Review Article Prolonged use of mosquito coil, mats, and liquidators: A review of its health implications Nitin Ashok John, Jyoti John1 Department of Physiology, Indira Gandhi Medical College and Research Institute, Puducherry, 1Department of Biochemistry, ESIC Medical College, Faridabad, Haryana, India Abstract Mosquito coils are burnt indoors and outdoors in India to control mosquitoes. Human beings get exposed to a chemically complex mosquito coil smoke containing small particles (<1 µm), metal fumes, and vapors that may reach the alveolar region of the lung. Coils consist of an insecticide/repellant, organic fillers, binders, and additives such as synergists, dyes, and fungicide. Thus, the smoke contains pollutants of health concern. The concentrations of pollutants resulting from burning mosquito coils may exceed health-based air quality standards and have ill effect on health. Hence, in this review, we have discussed the health implications due to burning of mosquito coil, mats, and heating of mosquito refill liquidators. Key words: Liquidators, mats, mosquito coil, prolonged use Received: 5th October, 2015; Revised: 13th November, 2015; Accepted: 15th December, 2015 INTRODUCTION are not specified. Most of them are aromatic and aliphatic hydrocarbons, which are combustible products of wood, Human beings are often protected from nuisance and dust filters, and dyes. The fumes emitted by burning of disease‑bearing mosquitoes by insecticides. The four the coils are responsible for ill effects on human health. major types of residential insecticide products that are widely used globally are aerosols, mosquito coils, liquid The coils and mats are often used overnight in sleeping vaporizers, and vaporizing mats.[1] quarters where elevated exposure may occur. Mosquito coil, mat, and liquidators smoke containing particulates Mosquito coils and mats are burnt indoors and outdoors (<1 µm), metal fumes, and vapors may reach the alveolar in India. Coils and mats consist of organic fillers (capable region of the lung on chronic and prolonged exposure, of burning with smoldering binders) and additives such thereby affecting lung functions in humans.[3,4] The as synergists, dyes, and fungicide.[2] The most common mosquito coils and mats contain octachlorodipropyl ether active ingredients in coils and mats are the various as a synergist or active ingredient. S‑2 is chloroalkyl ether derivatives of pyrethroids. Pyrethroid‑based coils and used both as an insecticide and insecticide synergist in mats are effective against genera of mosquitoes including mosquito coils and mats and the volatile constituents Aedes, Anopheles, and Mansonia. The liquid mosquito of S‑2 include undefined genotoxic agents.[5‑9] Pauluhn repellent bottle filled with the repellent and graphite rod reported that bis‑chloromethyl ether (BCME) is released at the center also produces fumes when heated, and it during combustion of mosquito coils.[10] BCME might act blocks the chemo sensors of mosquitoes so that they are unable to identify human beings.[1] The common brands Address for correspondence: Dr. Nitin Ashok John, of mosquito coils used in India label D‑trans allethrin as Department of Physiology, Indira Gandhi Medical College an active ingredient with 99% other constituents, which and Research Institute, Puducherry, India. E‑mail: [email protected] Access this article online This is an open access article distributed under the terms of the Creative Commons Quick Response Code: Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak, Website: and build upon the work non‑commercially, as long as the author is credited and the new www.ijcep.org creations are licensed under the identical terms. For reprints contact: [email protected] DOI: How to cite this article: John NA, John J. Prolonged use 10.4103/2348-8093.175390 of mosquito coil, mats, and liquidators: A review of its health implications. Int J Clin Exp Physiol 2015;2:209-13. © 2015 International Journal of Clinical and Experimental Physiology | Published by Wolters Kluwer - Medknow 209 John and John: Prolonged use of mosquito coil, mats, and liquidators: A review of its health implications as a potent lung carcinogen for residents including children version, they are regarded preferable to pyrethroids as on long‑term exposure even in unmeasured amount.[8‑10] mosquito repellant. Pyrethrins are found to be low toxicity pesticides from a human health standpoint.[15] Acute pyrethroid toxicity manifests as breathing problems, headache, eye irritation, bronchial irritation, and skin Insecticide and insect repellent effect of pyrethrin reaction. The subjects may complain of cough, cold, Pyrethrins cause the delayed closure of voltage‑gated and running nose with fever or sneezing.