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dc.contributor.authorBouwman, Hindrik
dc.contributor.authorVan den Berg, Henk
dc.contributor.authorKylin, Henrik
dc.date.accessioned2012-10-03T09:14:41Z
dc.date.available2012-10-03T09:14:41Z
dc.date.issued2011
dc.identifier.citationBouwman, H. et al. 2011. DDT and malaria prevention: addressing the paradox. Environmental health perspectives, 119(6):744-747. [http://ehp.niehs.nih.gov/journal-information/]en_US
dc.identifier.issn0091-6765
dc.identifier.issn1552-9924 (Online)
dc.identifier.urihttp://hdl.handle.net/10394/7430
dc.descriptionPublished by the National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Servicesen_US
dc.description.abstractBackground The debate regarding dichlorodiphenyltrichloroethane (DDT) in malaria prevention and human health is polarized and can be classified into three positions: anti-DDT, centrist-DDT, pro-DDT. Objective We attempted to arrive at a synthesis by matching a series of questions on the use of DDT for indoor residual spraying (IRS) with literature and insights, and to identify options and opportunities. Discussion Overall, community health is significantly improved through all available malaria control measures, which include IRS with DDT. Is DDT “good”? Yes, because it has saved many lives. Is DDT safe as used in IRS? Recent publications have increasingly raised concerns about the health implications of DDT. Therefore, an unqualified statement that DDT used in IRS is safe is untenable. Are inhabitants and applicators exposed? Yes, and to high levels. Should DDT be used? The fact that DDT is “good” because it saves lives, and “not safe” because it has health and environmental consequences, raises ethical issues. The evidence of adverse human health effects due to DDT is mounting. However, under certain circumstances, malaria control using DDT cannot yet be halted. Therefore, the continued use of DDT poses a paradox recognized by a centrist-DDT position. At the very least, it is now time to invoke precaution. Precautionary actions could include use and exposure reduction. Conclusions There are situations where DDT will provide the best achievable health benefit, but maintaining that DDT is safe ignores the cumulative indications of many studies. In such situations, addressing the paradox from a centrist-DDT position and invoking precaution will help design choices for healthier lives.en_US
dc.description.urihttp://dx.doi.org/10.1289/ehp.1002127
dc.description.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114806/pdf/ehp-119-744.pdf
dc.language.isoenen_US
dc.publisherSuperintendent of Documentsen_US
dc.rightsReproduced with permission from Environmental Health Perspectives.
dc.subjectEffectsen_US
dc.subjecthealthen_US
dc.subjectindoor residual sprayingen_US
dc.subjectmalaria vector managementen_US
dc.subjectprecautionen_US
dc.titleDDT and malaria prevention: addressing the paradoxen_US
dc.typeArticleen_US


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