Abstract

Mothballs, commonly used for household pest control, contain toxic substances that pose significant health risks, particularly among vulnerable populations such as children, the elderly with dementia, and pets. The primary chemicals in mothballs—naphthalene, paradichlorobenzene, and camphor are volatile compounds capable of causing a range of toxic effects, from mild gastrointestinal disturbances to severe hemolytic anemia, liver damage, and seizures. Despite their widespread use, awareness regarding the investigation, diagnosis, and management of mothball poisoning remains insufficient. This article presents a comprehensive guide for healthcare professionals on a structured investigative and management approach for suspected mothball poisoning. It outlines key diagnostic tools, including physical tests (such as the floating test), chemical analytical methods (GC-MS, HPLC), and the use of specific flowcharts for investigation. Furthermore, it addresses the toxicokinetic of naphthalene, highlighting its metabolic transformation into toxic metabolites that lead to hemolysis, particularly in individuals with G6PD deficiency. The article also discusses forensic considerations, such as differentiating between mothball types (naphthalene, paradichlorobenzene, and camphor) to ensure appropriate treatment. Emphasis is placed on preventive measures, particularly in households with young children and pets. By integrating physical, chemical, and clinical assessments, healthcare professionals can optimize care and outcomes for individuals affected by mothball poisoning, while raising awareness of the potential hazards of these common household products. Background: Mothballs, widely used as household pest repellents, contain toxic substances that pose risks of poisoning, especially among children, elderly individuals with dementia, and pets due to accidental ingestion or exposure. Naphthalene and paradichlorobenzene, the primary constituents, are volatile and can cause systemic toxicity with varied symptoms ranging from gastrointestinal distress to severe hemolytic anemia and hepatic damage. Despite widespread use, awareness and guidelines for the investigation, diagnosis, and management of mothball poisoning remain limited. This article seeks to outline a structured approach for healthcare professionals, combining physical, chemical, and clinical aspects to ensure comprehensive care and prevention. Aim: To develop a comprehensive algorithm for the investigation, diagnosis, and management of suspected mothball poisoning, integrating physical and chemical analysis, emergency intervention, and preventive measures. Objective: To outline a structured approach for healthcare professionals in investigating, diagnosing, and managing mothball poisoning, with an emphasis on identifying toxic substances (naphthalene, paradichlorobenzene, camphor) and providing effective treatment, while promoting preventive strategies. Conclusion: The proposed algorithm provides a systematic approach for investigating and managing suspected mothball poisoning cases. By integrating physical examination, chemical analysis, and emergency management protocols, it serves as a valuable tool for clinicians. Additionally, recommended preventive measures can significantly reduce accidental exposures. Future studies should validate this algorithm in clinical settings to enhance its effectiveness and adaptability.

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