A Symbol of the People

By Deborah Z. Altschuler, NPA President

You may or may not think Rush Limbaugh is a louse.  But I was struck by one of his positions, namely that he believes we need a new national symbol.  He devotes an entire chapter of his book, The Way Things Ought to Be, to the proposition that “we should junk the eagle and come up with a symbol more appropriate for the kind of government we have today.”

Copyrighted 1949 By W. H. Shaper MFG. C. Inc.

Limbaugh has a candidate in mind: the pig.  He suggests that …”we replace the eagle with a huge sow…one with lots of nipples and a bunch of fat little piglets hanging on, all trying to suckle as much nourishment as possible.”  Calling it “truth in advertising,” Limbaugh asks his readers to visualize the sow on the side of Air Force One.  This would prove a bitter rebuke to the bald eagle (selected over Ben Franklin’s original nomination of the turkey), which has barely escaped extinction at the hands of those who found in it a symbol of power and immortality.
I feel awful kicking a bird when it’s down, but I have to agree with Rush on this one:  the eagle is the wrong symbol for the times.  Air Force One should carry the image of a creature we not only can relate to, but one entwined in our national history.  One that accompanied the Pilgrims on the Mayflower, made itself part of every community in America, joined our solders in the trenches, has gone to school with our children, shared our lovers, and more recently been an environmentalist of the first order by resisting pesticides.  My candidate for the nation’s symbol is the louse – an equal opportunity, gender blind, ethnically diverse parasite.

The louse is also a fully pedigreed American.  It already has its own organization (the National Pediculosis Association), its own game (what did you think cooties were, anyway?), and its own coloring book (noted by Pulitzer Prize winner Dave Barry, who gave The Latest Greatest Coloring Book About Lice high praise in his nationally syndicated column).

Moreover, the louse long ago became an integral part of the American vernacular.  Everyone uses lousespeak:  Vice President Gore told Katie Couric that the “Clinton tax business has been gone over with a fine-toothed comb.”  Another Pulitzer winner, Ellen Goodman, referred to the money issues surrounding Hillary Clinton’s cattle futures as “the nitty gritty.”  A Boston Globe cartoonist depicted Hillary promising Bill that a Supreme Court appointment would get her and the Whitewater thing “out of his hair.”  All of these metaphors were taken straight from louse hunting.

The ubiquitous louse appears in more than political discourse.  Dear Abby described a Thanksgiving holiday that went from “lousy to worse,” and a series of TV and newspaper advertisements for Toyota’s upscale Lexus spoke of the car maker’s “nitpicky” approach to quality control.  Toyota went so far as to show a graphic of a fine-toothed comb with the caption, “Every car that enters our lot must pass through here.”

The renowned bacteriologist Hans Zinsser said it best when he immortalized the louse in his classic book, Rats, Lice and History. “We must endeavor to present the case of the louse in the humane spirit which our long intimacy [deserves]…”

Let’s face it, the world is in a lousy state of affairs.  If it isn’t the lousy weather, kit’s the lousy ballgame, the lousy food, the lousy paycheck, the lousy cigarette smoke, the lousy economy, the lousy crime rate, and, of course, the lousy politicians.  The louse has earned its rightful place of honor as a national symbol truly “of the people.”

Americans under the age of 25 are sure to embrace this catchy new symbol.  A creepy crawling icon that evokes the dangers of reckless intimacy seems especially appropriate for a generation growing up in a world of AIDS, antibiotic resistant microbes, and resurgent tuberculosis.  Even Beavis and Butthead would approve of a national symbol that sucks.

Nonetheless, however cute?  The cootie, the National Pediculosis Association, a non profit health education organization, is committed to its campaign to remind people of the prevalence of the head louse which does not spare even children who never share their baseball caps.  More prevalent than all other communicable childhood diseases combined, parents spend millions of dollars a year to apply lice pesticides directly to their children’s skin – a situation where misuse and abuse of products is normal use, where the ill effects can be acute, chronic or lethal, on a generation of children who deserve better.  You don’t get much lousier than that.

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The Hazards of Treating Head Lice

By Deborah Z. Altschuler

My family had just sat down to the dinner table a few weeks ago when the doorbell rang. These days the early evening doorbell means that someone from Mass. Pirg, Fair Share or, in this case, Greenpeace, is waiting with clipboard in hand to describe his cause and ask for a donation.

I’ve polished my response over the years. I write a small check and explain that the lion’s share of our charitable contributions goes to the agency I work for, the National Pediculosis Association. What I am angling for is an opportunity to describe my own cause, because I believe we are really working toward similar goals.

The gentleman from Greenpeace was more attentive than most and actually seemed interested in the work of the NPA, namely, to educate families and health professionals about head lice infestation and the importance of safe, appropriate treatment. Eventually, he confessed that he had a special place in his heart for pesticide-related issues because his mother was Rachel Carson.

My response to this revelation was one of sheer delight. I interpreted his appearance on my doorstep as an affirming omen, a message from the woman who began the pesticide awareness movement with the publication of the classic book, Silent Spring, in 1962. Her book, which I believe should be required reading in every high school in America, chronicles the range and effects of known toxic pesticides–some since banned—but some still utilized today throughout this country and the world.

What does all this have to do with head lice? For the past seven years, the NPA has been alerting physicians, nurses and parents that, while head lice remedies are marketed under the comfortable names of shampoos, creams and lotions, they are actually pesticides and must be used as safely – and infrequently – as possible.

We are helping people understand that head lice is more widespread than all other communicable childhood diseases combined, and is one of the few conditions that requires the direct application of potentially toxic pesticides on our children–$35 million worth in 1987,

We are pointing out that the anxiety that accompanies the discovery of bugs in your child’s hair often results in the mis-application or outright abuse of these products, which include environmental sprays and can contain pyrethrins/piperonyl butoxide, petroleum distillates or gamma benzene hexachloride (lindane, found in the widely-prescribed Kwell Shampoo).

