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Invited Commentary
December 30, 2019

Pyrethroid Insecticides—Time for a Closer Look

Author Affiliations
  • 1Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
  • 2Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York
JAMA Intern Med. 2020;180(3):374-375. doi:10.1001/jamainternmed.2019.6093

Pyrethroid pesticides are a large family of synthetic analogues of naturally occurring pyrethrins widely used for insect control in agricultural and numerous consumer products. Collectively, they are the second most–used insecticides in the world, totaling thousands of kilograms and billions of dollars in US sales.

In this issue of JAMA Internal Medicine, a group of researchers from the University of Iowa College of Public Health compared total and cardiovascular deaths among participants in 2 biennial cycles of the highly regarded National Health and Nutrition Examination Survey (NHANES), which includes a nationally representative sample of US adults. The researchers followed the participants for up to 16.8 years after urinary measurement of 3-phenoxybenzoic acid (3-PBA), a metabolite of pyrethroid exposure.1 They reported significant hazard ratios of 1.56 for death from any cause and 3.00 for death from cardiovascular disease for individuals in the highest compared with the lowest biomarker exposure tertile.

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