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Revision as of 13:36, 19 October 2011 editBeetstra (talk | contribs)Edit filter managers, Administrators172,031 edits Script assisted update of identifiers for the Chem/Drugbox validation project (updated: '').← Previous edit		Latest revision as of 02:31, 20 December 2024 edit undoIra Leviton (talk | contribs)Extended confirmed users330,714 editsm Fixed a reference. Please see Category:CS1 errors: unrecognized parameter.
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			{{Short description|Organochloride known for its insecticidal properties}}
	{{Other uses}}		{{Other uses}}
			{{Use mdy dates|date=April 2014}}
	{{chembox
			{{Chembox
	| verifiedrevid = 443557239
			| Verifiedfields = correct
	|Name=DDT
			| Watchedfields = correct
	|ImageFile=p,p'-dichlorodiphenyltrichloroethane.svg
			| verifiedrevid = 456348813
	|ImageSize=200px
			| Name = Dichlorodiphenyltrichloroethane
	|ImageFile1=DDT-from-xtal-3D-balls.png
			| ImageFile1 = p,p'-dichlorodiphenyltrichloroethane.svg
	|ImageFile2=DDT-from-xtal-3D-vdW.png
			| ImageClass1 = skin-invert-image
	|ImageName=Chemical structure of DDT
			| ImageFileL2 = DDT-from-xtal-3D-balls.png
	|IUPACName=1,1,1-trichloro-2,2-di(4-chlorophenyl)ethane
			| ImageFileR2 = DDT-from-xtal-3D-vdW.png
			| ImageName1 = Chemical structure of DDT
			| ImageFile3 = DDT_chemical_on_watch_glass.png
			| PIN = 1,1′-(2,2,2-Trichloroethane-1,1-diyl)bis(4-chlorobenzene)
			| OtherNames = Dichlorodiphenyltrichloroethane ''(DDT)''<br/>Clofenotane
	|Section1={{Chembox Identifiers		|Section1={{Chembox Identifiers
	|PubChem = 3036		| PubChem = 3036
	| UNII_Ref = {{fdacite|correct|FDA}}		| UNII_Ref = {{fdacite|correct|FDA}}
	| UNII = CIW5S16655		| UNII = CIW5S16655
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	| InChIKey = YVGGHNCTFXOJCH-UHFFFAOYAJ		| InChIKey = YVGGHNCTFXOJCH-UHFFFAOYAJ
	| ChEMBL_Ref = {{ebicite|correct|EBI}}		| ChEMBL_Ref = {{ebicite|correct|EBI}}
	| ChEMBL = <!-- blanked - oldvalue: 416898 -->		| ChEMBL = 416898
	| StdInChI_Ref = {{stdinchicite|correct|chemspider}}		| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
	| StdInChI = 1S/C14H9Cl5/c15-11-5-1-9(2-6-11)13(14(17,18)19)10-3-7-12(16)8-4-10/h1-8,13H		| StdInChI = 1S/C14H9Cl5/c15-11-5-1-9(2-6-11)13(14(17,18)19)10-3-7-12(16)8-4-10/h1-8,13H
	| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}		| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
	| StdInChIKey = YVGGHNCTFXOJCH-UHFFFAOYSA-N		| StdInChIKey = YVGGHNCTFXOJCH-UHFFFAOYSA-N
	| CASNo=50-29-3		| CASNo = 50-29-3
	|CASNo_Ref = {{cascite|correct|CAS}}		| CASNo_Ref = {{cascite|correct|CAS}}
	|ATCCode_prefix=P03
	|ATCCode_suffix=AB01
	|ATC_Supplemental={{ATCvet|P53|AB01}}
	| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}		| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
	| ChemSpiderID=2928		| ChemSpiderID=2928
	| ChEBI_Ref = {{ebicite|correct|EBI}}		| ChEBI_Ref = {{ebicite|correct|EBI}}
	| ChEBI = 16130		| ChEBI = 16130
	| SMILES=Clc1ccc(cc1)C(c2ccc(Cl)cc2)C(Cl)(Cl)Cl}}		| SMILES = ClC1=CC=C(C(C(Cl)(Cl)Cl)C2=CC=C(C=C2)Cl)C=C1
			}}
	|Section2={{Chembox Properties		|Section2={{Chembox Properties
	|Formula={{chem|C|14|H|9|Cl|5}}		| C=14 | H=9 | Cl=5
	|MolarMass=354.49&nbsp;g/mol		| Density = 0.99&nbsp;g/cm<sup>3</sup>
			| MeltingPtC = 108.5
	|Density=0.99&nbsp;g/cm³<ref name="ATSDRc5"/>
			| BoilingPtC = 260
	|MeltingPt=108.5&nbsp;°C
			| BoilingPt_notes = (decomposes)
	|BoilingPt=260&nbsp;°C (decomp.)}}
			| Solubility = 25 μg/L (25 °C)<ref name="ATSDRc5"/>
			}}
			| Section6 = {{Chembox Pharmacology
			| Pharmacology_ref =
			| ATCCode_prefix = P53
			| ATCCode_suffix = AB01
			| ATCvet = yes
			| Licence_EU =
			| INN =
			| INN_EMA =
			| Licence_US =
			| Legal_status =
			| Legal_AU =
			| Legal_AU_comment =
			| Legal_CA =
			| Legal_CA_comment =
			| Legal_NZ =
			| Legal_NZ_comment =
			| Legal_UK =
			| Legal_UK_comment =
			| Legal_US =
			| Legal_US_comment =
			| Legal_EU =
			| Legal_EU_comment =
			| Legal_UN =
			| Legal_UN_comment =
			| Pregnancy_category =
			| Pregnancy_AU =
			| Pregnancy_AU_comment =
			| Dependence_liability =
			| AdminRoutes =
			| Bioavail =
			| ProteinBound =
			| Metabolism =
			| Metabolites =
			| OnsetOfAction =
			| HalfLife =
			| DurationOfAction =
			| Excretion =
			}}
	|Section7={{Chembox Hazards		|Section7={{Chembox Hazards
			| MainHazards = Toxic, dangerous to the environment, suspected carcinogen
	|EUClass={{Hazchem T}} {{Hazchem N}}
			| FlashPtF = 162-171
	|EUIndex=
			| FlashPt_ref = <ref name=PGCH>{{PGCH|0174}}</ref>
	|MainHazards=T, N
			| NFPA-H = 2
	|RPhrases={{R25}} {{R40}} {{R48/25}} {{R50/53}}
			| NFPA-F = 2
	|SPhrases={{(S1/2)}} {{S22}} {{S36/37}} {{S45}} {{S60}} {{S61}}
			| NFPA-R = 0
	|LD50=113 mg/kg (rat)}}
			| NFPA-S =
			| GHSPictograms = {{GHS06}}{{GHS08}}{{GHS09}}
			| GHSSignalWord = Danger
			| HPhrases = {{H-phrases|301|350|372|410}}
			| PPhrases = {{P-phrases|201|202|260|264|270|273|281|301+310|308+313|314|321|330|391|405|501}}
			| PEL = TWA 1 mg/m<sup>3</sup>
			| IDLH = 500 mg/m<sup>3</sup>
			| REL = Ca TWA 0.5 mg/m<sup>3</sup>
			| NIOSH_id = 0174
			| LD50= 113–800 mg/kg (rat, oral)<ref name="ATSDRc5"/><br /> 250 mg/kg (rabbit, oral)<br />135 mg/kg (mouse, oral)<br />150 mg/kg (guinea pig, oral)<ref>{{IDLH|50293|DDT}}</ref>
			}}
	}}		}}
			'''Dichlorodiphenyltrichloroethane''', commonly known as '''DDT''', is a colorless, tasteless, and almost odorless ] chemical compound,<ref name=EHC009/> an ]. Originally developed as an ], it became infamous for its ]. DDT was first synthesized in 1874 by the Austrian chemist ]. DDT's insecticidal action was discovered by the Swiss chemist ] in 1939. DDT was used in the second half of ] to limit the spread of the insect-borne diseases ] and ] among civilians and troops. Müller was awarded the ] in 1948 "for his discovery of the high efficiency of DDT as a contact poison against several ]".<ref name="nobel">{{cite web|url=https://www.nobelprize.org/prizes/medicine/1948/summary/|publisher=Nobel Prize Outreach AB|title=The Nobel Prize in Physiology of Medicine 1948|access-date=July 26, 2007|archive-date=May 23, 2020|archive-url=https://web.archive.org/web/20200523072153/https://www.nobelprize.org/prizes/medicine/1948/summary/|url-status=live}}</ref> The ]'s anti-malaria campaign of the 1950s and 1960s relied heavily on DDT and the results were promising, though there was a resurgence in developing countries afterwards.<ref name="DDTBP.1/2"/><ref name="Feachem2007"/>
	'''DDT''' (from its ], '''d'''ichloro'''d'''iphenyl'''t'''richloroethane) is one of the most well-known synthetic ]s. It is a chemical with a long, unique, and controversial history.
			By October 1945, DDT was available for public sale in the United States. Although it was promoted by government and industry for use as an agricultural and household pesticide, there were also concerns about its use from the beginning.<ref name="Distillations"/> Opposition to DDT was focused by the 1962 publication of ]'s book '']''. It talked about environmental impacts that correlated with the widespread use of DDT in agriculture in the United States, and it questioned the logic of broadcasting potentially dangerous chemicals into the environment with little prior investigation of their environmental and health effects. The book cited claims that DDT and other pesticides caused ] and that their agricultural use was a threat to wildlife, particularly birds. Although Carson never directly called for an outright ban on the use of DDT, its publication was a seminal event for the ] and resulted in a large public outcry that eventually led, in 1972, to a ban on DDT's agricultural use in the United States.<ref name="Lear">{{cite book|first=Linda|last=Lear|title=Rachel Carson: Witness for Nature|url=https://books.google.com/books?id=36euz6DjmwUC|year=2009|publisher=Mariner Books|isbn=978-0-547-23823-4|access-date=August 29, 2022|archive-date=October 19, 2021|archive-url=https://web.archive.org/web/20211019215711/https://books.google.com/books?id=36euz6DjmwUC|url-status=live}}</ref> Along with the passage of the ], the United States ban on DDT is a major factor in the comeback of the ] (the ]) and the ] from near-extinction in the ].<ref name=Stokstad07>{{cite journal | vauthors = Stokstad E | s2cid = 5051469 | title = Species conservation. Can the bald eagle still soar after it is delisted? | journal = Science | volume = 316 | issue = 5832 | pages = 1689–1690 | date = June 2007 | pmid = 17588911 | doi = 10.1126/science.316.5832.1689 }}</ref><ref>], Fact Sheet: Natural History, Ecology, and History of Recovery {{Webarchive|url=https://web.archive.org/web/20200521110616/https://www.fws.gov/midwest/eagle/recovery/biologue.html|date=May 21, 2020}}</ref>
	First synthesized in 1874, DDT's insecticidal properties were not discovered until 1939, and it was used with great success in the second half of ] to control ] and ] among civilians and troops. The Swiss chemist ] was awarded the ] in 1948 "for his discovery of the high efficiency of DDT as a contact poison against several arthropods."<ref name=nobel> Accessed July 26, 2007.</ref> After the war, DDT was made available for use as an agricultural ], and soon its production and use skyrocketed.<ref name=EHC9>, World Health Organization, 1979.</ref>
			The evolution of DDT resistance and the harm both to humans and the environment led many governments to curtail DDT use.<ref name=Chapin81/> A worldwide ban on agricultural use was formalized under the ], which has been in effect since 2004. Recognizing that total elimination in many malaria-prone countries is currently unfeasible in the absence of affordable/effective alternatives for disease control, the convention exempts public health use within ] (WHO) guidelines from the ban.<ref name="Stockholm"/>
	In 1962, '']'' by American biologist ] was published. The book catalogued the environmental impacts of the indiscriminate spraying of DDT in the US and questioned the logic of releasing large amounts of chemicals into the environment without fully understanding their effects on ecology or human health. The book suggested that DDT and other pesticides may cause ] and that their agricultural use was a threat to wildlife, particularly birds. Its publication was one of the signature events in the birth of the ], and resulted in a large public outcry that eventually led to DDT being banned in the US in 1972.<ref name="Lear"/> DDT was subsequently banned for agricultural use worldwide under the ], but its limited use in ] ] continues to this day and remains controversial.<ref name="Larson">{{cite journal|last=Larson|first=Kim|date=December 1, 2007|title=Bad Blood|journal=On Earth|issue=Winter 2008|url=http://www.onearth.org/article/bad-blood?|accessdate=2008-06-05}}</ref><ref name=moyers>{{Citation | last = Moyers | first = Bill | author-link = Bill Moyers | title = Rachel Carson and DDT | date = 2007-09-21 | year = 2007 | url = http://www.pbs.org/moyers/journal/09212007/profile2.html | accessdate = 2011-03-05}}</ref>
			DDT still has limited use in ] ] because of its effectiveness in killing ]s and thus reducing ]l infections, but that use is controversial due to environmental and health concerns.<ref name="Larson">{{cite journal |last=Larson |first=Kim |name-list-style=vanc |date=December 1, 2007 |title=Bad Blood |journal=On Earth |issue=Winter 2008 |url=http://www.onearth.org/article/bad-blood |access-date=June 5, 2008 |archive-date=April 13, 2020 |archive-url=https://web.archive.org/web/20200413043917/https://www.nrdc.org/onearth |url-status=dead }}</ref><ref name=moyers>{{cite news |last=Moyers |first=Bill |name-list-style=vanc |author-link=Bill Moyers |title=Rachel Carson and DDT |work=Bill Moyers Journal |publisher=PBS |date=September 21, 2007 |url=https://www.pbs.org/moyers/journal/09212007/profile2.html |access-date=March 5, 2011 |archive-date=April 25, 2011 |archive-url=https://web.archive.org/web/20110425233245/http://www.pbs.org/moyers/journal/09212007/profile2.html |url-status=live }}</ref> DDT is one of many tools to fight malaria, which remains the primary ] challenge in many countries. WHO guidelines require that absence of DDT resistance must be confirmed before using it.<ref name="IRS-WHO"/> Resistance is largely due to agricultural use, in much greater quantities than required for disease prevention.<ref name="IRS-WHO"/>
	Along with the passage of the ], the US ban on DDT is cited by scientists as a major factor in the comeback of the ], the ], from near-] in the contiguous US.<ref name="pmid17588911">
	{{cite journal |author=Stokstad E |title=Species conservation. Can the bald eagle still soar after it is delisted? |journal=Science |volume=316 |issue=5832 |pages=1689–90 |year=2007 |month=June |pmid=17588911 |doi=10.1126/science.316.5832.1689 |url=http://www.sciencemag.org/cgi/content/summary/316/5832/1689}}</ref>
	==Properties and chemistry==		==Properties and chemistry==
	DDT is an ], similar in structure to the insecticide ] and the ] ]. It is a highly ], colorless, ]line solid with a weak, chemical ]. It is nearly ] in ] but has a good solubility in most ] ]s, ]s, and ]. DDT does not occur naturally, but is produced by the reaction of ] ({{chem|CCl|3|CHO}}) with ] ({{chem|C|6|H|5|Cl}}) in the presence of ], which acts as a ]. Trade names that DDT has been marketed under include Anofex, Cezarex, Chlorophenothane, Clofenotane, Dicophane, Dinocide, Gesarol, Guesapon, Guesarol, Gyron, Ixodex, Neocid, Neocidol, and Zerdane.<ref name=EHC9/>		DDT is similar in structure to the insecticide ] and the ] ]. It is highly ] and nearly ] in ] but has good solubility in most ] ]s, ]s and ]s. DDT does not occur naturally and is synthesised by consecutive ]s between ] ({{chem|CCl|3|CHO}}) and two ] of ] ({{chem|C|6|H|5|Cl}}), in the presence of an acidic ].<ref name="ATSDRc5"/> DDT has been marketed under ]s including Anofex, Cezarex, Chlorophenothane, Dicophane, Dinocide, Gesarol, Guesapon, Guesarol, Gyron, Ixodex, Neocid, Neocidol and Zerdane; ] is clofenotane.<ref name=EHC009/>
	===Isomers and related compounds===		===Isomers and related compounds===
			Commercial DDT is a mixture of several closely related compounds. Due to the nature of the chemical reaction used to synthesize DDT, several combinations of ''ortho'' and ''para'' ]s are formed. The major component (77%) is the desired ''p'',''p{{'}}'' ]. The ''o'',''p{{'}}'' isomeric impurity is also present in significant amounts (15%). ] (DDE) and ] (DDD) make up the balance of impurities in commercial samples. DDE and DDD are also the major ]s and environmental breakdown products.<ref name=EHC009/> DDT, DDE and DDD are sometimes referred to collectively as DDX.<ref>{{cite journal |pmid=22020740 |journal=J. Environ. Monit. |date=December 2011 |volume=13 |issue=12 |pages=3358–3364 |doi=10.1039/c1em10479a |title=Sources of organochlorine pesticides in air in an urban Mediterranean environment: volatilisation from soil |first1=G. |last1=Lammel |s2cid=22071869 |display-authors=et al }}</ref>
	]
	Commercial DDT is a mixture of several closely–related compounds. The major component (77%) is the '']'',''p' '' ] which is pictured at the top of this article. The ''o'',''p' '' isomer (pictured to the right) is also present in significant amounts (15%). ] (DDE) and ] (DDD) make up the balance. DDE and DDD are also the major ]s and breakdown products in the environment.<ref name=EHC9/> The term "'''total DDT'''" is often used to refer to the sum of all DDT related compounds (''p,p'-''DDT, ''o,p'-''DDT, DDE, and DDD) in a sample.
			<gallery mode="packed" heights="100" caption="Components of commercial DDT" class="skin-invert-image">
	===Production and use statistics===
			File:P,p'-dichlorodiphenyltrichloroethane.svg|''p'',''p{{'}}''-DDT<br />(desired compound)
	From 1950 to 1980, DDT was extensively used in ]—more than 40,000 ] were used each year worldwide<ref name="Geisz">{{
			File:O,p'-dichlorodiphenyltrichloroethane.svg|''o'',''p{{'}}''-DDT<br />(isomeric impurity)
	cite journal |author=Geisz HN, Dickhut RM, Cochran MA, Fraser WR, Ducklow HW |title=Melting Glaciers: A Probable Source of DDT to the Antarctic Marine Ecosystem |journal=Environ. Sci. Technol. |volume=ASAP |page= 3958|year=2005 |doi=10.1021/es702919n |url=http://pubs.acs.org/cgi-bin/abstract.cgi/esthag/asap/abs/es702919n.html |accessdate=2008-05-07}}</ref>—and it has been estimated that a total of 1.8 million tonnes have been produced globally since the 1940s.<ref name="ATSDRc5"> ], September 2002.</ref> In the U.S., where it was manufactured by ],<ref>{{cite news|url=http://www.al.com/news/mobileregister/index.ssf?/base/news/1215162908145190.xml&coll=3|title=McIntosh residents file suit against Ciba|last=DAVID|first=DAVID|date=July 4, 2008|accessdate=2008-07-07|archiveurl = http://www.webcitation.org/5uKxNtMeS |archivedate = 2010-11-18|deadurl=no}}</ref> ], Pennwalt<ref name="Oregon DEQ 2009">
			File:P,p'-dichlorodiphenyldichloroethene.svg|''p'',''p{{'}}''-DDE<br />(impurity)
	, Oregon DEQ, April 2009.</ref> and ],<ref>{{
			File:P,p'-dichlorodiphenyldichloroethane.svg|''p'',''p{{'}}''-DDD<br />(impurity)
	cite news |url=http://www.themorningsun.com/stories/012708/loc_tests.shtml| title=Tests shed light on how pCBSA got into St. Louis water|last=Rosemary|first=Rosemary|date=2008-01-27|publisher=Morning Sun|accessdate=2008-05-16}} {{Dead link|date=September 2010|bot=H3llBot}}</ref> production peaked in 1963 at 82,000 tonnes per year.<ref name=EHC9/> More than 600,000 tonnes (1.35 billion lbs) were applied in the U.S. before the 1972 ban. Usage peaked in 1959 at about 36,000 tonnes.<ref name="EPA1975">
			</gallery>
	, U.S. EPA, July 1975.</ref>
			===Production and use===
	In 2009, 3314 tonnes were produced for the control of malaria and ]. India is the only country still manufacturing DDT, with China having ceased production in 2007.<ref name=EG.3>Report of the Third Expert Group Meeting on DDT, UNEP/POPS/DDT-EG.3/3, Stockholm Convention on Persistent Organic Pollutants, November 12, 2010. Available .</ref> India is the largest consumer.<ref name="DDTBP.1/2">{{cite web|url=http://www.pops.int/documents/ddt/Global%20status%20of%20DDT%20SSC%2020Oct08.pdf|title=Global status of DDT and its alternatives for use in vector control to prevent disease|last=van den Berg|first=Henk|coauthors=Secretariat of the ]|date=October 23, 2008|publisher=]/]|accessdate=2008-11-22|archiveurl = http://www.webcitation.org/5uKxOub8a |archivedate = 2010-11-18|deadurl=no}}</ref>
			DDT has been formulated in multiple forms, including ]s in ] or ] ], ] ]s, water-]s, granules, ]s, ] and charges for vaporizers and lotions.<ref name=EHC83>{{EHC-ref | id = 83 | name = DDT and Its Derivatives: Environmental Aspects | isbn = 9241542837 |date=1989 }}</ref>
			From 1950 to 1980, DDT was extensively used in agriculture{{snd}}more than 40,000 ] each year worldwide<ref name="Geisz">{{cite journal | vauthors = Geisz HN, Dickhut RM, Cochran MA, Fraser WR, Ducklow HW | title = Melting glaciers: a probable source of DDT to the Antarctic marine ecosystem | journal = Environmental Science & Technology | volume = 42 | issue = 11 | pages = 3958–3962 | date = June 2008 | pmid = 18589951 | doi = 10.1021/es702919n | bibcode = 2008EnST...42.3958G | url = https://scholarworks.wm.edu/cgi/viewcontent.cgi?article=1984&context=vimsarticles | access-date = August 26, 2020 | archive-date = August 29, 2022 | archive-url = https://web.archive.org/web/20220829055157/https://scholarworks.wm.edu/cgi/viewcontent.cgi?article=1984&context=vimsarticles | url-status = live }}</ref>{{snd}}and it has been estimated that a total of 1.8 million tonnes have been produced globally since the 1940s.<ref name="ATSDRc5"> {{Webarchive|url=https://web.archive.org/web/20211125124535/https://wwwn.cdc.gov/TSP/ToxProfiles/ToxProfiles.aspx?id=81&tid=20 |date=November 25, 2021 }}. ], September 2002.</ref> In the United States, it was manufactured by some 15 companies, including ], ],<ref>{{cite news|url=http://www.al.com/news/mobileregister/index.ssf?/base/news/1215162908145190.xml&coll=3|title=McIntosh residents file suit against Ciba|last=David|first=David|name-list-style=vanc|date=July 4, 2008|access-date=July 7, 2008|archive-url=https://web.archive.org/web/20090808020048/http://www.al.com/news/mobileregister/index.ssf?%2Fbase%2Fnews%2F1215162908145190.xml&coll=3|archive-date=August 8, 2009|url-status=dead|df=mdy-all}}</ref> ], ],<ref name="Oregon DEQ 2009"> {{Webarchive|url=https://web.archive.org/web/20110723023510/http://www.deq.state.or.us/lq/ECSI/ecsidetail.asp?seqnbr=398 |date=July 23, 2011 }}, Oregon DEQ, April 2009.</ref> and ].<ref>{{cite news |url=http://www.themorningsun.com/stories/012708/loc_tests.shtml| title=Tests shed light on how pCBSA got into St. Louis water |last=Horvath |first=Rosemary | name-list-style = vanc |date=January 27, 2008 |newspaper=Morning Sun |location=Michigan, United States |publisher=] |access-date=May 16, 2008 |archive-url=https://web.archive.org/web/20080705170443/http://www.themorningsun.com/stories/012708/loc_tests.shtml |archive-date=July 5, 2008 }}</ref> Production peaked in 1963 at 82,000 tonnes per year.<ref name=EHC009/> More than 600,000 tonnes (1.35 billion pounds) were applied in the US before the 1972 ban. Usage peaked in 1959 at about 36,000 tonnes.<ref name="EPA1975"> {{Webarchive|url=https://web.archive.org/web/20161220162916/https://archive.epa.gov/epa/aboutepa/ddt-regulatory-history-brief-survey-1975.html |date=December 20, 2016 }}, U.S. EPA, July 1975.</ref>
	===Mechanism of insecticide action===
	In insects it opens ] in ]s, causing them to fire spontaneously, which leads to spasms and eventual death. Insects with certain ]s in their sodium channel ] are resistant to DDT and other similar insecticides. DDT resistance is also conferred by up-regulation of genes expressing ] in some insect species.<ref>{{
	cite journal |author=Denholm I, Devine GJ, Williamson MS |title=Evolutionary genetics. Insecticide resistance on the move |journal=Science |volume=297 |issue=5590 |pages=2222–3 |year=2002 |pmid=12351778 |doi=10.1126/science.1077266}}</ref>
			China ceased production in 2007,<ref>{{cite web |url=http://chm.pops.int/Programmes/DDT/Meetings/DDTEG32010/tabid/1108/mctl/ViewDetails/EventModID/1421/EventID/116/xmid/4037/language/en-US/Default.aspx |title=Report of the Third Expert Group Meeting on DDT |publisher=UNEP/POPS/DDT-EG.3/3, Stockholm Convention on Persistent Organic Pollutants |date=November 12, 2010 |access-date=January 26, 2011 |archive-date=December 21, 2010 |archive-url=https://web.archive.org/web/20101221115754/http://chm.pops.int/Programmes/DDT/Meetings/DDTEG32010/tabid/1108/mctl/ViewDetails/EventModID/1421/EventID/116/xmid/4037/language/en-US/Default.aspx |url-status=live }}</ref> leaving India the only country still manufacturing DDT; it is the largest consumer.<ref name="DDTBP.1/2">{{cite web|url=http://www.pops.int/documents/ddt/Global%20status%20of%20DDT%20SSC%2020Oct08.pdf|title=Global status of DDT and its alternatives for use in vector control to prevent disease|last=van den Berg|first=Henk|name-list-style=vanc|date=October 23, 2008|publisher=]/]|access-date=November 22, 2008|archive-url=https://web.archive.org/web/20101217022138/http://www.pops.int/documents/ddt/Global%20status%20of%20DDT%20SSC%2020Oct08.pdf|archive-date=December 17, 2010|url-status=dead|df=mdy-all}}</ref> In 2009, 3,314 tonnes were produced for malaria control and ]. In recent years, in addition to India, just seven other countries, all in Africa, are still using DDT.<ref>{{Cite web |date=September 13, 2017 |title=Alternatives to DDT |url=http://www.unep.org/topics/chemicals-and-pollution-action/pollution-and-health/persistent-organic-pollutants-pops-0 |access-date=2024-06-10 |website=UNEP - UN Environment Programme |language=en}}</ref>
	In humans, however, it may affect health through ] or ]. ''See ]''.
