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Permethrin exposure from wearing fabric-treated military uniforms in high heat conditions under varying wear-time scenarios

Journal of Exposure Science & Environmental Epidemiology (2019) | Download Citation



This study examined the effect of high-temperature conditions and uniform wear time durations (expeditionary, 33 h continuous wear; garrison, 3 days, 8 h/day wear) on permethrin exposure, assessed by urinary permethrin biomarkers, from wearing post-tailored, factory-treated military uniforms. Four group study sessions took place over separate 11-day periods, involving 33 male Soldiers. Group 1 (n = 10) and Group 2 (n = 8) participants wore a study-issued permethrin-treated Army uniform under high heat environment (35 °C, 40% relative humidity (rh)) and expeditionary and garrison wear-time conditions, respectively. For comparison, Group 3 (n = 7) and Group 4 (n = 8) participants wore study-issued permethrin-treated uniforms in cooler ambient conditions under operational and garrison wear-time conditions, respectively. Urinary biomarkers of permethrin (3-phenoxybenzoic acid, and the sum of cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid) were significantly higher under high temperature compared to ambient conditions, regardless of wear-time situations (Group 1 vs. Group 3; Group 2 vs. Group 4; p < 0.001, for both). Under high-temperature conditions, expeditionary (continuous) compared to garrison wear-time resulted in significantly (p < 0.001) higher urinary biomarker concentrations (Group 1 vs. Group 2). Differences related to wear-time under the ambient conditions (Group 3 vs. Group 4) were not statistically significant. Findings suggest that wearing permethrin-treated clothing in heat conditions results in higher internal dose of permethrin above that observed under ambient conditions.

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We acknowledge the contribution of additional USARIEM study team members who assisted in the data collection for this project and the laboratory technicians at the USARIEM Central Laboratory who performed sample analyses of creatinine. We also greatly appreciate the experience and input from Melynda Perry and Amy Johnson (Natick Textile Materials Evaluation Team, Natick Soldier Research, Development and Engineering Center, Natick, MA) who consulted on the project and conducted the permethrin analyses of the uniforms, respectively. We thank Mark Davis and Isuru Vidanage at the Centers for Disease Control and Prevention for technical assistance in the quantification of the pyrethroid metabolites in urine.

Author information


  1. United States Army Research Institute of Environmental Medicine, Military Performance Division, 10 General Greene Avenue, Natick, MA, USA

    • Susan P. Proctor
    • , Alexis L. Maule
    • , Kristin J. Heaton
    • , Bruce S. Cadarette
    • , Katelyn I. Guerriere
    • , Caitlin C. Haven
    • , Kathryn M. Taylor
    •  & Matthew M. Scarpaci
  2. VA Boston Healthcare System, Research Service, 180 South Huntington Avenue, Boston, MA, USA

    • Susan P. Proctor
  3. Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, Boston, MA, USA

    • Susan P. Proctor
    •  & Kristin J. Heaton
  4. Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720-A, Rockledge Drive, Suite 100, Bethesda, MD, USA

    • Alexis L. Maule
    •  & Matthew M. Scarpaci
  5. Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, 4770 Buford Hwy, Atlanta, GA, USA

    • Maria Ospina
    •  & Antonia M. Calafat


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The authors declare that they have no conflict of interest.

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Correspondence to Susan P. Proctor.

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