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DEET is the longest lasting insect repellent, according to one study, but its safety for children is a concern. Here we list tips on choosing a repellent and how to minimize risks associated with DEET.

Summertime means outdoor activities, and nothing spoils outdoor enjoyment more than mosquitoes. West Nile virus makes contact with mosquitoes even more undesirable. While it appears that the elderly are the most vulnerable to the disease, most parents naturally worry about their children's safety. Other infections spread by mosquitoes and ticks* can also have worrisome health effects. In areas where insect-borne disease is rife, effective insect repellents may be necessary to keep children safe.

Thus begins the debate over which risk is greater, the risk of mosquito borne disease or the risk posed by toxic chemicals in insect repellants.

DEET has long been hailed as the king of repellants, but DEET can have side effects when overused, especially on children. Most cases of reported toxicity from DEET exposure are children under the age of 8.

The most frequently reported symptoms of DEET toxicity in children are lethargy, headaches, tremors, involuntary movements, seizures, and convulsions (Braissoulis et al. 2001; Osimitz and Grothaus 1995; Osimitz and Murphy 1997; Pronczuk de Garbino et al. 1983). It should be used properly and sparingly to reduce risks (see below for tips).

The State of New York banned repellants containing more that 30% concentrations of DEET. Industry filed a lawsuit against the State and eventually the next administration overturned the ban. Health Canada has banned formulations over 30%, as well, based on research showing that concentrations higher than this are no more effective.

According to a study in The New England Journal of Medicine, repellents containing 20 percent or more DEET offer 3-5 hours of protection against mosquitoes.

Products containing less than 10 percent DEET ward off mosquitoes for approximately one to two hours.

In stark contrast, the citronella and herbal products kept mosquitoes away for less than 20 minutes. A product containing IR3535 was about the same. The only natural product that lasted more than an hour was a soybean oil product called Bite Blocker for Kids, which the US Department of Agriculture found to be as effective as a 15% concentration of DEET and lasted for 4-8 hours.

Another botanical insect repellent containing oil of lemon eucalyptus [not the essential oil, but the plant derived active ingredient p-menthane 3,8-diol (PMD)] has been found by the CDC  to be as effective as low concentration DEET formulas, as well, lasting two hours on average. . We must warn that a few studies show that eucalyptus is poisonous in high concentrations if ingested, especially for young children. If you are considering a eucalyptus-based product, choose only those that contain low concentrations of eucalyptus. Do not use undiluted eucalyptus oil or extracts.

Which Repellent Should You Choose?

In the end, your choice of insect repellent for your children depends on several factors:

• The Environment If you'll be in areas where disease-bearing insects are problematic or in the deep woods where there are a lot of ticks and/or mosquitoes, you'll want strong and effective protection. Similarly, if your family is traveling to Africa or Asia, you'll need to take proper anti-malaria precautions.
• Length of Time Spent Outdoors If your children will be outdoors where mosquitoes are active for long periods of time, you'll want to make sure they have adequate protection.
• Time of Day Mosquitoes are active at dusk, but repellent is less necessary during the day, when mosquitoes tend to lie low.
• Water Activities If your children will be swimming or playing in water, you must take care to avoid applying too much repellent. Reapplying DEET-based products frequently can lead to overexposure and possible side effects. Avoid sunscreen/repellent combination products since you'll want to reapply sunscreen often. Care should also be taken with herbal products, since large doses of some herbs can be dangerous and little research has been conducted on the safety of herbs.

If you decide to use DEET:

DO NOT USE ANY DEET PRODUCT ON CHILDREN TWO MONTHS AND YOUNGER!

For children, use products that contain 10 percent or less DEET. While higher amounts of DEET last longer, the concentration may be too much for little bodies to handle. Concentrations above 10 percent should be reserved for "deep woods" situations, rather than backyard use. Formulas containing more than 30 percent DEET are not necessarily more effective and may result in overexposure, so avoid them.

Avoid repellents that contain permethrin or malathion, which are stronger pesticides and should not be applied to the skin, especially children's skin. Look at the label under "Active Ingredients" to be sure.

Try to keep your children covered with long pants and long-sleeved shirts to reduce the amount of exposed skin that must be treated with repellent. You can spray the repellent on clothing (best to do this away from the child, before he or she puts the clothing on).

Don't apply the DEET repellent on your child's hands. Children frequently put their hands in their mouths.

Use lotion or cream products (but not those combined with sunscreen) instead of sprays. Your child won't inhale as much of the repellent, and you'll waste less of it, since aerosol sprays tend to go all over the place. (If you want to treat clothing, spray them away from your child before he or she puts them on.)

As soon as you are indoors again, have your child wash off their skin and change clothes.

Always read and follow the directions on the label.

For more information, see:

Background on West Nile Virus, U.S. Centers for Disease Control and Prevention

CDC Lyme Disease Home Page

CDC Rocky Mountain Spotted Fever information

OVERKILL: Why Pesticide Spraying for West Nile Virus May Cause More Harm Than Good, prepared by the Toxics Action Center and Maine Environmental Policy Institute

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