Preventing exposure to ticks and tick-borne illness in outdoor workers

描述（由申请人提供）：在北卡罗来纳州，蜱传疾病是一个日益严重的公共卫生问题，也是户外工作者的职业危害。目前，蜱叮咬的预防需要将杀虫剂重新施用到衣服和暴露的皮肤上，这是耗时的。不幸的是，这些程序的遵守情况很差。最近，已经开发了一种用于持久的氯菊酯浸渍衣物的基于工厂的方法，该方法允许衣物保持杀虫活性超过70次洗涤（衣物的有效寿命）。该处理工艺已获得美国环保署的批准，并被列为无毒。我们从一个小型试点项目中获得的初步证据表明，穿这种衣服的工人比不穿这种衣服的工人减少了约90%的蜱虫叮咬。为了衡量这种服装在保护户外工作者方面的有效性和安全性，我们建议在北卡罗来纳州环境和自然资源部（DENR）对300名工人进行随机对照干预。林业司和公园和娱乐司的户外工作者将被随机分配到两组。工人将以双盲方式对其制服进行处理或假处理。所有研究受试者将填写每周蜱虫日志，并将取出的蜱虫保存在标本瓶中，以供以后进行物种形成和病原体检测。将对入组和研究结束时采集的血清样本进行常见蜱传病原体抗体滴定。将记录可能与衣服相关的不良事件，如皮疹。这项研究的结果可能会导致一种简单且具有成本效益的方法，以保护户外工作者免受蜱传疾病的侵害。 公共卫生相关性：蜱传传染病是户外工作者的主要职业危害，包括北卡罗来纳州环境和自然资源部的雇员。该项目包括测试长效氯菊酯处理的制服在减少北卡罗来纳州林业和公园部门雇员蜱暴露的有效性。

DESCRIPTION (provided by applicant): In North Carolina, tick-borne diseases represent a growing public health problem and an occupational hazard for outdoor workers. Currently, tick-bite prevention requires time- consuming reapplication of insecticides to clothing and exposed skin. Unfortunately, adherence to these procedures is poor. Recently, a factory-based method for long- lasting permethrin impregnation of clothing has been developed which allows clothing to retain insecticidal activity for over 70 washes (the effective lifetime of a garment). The treatment process has been approved by the US EPA and classified as non-toxic. We have preliminary evidence from a small pilot project suggesting that workers wearing this clothing have ~90% fewer tick bites than workers not wearing this clothing. In order to measure the effectiveness and safety of this clothing in protecting outdoor workers, we are proposing a randomized controlled intervention with 300 workers in the NC State Department of Environmental and Natural Resources (DENR). Outdoor workers in the Division of Forestry and the Division of Parks and Recreation will be randomly assigned to two groups. Workers will have their uniforms treated or sham-treated in a double- blinded manner. All study subjects will fill out weekly tick logs, and keep removed ticks in specimen vials for later speciation and pathogen detection. Serum samples, drawn at enrollment and study conclusion will be titered for antibody to common tick-borne pathogens. Possible clothing-related adverse events, such as rashes, will be recorded. The results of this study could lead to a simple and cost-effective method of protecting outdoor workers from tick-borne illnesses. PUBLIC HEALTH RELEVANCE: Tick-borne infectious diseases are a major occupational hazard for outdoor workers, including employees of the North Carolina State Department of Environment and Natural Resources. This project involves testing the effectiveness of long-lasting permethrin- treated uniforms in reducing tick exposures in North Carolina Forestry and Parks Department employees.