Pesticides and Healthy Public Policy

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summarized in Table I. As with most industrial chemicals, toxicity data for ..... literature review prepared by the Occupational Health Program,. McM aster ...
Pesticides and Healthy Public Policy Author(s): RONALD N. LABONTE Source: Canadian Journal of Public Health / Revue Canadienne de Santé Publique, Vol. 80, No. 4 (July / August 1989), pp. 238-242 Published by: Canadian Public Health Association Stable URL: http://www.jstor.org/stable/41989736 Accessed: 18-04-2016 13:31 UTC REFERENCES Linked references are available on JSTOR for this article: http://www.jstor.org/stable/41989736?seq=1&cid=pdf-reference#references_tab_contents You may need to log in to JSTOR to access the linked references. Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at http://about.jstor.org/terms

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Pesticides and Healthy Public Policy RONALD N. LABONTE, M A.1

Despite concern over long-term human and environmental health risks , Canadian and international pesticide use continues to increase . Enormous gaps in pesticide toxicity data persist and ' though equivocal, there is mounting evidence that certain pesticide families are carcinogenic .

Farmworkers are at greatest risk of pesticide poisoning and long-term health effects , and unions representing farmworkers have initiated a boycott of California grapes to draw attention to the need to reduce pesticide use and

improve health and safety conditions. The boycott is a model of "healthy public policy" in action , and can be one element in a public health strategy to reduce significantly

pesticide use and promote less toxic alternatives and less chemically dependent forms of agriculture and silviculture.

En dépit de préoccupations à propos des dangers de santé à long terme pour l'homme et l'environnement ,

l'utilisation de pesticides au Canada et à l'échelle

internationale continue à s'accroître. Des écarts énormes

persistent dans les données sur la toxicité des pesticides et, bien que cela demeure non-prouvé, il y ade plus en plus de

données tendant à montrer que certaines familles de pesticides sont cancérigènes. Les travailleurs de la ferme courent les plus grands risques d'empoisonnement aux pesticides et d'effets à long terme pour la santé ; aussi les syndicats représentant les travailleurs agricoles ont amorcé un boycott des raisins de Californie pour attirer l'attention

sur la nécessité impérative de réduire l'utilisation de pesticides et d'améliorer les conditions de santé et de

sécurité. Le boycott est un modèle de "politique publique saine" en action et peut-être un élément dans la stratégie de

santé publique en vue de réduire de façon significative l'utilisation de pesticides et de promouvoir des alternatives

moins toxiques et des formes d'agriculture et de

sylviculture qui dépendent moins de produits chimiques.

bromide - the human health effects of which are

The grapegrape U.S. boycott boycott -based Unitedin in 2020 years.years. Farm Endorsed Endorsed Workers has by by calledthe the Canadian Canadian its third Farmworkers Union and other labour and health groups,

summarized in Table I. As with most industrial chemicals,

the boycott is considered a first step in a North American-

toxicity data for pesticides are often inadequate,

wide reduction in the use of hazardous agricultural

particularly data on carcinogenic, mutagenic, teratogenic and immunotoxic effects.3'4 Half of all new pesticides

chemicals. It focusses upon grapes because they are the most

registered in the U.S. between 1978 and 1984, for example,

heavily sprayed crop in California.

still lacked adequate health data.

Human Health Risks

By 1986, 14 years after U.S. legislation requiring testing and reregistration of older pesticides was passed, only one of

Montreal.1 These grapes may be contaminated with the

600 active pesticide ingredients was in the final reregistration stage.4 Only 10 to 15 of Canada's active pesticide ingredients commence a re-evaluation process

residues of 130 different pesticides, almost 4 million

each year. In both countries, little attention has been paid to

kilograms of which are sprayed annually on California

so-called "inert" ingredients that make up the bulk of pesticide products. (Table II) Estimates of annual worldwide pesticide poisonings are inexact and vary from 500,000 with 6,000 fatalities (WHO, 1973) to 1,500,000 with 22,500 fatalities (OXFAM, 1984). A

