NEUROLOGICAL EFFECTS ASSOCIATED WITH USE OF THE INSECT REPELLENT N,N-DIETHYL-M-TOLUAMIDE (DEET)

Background: N,N-Diethyl-m-toluamide, an effective tick repellent, when applied to the skin, is the major component of essentially all of the products marketed for this purpose. It is used by about 30% of the US population, and by 23-29% of children in this population.(1) Reports of neurologic adversity and death are rare and primarily involve child ren, but the dose relationship between N, N-diethyl-m-toluamide exposu re and the symptoms reported in the clinical literature is difficult t o establish. Methods: Animal toxicology studies, clinical reports of n eurological adversities in children and adults, and the available Pois on Control Center records have been reviewed in an effort to understan d the relationship between the N,N-diethyl-m-toluamide exposure and re ported adverse events. Conclusions: Based on (1) the animal toxicology database on N,N-diethyl-m-toluamide, (2) the reports of adverse event s in humans, and (3) the possible alternate etiologies for the symptom s reported in most patients, the risk of adversity from label-directed use of N, N-diethyl-m-toluamide appears low. Future efforts should fo cus on the prospective collection of adversity data with special atten tion paid to the documentation of clinical effects.