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Comment & Response
June 1, 2020

Exposure to Pyrethroids and Health Risk

Author Affiliations
  • 1Department of Public Health, Syracuse University, Syracuse, New York
JAMA Intern Med. 2020;180(7):1027-1028. doi:10.1001/jamainternmed.2020.1516

To the Editor I was alarmed to read the recent JAMA Internal Medicine article by Bao et al1 suggesting that pyrethroid insecticide exposure is associated with a 3-fold increase in the risk of adult mortality from cardiovascular disease. The significance of this finding cannot be overstated, should it be replicated and shown to be true. The world relies heavily on pyrethroids for the control of vector-borne diseases, including malaria. Huge advances have been made over the past 20 years in malaria control—we have cut transmission by about half, primarily using pyrethroid-treated mosquito nets, and prevented millions of malaria-caused deaths in the process.2 As Bao et al1 point out, contact absorption of pyrethroids is a less effective method of exposure, and therefore those sleeping under pyrethroid-treated mosquito nets are perhaps in less danger. However, these pyrethroid-treated mosquito nets are regularly used as fishing nets.3 It remains to be seen how pyrethroid-treated mosquito nets entering the waterways might bioaccumulate and affect human health, but the implications are grim.

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