To the Editor: About 5% of Australians of Asian, African, Middle Eastern or Mediterranean descent have glucose-6-phosphate dehydrogenase (G6PD) deficiency.1 Affected babies can develop massive haemolysis within hours of exposure to clothes stored with mothballs containing naphthalene. It has long been known that this results in severe jaundice, which may lead to kernicterus2 and profound brain damage, for which the cost is either a lifetime of dependency and very expensive care, or death.
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- 1. Nkhoma ET, Poole C, Vannappagari V, et al. The global prevalence of glucose-6-phosphate dehydrogenase deficiency: a systematic review and meta-analysis. Blood Cells Mol Dis 2009; 42: 267-278.
- 2. Valaes T, Doxiadis SA, Fessas P. Acute hemolysis due to naphthalene inhalation. J Pediatr 1963; 63: 904-915.
- 3. Commission of the European Communities. Commission Decision of 28 July 2008 concerning the non-inclusion of certain substances in Annexes I, IA or IB to Directive 98/8/EC of the European Parliament and of the Council concerning the placing of biocidal products on the market (notified under document number C(2008) 3854). 2008/681/EC. Official Journal of the European Union 20 Aug 2008. http://www.salute.gov.it/imgs/C_17_pagineBiocidi_30_listaFile_itemName_6_file.pdf (accessed Jan 2011).
- 4. European Chemicals Bureau. European Union risk assessment report. Naphthalene. CAS No: 91-20-3. EINECS No: 202-049-5. Luxembourg: Office for Official Publications of the European Communities, 2003. http://ecb.jrc.ec.europa.eu/documents/Existing-Chemicals/RISK_ASSESSMENT/REPORT/naphtha lenereport020.pdf (accessed Jan 2011).
- 5. Victorian Poisons Information Centre. Annual report 2008. http://www.austin.org.au/Assets/Files/VPIC%20Annual%20Report%2008.pdf (accessed Jan 2011).
We acknowledge the Advisory Committee of the Australian and New Zealand Neonatal Network for endorsing this letter. We thank Judith Kirby, Department Head, NSW Poisons Information Centre, for providing the data in the Box.