ABA Health eSource
January 2011 Volume 7 Number 5

Quit Bugging Me! Attempting to Solve the Bed Bug Epidemic

By Daniel Colbert, Earle Mack School of Law at Drexel University, Philadelphia, PA and
Gabbie Nirenburg, Esq., Philadelphia, PA

AuthorAuthorI. The Bed Bug Resurgence

Although they were once a common nuisance all over the world, bed bugs were all but eradicated in first world countries by the 1940’s. 1 The availability of DDT kept bed bug populations in check. The Environmental Protection Agency (EPA) banned this pesticide in the 1970’s after Rachel Carson’s Silent Spring brought the effect of pesticides on the environment to the public eye. 2 In the past few years, these irritating insects have made an overwhelming comeback. The old adage about letting the bed bugs bite has taken on an upsetting new meaning; the monsters under the bed are real—they’re just very, very small.

The public health ramifications of the bed bug resurgence have been unusual, but serious.  Bed bugs are not known to carry or transmit diseases and, at worst, cause hives or asthma attacks. Thus, they have not been very high on the list of priorities for public health departments. 3  However, bed bugs contribute to other public health concerns, such as psychological and economic well-being.

Bed bugs know no class, race or nationality; they feed equally on anybody unlucky enough to have upholstery. Yet, the social effects of having a bed bug infestation is staggering. A quick scan of any of the dozens of Internet fora dedicated to advising those dealing with bed bugs reveals an extensive support network for the afflicted.  Discussion threads range from practical tips to comfort for depression, anxiety, and even suicidal ideations. 4 Economically speaking, the toll is equally harrowing. Bed bugs are notoriously difficult to defeat.  They can live for 18 months without feeding, and often require several visits from the exterminator before they are completely eradicated. 5  Because “it’s not unusual for the typical afflicted family to spend $5,000 or more on inspections, exterminator fees, cleaning and storage,” treating bed bugs can be just as much of a burden as keeping them around. 6

II. Governmental Response to Bed Bugs

 The Centers for Disease Control and Prevention (CDC) and the EPA have taken notice of the impact of bed bugs on people’s psyches and pocketbooks. They have established a Federal Bed Bug Workgroup, 7 held a Bed Bug Summit in Arlington, Virginia in April 2009, and have already scheduled a second Bed Bug Summit to be held in Washington, D.C. in February 2011. 8 Their current recommended approach to control bed bug infestations is an “Integrated Pest Management” system. 9  This system includes using approved pesticides along with “[using] monitoring devices, removing clutter, applying heat treatment, vacuuming,” and “sealing cracks and crevices.” 10  This system is less than ideal.  Heat treatment is effective, but expensive and time consuming. 11  Other recommended actions do prevent bed bugs from spreading to other areas, but do nothing to kill them.  Indeed, these “solutions” are often such a hassle that it is unsurprising they have yet to have any noticeable influence.  The epidemic has spread from hotels and personal residences to clothing stores, movie theaters and public transportation systems. 12 “[I]ncreasingly frustrated landlords, hotel chains and housing authorities” believe that the time has come for decisive action. 13

III. Chemical Pesticide Propoxur as a Possible Solution

Some call for the EPA to deregulate DDT. 14  While the chemical is a known carcinogen in certain animals and was banned in an anticipatory effort to prevent cancer in humans, critics have begun to decry the ban, stating that the science regarding the risks to humans from DDT is still inconclusive. 15  There has been little research into the effects of DDT on humans since the ban’s enactment.  Proponents of the ban insist that further research would be fruitless, as bed bugs had already developed a resistance to DDT by the 1970s. 16  But the few studies that do exist do not indicate a risk to human health. 17

A promising, newer pesticide called propoxur emerged as a possible solution to bed bugs in the late 1990s. 18 The EPA approved the use of propoxur in commercial establishments such as restaurants where children are unlikely to be directly exposed, but refused to approve residential use of the pesticide in 1997. 19 In 2009, Ohio Governor Ted Strickland appealed to the EPA for an emergency exemption from the regulation of propoxur for his state so that the pesticide could be made available for use in residences; the EPA denied Strickland’s request, citing safety concerns. 20

Studies of propoxur are inadequate to establish whether it truly poses a risk to human health.  The manufacturer of propoxur pulled the pesticide from safety testing in 1997 when the EPA asked for studies that would have cost millions of dollars. 21  Propoxur is a neurotoxin and has earned the EPA classification of “probable carcinogen.” 22  The EPA fears that children and fetuses, whose neural pathways are still developing, could be significantly impaired by exposure to propoxur. 23   Perhaps the best solution is a middle-ground approach, similar to those favored in other arenas by the Obama administration: a pilot program to test the efficacy and safety of propoxur, along with funding for additional study into potential long-term solutions. 24 This approach will likely fall under the same scrutiny as a call for DDT deregulation.