			===Mechanism of insecticide action===
			In insects, DDT opens ] in ]s, causing them to fire spontaneously, which leads to spasms and eventual death.<ref name=":1">{{Cite journal|last=Dong|first=Ke|date=2007-01-06|title=Insect sodium channels and insecticide resistance|journal=Invertebrate Neuroscience |volume=7|issue=1|pages=17–30|doi=10.1007/s10158-006-0036-9|issn=1354-2516|pmc=3052376|pmid=17206406}}</ref> Insects with certain ]s in their sodium channel ] are ] to DDT and similar insecticides.<ref name=":1" /> DDT resistance is also conferred by up-regulation of genes expressing ] in some insect species,<ref>{{cite journal | vauthors = Denholm I, Devine GJ, Williamson MS | title = Insecticide resistance on the move | journal = Science | volume = 297 | issue = 5590 | pages = 2222–2223 | date = September 2002 | pmid = 12351778 | doi = 10.1126/science.1077266 | s2cid = 83741532}}</ref> as greater quantities of some enzymes of this group accelerate the toxin's metabolism into inactive metabolites. Genomic studies in the model genetic organism '']'' revealed that high level DDT resistance is polygenic, involving multiple resistance mechanisms.<ref>{{cite journal | vauthors = Pedra JH, McIntyre LM, Scharf ME, Pittendrigh BR | title = Genome-wide transcription profile of field- and laboratory-selected dichlorodiphenyltrichloroethane (DDT)-resistant ''Drosophila'' | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 101 | issue = 18 | pages = 7034–7039 | date = May 2004 | pmid = 15118106 | pmc = 406461 | doi = 10.1073/pnas.0400580101 | bibcode = 2004PNAS..101.7034P | doi-access = free }}</ref> In the absence of genetic adaptation, Roberts and Andre 1994 find ] nonetheless provides insects with some protection against DDT.<ref name="Bijlsma-Loeschcke-2011">{{cite journal | title=Genetic erosion impedes adaptive responses to stressful environments | last1=Bijlsma | first1=R. | last2=Loeschcke | first2=Volker | journal=] | publisher=] | issn=1752-4571 | date=7 November 2011 | volume=5 | issue=2 | pages=117–129 | doi=10.1111/j.1752-4571.2011.00214.x | pmid=25568035 | pmc=3353342 | s2cid=18877551}}</ref> The ] mutation event produces dramatic '']'' for ]s but Usherwood et al. 2005 find it is entirely ineffective against DDT.<ref name="Scott-2019">{{cite journal | last=Scott | first=Jeffrey G. | title=Life and Death at the Voltage-Sensitive Sodium Channel: Evolution in Response to Insecticide Use | journal=] | publisher=] | volume=64 | issue=1 | date=2019-01-07 | issn=0066-4170 | doi=10.1146/annurev-ento-011118-112420 | pages=243–257| pmid=30629893 | s2cid=58667542 }}</ref> Scott 2019 believes this test in ''Drosophila'' ]s holds for oocytes in general.<ref name="Scott-2019" />
	==History==		==History==
	]		]
			] Néocide (powder box, 50 g) containing 10% DDT, made in France.]]
	]. ]] DDT ; ''"Destroys parasites such as fleas, lice, ants, bedbugs, cockroaches, flies, etc.. Néocide Sprinkle caches of vermin and the places where there are insects and their places of passage. Leave the powder in place as long as possible. " "Destroy the parasites of man and his dwelling". "Death is not instantaneous, it follows inevitably sooner or later. " "French manufacturing" ; "harmless to humans and warm-blooded animals" "sure and lasting effect. Odorless.'' ]]
			{{external media | width =175px | float = right | headerimage= ] | audio1 = , ]}}
			DDT was first synthesized in 1874 by ] under the supervision of ].<ref>{{cite journal | author = Othmar Zeidler | year = 1874 | title = Verbindungen von Chloral mit Brom- und Chlorbenzol |trans-title=Compounds of chloral with bromo- and chlorobenzene | journal = Berichte der Deutschen Chemischen Gesellschaft | volume = 7 | issue = 2 | pages = 1180–1181 | url = http://babel.hathitrust.org/cgi/pt?id=uiug.30112025694776;view=1up;seq=231 | archive-url = https://archive.today/20160420035142/http://babel.hathitrust.org/cgi/pt?id=uiug.30112025694776;view=1up;seq=231 | url-status = dead | archive-date = 2016-04-20 | doi = 10.1002/cber.18740070278 }} On p. 1181, Zeidler called DDT ''dimonochlorphenyltrichloräthan''.</ref><ref name="augustin">{{cite book |last=Augustin |first=Frank |name-list-style=vanc |title=Zur Geschichte des Insektizids Dichlordiphenyltrichloräthan (DDT) unter besonderer Berücksichtigung der Leistung des Chemikers Paul Müller (1899–1965) |url=https://books.google.com/books?id=hY5btwAACAAJ&pg=PA1 |year=1993 |publisher=Medizinische Fakultät der Universität Leipzig |location=Leipzig |pages=1–77 |access-date=August 29, 2022 |archive-date=July 31, 2020 |archive-url=https://web.archive.org/web/20200731150524/https://books.google.com/books?id=hY5btwAACAAJ&pg=PA1 |url-status=live }}</ref><!--Augustin claims that Baeyer synthesized it already in 1872--> It was further described in 1929 in a dissertation by W. Bausch and in two subsequent publications in 1930.<ref>{{cite journal | vauthors = Brand K, Bausch W | title = Über Verbindungen der Tetraaryl-butanreihe. 10. Mitteilung. Über die Reduktion organischer Halogenverbindungen und Über Verbindungen der Tetraaryl-butanreihe | journal = Journal für Praktische Chemie | volume = 127 | pages = 219–239 | year = 1930 | doi = 10.1002/prac.19301270114 }}</ref><ref>{{cite journal | vauthors = Brand K, Horn O, Bausch W | title = Die elektrochemische Darstellung von 1,1,4,4-''p'',''p′'',''p"'',''p‴''-Tetraphenetyl-butin-2 und von 1,1,4,4-''p'',''p′'',''p"'',''p‴''-Tetra(chlorphenyl)-butin-2. 11. Mitteilung. Über die Reduktion organischer Halogenverbindungen und Verbindungen der Tetraarylbutanreihe | journal = Journal für Praktische Chemie | volume = 127 | pages = 240–247 | year = 1930 | doi = 10.1002/prac.19301270115 }}</ref> The insecticide properties of "multiple chlorinated aliphatic or fat-aromatic alcohols with at least one trichloromethane group" were described in a patent in 1934 by Wolfgang von Leuthold.<ref>Wolfgang von Leuthold, Schädlingsbekämpfung. DRP Nr 673246, April 27, 1934</ref> DDT's insecticidal properties were not, however, discovered until 1939 by the ] scientist ], who was awarded the 1948 ] for his efforts.<ref name=nobel/>
	First synthesized in 1874 by ],<ref name=EHC9/> DDT's insecticidal properties were not discovered until 1939 by the ] scientist ], who was awarded the 1948 ] in Physiology and Medicine for his efforts.<ref name=nobel/>
	===Use in the 1940s and 1950s===		===Use in the 1940s and 1950s===
			] as part of a ] control project, 1955]]
	DDT is the best-known of several ]-containing pesticides used in the 1940s and 1950s. With ] in short supply, DDT was used extensively during World War II by the ] to control the insect ] of ] — nearly eliminating the disease in many parts of ]. In the ], it was sprayed aerially for malaria control with spectacular effects. While DDT's chemical and insecticidal properties were important factors in these victories, advances in application equipment coupled with a high degree of organization and sufficient manpower were also crucial to the success of these programs.<ref name="Dunlap">{{
			] (])]]
	cite book|last=Dunlap|first=Thomas R.|title=DDT: Scientists, Citizens, and Public Policy|publisher=Princeton University Press|location=New Jersey|year=1981|isbn=978-0-691-04680-8}}</ref> In 1945, it was made available to farmers as an agricultural insecticide,<ref name=EHC9/> and it played a minor role in the final elimination of malaria in Europe and ].<ref name="Larson"/> By the time DDT was introduced in the U.S., the disease had already been brought under control by a variety of other means.<ref name="OreskesErik M. Conway2010">{{
			DDT is the best-known of several ]-containing pesticides used in the 1940s and 1950s. During this time, the use of DDT was driven by protecting American soldiers from diseases in tropical areas. Both British and American scientists hoped to use it to control spread of ], ], ], and ] among overseas soldiers, especially considering that the pyrethrum was harder to access since it came mainly from Japan.<ref name="auto">{{Cite web |last=Sonnenberg |first=J. |date=2015-05-02 |title=Shoot to Kill: Control and Controversy in the History of DDT Science |url=https://www.stanford.edu/group/sjph/cgi-bin/sjphsite/shoot-to-kill-control-and-controversy-in-the-history-of-ddt-science/ |access-date=2022-04-09 |website=Stanford Journal of Public Health |language=en-US |archive-date=August 29, 2022 |archive-url=https://web.archive.org/web/20220829055112/https://web.stanford.edu/group/sjph/cgi-bin/sjphsite/shoot-to-kill-control-and-controversy-in-the-history-of-ddt-science/ |url-status=live }}</ref><ref>{{Cite web |title=The Deadly Dust: The Unhappy History Of DDT |url=https://www.americanheritage.com/deadly-dust-unhappy-history-ddt |access-date=2022-04-09 |website=AMERICAN HERITAGE |language=en |archive-date=April 9, 2022 |archive-url=https://web.archive.org/web/20220409133455/https://www.americanheritage.com/deadly-dust-unhappy-history-ddt |url-status=live }}</ref> Due to the potency of DDT, it was not long before America's ] placed it on military supply lists in 1942 and 1943 and encouraged its production for overseas use. Enthusiasm regarding DDT became obvious through the American government's advertising campaigns of posters depicting Americans fighting the ] and insects and through media publications celebrating its military uses.<ref name="auto"/> In the ], it was sprayed aerially for malaria and dengue fever control with spectacular effects. While DDT's chemical and insecticidal properties were important factors in these victories, advances in application equipment coupled with competent organization and sufficient manpower were also crucial to the success of these programs.<ref name="Dunlap">{{cite book|first=Thomas|last=Dunlap|title=DDT: Scientists, Citizens, and Public Policy|url=https://books.google.com/books?id=PLL_AwAAQBAJ|year=2014|publisher=Princeton University Press|isbn=978-1-4008-5385-4|access-date=August 29, 2022|archive-date=October 19, 2021|archive-url=https://web.archive.org/web/20211019212022/https://books.google.com/books?id=PLL_AwAAQBAJ|url-status=live}}</ref>
	cite book|last1=Oreskes|first1=Naomi|authorlink1=Naomi Oreskes|last2=Erik M. Conway|first2=Erik M|title=]: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming|edition=First|year=2010|publisher=Bloomsbury Press|location=San Francisco, CA|isbn=978-1-59691-610-4}}</ref> One ] physician involved in the United States' DDT spraying campaign said of the effort that "we kicked a dying dog."<ref>
	Shah, Sonia The Nation. April 2006.</ref>
			In 1945, DDT was made available to farmers as an agricultural insecticide<ref name=EHC009/> and played a role in the elimination of malaria in Europe and ].<ref name="Larson"/><ref>{{cite journal | vauthors = de Zulueta J | title = The end of malaria in Europe: an eradication of the disease by control measures | journal = Parassitologia | volume = 40 | issue = 1–2 | pages = 245–246 | date = June 1998 | pmid = 9653750 }}</ref>'''<ref>{{cite web |url=https://www.cdc.gov/malaria/about/history/elimination_us.html |title=About Malaria – History – Elimination of Malaria in the United States (1947–1951) |website=CDC.gov |date=2019-01-28 |access-date=September 9, 2017 |archive-date=May 4, 2012 |archive-url=https://web.archive.org/web/20120504183309/http://www.cdc.gov/malaria/about/history/elimination_us.html |url-status=live }}</ref>''' Despite concerns emerging in the scientific community, and lack of research, the FDA considered it safe up to 7 parts per million in food. There was a large economic incentive to push DDT into the market and sell it to farmers, governments, and individuals to control diseases and increase food production.<ref name="auto"/>
	In 1955, the ] commenced a program to eradicate malaria worldwide, relying largely on DDT. The program was initially highly successful, eliminating the disease in "], much of the ], the ], parts of northern Africa, the northern region of Australia, and a large swath of the South Pacific"<ref name="Gladwell">{{
	Cite news |last = Gladwell | first = Malcolm |author-link = Malcolm Gladwell |title = The Mosquito Killer |newspaper = The New Yorker |date = July 2, 2001 |url = http://www.gladwell.com/2001/2001_07_02_a_ddt.htm}}</ref> and dramatically reducing mortality in ] and India.<ref name=Gordon/> However widespread agricultural use led to resistant insect populations. In many areas, early victories partially or completely reversed, and in some cases rates of transmission even increased.<ref name="pmid7278974">{{
	cite journal |author=Chapin G, Wasserstrom R |title=Agricultural production and malaria resurgence in Central America and India |journal=Nature |volume=293 |issue=5829 |pages=181–5 |year=1981 |pmid=7278974 |doi=10.1038/293181a0}}</ref> The program was successful in eliminating malaria only in areas with "high socio-economic status, well-organized healthcare systems, and relatively less intensive or seasonal malaria transmission".<ref name="AmJTrop">{{
	Cite journal |last = Sadasivaiah |first = Shobha |last2 = Tozan |first2 = Yesim |last3 = Breman |first3 = Joel G. |title = Dichlorodiphenyltrichloroethane (DDT) for Indoor Residual Spraying in Africa: How Can It Be Used for Malaria Control? |journal = Am. J. Trop. Med. Hyg. |volume = 77 |issue = Suppl 6 |pages =249–263 |date=1 December 2007|url = http://www.ajtmh.org/cgi/content/full/77/6_Suppl/249 }}</ref>
			DDT was also a way for American influence to reach abroad through DDT-spraying campaigns. In the 1944 issue of ] there was a feature regarding the Italian program showing pictures of American public health officials in uniforms spraying DDT on Italian families.<ref name="auto"/>
	DDT was less effective in tropical regions due to the continuous life cycle of mosquitoes and poor infrastructure. It was not applied at all in ] due to these perceived difficulties. Mortality rates in that area never declined to the same dramatic extent, and now constitute the bulk of malarial deaths worldwide, especially following the disease's resurgence as a result of resistance to drug treatments and the spread of the deadly malarial variant caused by '']''. The goal of eradication was abandoned in 1969, and attention was focused on controlling and treating the disease. Spraying programs (especially using DDT) were curtailed due to concerns over safety and environmental effects, as well as problems in administrative, managerial and financial implementation, but mostly because mosquitoes were developing resistance to DDT.<ref name="pmid7278974"/> Efforts shifted from spraying to the use of ] impregnated with insecticides and other interventions.<ref name="AmJTrop"/><ref name="pmid16125595">{{
	cite journal |author=Rogan WJ, Chen A |title=Health risks and benefits of bis(4-chlorophenyl)-1,1,1-trichloroethane (DDT) |journal=Lancet |volume=366 |issue=9487 |pages=763–73 |year=2005 |pmid=16125595 |doi=10.1016/S0140-6736(05)67182-6}}</ref>
			In 1955, the ] commenced a program to eradicate malaria in countries with low to moderate transmission rates worldwide, relying largely on DDT for mosquito control and rapid diagnosis and treatment to reduce transmission.<ref>{{cite journal | vauthors = Mendis K, Rietveld A, Warsame M, Bosman A, Greenwood B, Wernsdorfer WH | title = From malaria control to eradication: The WHO perspective | journal = Tropical Medicine & International Health | volume = 14 | issue = 7 | pages = 802–809 | date = July 2009 | pmid = 19497083 | doi = 10.1111/j.1365-3156.2009.02287.x | s2cid = 31335358 | doi-access = free }}</ref> The program eliminated the disease in "North America, Europe, the former ]",<ref name="AmJTrop"/> and in "], much of the ], the ], parts of northern Africa, the northern region of Australia, and a large swath of the South Pacific"<ref name="Gladwell">{{cite news |last=Gladwell |first=Malcolm |author-link=Malcolm Gladwell |name-list-style=vanc |title=The Mosquito Killer |newspaper=The New Yorker |date=July 2, 2001 |url=http://gladwell.com/the-mosquito-killer/ |access-date=August 20, 2014 |archive-url=https://web.archive.org/web/20160416165010/http://gladwell.com/the-mosquito-killer/ |archive-date=April 16, 2016 |url-status=dead }}</ref> and dramatically reduced mortality in ] and India.<ref name=Gordon/>
	===''Silent Spring'' and the U.S. ban===
	As early as the 1940s, scientists in the U.S. had begun expressing concern over possible hazards associated with DDT, and in the 1950s the government began tightening some of the regulations governing its use.<ref name=EPA1975/> However, these early events received little attention, and it was not until 1957, when the '']'' reported an unsuccessful struggle to restrict DDT use in ], that the issue came to the attention of the popular naturalist-author, ]. ], editor of '']'', urged her to write a piece on the subject, which developed into her famous book '']'', published in 1962. The book argued that ]s, including DDT, were poisoning both wildlife and the environment and were also endangering human health.<ref name="Lear">Lear, Linda (1997). ''Rachel Carson: Witness for Nature.'' New York: Henry Hoyten.</ref>
			However, failure to sustain the program, increasing mosquito tolerance to DDT, and increasing parasite tolerance led to a resurgence. In many areas early successes partially or completely reversed, and in some cases rates of transmission increased.<ref name=Chapin81>{{cite journal | vauthors = Chapin G, Wasserstrom R | title = Agricultural production and malaria resurgence in Central America and India | journal = Nature | volume = 293 | issue = 5829 | pages = 181–185 | year = 1981 | pmid = 7278974 | doi = 10.1038/293181a0 | bibcode = 1981Natur.293..181C | s2cid = 4346743 | doi-access = free }}</ref> The program succeeded in eliminating malaria only in areas with "high socio-economic status, well-organized healthcare systems, and relatively less intensive or seasonal malaria transmission".<ref name="AmJTrop">{{cite journal | vauthors = Sadasivaiah S, Tozan Y, Breman JG | title = Dichlorodiphenyltrichloroethane (DDT) for indoor residual spraying in Africa: how can it be used for malaria control? | journal = The American Journal of Tropical Medicine and Hygiene | volume = 77 | issue = 6 Suppl | pages = 249–263 | date = December 2007 | pmid = 18165500 | doi = 10.4269/ajtmh.2007.77.249 | doi-access = free }}</ref>
	''Silent Spring'' was a best seller, and public reaction to it launched the modern ] in the United States. The year after it appeared, ] ordered his Science Advisory Committee to investigate Carson's claims. The report the committee issued "add up to a fairly thorough-going vindication of Rachel Carson’s Silent Spring thesis," in the words of the journal '']'',<ref name="pmid17810673">{{cite journal |author=Greenberg DS |title=Pesticides: White House Advisory Body Issues Report Recommending Steps to Reduce Hazard to Public |journal=Science |volume=140 |issue=3569 |pages=878–9 |year=1963 |month=May |pmid=17810673 |doi=10.1126/science.140.3569.878 |url=http://www.sciencemag.org/cgi/pmidlookup?view=long&pmid=17810673 }} cited in {{cite journal|last=Graham Jr.|first=Frank|title=Nature’s Protector and Provocateur|journal=Audubon Magazine|url=http://audubonmagazine.org/books/editorchoice0709.html}} {{dead link|date=November 2010}}</ref> and recommended a phaseout of "persistent toxic pesticides".<ref name="Michaels2008">{{cite book|last=Michaels|first=David|title=]: How Industry's Assault on Science Threatens Your Health|publisher=Oxford University Press|location=New York|year=2008|isbn=978-0-19-530067-3}}</ref> DDT became a prime target of the growing anti-chemical and anti-pesticide movements, and in 1967 a group of scientists and lawyers founded the ] (EDF) with the specific goal of winning a ban on DDT. ], Charles Wurster, Art Cooley and others associated with inception of EDF had all witnessed bird kills or declines in bird populations and suspected that DDT was the cause. In their campaign against the chemical, EDF petitioned the government for a ban and filed a series of lawsuits.<ref>{{cite news |title=Sue the Bastards |url=http://www.time.com/time/magazine/article/0,9171,910111-2,00.html |publisher=] |date=October 18, 1971 |archiveurl = http://www.webcitation.org/5uKxR0D6f |archivedate = 2010-11-18|deadurl=no}}</ref> Around this time, ] ] was measuring ] levels in the eggs of ] and ]s and finding that increased levels corresponded with thinner shells.