About 20% of California grapes wind up in Canadian

supermarkets, primarily in Toronto, Vancouver and

grapes.2 The UFW boycott calls for a ban of five pesticides

- captan, dinoseb, parathion, mevinphos and methyl 1. Community Health Consultant, 90 Coady Avenue, Toronto, Ontario M4M 2Y8. President-Elect, OPHA Opinions expressed are those of the author.

recent U.S. study estimated that 300,000 farmworkers suffer

238 Canadian Journal of Public Health Vol. 80, July/ August 1989

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TABLE I

Health Effects of UFW "Target" Pesticides Ontario

Name

Acute Chronic Agricultural International Toxicity Toxicity Use, 19831 Regulations2

Captan (*) low experimental carcinogen,3 mutagen,4 100,000 kg. Banned, experimental teratogen3 Finland (1972)

Norway (1981)

Dinoseb

extreme

category (possible human)

C

800

kg.

Banned,

carcinogen5 Sweden ( 1 mutagen3 5 Norway ( 1 teratogen, Denmark immunotoxic5 Ecuador

may cause male sterility, birth defects in pregnant women5

97 1 ) 98 1 ) (1984) (1985)

Parathion (**) extreme category C 3,500 kg. Banned, USSR, East (possible human) carcinogen,6 Germany, Ecuador, fetotoxic, including sperm damage7 Japan, India, Sweden,

Philippines, Hungary, Turkey and Norway

Mevinphos extreme peripheral nerve damage;8 too little data 280 kg. Banned, India to evaluate chronic effects9

Methyl Bromide (***) high too little data to evaluate chronic effects10 Sources:

1. Ontario Task Force on Health and Safety in Agriculture. Agricultural Chemicals and Farm Health Safety, Volume III. December 1984. 2. United Nations, Consolidated List of Products Whose Consumption and/ or Sale have been Banned, Withdrawn, Severely Restricted or Not Approved by Governments , New York: UN Publications, 1987. (Second Edition) 3. Sax NI. Dangerous Properties of Industrial Materials, 6th Edition. New York: Van Nostrand Reinhold, 1984. 4. Izmerov, NF (ed.) Captan: Scientific Reviews of Soviet Literature on Toxicity and Hazards of Chemicals. Moscow: Centre of International Projects, GKNT, 1982. 5. United States Environmental Protection Agency. Pesticide Fact Sheet 130: Dinoseb. Washington: Office of Pesticide Programs, October, 1986. 6. United States Environmental Protection Agency. Pesticide Fact Sheet 116: Parathion. Washington: Office of Pesticide Programs, December, 1986. 7. Izmerov NF (ed.). Parathion: Scientific Reviews of Soviet Literature on Toxicity and Hazards of Chemicals. Moscow: Centre of International Projects, GKNT, 1982. 8. Moses M. Statement to the Maryland Legislature on behalf of the National Farm Workers Health Group, February 26, 1986. Toronto: United Farmworkers of America/

Canadian Labour Congress (mimeo)

9. United States Environmental Protection Agency. Pesticide Fact Sheet 156: Mevinphos. Washington: Office of Pesticide Programs, March, 1988. 10. United States Environmental Protection Agency. Pesticide Fact Sheet 98: Methyl Bromide. Washington: Office of Pesticide Programs, August, 1986. Notes:

♦Captan was the subject of Canadian controversy several years ago as a result of the Industrial Bio-Test laboratory testing scandal. The lab had falsified most of its data on

industrial chemicals, notably pesticides. Replacement studies have shown limited animal and inadequate human evidence for cancer; as of December, 1987, its

carcinogenesis had not been evaluated by either the Environmental Protection Agency or the International Agency for Research on Cancer. (Council on Scientific Affairs, "Cancer risk of pesticides in agricultural workers", JAMA 1988; 260: 959-66.) Despite environmental and farmworker lobbying, Canadian and U.S. regulators did not ban captan. The Canadian permitted residue level was lowered to 5 ppm for 12 food items (all others being restricted to 0.1 ppm), though these residue levels are frequently

exceeded.

