Vectorborne diseases quickly became an increasing issue early in the March 2003 invasion of Iraq. By January 2004, there had been 659 confirmed cases of the extremely rare parasite cutaneous leishmaniasis, an and 10 cases of plasmodium resulting in malaria (White et al., 2005). By January 2004, the United States Army 8th Medical Brigade had begun surveying at staging-bases in Kuwait while units waited to disburse throughout Iraq. The research gathered data from 754 servicemembers relating to their “personal protective readiness” against vectorborne illnesses. Items surveyed included permethrin-treated uniforms and bed nets, permethrin aerosol insecticides and n-diethyl-m-toluamide (DEET) repellant. Out of 754 servicemembers, 316 (36.3%) received DEET repellant, 392 (47.5%) received permethrin aerosol insecticides and 357 (41%) receiving ‘three or more’ permethrin-treated uniforms (White et al., 2005). With only a third of deploying servicemembers receiving DEET and only half receiving permethrin as of January 2004, the Army Office of the Surgeon General, Army Medical Department and the Office of Preventative Medicine called for a “proactive supply” (White et al., 2005, pg. 499) and by the late 2004 nearly all deploying servicemembers had a minimum of three permethrin-soaked uniforms and an endless supply of DEET.
However, considering the constant wearing of these uniforms, many of them needed to be replaced quite frequently – once new permethrin-soaked uniforms arrived, the old uniforms were thrown into a pit to be burned, reducing the risk of being taken and reused by the enemy. In addition, prior to the “impregnation” of combat uniforms in 2012, deploying servicemembers were required to “DEET-dip” uniforms, placing them into a large liquid barrel of stated chemical(s) and laid out to dry.
Exposure frequency is concerning from a medical perspective due to high operational tempo in the field. While oxygen consumption increases from sitting (8L/min) to walking at 4mph (33L/min) and running at 5mph
(58L/min) in addition to extremely high (or low) fluctuations in environmental temperature, the human bodies physiological “cool-down” excretory mechanism allows the 2.5 million (per person) sweat glands evenly distributed in the body to maintain at a functioning level. Two types of glands control this mechanism, “Eccrine” – opens the skin through a duct/pore on skin surface and “Apocrine” – larger ducts that empty into hair follicles, found mostly in armpits and groin area that are activated during pain and stress. With skin being the “largest” living organ on/in the human body, its functions are critical to human life and sustainability in terms of protection, body temperature regulation, sensory reception, water balance, vitamin and hormone synthesis; additionally, its primary function is to serve as a barrier to the entry to microbes and viruses.
Permethrin (C21H20Cl2O3) and N,N-Diethyl-Meta-Toluamide (DEET; C12H17NO) are water insoluble with a specific gravity of 1.2 (as compared to water, SG = 1) and can be found in bloodstream 12-hours post-application to skin where it is then broken down by the liver Cytochrome P450 into lesser chemical substrates and “unknown” amounts are then filtered into the kidneys and eliminated by means of urination (ester hydrolysis) within 24-hours. The Environmental Protection Agency (EPA.gov) classifies Permethrin as “Likely Human Carcinogen” as evidenced by malignant tumor growth in lung and liver of mice (EPA.gov, June 2006) at toxicity levels (skin; rabbit) of 2000mg/kg. Continued, prolonged use has shown to damage male reproductive systems via reduction in sperm count. Additionally, this insect repellent upon entering the body via excretory skin-pores, acts on nerve and neuronal cell membranes to disrupt sodium channel currents causing a neurological reaction delay in repolarization and causing subsequent paralysis. The American Society of Health System Pharm., stated that the use of these chemical insect repellents are absorbed and distributed into “most body tissues and fluids with peak concentration at the brain and sciatic nerve region indicating drug accumulation in the brain” (2013).
The licensed medical providers, clinical researchers and veterans alike have researched toxic exposures in combat veterans deployed overseas for over four years, have produced educational criteria, preventative medicine recommendations and publications to allow for the most effective means of protection. Recent statistics have identified that between 2002 to 2015, 51% (625k) combat veterans seen medically at the Department of Veterans Affairs (average age 34-years) have medical complaints and conditions specifically in the nervous/sensory body system, 25% (309k) reporting skin disorders/conditions/diseases and cancers, 18% (223k) reporting GU/urinary diseases and 5% (62k) reporting hematopoietic disorders/cancers.
As a continued concern in means of repeated, chronic exposures, we’ve collectively concluded in our medical and professional opinions that the most effective way to prevent chemical exposures by way of insect repellent is to refrain from direct skin contact. We highly suggest not applying insect repellent directly onto the skin due to the absorption rate, slow and multi-system excretion process and evidence-based adverse health effects.
The HunterSeven Foundations (EIN: 83-1983697, IRS 501c3) medical research team recommend replacing “direct-skin applications” of insect repellent with the MATBOCK, LLC SKEETER PATCH KIT SYSTEM (MB-Skeeter-USA)(www.Matbock.com/products/skeeter-patch-kit) which utilizes an internal, anti-microbial absorbent lining for direct application of insecticide, with the patch then placed on the uniform/clothing/pant leg opening/hat, etc. The HunterSeven team received patches for field testing (shown in image to left), first patch was applied to mutlicam pant leg, sprayed with USGI Individual Dynamic Absorption Kit (IDAK)(NSN 6840-01-345-0234) liquid spray. The internal lining absorbed completely all liquid spray utilized, the external of the patch showed no external moisture of evidence of malabsorption. For situational purposes, the location is Southeastern Massachusetts, 29 May 2019, time 17:35 to 21:10 in heavily wooded areas with recent rainfall and heavy vegetation. It is of importance to note the high tick and mosquito population in this area.
The opposite pant leg (right-side) had no patch present. Over the period of 4 hours, NO mosquitoes, ticks or any insects were located on the left side of the pants (where patch is present), three ticks were found on the right side of the pants (where no patch was present) and one tick found under the right-side pant leg on the sock. No smell was noted after application and no skin came in contact with the insect repellent patches. After use, the team removed the patch and placed the patch in side of a clear plastic bag, filled the plastic bag with water and noted the repellent did not readily seep from the patch, therefore showing durability in rainfall/water operations. All in all, the HunterSeven team supports the MATBOCK Skeeter Patch Product as a safe, effective way to decrease toxic exposures related to chemical application of insect repellent on the skin. After firsthand duration testing, the patch shows durability, sustainability and adheres with the US Military Uniform regulations and guidelines under AR 670-1. It is in our medical opinion that the MATBOCK Skeeter Patch System is currently the SAFEST and most EFFECTIVE method of primary prevention of insecticide exposures.