			DDT was less effective in tropical regions due to the continuous life cycle of mosquitoes and poor infrastructure. It was applied in ] by various colonial states, but the 'global' WHO eradication program didn't include the region.<ref>{{Cite book| publisher = Palgrave Macmillan| isbn = 978-1-349-31322-8 | pages = 133–153| editor1-first = Virginia |editor1-last = Berridge| editor2-first=Martin| editor2-last=Gorsky | last = Clarke| first = Sabine| title = Environment, Health and History| chapter = Rethinking the Post-War Hegemony of DDT: Insecticides Research and the British Colonial Empire| location = London| date = 2012}}</ref> Mortality rates in that area never declined to the same dramatic extent, and now constitute the bulk of malarial deaths worldwide, especially following the disease's resurgence as a result of resistance to drug treatments and the spread of the deadly malarial variant caused by '']''. Eradication was abandoned in 1969 and attention instead focused on controlling and treating the disease. Spraying programs (especially using DDT) were curtailed due to concerns over safety and environmental effects, as well as problems in administrative, managerial and financial implementation.<ref name=Chapin81/> Efforts shifted from spraying to the use of ] impregnated with insecticides and other interventions.<ref name="AmJTrop"/><ref name=Rogan05>{{cite journal | vauthors = Rogan WJ, Chen A | title = Health risks and benefits of bis(4-chlorophenyl)-1,1,1-trichloroethane (DDT) | journal = Lancet | volume = 366 | issue = 9487 | pages = 763–773 | year = 2005 | pmid = 16125595 | doi = 10.1016/S0140-6736(05)67182-6 | s2cid = 3762435 | url = https://zenodo.org/record/1259797 | access-date = June 13, 2019 | archive-date = October 17, 2019 | archive-url = https://web.archive.org/web/20191017205259/https://zenodo.org/record/1259797 | url-status = live }}</ref>
	In response to an EDF suit, the U.S. District Court of Appeals in 1971 ordered the ] to begin the de-registration procedure for DDT. After an initial six-month review process, ], the Agency's first ] rejected an immediate suspension of DDT's registration, citing studies from the EPA's internal staff stating that DDT was not an imminent danger to human health and wildlife.<ref name=EPA1975/> However, the findings of these staff members were criticized, as they were performed mostly by ]s inherited from the ], whom many environmentalists felt were biased towards agribusiness and tended to minimize concerns about human health and wildlife. The decision not to ban thus created public controversy.<ref name=Dunlap/>
			===United States ban===
	The EPA then held seven months of hearings in 1971–1972, with scientists giving evidence both for and against the use of DDT. In the summer of 1972, Ruckelshaus announced the cancellation of most uses of DDT—an exemption allowed for public health uses under some conditions.<ref name=EPA1975/> Immediately after the cancellation was announced, both EDF and the DDT manufacturers filed suit against the EPA, with the industry seeking to overturn the ban, and EDF seeking a comprehensive ban. The cases were consolidated, and in 1973 the ] ruled that the EPA had acted properly in banning DDT.<ref name=EPA1975/>
			By October 1945, DDT was available for public sale in the United States, used both as an agricultural pesticide and as a household insecticide.<ref name="Distillations"/> Although its use was promoted by government and the agricultural industry, US scientists such as FDA pharmacologist ] expressed concern over possible hazards associated with DDT as early as 1944.<ref name="Davis">{{cite book|last1=Davis|first1=Frederick Rowe|title=Banned : a history of pesticides and the science of toxicology|date=2014|publisher=Yale University Press|location=|isbn=978-0300205176|page=26|url=https://books.google.com/books?id=kuIdBQAAQBAJ&pg=PA26|access-date=25 July 2017|archive-date=July 31, 2020|archive-url=https://web.archive.org/web/20200731130621/https://books.google.com/books?id=kuIdBQAAQBAJ&pg=PA26|url-status=live}}</ref><ref name=EPA1975/><ref name="Distillations"/> In 1947, ], a physician and nutritionist practicing in ], warned of the dangers of using the pesticide DDT in agriculture. DDT had been researched and manufactured in St.&nbsp;Louis by the ], later purchased by ],<ref>{{cite web|url=http://www.velsicol.com/|title=Leading Chemical Company – Manufacture, Distribution & Sales|website=Velsicol Chemical, LLC|access-date=October 23, 2017|archive-date=October 16, 2017|archive-url=https://web.archive.org/web/20171016054516/http://www.velsicol.com/|url-status=live}}</ref> and had become an important part of the local economy.<ref name= STLH>{{cite web|url=http://www.stlouismi.com/1/stlouis/history_by_decades.asp|title=History by Decades|website=www.stlouismi.com|access-date=October 23, 2017|archive-date=November 18, 2006|archive-url=https://web.archive.org/web/20061118003950/http://www.stlouismi.com/1/stlouis/history_by_decades.asp|url-status=live}}</ref> Citing research performed by ]<ref>American Potato Journal, June 1947, volume&nbsp;24, issue&nbsp;6, pp.&nbsp;183–187. Results of spraying and dusting potatoes in Michigan in 1946.</ref> in 1946, Robinson, a past president of the local Conservation Club,<ref>"Conservation Club, St. Louis, Has Program", ''Lansing State Journal'' (Lansing, Michigan), p.&nbsp;14, March 2, 1931.</ref> opined that:
			{{blockquote|perhaps the greatest danger from D.D.T. is that its extensive use in farm areas is most likely to upset the natural balances, not only killing beneficial insects in great number but by bringing about the death of fish, birds, and other forms of wild life either by their feeding on insects killed by D.D.T. or directly by ingesting the poison.<ref>{{cite report | title = A Nutritionist Ponders the D.D.T. Problem | first = Bradbury | last = Robinson | author-link = Bradbury Robinson | name-list-style = vanc | location = St. Louis, Michigan | work = Private Publication | date = 1947}}</ref>}}
			As its production and use increased, public response was mixed. At the same time that DDT was hailed as part of the "world of tomorrow", concerns were expressed about its potential to kill harmless and beneficial insects (particularly ]), birds, fish, and eventually humans. The issue of toxicity was complicated, partly because DDT's effects varied from species to species, and partly because consecutive exposures could accumulate, causing damage comparable to large doses. A number of states attempted to regulate DDT.<ref name="Distillations">{{cite journal |last1=Conis |first1=Elena |title=Beyond Silent Spring: An Alternate History of DDT |journal=] |date=2017 |volume=2 |issue=4 |pages=16–23 |url=https://www.sciencehistory.org/distillations/magazine/beyond-silent-spring-an-alternate-history-of-ddt |access-date=20 March 2018 |archive-date=November 22, 2019 |archive-url=https://web.archive.org/web/20191122192729/https://www.sciencehistory.org/distillations/magazine/beyond-silent-spring-an-alternate-history-of-ddt |url-status=live }}</ref><ref name=EHC009>{{EHC-ref | id = 009 | name=DDT and its derivatives | date = 1979 | isbn = 92-4-154069-9 }}</ref> In the 1950s the federal government began tightening regulations governing its use.<ref name=EPA1975/> These events received little attention. Women like Dorothy Colson and Mamie Ella Plyler of ], gathered evidence about DDT's effects and wrote to the Georgia Department of Public Health, the National Health Council in New York City, and other organizations.<ref name="Conis">{{cite news|last1=Conis|first1=Elena|name-list-style=vanc|title=DDT Disbelievers: Health and the New Economic Poisons in Georgia after World War II|url=https://southernspaces.org/2016/ddt-disbelievers-health-and-new-economic-poisons-georgia-after-world-war-ii|access-date=25 July 2017|work=Southern Spaces|date=October 28, 2016|archive-date=August 6, 2017|archive-url=https://web.archive.org/web/20170806021326/https://southernspaces.org/2016/ddt-disbelievers-health-and-new-economic-poisons-georgia-after-world-war-ii|url-status=live}}</ref>
	The U.S. DDT ban took place amidst a growing public mistrust of industry, with the ] issuing a report on ] in 1964, the ] catching fire in 1969, the fiasco surrounding the use of ] (DES), and the well-publicized decline in the ] population.<ref name=Michaels2008/>
			In 1957 '']'' reported an unsuccessful struggle to restrict DDT use in ], and the issue came to the attention of the popular naturalist-author ] when a friend, ], wrote to her including an article she had written in the Boston Globe about the devastation of her local bird population after DDT spraying.<ref>{{Cite web |last=Knox |first=Robert |date=2012 |title=Duxbury celebrates Rachel Carson's 'Silent Spring' |url=https://www.bostonglobe.com/metro/regionals/south/2012/05/23/duxbury-celebrates-local-nature-lover-voice-rachel-carson-silent-spring/uhxGAO38m3kHbDMlYQfPqO/story.html |access-date=2023-12-16 |website=BostonGlobe.com |language=en-US}}</ref><ref>{{Cite web |last=Johnson |first=Jenn |date=2018-02-22 |title=Her Heart's Home {{!}} Timeless New England |url=https://newengland.com/yankee/magazine/her-hearts-home-timeless-new-england/ |access-date=2023-12-16 |website=New England |language=en}}</ref> ], editor of '']'', urged her to write a piece on the subject, which developed into her 1962 book '']''. The book argued that ]s, including DDT, were poisoning both wildlife and the environment and were endangering human health.<ref name="Lear"/> ''Silent Spring'' was a best seller, and public reaction to it launched the modern ] in the United States. The year after it appeared, ] ordered his Science Advisory Committee to investigate Carson's claims. The committee's report "add up to a fairly thorough-going vindication of Rachel Carson's Silent Spring thesis", in the words of the journal '']'',<ref>{{cite journal | vauthors = Greenberg DS | title = Pesticides: White House Advisory Body Issues Report Recommending Steps to Reduce Hazard to Public | journal = Science | volume = 140 | issue = 3569 | pages = 878–879 | date = May 1963 | pmid = 17810673 | doi = 10.1126/science.140.3569.878 | bibcode = 1963Sci...140..878G }}</ref> and recommended a phaseout of "persistent toxic pesticides".<ref name="Michaels2008">{{cite book |last=Michaels |first=David | name-list-style = vanc | title = Doubt is Their Product: How Industry's Assault on Science Threatens Your Health|publisher=Oxford University Press|location=New York|year=2008|isbn=978-0-19-530067-3|title-link=Doubt is Their Product }}</ref> In 1965, the U.S. military removed DDT from the military supply system due in part to the development of resistance by body lice to DDT; it was replaced by ].<ref>{{Cite web|title=Technical Guide No. 6 – Delousing Procedures for the Control of Louse-borne Disease During Contingency Operations |publisher=] Armed Forces Pest Management Board Information Services Division|date= November 2011|url= https://perma.cc/HY4A-ENXM }}</ref>
	Some uses of DDT continued under the public health exemption. For example, in June 1979, the California Department of Health Services was permitted to use DDT to suppress flea vectors of ].<ref name="urlAEI - Short Publications - The Rise, Fall, Rise, and Imminent Fall of DDT">{{cite web |url=http://www.aei.org/outlook/27063 |title=AEI - Short Publications - The Rise, Fall, Rise, and Imminent Fall of DDT |archiveurl = http://www.webcitation.org/5uKxRwUwH |archivedate = 2010-11-18|deadurl=no}}</ref> DDT also continued to be produced in the US for foreign markets until as late as 1985, when over 300 tonnes were exported.<ref name="ATSDRc5"/>
			In the mid-1960s, DDT became a prime target of the burgeoning ], as concern about DDT and its effects began to rise in local communities. In 1966, a fish kill in ], was linked to a 5,000-gallon DDT dump by the county's mosquito commission, leading a group of scientists and lawyers to file a lawsuit to stop the county's further use of DDT.{{r|n=CARTERLJ19671222|r={{cite journal | author-last=Carter |author-first=Luther J. | journal=Science | title=Environmental Pollution: Scientists Go to Court | volume=158 | issue=3808 | pages=1552–1556 | publisher=American Association for the Advancement of Science | date=22 December 1967 | url=https://www.science.org/doi/10.1126/science.158.3808.1552 | doi=10.1126/science.158.3808.1552 | access-date=26 October 2024}}}} A year later, the group, led by ] and ], founded the ] (EDF), along with scientists ] and ], and brought a string of lawsuits against DDT and other persistent pesticides in ] and ].{{r|n=PRIMACKJR_VONHIPPELF1974|r={{cite book | author-last1=Primack |author-first1=J. R. | author-last2=Von Hippel |author-first2=Frank | date= 1974 | title=Advice and Dissent: Scientists in the Political Arena | chapter=The Battle Over Persistent Pesticides: From Rachel Carson to the Environmental Defense Fund | publisher=Basic Books | pages=128–142 | chapter-url=https://sgs.princeton.edu/sites/default/files/2019-10/Advice-and-Dissent-Chapter10.pdf | isbn=978-0-465-00090-6}}}}<ref>{{cite magazine|title=Sue the Bastards |url=http://www.time.com/time/magazine/article/0,9171,910111-2,00.html |magazine=] |date=October 18, 1971 |archive-url=https://web.archive.org/web/20120119181231/http://www.time.com/time/magazine/article/0,9171,910111-2,00.html |archive-date=January 19, 2012 |url-status=dead |df=mdy }}</ref>
	===Restrictions on usage===
	In the 1970s and 1980s, agricultural use was banned in most developed countries, beginning with ] in 1968<ref>{{cite web|url=http://www.fvm.hu/main.php?folderID=1564&articleID=6169&ctag=articlelist&iid=1&part=2| title=Selected passages from the history of the Hungarian plant protection administration on the 50th anniversary of establishing the county plant protection stations
	}}</ref> then in ] and ] in 1970, ] and the United States in 1972, but not in the ] until 1984. Vector control use has not been banned, but it has been largely replaced by less persistent alternative insecticides.
			Around the same time, evidence was mounting further about DDT causing catastrophic declines in wildlife reproduction, especially in birds of prey like ], ], ], and ], whose eggshells became so thin that they often cracked before hatching.{{r|n=HENKINH_MERTAM_STAPLESJM1971|r={{cite book | author-last1=Henkin |author-first1=Harmon | author-last2=Merta |author-first2=Martin | author-last3=Staples |author-first3=James M. | date=1971 | title=The Environment, the Establishment, and the Law | publisher=Houghton Mifflin | isbn=978-0-395-11070-6}}}} Toxicologists like ] were measuring ] levels in the eggs of ] and ]s and finding that increased levels corresponded with thinner shells.<ref>{{cite journal|first1=David B.|last1=Peakall|first2=lloyd F.|last2=Kiff | name-list-style = vanc |title=Eggshell thinning and dde residue levels among peregrine falcons falco peregrinus: a global perspective|publisher=Wiley Online Library|date=April 1979|doi= 10.1111/j.1474-919X.1979.tb04962.x|volume=121|issue = 2|journal=Ibis|pages=200–204}}</ref> Compounding the effect was DDT’s persistence in the environment, as it was unable to dissolve in water, and ended up accumulating in animal fat and disrupting hormone metabolism across a wide range of species.{{r|n=DUNLAPTR1978|r={{cite journal | author-last=Dunlap |author-first=Thomas R. | journal=Wisconsin Magazine of History | title=DDT on Trial: The Wisconsin Hearing, 1968-1969 | volume=62 | issue=1 | pages=3–24 | date= 1978 | url=https://content.wisconsinhistory.org/digital/collection/wmh/id/33630 | issn=1943-7366 | access-date=11 December 2024}}}}
	The ], which took effect in 2004, outlawed several ]s, and restricted DDT use to ]. The Convention has been ratified by more than 170 countries and is endorsed by most environmental groups. Recognizing that total elimination in many malaria-prone countries is currently unfeasible because there are few affordable or effective alternatives, public health use is exempt from the ban pending acceptable alternatives. Malaria Foundation International states, "The outcome of the treaty is arguably better than the status quo going into the negotiations...For the first time, there is now an insecticide which is restricted to vector control only, meaning that the selection of resistant mosquitoes will be slower than before."<ref>{{cite web|url=http://www.malaria.org/DDTpage.html| title=MFI second page| publisher=Malaria Foundation International| accessdate=2006-03-15|archiveurl = http://www.webcitation.org/5uKxTLPxl |archivedate = 2010-11-18|deadurl=no}}</ref>
			In response to an EDF suit, the U.S. District Court of Appeals in 1971 ordered the ] to begin the de-registration procedure for DDT. After an initial six-month review process, ], the Agency's first ] rejected an immediate suspension of DDT's registration, citing studies from the EPA's internal staff stating that DDT was not an imminent danger.<ref name=EPA1975/> However, these findings were criticized, as they were performed mostly by ]s inherited from the ], who many environmentalists felt were biased towards ] and understated concerns about human health and wildlife. The decision thus created controversy.<ref name=Dunlap/>
	Despite the worldwide ban, agricultural use continues in India<ref>{{
	cite news |title = Concern over excessive DDT use in Jiribam fields |publisher = The Imphal Free Press |date = 2008-05-05 | url = http://www.kanglaonline.com/index.php?template=headline&newsid=42015&typeid=1 |accessdate = 2008-05-05 }}</ref> North Korea, and possibly elsewhere.<ref name="DDTBP.1/2"/>
			The EPA held seven months of hearings in 1971–1972, with scientists giving evidence for and against DDT. In the summer of 1972, Ruckelshaus announced the cancellation of most uses of DDT{{snd}} exempting public health uses under some conditions.<ref name=EPA1975/> Again, this caused controversy. Immediately after the announcement, both the EDF and the DDT manufacturers filed suit against EPA. Many in the agricultural community were concerned that food production would be severely impacted, while proponents of pesticides warned of increased breakouts of insect-borne diseases and questioned the accuracy of giving animals high amounts of pesticides for cancer potential.<ref name=":0">Susan Wayland and Penelope Fenner-Crisp. {{Webarchive|url=https://web.archive.org/web/20190412070256/https://www.epaalumni.org/hcp/pesticides.pdf |archive-url=https://web.archive.org/web/20161022222635/http://www.epaalumni.org/hcp/pesticides.pdf |archive-date=2016-10-22 |url-status=live |date=April 12, 2019 }}. EPA Alumni Association. March 2016.</ref> Industry sought to overturn the ban, while the EDF wanted a comprehensive ban. The cases were consolidated, and in 1973 the ] ruled that the EPA had acted properly in banning DDT.<ref name=EPA1975/> During the late 1970s, the EPA also began banning organochlorines, pesticides that were chemically similar to DDT. These included aldrin, dieldrin, chlordane, heptachlor, toxaphene, and mirex.<ref name=":0" />
	Today, about 3-4,000 ] each year are produced for ].<ref name=EG.3/> DDT is applied to the inside walls of homes to kill or repel mosquitoes. This intervention, called ] (IRS), greatly reduces environmental damage. It also reduces the incidence of DDT resistance.<ref>{{cite web| url=http://www.malaria.org/DDTcosts.html| title=Is DDT still effective and needed in malaria control?| publisher=Malaria Foundation International| accessdate=2006-03-15|archiveurl = http://www.webcitation.org/5uKxTzvxt |archivedate = 2010-11-18|deadurl=no}}</ref> For comparison, treating {{convert|40|ha|acre}} of cotton during a typical U.S. growing season requires the same amount of chemical as roughly 1,700 homes.<ref name="Roberts 1997">{{
	cite journal | url=http://www.cdc.gov/ncidod/eid/vol3no3/roberts.htm | first=Donald R.| last=Roberts | title=DDT, global strategies, and a malaria control crisis in South America | journal=Emerging Infectious Diseases | month=July–September | year=1997 | pages=295–302 | volume=3 | issue= 3| pmid=9284373 | doi=10.3201/eid0303.970305 | last2=Laughlin | first2=LL | last3=Hsheih | first3=P | last4=Legters | first4=LJ | pmc=2627649}}</ref>
			Some uses of DDT continued under the public health exemption. For example, in June 1979, the California Department of Health Services was permitted to use DDT to suppress ] vectors of ].<ref name="urlAEI – Short Publications – The Rise, Fall, Rise, and Imminent Fall of DDT">{{cite web |url=http://www.aei.org/outlook/27063 |publisher=AEI |title=The Rise, Fall, Rise, and Imminent Fall of DDT |archive-url=https://web.archive.org/web/20110102120306/http://www.aei.org/outlook/27063 |archive-date=January 2, 2011 |url-status=dead |df=mdy }}</ref> DDT continued to be produced in the United States for foreign markets until 1985, when over 300 tons were exported.<ref name="ATSDRc5"/>
			===International usage restrictions===
			In the 1970s and 1980s, agricultural use was banned in most developed countries, beginning with ] in 1968<ref name="Cheremisinoff-Rosenfeld-2011">{{cite book | editor1-first=Nicholas P. | editor1-last=Cheremisinoff | editor2-first=Paul E. | editor2-last=Rosenfeld | title=Handbook of Pollution Prevention and Cleaner Production: Best Practices in the Agrochemical Industry | chapter=6 DDT and Related Compounds | publisher=] | year=2011 | isbn=978-1-4377-7825-0 | pages=247–259}}</ref><ref name="Nagy-Vajna-1972">{{cite journal | last1=Nagy | first1=B. | last2=Vajna | first2=L. | title=The Increasing Possibilities of the Application of Integrated Control in Plant Protection in Hungary | journal=] | publisher=] (]) | volume=2 | issue=6 | year=1972 | issn=0250-8052 | doi=10.1111/j.1365-2338.1972.tb02138.x | pages=95–96 | s2cid=84111430}}</ref><ref>{{cite web |url=http://www.fvm.hu/main.php?folderID=1564&articleID=6169&ctag=articlelist&iid=1&part=2 |title=Selected passages from the history of the Hungarian plant protection administration on the 50th anniversary of establishing the county plant protection stations |url-status=dead |archive-url=https://web.archive.org/web/20090110025539/http://www.fvm.hu/main.php?folderID=1564&articleID=6169&ctag=articlelist&iid=1&part=2 |archive-date=January 10, 2009 |df=mdy-all }}</ref> {{ndash}} although in practice it continued to be used through at least 1970.<ref name="ag-use-stats-1979">{{cite book | title=Environmental Health Criteria 9 - DDT and its Derivatives | date=1979 | location=] | isbn=92-4-154069-9 | hdl=10665/39562 | oclc=67616765 | pages=194}} {{OCLC|1039198025}}. {{OCLC|504327918}}. {{ISBN|978-92-4-154069-8}}. {{OCLC|1158652149}}. {{OCLC|882544146}}. {{OCLC|5364752}}.</ref> This was followed by ] and ] in 1970, ] and the United States in 1972, but not in the ] until 1984.
			In contrast to West Germany, in the ] DDT was used until 1988. Especially of relevance were large-scale applications in forestry in the years 1982–1984, with the aim to combat ] and ]. As a consequence, DDT-concentrations in eastern German forest soils are still significantly higher compared to soils in the former western German states.<ref>{{Cite journal |last1=Aichner |first1=Bernhard |last2=Bussian |first2=Bernd |last3=Lehnik-Habrink |first3=Petra |last4=Hein |first4=Sebastian |date=2013 |title=Levels and Spatial Distribution of Persistent Organic Pollutants in the Environment: A Case Study of German Forest Soils |url=https://www.researchgate.net/publication/256836176 |journal=Environmental Science & Technology |language=en |volume=47 |issue=22 |pages=12703–12714 |doi=10.1021/es4019833|pmid=24050388 |bibcode=2013EnST...4712703A }}</ref>
			By 1991, total bans, including for disease control, were in place in at least 26 countries; for example, Cuba in 1970, the US in the 1980s, Singapore in 1984, Chile in 1985, and the Republic of Korea in 1986.<ref>{{Cite web|url=http://www.pic.int/Portals/5/DGDs/DGD_DDT_EN.pdf|title=DDT, Decision Guidance Document, Joint FAO/UNEP Programme for the operation of Prior Informed Consent, UNEP/FAO, Rome, Italy, 1991.|access-date=August 24, 2014|archive-date=April 13, 2020|archive-url=https://web.archive.org/web/20200413043928/http://www.pic.int/Portals/5/DGDs/DGD_DDT_EN.pdf|url-status=live}}</ref>
			The ], which took effect in 2004, put a global ban on several ]s, and restricted DDT use to ]. The convention was ratified by more than 170 countries. Recognizing that total elimination in many malaria-prone countries is currently unfeasible in the absence of affordable/effective alternatives, the convention exempts public health use within ] (WHO) guidelines from the ban.<ref name="Stockholm">{{Cite web|url=http://chm.pops.int/Portals/0/Repository/convention_text/UNEP-POPS-COP-CONVTEXT-FULL.English.PDF|title=Stockholm Convention on Persistent Organic Pollutants.|access-date=August 24, 2014|archive-date=June 5, 2015|archive-url=https://web.archive.org/web/20150605092808/http://chm.pops.int/Portals/0/Repository/convention_text/UNEP-POPS-COP-CONVTEXT-FULL.English.PDF|url-status=live}}</ref> Resolution 60.18 of the ] commits WHO to the Stockholm Convention's aim of reducing and ultimately eliminating DDT.<ref>{{Cite web|url=http://www.who.int/ipcs/capacity_building/ddt_statement/en/|archive-url=https://web.archive.org/web/20090404040645/http://www.who.int/ipcs/capacity_building/ddt_statement/en/|url-status=dead|archive-date=April 4, 2009|title=WHO &#124; Strengthening malaria control while reducing reliance on DDT|website=WHO}}</ref> Malaria Foundation International states, "The outcome of the treaty is arguably better than the status quo going into the negotiations. For the first time, there is now an insecticide which is restricted to vector control only, meaning that the selection of resistant mosquitoes will be slower than before."<ref>{{cite web|url=http://www.malaria.org/DDTpage.html |title=MFI second page |publisher=Malaria Foundation International |access-date=March 15, 2006 |archive-url=https://web.archive.org/web/20101026080133/http://www.malaria.org/DDTpage.html |archive-date=October 26, 2010 |url-status=live |df=mdy }}</ref>
			Despite the worldwide ban, agricultural use continued in India,<ref>{{cite news |title=Concern over excessive DDT use in Jiribam fields |agency=The Imphal Free Press |date=May 5, 2008 |url=http://www.kanglaonline.com/index.php?template=headline&newsid=42015&typeid=1 |access-date=May 5, 2008 |archive-url= https://web.archive.org/web/20081206120016/http://www.kanglaonline.com/index.php?template=headline&newsid=42015&typeid=1 |archive-date=December 6, 2008}}</ref> North Korea, and possibly elsewhere.<ref name="DDTBP.1/2"/> As of 2013, an estimated 3,000 to 4,000 ]s of DDT were produced for disease ], including 2,786 tons in India.<ref>{{cite web |url=http://chm.pops.int/Implementation/DDT/DDTMeetings/DDTEG62016/tabid/5348/Default.aspx |title=Report of the Sixth Expert Group Meeting on DDT |publisher=UNEP/POPS/DDT-EG.6, Stockholm Convention on Persistent Organic Pollutants |date=November 8, 2016 |access-date=March 4, 2018 |archive-date=March 5, 2018 |archive-url=https://web.archive.org/web/20180305063542/http://chm.pops.int/Implementation/DDT/DDTMeetings/DDTEG62016/tabid/5348/Default.aspx |url-status=live }}</ref> DDT is applied to the inside walls of homes to kill or repel mosquitoes. This intervention, called ] (IRS), greatly reduces environmental damage. It also reduces the incidence of DDT resistance.<ref>{{cite web|url=http://www.malaria.org/DDTcosts.html |title=Is DDT still effective and needed in malaria control? |publisher=Malaria Foundation International |access-date=March 15, 2006 |archive-url=https://web.archive.org/web/20110721175925/http://www.malaria.org/DDTcosts.html |archive-date=July 21, 2011 |url-status=live |df=mdy }}</ref> For comparison, treating {{convert|40|ha|acre}} of cotton during a typical U.S. growing season requires the same amount of chemical to treat roughly 1,700 homes.<ref name="Roberts 1997">{{cite journal | vauthors = Roberts DR, Laughlin LL, Hsheih P, Legters LJ | title = DDT, global strategies, and a malaria control crisis in South America | journal = Emerging Infectious Diseases | volume = 3 | issue = 3 | pages = 295–302 | date = July–September 1997 | pmid = 9284373 | pmc = 2627649 | doi = 10.3201/eid0303.970305 }}</ref>
