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

预防户外工作者接触蜱虫和蜱传播疾病 摘要 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， 户外工作者的职业危害。目前，蜱虫叮咬的预防需要时间- 将杀虫剂重新涂在衣服和暴露的皮肤上。不幸的是， 对这些程序的遵守情况很差。最近，一种基于工厂的方法， 已经开发了持久的氯菊酯浸渍衣物，其允许衣物 保持杀虫活性超过70次洗涤（服装的有效寿命）。的 处理过程已被美国环保署批准，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90%的蜱虫叮咬。为了 为量度这类衣物对保护户外工作者的成效及安全性， 建议对北卡罗来纳州的300名工人进行随机对照干预， 环境和自然资源部（DENR）。户外工作者在 林业司和公园和娱乐司将随机分配 分成两组。工人们的制服将在一个双重的处理或假处理- 盲目的方式。所有研究受试者将填写每周蜱虫日志，并保留清除的蜱虫 用于以后的物种形成和病原体检测。血清样本，采集时间 将对入组和研究结论进行常见蜱传抗体滴度 病原体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个简单和具有成本效益的方法，保护 户外工作者免受蜱虫传播疾病的侵害。

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