DDT

For other uses, see DDT (disambiguation).

1 Properties and chemistry

DDT (dichlorodiphenyltrichloroethane) is a colorless,

crystalline, tasteless and almost odorless organochloride
known for its insecticidal properties and environmental
impacts. DDT has been formulated in multiple forms,
including solutions in xylene or petroleum distillates,
emulsiable concentrates, water-wettable powders, granules, aerosols, smoke candles and charges for vaporizers
and lotions.[7][8]

DDT is similar in structure to the insecticide

methoxychlor and the acaricide dicofol. It is highly
hydrophobic and nearly insoluble in water but has good
solubility in most organic solvents, fats and oils. DDT
does not occur naturally. It is produced by the reaction
of chloral (CCl
3CHO) with chlorobenzene (C
6H
5Cl) in the presence of a sulfuric acid catalyst. DDT
has been marketed under trade names including Anofex,
Cezarex, Chlorophenothane, Clofenotane, Dicophane,
Dinocide, Gesarol, Guesapon, Guesarol, Gyron, Ixodex,
Neocid, Neocidol and Zerdane.[9]

First synthesized in 1874, DDTs insecticidal action was

discovered by the Swiss chemist Paul Hermann Mller in
1939. It was used in the second half of World War II
to control malaria and typhus among civilians and troops.
After the war, DDT was also used as an agricultural insecticide and its production and use duly increased.[9] Mller
was awarded the Nobel Prize in Physiology or Medicine
for his discovery of the high eciency of DDT as a contact poison against several arthropods" in 1948.[10]

1.1 Isomers and related compounds

In 1962, Rachel Carson published the book Silent Spring.

It cataloged the environmental impacts of widespread
DDT spraying in the United States and questioned the
logic of releasing large amounts of potentially dangerous chemicals into the environment without understanding their eects on the environment or human health.
The book claimed that DDT and other pesticides had
been shown to cause cancer and that their agricultural use
was a threat to wildlife, particularly birds. Its publication
was a seminal event for the environmental movement and
resulted in a large public outcry that eventually led, in
1972, to a ban on DDTs agricultural use in the United
States.[11] A worldwide ban on agricultural use was formalized under the Stockholm Convention on Persistent
Organic Pollutants, but its limited and still-controversial
use in disease vector control continues,[12][13] because of
its eectiveness in reducing malarial infections, balanced
o,p' -DDT, a minor component in commercial DDT.
by environmental and other health concerns.
Along with the passage of the Endangered Species Act,
the United States ban on DDT is cited by scientists as
a major factor in the comeback of the bald eagle (the
national bird of the United States) and the peregrine
falcon from near-extinction in the contiguous United
States.[14][15]

Commercial DDT is a mixture of several closelyrelated

compounds. The major component (77%) is the p,p'
isomer (pictured above). The o,p' isomer (pictured
to the right) is also present in signicant amounts
(15%). Dichlorodiphenyldichloroethylene (DDE) and
dichlorodiphenyldichloroethane (DDD) make up the balance. DDE and DDD are the major metabolites and environmental breakdown products.[9] The term total DDT
is often used to refer to the sum of all DDT related compounds (p,p'-DDT, o,p'-DDT, DDE, and DDD) in a sample.
1

1.2

HISTORY

Production and use

From 1950 to 1980, DDT was extensively used in

agriculture more than 40,000 tonnes each year
worldwide[16] and it has been estimated that a total of 1.8 million tonnes have been produced globally
since the 1940s.[1] In the United States, it was manufactured by some 15 companies, including Monsanto,[17]
Ciba,[18] Montrose Chemical Company, Pennwalt[19] and
Velsicol Chemical Corporation.[20] Production peaked in
1963 at 82,000 tonnes per year.[9] More than 600,000
tonnes (1.35 billion pounds) were applied in the US before the 1972 ban. Usage peaked in 1959 at about 36,000
tonnes.[21]
In 2009, 3,314 tonnes were produced for malaria control and visceral leishmaniasis. India is the only country
still manufacturing DDT and is the largest consumer.[22]
China ceased production in 2007.[23]

1.3

Mechanism of insecticide action

In insects it opens sodium ion channels in neurons, causing them to re spontaneously, which leads to spasms and
eventual death. Insects with certain mutations in their
sodium channel gene are resistant to DDT and similar
insecticides. DDT resistance is also conferred by upregulation of genes expressing cytochrome P450 in some
insect species,[24] as greater quantities of some enzymes
of this group accelerate the toxins metabolism into inactive metabolites.