	==Environmental impact==		==Environmental impact==
	]		]
	DDT is a ] that is extremely ] and strongly absorbed by ]. Depending on conditions, its soil ] can range from 22 days to 30 years. Routes of loss and degradation include runoff, volatilization, ] and ] and ] ]. When applied to ]s it is quickly absorbed by organisms and by soil or it evaporates, leaving little DDT dissolved in the water itself. Its breakdown products and metabolites, DDE and DDD, are also highly persistent and have similar chemical and physical properties.<ref name="ATSDRc5"/> DDT and its breakdown products are transported from warmer regions of the world to the ] by the phenomenon of ], where they then accumulate in the region's ].<ref>{{
	cite journal|title=The Grasshopper Effect and Tracking Hazardous Air Pollutants|journal=The Science and the Environment Bulletin|publisher=Environment Canada|issue=May/June 1998|url=http://www.ec.gc.ca/science/sandemay/PrintVersion/print2_e.html}}{{Dead link|date=November 2009}}</ref>
			DDT is a ] that is readily ] to ]s and ]s, which can act both as sinks and as long-term sources of exposure affecting organisms.<ref name=EHC83/> Depending on environmental conditions, its soil ] can range from 22 days to 30 years. Routes of loss and degradation include runoff, volatilization, ] and ] and ] ]. Due to ] properties, in ]s DDT and its metabolites are absorbed by aquatic organisms and adsorbed on suspended particles, leaving little DDT dissolved in the water (however, its half-life in aquatic environments is listed by the ] as 150 years<ref>{{cite web|title=DDT (Technical Fact Sheet)|url=http://npic.orst.edu/factsheets/archive/ddttech.pdf|access-date=1 August 2018|archive-date=February 19, 2018|archive-url=https://web.archive.org/web/20180219141527/http://npic.orst.edu/factsheets/archive/ddttech.pdf|url-status=live}}</ref>). Its breakdown products and metabolites, DDE and DDD, are also persistent and have similar chemical and physical properties.<ref name="ATSDRc5"/> DDT and its breakdown products are transported from warmer areas to the ] by the phenomenon of ], where they then accumulate in the region's ].<ref>{{cite journal|title=The Grasshopper Effect and Tracking Hazardous Air Pollutants |journal=The Science and the Environment Bulletin |publisher=Environment Canada |issue=May/June 1998 |url=http://www.ec.gc.ca/science/sandemay/PrintVersion/print2_e.html |url-status=dead |archive-url=https://web.archive.org/web/20040928235911/http://www.ec.gc.ca/science/sandemay/printversion/print2_e.html |archive-date=September 28, 2004 }}</ref>
	Because of its ] properties, DDT has a high potential to ], especially in ].<ref>{{cite book|title=Introduction to Ecotoxicology|publisher=Blackwell Science|year=1999|isbn=0-632-03852-7|page=68|url=http://books.google.com/books?id=X-ik73-vnXAC&pg=PA68|author=Connell, D. et al.}}</ref> DDT, DDE, and DDD ] through the ], with ]s such as ] concentrating more chemicals than other animals in the same environment. They are very ] and are stored mainly in body ]. DDT and DDE are very resistant to metabolism; in humans, their half-lives are 6 and up to 10 years, respectively. In the United States, these chemicals were detected in almost all human blood samples tested by the ] in 2005, though their levels have sharply declined since most uses were banned in the US.<ref name="PineRiver">{{
	cite journal|last=Eskenazi|first=Brenda|date=May 4, 2009|title=The Pine River Statement: Human Health Consequences of DDT Use|journal=] |url=http://www.ehponline.org/members/2009/11748/11748.pdf}}</ref> Estimated dietary intake has also declined,<ref name="PineRiver"/> although FDA food tests commonly detect it.<ref>
	USDA, ''Pesticide Data Program Annual Summary Calendar Year 2005'', November 2006.</ref>
			Medical researchers in 1974 found a measurable and significant difference in the presence of DDT in human milk between mothers who lived in ] and mothers who lived in ], "possibly because of the wider use of insecticide sprays in the past".<ref>{{Cite journal |last1=Musial |first1=C. J. |last2=Hutzinger |first2=O. |last3=Zitko |first3=V. |last4=Crocker |first4=J. |date=1974 |title=Presence of PCB, DDE and DDT in human milk in the provinces of New Brunswick and Nova Scotia, Canada |url=https://doi.org/10.1007/BF01709117 |journal=Bulletin of Environmental Contamination and Toxicology |language=en |volume=12 |issue=3 |pages=258–267 |doi=10.1007/BF01709117 |pmid=4215516 |bibcode=1974BuECT..12..258M |issn=1432-0800}}</ref>
	Marine macroalgae (]) help ] soil toxicity by up to 80% within six weeks.<ref>{{
	cite journal|doi=10.1002/jctb.1032|last=D Kantachote, R Naidu, B Williams, N McClure, M Megharaj, I Singleton|first1=D |year=2004|last2=Naidu|first2=R|last3=Williams|first3=B|last4=McClure|first4=N|last5=Megharaj|first5=M|last6=Singleton|first6=I|title=Bioremediation of DDT-contaminated soil: enhancement by seaweed addition|journal=Journal of Chemical Technology & Biotechnology|volume=79|issue=6|pages=632–8|url=http://www3.interscience.wiley.com/journal/108060819/abstract|accessdate=2009-05-26}}</ref>
			Because of its ] properties, DDT can ], especially in ].<ref>{{cite book | title = Introduction to Ecotoxicology | publisher = Blackwell Science | year = 1999 | isbn = 978-0-632-03852-7 | page = 68 | url = https://books.google.com/books?id=X-ik73-vnXAC&pg=PA68 | first1 = Des W. | last1 = Connell | first2 = Paul | last2 = Lam | first3 = Bruce | last3 = Richardson | first4 = Rudolf | last4 = Wu | name-list-style = vanc | access-date = August 29, 2022 | archive-date = March 19, 2015 | archive-url = https://web.archive.org/web/20150319000333/http://books.google.com/books?id=X-ik73-vnXAC&pg=PA68 | url-status = live }}</ref> DDT is toxic to a wide range of living organisms, including marine animals such as ], ], ] and many species of ]. DDT, DDE and DDD ] through the ], with ]s such as ] concentrating more chemicals than other animals in the same environment. They are stored mainly in body ]. DDT and DDE are resistant to metabolism; in humans, their half-lives are 6 and up to 10 years, respectively. In the United States, these chemicals were detected in almost all human blood samples tested by the ] in 2005, though their levels have sharply declined since most uses were banned.<ref name="PineRiver">{{cite journal | vauthors = Eskenazi B, Chevrier J, Rosas LG, Anderson HA, Bornman MS, Bouwman H, Chen A, Cohn BA, de Jager C, Henshel DS, Leipzig F, Leipzig JS, Lorenz EC, Snedeker SM, Stapleton D | title = The Pine River statement: human health consequences of DDT use | journal = Environmental Health Perspectives | volume = 117 | issue = 9 | pages = 1359–1367 | date = September 2009 | pmid = 19750098 | pmc = 2737010 | doi = 10.1289/ehp.11748 | bibcode = 2009EnvHP.117.1359E }}</ref> Estimated dietary intake has declined,<ref name="PineRiver"/> although FDA food tests commonly detect it.<ref>USDA, ] Annual Summary Calendar Year''Pesticide Data Program Annual Summary Calendar Year 2005'', November 2006.</ref>
	===Effects on wildlife and eggshell thinning===
	DDT is toxic to a wide range of animals in addition to insects, including marine animals such as ], ], ] and many species of ]. It is less toxic to mammals, but may be moderately toxic to some ] species, especially in the ] stage. Most famously, it is a reproductive toxicant for certain birds species, and it is a major reason for the decline of the ],<ref name="pmid17588911"/> ]<ref>
	"Endangered and Threatened Wildlife and Plants; 12-Month Petition Finding and Proposed Rule To Remove the Brown Pelican (Pelecanus occidentalis) From the Federal List of Endangered and Threatened Wildlife; Proposed Rule," Fish and Wildlife Service, U.S. Department of the Interior, February 20, 2008. {{Federal Register|73|9407}}</ref> ], and ].<ref name="ATSDRc5"/> ], ], and ] are more susceptible to ] thinning than ]s and ], and DDE appears to be more potent than DDT.<ref name="ATSDRc5"/> Even in 2010, more than forty years after the U.S. ban, ]s which feed on sea lions at ] which in turn feed in the Palos Verdes Shelf area of the Montrose Chemical ] site seemed to be having continued thin-shell problems. Scientists with the ] and others are intensifying studies and remediations of the condors' problems.<ref>Moir, John, , ''The New York Times'', November 15, 2010. Retrieved 2010-11-15.</ref>
			Despite being banned for many years, in 2018 research showed that DDT residues are still present in European soils and Spanish rivers.<ref name="Geissen">{{cite journal | vauthors = Silva V, Mol HG, Zomer P, Tienstra M, Ritsema CJ, Geissen V | title = Pesticide residues in European agricultural soils – A hidden reality unfolded | journal = The Science of the Total Environment | volume = 653 | pages = 1532–1545 | date = February 2019 | pmid = 30759587 | doi = 10.1016/j.scitotenv.2018.10.441 | bibcode = 2019ScTEn.653.1532S | doi-access = free }}</ref><ref name="PAN-E">{{cite web |last1=Roman |first1=Dolores |last2=Lysimachou |first2=Angeliki |last3=Balaguer |first3=Rodrigo |last4=Dimastrogiovanni |first4=Giorgio |last5=García |first5=Kistiñe |last6=González |first6=Erika |name-list-style=vanc |title=Ríos hormonados: Contamination of Spanish Rivers with Pesticides |url=https://www.pan-europe.info/resources/reports/2018/02/r%C3%ADos-hormonados-contamination-spanish-rivers-pesticides |website=Pesticide Action Network Europe |access-date=26 February 2019 |archive-date=February 27, 2019 |archive-url=https://web.archive.org/web/20190227060806/https://www.pan-europe.info/resources/reports/2018/02/r%C3%ADos-hormonados-contamination-spanish-rivers-pesticides |url-status=live }}</ref>
	The biological thinning mechanism is not entirely known, but there is strong evidence that p,p'-DDE inhibits ] in the ] of the shell gland and reduces the transport of ] from ] into the eggshell gland. This results in a dose-dependent thickness reduction.<ref name="ATSDRc5"/><ref>{{cite book |author=Walker C.H., ''et al'' |title=Principles of ecotoxicology |publisher=CRC/Taylor & Francis |location=Boca Raton, FL |year=2006 |isbn=978-0-8493-3635-5 |edition=3rd}}</ref><ref name="Guillette, 2006">{{cite web|last=Guillette| first=Louis J., Jr.|year=2006| url= http://www.ehponline.org/members/2005/8045/8045.pdf |format=PDF| title= Endocrine Disrupting Contaminants |accessdate=2007-02-02|archiveurl = http://www.webcitation.org/5uKxWWYm0 |archivedate = 2010-11-18|deadurl=no}}</ref><ref name="Lundholm, 1997">{{
	cite journal| last=Lundholm| first=C.E.| year=1997| title= DDE-Induced eggshell thinning in birds| journal=Comp Biochem Physiol C Pharmacol Toxicol Endocrinol| issue= 2| doi= 10.1016/S0742-8413(97)00105-9| volume= 118| page= 113| pmid=9490182}}</ref> There is also evidence that o,p'-DDT disrupts female reproductive tract development, impairing eggshell quality later.<ref name="pmid17022422">{{
	cite journal |author=Holm L, Blomqvist A, Brandt I, Brunström B, Ridderstråle Y, Berg C |title=Embryonic exposure to o,p'-DDT causes eggshell thinning and altered shell gland carbonic anhydrase expression in the domestic hen |journal=Environ. Toxicol. Chem. |volume=25 |issue=10 |pages=2787–93 |year=2006 |month=October |pmid=17022422 |doi= 10.1897/05-619R.1}}</ref> Multiple mechanisms may be at work, or different mechanisms may operate in different species.<ref name="ATSDRc5"/> Some studies show that although DDE levels have fallen dramatically, eggshell thickness remains 10–12 percent thinner than before DDT was first used.<ref></ref>
			===Eggshell thinning{{anchor|Effects_on_wildlife_and_eggshell_thinning}}===
	==Effects on human health==
			The chemical and its breakdown products DDE and DDD caused eggshell thinning and population declines in multiple North American and European ] species.<ref name="ATSDRc5"/><ref>{{cite journal | vauthors = Vos JG, Dybing E, Greim HA, Ladefoged O, Lambré C, Tarazona JV, Brandt I, Vethaak AD | title = Health effects of endocrine-disrupting chemicals on wildlife, with special reference to the European situation | journal = Critical Reviews in Toxicology | volume = 30 | issue = 1 | pages = 71–133 | date = January 2000 | pmid = 10680769 | doi = 10.1080/10408440091159176 | s2cid = 11908661 }}</ref><ref name=Stokstad07/><ref name="Lundholm, 1997"/><ref name=Tubbs2016>{{cite journal |doi=10.1080/23273747.2016.1173766 |title=California condors and DDT: Examining the effects of endocrine disrupting chemicals in a critically endangered species |journal=Endocrine Disruptors |volume=4 |pages=e1173766 |year=2016 |last1=Tubbs |first1=Christopher W. | name-list-style = vanc |doi-access=free }}</ref><ref name="ibis">{{cite journal |doi=10.1046/j.1474-919X.2003.00132.x |title=California Condors and DDE: A re-evaluation |journal=Ibis |volume=145 |issue=1 |pages=136–151 |year=2002 |last1=Snyder |first1=Noel F. R. |last2=Meretsky |first2=Vicky J. | name-list-style = vanc }}</ref> Both laboratory experiments and field studies confirmed this effect.<ref>{{cite news | url = https://www.epa.gov/caddis-vol1/case-ddt-revisiting-impairment | title = The Case of DDT: Revisiting the Impairment | work = US Environmental Protection Agency (EPA) | access-date = August 5, 2021 | archive-date = August 5, 2021 | archive-url = https://web.archive.org/web/20210805060600/https://www.epa.gov/caddis-vol1/case-ddt-revisiting-impairment | url-status = live }}</ref> The effect was first conclusively proven at ] in ] during ]-funded studies on ]s in the mid-1960s.<ref name="mynorthscience">{{cite web |last1=Smith |first1=Jeff |title=The Science Behind Northport's Gull Island |url=https://mynorth.com/2017/05/the-science-behind-northports-gull-island/ |website=MyNorth.com |access-date=8 September 2020 |date=9 May 2017 |archive-date=May 19, 2021 |archive-url=https://web.archive.org/web/20210519235311/https://mynorth.com/2017/05/the-science-behind-northports-gull-island/ |url-status=live }}</ref> DDE-related eggshell thinning is considered a major reason for the decline of the ],<ref name=Stokstad07/> ],<ref>"Endangered and Threatened Wildlife and Plants; 12-Month Petition Finding and Proposed Rule To Remove the Brown Pelican (Pelecanus occidentalis) From the Federal List of Endangered and Threatened Wildlife; Proposed Rule", Fish and Wildlife Service, U.S. Department of the Interior, February 20, 2008. {{Federal Register|73|9407}}</ref> ] and ].<ref name="ATSDRc5" /> However, birds vary in their sensitivity to these chemicals, with ], ] and ] being more susceptible than ]s and ].<ref name="ATSDRc5"/><ref name="EHC83" /> Even in 2010, ]s that feed on ]s at ] that in turn feed in the Palos Verdes Shelf area of the ] ] site exhibited continued thin-shell problems,<ref>{{cite news | last = Moir | first = John | name-list-style = vanc | url = https://www.nytimes.com/2010/11/16/science/16condors.html | title = New Hurdle for California Condors May Be DDT From Years Ago | work = The New York Times | date = November 15, 2010 | access-date = February 7, 2017 | archive-date = September 21, 2017 | archive-url = https://web.archive.org/web/20170921194609/http://www.nytimes.com/2010/11/16/science/16condors.html | url-status = live }}</ref><ref>{{cite journal |vauthors=Kurle CM, Bakker VJ, Copeland H, Burnett J, Jones Scherbinski J, Brandt J, Finkelstein ME |title=Terrestrial Scavenging of Marine Mammals: Cross-Ecosystem Contaminant Transfer and Potential Risks to Endangered California Condors (Gymnogyps californianus) |journal=Environmental Science & Technology |volume=50 |issue=17 |pages=9114–9123 |year=2016 |pmid=27434394 |doi=10.1021/acs.est.6b01990 |bibcode=2016EnST...50.9114K |s2cid=206559840 |url=http://www.escholarship.org/uc/item/1646t91t |access-date=June 13, 2019 |archive-date=June 22, 2020 |archive-url=https://web.archive.org/web/20200622174112/https://escholarship.org/uc/item/1646t91t |url-status=live }}</ref> though DDT's role in the decline of the ] is disputed.<ref name="ibis"/><ref name=Tubbs2016/>
	Potential mechanisms of action on humans are genotoxicity and endocrine disruption. DDT may be directly ],<ref name="Cohn07">{{
	cite journal |coauthors=Cohn BA, Wolff MS, Cirillo PM, Sholtz RI |title=DDT and breast cancer in young women: new data on the significance of age at exposure |journal=Environ. Health Perspect. |volume=115 |issue=10 |pages=1406–14 |year=2007 |month=October |pmid=17938728 |pmc=2022666 |doi=10.1289/ehp.10260 |last1=Cohn |first1=BA }}</ref> but may also induce ]s to produce other genotoxic intermediates and ]s.<ref name=Cohn07/> It is an endocrine disruptor; The DDT metabolite ] acts as an ] (but not as an ]). p,p'-DDT, DDT's main component, has little or no androgenic or estrogenic activity.<ref name=Cohn07/> Minor component o,p'-DDT has weak estrogenic activity.
			The biological thinning mechanism is not entirely understood, but DDE appears to be more potent than DDT,<ref name="ATSDRc5"/> and strong evidence indicates that ''p'',''p{{'}}''-DDE inhibits ] in the ] of the shell gland and reduces the transport of ] from ] into the eggshell gland. This results in a dose-dependent thickness reduction.<ref name="ATSDRc5"/><ref>{{cite book | vauthors = Walker CH, Sibly RM, Hopkin SP, Peakall DB | title = Principles of ecotoxicology | publisher = CRC/Taylor & Francis | location = Boca Raton, FL | isbn = 978-0-8493-3635-5 | year = 2006 | edition = 3rd | url = https://books.google.com/books?id=WxfSBQAAQBAJ&pg=PA300 | pages = 300 ff | access-date = August 29, 2022 | archive-date = July 31, 2020 | archive-url = https://web.archive.org/web/20200731135732/https://books.google.com/books?id=WxfSBQAAQBAJ&pg=PA300 | url-status = live }}</ref><ref name="Guillette, 2006">{{cite web |last=Guillette |first=Louis J. |name-list-style=vanc |year=2006 |url=http://www.ehponline.org/members/2005/8045/8045.pdf |title=Endocrine Disrupting Contaminants |access-date=February 2, 2007 |archive-url=https://web.archive.org/web/20090325085455/http://www.ehponline.org/members/2005/8045/8045.pdf |archive-date=March 25, 2009 |url-status=dead |df=mdy }}</ref><ref name="Lundholm, 1997">{{cite journal | vauthors = Lundholm CD | title = DDE-induced eggshell thinning in birds: effects of ''p'',''p{{'}}''-DDE on the calcium and prostaglandin metabolism of the eggshell gland | journal = Comparative Biochemistry and Physiology C | volume = 118 | issue = 2 | pages = 113–128 | date = October 1997 | pmid = 9490182 | doi = 10.1016/S0742-8413(97)00105-9 }}</ref> Other evidence indicates that o,p'-DDT disrupts female reproductive tract development, later impairing eggshell quality.<ref>{{cite journal | vauthors = Holm L, Blomqvist A, Brandt I, Brunström B, Ridderstråle Y, Berg C | title = Embryonic exposure to ''o'',''p{{'}}''-DDT causes eggshell thinning and altered shell gland carbonic anhydrase expression in the domestic hen | journal =Environmental Toxicology and Chemistry| volume = 25 | issue = 10 | pages = 2787–2793 | date = October 2006 | pmid = 17022422 | doi = 10.1897/05-619R.1 | s2cid = 9298213 }}</ref> Multiple mechanisms may be at work, or different mechanisms may operate in different species.<ref name="ATSDRc5"/>
	===Acute toxicity===
	DDT is classified as "moderately toxic" by the United States ] (NTP)<ref></ref> and "moderately hazardous" by the ] (WHO), based on the rat oral {{LD50}} of 113&nbsp;mg/kg.<ref name = "zvgfrt">
	World Health Organization, , 2005.</ref> DDT has on rare occasions been administered orally as a treatment for ] poisoning.<ref>{{
	cite journal| journal=Clin Toxicol| year=1973| volume=6| issue=2| pages=147–51| title=Use of oral DDT in three human barbiturate intoxications: hepatic enzyme induction by reciprocal detoxicants| last=Rappolt| first=RT| pmid=4715198| doi=10.3109/15563657308990512}}</ref><!-- not about toxicity-->
	===Chronic toxicity===		==Human health==
			]-carrying ].]]
	====Diabetes====
			] hospital of ], 1973]]
	DDT and DDE have been linked to ]. A number of studies from the US, Canada, and Sweden have found that the prevalence of the disease in a population increases with serum DDT or DDE levels.<ref>{{Cite journal |last = Jones |first = Oliver AH |last2 = Maguire |first2 = Mahon L |last3 = Griffin |first3 = Julian L |title = Environmental pollution and diabetes: a neglected association |journal = Lancet |volume = 371 |pages = 287–8 |date = January 26, 2008 |url = http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6T1B-4RNK38J-B-1&_cdi=4886&_user=4420&_orig=browse&_coverDate=02%2F01%2F2008&_sk=996280390&view=c&wchp=dGLbVtb-zSkzS&md5=49ceb153cf41f91572ac41664bcf057e&ie=/sdarticle.pdf |format=PDF| doi = 10.1016/S0140-6736(08)60147-6 |pmid = 18294985 |issue = 9609 }}</ref><ref>{{cite journal|last=Turyk|first=Mary|date=March 6, 2009|title=Organochlorine Exposure and Incidence of Diabetes in a Cohort of Great Lakes Sport Fish Consumers|journal=Environ. Health Perspect. |url=http://www.ehponline.org/docs/2009/0800281/abstract.html|archiveurl = http://www.webcitation.org/5uKxYtUcy |archivedate = 2010-11-18|deadurl=no}}</ref><ref>{{Cite journal |last = Codru |first = Neculai |last2 =Schymura| first2 = MJ | title = Diabetes in Relation to Serum Levels of Polychlorinated Biphenyls and Chlorinated Pesticides in Adult Native Americans |journal =Environ. Health Perspect. | volume = 115 |issue = 10| pages =1442–7 |year = 2007 |url = http://www.ehponline.org/members/2007/10315/10315.pdf|format=PDF |pmid = 17938733 |last3 = Negoita |first3 = S |author4 = Akwesasne Task Force on Environment |last5 = Rej |first5 = R |last6 = Carpenter |first6 = DO |doi = 10.1289/ehp.10315 |pmc = 2022671|archiveurl = http://www.webcitation.org/5uKxaOQ37 |archivedate = 2010-11-18|deadurl=no}}</ref><ref>{{Cite journal |last = Cox |first = Shanna |title = Prevalence of Self-Reported Diabetes and Exposure to Organochlorine Pesticides among Mexican Americans: Hispanic Health and Nutrition Examination Survey, 1982–1984 |journal = Environ. Health Perspect | volume = 115 |issue = 12| pages = 1747–52 |year = 2007 |url = http://www.ehponline.org/members/2007/10258/10258.pdf|format=PDF |pmid = 18087594 |last3 = Narayan |first3 = KM |last4 = Marcus |first4 = M |doi = 10.1289/ehp.10258 |pmc = 2137130 |last2 = Niskar |first2 = AS|archiveurl = http://www.webcitation.org/5uKxbd3tE |archivedate = 2010-11-18|deadurl=no}}</ref><ref name="pmid19654916">{{cite journal |author=Turyk M, Anderson H, Knobeloch L, Imm P, Persky V |title=Organochlorine exposure and incidence of diabetes in a cohort of Great Lakes sport fish consumers |journal=Environ. Health Perspect. |volume=117 |issue=7 |pages=1076–82 |year=2009 |month=July |pmid=19654916 |doi=10.1289/ehp.0800281 |pmc=2717133}}</ref><ref>{{cite journal|last=Philibert|first=Aline|coauthors=Harold Schwartz and Donna Mergler|date=11 December 2009|title=An Exploratory Study of Diabetes in a First Nation Community with Respect to Serum Concentrations of p,p’-DDE and PCBs and Fish Consumption|journal=Int. J. Environ. Res. Public Health|volume=6|issue=12|pages=3179–89|url=http://www.mdpi.com/1660-4601/6/12/3179|doi=10.3390/ijerph6123179|pmid=20049255|pmc=2800343|archiveurl = http://www.webcitation.org/5uKxcpvRO |archivedate = 2010-11-18|deadurl=no}}</ref>
			] is the build up of toxins in a food chain. The DDT concentration is in parts per million. As the trophic level increases in a food chain, the amount of toxic build up also increases. The X's represent the amount of toxic build up accumulating as the trophic level increases. Toxins build up in organism's tissues and fat. Predators accumulate higher toxins than the prey.]]
			DDT is an ].<ref>{{cite web |url= http://www.fws.gov/contaminants/issues/endocrinedisruptors.cfm |title= Endocrine (Hormone) Disruptors |work= ] |access-date= 8 April 2015 |archive-date= October 8, 2015 |archive-url= https://web.archive.org/web/20151008032722/http://www.fws.gov/contaminants/issues/EndocrineDisruptors.cfm |url-status= dead }}</ref><ref>{{cite web | url = http://gewa.mpcer.nau.edu/files/endocrine-disruptors.pdf | title = Endocrine Disruptors |work=] | date = 2007 | access-date = April 8, 2015 | archive-url = https://web.archive.org/web/20160305203707/http://gewa.mpcer.nau.edu/files/endocrine-disruptors.pdf | archive-date = March 5, 2016 |via= George Washington Birthplace National Monument}}</ref> It is considered likely to be a human ] although the majority of studies suggest it is not directly ].<ref>{{cite web |url=http://www.efsa.europa.eu/sites/default/files/scientific_output/files/main_documents/433.pdf |title=European Food Safety Administration – DDT |access-date=2014-10-29 |archive-date=June 3, 2018 |archive-url=https://web.archive.org/web/20180603023020/http://www.efsa.europa.eu/sites/default/files/scientific_output/files/main_documents/433.pdf |url-status=dead }}</ref><ref name=NTP-DDT>{{cite web |url=http://ntp.niehs.nih.gov/ntp/roc/content/profiles/dichlorodiphenyltrichloroethane.pdf |work=National Toxicology Program |title=DDT |access-date=2014-10-29 |archive-date=May 22, 2016 |archive-url=https://web.archive.org/web/20160522013510/http://ntp.niehs.nih.gov/ntp/roc/content/profiles/dichlorodiphenyltrichloroethane.pdf |url-status=live }}</ref><ref>{{cite book |url=http://monographs.iarc.fr/ENG/Monographs/vol53/mono53-9.pdf |title=IARC – DDT |year=1992 |isbn=9789283212539 |access-date=2014-10-29 |archive-date=October 29, 2014 |archive-url=https://web.archive.org/web/20141029134721/http://monographs.iarc.fr/ENG/Monographs/vol53/mono53-9.pdf |url-status=live }}</ref> ] acts as a weak ] ], but not as an ].<ref>{{Cite journal|last1=Kelce|first1=William R.|last2=Stone|first2=Christy R.|last3=Laws|first3=Susan C.|last4=Gray|first4=L. Earl|last5=Kemppainen|first5=Jon A.|last6=Wilson|first6=Elizabeth M.|date=1995|title=Persistent DDT metabolite p,p'–DDE is a potent androgen receptor antagonist|url=http://www.nature.com/articles/375581a0|journal=Nature|language=en|volume=375|issue=6532|pages=581–585|doi=10.1038/375581a0|pmid=7791873|bibcode=1995Natur.375..581K|s2cid=4344932|issn=0028-0836|access-date=October 14, 2020|archive-date=November 17, 2020|archive-url=https://web.archive.org/web/20201117150457/https://www.nature.com/articles/375581a0|url-status=live}}</ref> ''p'',''p{{'}}''-DDT, DDT's main component, has little or no androgenic or estrogenic activity.<ref name="Cohn07">{{cite journal | vauthors = Cohn BA, Wolff MS, Cirillo PM, Sholtz RI | title = DDT and breast cancer in young women: new data on the significance of age at exposure | journal = Environmental Health Perspectives | volume = 115 | issue = 10 | pages = 1406–1414 | date = October 2007 | pmid = 17938728 | pmc = 2022666 | doi = 10.1289/ehp.10260 | bibcode = 2007EnvHP.115.1406C }}</ref> The minor component ''o'',''p{{'}}''-DDT has weak estrogenic activity.
