A scoping review to determine if adverse human health effects are associated with use of pyrethroids for mosquito control

Abstract Mosquito control using pyrethrins and synthetic pyrethroids (PSP) is important for preventing vector-borne diseases. Although the benefits associated with PSP use are well-documented, public concern exists regarding potential human adverse health effects. The aim of this scoping review was to describe adverse human health effects associated with PSP use for community adult mosquito control. A literature search using the databases MEDLINE, EMBASE, Agricultural and Environmental Science Collection, CAB Abstracts, and Scopus obtained 6,154 original peer-reviewed articles published during 1 January 2000 to 22 May 2024. Articles were independently reviewed for inclusion using predetermined exclusion and inclusion criteria. Data were extracted from 10 included articles. Study designs included cohort (n = 5), cross-sectional (n = 2), and risk assessment (n = 4). One article included 2 study designs. Of the cohort studies, one was prospective and the remainder were retrospective. A causal relationship between PSP application for adult mosquito control and adverse human health impacts was not identified. No increases in acute health manifestations were reported. The 4 risk assessments estimated that PSP exposures were not above the regulatory level of concern; a meta-analysis determined the likelihood of PSP exposures exceeding the regulatory level of concern was <0.0001. The limited evidence indicated that PSP applied appropriately for control of nuisance mosquitoes or mosquitoes that transmit arboviruses do not pose acute or chronic human health risks. Continued investigation into potential human health impacts of PSP would help inform guidelines for adult mosquito control and help inform public health decision making.