|In the world of what
would have been, her son Matthew would have started
playing football this past year. His childhood dream was
to play for the Dallas Cowboys.
Pamela LaBrake of Schenectady can picture in that world
of what would have been how Matthew, who recently turned
15, would still be an outgoing, confident, happy kid with
lots of friends and a smile big enough to make you do the
Instead of what would have been, LaBrake has managed to
live with what is and what has been -- Matthew has been a
quieter, more withdrawn boy with convulsive disorders and
a variety of other health issues since soon after Dec. 18,
1997, when Matthew, then 7 years old, was sent home from
school with head lice.
"I called (the doctor) and told them that he was 7,"
said LaBrake, recently, sitting in the den of her mother's
house in Albany. "They prescribed a lindane shampoo. I
picked it up within an hour."
Lindane is the common name for an organochloride
pesticide known as gamma benzene hexachloride. Since the
1940s, it has been used in the United States as an
agricultural insecticide and as a chemical treatment for
lice and scabies.
In shampoo form, lindane is generally meant to be used
only once, in a very methodical way, as a "second-line"
LaBrake found this out later. She said that because she
hadn't received any explicit special instructions for
using lindane, she figured she'd use it on Matthew just
like any other shampoo. That's what she did.
The problems started a few weeks later. Matthew's eyes
were swollen and red. They rolled around in his head. He
was struck by twitches and spasms.
The first doctor who saw Matthew, in early January
1998, found a scraped cornea and diagnosed him with
At that point, LaBrake hadn't considered a correlation
between Matthew's problems and the lindane shampoo. That
changed a couple of months later, when she saw a
television news report about the possible side effects of
"It was like they were describing Matthew," said
LaBrake. "Oh my god, I knew right away."
From that point on, LaBrake began to find out
everything she could about lindane. She filled notebooks
and folders with information about the pesticide.
She got in touch with doctors, pharmacies, legislators,
other parents, the U.S. Food and Drug Administration, the
Environmental Protection Agency and organizations trying
to get the substance banned.
She filed Freedom of Information requests, posted
letters on Internet message boards and watched, guilty and
helpless, as Matthew's condition immediately worsened,
then refused to go away.
In September 1998, nine months after LaBrake used the
lindane, a neurologist saw Matthew and concluded in his
report that the boy's symptoms were "consistent with the
syndrome of acquired epileptic aphasia," a convulsive
condition. Later, he would receive other diagnoses:
epileptic encephalopathy, cortical irritability, cerebral
Going through changes
After a while, it didn't matter to LaBrake what they
called it. The worst part was watching her son and
realizing he might not ever be the same again.
He withdrew from other kids. He quit playing sports. He
began dreading school.
"He remembers how he was before," said LaBrake. "When
he was younger, he used to say, 'Why did you use that
shampoo on me?' He doesn't say that anymore."
Although LaBrake is not taking any legal action
regarding her own son's case, she has spent the past eight
years actively seeking a ban on lindane.
Today, a child is less likely to receive a lindane
shampoo prescription to treat head lice.
A little more than two years ago, the Food and Drug
Administration issued a public health advisory concerning
the use of lindane shampoo and lotion. It required lindane
shampoo and lotion bottles to come with a "black box"
warning highlighting the risks associated with the
"While FDA believes that the benefits of lindane
outweigh the risks when used as directed, given the
potential for neurotoxicity, patients should only be
treated with these medications if other treatments are not
tolerable or other approved therapies have failed," the
March 28, 2003, advisory stated.
In addition to stressing the use of lindane as a
"second-line therapy," in essence a fall-back option when
nothing else has worked, the FDA advised caution in using
lindane on anyone weighing less than 110 pounds. "These
warnings," the advisory read, "are based on reports to the
FDA's voluntary reporting system, which described
approximately one half of reported adverse events occurred
in pediatric patients."
The advisory also stressed that each new prescription
of lindane shampoo or lotion must be accompanied by a
"Medication Guide" spelling out the instructions for use
and the information about the possible side effects of
For some, this warning isn't enough.
In 2000, California became the first and, so far, only
state to ban the use or sale of lice and scabies
treatments using lindane. That bill cited not only the
health concerns associated with the direct use of lindane
but also the toxic polluting power of lindane being
flushed into the water system because it is still used in
A similar bill has been passed by the state House of
Representatives in Illinois. A hearing on the bill is
scheduled to take place Wednesday in the Health and Human
Services Committee of that state's Senate.
The state of law
In New York, Assemblyman Harvey Weisenberg of Long
Beach has sponsored a bill to ban lindane. He said he
first became aware of lindane because a constituent
suffered brain damage after using it.
"The evidence has proven that lindane is not only
detrimental to the person who's using this product but
also to the environment," said Weisenberg. "It has a
warning on it (to) not use it on animals. If we don't use
it on animals, why the hell would we use it on a child? It
just doesn't make any sense."
The bill has been put on the committee's agenda for
next Tuesday, May 10.
A number of public interest groups, including the
Citizens' Environmental Coalition, the New York Public
Interest Research Group, Physicians for Social
Responsibility and the Healthy Schools Network have voiced
strong support for the ban on lindane.
The ban seems to make sense, said Erin Cinelli, a
pharmacist and adjunct faculty member in the department of
pharmacy practice at the Albany College of Pharmacy. "You
don't really see it too much anymore, anyway. I've only
dispensed it once," said Cinelli.
"There are the over-the-counter (head lice treatments),
and I'm a big advocate of doing all the manual things,
Upon hearing last week that the lindane bill was
scheduled to be on the agenda soon, LaBrake was excited.
"I didn't want to get Matthew's hopes up, so I
explained to him that it has to go through all these
different committees and who knows what will happen," said
LaBrake. "I told him that it was a good first step,
though. He doesn't talk much, so he didn't say anything.
But when I told him, he did sort of have this little
William Brantley may be reached by e-mail at
* For the U.S. Food and Drug Administration's FAQ on
lindane shampoo and lotion, visit
* For the U.S. Environmental Protection Agency's fact
sheet on lindane, visit
* For the Centers for Disease Control and Prevention
fact sheet on head lice, visit
* For more information about head lice and head lice
treatments, visit http://www.nlm.nih.gov/medlineplus/headlice.html
* For more information about head lice and lindane,
visit the Web site of the National Pediculosis Association
* The text of the bill sponsored by Assemblyman Harvey
Weisenberg in the state Assembly Health Committee is
available at http://www.assembly.state.ny.us/leg/?bn=04162
* For the Web site of Morton Grove Pharmaceuticals, the
manufacturer of lindane shampoo, visit
* For the Web site of the Ban Lindane Campaign, vist
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