Laboratory of Entomology, Wageningen University, Wageningen, The Netherlands.
Environ Health Perspect. 2009 Nov;117(11):1656-63. doi: 10.1289/ehp.0900785. Epub 2009 May 29.
I review the status of dichlorodiphenyltrichloroethane (DDT), used for disease vector control, along with current evidence on its benefits and risks in relation to the available alternatives.
Contemporary data on DDT use were largely obtained from questionnaires and reports. I also conducted a Scopus search to retrieve published articles.
DDT has been recommended as part of the arsenal of insecticides available for indoor residual spraying until suitable alternatives are available. Approximately 14 countries use DDT for disease control, and several countries are preparing to reintroduce DDT. The effectiveness of DDT depends on local settings and merits close consideration in relation to the alternatives. Concerns about the continued use of DDT are fueled by recent reports of high levels of human exposure associated with indoor spraying amid accumulating evidence on chronic health effects. There are signs that more malaria vectors are becoming resistant to the toxic action of DDT, and that resistance is spreading to new countries. A comprehensive cost assessment of DDT versus its alternatives that takes side effects into account is missing. Effective chemical methods are available as immediate alternatives to DDT, but the choice of insecticide class is limited, and in certain areas the development of resistance is undermining the efficacy of insecticidal tools. New insecticides are not expected in the short term. Nonchemical methods are potentially important, but their effectiveness at program level needs urgent study.
To reduce reliance on DDT, support is needed for integrated and multipartner strategies of vector control and for the continued development of new technologies. Integrated vector management provides a framework for developing and implementing effective technologies and strategies as sustainable alternatives to reliance on DDT.
审查二氯二苯基三氯乙烷(DDT)用于病媒控制的现状,同时结合现有替代品的利弊证据进行分析。
DDT 使用的当代数据主要来自问卷调查和报告。我还进行了 Scopus 搜索,以检索已发表的文章。
DDT 一直被推荐作为室内滞留喷洒中可用杀虫剂的武器库的一部分,直到有合适的替代品出现为止。大约 14 个国家使用 DDT 进行疾病控制,并且有几个国家正在准备重新引入 DDT。DDT 的有效性取决于当地情况,需要与替代品密切考虑。由于最近有报道称,在室内喷洒过程中,人类接触 DDT 的水平很高,而且慢性健康影响的证据不断增加,因此人们对继续使用 DDT 感到担忧。有迹象表明,越来越多的疟疾媒介对 DDT 的毒性作用产生了抗药性,而且抗药性正在传播到新的国家。缺乏对 DDT 与其替代品进行全面的成本评估,该评估考虑了副作用。可以立即用有效的化学方法替代 DDT,但杀虫剂类别的选择有限,而且在某些地区,抗药性的发展正在削弱杀虫工具的效果。短期内预计不会有新的杀虫剂问世。非化学方法具有潜在的重要性,但需要紧急研究其在项目层面的效果。
为了减少对 DDT 的依赖,需要支持病媒控制的综合和多方合作伙伴战略,以及新技术的持续发展。综合病媒管理为开发和实施有效的技术和策略提供了一个框架,这些技术和策略是可持续替代对 DDT 的依赖的。