Risk assessments for exposure of deployed military personnel to insecticides and personal protective measures used for disease-vector management

Infectious diseases are problematic for deployed military forces throughout the world, and, historically, more military service days have been lost to insect-vectored diseases than to combat. Because of the limitations in efficacy and availability of both vaccines and therapeutic drugs, vector management often is the best tool that military personnel have against most vector- borne pathogens. However, the use of insecticides may raise concerns about the safety of their effects on the health of the military personnel exposed to them. Therefore, our objective was to use risk assessment methodologies to evaluate health risks to deployed U.S. military personnel from vector management tactics. Our conservative tier-1, quantitative risk assessment focused on acute, subchronic, and chronic exposures and cancer risks to military personnel after insecticide application and use of personal protective measures in different scenarios. Exposures were estimated for every scenario, chemical, and pathway. Acute, subchronic, and chronic risks were assessed using a margin of exposure (MOE) approach. Our MOE was the ratio of a no-observed-adverse-effect level (NOAEL) to an estimated exposure. MOEs were greater than the levels of concern (LOCs) for all surface residual and indoor space spraying exposures, except acute dermal exposure to lambda-cyhalothrin. MOEs were greater than the LOCs for all chemicals in the truck-mounted ultra-low-volume (ULV) exposure scenario. The aggregate cancer risk for permethrin exceeded 1 x 10(-6), but more realistic exposure refinements would reduce the cancer risk below that value. Overall, results indicate that health risks from exposures to insecticides and personal protective measures used by military personnel are low.