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In December 1990, the French-language
service of The Canadian Press, the Presse Canadienne, carried a report from
Quebec City that warned of the dangers of using lindane-based products to combat
infestations of head lice.
The story, picked up by Montreal's daily La Presse among others, has Dr. Guy
Sansfacon, a toxicologist and head of the Quebec Poison Control Centre, calling
for a ban on such products and warning of the serious health hazard that they
represent.
Lindane (or gamma benzene
hexachloride) is an organochloride from the same family as the already banned
DDT and chlordane. While considered a highly toxic substance with CNS toxicity
potential, for many years it has been a popular product for the treatment of
head lice infestation. Lindane can be absorbed through the skin when applied
topically and then transported in the blood stream to the brain. Trans-cutaneous
poisoning leading to convulsions or coma is a risk with lindane. In fact,
Quebec's Poison Control Centre documented 81 cases of lindane poisoning between
1988 and 1990, of which 14 cases were trans-cutaneous.
Further research has shown lindane
toxicity to be a Canada-wide phenomenon. For example, the Poison Control Centre
of the Children's Hospital of Eastern Ontario (Ottawa), has registered 51 cases
in the past three years, 16 of which involved trans-cutaneous poisonings. And
while record-keeping or report-entry processes differ from hospital to hospital,
similar statistics have emerged across the country.
At Toronto's Hospital for Sick
Children, treatment records for 1988 and 1989 have not yet been entered into the
computer database. However, 1986 statistics showed 76 lindane-based toxic
incidents of which 14 were trans-cutaneous; in 1987 exposures totaled 74 of
which 18 were trans-cutaneous. Figures for the first half of 1990 at the same
centre show 29 total cases of which 4 were trans-cutaneous.
The Poison Control Centre at St.
Paul's Hospital in Vancouver reported 20 and 31 lindane exposures in 1989 and
1990 respectively. Types of exposure were not differentiated.
This sampling of poison control
facilities has turned up more than 300 cases of poisoning involving
lindane-based products. All indications are that this may represent the tip of
the iceberg.
The Presse Canadienne report
continues: "Dr. Sansfacon says that even the presence of lindane in the home
represents a danger: a great many poisonings occurred because young children
swallowed amounts of this highly toxic compound which was left where they could
reach it."
The wire agency report quotes Dr.
Gilles Mannes of the community health clinic of Laval University recommending
the replacement of lindane-based shampoos with a product based on permethrin
which has fewer side effects.
Comparative studies (1 -5) prove
the therapeutic superiority of permethrin creme rinse over lindane shampoo. Not
only is permethrin safer than Lindane, but a variety of clinical studies show it
is also a more effective pediculicide.
- Davies J., Dedhia H., Morgarde
C., et al: Lindane Poisonings. Arch Dermatol 1983; 119; 142-144
- Brandenburg K., Deinard A.S..
DiNapoli J., et al: 1% Permethrin Creme Rinse vs 1% Lindane Shampoo in
treating Pediculosis Capitis. Am J Dis Child 1986; 140; 894-896.
- Tablin D., Meinking T.L.,
Castillero P.M., et al: Permethrin 1% Creme Rinse for the treatment of
pediculus humanus var capitis infestation. Pediatr Derm 1986; 3; 344-348.
- 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 Infest Dis J 1987; 6(3):
252-255.
- Canadian Paediatric Society News
Bulletin October 1987.
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