Rachel Carson had plenty to say about lindane and about the evidence associating it with neurological disease, leukemia and other blood disorders. She cited a Mayo Clinic hematologist, the late Dr. Malcolm Hargraves, who suggested that the majority of patients with blood and lymphoid diseases share a history of exposure to hydrocarbon pesticides.

He concluded that “a careful medical history will almost invariably establish such a relationship”. In the hydrocarbon category, Carson specifically emphasized DDT, chlordane, benzene and lindane.

Some people contend that the amount of pesticide in a single lice treatment is minimal and therefore insignificant. But Carson reminds us that “human exposures to cancer-producing chemicals are uncontrolled and they are multiple. An individual may have many different exposures to the same chemical.

Arsenic is an example. It exists in the environment of every individual in many different guises: as an air pollutant, a contaminant of water, a pesticide residue on food, in medicines, cosmetics, wood preservatives, or as a coloring agent in paints and inks. It is quite possible that no one of these exposures alone would be sufficient to precipitate a malignancy – yet any single supposedly “safe dose” may be enough to tip the scales that are already loaded with other “safe doses”.

Our message about children and head lice addresses the category of pediculicides – just one of the “supposedly safe doses” among the pesticide exposures we experience daily. Because of this concern, the NPA must work to build a stronger coalition with Greenpeace and other health/environmental organizations.

Consider the March of Dimes and the Genesis Fund with their focus on birth defects. Pregnant woman with young children are a population very vulnerable to both lice infestation and the effects of lice treatment.

Think of the American Lung Association and the Asthma and Allergy Foundation. Lice sprays are widely used and abused, despite their low benefit and high risk, particularly for people with respiratory ailments.

Or the Epilepsy Foundation. How many unexplained onsets of seizures may actually be related to pesticide treatment? One such case is now being litigated in Boston.

Or the Jimmy Fund and other cancer groups. Eventually, the medical histories on children with malignancies should explore inappropriate lice treatment as a possible contributing factor. Unfortunately, over-zealous treatment is an all-too-common occurrence.

As a result of our doorway chat, Rachel Carson’s son, Roger, will be coming to our Annual Meeting on May 11. Our guest speaker will be Jay Feldman of the Washington, D.C. –based National Coalition Against the Misuse of Pesticides.

I invite everyone working on behalf of children’s health and environmental issues to join us at the Harvard Club, One Federal Street, Boston at 7 p.m.

We can take this opportunity to become a “united way” of our own – not one designed to raise money, but to better appreciate the inter-connectedness of our goals and the importance of thinking in terms of prevention. Minimizing pesticide exposure to our children is a logical starting point for all of us.

Originally published in The Tab – May 2, 1989

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Activist in Public Health


By Deborah Z. Altschuler

“With the exception of an occasional accolade for all the hard work that goes into being an activist, I generally find myself resenting the term.”

To paraphrase an old proverb, Citizen Activists will never disappoint you if you observe two rules: 1. Find out what they are; 2. Expect them to be just that. Many of us come naturally to advocacy in our role as parents. The activist in public health, however, can face a peculiar set of problems.

Regarding Pediculosis, the consensus among contemporary physicians is that head lice are essentially a nuisance, leaving treatment protocols to the pharmaceutical manufacturers who market pediculicides for direct application to human skin. Although it can be a positive force, the pharmaceutical industry is not a proper guardian of children’s health.

This is where the activist evolves into educator, support system and collector of personal accounts – sometimes appalling – of families and individuals who have suffered from unnecessary, unsuccessful or excessive chemical treatments. The activist must do what disinterested experts will not do: investigate the origin, nature, methods and limits of knowledge in Pediculosis and its management. The activist must also seek allies – often the school nurses, occasionally the press, and sometimes (in cases where a child has suffered grievous harm), the lawyers – when there is no mechanism in place to exchange insights, experience and research.

With the exception of an occasional accolade for all the hard work that goes into being an activist, I generally find myself resenting the term. Perhaps it is because of what other think an activist should be. Activists are do-gooders working “on the outside” – people whose commitment to their cause keeps them from pursuing a “real job”. Here are some common perceptions:

  • Activists have information – Academics possess knowledge
  • Activists have points of view – Scientists have hypotheses
  • Activists have anecdotal evidence – Researchers have reports to the literature
  • Activists provide outreach – Specialists give consultations

No matter what the cause, such perceptions can alienate the activist as a key player in providing society with what it requires in the way of a unified effort to deliver the truth – on Pediculosis-related issues or on other important matters affecting the public’s health.

Meanwhile, families must be enabled to make informed decisions and seek safer alternatives before using potentially harmful but readily available chemicals for lice and scabies. The age-old disease of Pediculosis isn’t going away. It is the activist’s particular challenge to educate the public in spite of the relative indifference to this issue on the part of the professional communities the public turns to for advice. Ultimately, the task will be accomplished when we successfully teach the “experts” what the “experts” need to be taught. That it’s not about lice – it’s about kids.

Deborah Z. Altschuler
National Pediculosis Association

The National Pediculosis Association (NPA) is a 501(c) 3 non-profit organization dedicated to the mission of setting the highest possible public health standards for children as it relates to the communicability and treatment of children with head lice. As part of its mission, the NPA developed the LiceMeister® comb and makes it available on its website http://www.headlice.org. All proceeds from the comb allow the NPA to maintain independence from product manufacturers and stay loyal to its mission to protect children from the misuse and abuse of pesticides for lice.


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