♦♦Parathion is the leading cause of worldwide pesticide poisonings and is one of 12 pesticides targetted for an international ban by the Pesticide Action Network, a worldwide coalition of health and consumers' groups. ♦♦♦Methyl bromide is the leading cause of hospitalization for pesticide poisonings among California farmworkers.810

pesticide poisonings each year.5 There were 3,404 reported cases of pesticide poisoning in Canada in 1983, of which 1,458 required hospitalization.6 Most pesticide poisonings, particularly among farmworkers, go unreported. A 1982

studies implicated pesticide exposure as an etiological factor: 19 studies, for example, found an increased risk of all

safety training, had not been issued protective gear, reported health symptoms compatible with pesticide

blood cancers among farmers/ farmworkers, 6 of which illustrated a dose-response gradient.8 Two groups of pesticides - the phenoxy herbicides (e.g., 2,4-D; 2,4,5-T) and the chlorophenols (e.g. , PCP, TCP) show limited evidence of human carcinogenicity.9 The casual use of 2,4-D is particularly controversial given recent

poisonings and had been directly sprayed while working in

studies strongly linking it to increased cancer risks.10'11'12

survey of B.C. farmworkers found that most were ignorant of the pesticides they used, had not received any health and

the fields. None of these cases had been reported to

authorities.7

Pesticide Use and Efficacy

Epidemiological evidence supporting a causal relationship between pesticide exposure and increased cancer risks remains equivocal.6 The 1985 Ontario Task Force on Health and Safety in Agriculture, however, assessed pesticide/ cancer studies on standard epidemiological criteria and concluded, in part, that "there is mounting evidence. . . that modern farming practices may lead to a significantly greater risk of dying from certain kinds of cancer." Several of these

July/

Since 1975, worldwide pesticide use has increased 5% a year

and now exceeds 2 million tonnes annually.13 Canada uses over 30 million kilograms of pesticides annually, 8.7 million kilograms in Ontario alone. Pesticide use in Ontario increased 59% between 1973 and 1983, with a corresponding 56% rise in the quantity of pesticides used per hectare of cropland.6 There is little doubt that global pesticide use is excessive

with retrograde consequences. Between 1945 and 1980,

August

1989

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239

TABLE II

Environmental protection agency classification of "inert" ingredients Classification Immediate Concern Suspect Unknown Inocuous Number

in

category

55

51

800-900

273

Comments 28 potentially carcinogenic; Chemical structures similar Insufficient data to assess 26 approved for food use to other toxic chemicals; high research priority

Source: U.S. General Accounting Office. Pesticides: EPA's Formidable Task to Assess and Regulate Their Risks. Washington: USGAO, 1986.

global pesticide use increased 1,300%, yet the percentage of

crops lost to pests almost doubled due partly to the development of pesticide-resistant insects, weeds and fungi.14 Rather than examining the triangle of host, pathogen (or pest) and environment to determine where lies

the imbalance, current agricultural policy favours development of new pesticides while using genetic splicing to create crops immune to the toxic effects of herbicides, thereby allowing more massive applications.15 Significantly reducing pesticide use would not seriously disrupt food production. One U.S. study estimated that

More generally, new pesticide safety testing needs to be improved and re-evaluation of health and safety data on currently registered pesticides speeded up. This may require

adoption of a broad, health-biased carcinogens policy such as that advocated by the Ontario Public Health Association. This policy argues that positive findings in two or more well-designed bioassay or animal tests should be considered sufficient to designate a substance a human carcinogen until epidemiological studies are sufficiently strong to reach a

contrary conclusion. Regulation of designated human carcinogens should be based on substitution of safer

rapid pesticide withdrawal supplemented by more

alternatives or engineering controls reducing exposure to

ecological farming techniques would increase the dollar

the lowest detectable level, with personal protective gear the least desired option.21

value of food crop losses by 3.9% above existing levels; food

value loss would rise by only 1%.16 With over 300 million tonnes of worldwide surplus grain alone, international hunger rates would not be affected and may even improve owing to lower production costs.17

