Simultaneous presence of DDT and pyrethroid residues in human breast milk from a malaria endemic area in South Africa

DDT and pyrethroids were determined in 152 breast-milk samples from three towns in KwaZulu-Natal, South Africa, one of which had no need for DDT for malaria control. All compounds were found present in breast milk. Primiparae from one town had the highest mean ΣDDT whole milk levels (238.23 μg/l), and multiparae from the same town had the highest means for permethrin (14.51 μg/l), cyfluthrin (41.74 μg/l), cypermethrin (4.24 μg/l), deltamethrin (8.39 μg/l), and Σpyrethroid (31.5 μg/l), most likely derived from agriculture. The ADI for DDT was only exceeded by infants from one town, but the ADI for pyrethroids was not exceeded. Since the ADI for DDT was recently reduced from 20 to 10 μg/kg/bw, we suggest that this aspect be treated with concern. We therefore raise a concern based on toxicant interactions, due to the presence of four different pyrethroids and DDT. Breastfeeding however, remains safe under prevailing conditions.