[11‑14] Research sodium ion channels in the nerve cells of insects, abroad has already established that prolonged use of resulting in repeated and extended nerve firings. This mats is harmful to several organs in the human body. It hyperexcitation causes loss of motor coordination and can lead to corneal damage, shortness of breath, asthma, paralysis and death of the insect [Figure 1]. Pairing the and might even damage the liver in long run.[15] Hence, we insecticide with synthetic synergists such as piperonyl decided to review the various health implications due to butoxide has helped overcome the resistance effects toxicological effects of prolonged use of mosquito coils, to pyrethrin. The combo of pyrethrin and piperonyl mats, and liquidators. butoxide compounds prevent detoxification in the insect thus ensures insect death. Pyrethrin is a potent insecticide, and it also functions as an insect repellent at PYRETHRUM VERSUS PYRETHIN lower concentrations as depicted in Figure 2. Pyrethrins HEALTH EFFECTS being an insecticide and insect repellent is very successful in reducing insect pest population affecting The role of pyrethrins as the potent chemical in the humans, livestock, crops, and pets as well potentially Chrysanthemum plants responsible for the insecticidal disease‑carrying mosquitoes, fleas, and ticks.[1,3,15] properties in the crushed flowers was identified around the year 1800 in Asia. Pyrethrins are the natural extracts of Mosquito coil, mats, and liquidators and safe Chrysanthemum cinerariaefolium and Chrysanthemum practices coccineum flowers. Pyrethroids, synthetic analogs, and Apart from the toxic effect due to prolonged use of derivatives of pyrethrins are globally used as insecticides pyrethrins‑based mosquito coil, mats, and liquidators, and are the most common content of mosquito coil, mats, lack of knowledge regarding health hazards and safe and liquidators. Pyrethrins and pyrethroids can enter the practices and lack of supervision and national guidelines organism by accidental ingestion, by inhalation and/or regarding accepted formulation of contents of mosquito by skin contact. These pesticides have relatively low‑risk coil, mats, and liquidators have led to increase risk of toxicity in mammals due to rapid metabolism with no health‑related illnesses. significant accumulation. They can induce adverse health effects on chronic exposure.[15] Fewer studies have been carried out to estimate the prevalence of usage, unsafe practices, and risk Pyrethrum and pyrethrins are extracted from plants of the perception of household pesticides in India. A study Chrysanthemum family. Pyrethrins are the improvised carried in this regard in rural South India revealed that purified versions of these extracts. Pyrethrins are the the most commonly used pesticides at homes were pesticide of choice as compared to organophosphates mosquito coils (75%), mosquito liquid vaporizers and organochlorides since other compounds have (36%), ant‑killing powder (24%), and moth/naphthalene significant and persistent toxic effects to humans. As balls (18%). Moreover, 61% of the mosquito coil users pyrethrins are biodegradable compounds and the purified kept the windows and doors closed while the coil was Pyrethrin Delays closure of voltage-gated sodium ion channels in the nerve cells of insects Results in repeated and extended nerve firing Loss of motor coordination and paralysis Hyper excitation leading to the death of the insect Figure 1: Pyrethrin as insecticide International Journal of Clinical and Experimental Physiology | Oct-Dec 2015 | Vol 2 | Issue 4 210 International Journal of Clinical and Experimental Physiology | Oct-Dec 2015 | Vol 2 | Issue 4 211 John and John: Prolonged use of mosquito coil, mats, and liquidators: A review of its health implications Pyrethrin at lower concentration Insects are not immediately killed but are driven to windowsills or near doorways At low dosage, insects are driven to leave the area before dying As insecticide and insect repellent, pyrethrins have been very successful in controlling insects, mosquitoes, fleas, and ticks. Figure 2: Pyrethrin as an insect and mosquito repellent burning. In addition about half of the users did not know The toxicological effects of fumes from two locally that household pesticides were harmful to their health. manufactured mosquito coil insecticides (with pyrethroids: The study recommended that the users of household transfluthrin and d‑allethrin as active ingredients) on male pesticides must be educated about the health hazards albino rats exposed to mosquito fumes during 2, 4, 8, and safe practices and nonchemical methods of pest 12, and 16 weeks period revealed significant increase control be promoted.[16] (P < 0.05) in the levels