Journal of Medical Toxicology

, Volume 9, Issue 2, pp 133–138

Naphthalene Biomarkers and Relationship with Hemoglobin and Hematocrit in White, Black, and Hispanic Adults: Results from the 2003–2004 National Health and Nutrition Examination Survey

  • Daniel L. Sudakin
  • Ellen Smit
  • Andres Cardenas
  • Anna Harding
Toxicology Investigation

Abstract

Naphthalene is an important contaminant in indoor and outdoor air. Acute overexposure can have toxic effects, resulting in hemolysis. There have been no studies evaluating the impact of environmental exposure on red blood cell indices. We examined 1- and 2-hydroxynaphthalene urinary metabolites (NAP1 and NAP2) in non-Hispanic White, non-Hispanic Black, and Mexican-American adults in the USA and their relationship with hemoglobin (Hb) and hematocrit (HCT). Using the 2003–2004 National Health and Nutrition Examination Survey data, weighted generalized linear regression analyses were used to examine the association between Hb (in grams per deciliter) and HCT (in percent) with NAP1 and NAP2 (per 100,000 ng/L). Beta coefficients ± SE are reported. NAP1 and NAP2 were highest in non-Hispanic Blacks, followed by non-Hispanic Whites, and lowest in Mexican-American adults. There was a positive association between NAP1 and Hb (0.39 ± 0.11, p = 0.0034) and HCT (1.14 ± 0.28, p = 0.0009) after adjusting for age, gender, race, education, and smoking. Stratified analysis by smoking showed similar results with the association being stronger for smokers (Hb 0.63 ± 0.23, p = 0.02; HCT 1.43 ± 0.79, p = 0.09) than nonsmokers (Hb 0.34 ± 0.14, p = 0.03; HCT 1.08 ± 0.42, p = 0.02). The association was also stronger for non-Hispanic blacks (Hb 0.54 ± 0.20, p = 0.02; HCT 1.43 ± 0.55, p = 0.02) than for non-Hispanic whites (Hb 0.37 ± 0.18, p = 0.06; HCT 1.20 ± 0.51, p = 0.03) and was not significant for Mexican-Americans (Hb 0.30 ± 1.7, p = 0.10; HCT 0.99 ± 0.52, p = 0.08). NAP2 was not significantly associated with Hb or HCT. The observed disparity in NAP1 and NAP2 levels by race/ethnicity is consistent with published literature. The origin of these differences in exposure is unclear but may reflect differences in environmental exposure as well as genetic susceptibility. The positive association between NAP1 with HCT and Hb is an unexpected finding. Further research is needed to understand the possible biological mechanisms or other explanations for this association.