	====Developmental toxicity====
	DDT and DDE, like other organochlorines, have been shown to have ] activity, meaning they are chemically similar enough to estrogens to trigger hormonal responses in animals. This ] activity has been observed in ] and ] toxicological studies, and available ] evidence indicates that these effects may be occurring in humans as a result of DDT exposure. The US ] states that DDT exposure damages the reproductive system and reduces reproductive success. These effects may cause developmental and reproductive toxicity:
			===Acute toxicity===
	* A review article in '']'' states, "research has shown that exposure to DDT at amounts that would be needed in malaria control might cause preterm birth and early weaning ... toxicological evidence shows ] properties; human data also indicate possible disruption in semen quality, menstruation, gestational length, and duration of lactation."<ref name="pmid16125595"/>
			DDT is classified as "moderately toxic" by the U.S. ] (NTP) and "moderately hazardous" by WHO, based on the rat oral {{LD50}} of 113&nbsp;mg/kg.<ref name = "zvgfrt">World Health Organization, {{Webarchive|url=https://web.archive.org/web/20210704154307/https://www.who.int/ipcs/publications/pesticides_hazard_rev_3.pdf |date=July 4, 2021 }}, 2005.</ref> Indirect exposure is considered relatively non-toxic for humans.<ref name="Agarwal">{{cite journal | vauthors = Agarwal A, Aponte-Mellado A, Premkumar BJ, Shaman A, Gupta S | title = The effects of oxidative stress on female reproduction: a review | journal = Reproductive Biology and Endocrinology | volume = 10 | issue = 1 | pages = 49 | date = June 2012 | pmid = 22748101 | pmc = 3527168 | doi = 10.1186/1477-7827-10-49 | quote = In general, incidental human exposure to DDT has been considered relatively non-toxic, but prolonged exposure has long been recognized to adversely affect reproduction. | doi-access = free }}</ref>
	* Human epidemiological studies suggest that exposure is a risk factor for premature birth and low birth weight, and may harm a mother's ability to ].<ref name="Rogan&Ragan">{{
	cite journal |author=Rogan WJ, Ragan NB |title=Evidence of effects of environmental chemicals on the endocrine system in children |journal=Pediatrics |volume=112 |issue=1 Pt 2 |pages=247–52 |year=2003 |pmid=12837917 |url=http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=12837917 |doi=10.1542/peds.112.1.S1.247 |doi_brokendate=2009-11-27}}</ref> Some 21st century researchers argue that these effects may increase infant deaths, offsetting any anti-malarial benefits.<ref>{{
			=== Chronic toxicity ===
	cite journal |author=Chen A, Rogan WJ |title=Nonmalarial infant deaths and DDT use for malaria control |journal=Emerging Infect. Dis. |volume=9 |issue=8 |pages=960–4 |year=2003 |pmid=12967494 |url=http://www.cdc.gov/ncidod/EID/vol9no8/03-0082.htm |pmc=3020610}}<br/>{{cite journal |author=Roberts D, Curtis C, Tren R, Sharp B, Shiff C, Bate R |title=Malaria control and public health |journal=Emerging Infect. Dis. |volume=10 |issue=6 |pages=1170–1; author reply 1171–2 |year=2004 |pmid=15224677 |url=http://www.cdc.gov/ncidod/eid/vol10no6/03-0787_03-1116.htm}}<!-- Includes author reply --></ref> A 2008 study, however, failed to confirm the association between exposure and difficulty breastfeeding.<ref>{{
			Primarily through the tendency for DDT to build up in areas of the body with high lipid content, chronic exposure can affect reproductive capabilities and the embryo or fetus.<ref name="Agarwal"/>
	cite journal |last = Cupul-Uicab |first = LA |title = DDE, a Degradation Product of DDT, and Duration of Lactation in a Highly Exposed Area of Mexico |journal = Environ. Health Perspect. |volume = 116 |issue = 2 |pages = 179–183 |year = 2008 |url = http://www.ehponline.org/docs/2007/10550/abstract.html |doi = 10.1289/ehp.10550 |pmid = 18288315 |last2 = Gladen |first2 = BC |last3 = Hernández-Avila |first3 = M |last4 = Weber |first4 = JP |last5 = Longnecker |first5 = MP |pmc = 2235222}}</ref>
			* A review article in '']'' states: "research has shown that exposure to DDT at amounts that would be needed in malaria control might cause preterm birth and early weaning&nbsp;... toxicological evidence shows ] properties; human data also indicate possible disruption in semen quality, menstruation, gestational length, and duration of lactation".<ref name=Rogan05/>
	* Several recent studies demonstrate a link between ''in utero'' exposure to DDT or DDE and developmental neurotoxicity in humans. For example, a 2006 ] study suggests that children exposed while in the womb have a greater chance of development problems,<ref>{{
			* Other studies document decreases in ] quality among men with high exposures (generally from ]).<ref>{{cite journal | vauthors = Jurewicz J, Hanke W, Radwan M, Bonde JP | s2cid = 6681999 | title = Environmental factors and semen quality | journal = International Journal of Occupational Medicine and Environmental Health | volume = 22 | issue = 4 | pages = 305–329 | date = January 2010 | pmid = 20053623 | doi = 10.2478/v10001-009-0036-1 | doi-broken-date = November 11, 2024 }}</ref>
	cite news| url=http://news.bbc.co.uk/2/hi/health/5145450.stm|title=DDT 'link' to slow child progress| author=BBC| accessdate=2006-07-05 | date=2006-07-05 | work=BBC News}}</ref> and other studies have found that even low levels of DDT or DDE in ] serum at birth are associated with decreased attention at infancy<ref>{{
			* Studies are inconsistent on whether high blood DDT or DDE levels increase time to pregnancy.<ref name="PineRiver"/> In mothers with high DDE blood serum levels, daughters may have up to a 32% increase in the probability of conceiving, but increased DDT levels have been associated with a 16% decrease in one study.<ref name="Eskenazi">{{cite journal | vauthors = Eskenazi B, Chevrier J, Rosas LG, Anderson HA, Bornman MS, Bouwman H, Chen A, Cohn BA, de Jager C, Henshel DS, Leipzig F, Leipzig JS, Lorenz EC, Snedeker SM, Stapleton D | title = The Pine River statement: human health consequences of DDT use | journal = Environmental Health Perspectives | volume = 117 | issue = 9 | pages = 1359–1367 | date = September 2009 | pmid = 19750098 | doi = 10.1289/ehp.11748 | quote = Overall, the few studies conducted to date suggest that DDT exposure may affect time to pregnancy, but more research is needed. | pmc=2737010| bibcode = 2009EnvHP.117.1359E }}</ref>
	cite journal |author=Sagiv SK, Nugent JK, Brazelton TB, ''et al.'' |title=Prenatal organochlorine exposure and measures of behavior in infancy using the Neonatal Behavioral Assessment Scale (NBAS) |journal=Environ. Health Perspect. |volume=116 |issue=5 |pages=666–73 |year=2008 |month=May |pmid=18470320 |pmc=2367684 |doi=10.1289/ehp.10553 |url=http://www.ehponline.org/docs/2008/10553/abstract.html}}</ref> and decreased cognitive skills at 4 years of age.<ref>{{
			* Indirect exposure of mothers through workers directly in contact with DDT is associated with an increase in spontaneous abortions.<ref name="Agarwal"/>
	cite journal |author=Ribas-Fitó N, Torrent M, Carrizo D |title=In utero exposure to background concentrations of DDT and cognitive functioning among preschoolers |journal=Am. J. Epidemiol. |volume=164 |issue=10 |pages=955–62 |year=2006 |pmid=16968864 |doi=10.1093/aje/kwj299}}</ref> Similarly, Mexican researchers have linked first trimester DDE exposure to ].<ref>{{
	cite journal |author=Torres-Sánchez L, Rothenberg SJ, Schnaas L |title=In utero p, p'-DDE exposure and infant neurodevelopment: a perinatal cohort in Mexico |journal=Environ. Health Perspect. |volume=115 |issue=3 |pages=435–9 |year=2007 |pmid=17431495 |doi=10.1289/ehp.9566 |pmc=1849908}}</ref>		* Other studies found that DDT or DDE interfere with proper thyroid function in pregnancy and childhood.<ref name="PineRiver"/><ref>{{cite journal | vauthors = Chevrier J, Eskenazi B, Holland N, Bradman A, Barr DB | title = Effects of exposure to polychlorinated biphenyls and organochlorine pesticides on thyroid function during pregnancy | journal = American Journal of Epidemiology | volume = 168 | issue = 3 | pages = 298–310 | date = August 2008 | pmid = 18550560 | pmc = 2727265 | doi = 10.1093/aje/kwn136}}</ref>
			* Mothers with high levels of DDT circulating in their blood during pregnancy were found to be more likely to give birth to children who would go on to develop autism.<ref>{{Cite journal|last=Reardon|first=Sara|date=2018-08-16|title=Autism and DDT: What one million pregnancies can – and can't – reveal|url=https://www.nature.com/articles/d41586-018-05994-1|journal=Nature|doi=10.1038/d41586-018-05994-1|s2cid=81471566|issn=0028-0836|access-date=August 17, 2018|archive-date=August 19, 2018|archive-url=https://web.archive.org/web/20180819095150/https://www.nature.com/articles/d41586-018-05994-1|url-status=live}}</ref><ref>{{cite journal | vauthors = Brown AS, Cheslack-Postava K, Rantakokko P, Kiviranta H, Hinkka-Yli-Salomäki S, McKeague IW, Surcel HM, Sourander A | title = Association of Maternal Insecticide Levels With Autism in Offspring From a National Birth Cohort | journal = The American Journal of Psychiatry | volume = 175 | issue = 11 | pages = 1094–1101 | date = November 2018 | pmid = 30111184 | pmc = 6377859 | doi = 10.1176/appi.ajp.2018.17101129 }}</ref>
	* Other studies document decreases in semen quality among men with high exposures (generally from IRS).<ref name="pmid20053623">{{
	cite journal |author=Jurewicz J, Hanke W, Radwan M, Bonde JP |title=Environmental factors and semen quality |journal=Int J Occup Med Environ Health |volume= 22|issue= 4|pages=1–25 |year=2010 |month=January |pmid=20053623 |doi=10.2478/v10001-009-0036-1 |url=}}</ref><ref>{{
	cite journal |author=Aneck-Hahn NH, Schulenburg GW, Bornman MS, Farias P, de Jager C |title=Impaired semen quality associated with environmental DDT exposure in young men living in a malaria area in the Limpopo Province, South Africa |journal=J. Androl. |volume=28 |issue=3 |pages=423–34 |year=2007 |pmid=17192596 |doi=10.2164/jandrol.106.001701}}</ref><ref>{{
	cite journal |author=De Jager C, Farias P, Barraza-Villarreal A |title=Reduced seminal parameters associated with environmental DDT exposure and p,p'-DDE concentrations in men in Chiapas, Mexico: a cross-sectional study |journal=J. Androl. |volume=27 |issue=1 |pages=16–27 |year=2006 |pmid=16400073 |doi=10.2164/jandrol.05121}}</ref>
	* Studies generally find that high blood DDT or DDE levels do not increase time to pregnancy (TTP.)<ref name="pmid19092487">{{cite journal |author=Harley KG, Marks AR, Bradman A, Barr DB, Eskenazi B |title=DDT Exposure, Work in Agriculture, and Time to Pregnancy Among Farmworkers in California |journal=J. Occup. Environ. Med. |volume=50 |issue=12 |pages=1335–42 |year=2008 |month=December |pmid=19092487 |doi=10.1097/JOM.0b013e31818f684d |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?an=00043764-200812000-00003 |pmc=2684791|archiveurl = http://www.webcitation.org/5uKxdeKko |archivedate = 2010-11-18|deadurl=no}}</ref> There is some evidence that the daughters of highly exposed women may have more difficulty getting pregnant (i.e. increased TTP).<ref>{{cite journal |author=Cohn BA, Cirillo PM, Wolff MS |title=DDT and DDE exposure in mothers and time to pregnancy in daughters |journal=Lancet |volume=361 |issue=9376 |pages=2205–6 |year=2003 |pmid=12842376 |doi=10.1016/S0140-6736(03)13776-2}}</ref>
	* DDT is associated with early pregnancy loss, a type of ]. A prospective cohort study of Chinese ] workers found "a positive, monotonic, exposure-response association between preconception serum total DDT and the risk of subsequent early pregnancy losses."<ref>{{
	cite journal |author=Venners SA, Korrick S, Xu X |title=Preconception serum DDT and pregnancy loss: a prospective study using a biomarker of pregnancy |journal=Am. J. Epidemiol. |volume=162 |issue=8 |pages=709–16 |year=2005 |pmid=16120699 |doi=10.1093/aje/kwi275}}</ref> The median serum DDE level of study group was lower than that typically observed in women living in homes sprayed with DDT.<ref>{{
	cite journal |author=Longnecker MP |title=Invited Commentary: Why DDT matters now |journal=Am. J. Epidemiol. |volume=162 |issue=8 |pages=726–8 |year=2005 |pmid=16120697 |doi=10.1093/aje/kwi277}}</ref>
	* A Japanese study of ] concluded that ''in utero'' DDT exposure may affect ] ] levels and "play an important role in the incidence and/or causation of ]."<ref name="pmid17307219">{{
	cite journal |author=Nagayama J, Kohno H, Kunisue T |title=Concentrations of organochlorine pollutants in mothers who gave birth to neonates with congenital hypothyroidism |journal=Chemosphere |volume=68 |issue=5 |pages=972–6 |year=2007 |pmid=17307219 |doi=10.1016/j.chemosphere.2007.01.010 |url=http://linkinghub.elsevier.com/retrieve/pii/S0045-6535(07)00040-9}}</ref> Other studies have also found the DDT or DDE interfere with proper thyroid function.<ref name="pmid17933884">{{
	cite journal |author=Alvarez-Pedrerol M, Ribas-Fito N, Torrent M, Carrizo D, Grimalt JO, Sunyer J |title=Effects of PCBs, p,p'-DDT, p,p'-DDE, HCB and {beta}-HCH on thyroid function in preschoolers |journal=Occup Environ Med |year=2007 |month=October |pmid=17933884 |doi=10.1136/oem.2007.032763 |volume=65 |issue=7 |pages=452–7}}</ref><ref name="pmid18560538">{{
	cite journal |author=Schell LM, Gallo MV, Denham M, Ravenscroft J, Decaprio AP, Carpenter DO |title=Relationship of Thyroid Hormone Levels to Levels of Polychlorinated Biphenyls, Lead, p, p'- DDE, and Other Toxicants in Akwesasne Mohawk Youth |journal=Environ. Health Perspect. |volume=116 |issue=6 |pages=806–13 |year=2008 |month=June |pmid=18560538 |doi=10.1289/ehp.10490 |pmc=2430238}}</ref>
	====Other====		=== Carcinogenicity ===
			In 2015, the ] classified DDT as Group 2A "probably carcinogenic to humans".<ref>{{Cite web|url=http://www.iarc.fr/en/media-centre/pr/2015/pdfs/pr236_E.pdf|title=IARC Monographs evaluate DDT, lindane, and 2,4-D|access-date=August 13, 2015|archive-date=April 13, 2020|archive-url=https://web.archive.org/web/20200413043943/http://www.iarc.fr/en/media-centre/pr/2015/pdfs/pr236_E.pdf|url-status=live}}</ref> Previous assessments by the U.S. ] classified it as "reasonably anticipated to be a carcinogen" and by the EPA classified DDT, DDE and DDD as class B2 "probable" ]s; these evaluations were based mainly on animal studies.<ref name="ATSDRc5"/><ref name=Rogan05/> <!--In 2002, the ] reported, "Overall, in spite of some positive associations for some cancers within certain subgroups of people, there is no clear evidence that exposure to DDT/DDE causes cancer in humans."<ref name="ATSDRc5"/> -->
	Occupational exposure in agriculture and malaria control has been linked to neurological problems (i.e. Parkinsons)<ref>{{
	cite journal | author=van Wendel de Joode B, Wesseling C, Kromhout H, Monge P, Garcia M, Mergler D | title=Chronic nervous-system effects of long-term occupational exposure to DDT | journal=Lancet | year=2001 | pages=1014–6 | volume=357 | issue=9261 | pmid=11293598 | doi=10.1016/S0140-6736(00)04249-5}}</ref> and ].<ref>
	Anthony J Brown, , Scientific American, September 17, 2007.</ref>
			A 2005 Lancet review stated that occupational DDT exposure was associated with increased ] risk in 2 case control studies, but another study showed no DDE dose-effect association. Results regarding a possible association with ] and biliary tract cancer are conflicting: workers who did not have direct occupational DDT contact showed increased risk. White men had an increased risk, but not white women or black men. Results about an association with multiple myeloma, prostate and testicular cancer, endometrial cancer and colorectal cancer have been inconclusive or generally do not support an association.<ref name=Rogan05/> A 2017 review of liver cancer studies concluded that "organochlorine pesticides, including DDT, may increase ] risk".<ref>{{cite journal | vauthors = VoPham T, Bertrand KA, Hart JE, Laden F, Brooks MM, Yuan JM, Talbott EO, Ruddell D, Chang CH, Weissfeld JL | title = Pesticide exposure and liver cancer: a review | journal = Cancer Causes & Control | volume = 28 | issue = 3 | pages = 177–190 | date = March 2017 | pmid = 28194594 | pmc = 5336347 | doi = 10.1007/s10552-017-0854-6 }}</ref>
	===Carcinogenicity===
	DDT is suspected to ]. The NTP classifies it as "reasonably anticipated to be a carcinogen," the ] classifies it as a "possible" human carcinogen, and the EPA classifies DDT, DDE, and DDD as class B2 "probable" carcinogens. These evaluations are based mainly on the results of animal studies.<ref name="ATSDRc5"/><ref name="pmid16125595"/>
			A 2009 review, whose co-authors included persons engaged in DDT-related litigation, reached broadly similar conclusions, with an equivocal association with testicular cancer. ] did not support an association with leukemia or lymphoma.<ref name="PineRiver"/>
	There is evidence from epidemiological studies (i.e. studies in human populations) that indicates that DDT causes cancers of the ],<ref name="pmid16125595"/><ref name="PineRiver"/> ]<ref name="pmid16125595"/><ref name="PineRiver"/> and ].<ref name="PineRiver"/> There is mixed evidence that it contributes to ],<ref name="PineRiver"/> ]<ref name="PineRiver"/><ref>{{
	Cite journal |last = Spinelli |first =John J. |title = Organochlorines and risk of non-Hodgkin lymphoma |journal = Int. J. Cancer |volume = 121 |issue = 12 |pages = 2767–75 |date = 2007-12-15 |url = http://www3.interscience.wiley.com/cgi-bin/abstract/115807299/ABSTRACT |doi = 10.1002/ijc.23005 |pmid = 17722095 |last3 = Weber |first3 = JP |last4 = Connors |first4 = JM |last5 = Gascoyne |first5 = RD |last6 = Lai |first6 = AS |last7 = Brooks-Wilson |first7 = AR |last8 = Le |first8 = ND |last9 = Berry |first9 = BR |last2 = Ng |first2 = CH }}</ref> and ].<ref name="pmid16125595"/><ref name="PineRiver"/><ref>{{
	Cite journal |last = McGlynn |first = Katherine A. |last2 = Quraishi | first2 = Sabah M. |title = Persistent Organochlorine Pesticides and Risk of Testicular Germ Cell Tumors |journal = Journal of the National Cancer Institute |date = April 29, 2008 |url = http://jnci.oxfordjournals.org/cgi/content/abstract/djn101v1 |doi = 10.1093/jnci/djn101 |page = 663 |pmid = 18445826 |first3 = BI |last4 = Weber |first4 = JP |last5 = Rubertone |first5 = MV |last6 = Erickson |first6 = RL |issue = 9 |last3 = Graubard |volume = 100 }}</ref> Other epidemiological studies suggest that DDT/DDE does not cause ],<ref name="pmid16125595"/> or cancers of the ],<ref name="pmid16125595"/> ],<ref name="pmid16125595"/><ref name="PineRiver"/> ],<ref name="pmid16125595"/><ref name="PineRiver"/> ],<ref name="PineRiver"/> ],<ref name="PineRiver"/> or ].<ref name="PineRiver"/>
	====Breast cancer====		====Breast cancer====
			The question of whether DDT or DDE are ] has not been conclusively answered. Several meta analyses of observational studies have concluded that there is no overall relationship between DDT exposure and breast cancer risk.<ref>{{cite journal | vauthors = Park JH, Cha ES, Ko Y, Hwang MS, Hong JH, Lee WJ | title = Exposure to Dichlorodiphenyltrichloroethane and the Risk of Breast Cancer: A Systematic Review and Meta-analysis | journal = Osong Public Health and Research Perspectives | volume = 5 | issue = 2 | pages = 77–84 | date = April 2014 | pmid = 24955316 | pmc = 4064641 | doi = 10.1016/j.phrp.2014.02.001 }}</ref><ref>{{cite journal | vauthors = Ingber SZ, Buser MC, Pohl HR, Abadin HG, Murray HE, Scinicariello F | title = DDT/DDE and breast cancer: a meta-analysis | journal = ] | volume = 67 | issue = 3 | pages = 421–433 | date = December 2013 | pmid = 24021539 | doi = 10.1016/j.yrtph.2013.08.021 | doi-access = free | pmc = 11298241 }}</ref> The United States Institute of Medicine reviewed data on the association of breast cancer with DDT exposure in 2012 and concluded that a causative relationship could neither be proven nor disproven.<ref>{{cite journal | vauthors = Smith-Bindman R | title = Environmental causes of breast cancer and radiation from medical imaging: findings from the Institute of Medicine report | journal = Archives of Internal Medicine | volume = 172 | issue = 13 | pages = 1023–1027 | date = July 2012 | pmid = 22688684 | pmc = 3936791 | doi = 10.1001/archinternmed.2012.2329 }}</ref>
	The question of whether DDT or DDE are ] has been repeatedly studied. While individual studies conflict, the most recent reviews of all the evidence conclude that pre-puberty exposure increases the risk of subsequent breast cancer.<ref name="PineRiver"/><ref name="pmid18557596">{{
	cite journal |author=Clapp RW, Jacobs MM, Loechler EL |title=Environmental and occupational causes of cancer: new evidence 2005-2007 |journal=Rev Environ Health |volume=23 |issue=1 |pages=1–37 |year=2008 |pmid=18557596 |pmc=2791455 }}</ref> Until recently, almost all studies measured DDT or DDE blood levels at the time of breast cancer diagnosis or after. This study design has been criticized, since the levels at diagnosis do not necessarily correspond to levels when the cancer started.<ref name="pmid18629310">{{
	cite journal |author=Verner MA, Charbonneau M, López-Carrillo L, Haddad S |title=Physiologically based pharmacokinetic modeling of persistent organic pollutants for lifetime exposure assessment: a new tool in breast cancer epidemiologic studies |journal=Environ. Health Perspect. |volume=116 |issue=7 |pages=886–92 |year=2008 |month=July |pmid=18629310 |pmc=2453156 |doi=10.1289/ehp.10917 }}</ref> Taken as a whole such studies "do not support the hypothesis that exposure to DDT is an important risk factor for breast cancer."<ref name=Cohn07/> The studies of this design have been extensively reviewed.<ref name="pmid16125595"/><ref>{{