History

DDT was rst synthesized in 1874 by Othmar Zeidler

under the supervision of Adolf von Baeyer.[25][26] It was
further described in 1929 in a dissertation by W. Bausch
and in two subsequent publications in 1930.[27][28] The insecticide properties of multiple chlorinated aliphatic or
fat-aromatic alcohols with at least one trichloromethane
group were described in a patent in 1934 by Wolfgang
von Leuthold.[29] DDTs insecticidal properties were not,
however, discovered until 1939 by the Swiss scientist
Paul Hermann Mller, who was awarded the 1948 Nobel
Prize in Physiology and Medicine for his eorts.[10]

Commercial product concentrate containing 50% DDT, circa

1960s

DDTs chemical and insecticidal properties were important factors in these victories, advances in application
equipment coupled with competent organization and sufcient manpower were also crucial to the success of these
programs.[30]
In 1945, DDT was made available to farmers as an agricultural insecticide[9] and played a role in the nal elimination of malaria in Europe and North America.[12][31][32]

In 1955, the World Health Organization commenced a

program to eradicate malaria in countries with low to
moderate transmission rates worldwide, relying largely
on DDT for mosquito control and rapid diagnosis and
treatment to reduce transmission.[33] The program elimi2.1 Use in the 1940s and 1950s
nated the disease in "Taiwan, much of the Caribbean, the
of
DDT is the best-known of several chlorine-containing Balkans, parts of northern Africa, the northern region
[34]
and
Australia,
and
a
large
swath
of
the
South
Pacic
pesticides used in the 1940s and 1950s. With pyrethrum
[35]
in short supply, DDT was used extensively during World dramatically reduced mortality in Sri Lanka and India.
War II by the Allies to control the insect vectors of typhus However, failure to sustain the program, increasing
nearly eliminating the disease in many parts of Europe. mosquito tolerance to DDT, and increasing parasite tolIn the South Pacic, it was sprayed aerially for malaria erance led to a resurgence. In many areas early sucand dengue fever control with spectacular eects. While cesses partially or completely reversed, and in some cases

2.2

United States ban

tor of The New Yorker, urged her to write a piece on

the subject, which developed into her 1962 book Silent
Spring. The book argued that pesticides, including DDT,
were poisoning both wildlife and the environment and
were endangering human health.[11] Silent Spring was a
best seller, and public reaction to it launched the modern environmental movement in the United States. The
year after it appeared, President John F. Kennedy ordered his Science Advisory Committee to investigate
Carsons claims. The committees report add[ed] up
to a fairly thorough-going vindication of Rachel Carsons Silent Spring thesis, in the words of the journal Science,[39] and recommended a phaseout of persistent toxic pesticides.[40] DDT became a prime target of
Commercial product (Powder box, 50 g) containing 10% DDT;
the growing anti-chemical and anti-pesticide movements,
Nocide. Ciba Geigy DDT; Destroys parasites such as eas,
and in 1967 a group of scientists and lawyers founded
lice, ants, bedbugs, cockroaches, ies, etc.. Nocide Sprinkle
caches of vermin and the places where there are insects and their the Environmental Defense Fund (EDF) with the speplaces of passage. Leave the powder in place as long as possi- cic goal of enacting a ban on DDT. Victor Yannacone,
ble. Destroy the parasites of man and his dwelling. Death is Charles Wurster, Art Cooley and others in the group had
not instantaneous, it follows inevitably sooner or later. French all witnessed bird kills or declines in bird populations and
manufacturing"; harmless to humans and warm-blooded ani- suspected that DDT was the cause. In their campaign
mals sure and lasting eect. Odorless.
against the chemical, EDF petitioned the government for
a ban and led lawsuits.[41] Around this time, toxicologist
David Peakall was measuring DDE levels in the eggs of
rates of transmission increased.[36] The program suc- peregrine falcons and California condors and nding that
ceeded in eliminating malaria only in areas with high increased levels corresponded with thinner shells.
socio-economic status, well-organized healthcare systems, and relatively less intensive or seasonal malaria In response to an EDF suit, the U.S. District Court
of Appeals in 1971 ordered the EPA to begin the
transmission.[37]
de-registration procedure for DDT. After an initial
DDT was less eective in tropical regions due to the con- six-month review process, William Ruckelshaus, the
tinuous life cycle of mosquitoes and poor infrastructure. Agencys rst Administrator rejected an immediate susIt was not applied at all in sub-Saharan Africa due to pension of DDTs registration, citing studies from the
these perceived diculties. Mortality rates in that area EPAs internal sta stating that DDT was not an imnever declined to the same dramatic extent, and now con- minent danger.[21] However, these ndings were critistitute the bulk of malarial deaths worldwide, especially cized, as they were performed mostly by economic enfollowing the diseases resurgence as a result of resistance tomologists inherited from the United States Department
to drug treatments and the spread of the deadly malarial of Agriculture, who many environmentalists felt were
variant caused by Plasmodium falciparum.
biased towards agribusiness and understated concerns
Eradication was abandoned in 1969 and attention instead about human health and wildlife. The decision thus crefocused on controlling and treating the disease. Spraying ated controversy.[30]
programs (especially using DDT) were curtailed due to The EPA held seven months of hearings in 19711972,
concerns over safety and environmental eects, as well with scientists giving evidence for and against DDT. In
as problems in administrative, managerial and nancial the summer of 1972, Ruckelshaus announced the canimplementation.[36] Eorts shifted from spraying to the cellation of most uses of DDT exempting public health
use of bednets impregnated with insecticides and other uses under some conditions.[21] Immediately after the aninterventions.[37][38]
nouncement, both EDF and the DDT manufacturers led
suit against EPA. Industry sought to overturn the ban,
while EDF wanted a comprehensive ban. The cases were
2.2 United States ban
consolidated, and in 1973 the United States Court of Appeals for the District of Columbia Circuit ruled that the
As early as the 1940s, US scientists began expressing con- EPA had acted properly in banning DDT.[21]
cern over possible hazards associated with DDT, and in
the 1950s the government began tightening regulations Some uses of DDT continued under the public health exgoverning its use.[21] These events received little atten- emption. For example, in June 1979, the California Deto use DDT to
tion. In 1957 the New York Times reported an unsuccess- partment of Health Services was permitted
[42]
ea
vectors
of
bubonic
plague.
DDT continsuppress
ful struggle to restrict DDT use in Nassau County, New
ued
to
be
produced
in
the
United
States
for
foreign marYork, that the issue came to the attention of the popular
[1]
kets
until
1985,
when
over
300
tons
were
exported.
naturalist-author, Rachel Carson. William Shawn, edi-