Keywords

Naphthalene Biomonitoring Biomarker Mothballs Hemolysis 

References

  1. 1.
    Jia C, Batterman S (2010) A critical review of naphthalene sources and exposures relevant to indoor and outdoor air. Int J Environ Res Public Health 7(7):2903–2939PubMedCrossRefGoogle Scholar
  2. 2.
    ATSDR (2005) Toxicological profile for naphthalene, 1-methylnaphthalene, and 2-methylnaphthalene. ATSDR, AtlantaGoogle Scholar
  3. 3.
    Lin T-C, Krishnaswamy G, Chi D (2008) Incense smoke: clinical, structural and molecular effects on airway disease. Clin Mol Allergy 6(1):3PubMedCrossRefGoogle Scholar
  4. 4.
    Kuo CY, Yang YH, Chao MR, Hu CW (2008) The exposure of temple workers to polycyclic aromatic hydrocarbons. Sci Total Environ 401(1–3):44–50PubMedCrossRefGoogle Scholar
  5. 5.
    Sjaastad AK, Jorgensen RB, Svendsen K (2010) Exposure to polycyclic aromatic hydrocarbons (PAHs), mutagenic aldehydes and particulate matter during pan frying of beefsteak. Occup Environ Med 67(4):228–232PubMedCrossRefGoogle Scholar
  6. 6.
    Chen Y, Ho KF, Ho SS, Ho WK, Lee SC, Yu JZ et al (2007) Gaseous and particulate polycyclic aromatic hydrocarbons (PAHs) emissions from commercial restaurants in Hong Kong. J Environ Monit 9(12):1402–1409PubMedCrossRefGoogle Scholar
  7. 7.
    Sudakin DL, Canoy SD, Power L (2011) Naphthalene mothballs: emerging and recurring issues and their relevance to environmental health. Curr Top Toxicol 7:13–19Google Scholar
  8. 8.
    Bronstein AC, Spyker DA, Cantilena LR, Green JL, Rumack BH, Giffin SL (2010) 2009 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 27th annual report. Clin Toxicol 48(10):979–1178CrossRefGoogle Scholar
  9. 9.
    Van Winkle MR, Scheff PA (2001) Volatile organic compounds, polycyclic aromatic hydrocarbons and elements in the air of ten urban homes. Indoor Air 11(1):49–64PubMedCrossRefGoogle Scholar
  10. 10.
    Zhu L, Lu H, Chen S, Amagai T (2009) Pollution level, phase distribution and source analysis of polycyclic aromatic hydrocarbons in residential air in Hangzhou, China. J Hazard Mater 162(2–3):1165–1170PubMedCrossRefGoogle Scholar
  11. 11.
    Kong JT, Schmiesing C (2005) Concealed mothball abuse prior to anesthesia: mothballs, inhalants, and their management. Acta Anaesthesiol Scand 49(1):113–116PubMedCrossRefGoogle Scholar
  12. 12.
    Weintraub E, Gandhi D, Robinson C (2000) Medical complications due to mothball abuse. South Med J 93(4):427–429PubMedGoogle Scholar
  13. 13.
    Shannon K, Buchanan GR (1982) Severe hemolytic anemia in black children with glucose-6-phosphate dehydrogenase deficiency. Pediatrics 70(3):364–369PubMedGoogle Scholar
  14. 14.
    Melzer-Lange M, Walsh-Kelly C (1989) Naphthalene-induced hemolysis in a black female toddler deficient in glucose-6-phosphate dehydrogenase. Pediatr Emerg Care 5(1):24–26PubMedCrossRefGoogle Scholar
  15. 15.
    Bieniek G (1997) Urinary naphthols as an indicator of exposure to naphthalene. Scand J Work Environ Health 23(6):414–420PubMedCrossRefGoogle Scholar
  16. 16.
    Hansen AM, Christensen JM, Sherson D (1995) Estimation of reference values for urinary 1-hydroxypyrene and alpha-naphthol in Danish workers. Sci Total Environ 163(1–3):211–219PubMedCrossRefGoogle Scholar
  17. 17.
    Serdar B, Waidyanatha S, Zheng Y, Rappaport SM (2003) Simultaneous determination of urinary 1- and 2-naphthols, 3- and 9-phenanthrols, and 1-pyrenol in coke oven workers. Biomarkers 8(2):93–109PubMedCrossRefGoogle Scholar
  18. 18.
    Aquilina NJ, Delgado-Saborit JM, Meddings C, Baker S, Harrison RM, Jacob P 3rd et al (2010) Environmental and biological monitoring of exposures to PAHs and ETS in the general population. Environ Int 36(7):763–771PubMedCrossRefGoogle Scholar
  19. 19.
    Li Z, Sandau CD, Romanoff LC, Caudill SP, Sjodin A, Needham LL et al (2008) Concentration and profile of 22 urinary polycyclic aromatic hydrocarbon metabolites in the US population. Environ Res 107(3):320–331PubMedCrossRefGoogle Scholar
  20. 20.
