Frequently Asked Questions (FAQs)

Flame Resistant Army Combat Uniform - Permethrin (FR ACU-P)

Why is the Army issuing permethrin factory-treated FR ACUs?

The Army is committed to fully protecting Soldiers. Factory-treated uniforms provide the most consistent protection from diseases transmitted by insects or ticks, such as malaria and leishmaniasis — more than 60 diseases in all. Some of these vector-borne diseases can be fatal, and there are vaccines against only a few. Wearing this factory-treated uniform can literally save Soldiers’ lives. Permethrin-treated uniforms, permethrin-treated bed nets, and topical insect repellents (DEET), provide the best, most thorough protection available anywhere against vector-borne diseases. Issuing uniforms treated with permethrin, as opposed to the current practice of Soldiers applying the permethrin to their uniforms, eliminates the most likely risk of direct exposure to the chemical, including improper application; accidental eye, skin, or ingestion exposure, and overuse. The Army began with factory-treatment of the FR ACU-P (the Universal Camouflage Pattern and the OEF Camouflage Pattern (OCP, aka Multicam) respectively) to provide the best protection to our deployed forces. Future plans include factory-treatment of the non flame resistant Army Combat Uniform (ACU).

What is permethrin, and how does it work?

Permethrin is a synthetic repellent that mimics natural compounds found in chrysanthemum flowers and is effective against mosquitoes, ticks, sand flies, and other biting arthropods. Permethrin irritates the sensory receptors in their legs and feet. An insect or bug that lands on a permethrin-treated uniform is immediately agitated, and crawls or flies away.

Does permethrin cause cancer?

There is no epidemiological evidence to suggest that permethrin causes cancer in humans. Permethrin underwent more than 15 years of testing and literally hundreds of toxicity studies before the US Environmental Protection Agency (EPA) approved it for use as a fabric treatment. The EPA asked a group of independent experts to review the data and assess the cancer-causing potential of permethrin; this panel concluded that: “…based on all the data together …the possibility of [cancer caused by permethrin] in man was extremely remote.” The National Academy of Sciences also reviewed the data and stated: “…the subcommittee concludes that permethrin-impregnation of [Battle Dress Uniforms] is not a serious carcinogenic risk to field or non-field military personnel or to garment workers.”

What are the known toxicities of permethrin?

The bulk of the research on permethrin has studied the effects of liquid chemical applied or fed to animals, the exposures with the greatest risk. It is important to note that Soldiers wearing a permethrin-treated uniform are not exposed in this way; they have a far lower exposure.

The National Research Council’s Committee on Toxicology, in a 1994 report on health effects of permethrin-impregnated uniforms, found that:

  • Although highly toxic to arthropods, permethrin is one of the least toxic insecticides to mammals.
  • The LD50 (acute oral lethal dose for 50 percent of the subjects) using aqueous suspensions of concentrated permethrin in experimental animals is from 3 to 4 grams per kilogram (kg) body weight. For comparison:
    • Ibuprofen is 6 to 8 times more toxic (LD50 0.5 grams per kg).
    • Caffeine is 15 to 20 times more toxic (LD50 about 0.2 grams per kg).

A few people might be hypersensitive to permethrin-treated uniforms and thus develop skin sensitization. Permethrin is classified as EPA Category IV (practically nontoxic) in terms of its potential for dermal irritation.

At extremely high doses, permethrin is neurotoxic. However, there is no way for a person wearing a factory-treated uniform to even remotely approach this dose.

What research supports the safety of permethrin?

Permethrin underwent more than 15 years of testing and hundreds of studies to meet EPA, US Food and Drug Administration (FDA), and US Department of Agriculture requirements to license these products. The EPA is constantly updating its review process to address changing technology as well as health and environmental concerns. Industry, academia, government, and foreign laboratories conduct new research to evaluate the safety of permethrin in regards to changes in application and material technology. The EPA renewed the DoD’s permethrin clothing application registration in 2006 after considering all the new studies and information.

The Army has used permethrin for over 20 years to treat Soldiers’ uniforms with “no observed or anecdotal reports of adverse reactions,” according to the Army Surgeon General (Memorandum, DASG-PPM-SA, “Permethrin Treated Uniforms,” 8 April 2008). Independent agencies, including the National Research Council Committee on Toxicology, the World Health Organization, the Centers for Disease Control and Prevention (CDC), American College of Family Physicians, and the EPA, all agree that Soldiers who wear uniforms treated with permethrin at doses approved for factory treatment (fabric impregnation concentration of 0.52% weight of permethrin/weight of fabric) are unlikely to experience adverse health effects.