2.3

Restrictions on usage

In the 1970s and 1980s, agricultural use was banned

in most developed countries, beginning with Hungary
in 1968[43] followed by Norway and Sweden in 1970,
Germany and the US in 1972, but not in the United Kingdom until 1984. By 1991 total bans, including for disease
control, were in place in at least 26 countries; for example
Cuba in 1970, Singapore in 1984, Chile in 1985 and the
Republic of Korea in 1986.[44]
The Stockholm Convention on Persistent Organic Pollutants, which took eect in 2004, outlawed several
persistent organic pollutants, and restricted DDT use to
vector control. The Convention was ratied by more
than 170 countries. Recognizing that total elimination
in many malaria-prone countries is currently unfeasible
absent aordable/eective alternatives. The convention
exempts public health use within World Health Organization (WHO) guidelines from the ban.[45] Resolution
60.18 of the World Health Assembly commits WHO to
the Stockholm Conventions aim of reducing and ultimately eliminating DDT.[46] Malaria Foundation International states, The outcome of the treaty is arguably better
than the status quo going into the negotiations. For the
rst time, there is now an insecticide which is restricted
to vector control only, meaning that the selection of resistant mosquitoes will be slower than before.[47]

ENVIRONMENTAL IMPACT

sorbed to soils and sediments, which can act both as

sinks and as long-term sources of exposure aecting
organisms.[7] Depending on conditions, its soil half life
can range from 22 days to 30 years. Routes of loss
and degradation include runo, volatilization, photolysis
and aerobic and anaerobic biodegradation. Due to
hydrophobic properties, in aquatic ecosystems DDT and
its metabolites are absorbed by aquatic organisms and
adsorbed on suspended particles, leaving little DDT dissolved in the water. Its breakdown products and metabolites, DDE and DDD, are also persistent and have similar
chemical and physical properties.[1] DDT and its breakdown products are transported from warmer areas to the
Arctic by the phenomenon of global distillation, where
they then accumulate in the regions food web.[51]

Because of its lipophilic properties, DDT can

bioaccumulate, especially in predatory birds.[52] DDT,
DDE and DDD magnify through the food chain, with
apex predators such as raptor birds concentrating more
chemicals than other animals in the same environment.
They are stored mainly in body fat. DDT and DDE are
resistant to metabolism; in humans, their half-lives are
6 and up to 10 years, respectively. In the United States,
these chemicals were detected in almost all human blood
samples tested by the Centers for Disease Control in
2005, though their levels have sharply declined since
most uses were banned.[53] Estimated dietary intake has
declined,[53] although FDA food tests commonly detect
Despite the worldwide ban, agricultural use continued
it.[54]
in India,[48] North Korea, and possibly elsewhere as of
Marine macroalgae (seaweed) help reduce soil toxicity by
2008.[22]
up to 80% within six weeks.[55]
Today, about 3,000 to 4,000 tons of DDT are produced
each year for disease vector control.[23] DDT is applied
to the inside walls of homes to kill or repel mosquitoes.
This intervention, called indoor residual spraying (IRS), 3.1 Eects on wildlife and eggshell thinning
greatly reduces environmental damage. It also reduces
the incidence of DDT resistance.[49] For comparison,
treating 40 hectares (99 acres) of cotton during a typical DDT is toxic to a wide range of living organisms, includU.S. growing season requires the same amount of chem- ing marine animals such as craysh, daphnids, sea shrimp
and many species of sh. DDE caused eggshell thinning
ical as roughly 1,700 homes.[50]
and population declines in multiple North American and
European bird of prey species.[56] Eggshell thinning lowers the reproductive success rate of certain bird species by
3 Environmental impact
causing egg breakage and embryo deaths. DDE-related
eggshell thinning is considered a major reason for the decline of the bald eagle,[14] brown pelican,[57] peregrine
falcon and osprey.[1] However, birds vary in their sensitivity to these chemicals.[7] Birds of prey, waterfowl and
song birds are more susceptible than chickens and related
species. DDE appears to be more potent than DDT.[1]
Even in 2010, California condors that feed on sea lions at
Big Sur that in turn feed in the Palos Verdes Shelf area
of the Montrose Chemical Superfund site exhibited continued thin-shell problems. Scientists with the Ventana
Wildlife Society and others study and remediate the conDegradation of DDT to form DDE (by elimination of HCl, left)
dors problems.[58]
and DDD (by reductive dechlorination, right)

The biological thinning mechanism is not entirely unDDT is a persistent organic pollutant that is readily ad- derstood, but strong evidence indictates that p,p'-DDE

