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Head of the Quebec Poison Control Centre calls
for a ban on lindane-based head lice products

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.

  1. Davies J., Dedhia H., Morgarde C., et al: Lindane Poisonings. Arch Dermatol 1983; 119; 142-144
  2. 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.
  3. 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.
  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 Infest Dis J 1987; 6(3): 252-255.
  5. Canadian Paediatric Society News Bulletin October 1987.


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