SEO Dr. Thomas Morwinsky SanABw V 1.2, CDR (Res.) SEO Dr. Thomas Morwinsky SanABw V 1.2, CDR (Res.) Current research and usage of repellents in the German

SEO Dr. Thomas Morwinsky SanABw V 1.2, CDR (Res.)SEO Dr. Thomas Morwinsky SanABw V 1.2, CDR (Res.)

Current research and usage ofCurrent research and usage ofrepellents in the German Armed Forcesrepellents in the German Armed Forces

AFPMB

Jacksonville

February 10, 2010

Carl Spitzweg: The Hunter of Butterflies (1840)

“...it is easier for an officer to keep soldiers healthy than for the physician to cure them...”

(Admiral H. Nelson, 1804)



Outline

I. Introduction

II. Current BDU ImpregnationMethod & distribution, types of clothing, developments

III. Occupational safety and Permethrin

IV. Wishlist



I. Introduction

Beginning in 1992, the Bundeswehr began to be deployed outside Europe

Initially, impregnation was done by spraying and dipping methods

2002 a new impregnation method for BDU was introduced to eliminate issues with efficacy and safety of impregnation

Due to several factors, demand for impregnation of specialized clothing has increased since 2008

Occupational safety remains an imminent important point concerning development and use of repellents for soldiers



I. Introduction



IV. Wishlist



II. Current BDU impregnation

Developed in cooperation of the Bundeswehr and UTEXBEL

First introduced in 2002 for BDU’s in deployments

Applied by manufaturer and delivered ready-to-use

Designed for the service lifeof the uniform without needfor re-impregnation



SEM-Image: BDU fabric treated with UTEXBEL-method (Faulde, Uedelhoven 2006)

b)a)


a) before washingb) worn out during deployment (residual concentration of

Permethrin of 560 mg/m2) arrows point to resin bridges



Beside BDU, the need for impregnation of additional specialized uniforms has emerged:

- Overalls for aircrews and mechanics- BDU’s for troops within Germany

Borreliosis recently federally acknowledged as an occupational disease with the duty for regular examinations for lumbermen, forest rangers etc.

Due to the occupational exposition of soldiers to Borreliosis, personal protection has increased in importance

To estimate risk within Germany, two training grounds (Seedorf & Hannover) are being evaluated for

a) number of ticks (Ixodes ricinus) andb) rate of Borrelia spp.-infected ticks




II. Current BDU impregnation rate of infection for Ixodes

ricinus varies widely from ca. 2% up to 30+%

single reports of up to 70 ticks on a soldier from a training ground

22.8% Gupta SK et al.: Prevalence of ticks in relation to their role as vector of Borrelia burgdorferi under autochthone conditions. Appl Parasitol 1995 36: 97–106; Brandenburg

27% Schönberg A, Loser C: Vorkommen von Borrelien im Berliner Raum. In: Potsdamer Symposien. Weller-Verlag, 1994, S. 84–93; Berlin

6.9-30.5% Fingerle V et al.: Prevalence of Borrelia burgdorferi sensu lato in Ixodes ricinus in Southern Germany. J Spirochetal Tick-Borne Dis 1994; 1: 41–45; southern Germany

2-23% Report from Department of Epidemiology of Infectious Diseases at the RKI, Epidemiologisches Bulletin 21, 23. Mai 2001

Source: Google Earth



I. Introduction



IV. Wishlist



Increasing use of repellents on clothing has caused concerns about occupational safety

several studies since 2003 have evaluated the risks and safety of Permethrin-impregnated clothing, some of them by Bundeswehr personnel

The results showed that the Permethrin uptake was always well below the safety threshold for Permethrin




Faulde, Uedelvoven, Robbins: Contact Toxicity and Residual Activity of Different Permethrin-Based Fabric Impregnation Methods for Aedes aegypti (Diptera: Culicidae), Ixodes ricinus (Acari: Ixodidae), and Lepisma saccharina (Thysanura: Lepismatidae), J. Med. Entomol. 40(6): 935-941 (2003)

Bekanntmachungen des Umweltbundesamtes: Stellungnahme der Kommission „Human-Biomonitoring“ des Umweltbundesamtes: Innere Belastung der Allgemeinbevölkerung in Deutschland mit Pyrethroiden und Referenzwerte für Pyrethroid-Metabolite im Urin Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz 2005;48:1187-93

Faulde, MK, Uedelhoven, WM, Malerius, M, Robbins, RG: Factory-Based Permethrin Impregnation of Uniforms: Residual Activity against Aedes aegypti and Ixodes ricinus in Battle Dress Uniforms Worn under Field Conditions, and Cross-Contamination during the Laundering and Storage Process, Military Medicine 2006;171: 472-77

Appel, KE, Gundert-Remy, U, Fischer, H, Faulde, M, Mross, KG, Letzel, S, Rossbach, B: Risk assessment of Bundeswehr (German Federal Armed Forces) permethrin-impregnated battle dress uniforms (BDU) ,Int J Hyg Environ Health 2008;211:88-104

Rossbach, B., et al.: Uptake of permethrin from impregnated clothing. Toxicol. Lett. (2009), doi:10.1016/j.toxlet.2009.06.863





Results from a biomonitoring study GE/AFG

no significant differences within MeS during summer, lower (p<0.001) in winter

Source: Zimmer & Faulde, Biomonitoring in der Bundeswehr, Poster at DGKL meeting




significant differences of milPrevMedTech between MeS and Kabul (p<0.001)





significant differences within camp (summer/winter) and occupationally exposed individuals (mil PrevMedTech) and controls in summer





metabolite concentration about double that of earlier study from AFG

sum of Permethrin-metabolites represents about 40% of Permethrin ADI according to WHO




III. Occupational safety and Permethrin - Conclusions

Biomonitoring provides necessary data for evaluation of environmental- or occupational-caused health threat

A risk-benefit-analysis for the application of biocides in Bundeswehr camps has to be part of the biomonitoring

For the deployed soldiers, this includes the assessment of Permethrin by wearing of pre-impreganted BDU (by manufacturer) in deployments

Further analysis of the data obtained by measuring the metabolites of Permethrin enables us to differentiate between the various ways of uptake and sources of exposition and the causes for the increased metabolite levels



I. Introduction



IV. Wishlist



bednets as domes made for the camp bed

lasting impregnation of such bednets

impregnated BDU for every soldier in Germany

IV. Wishlist



Dpt. V 1.2CDR Dr. Erkens, MDSenior Executive Officer Dr.

Morwinsky, CDR (Res.)Phone +49 89 1249 7543

Dpt. V 1.4COL Dr. Holtherm, MDLTC Schmidt, MDMAJ Dr. Berger, MDMAJ Maaßen, MD

SanABw V 1.2

Dachauer Str. 12880637 München / MunichFax. +49 89 1249 7509

Documents

SEO Dr. Thomas Morwinsky SanABw V 1.2, CDR (Res.) SEO Dr. Thomas Morwinsky SanABw V 1.2, CDR (Res.) Current research and usage of repellents in the German