Should I be concerned about exposing my family members to permethrin-treated uniforms?

“There appears to be little potential, if any, for either military or civilian personnel to become exposed as a result of the process of laundering impregnated uniforms,” the National Research Council Committee on Toxicology concluded in its 1994 report. Permethrin sticks to the uniform fabric quite tightly; therefore, if you are holding your clothed child or infant, there is minimal opportunity for them to absorb permethrin from the treated uniform.

Does that mean permethrin is safe for infants and children?

The EPA has approved the production of permethrin-impregnated children’s clothing for the civilian market. In addition, the FDA has licensed permethrin-containing shampoo for control of head lice on children. Safety tests were extensively conducted prior to the approval of these products and the risk was determined to be insignificant.

What if I am pregnant or nursing? Will wearing a permethrin-treated FR ACU harm my baby?

In 2003, an independent panel of toxicologists, working together as the Subcommittee to Review Permethrin Toxicity from Military Uniforms, investigated the possible reproductive and developmental toxicity of permethrin. After reviewing the results of studies conducted on a variety of mammal species, this subcommittee concluded that exposure to permethrin from wearing treated uniforms is unlikely to cause harmful effects to fetuses or newborns. In 2003, the EPA agreed with these findings and approved commercial sale of outdoor clothing treated with permethrin for children of all ages and pregnant women. The CDC also considers permethrin-treated clothing to be safe for wear by nursing women.

Should people with hypersensitive skin or allergies be concerned with side affects resulting from exposure to permethrin?

No significant skin effects are expected from wearing permethrin-treated clothing. After four years of issuing treated uniforms, the Marine Corps hasn't received any reports of skin rash, so it’s safe to say that even this minor health risk is highly unlikely. Studies in animals have demonstrated that no skin irritation or sensitization should be expected following the direct application of liquid permethrin. In a controlled human study, permethrin did not cause significant skin irritation or sensitization when tested on 200 subjects.

What about pets? Will it hurt a cat to sleep on top of the FR ACU-P, for instance? What if a puppy chews on it?

Permethrin-treated clothing should not cause any harm to your dogs or cats. All reports of permethrin toxicity in cats trace back to the misuse of concentrated liquid permethrin that is not labeled for use on cats.

What are the advantages of factory-treated uniforms over individually treated uniforms?

Factory treatment results in a more consistent application of permethrin compared to individual treatment methods; this improved application therefore provides better protection. Factory treatment also eliminates a potential risk of Soldier exposure by eliminating the need for Soldiers to apply liquid permethrin products. In fact, it eliminates the need for Soldiers to think about treating the FR ACU at all. Factory treatment is the only effective option for treating the FR ACU, because self-applied liquid permethrin products are not absorbed easily into the fabric of the FR ACU or other FR uniforms, which results in patches of inadequate protection.

How common is the process of treating uniforms or other outer garments?

Permethrin for treating uniforms has been available in the Army supply system since the early 1990s. As the only pesticide registered by the EPA to treat fabrics for protection against biting arthropods, permethrin is also widely available at sporting goods and outdoor retailers for treating clothing and gear. In addition, well-known companies sell outdoor factory permethrin-impregnated gear and clothing. FR ACU-Ps are factory treated by the same companies that produce treated clothing for the civilian market.

The CDC, World Health Organization, American College of Family Physicians, and other national and international health organizations all advocate the use of permethrin-treated clothing as a method of preventing vector-borne disease. The EPA, the National Academy of Sciences, the US Army Surgeon General, and the Commandant of the U.S. Marine Corps all approved permethrin treatment of clothing. Since March of 2007, the US Marine Corps has sold and issued factory-treated Marine Corps Combat Utility Uniforms. Other military organizations that make use of permethrin factory-treated uniforms are the US Navy and Air Force, and the Canadian, British, German, and Australian militaries.

Will the FR ACU-P smell like a chemical lab?

The new uniforms won’t have any smell because the factory treatment allows for the direct application of permethrin. The permethrin treatment is invisible, odorless, colorless, and does not change the feel of the uniform. The smell created by the self-application of permethrin was the result of it being suspended in another chemical. The factory treatment process does not use this other chemical.

Will the permethrin wash off my factory-treated FR ACU and transfer to other clothes if I launder them together?

With the modern technology used to factory-treat FR ACUs with permethrin, only a very small amount of repellent will leave the uniform when laundered. In laboratory studies conducted to date, only tiny amounts of permethrin residues have transferred to untreated clothing during laundering. However, just as you would not wash work clothes with non-duty apparel, permethrin factory-treated FR ACUs should be laundered according to the hang tag label which states, “Wash separately from other clothing. May be laundered with other clothing when in field or combat situations.”

