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，蜱传疾病代表着日益严重的公共卫生问题和户外工作者的职业危害。目前，预防蜱虫叮咬需要在衣服和暴露的皮肤上重复施用杀虫剂，这非常耗时。不幸的是，遵守这些程序的人很少。最近，一种以工厂为基础的长期浸渍氯菊酯衣物的方法已经开发出来，这种方法可以使衣物在洗涤70次以上（衣物的有效使用寿命）时保持杀虫活性。该处理方法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了初步证据，表明穿这种衣服的工人比不穿这种衣服的工人被蜱虫叮咬的几率少90%。为了衡量这种服装在保护户外工人方面的有效性和安全性，我们提议对北卡罗来纳州环境和自然资源部（DENR）的300名工人进行随机对照干预。林业司和公园娱乐司的户外工作者将被随机分为两组。工人们的制服将以双盲的方式进行处理或假处理。所有研究对象将填写每周蜱虫日志，并将取出的蜱虫保存在样品瓶中，以便以后进行物种形成和病原体检测。在入组和研究结论时抽取的血清样本将被滴度检测常见蜱传病原体的抗体。可能与服装有关的不良事件，如皮疹，将被记录下来。这项研究的结果可能会导致一种简单而经济有效的方法来保护户外工作者免受蜱传疾病的侵害。

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.