4.2

Chronic toxicity

inhibits calcium ATPase in the membrane of the shell

gland and reduces the transport of calcium carbonate
from blood into the eggshell gland. This results in
a dose-dependent thickness reduction.[1][59][60][61] Other
evidence indicates that o,p'-DDT disrupts female reproductive tract development, later impairing eggshell
quality.[62] Multiple mechanisms may be at work, or different mechanisms may operate in dierent species.[1]
Some studies show that although DDE levels have fallen
dramatically, eggshell thickness remains 1012 percent
thinner than before DDT was rst used.[63]

Human health

4.2 Chronic toxicity

DDT and DDE, like other organochlorines, have been
shown to have xenoestrogenic activity, meaning they are
chemically similar enough to estrogens to trigger hormonal responses in animals. This endocrine disrupting
activity has been observed in mice and rat toxicological
studies. Epidemiological evidence indicates that these effects may be occurring in humans as a result of DDT
exposure. EPA states that DDT exposure damages the
reproductive system and reduces reproductive success.
These eects may cause developmental and reproductive
toxicity:
A review article in The Lancet states, research has
shown that exposure to DDT at amounts that would
be needed in malaria control might cause preterm
birth and early weaning ... toxicological evidence
shows endocrine-disrupting properties; human data
also indicate possible disruption in semen quality,
menstruation, gestational length, and duration of
lactation.[38]
Other studies document decreases in semen quality among men with high exposures (generally from
IRS).[74]
Studies generally nd that high blood DDT or DDE
levels do not increase time to pregnancy (TTP.)
Some evidence indicates that the daughters of highly
exposed women may have more increased TTP.

A U.S. soldier is demonstrating DDT hand-spraying equipment.

DDT was used to control the spread of typhus-carrying lice.

DDT is an endocrine disruptor.[64][65] It is considered

likely to be a human carcinogen although the majority of
studies suggest it is not directly genotoxic.[66][67][68] DDE
acts as a weak androgen receptor antagonist, but not as an
estrogen.[69] p,p'-DDT, DDTs main component, has little or no androgenic or estrogenic activity.[70] The minor
component o,p'-DDT has weak estrogenic activity.

4.1

DDT is associated with early pregnancy loss, a type

of miscarriage.[75] A prospective cohort study of
Chinese textile workers found a positive, monotonic, exposure-response association between preconception serum total DDT and the risk of subsequent early pregnancy losses. The median serum
DDE level of study group was lower than that typically observed in women living in homes sprayed
with DDT.
A Japanese study of congenital hypothyroidism concluded that in utero DDT exposure may aect
thyroid hormone levels and play an important role
in the incidence and/or causation of cretinism.
Other studies found that DDT or DDE interfere
with proper thyroid function in pregnancy and
childhood.[76][77]
Exposure to DDT can cause shorter menstrual cycles.[75]

Acute toxicity
4.3 Carcinogenicity

DDT is classied as moderately toxic by the US

National Toxicology Program (NTP)[71] and moderately
hazardous by WHO, based on the rat oral LD50 of 113
mg/kg.[72] DDT has on rare occasions been administered
orally as a treatment for barbiturate poisoning.[73]

In 2002, the Centers for Disease Control and Prevention reported, Overall, in spite of some positive associations for some cancers within certain subgroups
of people, there is no clear evidence that exposure to

5 MALARIA

DDT/DDE causes cancer in humans.[1] The NTP classies it as reasonably anticipated to be a carcinogen,
the International Agency for Research on Cancer classies it as probably carcinogenic to humans,[78] and the
EPA classies DDT, DDE and DDD as class B2 probable carcinogens. These evaluations are based mainly on
animal studies.[1][38]
A 2005 Lancet review stated that occupational DDT exposure was associated with increased pancreatic cancer
risk in 2 case control studies, but another study showed
no DDE dose-eect association. Results regarding a
possible association with liver cancer and biliary tract
cancer are conicting: workers who did not have direct occupational DDT contact showed increased risk.
White men had an increased risk, but not white women
or black men. Results about an association with multiple myeloma, prostate and testicular cancer, endometrial
cancer and colorectal cancer have been inconclusive or
generally do not support an association.[38]
A 2009 review, whose co-authors included persons engaged in DDT-related litigation, reached broadly similar
conclusions, with an equivocal association with testicular
cancer. Casecontrol studies did not support an association with leukemia or lymphoma.[53]

4.3.1

Breast cancer

The question of whether DDT or DDE are risk factors in

breast cancer has not been conclusively answered. Several
meta analyses of observational studies have concluded
that there is no overall relationship between DDT exposure and breast cancer risk.[79][80] The United States Institute of Medicine reviewed data on the association of
breast cancer with DDT exposure in 2012 and concluded
that a causative relationship could neither be proven nor
disproven.[81]
A 2007 case control study using archived blood samples
found that breast cancer risk was increased 5-fold among
women who were born prior to 1931 and who had high
serum DDT levels in 1963. Reasoning that DDT use became widespread in 1945 and peaked around 1950, they
concluded that the ages of 14-20 were a critical period in
which DDT exposure leads to increased risk. This study,
which suggests a connection between DDT exposure and
breast cancer that would not be picked up by most studies, has received variable commentary in third party reviews. One review suggested that previous studies that
measured exposure in older women may have missed the
critical period.[53][82] A second review suggested a cautious approach to the interpretation of these results given
methodological weaknesses in the study design.[83] The
National Toxicology Program notes that while the majority of studies have not found a relationship between
DDT exposure and breast cancer that positive associations have been seen in a few studies among women with
higher levels of exposure and among certain subgroups of

women[84]
A 2015 case control study identied a link (odds ratio 3.4)
between in-utero exposure (as estimated from archived
maternal blood samples) and breast cancer diagnosis in
daughters. The ndings support classication of DDT
as an endocrine disruptor, a predictor of breast cancer,
and a marker of high risk.[85]