Several examples of impressive pesticide use reduction through use of minimally toxic Integrated Pest Management (IPM) strategies exist. Between 1964 and 1976, Texas cotton farmers reduced their pesticide use 8-fold while doubling their yield;18 Nicaragua reduced its pesticide consumption 40% between 1981 and 1985 without crop loss;19 and similar successes have been reported in Peru (cotton), Costa Rica (bananas), Philippines (rice), the South Pacific (coconuts) and Africa (cassava).20 Public Health Strategies Health professionals and agencies might consider four broad categories of action related to pesticide reform.

i. Advocating Better Health and Safety Regulations Farmworkers in Canada remain exempt from provincial health and safety legislation; few binding regulations govern

occupational exposure to pesticides. Few provinces extend hourly minimum wage or workers' compensation benefits protection to farmworkers which may lead to unhealthy living

conditions. Health agencies could join with the Canadian Farmworkers Union or other farmworker support groups in

ii. Assessing Urban and Domestic Use More than a third (35%) of pesticide use occurs in large cities.22 The increasing popularity of lawn care companies, and the subsequent rise in the use of herbicides, is of special

concern. U.S. data indicate that more kilograms of pesticides are applied per hectare of urban land than in agricultural or forestry use, and that between 2.5 and 5 kilograms of herbicides per acre are applied annually to domestic lawns.22 Fewer than one in five domestic users of

pesticides are aware of any associated health risks.23 A major approach to limiting urban and domestic pesticide use is enactment of "right-to-know" laws. A Montreal suburb requires lawn posting for 48 hours after pesticide spraying and the company must leave a fact sheet on the pesticides used, including first aid information. Vancouver has also passed a bylaw requiring posting of warning signs whenever pesticides are used on city-owned land, lawns surrounding apartment buildings, and in apartment and office buildings. At least two

other municipalities (Toronto and Windsor) are enacting more comprehensive right-to-know bylaws that will include pesticides.

Health departments can also impose restrictions on certain pesticide use. The Toronto health department has maintained a ban on 2,4-D use in public parks (excluding poison ivy control) since 1979.

lobbying provincial governments to extend full legislative

iii. Promoting Less Toxic Alternatives

rights and protections to farmworkers. A beginning step in this process might involve a small survey of the health status, needs and risks facing local farmworkers and farmers.

advocacy position on pesticides should include a description

240

Canadian

Journal

Safer alternatives to most pesticides exist. A health and evaluation of these less toxic options.

of

Public

Health

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Vol.

80

TABLE III

Sources of Pesticide Information 1. Government

Information Secretariat of the Pesticide Directorate

Agriculture Canada Ottawa, Ontario KIA 0C6

N ational Pesticide Call Line 1 -800-267-63 1 5

Publishes new product notes, discussion documents and reports

Office of Pesticides and Toxic Substances, Environmental Protection Agency, Washington DC 20460 Publishes pesticide fact sheets

National Toxicology Program Toxicology Research and Testing Program NIEHS, P.O. Box 12233, Research Triangle Park, NC 27709 Publishes annual reports, review documents and minutes of peer review meetings pertaining to research to fill the data gaps for existing toxic substances, including pesticides and pesticide inert ingredients

United Nations Environmental Program International Register of Potentially Toxic Chemicals

