absorption (n=6 per dose). The 5-d percutaneous absorption of 14C-PBO at 100 µg/cm2 was determined to be 42% (n=6). Dose and test duration did not exert a statistically significant effect on percutaneous absorption of permethrin in the rat in vivo. For in vitro absorption determination, 14C-permethrin in ethanol solution was applied to freshly excised human skin in an in vitro test system predictive of skin absorption in humans. Twenty-four hours after application, the radiolabel recovered from dermis and receptor fluid was summed to determine percent absorption. At doses of approximately 2.25, 20, and 200 µg/cm2 permethrin, values of 1, 3, and 2%, respectively, were obtained for percutaneous absorption (n=9 per dose). Excised human skin absorption of 14C-PBO at 100 µg/cm2 was determined to be 7% (n=9). Excised rat skin absorptions of permethrin at 2.25, 20, and 200 µg/cm2 were found to be 20, 18, and 24%, respectively (n=6 per dose), approximately 10-fold higher than human skin absorption. Excised rat skin absorption of PBO was also higher (35%) than the value obtained for human skin by a factor of about 5.

Urinary pesticide metabolites in school students from northern Thailand.

We evaluated exposure to pesticides among secondary school students aged 12-13 years old in Chiang Mai Province, Thailand. Pesticide-specific urinary metabolites were used as biomarkers of exposure for a variety of pesticides, including organophosphorus insecticides, synthetic pyrethroid insecticides and selected herbicides. We employed a simple solid-phase extraction with analysis using isotope dilution high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS). A total of 207 urine samples from Thai students were analyzed for 18 specific pesticide metabolites. We found 14 metabolites in the urine samples tested; seven of them were detected with a frequency > or=17%. The most frequently detected metabolites were 2-[(dimethoxyphosphorothioyl) sulfanyl] succinic acid (malathion dicarboxylic acid), para-nitrophenol (PNP), 3,5,6-trichloro-2-pyridinol (TPCY; metabolite of chlorpyrifos), 2,4-dichlorophenoxyacetic acid (2,4-D), cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acids (c-DCCA and t-DCCA; metabolite of permethrin) and 3-phenoxybenzoic acid (3-PBA; metabolite of pyrethroids). The students were classified into 4 groups according to their parental occupations: farmers (N=60), merchants and traders (N=39), government and company employees (N=52), and laborers (N=56). Children of farmers had significantly higher urinary concentrations of pyrethroid insecticide metabolites than did other children (p<0.05). Similarly, children of agricultural families had significantly higher pyrethroid metabolite concentrations. Males had significantly higher values of PNP (Mann-Whitney test, p=0.009); however, no other sex-related differences were observed. Because parental occupation and agricultural activities seemed to have little influence on pesticide levels, dietary sources were the likely contributors to the metabolite levels observed.

Pesticide exposure resulting from treatment of lice infestation in school-aged children in Georgia.

OBJECTIVE: The objective of this study was to assess pesticide exposures in children being treated for head lice with either lindane or permethrin (exposed group) and children who did not have a lice infestation and thus were not being treated with chemicals for head lice or scabies (unexposed group). METHODS: In 2001, we enrolled 78 children aged 6-10 years old and collected baseline urine samples and demographic information from all the children. We subsequently collected post-exposure urine samples and questionnaire information about lice treatment from the 29 (37%) children (exposed children) who had been diagnosed and were being treated for head lice. Metabolites of the pesticides lindane and permethrin were measured in the samples. RESULTS: The mean age of exposed and unexposed children in the study population was 9.3 years and 8.5 years, respectively. Fourteen of the 29 exposed children used prescription lice treatments (i.e., lindane or malathion); 25 of the 29 exposed children used at least one over-the-counter permethrin treatment, either alone or in addition to prescription treatments. Exposed children in both counties had higher urinary pyrethroid metabolite levels in their post-exposure samples compared with their baseline samples. However this difference was only significant in Forsyth County children. CONCLUSIONS: The significantly increased post-exposure pyrethroid metabolite levels in the urine of Forsyth County children suggest that the children are exposed to pyrethroid insecticides through the use of lice shampoos.

Multimedia measurements and activity patterns in an observational pilot study of nine young children.

