1. Lindane: A Toxicological Profile Source: US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry (2005): http://www.atsdr.cdc.gov/toxprofiles/tp43.pdf

2. Uses of Lindane  Agricultural Pesticide … –1940s – registered as an agricultural insecticide and fumigant –regulated by the Environmental Protection Agency  Pharmaceutical … –1951 – approved for medical use –Regulated by Food and Drug Administration

3. Lindane: “Restricted Use” Insecticide  This means… –It can only be applied by licensed and certified applicators –Amounts in drinking water restricted –Is a hazardous waste which must meet certain disposal requirements  OSHA (Occupational Safety and Health Administration) regulates allowable workplace levels

4. More about Lindane as an Agricultural Insecticide … –Has not been produced in US since 1976 –Has been imported for use on fruits, vegetables and forest crops –Residue has been found in 189 of the Environmental Protection Agency’s (EPA) National Priority List (NPL) sites (out of a total of 1,662) –Is a persistent organic pollutant

5. More about Lindane as a Medication …  Obtained by prescription  Available as lotion, cream or shampoo  Used to treat scabies (mites) and lice in humans

6. Sources of Exposure to Lindane  The public –Ingestion: contaminated food and water –Inhalation: contaminated air –Absorption: contaminated soil and medical uses (creams, lotions or shampoos)  Workers –May be involved in the formulation of products using this chemical

7. Potential Adverse Effects of Lindane Exposures  Gastrointestinal: –Nausea and vomiting following ingestion, and occasionally dermal exposures  Neurological effects: –hyperexcitability, headaches, seizures, convulsions –can lead to death  Skin rashes from topical exposures  Other possible effects include (data limited): –hepatic toxicity –immune problems –Cancer

8. Some other Facts about Lindane  In 2006, EPA called for voluntary cancellation of agricultural uses of Lindane  In 2002, State of California banned pharmaceutical use – other states considering a ban or restriction  As of 2006, is banned in 52 countries, restricted in 33, not registered in 10, registered in 17 (including the US)

9. Preventing Adverse Effects of Lindane Medical Products  Never use on infants or on anyone weighing less than 50 kg (110 lbs)  Do not use on persons with seizure disorders  Use alternative treatments first  Keep out of the reach of children

10. Examples of Alternative Treatments for Lice and Scabies Scabies: - permethrin cream 5% (Acticine, Elimite, Nix) - crotamiton cream (Eurax) Lice: - malathion lotion 0.5% (Ovide, prescription only) - pyrethrum 0.33% with piperonyl butoxide shampoo and cream rinse - pyrethrum 0.33% with piperonyl butoxide shampoo and cream rinse - permethrin cream rinse 1% (Nix and Rid)

11. For further information…  US Department of Health and Human Services (USDHHS), Agency for Toxic Substances and Disease Registry Report (ATSDR) (2005): http://www.atsdr.cdc.gov/toxprofiles/tp43.pdf http://www.atsdr.cdc.gov/toxprofiles/tp43.pdf  Call ATSDR at 1-800-42ATSDR (1-800-422-8737)  Email at atsdric@cdc.gov atsdric@cdc.gov  U.S. Food and Drug Administration (FDA). Lindane Assessment Memorandum (posted in 2003) http://www.fda.gov/cder/drug/infopage/lindane/li ndanememoassessment.pdf