Recreation Board passed a tough "Pesticide Use Policy" in March, 1987, committing itself to IPM pest control. Cockroach infestations are another reason for pesticide

use in urban centres. The Toronto health department studied the efficacy of IPM techniques in controlling cockroach infestations, and found that a program combining diatomaceous earth, boric acid, caulking of floorboard and cupboard cracks, proper food storage and other "roach-proofing" techniques was as successful as pesticide control.25 It may even be more durable, since it relies upon structural barriers to re-infestation rather than

on re-application of chemicals.

iv. Endorsing and Promoting the Grape Boycott A starting point for healthy public policy on pesticides would be to endorse the current grape boycott. Toronto,

Palais des Nations

Hamilton and Ottawa city councils have endorsed the

1211 Geneva 10, Switzerland

boycott, as have at least 16 members of parliament and the

Publishes a biannual bulletin summarizing key international research findings and regulatory actions on toxic substances,

including pesticides

Bio-Integral Research Corporation P.O. Box 7414

Berkeley, California 94707 Publishes a quarterly magazine and monthly newsletter on lowtoxic IPM approaches to pest control 2. Pesticide Reform Networks

National Coalition Against Misuse of Pesticides

530 7th Street SE

Ontario Public Health Association.

The process of endorsing the boycott presents an opportunity for professional and community health education. The specific health risks of pesticides are only partially at issue with the grape boycott. More fundamental

is the question of how agricultural production, with its

heavy reliance on chemical inputs and its "industrial" (monocrop) organization, poses more serious health risks

Washington DC 20003

for future generations. The role of increased public

Northwest Coalition for Alternatives to Pesticides P.O. Box 1393

participation in future policy development is also at issue: repeated opinion polls show that most Canadians would pay higher prices for goods if it meant preserving the

Publishes a regular newsletter

Eugene, Oregon 97440 Publishes a bimonthly journal and several information packages Pesticides Action Network

environment.26

The grape boycott emphasizes social justice (decent wages

c/o Friends of the Earth 1045 Sansome Street

San Francisco, California 941 1 1 Publishes an irregular newsletter and several information packages

3. Grape Boycott

and working conditions for farmworkers), occupational health and safety regulation and enforcement, and longer-

term environmental sustainability through decreased

United Farm Workers

pesticide use and increased IPM strategies. It is a model of

c/ o Canadian Labour Congress

healthy public policy in action and warrants the attention of

305 - 15 Gervais Drive

Don Mills, Ontario M3C IY8 Publishes a regular newsletter on the boycott and farmworker pesticide issues, and distributes several information packages including a 15-minute film and videotape titled "The Wrath of Grapes."

Several studies have shown manual weed-release to be both cost-effective and efficacious.24 Citizen concern in

Eugene, Oregon, prompted that city to adopt a comprehensive IPM approach to weed control in all its public parks and school grounds. This strategy encourages people using the fields to pull up weeds. The fields are

health professionals and agencies across Canada. REFERENCES

1. United Farm Workers. "Boycott Hopes Soar in Canada", Food and

Justice 1986; 3(i): 3-6. 2. Moses M. Statement to the Maryland State Legislature on behalf of the National Farm Workers Health Group. February 26, 1986.

3. National Toxicology Program. Toxicity Testing: Strategies to Determine Needs and Priorities. National Academy Press, 1984.

4. U.S. Comptroller-General. Pesticides: EPA's Formidable Task to

Assess and Regulate Their Risks. Washington: General Accounting

Office, 1986.

5. Occupational Safety and Health Reports 1985; 15(7): 115-16.

6. Ontario Task Force on Health and Safety in Agriculture. Agriculture Chemicals and Farm Health Safety, Volume III. December, 1984.

