Undisturbed dust as a metric of long-term indoor insecticide exposure : residential DDT contamination from indoor residual spraying and its association with serum levels in the VHEMBE cohort

Abstract

Although approximately 123 million people may be exposed to high levels of insecticides through the use of indoor residual spraying (IRS) for malaria control, fewstudies exist on indoor insecticide contamination due to IRS and its relationship with human exposure. In the present study, we developed a sampling method to collect undisturbed dust from50 homes in Limpopo, South Africa, a region where dichlorodiphenyltrichloroethane (DDT) has been used in IRS programs to preventmalaria for ~70 years.WequantifiedDDT and its degradation products, dichlorodiphenyldichloroethylene (DDE), and dichlorodiphenyldichloroethane (DDD) in dust samples to determine dust loading levels and compared these levels to paired serum concentrations of p,p′-DDT and p,p′-DDE in women residents. p,p′-DDT and p,p′-DDE had the highest detection frequencies in both dust (58% and 34% detection, respectively) and serumsamples (98% and 100% detection, respectively). Significantly higher detection frequencies for o,p′-DDT, p,p′-DDE, and p,p′-DDDwere observed in dust samples collected in buildings that had been previously sprayed for malaria control.We also observed a significant, positive association between dust loading and serumconcentrations of p,p′-DDT and p,p′-DDE (Spearman's rho=0.68 and 0.54, respectively). Despite the lowdetection frequency in dust, our results indicate that undisturbed dustmay be a goodmetric to quantify longterm home exposure to DDT-related compounds and that contamination of the home environment may be an important determinant/source of DDT and DDE exposure.