DDT IN INDOOR RESIDUAL SPRAYING: HUMAN HEALTH …

1 Environmental HEALTH Criteria 241 DDT IN INDOOR RESIDUAL SPRAYING: HUMAN HEALTH ASPECTS The International Programme on Chemical Safety (IPCS) was established in 1980. The overall objectives of the IPCS are to establish the scientific basis for assessment of the risk to HUMAN HEALTH and the environment from exposure to chemicals, through international peer review processes, as a prerequisite for the promotion of chemical safety, and to provide technical assistance in strengthening national capacities for the sound management of chemicals. This publication was developed in the IOMC context. The contents do not necessarily reflect the views or stated policies of individual IOMC Participating Organizations.

2 The Inter-Organization Programme for the Sound Management of Chemicals (IOMC) was established in 1995 following recommendations made by the 1992 UN Conference on Environment and Development to strengthen cooperation and increase international coordination in the field of chemical safety. The Participating Organizations are FAO, ILO, UNEP, UNIDO, UNITAR, WHO, World Bank and OECD. UNDP is an Observer. The purpose of the IOMC is to promote coordination of the policies and activities pursued by the Participating Organizations, jointly or separately, to achieve the sound management of chemicals in relation to HUMAN HEALTH and the environment.

3 WHO Library Cataloguing-in-Publication Data DDT in INDOOR RESIDUAL spraying: HUMAN HEALTH aspects. (Environmental HEALTH criteria ; 241) - adverse effects. residues - toxicity. pollution, INDOOR . assessment. HEALTH Organization. ISBN 978 92 4 157241 5 (NLM classification: WA 240) ISSN 0250-863X World HEALTH Organization 2011 All rights reserved. Publications of the World HEALTH Organization can be obtained from WHO Press, World HEALTH Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 3264; fax: +41 22 791 4857; e-mail: Requests for permission to reproduce or translate WHO publications whether for sale or for non-commercial distribution should be addressed to WHO Press at the above address (fax: +41 22 791 4806.))

4 E-mail: The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World HEALTH Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the World HEALTH Organization in prefer-ence to others of a similar nature that are not mentioned.

5 Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World HEALTH Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World HEALTH Organization be liable for damages arising from its use. This report contains the collective views of an international group of experts and does not necessarily represent the decisions or the stated policy of the World HEALTH Organization.

6 CONTENTS ACRONYMS AND ABBREVIATIONS vii INTRODUCTION 1 PART A REPORT OF WHO EXPERT CONSULTATION ON DDT RISK CHARACTERIZATION 3 1. INTRODUCTION 4 2. CONSENSUS STATEMENT 5 Data considerations 5 Evaluation of studies post-dating the hazard assessment 5 Testicular cancer 6 Diabetes 6 Risk characterization 7 Exposures for use in risk characterization 7 Uncertainty factors 8 Conclusions on HUMAN HEALTH risks 9 Acute poisoning 9 Carcinogenicity 9 Developmental effects 11 Reproductive effects.

7 Males 13 Reproductive effects: females 15 Overall conclusions of the risk characterization 16 PART B HAZARD AND EXPOSURE ASSESSMENTS 17 1. SUMMARY AND CONCLUSIONS 18 Introduction 18 Hazard identification 18 Hazard characterization 22 Exposure assessment 23 2. CHEMICAL IDENTITY 29 3. EXPOSURE SOURCES AND METRICS 31 Sources of exposure 31 Metrics of exposure 32 4. KINETICS AND METABOLISM 37 EHC 241: DDT in INDOOR RESIDUAL spraying: HUMAN HEALTH aspects iv 5. HEPATIC EFFECTS AND ENZYME INDUCTION 42 Laboratory animals and in vitro systems 42 Humans 44 6.

8 NEUROTOXICITY 47 Laboratory animals and in vitro systems 47 Humans 48 7. IMMUNOTOXICITY 50 Laboratory animals and in vitro systems 50 Humans 50 8. CARCINOGENICITY 52 Laboratory animals 52 Mice 52 Rats 61 Other laboratory animals 63 Conclusions for laboratory animals 64 Humans 64 Ecological and cohort studies 64 Case control and nested case control studies 71 Breast cancer 71 Testicular cancer 75 Liver cancer 77 Lymphocytic cancers 78 Lung

9 Cancer 81 Pancreatic cancer 81 Other cancers 83 Mode of action 84 9. GENOTOXICITY 88 Summary of past studies 88 Recent studies 88 Laboratory animals and in vitro systems 88 Humans 88 10. ENDOCRINOLOGICAL AND REPRODUCTIVE EFFECTS 91 Diabetes mellitus 91 Thyroid effects 93 In vitro 93 v Laboratory animals 93 Humans 94 Reproductive and developmental toxicity 97 In vitro 97 Laboratory animals 98 Multigeneration studies 98 Effects on fertility in males 100 Effects on fertility in females 102 Developmental toxicity 103 Reproductive endocrine effects 108 Humans 112 Male reproductive functions and

10 Hormone levels 112 Female reproductive functions 122 Developmental effects 129 11. HAZARD CHARACTERIZATION 151 Summary of hazard identification for use in hazard characterization 151 Dose response assessment 154 Methods used for dose response assessment 154 Non-cancer effects 158 Experimental animal studies 171 HUMAN studies 173 Carcinogenicity 176 Experimental animal studies 176 HUMAN studies 183 12.