A Systematic Review of Aircraft Disinsection Safety, Toxicity, and Tolerability

Area of Science:

• Public Health
• Toxicology
• Environmental Health

Background:

• International travel necessitates measures like aircraft disinsection to prevent disease vector spread.
• The human health impacts of insecticides used in conveyance disinsection require comprehensive synthesis.

Purpose of the Study:

• To systematically review and evaluate the human safety and toxicity of insecticides used in disinsection.
• To synthesize human health outcomes associated with disinsection across various transportation modes.

Main Methods:

• Systematic review adhering to PRISMA guidelines, registered in PROSPERO.
• Inclusion of 21 studies reporting human health effects, safety, toxicity, and tolerability outcomes.
• Assessment of evidence certainty and risk of bias for included studies.

Main Results:

• Included studies were of generally limited quality with high risk of bias, yielding low to very low certainty estimates.
• No high-quality studies on disinsection safety, toxicity, or tolerability were identified.
• Reported human health effects included morbidity, adverse events (e.g., hospitalization), and signs of acute insecticide poisoning.

Conclusions:

• Existing evidence on the human health impacts of disinsection is limited and of low certainty.
• Reported adverse effects suggest potential risks to passengers and crew.
• Well-designed studies are urgently needed to investigate the full spectrum of health impacts from conveyance disinsection.