7. Matsqui, Abbotsford Community Services. Agricultural Pesticides and Health Survey Results. Abbotsford, British Columbia. 1982.

aerated to discourage growth, diverse grass strains "outcompete" weeds, low-toxic insecticidal soap curbs

8. Chong J et al. Health of persons engaged in farm work: A background

insect infestations, hardy flowering plants control weed growth along fences and right-of-ways, and ammonium

in Agriculture. March, 1985. (mimeo) 9. International Agency for Research on Cancer, Volume 30, 1983.

sulfate, a low-toxic chemical, is used for spot applications of

problem areas. Similarly, the Vancouver Parks and July/

literature review prepared by the Occupational Health Program, McM aster University for the Ontario Task Force on Health and Safety

10. Hardell et al Malignant lymphoma and exposure to chemicals,

especially organic solvents, chlorophenols and phenoxy acids: A casecontrol study. Br J Cancer 1981; 43: 169-76.

August

1989

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241

11. Colton T. Herbicide exposure and cancer. JAMA 1986; 256: 1176-8. 12. Hoar SK et al. Agricultural Herbicide Use and Risk of Lymphoma and Soft-Tissue Sarcoma. JAMA 1986: 256: 1141-7.

13. Pesticide Action Network. The Dirty Dozen. San Francisco: Friends of the Earth, 1985.

14. Van den Bosch R. The Pesticide Conspiracy. New York: Doubleday, 1978.

15. Fisher A. Seeds of discontent. Report on Business Magazine , March 1987.

Nix

CREME RINSE PERMETHRIN 1%

THERAPEUTIC CLASSIFICATION: Topical pediculicide and

ovicide.

16. Pimental D et al. Benefits and costs of pesticide use in U.S. food production. Bioscience 1978; 28(12): 772-84.

ACTIONS: Permethrin is a synthetic pyrethroid, active against a broad range of pests including lice, ticks, fleas,

18. Atkisson P et al. Controlling cotton's insect pests: À new system.

mites, and other arthropods. It acts on the nerve cell membrane to disrupt the sodium channel current by which the polarization of the membrane is regulated. Delayed repolar-

19. Swezey S et al. Nicaragua's Revolution in Pesticide Policy,

this disturbance.

20. Hansen M. Alternatives to Pesticides in Developing Countries: Preliminary Report. Washington: Institute for Consumer Policy

capitis. The high cure rate of permethrin in patients with head

17. Tanner J. Feast and Famine. New Internationalist , September, 1985. Science 1982.

Environment 1986; 28(1): 6-9, 29-36. Research, 1986.

21. Labonte R, Davies K. Stop the Carcinogens. Policy Options 1986

(May): 33-7. 22. Christoffel T. Grassroots environmentalism. AJPH 1985; 75(5): 565-7.

23. Dreistadt S. Our cities: more people and more pesticides per acre. NCAP News 1984; 4(2): 2-4. 24. See, for example, NCAP News 1985; 4(4). (special issue on alternative forest management) and Journal of Pesticide Reform 1985; 5(3). (special issue on weed management). 25. Davies K. Does caulking control cockroaches? Pest Control Technology , August, 1985.

26. Environment Canada. Canada's Environment: An Overview. Ottawa:

Environment Canada, 1986.

ization and paralysis of the pests are the consequences of

In vitro data indicate that permethrin has excellent pediculi-

cidal and ovicidal activity against pediculus humanus var.

lice following a single application is attributable to a combination of its pediculicidal and ovicidal activities and its residual persistence on the hair which may also prevent reinfestation.

INDICATIONS: Nix is indicated for the single application

treatment of infestation with Pediculus humanus var capitis (the head louse) and its nits (eggs). Retreatment for recur-

rences is required in less than 1% of patients since the ovicidal activity may be supplemented by residual persis-

tence in the hair. If live lice are observed after at least seven

days following the initial application, a second application can be given.

CONTRAINDICATIONS: Nix is contraindicated in patients

with known hypersensitivity to any of its components, to any synthetic pyrethroid or Pyrethrin, or to chrysanthemums.

WARNING: If hypersensitivity to Nix occurs, discontinue use. PRECAUTIONS:

General: Head lice infestation is often accompanied by

Received: July 27, 1987 Accepted: March 3, 1988

pruritus, erythema, and edema. Treatment with Nix may

temporarily exacerbate these conditions.

