Preventing Lyme Disease Exposure Among Outdoor Workers

预防户外工作者接触莱姆病

• 批准号: 9131735
• 负责人: Thomas N Mather
• 金额: $ 50.37万
• 依托单位: UNIVERSITY OF RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9131735
• 关键词: Preventing; Lyme; Disease; Exposure; Among

 DESCRIPTION (provided by applicant): Lyme and other tick-borne diseases pose a significant health threat to outdoor workers. In a double - blind randomized controlled trial (RCT) in North Carolina outdoor workers, we previously showed that long-lasting permethrin-impregnated (LLPI) clothing provided >80% protection for one year against Lone Star tick bites among outdoor workers in North Carolina. But there are three issues that need to be addressed before this finding can be translated into policy: 1) Do LLPI clothing protect t against blacklegged ticks, the vector for Lyme disease, babesiosis and anaplasmosis, as well as against the Lone Star tick? 2) What levels of permethrin and its metabolites are absorbed, and are they potentially toxic? 3) Why did the LLPI clothing in our previous study lose efficacy after a year? To answer these questions, we propose a two year double-blind RCT with 200 outdoor workers in Lyme endemic areas of the Northeast. Outdoor workers from the National Park Service, the Rhode Island Department of Environmental Management, and NationalGrid will be randomly assigned to the treatment or control group. All study subjects will fill out weekly tick logs, collct attached ticks for later speciation and pathogen detection, and submit annual serum samples to test for exposure to tick-borne pathogens. A randomly selected subset of subjects also will be asked to submit urine samples for permethrin metabolite analysis at several time points during follow-up. Others will be asked to submit worn items of clothing for tick knockdown testing and permethrin content analysis at the end of the first and second years of field testing. This project specifically addresses the following NIOSH Priority Goals for Extramural Research: Goal 2: Reduce deleterious health and safety outcomes in workers more susceptible to injury or illness due to circumstances limiting options for safeguarding their own safety and health, Goal 7: Improve the health and well-being of forestry workers by reducing occupational causes or contributing factors to acute and chronic illness and disease. This research will address the agriculture, forestry, and fishing sector and personal protective technology cross-sector by evaluating the protective effectiveness and toxicological risk of long-lasting permethrin impregnated clothing for prevention of tick bites and tick-borne disease among forestry and utility workers and park rangers. The results of this study could help protect hundreds of thousands of outdoor workers with exposure to ticks and tick-borne pathogens.

 描述（由申请人提供）：莱姆病和其他蜱传疾病对户外工人构成严重的健康威胁。在一项双盲随机对照试验（RCT）中 在北卡罗来纳州的户外工作人员中，我们之前表明，长效氯菊酯浸渍 (LLPI) 服装为北卡罗来纳州的户外工作人员提供了超过 80% 的一年保护，防止孤星蜱虫叮咬。但在这一发现转化为政策之前，需要解决三个问题：1) LLPI 服装是否可以预防黑腿蜱（莱姆病、巴贝斯虫病和无形体病的传播媒介）以及孤星蜱？ 2) 氯菊酯及其代谢物的吸收水平是多少？它们是否具有潜在毒性？ 3）为什么我们之前研究中的LLPI服装在一年后就失效了？为了回答这些问题，我们提议对东北部莱姆病流行区的 200 名户外工作者进行为期两年的双盲随机对照试验。来自国家公园管理局、罗德岛州环境管理部和国家电网的户外工作人员将被随机分配到治疗组或对照组。所有研究对象将填写每周蜱虫日志，收集附着的蜱虫以供以后的物种形成和病原体检测，并提交年度血清样本以测试是否接触蜱传病原体。随机选择的受试者子集还将被要求在随访期间的几个时间点提交尿液样本以进行氯菊酯代谢物分析。其他人将被要求在第一年和第二年的现场测试结束时提交旧衣服进行蜱击倒测试和氯菊酯含量分析。这个项目 具体阐述了以下 NIOSH 校外研究优先目标：目标 2：减少由于环境限制保护自身安全和健康的选择而更容易受伤或患病的工人的有害健康和安全后果，目标 7：通过减少职业原因或急性和慢性疾病的促成因素来改善林业工人的健康和福祉。这项研究将通过评估长效氯菊酯浸渍服装的防护效果和毒理学风险，以预防林业和公用事业工作人员以及公园管理员被蜱虫叮咬和蜱传疾病，从而解决农业、林业和渔业部门以及跨部门的个人防护技术问题。这项研究的结果可以帮助保护数十万接触蜱虫和蜱传病原体的户外工人。