Too many in the U.S. bury their heads in the sands about the issues, but researchers in Spain and Mozambique wondered whether indoor residual spraying (IRS) with DDT, to fight malaria-carrying mosquitoes, might produce harms to children in those homes. They studied the issue in homes sprayed with DDT in Mozambique.
It turns out that young mothers ingest DDT and pass a significant amount of it to their children when the children breast feed.
The study itself is behind Elsevier’s mighty paywall, but the abstract from Chemosphere is available at no cost:
Concentration of DDT compounds in breast milk from African women (Manhiça, Mozambique) at the early stages of domestic indoor spraying with this insecticide
Maria N. Manacaa, b, c, Joan O. Grimaltb,
,
, Jordi Sunyerd, e, Inacio Mandomandoa, f, Raquel Gonzaleza, c, e, Jahit Sacarlala, Carlota Dobañoa, c, e, Pedro L. Alonsoa, c, e and Clara Menendeza, c, e
a Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
b Institute of Environmental Assessment and Water Research (IDÆA-CSIC), Jordi Girona 18, 08034 Barcelona, Catalonia, Spain
c Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Rosselló 132, 4a, 08036 Barcelona, Catalonia, Spain
d Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Catalonia, Spain
e Ciber Epidemiología y Salud Pública, Spain
f Instituto Nacional de Saúde, Ministerio de Saúde, Maputo, Mozambique
Received 6 November 2010;
revised 19 March 2011;
accepted 1 June 2011.
Available online 20 July 2011.
Abstract
Breast milk concentrations of 4,4′-DDT and its related compounds were studied in samples collected in 2002 and 2006 from two populations of mothers in Manhiça, Mozambique. The 2006 samples were obtained several months after implementation of indoor residual spraying (IRS) with DDT for malaria vector control in dwellings and those from 2002 were taken as reference prior to DDT use. A significant increase in 4,4′-DDT and its main metabolite, 4,4′-DDE, was observed between the 2002 (median values 2.4 and 0.9 ng/ml, respectively) and the 2006 samples (7.3 and 2.6 ng/ml, respectively, p < 0.001 and 0.019, respectively). This observation identifies higher body burden intakes of these compounds in pregnant women already in these initial stages of the IRS program. The increase in both 4,4′-DDT and 4,4′-DDE suggest a rapid transformation of DDT into DDE after incorporation of the insecticide residues. The median baseline concentrations in breast milk in 2002 were low, and the median concentrations in 2006 (280 ng/g lipid) were still lower than in other world populations. However, the observed increases were not uniform and in some individuals high values (5100 ng/g lipid) were determined. Significant differences were found between the concentrations of DDT and related compounds in breast milk according to parity, with higher concentrations in primiparae than multiparae women. These differences overcome the age effect in DDT accumulation between the two groups and evidence that women transfer a significant proportion of their body burden of DDT and its metabolites to their infants.
Highlights
► DDT increases in pregnant women at the start of indoor spraying with this compound. ► Rapid transformation of DDT into DDE occurs in women after intake of this insecticide. ► The DDT increases in breast milk of women due to indoor spraying are not uniform. ► Breast milk DDT content in primiparae women is higher than in multiparae women. ► Women transfer a high proportion of their DDT and DDE body burden to their infants.
“Primiparae” women are those with one child, their first; “multiparae” women are those who have delivered more than one child.
Without having read the study, I suggest there are a few key points this research makes:
- Claims that DDT has been “banned” from Africa and is not in use, are patently false.
- Spraying poisons in homes cannot be considered to have no consequences; poisons in in very small concentrations get into the bodies of the people who live in those homes.
- We should not cavalierly dismiss fears of harms to humans from DDT, because it appears that use of even tiny amounts of the stuff exposes our youngest and most vulnerable children.
- Beating malaria has no easy, simple formula.
Women, even poor women in malaria-endemic areas, should not have to worry about passing poisonous DDT or its breakdown products to their children, through breastfeeding. The national Academy of Sciences was right in 1970: DDT use should be stopped, and work should be hurried to find alternatives to DDT.
Resources:
- PubMed reference to the study
- Abstract of a 2010 article in Science of the Total Environment, showing significant DDT exposures in all aspects of households treated with DDT in IRS
- Abstract of a 1991 study published in the Central African Journal of Medicine showing significant DDT exposure from breast milk from mothers in Zimbabwe
- PubMed article explaining DDT was reintroduced to Mozambique in 2005, after a determination that local mosquito populations were susceptible to DDT
Always something new out of Africa; nothing new under the Sun. The ancients were pretty smart.
In this case, what’s not new: Around 1970, you could buy a lot of interesting posters on Telegraph Avenue. It was also the time when people had got serious in this advanced country about the hazards of DDT. One poster, which regrettably I didn’t buy at the time, showed a pair of breasts and a warning label, quite true, that “Milk in these containers may contain DDT in quantities unsafe for infants.”
Good times, those. If, of course, one was not in Vietnam or guilty of being Black While in the South.
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Interested in U.S. policies on malaria? You may also want to take a look at some of the material at the Global Health Delivery Project, specifically their recommendations on how the U.S. should deal with malaria aid:
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It’s a really odd claim. During the Bush administration, the policy was that USAID money could not be used to purchase DDT, but no one was proud of the policy or would explain why it existed. USAID eventually dropped the policy as part of the President’s malaria initiative, which has been continued under Obama.
Here’s USAID’s statement saying they don’t withhold funds and support the use of DDT in IRS, where appropriate:
https://timpanogos.wordpress.com/2011/02/16/usaid-policy-statement-on-ddt-and-malaria-control/
Here’s an excerpt from that statement:
The U.S. is committed to fighting malaria. If DDT is the best way to do that in some location, the U.S. is for it — the U.S. does not oppose the use of DDT in any case.
Here’s the website for the President’s Malaria Initiative:
http://www.pmi.gov/
DDT simply is not the best way to fight the disease any more, if it ever was. DDT only works to hold down mosquito populations temporarily. It was used in an ambitious campaign to beef up medical care in the interim to cure malaria in the human carriers while the mosquito population was knocked down. Without that medical care improvement component, DDT is worse than worthless, it’s destructive and it aids malaria.
So, the U.S. is putting money into bednets, improving medical care, and other effective treatments.
You may want to note that the death toll from malaria, right now at the lowest total in human history, continues to fall. Since the heyday of DDT (1959-1960), when 4 million people died from malaria each year, the death toll has been reduced to under 900,000 — a more than 75% reduction in deaths while the target populations have skyrocketed and the range of malaria-carrying mosquitoes has increased.
We’re reducing malaria without DDT, successfully. In most of the world, DDT would be a waste of money. Surely your debating opponents are not arguing to waste money instead of fighting malaria, would they?
One other note: India still makes DDT (China and North Korea may still be making the stuff, too). India uses more DDT than all the rest of the world together. India has an increasing malaria problem. If DDT were magic against malaria, it should have been eradicated from India years ago. But DDT is not magic, and often is not even very effective.
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I am hearing claims that the US threatens to withhold foreign aid from countries that do not also ban DDT. How do I answer this claim?
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