Use in Pregnancy: Reproduction studies have been performed in mice, rats and rabbits and have revealed no evidence of impaired fertility or harm to the fetus due to permethrin. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Nursing Mothers: It is not known whether this drug is

excreted in human milk. Because many drugs are excreted in

human milk and because of the evidence for tumorigenic potential of permethrin in animal studies, consideration should be given to discontinuing nursing temporarily or

withholding the drug while the mother is nursing.

Use in children: Nix is safe and effective in children two years

of age and older. Safety and effectiveness in children less

than two years of age have not been established.

INTERNATIONAL SYMPOSIUM ON DRUG SAFETY

ADVERSE REACTIONS: The most frequent adverse reac-

tion to Nix is pruritus. This is usually a consequence of head

DATE: September 28th & 29th, 1 989 LOCATION: Ottawa Congress Centre Ottawa, Ontario, Canada

SPONSOR: Health & Welfare Canada Health Protection Branch

Internationally recognized scientific

authorities are scheduled to deliver

important papers on major aspects of drug safety including drug development,

toxicological assessments, therapeutic

challenges, pharmaceutical considerations

and regulatory perspectives.

lice infestation itself, but may be temporarily aggravated following treatment with Nix. 5.9% of patients in clinical studies experienced mild temporary itching; 3.4% experi-

enced mild transient burning/stinging, tingling, numbness, or

scalp discomfort; and 2.1% experienced mild transient erythema, edema, or rash of the scalp.

SYMPTOMS AND TREATMENT OF OVERDOSAGE: No

instance of accidental ingestion of Nix has been reported. If

ingested, gastric lavage and general supportive measures should be employed.

DOSAGE ADMINISTRATION: Adults and Children: Nix is intended for use after the hair

has been washed with shampoo, rinsed with water and towel

dried. Apply a sufficient volume of Nix to saturate the hair and

scalp. Nix should remain on the hair for 10 minutes before

being rinsed off with water. A single treatment is sufficient to eliminate head lice infestation. Combing of nits is not required for therapeutic efficacy, but may be done for cosmetic or other reasons.

SHAKE WELL BEFORE USING.

This comprehensive program has been designed to interest health care professionals in academia, government, industry and allied professions.

SUPPLIED: Nix (Permethrin) 1% (wt./wt.) Creme Rinse is supplied in plastic squeeze bottles that contain 59ml weigh-

FOR MORE INFORMATION CONTACT G.T. Herbert,

1. Davies J., Dedhia H., Morgarde C., et al: Lindane poisonings. Arch Dermatol 1983; 119:142-144. 2. Brandenburg K.,

Canadian Pharmaceutical Assn., 1785 Alta Vista Drive, Ottawa, Ont., Canada K1G3Y6.

Tel. (61 3) 523-7877 FAX (61 3) 523-0445 A poster program will be available for interested persons.

ing 56g.

Product monograph available on request.

Deinhard A.S., DiNapoli J., et al: 1% Permethrin Cream Rinse vs1% Lindane Shampoo in treating pediculosis capitis. AJDC 1986; 140: 894-896. 3. Tapi in D., Meinking T., Castillero P., et al: Permethrin 1% Creme Rinse for the treatment of pediculus

humanus var capitis infestation. Pediatr Dermatol 1986;

3.4:344-348. 4. Bowerman J.G., Gomez M.P., Austin R.D., et al: Comparative study of permethrin 1% creme rinse and

lindane shampoo for the treatment of head lice. Pediatric

Infect. Dis. J. 1987; 6 (3): 252-255. * Trade Mark

-Äe, I CONSUMERS PRODUCTS DIVISION

242 Canadian Journal of Public Health Vol. 80

rpjr BURROUGHS WELLCOME INC. 1 / A I KIRKLAND, QUÉ., CANADA

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