CONFUSED ABOUT INSECT REPELLENTS?

What You Should Know About DEET Before Choosing Repellent and How to Safely Protect Yourself and Your Children From Insects and the Diseases They Carry.
News reports of mosquitoes harboring the Eastern equine encephalitis (EEE) virus alarmed much of Rhode Island and parts of southern Massachusetts last fall. People stayed indoors during early evening hours, canceled late afternoon outdoor sporting events, opened schools an hour later in the mornings, and kept children indoors during recesses. Given EEE's mortality rate of 50 to 60 percent, such precautions were not unwarranted, even though the disease is extremely rare, with only 152 cases reported in the US since 1964.
The response in Rhode Island, which included spraying of infested areas and public health advisories, was well-orchestrated by state and local health officials. But such situations point to the need for better understanding of the measures individuals can take to protect themselves and their children from the risk of diseases transmitted by insect bites.

In recent years, a very public debate has been waged over DEET, the active ingredient in most insect repellents. "As a result of this discussion, many consumers are torn between wanting to avoid a product with possible harmful side effects and wanting to protect themselves from insect bites and the illnesses that can result from them," says Boyd Bush, president of Tender Corporation, a New Hampshire company that manufactures insect repellents both with and without DEET. "It is important for people to know the facts about DEET and about the risks involved with not using a repellent so they can make informed choices.

What About DEET?
DEET was developed by the US government in 1951 after testing 11,000 compounds for their effectiveness in repelling insects. It is approved by the Environmental Protection Agency (EPA) as an insect repellent and no other substance has been found to be more effective. Repellents with DEET are used by an estimated 200 million people worldwide each year, including 100 million individuals in America. According to a bulletin issued by the EPA in 1989, less than 10 reports of adverse side effects are received annually, and most of these stem from repeated use on children, which manufacturers like Tender Corporation strongly advise against.
Beginning in 1985, a consortium of companies that manufacture and market products with DEET began conducting DEET health-effects studies, including short-term, long-term and human exposure studies. To date, 34 such studies have been done and no unreasonable adverse effects to people or the environment have been found from the suggested use of DEET. When reactions to DEET are reported, they are generally limited to eye irritation from inadvertent exposure to the eyes and infrequent skin reactions from sensitive individuals.

"The bottom line is that DEET repellents can be used confidently by following label instructions," says Bush. "In a study by the American Association of Poison Control Centers, only 0.16 of 1% of calls made to the Poison Control Centers over a five-year period involved DEET products. Of those, the majority were inconsequential. And of these few reported calls, no correlation was found between the number or severity of reported incidents and the concentration of DEET in products."

Risks from Insect Bites and Stings
Everybody has experienced the annoyance of itching insect bites. But some insect bites result in far more serious problems. Approximately 100 Americans are reported to die each year from insect bites or stings. However, the true number is probably much higher since researchers are convinced that an unknown number of deaths attributed to natural causes are actually caused by insect stings. For example, a severely allergic reaction to bee stings can masquerade as a heart-attack.
Lyme disease is one of the better known insect-spread diseases; it is carried by ticks, mostly commonly the deer tick. While highly treatable in its early stages, if undetected Lyme disease can cause serious long-term disabilities, including arthritic joints, severe headaches and abnormal heartbeat. Cases have been reported in 49 states; the disease is most common in the Northeast and upper Midwest. The Centers for Disease Control reported approximately 13,000 new cases nationwide in 1994, a 58% increase from the previous year.

Besides Lyme disease, ticks also transmit Rocky Mountain spotted fever, Colorado tick fever and several forms of encephalitis. In addition to the Eastern equine encephalitis mosquitoes also spread other forms of encephalitis. Even common house flies and horse flies can transmit serious diseases, such as anthrax, tuberculosis, tularemia, tetanus, typhoid, dysentery and cholera.

Choices in Repellents
The problems posed by insects, then, certainly warrant using protection when engaging in outdoor activities, particularly if you live in areas known to be infested with disease-carrying bugs. DEET has been proven effective against many types of pests, including mosquitoes, chiggers, ticks, fleas, biting flies, biting midges (commonly called no-see-ums), and gnats.
"Used according to label instructions, DEET is a perfectly safe and highly effective way to protect yourself from insects," says Bush.

The Environmental Protection Agency (EPA) has notified industry that all single-use insect repellent formulations of DEET (N, N-diethyl-m-toluamide) are eligible for re-registration provided labeling is amended as specified by the agency. DEET is the active ingredient in most insect repellent products sold in the U.S. and is widely considered preferred and only scientifically proven effective protection against biting insects.

EPA approved continued use of currently available DEET insect repellent products after a comprehensive review of 11 years of extensive independent research into potential DEET human and environmental toxicity. In its evaluation, the agency concluded: "_normal use of DEET does not present health concerns to the general U.S. population;"

DEET is "not classifiable as a human carcinogen" and "_no toxicologically significant effects in animal studies" could be identified;

Despite some allegation that DEET use can lead to adverse health effect, "the incident data are insufficient to establish DEET as the cause of the reported effect;"

"The application of DEET insect repellents to the skin and clothing can help prevent bites form ticks and other biting insects that may cause disease."

EPA postponed a formal re-registration decision on dual-use DEET insect repellent/sunscreen products until it has "solicited the views of various governmental agencies and other groups." Combination DEET/sunscreen products will remain available at the retail level and consumers should be assured that combination DEET insect repellent/sunscreen products are safe and effective when used according to label directions.

The agency's decision is particularly important and good news for American public health in light of the widely recognized climatic impact of El Nino will create larger than normal insect populations in the U.S. this year. Experts warn that those lager populations will lead to an increased risk for the diseases that mosquitoes, ticks, gnats, biting flies, fleas, chiggers and no-see-ums (biting midges) can carry. Those serious, potentially deadly diseases include Eastern equine, Western equine, St.Louis and La Crosse enciphalitis, Lyme disease, malaria, dengue fever, Rocky Mountain spotted fever, Human granulocytic ehrlichiosis and Babesiosis.

In the DEET re-registration eligibility document, EPA outline additional labeling requirements for DEET insect repellent products, such as, requiring the word "DEET," not the chemical name (N, N-diethyl-m-toluamide), be listed under "active ingredients". As it has for more than two decades, the DEET industry will work closely with EPA to further improve product labels to ensure continued appropriate use of DEET insect repellents by people of all ages.