University of Zurich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Department of Public and Global Health, Institute for Epidemiology, Biostatistics and Prevention, Hirschengraben 84, 8001, Zurich, Switzerland.
Boarder Clearance Services, MPI Centre Auckland, Auckland Airport, New Zealand Ministry for Primary Industries, Auckland, New Zealand.
Travel Med Infect Dis. 2020 Jan-Feb;33:101570. doi: 10.1016/j.tmaid.2020.101570. Epub 2020 Jan 30.
Air travel contributes to the global spread of vectors and vector-borne infections. Although WHO provides guidance on methods for disinsection of aircraft, there is currently no harmonized or standardized decision-making process to decide when disinsection of an aircraft should be conducted. It is however compulsory for flights arriving in certain countries. Concerns have been expressed about the usefulness of disinsection for preventing the international spread of vectors and vector-borne diseases via air travel and possible toxicity for passengers and flight crew.
We performed a systematic literature review using the databases PubMed, Embase, Medline, Scopus and CINAHL to evaluate all research findings about the applicability and safety of chemical-based, aircraft disinsection. Official reports from the WHO were also screened. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and meta-analysis (PRISMA) statement. The literature search strategy included "disinsection, airplane/plane/aviation/aircraft" and several other search items including d-phenothrin, permethrin, insecticide. Papers in English, French and German were reviewed. Reports of adverse events attributed to the disinsection of aircraft were also searched. AMP and PS screened all papers of relevance and agreed on a final selection.
Our search resulted in 440 papers of possible relevance. After screening, we included a total of 25 papers in this systematic review. Ten papers reported possible human toxicity and 17 papers addressed the applicability of disinsection and 2 papers addressed both topics. Chemical disinsection at recommended insecticide concentrations was found to be highly effective against a broad range of arthropods. Three papers reported passenger or crew illness possibly associated with insecticide spraying in passenger cabins - one describing a single passenger, the other two papers describing occupational illness of 12 and 33 aircrew members respectively, possibly due to aircraft disinsection. Another paper evaluating exposure of flight attendants to permethrin found higher levels of urinary metabolites in those working in planes that had recently been sprayed but this could not be linked to adverse health outcomes.
Our analysis confirmed that disease vectors are carried on international flights and can pose a threat particularly to island populations and certain airport hub areas. Disinsection with permethrin or d-phenothrin was shown to be highly effective against vectors. Despite several hundred million passenger and crew exposures to chemical disinsection, very few proven cases of toxicity have been reported. There is limited evidence linking exposure to insecticide spraying with negative health impact.
航空旅行导致病媒和病媒传播感染在全球范围内传播。尽管世卫组织提供了有关飞机消毒方法的指南，但目前尚无协调或标准化的决策过程来决定何时应进行飞机消毒。但是，某些国家的航班入境时必须进行消毒。人们对飞机消毒防止病媒和病媒传播疾病通过航空旅行在国际上的传播的有效性以及对乘客和机组人员可能产生的毒性表示担忧。
我们使用 PubMed、Embase、Medline、Scopus 和 CINAHL 数据库进行了系统文献综述，以评估所有关于化学基础飞机消毒的适用性和安全性的研究结果。还筛选了世卫组织的官方报告。这项系统评价是根据系统评价和荟萃分析的首选报告项目 (PRISMA) 声明进行的。文献检索策略包括“消毒、飞机/飞机/航空/飞机”和其他一些搜索项，包括除虫菊酯、氯菊酯、杀虫剂。审查了英文、法文和德文的论文。还搜索了归因于飞机消毒的不良事件报告。AMP 和 PS 筛选了所有相关论文，并就最终选择达成一致。
我们的搜索结果产生了 440 篇可能相关的论文。经过筛选，我们在这项系统评价中总共纳入了 25 篇论文。有 10 篇论文报告了可能的人类毒性，有 17 篇论文涉及消毒的适用性，有 2 篇论文涉及这两个主题。以推荐的杀虫剂浓度进行化学消毒被发现对广泛的节肢动物非常有效。有 3 篇论文报告了乘客或机组人员因在客舱内喷洒杀虫剂而生病的情况-其中一篇描述了一名乘客，另外两篇论文分别描述了 12 名和 33 名机组人员的职业疾病，可能是由于飞机消毒引起的。另一篇评估空乘人员接触氯菊酯的论文发现，最近喷洒过杀虫剂的飞机上的空乘人员尿液代谢物水平较高，但这与不良健康结果无关。
我们的分析证实，疾病媒介在国际航班上携带，并对岛屿人口和某些机场枢纽地区构成威胁。用氯菊酯或除虫菊酯进行消毒被证明对病媒非常有效。尽管有数亿人次的乘客和机组人员接触化学消毒，但报告的毒性病例非常少。有有限的证据表明接触杀虫剂喷洒与负面健康影响有关。
