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Proctor SP, Nguyen VT, Hebert AA, Taylor KM, McClung HL, Heaton KJ, Ospina M, Calafat AM. Individual-level permethrin exposure biomarkers in U.S. army soldiers: comparison of two treatment formulations for military uniforms. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:132-139. [PMID: 35999257 PMCID: PMC10140735 DOI: 10.1038/s41370-022-00466-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence suggests that wearing permethrin-treated military uniforms is not associated with current adverse health conditions. However, exposure through this route results in permethrin biomarker concentrations considerably higher than those in the U.S. POPULATION The U.S. Army is exploring different methods of uniform treatment that reduce exposure while maintaining effective protection from insect vector-borne diseases. OBJECTIVE To compare permethrin exposure when wearing two types of permethrin-treated military uniforms. METHODS Eight male soldiers participated in a 32-day crossover design study to compare permethrin exposure when wearing the current Army uniform (CurrU) and a uniform with a new applied fabric treatment (NewU). Each soldier wore the uniforms for designated 8 h/day time periods over 3 consecutive days separated by a 'wash-out' week of no exposure. Permethrin exposure was assessed from the urinary concentrations of 3-phenoxybenzoic acid (3-PBA) and of the sum of cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (∑DCCA). Estimated dose was determined based on ∑DCCA concentrations. RESULTS Permethrin exposure biomarkers were 21% (3-PBA, p = 0.025) and 35% (∑DCCA, p < 0.001) lower when wearing the NewU compared to the CurrU; the dose was 33% lower (p = 0.05). SIGNIFICANCE Findings suggest the new treatment reduces human permethrin exposure biomarkers resulting from wearing-treated military uniforms.
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Affiliation(s)
- Susan P Proctor
- Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, MA, USA.
- VA Boston Healthcare System, Research Service, 180 South Huntington Avenue, Boston, MA, USA.
| | - V T Nguyen
- Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, MA, USA
| | - Ashley A Hebert
- Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, MA, USA
| | - Kathryn M Taylor
- Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, MA, USA
| | - Holly L McClung
- Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, MA, USA
| | - Kristin J Heaton
- Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, MA, USA
| | - Maria Ospina
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, 4770 Buford Hwy, Atlanta, GA, USA
| | - Antonia M Calafat
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, 4770 Buford Hwy, Atlanta, GA, USA
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Richards SL, Driver J, Dyer MC, Mather TN, Funkhouser S, Mitchell C, Anne Balanay J, White A, Meshnick S. Assessing Durability and Safety of Permethrin Impregnated Uniforms Used by Outdoor Workers to Prevent Tick Bites after One Year of Use. JOURNAL OF MEDICAL ENTOMOLOGY 2022; 59:615-622. [PMID: 34958094 PMCID: PMC9272190 DOI: 10.1093/jme/tjab216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Indexed: 06/14/2023]
Abstract
Long lasting permethrin-impregnated (LLPI) clothing can retain permethrin and repel ticks for up to three months and without exceeding EPA-approved safe levels; however, little is known about longer term effects of wearing LLPI clothing. Here, permethrin content was measured in new forester pants soon after initial impregnation (Insect Shield) and again one year later after being repeatedly worn by foresters in the field. Urine samples were collected from foresters for biomonitoring of permethrin metabolites at multiple time intervals (pre-use, one-month, three-to-four-months, and one-year post-use). Lethality against nymphal Ixodes scapularis Say was measured in clothing after one year of wear by foresters. Furthermore, to test potential variability in permethrin impregnation of different batches of clothing, separate sets of clothing were anonymously sent to Insect Shield for permethrin treatment over a period of three months and permethrin was quantified. Results demonstrated 33% of participants' pants had no measurable permethrin after one year of wear and permethrin content and tick mortality varied significantly between clothing. Only two of the participants' clothing resulted in ≥ 30% tick mortality after one year of wear. Significant differences were observed in 3-PBA and trans-DCCA, but not cis-DCCA metabolites in participants over the four measured time points and were higher than general United States population levels. This study provides practical information on the safety (measured by urinary metabolites) over time of LLPI clothing. It also provides snapshots (pre-washing and after one year of wear) of effectiveness of LLPI clothing as personal protective equipment against ticks for outdoor workers.
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Affiliation(s)
- Stephanie L Richards
- Environmental Health Sciences Program, Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 300 Curry Court, Greenville, NC 27858, USA
| | - Jeffrey Driver
- risksciences LLC, 5285 Gulf of Mexico Dr., Longboat Key, FL 34228, and University of South Florida, College of Public Health, 13201 Bruce B Downs Blvd, Tampa, FL 33612, USA
| | - Megan C Dyer
- Center for Vector-Borne Disease, University of Rhode Island, 45 Upper College Rd, Kingston, RI 02881, USA
| | - Thomas N Mather
- Center for Vector-Borne Disease, University of Rhode Island, 45 Upper College Rd, Kingston, RI 02881, USA
| | - Sheana Funkhouser
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC 27599, USA
| | - Cedar Mitchell
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC 27599, USA
| | - Jo Anne Balanay
- Environmental Health Sciences Program, Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 300 Curry Court, Greenville, NC 27858, USA
| | - Avian White
- Environmental Health Sciences Program, Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 300 Curry Court, Greenville, NC 27858, USA
| | - Steven Meshnick
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC 27599, USA
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Maule AL, Heaton KJ, Cadarette B, Taylor KM, Guerriere KI, Haven CC, Scarpaci MM, Kenefick RW, Ospina M, Calafat AM, Proctor SP. Effect of Environmental Temperature and Humidity on Permethrin Biomarkers of Exposure in U.S. Soldiers Wearing Permethrin-Treated Uniforms. Am J Trop Med Hyg 2020; 102:1455-1462. [PMID: 32228790 DOI: 10.4269/ajtmh.19-0543] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
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.
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Affiliation(s)
- Alexis L Maule
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland.,United States Army Research Institute of Environmental Medicine, Military Performance Division, Natick, Massashusetts
| | - Kristin J Heaton
- Boston University School of Public Health, Department of Environmental Health, Boston, Massachusetts.,United States Army Research Institute of Environmental Medicine, Military Performance Division, Natick, Massashusetts
| | - Bruce Cadarette
- United States Army Research Institute of Environmental Medicine, Thermal and Mountain Medicine Division, Natick, Massachusetts
| | - Kathryn M Taylor
- United States Army Research Institute of Environmental Medicine, Military Performance Division, Natick, Massashusetts
| | - Katelyn I Guerriere
- United States Army Research Institute of Environmental Medicine, Military Performance Division, Natick, Massashusetts
| | - Caitlin C Haven
- United States Army Research Institute of Environmental Medicine, Military Performance Division, Natick, Massashusetts
| | - Matthew M Scarpaci
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland.,United States Army Research Institute of Environmental Medicine, Military Performance Division, Natick, Massashusetts
| | - Robert W Kenefick
- United States Army Research Institute of Environmental Medicine, Thermal and Mountain Medicine Division, Natick, Massachusetts
| | - Maria Ospina
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Atlanta, Georgia
| | - Antonia M Calafat
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Atlanta, Georgia
| | - Susan P Proctor
- United States Army Research Institute of Environmental Medicine, Military Performance Division, Natick, Massashusetts.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland.,VA Boston Healthcare System, Research Service, Boston, Massachusetts
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