	cite journal |author=Brody JG, Moysich KB, Humblet O, Attfield KR, Beehler GP, Rudel RA |title=Environmental pollutants and breast cancer: epidemiologic studies |journal=Cancer |volume=109 |issue=12 Suppl |pages=2667–711 |year=2007 |month=June |pmid=17503436 |doi=10.1002/cncr.22655 |url=http://www3.interscience.wiley.com/cgi-bin/fulltext/114261513/HTMLSTART?CRETRY=1&SRETRY=0}}</ref><ref>{{
	cite journal |doi=10.1289/ehp.6492 |author=López-Cervantes M, Torres-Sánchez L, Tobías A, López-Carrillo L |title=Dichlorodiphenyldichloroethane burden and breast cancer risk: a meta-analysis of the epidemiologic evidence |journal=Environ. Health Perspect. |volume=112 |issue=2 |pages=207–14 |year=2004 |month=February |pmid=14754575 |pmc=1241830 |url=http://www.ehponline.org/members/2003/6492/6492.html}}</ref>
			A 2007 case-control study<ref name="Cohn07"/> using archived blood samples found that breast cancer risk was increased 5-fold among women who were born prior to 1931 and who had high serum DDT levels in 1963. Reasoning that DDT use became widespread in 1945 and peaked around 1950, they concluded that the ages of 14–20 were a critical period in which DDT exposure leads to increased risk. This study, which suggests a connection between DDT exposure and breast cancer that would not be picked up by most studies, has received variable commentary in third-party reviews. One review suggested that "previous studies that measured exposure in older women may have missed the critical period".<ref name="PineRiver"/><ref>{{cite journal | vauthors = Clapp RW, Jacobs MM, Loechler EL | title = Environmental and occupational causes of cancer: new evidence 2005–2007 | journal = Reviews on Environmental Health | volume = 23 | issue = 1 | pages = 1–37 | year = 2008 | pmid = 18557596 | pmc = 2791455 | doi = 10.1515/REVEH.2008.23.1.1 }}</ref> The National Toxicology Program notes that while the majority of studies have not found a relationship between DDT exposure and breast cancer that positive associations have been seen in a "few studies among women with higher levels of exposure and among certain subgroups of women".<ref name=NTP-DDT/>
	In contrast, a study published in 2007 strongly associated early exposure (the ''p,p'-'' isomer) and breast cancer later in life. Unlike previous studies, this ] collected blood samples from young mothers in the 1960s while DDT was still in use, and their breast cancer status was then monitored over the years. In addition to suggesting that the ''p,p'-'' isomer is the more significant risk factor, the study also suggests that the timing of exposure is critical. For the subset of women born more than 14 years before agricultural use, there was no association between DDT and breast cancer. However, for younger women—exposed earlier in life—the third who were exposed most to ''p,p'-''DDT had a fivefold increase in breast cancer incidence over the least exposed third, after correcting for the protective effect of ''o,p'-''DDT.<ref name=Cohn07/><ref>{{cite news |author=Douglas Fischer |title=Exposure to DDT is linked to cancer |url=http://www.contracostatimes.com/health/ci_6524706?nclick_check=1 |publisher=Contra Costa Times |date=August 8, 2007 |archiveurl = http://www.webcitation.org/5uKxfh59f |archivedate = 2010-11-18|deadurl=no}}</ref><ref>{{cite news |author=Marla Cone |title=Study suggests DDT, breast cancer link |url=http://www.latimes.com/news/nationworld/nation/la-na-ddt30sep30,0,3451847.story?coll=la-home-nation |publisher=LA Times |date=September 30, 2007 }} {{dead link|date=November 2010}}</ref> These results are supported by animal studies.<ref name="PineRiver"/>
			A 2015 case control study identified a link (odds ratio 3.4) between ''in-utero'' exposure (as estimated from archived maternal blood samples) and ] diagnosis in daughters. The findings "support classification of DDT as an endocrine disruptor, a predictor of breast cancer, and a marker of high risk".<ref>{{cite journal | vauthors = Cohn BA, La Merrill M, Krigbaum NY, Yeh G, Park JS, Zimmermann L, Cirillo PM | title = DDT Exposure in Utero and Breast Cancer | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 100 | issue = 8 | pages = 2865–2872 | date = August 2015 | pmid = 26079774 | pmc = 4524999 | doi = 10.1210/jc.2015-1841 }}</ref>
	==Use against malaria==
	] remains a major public health challenge in many countries. 2008 WHO estimates were 243 million cases, and 863,000 deaths. About 89% of these deaths occur in ], and mostly to children under the age of 5.<ref name="wmr09">
	2009 WHO </ref> DDT is one of many tools that public health officials use to fight the disease. Its use in this context has been called everything from a "miracle weapon like ] to the mosquitoes,"<ref name=salon/> to "toxic colonialism."<ref>{{
	cite journal |author=Paull, John |title=Toxic Colonialism |journal=New Scientist |issue=2628 |page=25 |date=3 November 2007 |url=http://www.newscientist.com/article/mg19626280.400-toxic-colonialism.html/}}</ref>
			==Malaria control{{anchor|Use_against_malaria}}==
	Before DDT, eliminating mosquito breeding grounds by drainage or poisoning with ] or ] was sometimes successful in fighting malaria. In parts of the world with rising living standards, the elimination of malaria was often a collateral benefit of the introduction of window screens and improved sanitation.<ref name="Gladwell"/> Today, a variety of usually simultaneous interventions is the norm. These include ] to prevent or treat infection; improvements in public health infrastructure to quickly diagnose, sequester, and treat infected individuals; ] and other methods intended to keep mosquitoes from biting humans; and ] strategies<ref name=wmr09/> such as ] with insecticides, ecological controls such as draining mosquito breeding grounds or introducing fish to eat larvae, and ] with insecticides, possibly including DDT. IRS involves the treatment of all interior walls and ceilings with insecticides, and is particularly effective against mosquitoes, since many species rest on an indoor wall before or after feeding. DDT is one of 12 WHO–approved IRS insecticides. How much of a role DDT should play in this mix of strategies is still controversial.<ref>Yakob, L., Dunning, R. & Yan, G. Indoor residual spray and insecticide-treated bednets for malaria control: theoretical synergisms and antagonisms. </ref>
			] remains the primary ] challenge in many countries. In 2015, there were 214 million cases of malaria worldwide resulting in an estimated 438,000 deaths, 90% of which occurred in Africa.<ref name=WHO15>{{cite web|title=Malaria Fact sheet N°94|url=https://www.who.int/mediacentre/factsheets/fs094/en/|publisher=WHO|access-date=2 February 2016|archive-date=September 3, 2014|archive-url=https://web.archive.org/web/20140903002027/http://www.who.int/mediacentre/factsheets/fs094/en/|url-status=live}}</ref> DDT is one of many tools to fight the disease. Its use in this context has been called everything from a "miracle weapon like ] to the mosquitoes",<ref name="salon">{{cite news |first=Kirsten |last=Weir |name-list-style=vanc |title=Rachel Carson's birthday bashing |url=http://www.salon.com/news/feature/2007/06/29/rachel_carson/ |work=Salon.com |date=June 29, 2007 |access-date=July 1, 2007 |archive-date=April 15, 2008 |archive-url=https://web.archive.org/web/20080415165815/http://www.salon.com/news/feature/2007/06/29/rachel_carson/ |url-status=live }}</ref> to "toxic colonialism".<ref>{{cite journal | last = Paull | first = John | name-list-style = vanc | title = Toxic Colonialism | journal = New Scientist | issue = 2628 | page = 25 | date = November 3, 2007 | volume = 196 | doi = 10.1016/S0262-4079(07)62774-2 | url = https://www.newscientist.com/article/mg19626280.400-toxic-colonialism.html/ | access-date = August 26, 2017 | archive-date = April 24, 2015 | archive-url = https://web.archive.org/web/20150424205340/http://www.newscientist.com/article/mg19626280.400-toxic-colonialism.html | url-status = live }}</ref>
			Before DDT, eliminating mosquito breeding grounds by drainage or poisoning with ] or ] was sometimes successful. In parts of the world with rising living standards, the elimination of malaria was often a collateral benefit of the introduction of window screens and improved sanitation.<ref name="Gladwell"/> A variety of usually simultaneous interventions represents best practice. These include ] to prevent or treat infection; improvements in public health infrastructure to diagnose, sequester and treat infected individuals; ] and other methods intended to keep mosquitoes from biting humans; and ] strategies<ref name="wmr09">{{cite web | date = 2009 | publisher = World Health Organization | url = http://whqlibdoc.who.int/publications/2009/9789241563901_eng.pdf | title = World Malaria Report | access-date = December 17, 2009 | archive-date = January 12, 2010 | archive-url = https://web.archive.org/web/20100112144947/http://whqlibdoc.who.int/publications/2009/9789241563901_eng.pdf | url-status = live }}</ref> such as ] with insecticides, ecological controls such as draining mosquito breeding grounds or introducing fish to eat larvae and ] (IRS) with insecticides, possibly including DDT. IRS involves the treatment of interior walls and ceilings with insecticides. It is particularly effective against mosquitoes, since many species rest on an indoor wall before or after feeding. DDT is one of 12 WHO–approved IRS insecticides.<ref name="AmJTrop"/>
	WHO's anti-malaria campaign of the 1950s and 1960s relied heavily on DDT and the results were promising, though temporary. Experts tie the resurgence of malaria to multiple factors, including poor leadership, management and funding of malaria control programs; poverty; civil unrest; and increased ]. The evolution of resistance to first-generation drugs (e.g. ]) and to insecticides exacerbated the situation.<ref name="DDTBP.1/2"/><ref>{{
	cite journal |author=Feachem RG, Sabot OJ |title=Global malaria control in the 21st century: a historic but fleeting opportunity |journal=JAMA |volume=297 |issue=20 |pages=2281–4 |year=2007 |pmid=17519417 |doi=10.1001/jama.297.20.2281}}</ref> Resistance was largely fueled by often unrestricted agricultural use. Resistance and the harm both to humans and the environment led many governments to restrict or curtail the use of DDT in vector control as well as agriculture.<ref name="pmid7278974"/>
			The WHO's anti-malaria campaign of the 1950s and 1960s relied heavily on DDT and the results were promising, though temporary in developing countries. Experts tie malarial resurgence to multiple factors, including poor leadership, management and funding of malaria control programs; poverty; civil unrest; and increased ]. The evolution of resistance to first-generation drugs (e.g. ]) and to insecticides exacerbated the situation.<ref name="DDTBP.1/2"/><ref name="Feachem2007">{{cite journal | vauthors = Feachem RG, Sabot OJ | title = Global malaria control in the 21st century: a historic but fleeting opportunity | journal = JAMA | volume = 297 | issue = 20 | pages = 2281–2284 | date = May 2007 | pmid = 17519417 | doi = 10.1001/jama.297.20.2281 }}</ref> Resistance was largely fueled by unrestricted agricultural use. Resistance and the harm both to humans and the environment led many governments to curtail DDT use in vector control and agriculture.<ref name=Chapin81/> In 2006 WHO reversed a longstanding policy against DDT by recommending that it be used as an indoor pesticide in regions where malaria is a major problem.<ref>{{cite news |url=https://www.washingtonpost.com/wp-dyn/content/article/2006/09/15/AR2006091501012.html |title=WHO Urges Use of DDT in Africa |date=September 16, 2006 |newspaper=Washington Post |access-date=August 22, 2017 |archive-date=September 2, 2017 |archive-url=https://web.archive.org/web/20170902230036/http://www.washingtonpost.com/wp-dyn/content/article/2006/09/15/AR2006091501012.html |url-status=live }}</ref>
	Once the mainstay of anti-malaria campaigns, as of 2008 only 12 countries used DDT, including India and some southern African states,<ref name=wmr09/> though the number is expected to rise.<ref name="DDTBP.1/2"/>
			Once the mainstay of anti-malaria campaigns, as of 2019 only five countries used DDT for Indoor Residual Spraying <ref>{{cite web |url= https://www.un.org/africarenewal/magazine/january-2022/widespread-use-ddt-malaria-control-worries-environmentalist|title=Widespread use of DDT for malaria control worries environmentalist|work=Africa Renewal|date=January 5, 2022 }}</ref>
	===Effectiveness of DDT against malaria===
	When it was first introduced in World War II, DDT was very effective in reducing malaria ] and ].<ref name=Dunlap/> The WHO's anti-malaria campaign, which consisted mostly of spraying DDT, was initially very successful as well. For example, in ], the program reduced cases from about 3 million per year before spraying to just 29 in 1964. Thereafter the program was halted to save money and malaria rebounded to 600,000 cases in 1968 and the first quarter of 1969. The country resumed DDT vector control but the mosquitoes had acquired resistance in the interim, presumably because of continued agricultural use. The program switched to ], which though more expensive proved effective.<ref name="Gordon">{{
	cite book|last=Harrison|first=Gordon A|title=Mosquitoes, Malaria, and Man: A History of the Hostilities Since 1880|publisher=Dutton|year=1978|isbn=978-0-525-16025-0}}</ref>
			===Initial effectiveness===
	Today, DDT remains on the WHO's list of insecticides recommended for IRS. Since the appointment of ] as head of its anti-malaria division, WHO's policy has shifted from recommending IRS only in areas of seasonal or episodic transmission of malaria, to also advocating it in areas of continuous, intense transmission.<ref>
			When it was introduced in World War II, DDT was effective in reducing malaria ] and ].<ref name=Dunlap/> WHO's anti-malaria campaign, which consisted mostly of spraying DDT and rapid treatment and diagnosis to break the transmission cycle, was initially successful as well. For example, in ], the program reduced cases from about one million per year before spraying to just 18 in 1963<ref>{{cite book|title=The Coming Plague: Newly Emerging Diseases in a World Out of Balance|page=51|last=Garrett|first=Laurie|url=https://books.google.com/books?id=v9RY2PVOtOMC&pg=PA51|year=1994|publisher=Farrar, Straus and Giroux|isbn=978-1-4299-5327-6|access-date=August 29, 2022|archive-date=October 19, 2021|archive-url=https://web.archive.org/web/20211019223243/https://books.google.com/books?id=v9RY2PVOtOMC&pg=PA51|url-status=live}}</ref><ref>{{cite news | url = https://www.nytimes.com/2010/12/28/health/28global.html | title = Malaria: A Disease Close to Eradication Grows, Aided by Political Tumult in Sri Lanka | first = Donald G. | last = McNeil | name-list-style = vanc | work = The New York Times | date = December 27, 2010 | access-date = February 7, 2017 | archive-date = January 4, 2017 | archive-url = https://web.archive.org/web/20170104050535/http://www.nytimes.com/2010/12/28/health/28global.html | url-status = live }}</ref> and 29 in 1964. Thereafter the program was halted to save money and malaria rebounded to 600,000 cases in 1968 and the first quarter of 1969. The country resumed DDT vector control but the mosquitoes had evolved resistance in the interim, presumably because of continued agricultural use. The program switched to ], but despite initial successes, malaria continued its resurgence into the 1980s.<ref name="Gordon">{{cite book|name-list-style=vanc|title=Mosquitoes, Malaria, and Man: A History of the Hostilities Since 1880|isbn=978-0-525-16025-0|first=Gordon A.|last=Harrison|url=https://books.google.com/books?id=mfkBr2oskyEC|year=1978|publisher=Dutton|access-date=August 29, 2022|archive-date=October 19, 2021|archive-url=https://web.archive.org/web/20211019210418/https://books.google.com/books?id=mfkBr2oskyEC|url-status=live}}</ref><ref>{{cite journal | vauthors = Karunaweera ND, Galappaththy GN, Wirth DF | title = On the road to eliminate malaria in Sri Lanka: lessons from history, challenges, gaps in knowledge and research needs | journal = Malaria Journal | volume = 13 | page = 59 | year = 2014 | pmid = 24548783 | pmc = 3943480 | doi = 10.1186/1475-2875-13-59 | doi-access = free }}</ref>
	</ref> The WHO has reaffirmed its commitment to eventually phasing out DDT, aiming "to achieve a 30% cut in the application of DDT world-wide by 2014 and its total phase-out by the early 2020s if not sooner" while simultaneously combating malaria. The WHO plans to implement alternatives to DDT to achieve this goal.<ref></ref>
			DDT remains on WHO's list of insecticides recommended for IRS. After the appointment of ] as head of its anti-malaria division, WHO's policy shifted from recommending IRS only in areas of seasonal or episodic transmission of malaria, to advocating it in areas of continuous, intense transmission.<ref>
	South Africa is one country that continues to use DDT under WHO guidelines. In 1996, the country switched to alternative insecticides and malaria incidence increased dramatically. Returning to DDT and introducing new drugs brought malaria back under control.<ref>{{cite journal| title=Roll Back Malaria: a failing global health campaign| first=Gavin| last=Yamey| journal=BMJ| year=2004| volume=328| pages=1086–1087| month=8 May| doi=10.1136/bmj.328.7448.1086 | pmid=15130956| issue=7448| pmc=406307}}</ref> According to DDT advocate Donald Roberts, malaria cases increased in ] after countries in that continent stopped using DDT. Research data shows a significantly strong negative relationship between DDT residual house sprayings and malaria rates. In a research from 1993 to 1995, Ecuador increased its use of DDT and resulted in a 61% reduction in malaria rates, while each of the other countries that gradually decreased its DDT use had large increase in malaria rates.<ref name="Roberts 1997"/>
			{{cite web | url =https://www.who.int/mediacentre/news/releases/2006/pr50/en/index.html | archive-url =https://web.archive.org/web/20060918220144/http://www.who.int/mediacentre/news/releases/2006/pr50/en/index.html | url-status =dead | archive-date =September 18, 2006 | publisher = World Health Organization | title = Who gives indoor use of DDT a clean bill of health for controlling malaria }}</ref> WHO reaffirmed its commitment to phasing out DDT, aiming "to achieve a 30% cut in the application of DDT world-wide by 2014 and its total phase-out by the early 2020s if not sooner" while simultaneously combating malaria. WHO plans to implement alternatives to DDT to achieve this goal.<ref>{{cite web | url =https://www.who.int/mediacentre/news/releases/2009/malaria_ddt_20090506/en/index.html | archive-url =https://web.archive.org/web/20090506212626/http://www.who.int/mediacentre/news/releases/2009/malaria_ddt_20090506/en/index.html | url-status =dead | archive-date =May 6, 2009 | title = Countries move toward more sustainable ways to roll back malaria | publisher = World Health Organization }}</ref>
			South Africa continues to use DDT under WHO guidelines. In 1996, the country switched to alternative insecticides and malaria incidence increased dramatically. Returning to DDT and introducing new drugs brought malaria back under control.<ref>{{cite journal | vauthors = Yamey G | title = Roll Back Malaria: a failing global health campaign | journal = BMJ | volume = 328 | issue = 7448 | pages = 1086–1087 | date = May 2004 | pmid = 15130956 | pmc = 406307 | doi = 10.1136/bmj.328.7448.1086 }}</ref> Malaria cases increased in ] after countries in that continent stopped using DDT. Research data showed a strong negative relationship between DDT residual house sprayings and malaria. In a research from 1993 to 1995, Ecuador increased its use of DDT and achieved a 61% reduction in malaria rates, while each of the other countries that gradually decreased its DDT use had large increases.<ref name="Roberts 1997"/><ref>{{cite journal | vauthors = Griffing SM, Gamboa D, Udhayakumar V | title = The history of 20th century malaria control in Peru | journal = Malaria Journal | volume = 12 | page = 303 | year = 2013 | pmid = 24001096 | pmc = 3766208 | doi = 10.1186/1475-2875-12-303 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Curtis CF | title = Should the use of DDT be revived for malaria vector control? | journal = Biomédica | volume = 22 | issue = 4 | pages = 455–461 | date = December 2002 | pmid = 12596442 | doi = 10.7705/biomedica.v22i4.1171| doi-access = free }}</ref>
	===Mosquito resistance===		===Mosquito resistance===
	Resistance has greatly reduced DDT's effectiveness. WHO guidelines require that absence of resistance must be confirmed before using the chemical.<ref name="IRS-WHO">		In some areas, resistance reduced DDT's effectiveness. WHO guidelines require that absence of resistance must be confirmed before using the chemical.<ref name="IRS-WHO">"
	World Health Organization, 2006.</ref> Resistance is largely due to agricultural use, in much greater quantities than required for disease prevention. According to one study that attempted to quantify the lives saved by banning agricultural use and thereby slowing the spread of resistance, "it can be estimated that at current rates each kilo of insecticide added to the environment will generate 105 new cases of malaria."<ref name="pmid7278974"/>		{{Webarchive|url=https://web.archive.org/web/20081002173139/http://whqlibdoc.who.int/hq/2006/WHO_HTM_MAL_2006.1112_eng.pdf |date=October 2, 2008 }}". World Health Organization, 2006.</ref> Resistance is largely due to agricultural use, in much greater quantities than required for disease prevention.