    Preuss R, Koch HM, Wilhelm M, Pischetsrieder M, Angerer J (2004) Pilot study on the naphthalene exposure of German adults and children by means of urinary 1- and 2-naphthol levels. Int J Hyg Environ Health 207(5):441–445PubMedCrossRefGoogle Scholar
  21. 21.
    Suwan-ampai P, Navas-Acien A, Strickland PT, Agnew J (2009) Involuntary tobacco smoke exposure and urinary levels of polycyclic aromatic hydrocarbons in the United States, 1999 to 2002. Cancer Epidemiol Biomarkers Prev 18(3):884–893PubMedCrossRefGoogle Scholar
  22. 22.
    Centers for Disease Control and Prevention (CDC). (2011) National Health and Nutrition Examination Survey Data (NHANES), 2003–2004. Centers for Disease Control and Prevention, HyattsvilleGoogle Scholar
  23. 23.
    Romanoff LC, Li Z, Young KJ, Blakely NC 3rd, Patterson DG Jr, Sandau CD (2006) Automated solid-phase extraction method for measuring urinary polycyclic aromatic hydrocarbon metabolites in human biomonitoring using isotope-dilution gas chromatography high-resolution mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 835(1–2):47–54PubMedGoogle Scholar
  24. 24.
    Santucci K, Shah B (2000) Association of naphthalene with acute hemolytic anemia. Acad Emerg Med 7(1):42–47PubMedCrossRefGoogle Scholar
  25. 25.
    Kim Y-D, Lee C-H, Nan H-M, Kang J-W, Kim H (2003) Effects of genetic polymorphisms in metabolic enzymes on the relationships between 8-hydroxydeoxyguanosine levels in human leukocytes and urinary 1-hydroxypyrene and 2-naphthol concentrations. J Occup Health 45(3):160–167PubMedCrossRefGoogle Scholar
  26. 26.
    Bogen KT, Benson JM, Yost GS, Morris JB, Dahl AR, Clewell HJ 3rd et al (2008) Naphthalene metabolism in relation to target tissue anatomy, physiology, cytotoxicity and tumorigenic mechanism of action. Regul Toxicol Pharmacol 51(2 Suppl):S27–S36PubMedCrossRefGoogle Scholar
  27. 27.
    Li Z, Sjödin A, Romanoff LC, Horton K, Fitzgerald CL, Eppler A et al (2011) Evaluation of exposure reduction to indoor air pollution in stove intervention projects in Peru by urinary biomonitoring of polycyclic aromatic hydrocarbon metabolites. Environ Int 37(7):1157–1163PubMedCrossRefGoogle Scholar
  28. 28.
    Viau C, Hakizimana G, Bouchard M (2000) Indoor exposure to polycyclic aromatic hydrocarbons and carbon monoxide in traditional houses in Burundi. Int Arch Occup Environ Health 73(5):331–338PubMedCrossRefGoogle Scholar
  29. 29.
    Smith JR, Landaw SA (1978) Smokers’ polycythemia. N Engl J Med 298(1):6–10PubMedCrossRefGoogle Scholar
  30. 30.
    Meeker JD, Barr DB, Serdar B, Rappaport SM, Hauser R (2007) Utility of urinary 1-naphthol and 2-naphthol levels to assess environmental carbaryl and naphthalene exposure in an epidemiology study. J Expo Sci Environ Epidemiol 17(4):314–320PubMedCrossRefGoogle Scholar
  31. 31.
    Wu R, Waidyanatha S, Henderson AP, Serdar B, Zheng Y, Rappaport SM (2005) Determination of dihydroxynaphthalenes in human urine by gas chromatography–mass spectrometry. J Chromatogr B 826(1–2):206–213CrossRefGoogle Scholar
  32. 32.
    Klotz K, Schindler BK, Angerer J (2011) 1,2-Dihydroxynaphthalene as biomarker for a naphthalene exposure in humans. Int J Hyg Environ Health 214(2):110–114PubMedCrossRefGoogle Scholar
  33. 33.
    Campo L, Addario L, Buratti M, Scibetta L, Longhi O, Valla C, et al. (2006) Biological monitoring of exposure to polycyclic aromatic hydrocarbons by determination of unmetabolized compounds in urine. Toxicol Lett, 162(2, 3):132–138Google Scholar
  34. 34.
    Schulz C, Wilhelm M, Heudorf U, Kolossa-Gehring M (2011) Update of the reference and HBM values derived by the German Human Biomonitoring Commission. Int J Hyg Environ Health 215(1):26–35PubMedCrossRefGoogle Scholar

Copyright information

© American College of Medical Toxicology 2012

Authors and Affiliations

  • Daniel L. Sudakin
    • 1
  • Ellen Smit
    • 2
  • Andres Cardenas
    • 2
  • Anna Harding
    • 2
  1. 1.Department of Environmental and Molecular ToxicologyOregon State UniversityCorvallisUSA
  2. 2.School of Biological and Population Health Sciences, College of Public Health and Human SciencesOregon State UniversityCorvallisUSA

Personalised recommendations