5 Malaria
Malaria remains the primary public health challenge in
many countries. 2008 WHO estimates were 243 million
cases and 863,000 deaths. About 89% of these deaths occur in Africa, mostly to children under age 5.[86] DDT is
one of many tools to ght the disease. Its use in this context has been called everything from a miracle weapon
[that is] like Kryptonite to the mosquitoes,[87] to toxic
colonialism.[88]
Before DDT, eliminating mosquito breeding grounds by
drainage or poisoning with Paris green or pyrethrum was
sometimes successful. In parts of the world with rising living standards, the elimination of malaria was often a collateral benet of the introduction of window
screens and improved sanitation.[34] A variety of usually simultaneous interventions represents best practice.
These include antimalarial drugs to prevent or treat infection; improvements in public health infrastructure to diagnose, sequester and treat infected individuals; bednets
and other methods intended to keep mosquitoes from
biting humans; and vector control strategies[86] such as
larvaciding with insecticides, ecological controls such as
draining mosquito breeding grounds or introducing sh to
eat larvae and indoor residual spraying (IRS) with insecticides, possibly including DDT. IRS involves the treatment of interior walls and ceilings with insecticides. It
is particularly eective against mosquitoes, since many
species rest on an indoor wall before or after feeding.
DDT is one of 12 WHOapproved IRS insecticides.
WHOs anti-malaria campaign of the 1950s and 1960s
relied heavily on DDT and the results were promising, though temporary in developing countries. Experts tie malarial resurgence to multiple factors, including poor leadership, management and funding of malaria
control programs; poverty; civil unrest; and increased
irrigation. The evolution of resistance to rst-generation
drugs (e.g. chloroquine) and to insecticides exacerbated
the situation.[22][89] Resistance was largely fueled by unrestricted agricultural use. Resistance and the harm both
to humans and the environment led many governments to
curtail DDT use in vector control and agriculture.[36] In
2006 WHO reversed a longstanding policy against DDT
by recommending that it be used as an indoor pesticide
in regions where malaria is a major problem.[90]
Once the mainstay of anti-malaria campaigns, as of 2008
only 12 countries used DDT, including India and some

5.3

Residents concerns

southern African states,[86] though the number was ex- Lanka, Pakistan, Turkey and Central America and it has
pected to rise.[22]
largely been replaced by organophosphate or carbamate
insecticides, e.g. malathion or bendiocarb.[100]
In many parts of India, DDT is ineective.[101] Agricultural uses were banned in 1989 and its anti-malarial use
has been declining. Urban use ended.[102] DDT is still
When it was introduced in World War II, DDT was ef- manufactured and used.[103] One study concluded that
fective in reducing malaria morbidity and mortality.[30] DDT is still a viable insecticide in indoor residual sprayWHOs anti-malaria campaign, which consisted mostly ing owing to its eectivity in well supervised spray operof spraying DDT and rapid treatment and diagnosis to ation and high excito-repellency factor.[104]
break the transmission cycle, was initially successful as
well. For example, in Sri Lanka, the program reduced Studies of malaria-vector mosquitoes in KwaZulu-Natal
cases from about one million per year before spraying to Province, South Africa found susceptibility to 4% DDT
just 18 in 1963[91][92] and 29 in 1964. Thereafter the pro- (WHOs susceptibility standard), in 63% of the samples,
gram was halted to save money and malaria rebounded to compared to the average of 86.5% in the same species
600,000 cases in 1968 and the rst quarter of 1969. The caught in the open. The authors concluded that Finding
country resumed DDT vector control but the mosquitoes DDT resistance in the vector An. arabiensis, close to the
had evolved resistance in the interim, presumably because area where we previously reported pyrethroid-resistance
of continued agricultural use. The program switched to in the vector An. funestus Giles, indicates an urgent need
malathion, but despite initial successes, malaria contin- to develop a strategy of insecticide resistance management for the malaria control programmes of southern
ued its resurgence into the 1980s.[35][93]
Africa.[105]
DDT remains on WHOs list of insecticides recommended for IRS. After the appointment of Arata Kochi DDT can[106]still be eective against resistant
and the avoidance of DDT-sprayed
as head of its anti-malaria division, WHOs policy shifted mosquitoes
walls
by
mosquitoes
is an additional benet of the
from recommending IRS only in areas of seasonal or
[104]
chemical.
For
example,
a 2007 study reported that
episodic transmission of malaria, to advocating it in areas
resistant
mosquitoes
avoided
treated huts. The re[94]
of continuous, intense transmission. WHO rearmed
searchers
argued
that
DDT
was
the best pesticide for use
its commitment to phasing out DDT, aiming to achieve
in
IRS
(even
though
it
did
not
aord
the most protection
a 30% cut in the application of DDT world-wide by 2014
from
mosquitoes
out
of
the
three
test
chemicals) because
and its total phase-out by the early 2020s if not sooner
the
others
pesticides
worked
primarily
by killing or
while simultaneously combating malaria. WHO plans to
irritating
mosquitoes

