Exposure Assessment Policy Recommendation for Neurodevelopmental Testing in Communities Exposed to DDT Through Indoor Residual Spraying Open Access

Abstract

Dichlorodiphenyltrichloroethane (DDT) is an insecticide that has been used primarily for vector control. Years of known environmental destruction and identified adverse human health effects lead to a global ban of the use of DDT, with an exception being made for countries struggling to control vector borne diseases. With the introduction of malaria control initiatives, DDT use increased as it became the primary insecticide for indoor residual spraying (IRS). IRS and other forms of community spraying have now existed for decades. DDT has been found to persist in the environment for years, putting both current and future communities at risk of DDT exposure and its potential adverse effects. DDT exposure results in fertility loss, increased risk of diabetes, and increased risk of cancers. DDT exposure has also been determined to lead to neurological deficits including Parkinson’s disease, impaired cognitive functioning, and an increase in neuropsychological symptoms. In utero exposure to DDT leads to impaired neurodevelopment of children; studies show low general cognitive index scores and decreased verbal, quantitative, and memory skills for prenatal exposure. Limited studies have been conducted among populations who have long-term, high dose exposure to DDT through IRS. In order to achieve the Sustainable Development Goals (SDGs) and work towards health equity for all, an exposure assessment must be conducted in communities exposed to DDT through IRS in order to determine the true health status of individuals in these communities. The exposure assessment will allow us to address any potential neurological disorders as well as promote alternative and sustainable vector control solutions.

Table of Contents

CHAPTER 1: INTRODUCTION

Overview and Global Status of DDT

Problem Statement

Purpose

CHAPTER 2: LITERATURE REVIEW

Overview of Major Insecticides

Organophosphates

Pyrethroids

Neonicotinoids

Organochlorine Utilization and Persistence

Malaria and Vector Control

Neurological Effects of DDT Exposure

Prenatal Exposure

Occupational/Long-term Exposure

Parkinson’s Disease

Neurological Effects of Indoor Residual Spraying

CHAPTER 3: EXPOSURE ASSESSMENT

Methodology

Study Area

Study Population and Sampling Procedure

Exposure Measurement and Analysis

CHAPTER 4: CONCLUSION

Public Health Implications

Limitations

Future Directions

Conclusion

REFERENCES

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Environmental Health
Keyword	DDT Indoor Residual Spraying
Committee Chair / Thesis Advisor	Michael Caudle, Emory University
Committee Members	Deborah McFarland, Emory University

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