	Resistance was noted early in spray campaigns. Paul Russell, a former head of the ] Anti-Malaria campaign, observed in 1956 that "resistance has appeared after six or seven years."<ref name="Gladwell"/> DDT has lost much of its effectiveness in Sri Lanka, ], ] and ], and it has largely been replaced by ] or ] insecticides, ''e.g.'' malathion or ].<ref name = "Curtis">		Resistance was noted early in spray campaigns. Paul Russell, former head of the ] Anti-Malaria campaign, observed in 1956 that "resistance has appeared after six or seven years".<ref name="Gladwell"/> Resistance has been detected in Sri Lanka, ], ] and ] and it has largely been replaced by ] or ] insecticides, e.g. malathion or ].<ref name="Curtis">{{cite web | vauthors = Curtis CF | url = http://ipmworld.umn.edu/chapters/curtiscf.htm | title = Control of Malaria Vectors in Africa and Asia | archive-url = https://web.archive.org/web/20071002124232/http://ipmworld.umn.edu/chapters/curtiscf.htm | archive-date = October 2, 2007 | url-status = dead | date = February 1996 | publisher = University of Minnesota }}</ref>
	C.F.Curtis</ref>
			In many parts of ], DDT is ineffective.<ref>{{cite journal | vauthors = Sharma VP | title = Current scenario of malaria in India | journal = Parassitologia | volume = 41 | issue = 1–3 | pages = 349–353 | date = September 1999 | pmid = 10697882 }}</ref> Agricultural uses were banned in 1989 and its anti-malarial use has been declining. Urban use ended.<ref>{{cite journal |title=No Future in DDT: A case study of India |last=Agarwal |first=Ravi | name-list-style = vanc | journal=Pesticide Safety News |date=May 2001}}</ref> One study concluded that "DDT is still a viable insecticide in indoor residual spraying owing to its effectivity in well supervised spray operation and high excito-repellency factor."<ref name="mrc">{{cite journal | vauthors = Sharma SN, Shukla RP, Raghavendra K, Subbarao SK | title = Impact of DDT spraying on malaria transmission in Bareilly District, Uttar Pradesh, India | journal = Journal of Vector Borne Diseases | volume = 42 | issue = 2 | pages = 54–60 | date = June 2005 | pmid = 16161701 }}</ref>
	In many parts of ], DDT has also largely lost its effectiveness.<ref>{{
	cite journal | last=Sharma | first=V.P. | title=Current scenario of malaria in India | journal=Parassitologia | year=1999 | pages=349–53 | volume=41 | issue=1-3 | pmid=10697882}}</ref> Agricultural uses were banned in 1989, and its anti-malarial use has been declining. Urban use has halted completely.<ref>{{
	cite journal| title=No Future in DDT: A case study of India| last=Agarwal| first=Ravi| journal=Pesticide Safety News| month=May| year=2001}}</ref> Nevertheless, DDT is still manufactured and used,<ref>{{cite web| url=http://www.unce.unr.edu/publications/files/nr/2003/SP0316.pdf| title=DDT and DDE: Sources of Exposure and How to Avoid Them| author=Art Fisher, Mark Walker, Pam Powell| format=PDF| accessdate=2010-12-02}}</ref> and one study had concluded that "DDT is still a viable insecticide in indoor residual spraying owing to its effectivity in well supervised spray operation and high excito-repellency factor."<ref name="mrc">{{
	cite journal |author=Sharma SN, Shukla RP, Raghavendra K, Subbarao SK |title=Impact of DDT spraying on malaria transmission in Bareilly District, Uttar Pradesh, India |journal=J Vector Borne Dis |volume=42 |issue=2 |pages=54–60 |year=2005 |month=June |pmid=16161701 }}</ref>
	Studies of malaria-vector mosquitoes in ], ] found susceptibility to 4% DDT (the WHO susceptibility standard), in 63% of the samples, compared to the average of 86.5% in the same species caught in the open. The authors concluded that "Finding DDT resistance in the vector ''An. arabiensis'', close to the area where we previously reported pyrethroid-resistance in the vector ''An. funestus'' Giles, indicates an urgent need to develop a strategy of insecticide resistance management for the malaria control programmes of southern Africa."<ref name="Hargreaves">{{		Studies of malaria-vector mosquitoes in ], ] found susceptibility to 4% DDT (WHO's susceptibility standard), in 63% of the samples, compared to the average of 87% in the same species caught in the open. The authors concluded that "Finding DDT resistance in the vector ''An. arabiensis'', close to the area where we previously reported pyrethroid-resistance in the vector ''An. funestus'' Giles, indicates an urgent need to develop a strategy of ] management for the malaria control programmes of southern Africa."<ref name="Hargreaves">{{cite journal | vauthors = Hargreaves K, Hunt RH, Brooke BD, Mthembu J, Weeto MM, Awolola TS, Coetzee M | title = Anopheles arabiensis and An. quadriannulatus resistance to DDT in South Africa | journal = Medical and Veterinary Entomology | volume = 17 | issue = 4 | pages = 417–422 | date = December 2003 | pmid = 14651656 | doi = 10.1111/j.1365-2915.2003.00460.x | s2cid = 22748077 }}</ref>
	cite journal |author=Hargreaves K, Hunt RH, Brooke BD |title=Anopheles arabiensis and An. quadriannulatus resistance to DDT in South Africa |journal=Med. Vet. Entomol. |volume=17 |issue=4 |pages=417–22 |year=2003 |pmid=14651656 |doi=10.1111/j.1365-2915.2003.00460.x}}</ref>
	DDT can still be effective against resistant mosquitoes,<ref name=PLoS1/> and the avoidance of DDT-sprayed walls by mosquitoes is an additional benefit of the chemical.<ref name="mrc"/> For example, a 2007 study reported that resistant mosquitoes avoided treated huts. The researchers argued that DDT was the best pesticide for use in IRS (even though it did not afford the most protection from mosquitoes out of the three test chemicals) because the others pesticides worked primarily by killing or irritating mosquitoes—encouraging the development of resistance to these agents.<ref name="PLoS1">{{cite journal |author=Grieco JP, Achee NL, Chareonviriyaphap T |title=A new classification system for the actions of IRS chemicals traditionally used for malaria control |journal=PLoS ONE |volume=2 |issue=1 |pages=e716 |year=2007 |pmid=17684562 |doi=10.1371/journal.pone.0000716 |pmc=1934935}}</ref> Others argue that the avoidance behavior slows the eradication of the disease.<ref name="Musawenkosi"/> Unlike other insecticides such as pyrethroids, DDT requires long exposure to accumulate a lethal dose; however its irritant property shortens contact periods. "For these reasons, when comparisons have been made, better malaria control has generally been achieved with pyrethroids than with DDT."<ref name = "Curtis"/> In India, with its outdoor sleeping habits and frequent night duties, "the excito-repellent effect of DDT, often reported useful in other countries, actually promotes outdoor transmission."<ref>{{		DDT can still be effective against resistant mosquitoes<ref name=PLoS1/> and the avoidance of DDT-sprayed walls by mosquitoes is an additional benefit of the chemical.<ref name="mrc"/> For example, a 2007 study reported that resistant mosquitoes avoided treated huts. The researchers argued that DDT was the best pesticide for use in IRS (even though it did not afford the most protection from mosquitoes out of the three test chemicals) because the other pesticides worked primarily by killing or irritating mosquitoes – encouraging the development of resistance.<ref name="PLoS1">{{cite journal | vauthors = Grieco JP, Achee NL, Chareonviriyaphap T, Suwonkerd W, Chauhan K, Sardelis MR, Roberts DR | title = A new classification system for the actions of IRS chemicals traditionally used for malaria control | journal = PLOS ONE | volume = 2 | issue = 8 | page = e716 | year = 2007 | pmid = 17684562 | pmc = 1934935 | doi = 10.1371/journal.pone.0000716 | doi-access = free | editor1-last = Krishna | editor1-first = Sanjeev | bibcode = 2007PLoSO...2..716G }}</ref> Others argue that the avoidance behavior slows eradication.<ref name="Musawenkosi">{{cite journal|vauthors=Mabaso ML, Sharp B, Lengeler C|date=August 2004|title=Historical review of malarial control in southern African with emphasis on the use of indoor residual house-spraying|journal=Tropical Medicine & International Health|volume=9|issue=8|pages=846–856|doi=10.1111/j.1365-3156.2004.01263.x|pmid=15303988|doi-access=free|s2cid=10018052}}</ref> Unlike other insecticides such as ]s, DDT requires long exposure to accumulate a lethal dose; however its irritant property shortens contact periods. "For these reasons, when comparisons have been made, better malaria control has generally been achieved with pyrethroids than with DDT."<ref name="Curtis"/> In India outdoor sleeping and night duties are common, implying that "the excito-repellent effect of DDT, often reported useful in other countries, actually promotes outdoor transmission".<ref>{{cite journal |title=DDT: The fallen angel |first=V. P. |last=Sharma |name-list-style=vanc |journal=Current Science |volume=85 |pages=1532–1537 |issue=11 |date=December 2003 |url=http://www.ias.ac.in/currsci/dec102003/1532.pdf |url-status=dead |archive-url=https://web.archive.org/web/20050518063647/http://www.ias.ac.in/currsci/dec102003/1532.pdf |archive-date=May 18, 2005 |df=mdy-all }}</ref>
	cite journal|title=DDT: The fallen angel| first=V. P.| last=Sharma| journal=Current Science| volume=85| pages=1532–1537| issue=11| month=10 December| year=2003| url=http://www.ias.ac.in/currsci/dec102003/1532.pdf|format=PDF}}</ref>
	===Residents' concerns===		===Residents' concerns===
	{{Main|Indoor residual spraying#Residents's opposition to IRS}}		{{Main|Indoor residual spraying#Residents' opposition to IRS}}
			IRS is effective if at least 80% of homes and barns in a residential area are sprayed.<ref name="IRS-WHO"/> Lower coverage rates can jeopardize program effectiveness. Many residents resist DDT spraying, objecting to the lingering smell, stains on walls, and the potential exacerbation of problems with other insect pests.<ref name="Curtis"/><ref name="Musawenkosi"/><ref name="Thurow">"" {{webarchive|url=https://web.archive.org/web/20071013113406/http://mindfully.org/Health/Malaria-New-Strain.htm |date=October 13, 2007 }}, Roger Thurow, '']'', July 26, 2001</ref> ] insecticides (e.g. ] and ]) can overcome some of these issues, increasing participation.<ref name="Curtis"/>
	For IRS to be effective, at least 80% of homes and barns in an area must be sprayed.<ref name="IRS-WHO"/> Lower coverage rates can jeopardize program effectiveness. Many residents resist DDT spraying, objecting to the lingering smell, stains on walls, and may exacerbate problems with other insect pests.<ref name = "Curtis"/><ref name="Musawenkosi">{{
	cite journal |author=Mabaso ML, Sharp B, Lengeler C |title=Historical review of malarial control in southern African with emphasis on the use of indoor residual house-spraying |journal=Trop. Med. Int. Health |volume=9 |issue=8 |pages=846–56 |year=2004 |pmid=15303988 |doi=10.1111/j.1365-3156.2004.01263.x}}</ref><ref name = "Thurow">
	, Roger Thurow, ], July 26, 2001</ref> ] insecticides (e.g. ] and ]) can overcome some of these issues, increasing participation.<ref name = "Curtis"/>
	===Human exposure===		===Human exposure===
	People living in areas where DDT is used for IRS have high levels of the chemical and its breakdown products in their bodies. Compared to contemporaries living where DDT is not used, ]ns living in sprayed homes have levels that are several orders of magnitude greater.<ref name="PineRiver"/> ] in regions where DDT is used against malaria greatly exceeds the allowable standards for breast-feeding infants.<ref name="Bouwman H, Sereda B, Meinhardt HM 2006 902–17">{{		A 1994 study found that ]ns living in sprayed homes have levels that are several orders of magnitude greater than others.<ref name="PineRiver"/> ] from South African mothers contains high levels of DDT and DDE.<ref name="PineRiver"/> It is unclear to what extent these levels arise from home spraying vs food residues. Evidence indicates that these levels are associated with infant neurological abnormalities.<ref name="Curtis"/>
	cite journal |author=Bouwman H, Sereda B, Meinhardt HM |title=Simultaneous presence of DDT and pyrethroid residues in human breast milk from a malaria endemic area in South Africa |journal=Environ. Pollut. |volume=144 |issue=3 |pages=902–17 |year=2006 |pmid=16564119 |doi=10.1016/j.envpol.2006.02.002}}</ref><ref name="Ntow">{{
	cite journal |author=Ntow WJ, Tagoe LM, Drechsel P, Kelderman P, Gijzen HJ, Nyarko E |title=Accumulation of persistent organochlorine contaminants in milk and serum of farmers from Ghana |journal=Environ. Res. |volume=106 |issue=1 |pages=17–26 |year=2008 |pmid=17931619 |doi=10.1016/j.envres.2007.05.020}}</ref><ref>{{
	cite journal |author=Spicer PE, Kereu RK |title=Organochlorine insecticide residues in human breast milk: a survey of lactating mothers from a remote area in Papua New Guinea |journal=Bull Environ Contam Toxicol |volume=50 |issue=4 |pages=540–6 |year=1993 |month=April |pmid=8467139 }}</ref> These levels are associated with neurological abnormalities in babies.<ref name = "Curtis"/><ref name="Bouwman H, Sereda B, Meinhardt HM 2006 902–17"/><ref name="Ntow"/>
	Most studies of DDT's human health effects have been conducted in developed countries where DDT is not used and exposure is relatively low. Many experts urge that alternatives be used instead of IRS.<ref name="pmid16125595"/><ref name="PineRiver"/> Epidemiologist Brenda Eskenazi argues, "We know DDT can save lives by repelling and killing disease-spreading mosquitoes. But evidence suggests that people living in areas where DDT is used are exposed to very high levels of the pesticide. The only published studies on health effects conducted in these populations have shown profound effects on male fertility. Clearly, more research is needed on the health of populations where indoor residual spraying is occurring, but in the meantime, DDT should really be the last resort against malaria rather than the first line of defense."<ref>{{		Most studies of DDT's human health effects have been conducted in developed countries where DDT is not used and exposure is relatively low.<ref name=Rogan05/><ref name="PineRiver"/><ref>{{cite news |url=https://www.sciencedaily.com/releases/2009/05/090504122058.htm |title=Unprecedented Use Of DDT Concerns Experts |last=Science Daily |date=May 9, 2009 |publisher=ScienceDaily.com |access-date=May 30, 2009 |archive-date=May 14, 2009 |archive-url=https://web.archive.org/web/20090514171439/http://www.sciencedaily.com/releases/2009/05/090504122058.htm |url-status=live }}</ref>
	cite news|url=http://www.sciencedaily.com/releases/2009/05/090504122058.htm|title=Unprecedented Use Of DDT Concerns Experts|last=Science Daily|date=May 9, 2009|publisher=ScienceDaily.com|accessdate=2009-05-30}}</ref>
			Illegal diversion to agriculture is also a concern as it is difficult to prevent and its subsequent use on crops is uncontrolled. For example, DDT use is widespread in Indian agriculture,<ref>{{cite news|url=http://economictimes.indiatimes.com/Markets/Commodities/Pesticide-level-in-veggies-fruits-rises/articleshow/4637527.cms|title=Pesticide level in veggies, fruits rises|last=Jayashree|first=Jayashree|name-list-style=vanc|date=10 June 2009|newspaper=]|access-date=10 June 2009|archive-date=July 11, 2018|archive-url=https://web.archive.org/web/20180711064205/https://economictimes.indiatimes.com/Markets/Commodities/Pesticide-level-in-veggies-fruits-rises/articleshow/4637527.cms|url-status=live}}</ref> particularly ] production<ref>{{cite journal|last=Sanjana|date=June 13, 2009|title=A Whole Fruit|journal=] |volume=6|issue=23|url=http://www.tehelka.com/story_main42.asp?filename=cr130609a_whole.asp|access-date=June 8, 2009|archive-url=https://web.archive.org/web/20120405075828/http://www.tehelka.com/story_main42.asp?filename=cr130609a_whole.asp|archive-date=April 5, 2012|url-status=dead}}</ref> and is reportedly used by librarians to protect books.<ref>{{cite news|url=http://www.indianexpress.com/news/State-public-libraries-gasp-for-breath/472785|title=State public libraries gasp for breath|last=Chakravartty|first=Anupam|name-list-style=vanc|date=8 June 2009|newspaper=Indian Express|access-date=June 8, 2009|archive-date=April 13, 2020|archive-url=https://web.archive.org/web/20200413043945/http://archive.indianexpress.com/news/State-public-libraries-gasp-for-breath/472785|url-status=live}}</ref> Other examples include Ethiopia, where DDT intended for malaria control is reportedly used in coffee production,<ref>{{cite journal | last = Katima | first = Jamidu | name-list-style = vanc | date = June 2009 | title = African NGOs outline commitment to malaria control without DDT | url = http://www.pan-uk.org/pestnews/Issue/pn84/PN84_5.pdf | journal = Pesticides News | issue = 84 | page = 5 | url-status = dead | archive-url = https://web.archive.org/web/20160224231607/http://www.pan-uk.org/pestnews/Issue/pn84/PN84_5.pdf | archive-date = February 24, 2016 | df = mdy-all }}</ref> and Ghana where it is used for fishing.<ref>{{cite web|url=http://www.ghananewsagency.org/s_social/r_9596/ |title=Ministry moves to check unorthodox fishing methods |last=Ghana News Agency |date=November 17, 2009 |publisher=Ghana News Agency |access-date=November 18, 2009 |archive-url=https://web.archive.org/web/20120118212645/http://www.ghananewsagency.org/s_social/r_9596/ |archive-date=January 18, 2012 |url-status=live |df=mdy }}</ref><ref>{{cite news|url=http://news.myjoyonline.com/news/201004/45316.asp|title=Northern fisherfolks complain of committee's harassment|last=Appiah|first=Samuel|name-list-style=vanc|date=27 April 2010|publisher=Joy Online|access-date=April 27, 2010|url-status=dead|archive-url=https://web.archive.org/web/20100429002159/http://news.myjoyonline.com/news/201004/45316.asp|archive-date=April 29, 2010|df=mdy-all}}</ref> The residues in crops at levels unacceptable for export have been an important factor in bans in several tropical countries.<ref name="Curtis"/> Adding to this problem is a lack of skilled personnel and management.<ref name="Musawenkosi"/>
	Illegal diversion to agriculture is also a concern, as it is almost impossible to prevent, and its subsequent use on crops is uncontrolled. For example, DDT use is widespread in Indian agriculture,<ref>{{
	cite news|url=http://economictimes.indiatimes.com/Markets/Commodities/Pesticide-level-in-veggies-fruits-rises/articleshow/4637527.cms|title=Pesticide level in veggies, fruits rises|last=Jayashree|first=Jayashree|date=June 10, 2009|publisher=Economic Times|accessdate=2009-06-10}}</ref> particularly ] production,<ref>{{
	cite journal|last=SANJANA|date=June 13, 2009|title=A Whole Fruit|journal=Tehelka Magazine|volume=6|issue=23|url=http://www.tehelka.com/story_main42.asp?filename=cr130609a_whole.asp}}</ref> and is reportedly used by librarians to protect books.<ref>{{
	cite news|url=http://www.indianexpress.com/news/State-public-libraries-gasp-for-breath/472785|title=State public libraries gasp for breath|last=Chakravartty|first=Anupam|date=June 8, 2009|publisher=Indian Express|accessdate=2009-06-08}}</ref> Other examples include Ethiopia, where DDT intended for malaria control is reportedly being used in coffee production,<ref>{{
	cite journal|last=Katima|first=Jamidu|date=June 2009|title=African NGOs outline commitment to malaria control without DDT|journal=Pesticides News|issue=84|page=5}}</ref> and Ghana where it is used for fishing."<ref>{{cite web|url=http://www.ghananewsagency.org/s_social/r_9596/|title=Ministry moves to check unorthodox fishing methods|last=Ghana News Agency|date=November 17, 2009|publisher=Ghana News Agency|accessdate=2009-11-18|archiveurl = http://www.webcitation.org/5uKxjHSId |archivedate = 2010-11-18|deadurl=no}}</ref><ref>{{cite news|url=http://news.myjoyonline.com/news/201004/45316.asp|title=Northern fisherfolks complain of committee’s harassment|last=Appiah|first=Samuel |date=27 April 2010|publisher=Joy Online|accessdate=27 April 2010}}</ref> The residues in crops at levels unacceptable for export have been an important factor in recent bans in several tropical countries.<ref name = "Curtis"/> Adding to this problem is a lack of skilled personnel and supervision.<ref name="Musawenkosi"/>
	===Criticism of restrictions on DDT use===		===Criticism of restrictions on DDT use===
			Restrictions on DDT usage have been criticized by some organizations opposed to the environmental movement, including ] of the pro-DDT advocacy group ] and the libertarian ] ]; these sources oppose restrictions on DDT and attribute large numbers of deaths to such restrictions, sometimes in the millions.<ref name="Crichton">{{cite news |title=Rachel Carson Didn't Kill Millions of Africans |first=William |last=Souder |name-list-style=vanc |date=September 4, 2012 |work=Slate |url=http://www.slate.com/articles/health_and_science/science/2012/09/silent_spring_turns_50_biographer_william_souder_clears_up_myths_about_rachel_carson_.html |access-date=September 5, 2012 |archive-date=April 22, 2014 |archive-url=https://web.archive.org/web/20140422025120/http://www.slate.com/articles/health_and_science/science/2012/09/silent_spring_turns_50_biographer_william_souder_clears_up_myths_about_rachel_carson_.html |url-status=live }}</ref><ref>{{cite book |last1=Oreskes |first1=Naomi |author-link1=Naomi Oreskes |last2=Conway |first2=Erik M. |author-link2=Erik M. Conway |title=Merchants of Doubt |publisher=Bloomsbury |location=New York |year=2010 |isbn=978-1-59691-610-4 |title-link=Merchants of Doubt|page=217}}</ref><ref>{{cite journal|last=Baum|first=Rudy M.|date=June 4, 2007|title=Rachel Carson|journal=Chemical and Engineering News|volume=85|issue=23|page=5|url=http://pubs.acs.org/isubscribe/journals/cen/85/i23/html/8523editor.html}}</ref> These arguments were rejected as "outrageous" by former WHO scientist ].<ref name="salon"/> ], ] entomologist, says, "to blame environmentalists who oppose DDT for more deaths than Hitler is worse than irresponsible".<ref name="salon"/> More recently, ], a professor of chemistry at the ], has pointed out that DDT is still used to prevent malaria, that its declining use is primarily due to increases in manufacturing costs, and that in Africa, efforts to control malaria have been regional or local, not comprehensive.<ref>{{cite web |url=http://www.science.uwaterloo.ca/~mpalmer/stuff/DDT-myth.pdf |title=The ban of DDT did not cause millions to die from malaria |first=Michael |last=Palmer |date=29 September 2016 |publisher=University of Waterloo |access-date=August 14, 2018 |archive-date=June 16, 2021 |archive-url=https://web.archive.org/web/20210616080102/http://science.uwaterloo.ca/~mpalmer/stuff/DDT-myth.pdf |url-status=live }}</ref>
	Critics claim that restricting DDT in vector control have caused unnecessary deaths due to malaria. Estimates range from hundreds of thousands,<ref>{{
			{{Quote box
	cite news| url=http://query.nytimes.com/gst/abstract.html?res=F40B1EFB3F580C718DDDAA0894DD404482&n=Top%252fOpinion%252fEditorials%2520and%2520Op%252dEd%252fOp%252dEd%252fColumnists%252fNicholas%2520D%2520Kristof| publisher= New York Times| month=March 12| year=2005| title=I Have a Nightmare| first=Nicholas D.| last=Kristof| pages=Section A, Page 15 , Column 1| nopp=true}}</ref> to millions. Robert Gwadz of the ] said in 2007, "The ban on DDT may have killed 20 million children."<ref>
			|quote = The question that&nbsp;... malaria control experts must ask is not "Which is worse, malaria or DDT?" but rather "What are the best tools to deploy for malaria control in a given situation, taking into account the on-the-ground challenges and needs, efficacy, cost, and collateral effects{{snd}}both positive and negative{{snd}}to human health and the environment, as well as the uncertainties associated with all these considerations?"
	{{cite news |author=Finkel, Michael |title=Malaria |url=http://www7.nationalgeographic.com/ngm/0707/feature1/text4.html |publisher=National Geographic |date=July 2007 }}</ref> These arguments have been dismissed as "outrageous" by former WHO scientist Socrates Litsios. May Berenbaum, ] entomologist, says, "to blame environmentalists who oppose DDT for more deaths than Hitler is worse than irresponsible."<ref name="salon">
			|width = 50%
	{{cite news |author=Kirsten Weir |title=Rachel Carson's birthday bashing |url=http://www.salon.com/news/feature/2007/06/29/rachel_carson/ |publisher=Salon.com |date=June 29, 2007 |accessdate=2007-07-01 }}</ref> Investigative journalist Adam Sarvana and others characterize this notion as a "myth" promoted principally by ] of the pro-DDT advocacy group ] (AFM).<ref name="NRNS">{{
			|author = Hans Herren & Charles Mbogo<ref name="Herren Mbogo 2010 pp. a282–a282">{{cite journal | vauthors = Herren HR, Mbogo C | title = The role of DDT in malaria control | journal = Environmental Health Perspectives | volume = 118 | issue = 7 | pages = A282–A283; author reply A283 | date = July 2010 | pmid = 20601331 | doi = 10.1289/ehp.1002279 | pmc=2920925}}</ref>
	cite news|url=http://www.nrns.org/index.php?option=com_content&view=article&id=51:bate-and-switch-how-a-free-market-magician-manipulated-two-decades-of-environmental-science-|title=Bate and Switch: How a free-market magician manipulated two decades of environmental science|last=Sarvana|first=Adam|date=May 28, 2009|publisher=Natural Resources New Service|accessdate=2009-06-02}}</ref><ref name="Guts">{{
			}}
	cite book|last=Gutstein|first=Donald|title=Not a Conspiracy Theory: How Business Propaganda Hijacks Democracy|publisher=Key Porter Books|date=November 24, 2009|isbn=978-1-55470-191-9}}. Relevant section excepted at: {{
	cite news|url=http://thetyee.ca/Mediacheck/2010/01/22/DDTPropaganda/|title=Inside the DDT Propaganda Machine|last=Gutstein|first=Donald|date=January 22, 2010|publisher=The Tyee|accessdate=22 January 2010}}</ref>
	Criticisms of a DDT "ban" often specifically reference the 1972 US ban (with the erroneous implication that this constituted a worldwide ban and prohibited use of DDT in vector control). Reference is often made to ]'s ''Silent Spring'' even though she never pushed for a ban on DDT. ] and Tim Lambert wrote, "the most striking feature of the claim against Carson is the ease with which it can be refuted."<ref name="quig">
	, John Quiggin & Tim Lambert, ''Prospect'', May 2008.</ref> Carson actually devoted a page of her book to considering the relationship between DDT and malaria, warning of the ] of DDT resistance in mosquitoes and concluding:
			Criticisms of a DDT "ban" often specifically reference the 1972 United States ban (with the erroneous implication that this constituted a worldwide ban and prohibited use of DDT in vector control). Reference is often made to ''Silent Spring'', even though Carson never pushed for a DDT ban. ] and Tim Lambert wrote, "the most striking feature of the claim against Carson is the ease with which it can be refuted".<ref name="quig">{{cite news |first1=John |last1=Quiggin |first2=Tim |last2=Lambert |title=Rehabilitating Carson |newspaper=] |date=May 2008 |url=http://www.prospectmagazine.co.uk/magazine/rehabilitatingcarson/ |name-list-style=vanc |access-date=June 22, 2012 |archive-date=April 13, 2020 |archive-url=https://web.archive.org/web/20200413043951/http://www.prospectmagazine.co.uk/magazine/rehabilitatingcarson |url-status=live }}</ref>
	<blockquote>It is more sensible in some cases to take a small amount of damage in preference to having none for a time but paying for it in the long run by losing the very means of fighting . Practical advice should be "Spray as little as you possibly can" rather than "Spray to the limit of your capacity."</blockquote>
	<!--what can she have meant by "small amount of damage" and who did she think was spraying "to the limit of your capacity"?-->
			Investigative journalist Adam Sarvana and others characterize these notions as "myths" promoted principally by ] of the pro-DDT advocacy group ] (AFM).<ref name="NRNS">{{cite news |url=http://www.nrns.org/index.php?option=com_content&view=article&id=51:bate-and-switch-how-a-free-market-magician-manipulated-two-decades-of-environmental-science- |title=Bate and Switch: How a free-market magician manipulated two decades of environmental science |last=Sarvana |first=Adam |name-list-style=vanc |date=May 28, 2009 |publisher=Natural Resources New Service |access-date=June 2, 2009 |url-status=dead |archive-url=https://web.archive.org/web/20100524144406/http://www.nrns.org/index.php?option=com_content&view=article&id=51%3Abate-and-switch-how-a-free-market-magician-manipulated-two-decades-of-environmental-science- |archive-date=May 24, 2010 |df=mdy }}</ref><ref name="Guts">{{cite book|last=Gutstein|first=Donald|name-list-style=vanc|title=Not a Conspiracy Theory: How Business Propaganda is Hijacking Democracy|url=https://books.google.com/books?id=zDRePgAACAAJ|year=2009|publisher=Key Porter Books |isbn=978-1-55470-191-9|access-date=August 29, 2022|archive-date=October 19, 2021|archive-url=https://web.archive.org/web/20211019223230/https://books.google.com/books?id=zDRePgAACAAJ|url-status=live}}. Relevant excerpt at {{cite magazine |url=https://thetyee.ca/Mediacheck/2010/01/22/DDTPropaganda/ |title=Inside the DDT Propaganda Machine |last=Gutstein |first=Donald |name-list-style=vanc |date=January 22, 2010 |magazine=] |access-date=January 22, 2010 |archive-date=January 25, 2010 |archive-url=https://web.archive.org/web/20100125172424/http://thetyee.ca/Mediacheck/2010/01/22/DDTPropaganda/ |url-status=live }}</ref>
	It has also been alleged that donor governments and agencies have refused to fund DDT spraying, or made aid contingent upon not using DDT. According to a report in the ''British Medical Journal'', use of DDT in ] "was stopped several decades ago, because 80% of the country's health budget came from donor funds, and donors refused to allow the use of DDT."<ref>{{
	cite journal |author=Sidley P |title=Malaria epidemic expected in Mozambique |journal=BMJ |volume=320 |issue=7236 |page=669 |year=2000 |pmid=10710569 |doi=10.1136/bmj.320.7236.669 |pmc=1117705}}</ref> Roger Bate asserts, "many countries have been coming under pressure from international health and environment agencies to give up DDT or face losing aid grants: Belize and Bolivia are on record admitting they gave in to pressure on this issue from ."<ref>{{cite journal| url=http://www.cid.harvard.edu/cidinthenews/articles/nr_051401.html| year= 2001| journal=National Review| month=May 14|volume= LIII| issue=9| first=Roger| last=Bate| title=A Case of the DDTs: The war against the war against malaria|archiveurl = http://www.webcitation.org/5uKxmunGp |archivedate = 2010-11-18|deadurl=no}}</ref>
			===Alternatives===
	The ] (USAID) has been the focus of much criticism. While the agency is currently funding the use of DDT in some African countries,<ref name="USAID">{{cite web|url=http://www.usaid.gov/our_work/global_health/id/malaria/techareas/irs.html|title=USAID Health: Infectious Diseases, Malaria, Technical Areas, Prevention and Control, Indoor Residual Spraying|publisher=USAID|accessdate=2008-10-14|archiveurl = http://www.webcitation.org/5uKxoMqlg |archivedate = 2010-11-18|deadurl=no}}</ref> in the past it did not. When ] accused USAID of not funding DDT because it wasn't "politically correct," Anne Peterson, the agency's assistant administrator for global health, replied that "I believe that the strategies we are using are as effective as spraying with DDT ... So, politically correct or not, I am very confident that what we are doing is the right strategy."<ref>{{
	cite news|url=http://abcnews.go.com/2020/Stossel/story?id=1898820|title=Excerpt: 'Myths, Lies, and Downright Stupidity'|last=Stossel|first=John|date=November 16, 2007|publisher=ABC News|accessdate=2008-10-14}}</ref> USAID's Kent R. Hill states that the agency has been misrepresented: "USAID strongly supports spraying as a preventative measure for malaria and will support the use of DDT when it is scientifically sound and warranted."<ref>{{cite web|url=http://www.hillnews.com/thehill/export/TheHill/Comment/LetterstotheEditor/111505.html |title=USAID isn’t against using DDT in worldwide malaria battle |author=] |accessdate=2006-04-03|year=2005 |archiveurl = http://web.archive.org/web/20060331190237/http://www.hillnews.com/thehill/export/TheHill/Comment/LetterstotheEditor/111505.html |archivedate = 2006-03-31}}</ref> The Agency's website states that "USAID has never had a 'policy' as such either 'for' or 'against' DDT for IRS. The real change in the past two years has been a new interest and emphasis on the use of IRS in general—with DDT or any other insecticide—as an effective malaria prevention strategy in tropical Africa."<ref name=USAID/> The website further explains that in many cases alternative malaria control measures were judged to be more cost-effective that DDT spraying, and so were funded instead.<ref>{{cite web| url=http://www.usaid.gov/our_work/global_health/id/malaria/news/afrmal_ddt.html| title=USAID Health: Infectious Diseases, Malaria, News, Africa Malaria Day, USAID Support for Malaria Control in Countries Using DDT| accessdate=2006-03-15| year=2005|archiveurl = http://www.webcitation.org/5uKxp31Ck |archivedate = 2010-11-18|deadurl=no}}</ref>
	===Alternatives ===		====Insecticides====
	====Other insecticides====
	{{Main|Indoor residual spraying}}		{{Main|Indoor residual spraying}}
			] and ] insecticides, e.g. ] and ], respectively, are more expensive than DDT per kilogram and are applied at roughly the same dosage. ]s such as ] are also more expensive than DDT, but are applied more sparingly (0.02–0.3&nbsp;g/m<sup>2</sup> vs 1–2&nbsp;g/m<sup>2</sup>), so the net cost per house per treatment is about the same.<ref name="AmJTrop"/> DDT has one of the longest residual efficacy periods of any IRS insecticide, lasting 6 to 12 months. Pyrethroids will remain active for only 4 to 6 months, and organophosphates and carbamates remain active for 2 to 6 months. In many malaria-endemic countries, malaria transmission occurs year-round, meaning that the high expense of conducting a spray campaign (including hiring spray operators, procuring insecticides, and conducting pre-spray outreach campaigns to encourage people to be home and to accept the intervention) will need to occur multiple times per year for these shorter-lasting insecticides.<ref>{{Cite web|url=https://apps.who.int/iris/bitstream/handle/10665/69386/WHO_HTM_MAL_2006.1112_eng.pdf?sequence=1|title=Indoor Residual Spraying|date=2019|website=World Health Organization|access-date=March 14, 2019|archive-date=July 29, 2020|archive-url=https://web.archive.org/web/20200729031424/https://apps.who.int/iris/bitstream/handle/10665/69386/WHO_HTM_MAL_2006.1112_eng.pdf?sequence=1|url-status=live}}</ref>
	Advocates of increased use of DDT in IRS claim that alternative insecticides are more expensive, more toxic, or not as effective. As discussed above, susceptibility of mosquitoes to DDT varies geographically. The same is true for alternative insecticides, so its relative effectiveness varies. Toxicity and cost-effectiveness comparisons lack data. Relative insecticide costs vary by location and ease of access, the habits of the local mosquitoes, the degrees of resistance exhibited by the mosquitoes, and the habits and compliance of the population, among other factors. The choice of insecticide has little impact on the total cost of a round of spraying, since product costs are only a fraction of campaign costs. IRS coverage needs to be maintained throughout the malaria season, making DDT's relatively long life an important cost savings.
