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Abstract
Risk assessments covering the use of the pyrethroid, deltamethrin, on bednets for
the prevention of malaria have been conducted The toxicity of deltamethrin in humans
and animals is reviewed following both dermal and oral exposure. The no-adverse-effect
level (NOEL) for exposure via the dermal route was 1000 mg/kg body weight/day. From
this an acceptable exposure level (AEL) of 10 mg/kg body weight/day has been derived.
The NOEL for exposure via the oral route was 1 mg/kg body weight/day, with exposures
above this causing neurotoxic effects in animals. This NOEL has been used to derive
margins of safety compared with predicted exposures. While direct skin contact does
not seem to cause systemic toxicity in humans, it can cause burning, numbness and
tingling of the skin, which is a local effect. This too is taken into account in the
risk assessments. The risk assessments cover those treating bednets, on an intermittent
or regular basis, the washing of treated nets, sleeping under treated nets (infants,
children and adults). Worst case scenarios for each of these situations show that
dermal exposures are low (one-tenth or less of the AEL) and the margins of safety
for systemic exposure derived from oral data are acceptable, ranging from 10 to 3300.
The benefits of the use of treated bednets in reducing morbidity and mortality from
malaria are considerable and it can be concluded that the risk:benefit ratio is very
favourable.