TL;DR: Mothballs are used for previously unrecognized reasons and can pose a hematologic threat to vulnerable populations, according to the rationale for naphthalene-containing moth repellent (mothball) use.
Abstract: Objectives: To describe the prevalence and severity of naphthalene-associated hemolysis (NAH) and infection-associated hemolysis (IAH) in children with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. To survey the rationale for naphthalene-containing moth repellent (mothball) use in the study population and to compare this with that of a more diverse population. Methods: A ten-year retrospective chart review of 160 patients with G-6-PD deficiency and/or anemia and an analysis of 24 hospitalized African-American children with an episode of acute hemolysis associated with G-6-PD deficiency were conducted. The parents of 330 children cared for in the pediatric emergency departments (EDs) of two tertiary care centers were questioned regarding domestic mothball (naphthalene) use. Results: Fourteen of 24 (58.3%) of the children identified with G-6-PD deficiency presented with hemolysis associated with exposure to naphthalene-containing moth repellents. The remaining ten had IAH. Seventy-nine percent of the NAH group required transfusion, compared with 60% of the IAH group. Mothballs were reportedly used by 27% of the families surveyed in one inner-city population with a 2-13% incidence of G-6-PD deficiency and by 15% in a more culturally diverse city. The main reported motivation for use was the fresh scent, not as a moth repellent. Conclusions: Mothballs are used for previously unrecognized reasons. Naphthalene-containing mothballs can pose a hematologic threat to vulnerable populations.
TL;DR: Recurring and emerging environmental health issues relating to mothballs containing naphthalene are described, with discussion of high-risk populations and risk mitigation strategies.
Abstract: Naphthalene is a polycyclic aromatic hydrocarbon that is commonly encountered in indoor and outdoor environments. There is growing awareness of the environmental health risks associated with inhalation exposure to naphthalene in the indoor environment. While there are numerous potential sources of naphthalene indoors, the use of mothballs can be a significant contributor to ambient concentrations. This review article describes recurring and emerging environmental health issues relating to mothballs containing naphthalene. The toxicology and health effects of naphthalene exposure are reviewed, with discussion of high-risk populations and risk mitigation strategies. Environmental health professionals should be aware of mothball use in the home, and recognize risks associated with accidental exposure and misuse.
TL;DR: The case illustrates that common household products not usually identified as recreational drugs can be abused; furthermore, linking specific medical problems with particular inhalants can be difficult because of confounding variables.
Abstract: Inhalant abuse is a major public health problem that has been associated with numerous acute and chronic medical problems. Inhalants are defined as volatile organic substances and are found in common household and commercial products that are easily accessible, inexpensive, and legally obtained. We discuss a rare case of mothball abuse predominantly by inhalation. The patient had acute peripheral neuropathy and chronic renal failure, both of which were concluded to be casually related to mothball abuse. We briefly review the abuse potential and medical complications of naphthalene and paradichlorobenzene, the compounds in mothballs. Our case illustrates that common household products not usually identified as recreational drugs can be abused; furthermore, linking specific medical problems with particular inhalants can be difficult because of confounding variables.
TL;DR: A case of a young adult who initially concealed her chronic mothball inhalation is presented and the literature regarding mothball abuse as well as inhalant abuse relevant to anesthesia is reviewed, and suggestions for the diagnosis and peri‐operative management are offered.
Abstract: Mothballs are one of a number of volatile compounds including model airplane glue, spray paint, nail polish remover, room fresheners, and gasoline that are intentionally inhaled for the purpose of recreational self-intoxication Their inhalation produces a rapid 'high' characterized by euphoria and generalized intoxication Chronic abuse can be associated with significant organ impairment, and, in rare cases, cardiac dysrhythmias and deranged end-tidal gas monitoring Mothballs contain the aromatic compound naphthalene and/or paradichlorobenzene Prolonged exposure can cause hepatic failure and severe hemolytic anemia We present a case of a young adult who initially concealed her chronic mothball inhalation The literature regarding mothball abuse as well as inhalant abuse relevant to anesthesia is reviewed, and suggestions for the diagnosis and peri-operative management are offered