Health Care and DEET

During the warmer months of the year, Americans face the perennial battle against the peskiest of bugs--the inimitable mosquito. Of all the flying insects, these winged instruments of torture seem to invariably find a landing pad of soft skin to do their dirty deed. Have you ever been outside at a party, or lounging on a hammock in the back yard, or fishing with your buds, or doing countless other activities when all of a sudden you feel the sting of the mosquito? Happily, he is there with his probiscus buried snugly in your epidermal layers and sucking your life's blood out. He is blissfully content to stay there until the damage has been done leaving you to suffer the consequences of his bite. Well, there is a way to counter the itchy effects of this pest.

According to DEET.com, bites from mosquitoes and other insects, as well as ticks (which officially are arthropods, not insects), are more than just annoying. They can lead to lasting health issues and can even result in death. Through proper use of DEET-based repellents, you and your loved ones can enjoy outdoor activities more comfortably. Perhaps more importantly, you’ll help reduce the risk of getting Lyme disease, West Nile virus and a host of other serious illnesses spread by these pests. DEET has been available for more than 50 years in the U.S. and has been studied more extensively than any other repellent ingredient. It is the most widely used active ingredient in repellents worldwide and is unequalled when it comes to keeping mosquitoes, ticks, and other bugs away. DEET-based repellents are recommended by the Centers for Disease Control and Prevention (CDC), the National Institute for Occupational Safety and Health (NIOSH), the American Academy of Pediatrics (AAP), and state and local public health officials, among others. The AAP says they can be used on all family members over the age of two (2) months in concentrations up to 30%.

According to the CDC, insect repellents can help reduce exposure to mosquito bites that may carry viruses such as West Nile virus that can cause serious illness and even death. Using insect repellent allows you to continue to play and work outdoors with a reduced risk of mosquito bites. Apply repellent when you are going to be outdoors. Even if you don’t notice mosquitoes there is a good chance that they are around. Many of the mosquitoes that carry West Nile virus bite between dusk and dawn. If you are outdoors around these times of the day, it is especially important to apply repellent. In many parts of the country, there are mosquitoes that also bite during the day, and some of these mosquitoes have also been found to carry West Nile virus. In general you should re-apply repellent if you are being bitten by mosquitoes. Always follow the directions on the product you are using. Sweating, perspiration or getting wet may mean that you need to re-apply repellent more frequently. Repellents containing a higher concentration (higher percentage) of active ingredient typically provide longer-lasting protection.

Typically, according to the CDC, the more active ingredient a product contains the longer it provides protection from mosquito bites. The concentration of different active ingredients cannot be directly compared (that is, 10% concentration of one product doesn’t mean it works exactly the same as 10% concentration of another product.) DEET is an effective active ingredient found in many repellent products and in a variety of formulations. Based on a 2002 study:
--A product containing 23.8% DEET provided an average of 5 hours of protection from mosquito bites.
--A product containing 20% DEET provided almost 4 hours of protection.
--A product with 6.65% DEET provided almost 2 hours of protection.
--Products with 4.75% DEET were both able to provide roughly 1 and a half hour of protection.
These examples represent results from only one study and are only included to provide a general idea of how such products may work. Actual protection will vary widely based on conditions such as temperature, perspiration, and water exposure. In some cases you will note the chemical name in addition to/instead of the “common” name: DEET is N,N-diethyl-m-toluamide.

According to EPA.gov, every year, approximately one-third of the U.S. population is expected to use DEET. Products containing DEET currently are available to the public in a variety of liquids, lotions, sprays, and impregnated materials (e.g., wrist bands). Formulations registered for direct application to human skin contain from 4 to 100% DEET. Except for a few veterinary uses, DEET is registered for use by consumers, and it is not used on food. DEET is designed for direct application to human skin to repel insects, rather than kill them. After it was developed by the U.S. Army in 1946, DEET was registered for use by the general public in 1957. Approximately 140 products containing DEET are currently registered with EPA by about 39 different companies. DEET is approved for use on children with no age restriction. There is no restriction on the percentage of DEET in the product for use on children, since data do not show any difference in effects between young animals and adult animals in tests done for product registration. There also are no data showing incidents that would lead EPA to believe there is a need to restrict the use of DEET. Consumers are always advised to read and follow label directions in using any pesticide product, including insect repellents.