encouraging
the
development
of
[95]
implement alternatives to DDT to achieve this goal.
resistance.[106] Others argue that the avoidance behavior
South Africa continues to use DDT under WHO guide- slows eradication.[107] Unlike other insecticides such as
lines. In 1996, the country switched to alternative in- pyrethroids, DDT requires long exposure to accumulate a
secticides and malaria incidence increased dramatically. lethal dose; however its irritant property shortens contact
Returning to DDT and introducing new drugs brought periods. For these reasons, when comparisons have
malaria back under control.[96] Malaria cases increased in been made, better malaria control has generally been
South America after countries in that continent stopped achieved with pyrethroids than with DDT.[100] In India
using DDT. Research data showed a strong negative re- outdoor sleeping and night duties are common, implying
lationship between DDT residual house sprayings and that the excito-repellent eect of DDT, often reported
malaria. In a research from 1993 to 1995, Ecuador in- useful in other countries, actually promotes outdoor
creased its use of DDT and achieved a 61% reduction in transmission.[108] Genomic studies in the model genetic
malaria rates, while each of the other countries that grad- organism Drosophila melanogaster revealed that high
ually decreased its DDT use had large increases.[50][97][98] level DDT resistance is polygenic, involving multiple
resistance mechanisms.[109]

5.1

Initial eectiveness

5.2

Mosquito resistance
5.3 Residents concerns

In some areas resistance reduced DDTs eectiveness.

WHO guidelines require that absence of resistance must Main article: Indoor residual spraying Residents
be conrmed before using the chemical.[99] Resistance is opposition to IRS
largely due to agricultural use, in much greater quantities
than required for disease prevention.
IRS is eective if at least 80% of homes and barns in a
Resistance was noted early in spray campaigns. Paul Rus- residential area are sprayed.[99] Lower coverage rates can
sell, former head of the Allied Anti-Malaria campaign, jeopardize program eectiveness. Many residents resist
observed in 1956 that resistance has appeared after six DDT spraying, objecting to the lingering smell, stains on
or seven years.[34] Resistance has been detected in Sri walls, and the potential exacerbation of problems with

5 MALARIA

other insect pests.[100][107][110] Pyrethroid insecticides cies refused to fund DDT spraying, or made aid contin(e.g. deltamethrin and lambda-cyhalothrin) can over- gent upon not using DDT. According to a report in the
come some of these issues, increasing participation.[100] British Medical Journal, use of DDT in Mozambique was
stopped several decades ago, because 80% of the countrys health budget came from donor funds, and donors re5.4 Human exposure
fused to allow the use of DDT.[124] Roger Bate asserted,
many countries have been coming under pressure from
A 1994 study found that South Africans living in sprayed international health and environment agencies to give up
homes have levels that are several orders of magnitude DDT or face losing aid grants: Belize and Bolivia are on
greater than others.[53] Breast milk from South African record admitting they gave in to pressure on this issue
mothers contains high levels of DDT and DDE.[53] It is from [USAID].[125]
unclear to what extent these levels arise from home sprayThe US Agency for International Development (USAID)
ing vs food residues. Evidence indicates that these levels
has been the focus of much criticism. While the agency
are associated with infant neurological abnormalities.[100]
now funds DDT use in some African countries,[126] in the
Most studies of DDTs human health eects have been past it did not. When John Stossel accused USAID of not
conducted in developed countries where DDT is not used funding DDT because it wasn't politically correct, Anne
and exposure is relatively low.[38][53][111]
Peterson, the agencys assistant administrator for global
Illegal diversion to agriculture is also a concern as health, replied that I believe that the strategies we are
it is dicult to prevent and its subsequent use on using are as eective as spraying with DDT ... So, pocondent that what we
crops is uncontrolled. For example, DDT use is litically correct or not, I am very
[127]
are
doing
is
the
right
strategy.
USAIDs Kent R. Hill
[112]
particularly mango
widespread in Indian agriculture,
stated
that
the
agency
had
been
misrepresented:
USAID
[113]
production
and is reportedly used by librarians to prostrongly
supports
spraying
as
a
preventative
measure
for
[114]
tect books.
Other examples include Ethiopia, where
malaria
and
will
support
the
use
of
DDT
when
it
is
scienDDT intended for malaria control is reportedly used in
[128]
The Agencys website
coee production,[115] and Ghana where it is used for tically sound and warranted.
states
that
USAID
has
never
had
a
'policy' as such either
[116][117]
shing.
The residues in crops at levels unaccept'for'
or
'against'
DDT
for
IRS
(Indoor
residual spraying).
able for export have been an important factor in bans in
The
real
change
in
the
past
two
years
[2006/07]
was a new
[100]
several tropical countries.
Adding to this problem is
interest
and
emphasis
on
IRS
in
general