A pilot observational exposure study was performed to evaluate methods for collecting multimedia measurements (air, dust, food, urine) and activity patterns to assess potential exposures of young children to pesticides in their homes. Nine children (mean age=5 years) and their caregivers participated in this study, performed in the Duval County, Florida, in collaboration with the Centers for Disease Control and Prevention and the Duval County Health Department. For all nine children, the total time reported for sleeping and napping ranged from 9.5 to 14 h per day, indoor quiet time from 0 to 5.5 h per day, indoor active time from 0.75 to 5.5 h per day, outdoor quiet time from 0 to 1.5 h per day, and outdoor active time from 0.5 to 6.5 h per day. Each home had one to three pesticide products present, with aerosols being most common. Pesticide inventories, however, were not useful for predicting pesticide levels in the home. Synthetic pyrethroids were the most frequently identified active ingredients in the products present in each home. Fifteen pesticide active ingredients were measured in the application area wipes (not detected (ND) to 580 ng/cm(2)), 13 in the play area wipes (ND-117 ng/cm(2)), and 14 in the indoor air samples (ND-378 ng/m(3)) and the socks (ND-1000 ng/cm(2)). Cis-permethrin, trans-permethrin, and cypermethrin were measured in all nine homes. Chlorpyrifos was measured in all nine homes even though it was not reported used by the participants. All urine samples contained measurable concentrations of 3-phenoxybenzoic acid (3-PBA). The median 3-PBA urinary concentration for the nine children was 2.2 mug/l. A wide variety of pesticide active ingredients were measured in these nine homes at median concentrations that were often higher than reported previously in similar studies. These data highlight the need for additional observational studies in regions where pesticides are used in order to understand the factors that affect young children's exposures and the education/mitigation strategies that can be used to reduce children's exposures.

An observational study of 127 preschool children at their homes and daycare centers in Ohio: environmental pathways to cis- and trans-permethrin exposure.

The potential exposures of 127 preschool children to the pyrethroid insecticides, cis- and trans-permethrin, in their everyday environments were examined. Participants were recruited randomly from 127 homes and 16 daycare centers in six Ohio (OH) counties. Monitoring was performed over a 48-h period at the children's homes and/or daycare centers. Samples collected included soil, carpet dust, indoor air, outdoor air, diet, hand wipes, surface wipes, transferable residues, and urine. The environmental samples were analyzed for the cis and trans isomers of permethrin, and the urine samples were analyzed for the pyrethroid urinary metabolite, 3-phenoxybenzoic acid (3-PBA), by gas chromatography/mass spectrometry. The isomers were detected most often in the dust (100%) and hand wipe (>78%) samples collected at both homes and daycare centers. The median levels of cis-permethrin (470 and 1010 ng/g) were higher than the median levels of trans-permethrin (344 and 544 ng/g) in the dust samples at both the children's homes and daycare centers, respectively. In the children's hand wipe samples, the median levels of cis- and trans-permethrin were similar, ranging from 0.03 to 0.04 ng/cm(2), at both locations. The urinary metabolite 3-PBA was detected in 67% of the children's urine samples. The median urinary 3-PBA concentration for the children was 0.3 ng/mL, and the maximum value for one child was 33.8 ng/mL. The primary route of the children's exposure to the combined isomers was through dietary ingestion, followed by indirect ingestion. In addition, our calculated aggregate absorbed doses of permethrin accounted for about 60% of the excreted amounts of 3-PBA found in the children's urine. In conclusion, these children were potentially exposed to low levels of permethrin from several sources, and through several pathways and routes.

Dermal absorption of permethrin following topical administration.

OBJECTIVE: Permethrin is an insecticide used in the treatment of lice and scabies infections. Although its efficacy and safety have been well documented, pharmacokinetic data are sparse. The objective of this study was to determine the systemic exposure of permethrin and the duration of residence in the human body following topical administration. METHODS: The study consisted of three parts. In six young healthy men (part 1), 50 ml of an ethanolic solution containing 215 mg permethrin (cis/trans: 25/75) was administered to the hair of the head. In another six young healthy men (part 2) and in six male or female scabies patients (part 3), 60 g of cream containing 3 g permethrin was administered to the skin of the whole body. Urine was collected up to 168 h post-dose. Urinary excretion of the main metabolite of permethrin, 3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid, and its conjugates was measured using a gas chromatography/electron capture detection method. RESULTS: Pharmacokinetics were similar in all study parts. The time of maximal urinary excretion rate was 12.3, 20.0 and 14.6 h, terminal elimination half-life was 32.7, 28.8 and 37.8 h and urinary recovery of the metabolite reached 0.35, 0.47 and 0.52 M percent of the permethrin dose, respectively, in parts 1, 2 and 3 (means). The treatment was well tolerated. CONCLUSIONS: The extent of systemic exposure following external therapeutic administration of permethrin is very low compared with doses used for preclinical toxicity studies, and elimination is virtually complete after 1 week. These data provide the pharmacokinetic basis for the clinical safety of topical permethrin.