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.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Larsen DA. Exposure to Pyrethroids and Health Risk. JAMA Intern Med. 2020;180(7):1027–1028. doi:10.1001/jamainternmed.2020.1516
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: