Lindane: banned in 52 countries-still used on kids in US

Townsend Letter for Doctors and Patients,  Oct, 2006  by Rose Marie Williams

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Every September children across the country begin another school term. The traditional schoolbags of yesteryear have morphed into fancy back packs, and computers are rapidly replacing pens and dictionaries. One age-old tradition, however, has changed little over the decades, except to become an even testier problem, and that is head lice. Pediculus humanus capilis are often found on children between the ages of three and ten, and except for the common cold, affect more school age children than all other communicable diseases combined. As many as six million children are treated for head lice each year in the US alone. That constitutes a very large market for lice shampoos. (1)

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Infestation travels fast in group settings such as daycare, nursery school, and classrooms. Lice attach to the scalp and, like mosquitoes, dine on human blood. The bites are painless, but the saliva and feces usually cause an itching allergic reaction (which is often the first sign that unwanted guests have taken up residence) and can easily spread to other family members.

Head lice are not considered vectors of human disease, nor are they life-threatening. However, excessive scratching can lead to broken and inflamed skin, which sometimes enables pathogens to enter and cause infections like impetigo. (1)

Lindane Related to DDT

DDT, the infamous organochlorine pesticide brought to public attention by Rachel Carson's landmark book Silent Spring, was banned for most uses in the US. Lindane, the active ingredient in many prescription lice treatments, is a neurotoxic chemical in the same family as DDT. Both are persistent in the environment, bioaccumulate up the food chain, and travel on air and water currents to pollute the farthest reaches of the globe. Lindane blocks specific sodium channels causing overstimulation of the body. Lindane breaks down into several metabolites, one of which is the gamma isomer with insecticidal properties that is readily stored in body fat. (1)

Health Risks

A 2003 study by the US Centers for Disease Control and Prevention (CDC) determined that 62% of Americans have the insecticide in their bodies. Lindane is implicated in causing cancer, fetal toxicity, birth defects, reproductive problems, aplastic anemia (a blood disorder), kidney damage, endocrine disruption; lindane also is acutely toxic to aquatic life. A higher incidence of breast cancer has been found in areas where lindane is used extensively. (1,2)

Like many persistent toxic chemicals, lindane bioaccumulates up the food chain and is found in human blood serum, fat, and adipose tissue; in utero of pregnant women; and in breast milk. The US Environmental Protection Agency (EPA) acknowledges that lindane is transmitted via breast milk and that nursing children are exposed during critical periods of postnatal development. (2)

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Children are particularly susceptible to lindane's toxic effects. Everything we put on our skin can be absorbed, including shampoo chemicals. The terrible irony here is that lice cause itching, which promotes scratching that may cause breaks in the skin, which in turn could increase absorption of lindane and other toxic chemicals from lice shampoos. Lindane exposure can cause convulsions, blood disorders, and brain tumors in children. For more than ten years, Dr. Marion Moses, author of Designer Poisons, has been advocating for a ban on all uses of lindane. (2,3)

Warnings Update

Lindane was introduced in 1951 as a consumer product. In 1995, it was labeled as a second-line therapy while promoting effective alternative treatments, which are more protective of human health and the environment. (4) On March 28, 2003, the FDA issued a Public Health Advisory regarding the use of lindane lotions and shampoos for the treatment of lice and scabies. Consumers purchasing prescription lindane products must now receive the FDA's Lindane Medication Guide, with explicit instructions for product use and health risks: (4)

  WARNING: Infrequently, lindane has caused seizures (sometimes death)
  after prolonged or repeated use. Rare (sometimes fatal) nervous system
  reactions such as seizures may occur, even after correct one-time use
  of lindane. Lindane should not be used on premature infants or
  patients with poorly controlled seizures.... Lindane should be used
  with caution in infants, children, the elderly, patients with skin
  conditions, and patients with low body weight (less than 110 lbs or 50
  kilograms). (5)

All infants and most children weigh less than 110 lbs. What are they thinking?

Corporate Influence

Lindane was first targeted for elimination in 1977, a decade after DDT was banned for use on food crops in this country. There was growing concern about lindane's risk to fetal and reproductive health, connection to blood disorders, acute toxicity to wildlife, and persistence in the environment. (6) In 1983, the EPA announced its intent to cancel lindane's registration. Two years later, the decision was reversed when the EPA decided to call for more studies. For the next thirteen years, the banning decision lay dormant while the EPA collected studies from the Centre Internationale d'Etudes du Lindane (CIEL), an industry task force protecting the registration of lindane. (6) This appears to be the usual delaying tactic. When corporate influence interferes with our regulatory agencies' intent to protect the health and welfare of the American public, industry demands more studies.