Vol. 114, No. 9 PerspectivesOpen AccessComparing Risk of West Nile Virus against Risk of Adulticidingis companion ofWest Nile Virus: Peterson et al. Respond Steve Schofield, Martin Tepper, and Janick Lalonde Steve Schofield Search for more papers by this author , Martin Tepper Search for more papers by this author , and Janick Lalonde Search for more papers by this author Published:1 September 2006https://doi.org/10.1289/ehp.114-a519aCited by:2AboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit Peterson et al. (2006) compared the risk of ground-based ultra-low-volume (ULV) adulticiding against the risk of West Nile virus (WNV). They concluded that[B]y virtually any current human-health measure, the risks from infection by WNV exceed the risks from exposure to mosquito insecticides. Therefore, perceptions that human-health risks from the insecticides used to control adult mosquitoes are greater than the risks from WNV currently cannot be supported by the current scientific evidence.We appreciate their elegant analysis of health risks associated with residential exposure to ground-based ULV adulticides, and we concur that such risks are very low. However, we are concerned that their risk–risk comparison may be misinterpreted to indicate that the human health risk associated with adulticiding is more than offset by its potential for WNV disease reduction. Peterson et al. (2006) did not provide data to support this. Such a risk–benefit comparison requires at least two refinements.First, it needs to take into account intervention effectiveness. Although it is not unreasonable to expect some benefit, it is unlikely that adulticiding is completely (or even mostly) effective. Hence, a risk–benefit comparison would need to address the likely situation of adulticiding being substantially < 100% effective, for example, by reducing estimates of adulticiding-based benefit by a factor of 1/x, where x represents the effectiveness of adulticiding.Second, it needs to discount benefit based on upstream interventions. Adulticiding often takes place in the context of an integrated mosquito/WNV management program. In this situation, upstream approaches (e.g., larviciding, personal protection) discount the attributable benefit of downstream interventions (e.g., adulticiding). For example, use of larviciding and personal protection, respectively, providing y and z effectiveness, reduces the potential benefit of adulticiding by a factor of 1/[(1 − y) × (1 − z)].Where upstream interventions are used and are fairly effective and adulticiding is not (or even if it is), adulticiding-attributable disease reduction may by substantially less than overall WNV risk. For example, if larviciding is 75% effective, personal protection 90% effective, and adulticiding 10% effective, the risk reduction achieved through adulticiding would be 1/400th of the overall risk of WNV-related disease; that is,ReferencePeterson RKD, Macedo PA, Davis RS. 2006. A human-health risk assessment for West Nile virus and insecticides used in mosquito management. Environ Health Perspect 114:366-37216507459. Link, Google ScholarFiguresReferencesRelatedDetailsCited by Petersen L and Hayes E (2008) West Nile Virus in the Americas, Medical Clinics of North America, 10.1016/j.mcna.2008.07.004, 92:6, (1307-1322), Online publication date: 1-Nov-2008. Kramer L, Styer L and Ebel G (2008) A Global Perspective on the Epidemiology of West Nile Virus, Annual Review of Entomology, 10.1146/annurev.ento.53.103106.093258, 53:1, (61-81), Online publication date: 1-Jan-2008. Related articlesWest Nile Virus: Peterson et al. Respond1 September 2006Environmental Health Perspectives Vol. 114, No. 9 September 2006Metrics About Article Metrics Publication History Originally published1 September 2006Published in print1 September 2006 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected]. Our staff will work with you to assess and meet your accessibility needs within 3 working days.