Since, bed bugs have developed a resistance to many other pesticides, and there is no guarantee that propoxur will remain effective indefinitely, a pilot program would at least mean progress, while providing useful data to construct a more complete program for eradication of the bed bug nuisance.  Even a temporary fix would bring relief and buy time for more innovative research.  Coupled with stronger regulations on furniture disposal, building maintenance and public education, this approach could prove very effective.

IV. The Difficult Choice between Bed Bugs and Pesticides

In the first half of the twentieth century, bed bugs were so commonplace that people were accustomed to both the pests and precautions that Americans no longer practice. If the EPA continues to ban effective pesticides, people may have to resign themselves to a life of vigilant sheet-checking and clutter reduction.  “Before World War II, one in three homes were infested with bed bugs”, so perhaps people simply need to adjust their expectations accordingly. 25 On the other hand, with international travel so much more commonplace than it was sixty years ago, the infestations may become far worse than previously imaginable.  Unless people are willing to admit defeat, people must be open to more intensive chemical treatment. Widespread but temporally limited use of insecticides like propoxur—enough to bring bed bug populations back down to the DDT era—could clean the slate and make preventative action more feasible and less stressful.  In the case of bed bugs, cure may just have to come before prevention.


1 Centers for Disease Control and Prevention, Joint Statement on Bed Bug Control in the United States from the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Environmental Protection Agency (EPA), http://www.cdc.gov/nceh/ehs/publications/bed_bugs_cdc-epa_statement.htm (last visited Dec. 17, 2010) (hereafter “Joint Statement”). “Bed bugs are small, flat insects that feed on the blood of sleeping people and animals. They are reddish-brown in color, wingless, and range from 1 to 7 millimeters in length.” (Joint Statement).
2 Dorothy McLaughlin, Silent Spring Revisited, PBS Frontline, at this link (last visited Dec. 17, 2010).
3 Joint Statement.
4 See, e.g., Bedbugger Forums, http://bedbugger.com/forum/ (containing “stickied” threads on topics such as “If You Are Feeling Suicidal or Anxious…”).
5 Rebecca Berg, Bed Bugs: The Pesticide Dilemma, J. Envtl. Health, Jun. 1, 2010, at 2.
6 Walecia Konrad, Sleeping with the Enemy (Bed Bugs), N.Y. Times, July 10, 2009 ( available at http://www.nytimes.com/2009/07/11/health/11patient.html?_r=3&pagewanted=1).
7 Susan Jennings, EPA’s Role in Bed Bug Control (PowerPoint presentation), slide 14 ( available at www.jhsph.edu/maphtc/_images/2010_Images/Bedbugs_ppt_1.pdf).
8 Press Release, EPA, EPA, Other Federal Agencies to Hold Bed Bug Summit in February (December 8, 2010) ( available at this link).
9 Joint Statement.
10 Id. (bullet points removed and list reformatted).
11

Kenneth F. Haynes, et al., Bed Bugs, Heat and Hotel Rooms, Pest Control Technology Magazine, August 2008 ( available at this link).

12 Jon C. Hopwood, Bedbugs Take Manhattan!, Associated Content from Yahoo!, July 20, 2010 ( available at this link).
13 EPA Seeks to Squash Bedbug Resurgence, The Intelligencer/Wheeling News-Register, April 15, 2009 ( available at http://theintelligencer.net/page/content.detail/id/522918.html).
14 Jerry Adler, The Politics of Bedbugs, Newsweek, Sept. 8, 2010 ( available at http://www.newsweek.com/2010/09/08/conservatives-blame-environmentalists-for-bedbugs.html).
15 Id.
16 Id.
17 See, E.g., News Release, National Institutes of Health, DDT, PCBs Not Linked to Higher Rates of Breast Cancer, an Analysis of Five Northeast Studies Concludes (May 15, 2001) ( available at http://www.nih.gov/news/pr/may2001/niehs-15.htm).
18 Berg, at 4.
19 Id., at 3-5.
20 Adler.
21 Id.
22 Berg, at 5.
23 Id.
24 The Obama administration has a history of using pilot programs to test the viability of new approaches to healthcare problems. For example, the Health IT Pilot is being used to expand electronic medical resources and harness the resources in new ways in 15 communities. (Press Release, Office of the Vice President, Vice President Biden, HHS Secretary Sebelius Announce Selection of 15 Health IT Pilot Communities through Recovery Act Beacon Community Program (May 4, 2010) ( available at this link)). The Healthy Incentives Pilot intends to incentivize the consumption of fruits and vegetables by refunding a portion of their cost to low-income individuals who use public assistance for food in Hampden County, MA. (Press Release, USDA, USDA Selects Massachusetts to Test Ground-Breaking Nutrition Pilot Program (Aug. 19, 2010) ( available at http://www.fns.usda.gov/cga/PressReleases/2010/0413.htm)).
25 Berg, at 1.

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