A Human-Health Risk Assessment for West Nile Virus and Insecticides Used in Mosquito Management
Peterson, Robert K. D., Macedo, Paula A., Davis, Ryan S., Environmental Health Perspectives
West Nile virus (WNV) has been a major public health concern in North America since 1999, when the first outbreak in the Western Hemisphere occurred in New York City. As a result of this ongoing disease outbreak, management of mosquitoes that vector WNV throughout the United States and Canada has necessitated using insecticides in areas where they, traditionally have not been used or have been used less frequently. This has resulted in concerns by the public about the risks from insecticide use. The objective of this study was to use reasonable worst-case risk assessment methodologies to evaluate human-health risks for WNV and the insecticides most commonly used to control adult mosquitoes. We evaluated documented health effects from WNV infection and determined potential population risks based on reported frequencies. We determined potential acute (1-day) and subchronic (90-day) multiroute residential exposures from each insecticide for several human subgroups during a WNV disease outbreak scenario. We then compared potential insecticide exposures to toxicologic and regulatory effect levels. Risk quotients (RQs, the ratio of exposure to toxicologic effect) were < 1.0 for all subgroups. Acute RQs ranged from 0.0004 to 0.4726, and subchronic RQs ranged from 0.00014 to 0.2074. Results from our risk assessment and the current weight of scientific evidence indicate that human-health risks from residential exposure to mosquito insecticides are low and are not likely to exceed levels of concern. Further, our results indicate that, based on human-health criteria, the risks from WNV exceed the risks from exposure to mosquito insecticides. Key words: comparative risk assessment, mosquito control, urganophosphates, pesticide exposure, pyrethroids, risk analysis, vectorborne disease. Environ Health Perspeet 114:366-372 (2006). doi:10.1289/ehp.8667 available via http://dx.doi.org/[Online 28 October 2005]
West Nile virus (WNV) has become a major public health concern in North America since 1999, when the first outbreak in the Western Hemisphere occurred in New York City, causing 62 cases of human encephalitis and 7 deaths [Centers for Disease Control and Prevention (CDC) 1999]. The initial outbreak in New York City is thought to have affected 2.6% of the population (Hubalek 2001). In 2000, WNV spread to three states, with 21 human cases of WNV infection and 2 deaths. In 2001, 66 human cases and 9 deaths were reported in 10 states, before WNV spread westward, affecting all but 6 states in 2002 and causing the largest arboviral encephalitis epidemic in U.S. history (Huhn et al. 2003). A total of 4,156 human cases were documented, with 284 deaths reported (CDC 2003), and numbers continued to grow in 2003, when 46 states reported 9,862 human cases with 264 deaths (CDC 2004a). In 2004, 2,539 human cases and 100 deaths were reported in 41 states (Hayes et al. 2005). Since the first appearance of WNV in the United States in 1999, the CDC has reported 16,706 documented human cases and 666 deaths (CDC 2004b; Hayes et al. 2005); however, large numbers of human infections may not be detected because of significant underreporting of milder cases of West Nile fever (Hubalek 2001; Huhn et al. 2003). Given the infection rate observed for previous years, Peleman (2004) estimated that 1.5 million people were infected with the virus in 2003.
As a result of this ongoing disease outbreak, management of mosquitoes that vector WNV throughout the United States and Canada has necessitated using insecticides in areas where they traditionally have not been used or have been used less frequently. This practice has raised concerns by the public about risks from insecticide use. In a survey by Hinten (2000), 54% of 880 people surveyed were either equally afraid of WNV and pesticides or were more afraid of the insecticides. Since 1999, numerous concerns have been raised by the public regarding the safety of using insecticides to control mosquitoes (Cohen 2003; Fehr-Snyder 2004; Fitz 2003). …