			In 2019, the related compound difluorodiphenyltrichloroethane (]) was described as a potentially more effective and therefore potentially safer alternative to DDT.<ref>{{cite journal |last1=Zhu |first1=Xiaolong |last2=Hu |first2=Chunhua T. |last3=Yang |first3=Jingxiang |last4=Joyce |first4=Leo A. |last5=Qiu |first5=Mengdi |last6=Ward |first6=Michael D. |last7=Kahr |first7=Bart |title=Manipulating Solid Forms of Contact Insecticides for Infectious Disease Prevention |journal=Journal of the American Chemical Society |volume=141 |issue=42 |pages=16858–16864 |date=11 October 2019 |doi=10.1021/jacs.9b08125|pmid=31601104 |s2cid=204244148 }}</ref><ref name="NYT 17 October 2019">{{cite news |last1=Chang |first1=Kenneth |title=A Nazi Version of DDT Was Forgotten. Could It Help Fight Malaria? |url=https://www.nytimes.com/2019/10/17/science/nazi-ddt-malaria.html |archive-url=https://ghostarchive.org/archive/20220101/https://www.nytimes.com/2019/10/17/science/nazi-ddt-malaria.html |archive-date=2022-01-01 |url-access=limited |access-date=18 October 2019 |work=The New York Times |date=17 October 2019}}{{cbignore}}</ref>
	] and ] insecticides, ''e.g.'' ] and ], respectively, are more expensive than DDT per kilogram and are applied at roughly the same dosage. ]s such as ] are also more expensive than DDT, but are applied more sparingly (0.02-0.3&nbsp;g/m<sup>2</sup> vs 1-2&nbsp;g/m<sup>2</sup>), so the net cost per house is about the same over 6 months.<ref name="AmJTrop"/>
	====Non-chemical vector control====		====Non-chemical vector control====
			Before DDT, malaria was successfully eliminated or curtailed in several tropical areas by removing or poisoning mosquito breeding grounds and larva habitats, for example by eliminating standing water. These methods have seen little application in Africa for more than half a century.<ref>{{cite journal | vauthors = Killeen GF, Fillinger U, Kiche I, Gouagna LC, Knols BG | title = Eradication of Anopheles gambiae from Brazil: lessons for malaria control in Africa? | journal = The Lancet. Infectious Diseases | volume = 2 | issue = 10 | pages = 618–627 | date = October 2002 | pmid = 12383612 | doi = 10.1016/S1473-3099(02)00397-3 }}</ref> According to CDC, such methods are not practical in Africa because "''Anopheles gambiae'', one of the primary vectors of malaria in Africa, breeds in numerous small pools of water that form due to rainfall&nbsp;... It is difficult, if not impossible, to predict when and where the breeding sites will form, and to find and treat them before the adults emerge."<ref>{{cite web |url=https://www.cdc.gov/malaria/malaria_worldwide/reduction/vector_control.html |title=Malaria Worldwide – How Can Malaria Cases and Deaths Be Reduced? – Larval Control and Other Vector Control Interventions |website=CDC.gov |date=January 29, 2019 |access-date=September 9, 2017 |archive-date=July 9, 2017 |archive-url=https://web.archive.org/web/20170709190523/https://www.cdc.gov/malaria/malaria_worldwide/reduction/vector_control.html |url-status=live }}</ref>
	Before DDT, malaria was successfully eradicated or curtailed in several tropical areas by removing or poisoning mosquito breeding grounds and larva habitats, for example by filling or applying oil to standing water. These methods have seen little application in Africa for more than half a century.<ref>{{
	cite journal |author=Killeen GF, Fillinger U, Kiche I, Gouagna LC, Knols BG |title=Eradication of Anopheles gambiae from Brazil: lessons for malaria control in Africa? |journal=Lancet Infect Dis |volume=2 |issue=10 |pages=618–27 |year=2002 |pmid=12383612 |doi=10.1016/S1473-3099(02)00397-3}}</ref>
	The relative effectiveness of IRS (with DDT or alternative insecticides) versus other malaria control techniques (e.g. bednets or prompt access to anti-malarial drugs) varies greatly and is highly dependent on local conditions.<ref name="AmJTrop"/>		The relative effectiveness of IRS versus other malaria control techniques (e.g. bednets or prompt access to anti-malarial drugs) varies and is dependent on local conditions.<ref name="AmJTrop"/>
	A WHO study released in January 2008 found that mass distribution of insecticide-treated mosquito nets and ]–based drugs cut malaria deaths in half in Rwanda and Ethiopia, countries with high malaria burdens. IRS with DDT did not play an important role in mortality reduction in these countries.<ref>		A WHO study released in January 2008 found that mass distribution of insecticide-treated mosquito nets and ]–based drugs cut malaria deaths in half in malaria-burdened Rwanda and Ethiopia. IRS with DDT did not play an important role in mortality reduction in these countries.<ref>"". World Health Organization, January 31, 2008.</ref><ref> {{Webarchive|url=https://web.archive.org/web/20080210024708/http://www.sfgate.com/cgi-bin/article.cgi?f=%2Fc%2Fa%2F2008%2F02%2F01%2FMN4EUPS3D.DTL&type=health |date=February 10, 2008 }}, David Brown (Washington Post), ''SF Chronicle'', A-12, February 1, 2008.</ref>
	World Health Organization, January 31, 2008.</ref><ref>
	, David Brown (Washington Post), ''SF Chronicle'', A-12, February 1, 2008.</ref>
	] has enjoyed declining malaria cases and a 97% mortaility reduction after switching in 1991 from a poorly funded DDT-based campaign to a program based on prompt treatment, bednets, and pyrethroid group insecticides.<ref></ref>		] has enjoyed declining malaria cases and a 97% mortality reduction after switching in 1991 from a poorly funded DDT-based campaign to a program based on prompt treatment, bednets and pyrethroid group insecticides.<ref>"", November 6, 2000. {{webarchive |url=https://web.archive.org/web/20080226224853/http://www.afronets.org/files/malaria.pdf |date=February 26, 2008 }}</ref>
	In Mexico, effective and affordable chemical and non-chemical strategies against malaria have been so successful that the Mexican DDT manufacturing plant ceased production due to lack of demand.<ref name="PMC1119118">{{cite web| url=http://www.ipen.org/ipenweb/documents/work%20documents/ddt_ipenreport_english.pdf|title=DDT & Malaria| accessdate=2009-03-11|archiveurl = http://www.webcitation.org/5pt5PazSh |archivedate = 2010-05-21|deadurl=no}}</ref>		In Mexico, effective and affordable chemical and non-chemical strategies were so successful that the Mexican DDT manufacturing plant ceased production due to lack of demand.<ref name="PMC1119118">{{cite web |url=http://www.ipen.org/ipenweb/documents/work%20documents/ddt_ipenreport_english.pdf |title=DDT & Malaria |access-date=March 11, 2009 |archive-url=https://web.archive.org/web/20110726185356/http://www.ipen.org/ipenweb/documents/work%20documents/ddt_ipenreport_english.pdf |archive-date=July 26, 2011 |url-status=dead |df=mdy }}</ref>
			A review of fourteen studies in sub-Saharan Africa, covering insecticide-treated nets, residual spraying, chemoprophylaxis for children, chemoprophylaxis or intermittent treatment for pregnant women, a hypothetical vaccine and changing front–line drug treatment, found decision making limited by the lack of information on the costs and effects of many interventions, the small number of cost-effectiveness analyses, the lack of evidence on the costs and effects of packages of measures and the problems in generalizing or comparing studies that relate to specific settings and use different methodologies and outcome measures. The two cost-effectiveness estimates of DDT residual spraying examined were not found to provide an accurate estimate of the cost-effectiveness of DDT spraying; the resulting estimates may not be good predictors of cost-effectiveness in current programs.<ref>{{cite journal | vauthors = Goodman CA, Mills AJ | title = The evidence base on the cost-effectiveness of malaria control measures in Africa | journal = Health Policy and Planning | volume = 14 | issue = 4 | pages = 301–312 | date = December 1999 | pmid = 10787646 | doi = 10.1093/heapol/14.4.301 | doi-access = free }}</ref>
	While the increased numbers of malaria victims since DDT usage collapsed document its value, many other factors contributed to the rise in cases.
			However, a study in Thailand found the cost per malaria case prevented of DDT spraying (]1.87) to be 21% greater than the cost per case prevented of ]–treated nets (US$1.54),<ref>{{cite journal | vauthors = Kamolratanakul P, Butraporn P, Prasittisuk M, Prasittisuk C, Indaratna K | title = Cost-effectiveness and sustainability of lambdacyhalothrin-treated mosquito nets in comparison to DDT spraying for malaria control in western Thailand | journal = The American Journal of Tropical Medicine and Hygiene | volume = 65 | issue = 4 | pages = 279–284 | date = October 2001 | pmid = 11693869 | doi = 10.4269/ajtmh.2001.65.279 | doi-access = free }}</ref> casting some doubt on the assumption that DDT was the most cost-effective measure. The director of Mexico's malaria control program found similar results, declaring that it was 25% cheaper for Mexico to spray a house with synthetic pyrethroids than with DDT.<ref name="PMC1119118"/> However, another study in South Africa found generally lower costs for DDT spraying than for impregnated nets.<ref>{{cite journal | vauthors = Goodman CA, Mnzava AE, Dlamini SS, Sharp BL, Mthembu DJ, Gumede JK | title = Comparison of the cost and cost-effectiveness of insecticide-treated bednets and residual house-spraying in KwaZulu-Natal, South Africa | journal = Tropical Medicine & International Health | volume = 6 | issue = 4 | pages = 280–295 | date = April 2001 | pmid = 11348519 | doi = 10.1046/j.1365-3156.2001.00700.x | s2cid = 28103584 | doi-access = free }}</ref>
	A review of fourteen studies on the subject in sub-Saharan Africa, covering insecticide-treated nets, residual spraying, chemoprophylaxis for children, chemoprophylaxis or intermittent treatment for pregnant women, a hypothetical vaccine, and changing front–line drug treatment, found decision making limited by the gross lack of information on the costs and effects of many interventions, the very small number of cost-effectiveness analyses available, the lack of evidence on the costs and effects of packages of measures, and the problems in generalizing or comparing studies that relate to specific settings and use different methodologies and outcome measures. The two cost-effectiveness estimates of DDT residual spraying examined were not found to provide an accurate estimate of the cost-effectiveness of DDT spraying; furthermore, the resulting estimates may not be good predictors of cost-effectiveness in current programs.<ref>{{
	cite journal| title=The evidence base on the cost-effectiveness of malaria control measures in Africa| author=C. A. Goodman and A. J. Mills| journal=Health Policy and Planning| volume=14| issue=4| pages=301–312| year=1999| url=http://heapol.oxfordjournals.org/cgi/reprint/14/4/301.pdf |format=PDF| pmid=10787646 | doi = 10.1093/heapol/14.4.301}}</ref>
			A more comprehensive approach to measuring the cost-effectiveness or efficacy of malarial control would not only measure the cost in dollars, as well as the number of people saved, but would also consider ecological damage and negative human health impacts. One preliminary study found that it is likely that the detriment to human health approaches or exceeds the beneficial reductions in malarial cases, except perhaps in epidemics. It is similar to the earlier study regarding estimated theoretical infant mortality caused by DDT and subject to the criticism also mentioned earlier.<ref>{{cite journal |url=http://www.jcu.edu.au/jrtph/vol/v04corin.pdf |vauthors=Corin SE, Weaver SA |year=2005 |title=A risk analysis model with an ecological perspective on DDT and malaria control in South Africa |journal=Journal of Rural and Tropical Public Health |volume=4 |issue=4 |pages=21–32 |access-date=January 30, 2006 |archive-date=March 6, 2006 |archive-url=https://web.archive.org/web/20060306003634/http://www.jcu.edu.au/jrtph/vol/v04corin.pdf |url-status=live }}</ref>
	However, a study in Thailand found the cost per malaria case prevented of DDT spraying ($1.87 US) to be 21% greater than the cost per case prevented of ]–treated nets ($1.54 US),<ref>{{
	cite journal| title=Cost-effectiveness and sustainability of lambdacyhalothrin-treated mosquito nets in comparison to DDT spraying for malaria control in western Thailand| first5=K| last5=Indaratna| first4=C| last4=Prasittisuk| first3=M| last3=Prasittisuk| first2=P| last=Kamolratanakul| last2=Butraporn| first=P.| journal=American Journal of Tropical Medicine and Hygiene| year=2001| volume=65| issue=4| pages=279–84 | pmid=11693869 | doi = }}</ref> at very least casting some doubt on the unexamined assumption that DDT was the most cost-effective measure to use in all cases. The director of Mexico's malaria control program finds similar results, declaring that it is 25% cheaper for Mexico to spray a house with synthetic pyrethroids than with DDT.<ref name="PMC1119118"/> However, another study in South Africa found generally lower costs for DDT spraying than for impregnated nets.<ref>{{
	cite journal |author=Goodman CA, Mnzava AE, Dlamini SS, Sharp BL, Mthembu DJ, Gumede JK |title=Comparison of the cost and cost-effectiveness of insecticide-treated bednets and residual house-spraying in KwaZulu-Natal, South Africa |journal=Trop. Med. Int. Health |volume=6 |issue=4 |pages=280–95 |year=2001 |pmid=11348519 |doi=10.1046/j.1365-3156.2001.00700.x}}</ref>
			A study in the ] found that "although impregnated bed nets cannot entirely replace DDT spraying without substantial increase in incidence, their use permits reduced DDT spraying".<ref>{{cite journal | vauthors = Over M, Bakote'e B, Velayudhan R, Wilikai P, Graves PM | title = Impregnated nets or DDT residual spraying? Field effectiveness of malaria prevention techniques in solomon islands, 1993–1999 | journal = The American Journal of Tropical Medicine and Hygiene | volume = 71 | issue = 2 Suppl | pages = 214–223 | date = August 2004 | pmid = 15331840 | doi = 10.4269/ajtmh.2004.71.214 | doi-access = free }}</ref>
	A more comprehensive approach to measuring cost-effectiveness or efficacy of malarial control would not only measure the cost in dollars of the project, as well as the number of people saved, but would also consider ecological damage and negative aspects of insecticide use on human health. One preliminary study regarding the effect of DDT found that it is likely the detriment to human health approaches or exceeds the beneficial reductions in malarial cases, except perhaps in malarial epidemic situations. It is similar to the earlier mentioned study regarding estimated theoretical infant mortality caused by DDT and subject to the criticism also mentioned earlier.<ref>{{
	cite journal| url=http://www.jcu.edu.au/jrtph/vol/v04corin.pdf|format=PDF| author= Corin, S. E & Weaver, S.A.| year=2005| title=A risk analysis model with an ecological perspective on DDT and malaria control in South Africa| journal=Journal of Rural and Tropical Public Health| volume=4| issue=4| pages=21–32 | doi = }}</ref>
			A comparison of four successful programs against malaria in Brazil, India, Eritrea and Vietnam does not endorse any single strategy but instead states, "Common success factors included conducive country conditions, a targeted technical approach using a package of effective tools, data-driven decision-making, active leadership at all levels of government, involvement of communities, decentralized implementation and control of finances, skilled technical and managerial capacity at national and sub-national levels, hands-on technical and programmatic support from partner agencies, and sufficient and flexible financing."<ref>{{cite journal | vauthors = Barat LM | title = Four malaria success stories: how malaria burden was successfully reduced in Brazil, Eritrea, India, and Vietnam | journal = The American Journal of Tropical Medicine and Hygiene | volume = 74 | issue = 1 | pages = 12–16 | date = January 2006 | pmid = 16407339 | doi = 10.4269/ajtmh.2006.74.12 | doi-access = free }}</ref>
	A study in the ] found that "although impregnated bed nets cannot entirely replace DDT spraying without substantial increase in incidence, their use permits reduced DDT spraying."<ref>{{
	cite journal |last=Over |first=M |title=Impregnated nets or DDT residual spraying? Field effectiveness of malaria prevention techniques in solomon islands, 1993-1999 |journal=Am. J. Trop. Med. Hyg. |volume=71 |issue=2 Suppl |pages=214–23 |year=2004 |url=http://www.ajtmh.org/cgi/content/full/71/2_suppl/214 |pmid=15331840 |last2=Bakote'e |first2=B |last3=Velayudhan |first3=R |last4=Wilikai |first4=P |last5=Graves |first5=PM}}</ref>
			DDT resistant mosquitoes may be susceptible to pyrethroids in some countries. However, pyrethroid resistance in ''Anopheles'' mosquitoes is on the rise with resistant mosquitoes found in multiple countries.<ref>{{cite journal | vauthors = Mint Mohamed Lemine A, Ould Lemrabott MA, Niang EH, Basco LK, Bogreau H, Faye O, Ould Mohamed Salem Boukhary A | title = Pyrethroid resistance in the major malaria vector Anopheles arabiensis in Nouakchott, Mauritania | journal = Parasites & Vectors | volume = 11 | issue = 1 | pages = 344 | date = June 2018 | pmid = 29895314 | pmc = 5998517 | doi = 10.1186/s13071-018-2923-4 | doi-access = free }}</ref>
	A comparison of four successful programs against malaria in Brazil, India, Eritrea, and Vietnam does not endorse any single strategy but instead states, "Common success factors included conducive country conditions, a targeted technical approach using a package of effective tools, data-driven decision-making, active leadership at all levels of government, involvement of communities, decentralized implementation and control of finances, skilled technical and managerial capacity at national and sub-national levels, hands-on technical and programmatic support from partner agencies, and sufficient and flexible financing."<ref>{{
	cite journal |author=Barat LM |title=Four malaria success stories: how malaria burden was successfully reduced in Brazil, Eritrea, India, and Vietnam |journal=Am. J. Trop. Med. Hyg. |volume=74 |issue=1 |pages=12–6 |year=2006 |pmid=16407339 }}</ref>
			== See also ==
	DDT resistant mosquitoes have generally proved susceptible to pyrethroids. Thus far, pyrethroid resistance in ''Anopheles'' has not been a major problem.<ref name = "Curtis"/>
	==See also==
	* ]
	* ]		* ]
	* ]
	* ]
	* ], a short-lived cocktail that combined ] with a pinch of DDT.
	* ]		* ]
			* ]
			* ]
			** ]
			** ]
			** ]
			** ]
			** ]
			* ]
			== References ==
			{{Reflist}}
			== Further reading ==
			* Berry-Cabán, Cristóbal S. "DDT and silent spring: fifty years after". ''Journal of Military and Veterans' Health'' 19 (2011): 19–24.
			* Conis, Elena. "Debating the health effects of DDT: Thomas Jukes, Charles Wurster, and the fate of an environmental pollutant". ''Public Health Reports'' 125.2 (2010): 337–342.
			* Davis, Frederick Rowe. "Pesticides and the perils of synecdoche in the history of science and environmental history". ''History of Science'' 57.4 (2019): 469–492. {{doi|10.1177/0073275319848964}}
			* "DDT Banning" in Richard L. Wilson, ed. ''Historical Encyclopedia of American Business'', Vol I. Accounting Industry – Google, (Salem Press: 2009) p.&nbsp;223 {{ISBN|978-1587655180}}. {{OCLC|430057855}}
			* Dunlap, Thomas, ed. ''DDT, Silent Spring, and the Rise of Environmentalism'' (University of Washington Press, 2008). {{oclc|277748763}}
			* Dunlap, Thomas, ed. ''DDT, Silent Spring, and the Rise of Environmentalism: Classic texts'' (University of Washington Press, 2015). {{ISBN|978-0295998947}}. {{OCLC|921868876}}
			* {{cite journal | author = Jarman Walter M., Ballschmiter Karlheinz | year = 2012 | title = From coal to DDT: the history of the development of the pesticide DDT from synthetic dyes till Silent Spring | journal = Endeavour | volume = 36 | issue = 4| pages = 131–142 | doi = 10.1016/j.endeavour.2012.10.003 | pmid = 23177325 }}
			* Kinkela, David. ''DDT and the American Century: Global Health, Environmental Politics, and the Pesticide That Changed the World'' (University of North Carolina Press, 2011). {{ISBN|978-0807835098}}. {{OCLC|934360239}}
			* Morris, Peter J. T. (2019). "Chapter 9: A Tale of Two Nations: DDT in the United States and the United Kingdom". ''Hazardous Chemicals: Agents of Risk and Change, 1800–2000''. Environment in History: International Perspectives 17. Berghahn Books. 294–327. {{doi|10.2307/j.ctv1850hst.15}} (book: {{doi|10.2307/j.ctv1850hst}}; {{JSTOR|j.ctv1850hst}}).
			== External links ==
			{{Commons}}
			{{wikiquote}}
			{{External links|section|date=April 2023}}
			;Chemistry
	==References==
			* at '']'' (University of Nottingham)
	{{Reflist|2}}
	==External links==
	{{Commons category|DDT}}
	;Toxicity		;Toxicity
			* {{cite web |title=DDT Technical Fact Sheet |publisher=National Pesticide Information Center |url=http://npic.orst.edu/factsheets/ddttech.pdf |archive-url=https://web.archive.org/web/20030629051317/http://npic.orst.edu/factsheets/ddttech.pdf |archive-date=2003-06-29 |url-status=live }}
	*
			* {{cite web |title=DDT General Fact Sheet |publisher=National Pesticide Information Center |url=http://npic.orst.edu/factsheets/ddtgen.pdf |archive-url=https://web.archive.org/web/20030322172257/http://npic.orst.edu/factsheets/ddtgen.pdf |archive-date=2003-03-22 |url-status=live }}
	*
	*		*
			* with ], PhD about DDT and breast cancer
	*
	*
	*		*
	;Politics and DDT		;Politics and DDT
			* {{cite web |first=Aaron |last=Swartz |author-link=Aaron Swartz |title=Rachel Carson, Mass Murderer?: The creation of an anti-environmental myth |date=September–October 2007 |publisher=Extra! |url=http://www.fair.org/index.php?page=3186}}
	* Article from ] by ].
			* {{cite news |last1=Tierney |first1=John |title=Fateful Voice of a Generation Still Drowns Out Real Science |url=https://www.nytimes.com/2007/06/05/science/earth/05tier.html |work=The New York Times |date=June 5, 2007}}
	* Aaron Swartz, ''Extra!'', September/October, 2007.
	;Malaria and DDT		;Malaria and DDT
	* , a '']'' column by ] May Berenbaum		* {{cite news |first=May |last=Berenbaum | name-list-style = vanc |author-link=May Berenbaum |title=If Malaria's the Problem, DDT's Not the Only Answer |newspaper=Washington Post |date=4 June 2005 |url=https://www.washingtonpost.com/wp-dyn/content/article/2005/06/04/AR2005060400130.html}}
	* Freeview video provided by the Vega Science Trust		* Freeview video provided by the Vega Science Trust
			* {{cite news |title=Ugandan farmers push for DDT ban |work=ABC News |publisher=Australian Broadcasting Commission |date=31 May 2008 |url=http://www.abc.net.au/news/stories/2008/05/31/2261160.htm}}
	*
	*
			;DDT in popular culture
	{{insecticides}}
			* {{Skeptoid | id= 4230| number= 230| title=DDT: Secret Life of a Pesticide | date= November 2, 2010| last= Dunning| first= Brian| access-date=}}
			* consisting of ephemera and 3-D objects, including cans, sprayers, and diffusers, related to DDT pesticide and insecticide in the United States in the mid-20th century (all images freely available for download in variety of formats from ] Digital Collections at ).
	{{DEFAULTSORT:Ddt}}		{{Insecticides}}
			{{Carcinogen}}
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