May 6, 2009 — (BRONX, NY) — Inappropriate use of camphor-containing products may be a common and underappreciated cause of seizures in young children, according to a new study by researchers at Albert Einstein College of Medicine of Yeshiva University. The study, published in this month's issue of Pediatrics, calls for efforts to educate communities about the hazards of camphor and to crack down on illegally marketed camphor products.
Camphor—a naturally occurring waxy substance with a strong, aromatic odor—is found in many consumer products. Scientists have known for some time that camphor can cause serious health problems, including seizures.
Children are particularly vulnerable to the toxic effects of camphor, which is easily absorbed through the skin and mucous membranes. As a result, the FDA limits the camphor content of common cold preparations, and federal and New York City regulations require that camphor-containing products be properly labeled.
Nevertheless, camphor products without proper or complete labeling are widely available and commonly used for medicinal, spiritual and aromatic purposes and for pest control, especially in the Hispanic community.
The Einstein researchers report on three cases of camphor-associated seizures in children seen in the emergency department of a single New York City hospital─Children's Hospital at Montefiore in the Bronx─over a two-week period.
In the first case, a 15-month-old Hispanic boy accidently ingested camphor cubes that his parents were using to ward off evil spirits. In the second case, a 22-month-old Hispanic boy ate a camphor-containing product that was placed around his apartment to control roaches. In the third case, a three-year-old Hispanic girl had been heavily exposed to numerous camphor-containing products, including crushed tablets spread around the house to control roaches and an ointment that her mother had rubbed on her skin hourly for 10 hours before her seizures began. (Interestingly, this girl and two of her siblings had a history of seizures that may have been due to previous camphor exposure.)
All three children received drug treatment to terminate their seizures, and their parents were advised to stop using all camphor-containing products. The children were all seizure-free when followed up 10 weeks later.
"With the exception of the first case, the information about camphor exposure became apparent only after we directly questioned the parents," said study leader Hnin Khine, M.D., associate professor of clinical pediatrics at both Einstein and Children's Hospital at Montefiore, The University Hospital and Academic Medical Center for Einstein.
These cases highlight the toxicity associated with camphor usage in the community and indicate that inappropriate use of illegally sold camphor products is an important public health issue, Dr. Khine says. "We believe that steps are needed to educate the communities about the hazards of using camphor-containing products and to stop them from being illegally sold."
The study, "A cluster of children with seizures caused by camphor poisoning," appears in the May 2009 issue of Pediatrics. In addition to Dr. Khine, other contributors were Jeffrey Avner, M.D., professor of clinical pediatrics at Einstein and chief of emergency pediatric medicine at Montefiore; Nora Esteban-Cruciani, M.D., assistant professor of clinical pediatrics at Einstein; and Don Weiss, M.D., M.P.H., Nathan Graber, M.D., M.P.H., and Robert S. Hoffman, M.D., all of the New York City Department of Health and Mental Hygiene.
About Albert Einstein College of Medicine of Yeshiva University
Albert Einstein College of Medicine of Yeshiva University is one of the nation's premier centers for research, medical education and clinical investigation. It is the home to some 2,000 faculty members, 750 M.D. students, 350 Ph.D. students (including 125 in combined M.D./Ph.D. programs) and 380 postdoctoral investigators. Last year, Einstein received more than $130 million in support from the NIH. This includes the funding of major research centers at Einstein in diabetes, cancer, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Through its extensive affiliation network involving five hospital centers in the Bronx, Manhattan and Long Island – which includes Montefiore Medical Center, The University Hospital and Academic Medical Center for Einstein – the College runs one of the largest post-graduate medical training program in the United States, offering approximately 150 residency programs to more than 2,500 physicians in training. For more information, please visit www.aecom.yu.edu.
Montefiore Medical Center encompasses 125 years of outstanding patient care, innovative medical "firsts," pioneering clinical research, dedicated community service and ground-breaking social activism. A full-service, integrated delivery system caring for patients in the New York metropolitan region and beyond, Montefiore is a 1,491-bed medical center that includes: four hospitals -- the Henry and Lucy Moses Division, the Jack D. Weiler Division, the North Division and The Children's Hospital at Montefiore; a large home healthcare agency; the largest school health program in the U.S.; a 25-site medical group practice integrated throughout the Bronx and Westchester; and, a care management organization providing services to 179,000 health plan members.
In 2008, The Children's Hospital at Montefiore was ranked as one of "America's Best Children's Hospitals" in US News & World Report's prestigious annual listing. The Leapfrog Group lists Montefiore among the top one percent of all U.S. hospitals based on its strategic investments in sophisticated and integrated healthcare technology.
Montefiore is committed to meeting the healthcare needs of the future through medical education and manages one of the largest residency programs in the country. Montefiore is The University Hospital and Academic Medical Center for Albert Einstein College of Medicine and has an affiliation with New York Medical College for residency programs at the North Division.
Distinguished centers of excellence at Montefiore include cardiology and cardiac surgery, cancer care, tissue and organ transplantation, children's health, women's health, surgery and the surgical subspecialties. Montefiore is a national leader in the research and treatment of diabetes, headaches, obesity, cough and sleep disorders, geriatrics and geriatric psychiatry, neurology and neurosurgery, adolescent and family medicine, HIV/AIDS and social and environmental medicine, among many other specialties. For more information, please visit www.montefiore.org or www.montekids.org .
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PEDIATRICS