with
DDT or
[107]
a lack of skilled personnel and management.
any other insecticide as an eective malaria prevention
strategy in tropical Africa.[126] The agency claimed that
in many cases alternative malaria control measures were
5.5 Criticism of restrictions on DDT use
more cost-eective than DDT spraying.[129]
Critics argue that limitations on DDT use for public
health purposes have caused unnecessary morbidity and
mortality from vector-borne diseases, with some claims
of malaria deaths ranging as high as the hundreds of
thousands[118] and millions.[119] Robert Gwadz of the US
National Institutes of Health said in 2007, The ban on
DDT may have killed 20 million children.[120] These arguments were rejected as outrageous by former WHO
scientist Socrates Litsios. May Berenbaum, University of
Illinois entomologist, says, to blame environmentalists
who oppose DDT for more deaths than Hitler is worse
than irresponsible.[87] Investigative journalist Adam Sarvana and others characterize this notion as a myth promoted principally by Roger Bate of the pro-DDT advocacy group Africa Fighting Malaria (AFM).[121][122]
Criticisms of a DDT ban often specically reference the
1972 United States ban (with the erroneous implication
that this constituted a worldwide ban and prohibited use
of DDT in vector control). Reference is often made to
Silent Spring, even though Carson never pushed for a DDT
ban. John Quiggin and Tim Lambert wrote, the most
striking feature of the claim against Carson is the ease
with which it can be refuted.[123]

5.6 Alternatives
5.6.1 Insecticides
Main article: Indoor residual spraying
Organophosphate and carbamate insecticides, e.g.
malathion and bendiocarb, respectively, are more expensive than DDT per kilogram and are applied at roughly
the same dosage. Pyrethroids such as deltamethrin are
also more expensive than DDT, but are applied more
sparingly (0.020.3 g/m2 vs 12 g/m2 ), so the net cost
per house is about the same.[37]
5.6.2 Non-chemical vector control

Before DDT, malaria was successfully eliminated or curtailed in several tropical areas by removing or poisoning mosquito breeding grounds and larva habitats, for
example by eliminating standing water. These methods
have seen little application in Africa for more than half
It has been alleged that donor governments and agen- a century.[130] According to CDC, such methods are not

9
practical in Africa because "Anopheles gambiae, one of
the primary vectors of malaria in Africa, breeds in numerous small pools of water that form due to rainfall ... It
is dicult, if not impossible, to predict when and where
the breeding sites will form, and to nd and treat them
before the adults emerge.[131]

of people saved, but would also consider ecological damage and negative human health impacts. One preliminary
study found that it is likely that the detriment to human
health approaches or exceeds the benecial reductions in
malarial cases, except perhaps in epidemics. It is similar
to the earlier study regarding estimated theoretical infant
DDT and subject to the criticism also
The relative eectiveness of IRS versus other malaria mortality caused by[139]
mentioned
earlier.
control techniques (e.g. bednets or prompt access to
anti-malarial drugs) varies and is dependent on local A study in the Solomon Islands found that although imconditions.[37]
pregnated bed nets cannot entirely replace DDT spraying
incidence, their use perA WHO study released in January 2008 found that without substantial increase in
[140]
mits
reduced
DDT
spraying.
mass distribution of insecticide-treated mosquito nets and
artemisininbased drugs cut malaria deaths in half in
malaria-burdened Rwanda and Ethiopia. IRS with DDT
did not play an important role in mortality reduction in
these countries.[132][133]
Vietnam has enjoyed declining malaria cases and a
97% mortality reduction after switching in 1991 from
a poorly funded DDT-based campaign to a program
based on prompt treatment, bednets and pyrethroid group
insecticides.[134]

A comparison of four successful programs against

malaria in Brazil, India, Eritrea and Vietnam does not
endorse any single strategy but instead states, Common
success factors included conducive country conditions, a
targeted technical approach using a package of eective
tools, data-driven decision-making, active leadership at
all levels of government, involvement of communities,
decentralized implementation and control of nances,
skilled technical and managerial capacity at national and
sub-national levels, hands-on technical and programmatic
support from partner agencies, and sucient and exible
nancing.[141]

In Mexico, eective and aordable chemical and nonchemical strategies were so successful that the Mexican
DDT manufacturing plant ceased production due to lack
DDT resistant mosquitoes have generally proved suscepof demand.[135]
tible to pyrethroids. Thus far, pyrethroid resistance in
A review of fourteen studies in sub-Saharan Africa, cov- Anopheles has not been a major problem.[100]
ering insecticide-treated nets, residual spraying, chemoprophylaxis for children, chemoprophylaxis or intermittent treatment for pregnant women, a hypothetical vaccine and changing frontline drug treatment, found de- 6 See also
cision making limited by the lack of information on the
costs and eects of many interventions, the small num DDT in Australia
ber of cost-eectiveness analyses, the lack of evidence
DDT in New Zealand
on the costs and eects of packages of measures and the
problems in generalizing or comparing studies that relate
DDT in the United States
to specic settings and use dierent methodologies and
outcome measures. The two cost-eectiveness estimates
Mickey Slim, a short-lived cocktail that combined
of DDT residual spraying examined were not found to
gin with a pinch of DDT.
provide an accurate estimate of the cost-eectiveness of
DDT spraying; the resulting estimates may not be good
Operation Cat Drop
predictors of cost-eectiveness in current programs.[136]
However, a study in Thailand found the cost per malaria
case prevented of DDT spraying (US$1.87) to be 21%
greater than the cost per case prevented of lambdacyhalothrintreated nets (US$1.54),[137] casting some
doubt on the assumption that DDT was the most costeective measure. The director of Mexicos malaria control program found similar results, declaring that it was
25% cheaper for Mexico to spray a house with synthetic
pyrethroids than with DDT.[135] However, another study
in South Africa found generally lower costs for DDT
spraying than for impregnated nets.[138]
A more comprehensive approach to measuring costeectiveness or ecacy of malarial control would not
only measure the cost in dollars, as well as the number

Biomagnication

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[133] Malaria deaths halved in Rwanda and Ethiopia Better
drugs, mosquito nets are the crucial tools, David Brown
(Washington Post), SF Chronicle, A-February 12, 1, 2008.