Consumers can reduce their own risks when using DEET by reading and following products labels. According to the EPA, all DEET product labels include the following directions:
--Read and follow all directions and precautions on this product label.
--Do not apply over cuts, wounds, or irritated skin.
--Do not apply to hands or near eyes and mouth of young children.
--Do not allow young children to apply this product.
--Use just enough repellent to cover exposed skin and/or clothing.
--Do not use under clothing.
--Avoid over-application of this product.
--After returning indoors, wash treated skin with soap and water.
--Wash treated clothing before wearing it again.
Use of this product may cause skin reactions in rare cases. The following additional statements will appear on the labels of all aerosol and pump spray formulation labels:
--Do not spray in enclosed areas.
--To apply to face, spray on hands first and then rub on face. Do not spray directly onto face.

People can, and should, use both a sunscreen and an insect repellent when they are outdoors. Follow the instructions on the package for proper application of each product. In general, the recommendation is to apply sunscreen first, followed by repellent. It's recommended NOT to use a single product that combines insect repellent containing DEET and sunscreen, because the instructions for use of insect repellents and use of sunscreen are different. In most situations, insect repellent does not need to be reapplied as frequently as sunscreen. While no recommendations are available at this time regarding products that combine other active ingredients and sunscreen, it is important to always follow the label on whatever product you are using, according to the CDC.

There are no reported adverse events following use of repellents containing DEET in pregnant or breastfeeding women, according to the Illinois Department of Public Health. If you do not want to use a product containing DEET, or if your physician advises you to avoid DEET, there are other products that can give you limited protection. These repellents generally use plant-based oils to repel insects. In comparison to DEET-based products, plant oil-based repellents are generally effective for a shorter time (usually less than about two hours). Note: Vitamin B, ultrasonic devices and incense have not been shown to be effective in preventing mosquito bites.

According to IDPH.gov, Before DEET and other repellents may be legally distributed, sold or used in this country, they must be evaluated and registered by the U.S. Environmental Protection Agency (USEPA). When used according to label directions, millions of people have used DEET repellents to provide protection against mosquitoes and ticks with minimal risk. Nevertheless, no repellent is 100 percent safe and all repellents must be used carefully. Use of DEET concentrations above 50 percent have been associated with increased skin irritation and similar reactions. In very rare circumstances, slurred speech, confusion and seizures have been associated with the use of DEET, particularly in children. However, some of these persons had a history of long-term, excessive or improper use of DEET repellents. The risk of experiencing any adverse health effects is reduced when products containing DEET are used according to label instructions and concentrated DEET products are avoided. A fact sheet by USEPA about insect repellents may be found at www.epa.gov/pesticides/citizens/insectrp.htm. Additionally, an article reviewing DEET and other repellents, "Mosquitoes and Mosquito Repellents: A Clinician's Guide," may be found at www.acponline.org/journals/annals/01jun98/mosquito.htm.

The American Academy of Pediatrics (AAP) and other experts suggest that it is acceptable to apply repellent with low concentrations of DEET to infants over 2 months old. Other guidelines cite that it is acceptable to use repellents containing DEET on children over 2 years of age. Repellent products that do not contain DEET are not likely to offer the same degree of protection from mosquito bites as products containing DEET. Non-DEET repellents have not necessarily been as thoroughly studied as DEET, and may not be safer for use on children. Parents should choose the type and concentration of repellent to be used by taking into account the amount of time that a child will be outdoors, exposure to mosquitoes, and the risk of mosquito-transmitted disease in the area. Persons who are concerned about using DEET or other products on children may wish to consult their health care provider for advice.

So, you want to stay safe and bug bite free when you're outside? Use insect repellents with DEET to ward off those pesky little critters that are literally looking for a blood bath, and always FOLLOW THE DIRECTIONS! Have a safe and bug free time. Fight back. Remember, it's your health. Put insects in their place--away from you!

Until next time. Let me know what you think.