What are some of the threats Soldiers face by NOT wearing treated uniforms?

Soldiers who do not wear treated uniforms on deployment are at greater risk of becoming ill, developing long-term health problems, or even dying from a disease transmitted by a biting insect or tick. Vaccines are not available against most of these diseases; for these, the implementation of Personal Protective Measures (PPMs), such as the wearing of permethrin-treated clothing and use of insect repellent are the only defense.

Although vector control programs are effective in reducing insect populations and slowing the transmission of disease, rapidly moving military units cannot wait for pesticide programs to be implemented, and spraying is impossible in areas under enemy control. Deployed US personnel are not routinely exposed to vector-borne diseases in the United States and, therefore, are at increased risk of developing severe cases of those diseases.

What proof exists that supports the effectiveness of permethrin-treated uniforms in preventing disease?

This is an ongoing process and we continue to add to our knowledge. For example, a 1990 Army evaluation reported 97 percent fewer ticks on permethrin-impregnated uniforms than were found on untreated uniforms. Other findings:

  • Each year, a few Cadets at the United States Military Academy contracted Lyme disease during field training, even though they had been given the Individual Dynamic Absorption (IDA) kits to treat their uniforms with permethrin. Beginning in 2002, the Cadets were issued factory-treated uniforms, and in 2003 the number of cases of Lyme disease in Cadets dropped to zero. We are searching for the case breakdown for ensuing years at West Point.
  • In a study in Colombia in 1995, Soldiers going on patrol were issued either treated or untreated uniforms. Three of 86 Soldiers wearing treated uniforms (3 percent) contracted malaria, whereas 12 of 86 (14 percent) wearing untreated uniforms contracted malaria.
  • A 2008 civilian Lyme disease study in Connecticut concluded that use of protective (permethrin-impregnated) clothing is effective in preventing Lyme disease.

What research has occurred to study the health effects of long-term exposure to permethrin?

No long-term permethrin-treated clothing study has been initiated by either military or civilian researchers since the EPA registered permethrin fabric impregnation in 1991. The standard scientific practice is to conduct short-term studies and use that information to calculate the possible long-term exposure. These calculations are compared with established safety limits to estimate the long-term risk. Several organizations verified these processes and the findings from these short-term studies. They confirm that no long-term risk is expected from permethrin-treated clothing, based on the available information.

Will permethrin leave the treated uniform and enter your skin? How harmful is that?

All substances that contact the skin surface are absorbed to some extent, whether they are fabric finishes, cosmetics, sunscreens, or insect repellents. Studies performed by the US Army have shown that about 0.5 percent per day of the permethrin in fabric may reach the skin surface of the wearer. A 1992 study performed by H.L. Snodgrass determined that during the first week of wear, permethrin is released (called “leaching”) from the uniform fabric to the skin surface at a rate of 0.5 percent per day. Since skin absorption of permethrin in humans is less than 2 percent, this is a negligible absorbed dose. Also, a study conducted in Germany in 2007 showed that the tiny amount of permethrin absorbed through the skin is quickly broken down and excreted in urine.

Have there been reports of increased cases of mosquito- or tick-related diseases in Soldiers?

In recent years, deployments to CENTCOM area of operations have exposed thousands of Soldiers to diseases not present in the United States, to include vector-borne diseases. Leishmaniasis, a disease transmitted by infected sand flies, was reported in over 4,000 Soldiers deployed to the Middle East/Africa from 2003-2009. Additionally, more than 130 cases per month were diagnosed early in the 2003 Iraq invasion. Over the past 6 years, the incidence of reported tick-borne and mosquito-borne disease in the United States population has increased over the past 25 years.

Will the FR ACU-P eliminate the need for Soldiers to wear DEET and use other personal protection measures?

Soldiers wearing FR ACUs should continue to properly protect themselves against insect bites and diseases by complying to the maximum extent possible with DoD policy, as outlined in Health Affairs Policy 07–007. Commanders must emphasize PPMs, which include proper wear of the uniform and the use of insect repellents. Soldiers should still:

  • Wear the uniform sleeves rolled down; close all openings in clothing that might let insects in; tuck pants into boots and undershirt into pants; and keep the uniform loose, because some insects, such as mosquitoes, can bite through fabric that is pulled tight against the skin. In short, the uniform serves as a physical barrier against pests.
  • Apply a thin coat of DEET lotion to all areas of exposed skin.
  • Sleep or rest under a permethrin-treated bed net.
  • Take malaria prophylaxis pills if directed to do so by the medical authority.
  • Do not use aftershave lotion, cologne, perfume, or scented deodorants or soaps while in the field; they may attract insects.
  • Wash and inspect your body for insects and their bites daily, or as often as the tactical situation permits.
  • Use the buddy system to check your clothing for ticks.
  • Wash your uniform routinely to remove any pests and their eggs.