8 Further reading
David Kinkela. DDT and the American Century:
Global Health, Environmental Politics, and the Pesticide That Changed the World (University of North
Carolina Press, 2011).

9 External links
Chemistry
DDT at The Periodic Table of Videos (University of
Nottingham)
Toxicity

15
DDT Technical Fact Sheet (PDF). National Pesticide Information Center.
DDT General Fact Sheet (PDF). National Pesticide Information Center.
DDT.
Pesticide Information Proles.
TOXNET.

EX-

Scorecard: The Pollution Information Site DDT

Interview with Barbara Cohn, PhD about DDT and
breast cancer
Pesticide residues in food 2000 : DDT
DDT. NIOSH Pocket Guide to Chemical Hazards.
CDC.
Politics and DDT
Bailey, Ronald (7 January 2004). DDT, Eggshells,
and Me. Reason magazine.
Swartz, Aaron (SeptemberOctober 2007). Rachel
Carson, Mass Murderer?: The creation of an antienvironmental myth. Extra!.
Malaria and DDT
Berenbaum, May (4 June 2005). If Malarias the
Problem, DDTs Not the Only Answer. Washington Post.
'Andrew Spielman, Harvard School of Public
Health, discusses environmentally friendly control
of Malaria and uses of DDT Freeview video provided by the Vega Science Trust
Ugandan farmers push for DDT ban. ABC News.
Australian Broadcasting Commission. 31 May
2008.

16

10

10
10.1

TEXT AND IMAGE SOURCES, CONTRIBUTORS, AND LICENSES

Text and image sources, contributors, and licenses

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10.2

Images

17

morda, RexRowan, Frosty, Jamesx12345, Little green rosetta, ComfyKem, Telfordbuck, Howicus, TeragR, Melonkelon, Wuerzele, CensoredScribe, Clr324, Joker99199, Kingofaces43, NorthBySouthBaranof, Ginsuloft, Trtehp35, Paul2520, Talinacookie, AddWittyNameHere, Barrypittendrigh29, Brasnow, Ajacob4469, Monkbot, Patient Zero, Renamed user 51g7z61hz5af2azs6k6, Teddyktchan, ,
Rolltheblunt, Spiderwebman, ChipStax420, Asdklf;, MaxFear69, Tejaskumar3005, Hariss123456789, FourViolas, Mr Bee Pod, VexorAbVikipdia, Emily Temple-Wood (NIOSH), Innite0694, GeneralizationsAreBad, Lilman11121, KasparBot, ThatRandomGuyataParty,
HamPlease, Jinnantonix, CAPTAIN RAJU, James Hare (NIOSH), Jdzz1776, CLCStudent, Dan Dickeson, Kartupelis81, Kingofxbox99
and Anonymous: 1037

10.2

Images

File:Commons-logo.svg Source: https://upload.wikimedia.org/wikipedia/en/4/4a/Commons-logo.svg License: CC-BY-SA-3.0 Contributors: ? Original artist: ?

File:DDT-from-xtal-3D-balls.png Source: https://upload.wikimedia.org/wikipedia/commons/b/b1/DDT-from-xtal-3D-balls.png License: Public domain Contributors: Own work Original artist: Ben Mills
File:DDT-from-xtal-3D-vdW.png Source: https://upload.wikimedia.org/wikipedia/commons/e/ec/DDT-from-xtal-3D-vdW.png License: Public domain Contributors: Own work Original artist: Ben Mills
File:DDTDichlordiphnyltrichlorthane7.JPG Source: https://upload.wikimedia.org/wikipedia/commons/2/29/DDTDichlordiph%
C3%A9nyltrichlor%C3%A9thane7.JPG License: CC BY-SA 3.0 Contributors: Own work Original artist: Lamiot
File:DDT_Powder.jpg Source: https://upload.wikimedia.org/wikipedia/en/6/66/DDT_Powder.jpg License: CC0 Contributors:
Photograph of an old DDT powder container
Original artist:
Xanthis
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Providers(s): CDC
File:DDT_to_DDD_and_DDE.svg Source: https://upload.wikimedia.org/wikipedia/commons/1/11/DDT_to_DDD_and_DDE.svg License: Public domain Contributors: Own work Original artist: Leyo
File:Hazard_N.svg Source: https://upload.wikimedia.org/wikipedia/commons/6/6a/Hazard_N.svg License: Public domain Contributors:
Converted from EPS le at http://forum.cptec.org/index.php?showtopic=368 Original artist: See historic
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? Original artist: ?
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File:O,p'-dichlorodiphenyltrichloroethane.svg
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