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Illness Associated with Exposure to Naphthalene in Mothballs -- Indiana

In April 1982, the Clark County Health Department in Jeffersonville, Indiana, received a telephone call from a 26-year-old woman whose friends were becoming ill with symptoms of headache, nausea, and vomiting while visiting her apartment.

An investigation of the home by the health department identified large numbers of mothballs (approximately 300-500) distributed throughout the apartment in such places as the kitchen and living room. The woman said members of her family had used mothballs for many years to curb odors and to control insects. Air samples collected in the apartment on charcoal and analyzed by gas chromatography and flame ionization revealed detectable levels of naphthalene (20 parts per billion).

The woman, her 4-year-old daughter, and seven relatives living in two other households where mothballs were extensively used, had symptoms and medical findings compatible with naphthalene exposure--headache, nausea, vomiting, abdominal pain, malaise, confusion, anemia, icterus, and renal disease. Headache, nausea, vomiting, abdominal cramps, and malaise disappeared in members of all three households when mothball use was discontinued, and visitors no longer developed symptoms when visiting the woman's apartment. Reported by M Linick, Clark County Health Dept, Jeffersonville, Indiana; Special Studies Br, Div of Chronic Diseases, Center for Environmental Health, CDC.

Editorial Note

Editorial Note: The use of mothballs in homes to control odors and insects is common in some areas of the country, although the quantity of mothballs used in this situation appears uncommon. The major component of mothballs is naphthalene. Inhalation of naphthalene may cause skin and eye irritation; gastrointestinal symptoms, such as nausea, vomiting, abdominal cramps, and diarrhea; neurologic symptoms, such as confusion, excitement, and convulsions; renal problems, such as acute renal shutdown; and hematologic features, such as icterus and severe anemia. The erythrocytes of individuals with glucose-6-phosphate dehydrogenase deficiency are more susceptible to hemolysis by naphthalene (1-3).

Although naphthalene levels were relatively low when measurements were taken in the home, levels may have been much higher--because of increased volatilization of naphthalene--when fresh supplies of mothballs were first introduced. Individuals vary widely in susceptibility to naphthalene exposure, and among sensitive individuals, minute doses have induced symptomatic reactions (3). Although adequate air monitoring to fully characterize exposure was not available, it seems possible that such excessive use of mothballs could lead to symptomatic reactions. Because of the wide range of sensitivity to naphthalene, the excessive and inappropriate use of mothballs for odor and insect control is inadvisable.

References

  1. Daugaard J. Symptoms and signs in occupational diseases: a practical guide. Chicago: Year Book Medical, 1979.

  2. Sittig M. Handbook of toxic and hazardous chemicals. Park Ridge, New Jersey: Noyes, 1981.

  3. Gosselin R, Hodge H, Smith R, Gleason M. Clinical toxicology of commercial products, 4th ed. Baltimore: Williams and Wilkins, 1976.



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