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The Hazards of Treating Head Lice


By Deborah Z. Altschuler
The Tab - May 2, 1989

My family had just sat down to the dinner table a few weeks ago when the doorbell rang. These days the early evening doorbell means that someone from Mass. Pirg, Fair Share or, in this case, Greenpeace, is waiting with clipboard in hand to describe his cause and ask for a donation. 

I’ve polished my response over the years. I write a small check and explain that the lion’s share of our charitable contributions goes to the agency I work for, the National Pediculosis Association. What I am angling for is an opportunity to describe my own cause, because I believe we are really working toward similar goals. 

The gentleman from Greenpeace was more attentive than most and actually seemed interested in the work of the NPA, namely, to educate families and health professionals about head lice infestation and the importance of safe, appropriate treatment. Eventually, he confessed that he had a special place in his heart for pesticide-related issues because his mother was Rachel Carson. 

My response to this revelation was one of sheer delight. I interpreted his appearance on my doorstep as an affirming omen, a message from the woman who began the pesticide awareness movement with the publication of the classic book, Silent Spring, in 1962. Her book, which I believe should be required reading in every high school in America, chronicles the range and effects of known toxic pesticides--some since banned—but some still utilized today throughout this country and the world.

What does all this have to do with head lice? For the past seven years, the NPA has been alerting physicians, nurses and parents that, while head lice remedies are marketed under the comfortable names of shampoos, creams and lotions, they are actually pesticides and must be used as safely – and infrequently – as possible. 

We are helping people understand that head lice is more widespread than all other communicable childhood diseases combined, and is one of the few conditions that requires the direct application of potentially toxic pesticides on our children--$35 million worth in 1987, 

We are pointing out that the anxiety that accompanies the discovery of bugs in your child’s hair often results in the mis-application or outright abuse of these products, which include environmental sprays and can contain pyrethrins/piperonyl butoxide, petroleum distillates or gamma benzene hexachloride (lindane, found in the widely-prescribed Kwell Shampoo).

Rachel Carson had plenty to say about lindane and about the evidence associating it with neurological disease, leukemia and other blood disorders. She cited a Mayo Clinic hematologist, the late Dr. Malcolm Hargraves, who suggested that the majority of patients with blood and lymphoid diseases share a history of exposure to hydrocarbon pesticides. 

He concluded that “a careful medical history will almost invariably establish such a relationship”. In the hydrocarbon category, Carson specifically emphasized DDT, chlordane, benzene and lindane. 

Some people contend that the amount of pesticide in a single lice treatment is minimal and therefore insignificant. But Carson reminds us that “human exposures to cancer-producing chemicals are uncontrolled and they are multiple. An individual may have many different exposures to the same chemical. 

Arsenic is an example. It exists in the environment of every individual in many different guises: as an air pollutant, a contaminant of water, a pesticide residue on food, in medicines, cosmetics, wood preservatives, or as a coloring agent in paints and inks. It is quite possible that no one of these exposures alone would be sufficient to precipitate a malignancy – yet any single supposedly “safe dose” may be enough to tip the scales that are already loaded with other “safe doses”.

Our message about children and head lice addresses the category of pediculicides – just one of the “supposedly safe doses” among the pesticide exposures we experience daily. Because of this concern, the NPA must work to build a stronger coalition with Greenpeace and other health/environmental organizations. 

Consider the March of Dimes and the Genesis Fund with their focus on birth defects. Pregnant woman with young children are a population very vulnerable to both lice infestation and the effects of lice treatment. 

Think of the American Lung Association and the Asthma and Allergy Foundation. Lice sprays are widely used and abused, despite their low benefit and high risk, particularly for people with respiratory ailments. 

Or the Epilepsy Foundation. How many unexplained onsets of seizures may actually be related to pesticide treatment? One such case is now being litigated in Boston. 

Or the Jimmy Fund and other cancer groups. Eventually, the medical histories on children with malignancies should explore inappropriate lice treatment as a possible contributing factor. Unfortunately, over-zealous treatment is an all-too-common occurrence. 

As a result of our doorway chat, Rachel Carson’s son, Roger, will be coming to our Annual Meeting on May 11. Our guest speaker will be Jay Feldman of the Washington, D.C. –based National Coalition Against the Misuse of Pesticides.

I invite everyone working on behalf of children’s health and environmental issues to join us at the Harvard Club, One Federal Street, Boston at 7 p.m.

We can take this opportunity to become a “united way” of our own – not one designed to raise money, but to better appreciate the inter-connectedness of our goals and the importance of thinking in terms of prevention. Minimizing pesticide exposure to our children is a logical starting point for all of us.



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