Whom can I contact if I have any questions or concerns?

Contact your local Preventive Medicine Service/Army Public Health Command Regional Support Staff. E-mail inquiries concerning the DoD Insect Repellent System and PPMs to the DoD Pesticide Hotline at pesticide.hotline@amedd.army.mil or via commercial telephone 410-436-3773 / DSN 584-3773. Additional information is available from the DoD Armed Forces Pest Management Board (AFPMB) Website at www.afpmg.org. If the AFPMB Website does not suffice to answer specific questions, contact the AFPMB, Contingency Liaison Officer by calling DSN 295-8312 or commercial 301-295-8312; or by writing to AFPMB, ATTN: Contingency Liaison Officer, Forest Glen Annex, Bldg 172, 6900 Georgia Avenue, NW, Washington, DC 20307-5001.

When will Soldiers start receiving the FR ACU-P?

July 2010 commenced the Army’s issuance of the FR ACU-P. Program Executive Office (PEO) Soldier, the acquisition agency responsible for developing, fielding, and acquiring nearly everything a Soldier wears or carries, is the organization issuing the FR ACU-P. Soldiers will receive FR ACU-P issue through the Rapid Fielding Initiative (RFI). The FR ACU-P will be available through Army Direct Ordering (ADO) if the uniform is damaged or destroyed in Theater. This is the case for the Universal Camouflage Pattern (UCP), but not for the “Operation Enduring Freedom Camouflage Pattern” - called OCP for short and otherwise known as the “MultiCam” worn by Soldiers in Afghanistan. The factory-treated OCP uniforms, which are and will remain in high demand for the next several months, are not currently available through ADO.

How many of the FR ACU-P will each Soldier receive?

Commencing July 2010, deploying Soldiers currently receive four FR ACU-P as specified by TRADOC and Service Requirements Documents. Each Soldier will receive four sets of FR ACU-P (pattern dependent upon deployment area) and four Army Combat Shirts.

Does permethrin reduce the FR properties?

Permethrin has absolutely no effect on the uniform’s flame-resistant properties. System-level and bench-top testing have verified no degradation of FR performance for the FR ACU, Improved Combat Vehicle Coverall (iCVC), and the Army Aviation Combat Uniform (A2CU).

How long does the factory treatment last?

A single factory treatment will protect a Soldier from bug bites through 50 launderings, the estimated field life of the uniform. Beyond this point, the uniform still provides protection, but not as much (below 90 percent). However, this still meets the Core Soldier System Capabilities Document threshold (70% bite protection out to 50 launderings).

How can deploying Soldiers differentiate between factory permethrin-treated and untreated FR ACUs?

Treated and untreated FR ACUs look identical on the outside. The FR ACU-P is distinguished from other uniforms by factory sewn labels on the inside of the blouse and trouser indicating permethrin treatment.

What about the non Flame Resistant ACU? Is the Army going to start factory-treating the ACU with permethrin, too? Or will Soldiers assigned stateside continue to wear the current ACU with the current methods of permethrin application?

Permethrin factory-treatment is scheduled to begin for all ACUs starting in 2012. Soldiers probably will not start to see the ACU-P until 2013. All Soldiers get four ACUs in their clothing bag, and will receive the permethrin factory-treated ACU in the same manner. Until factory-treated ACUs become standard issue, Soldiers can treat ACUs using the Individual Dynamic Absorption (IDA) Kit (NSN 6840-01-345-0237) or the Aerosol Can (NSN 6840-01-278-1336) method. At the unit level, treat ACUs with permethrin via DoD-certified applicators and a two-gallon sprayer (NSN 6840-01-334-2666) or contract with industry professionals to treat in accordance with the US EPA-approved permethrin label.

What is the proper way to dispose of the FR ACU-P after it is no longer serviceable?

The FR ACU-P label states “dispose of garment in trash.” This indicates that the permethrin-treated FR ACU-P can simply be deposited in the trash and requires no special disposal procedures according to the EPA. However, based on operational security, the Army will look into adjusting the label language to include proper disposal according to Unit/Command/Theater policy.


Last Updated: 24 February, 2012 4:09 PM EST