{"hq_id":"hq-p-spe-000096","name":"G6PD Deficiency Triggers (Fava Beans, Naphthalene, Drug-Induced Hemolysis)","category":{"primary":"specialty","secondary":"genetic","tags":["G6PD","favism","naphthalene","hemolysis","genetic","enzyme deficiency","antimalarial"]},"product_tier":"SPE","overall_risk_level":"high","description":"Glucose-6-phosphate dehydrogenase (G6PD) deficiency: most common enzyme deficiency worldwide (400 million people). Triggers hemolytic crisis: fava beans (favism), naphthalene mothballs, certain medications (primaquine, dapsone, nitrofurantoin, high-dose aspirin), and infections. Red blood cells cannot handle oxidative stress — hemoglobin precipitates causing anemia, jaundice, and potentially fatal hemolytic crisis. Highest prevalence: African, Mediterranean, Middle Eastern, and Southeast Asian descent.","synthesis":{"derived_risk_level":"moderate_to_high","synthesis_confidence":0.738,"synthesis_method":"compound_composition","context_used":"human_adult","context_source":"product_users","exposure_modifier":0.654,"vulnerability_escalated":true,"escalation_reason":"Child exposure group","compounds_resolved":1,"compounds_total":1,"synthesis_date":"2026-05-09","synthesis_version":"1.2.0","methodology_note":"exposure_modifier and adjusted_magnitude are computed from ALETHEIA-calibrated heuristics (route × duration × frequency multipliers, clamped to [0.5, 1.4]). Multipliers are directionally informed by EPA Exposure Factors Handbook (2011) and CalEPA OEHHA but are not regulatory consensus. See /api/methodology for full disclosure."},"hazard_summary":{"sensitive_populations":"400 million people worldwide with G6PD deficiency","overall_risk":"high","primary_concerns":["Hemolytic crisis triggered by fava beans, naphthalene, or specific medications","400 million people worldwide — most common enzyme deficiency","Medication triggers: 40+ drugs can cause hemolysis in G6PD-deficient","Neonatal jaundice risk in G6PD-deficient newborns (kernicterus prevention)"],"exposure_routes":"Oral (fava beans, medications); inhalation (naphthalene mothballs)"},"exposure":{"routes":["oral","inhalation"],"contact_types":["oral_direct","inhalation"],"users":["adult","child"],"duration":"minutes","frequency":"rarely","scenarios":["Fava bean ingestion triggering hemolytic crisis (favism)","Naphthalene mothball inhalation or ingestion causing hemolysis","Medication-triggered hemolysis (primaquine, dapsone, nitrofurantoin)","Neonatal jaundice in G6PD-deficient newborns (phototherapy required)"],"notes":"G6PD deficiency is X-linked — primarily affects males. Newborn screening: not universal in US (varies by state). NEVER give naphthalene mothballs to families of Mediterranean, African, Middle Eastern, or Southeast Asian descent without G6PD testing. Drug-induced hemolysis: list of 40+ medications that G6PD-deficient individuals must avoid. G6PD-deficient newborns: increased risk of severe neonatal jaundice and kernicterus."},"consumer_guidance":{"usage_warning":"If G6PD-deficient: AVOID fava beans, naphthalene mothballs, and medications on the G6PD avoidance list (consult physician/pharmacist). Screen newborns of at-risk ethnic backgrounds. Inform ALL healthcare providers of G6PD status — many common medications are contraindicated.","safer_alternatives":["Cedar or lavender moth repellent (instead of naphthalene mothballs)","Medication alternatives for G6PD-safe drugs (physician-guided)","Universal newborn G6PD screening (advocate in your state)","MedicAlert identification for G6PD-deficient individuals"],"red_flags":[{"indicator":"Product not tested for or labeled for specific vulnerable population","meaning":"Standard safety data may not apply to your specific condition.","action":"Consult specialist physician for population-specific guidance."}],"green_flags":[{"indicator":"Physician-recommended or specifically tested for vulnerable population","meaning":"Safety evaluated for your specific condition/life stage.","verification":"Check for condition-specific certifications or physician guidance."}],"what_to_ask":[{"question":"Is this product safe for my specific health condition or life stage?","why_it_matters":"Safety varies dramatically by genetic background, life stage, and health condition.","good_answer":"Evaluated for your specific population with physician input.","bad_answer":"Generic safety data without population-specific consideration."}],"alternatives":[{"name":"Cedar or lavender moth repellent","notes":"instead of naphthalene mothballs"},{"name":"Medication alternatives for G6PD-safe drugs","notes":"physician-guided"},{"name":"Universal newborn G6PD screening","notes":"advocate in your state"}]},"regulatory":{"applicable_regulations":[{"jurisdiction":"USA — California","regulation":"California Proposition 65 (Safe Drinking Water and Toxic Enforcement Act of 1986)","citation":null,"requirements":"Products containing chemicals on the Prop 65 list require clear and reasonable warnings if exposure exceeds safe harbor levels. Applies to products sold in California.","compliance_status":null,"effective_date":null,"enforcing_agency":null,"penalties":null,"source_ref":null},{"jurisdiction":"EU","regulation":"REACH Regulation (EC) No 1907/2006","citation":null,"requirements":"Registration, Evaluation, Authorisation and Restriction of Chemicals. Articles containing SVHCs >0.1% w/w must notify ECHA and inform consumers on request.","compliance_status":null,"effective_date":null,"enforcing_agency":null,"penalties":null,"source_ref":null}],"certifications":[],"labeling":{"required_disclosures":[],"prop65_warning":{"required":null,"chemicals":[],"endpoint":null,"notes":null},"ghs_labeling":{"required":null,"signal_word":null,"pictograms":[],"hazard_statements":[],"notes":null},"hidden_ingredients":{"trade_secret_protected":null,"categories_hidden":[],"estimated_count":null,"known_concerns":null,"notes":null},"notes":null},"recalls":[],"regulatory_gap":null,"notes":null},"lifecycle":{"recyclable":false,"disposal_guidance":"N/A — genetic condition management.","hazardous_waste":false,"expected_lifespan":"varies"},"formulation":{"form":"varies","key_ingredients":[{"hq_id":"hq-c-org-000096","name":"Naphthalene","role":"hemolysis_trigger","concentration_pct":"mothball (99)"}],"certifications":[]},"materials":{"common":[],"concerning":[],"preferred":[]},"compound_composition":[{"hq_id":"hq-c-org-000096","compound_name":null,"role":"hemolysis_trigger","typical_concentration":"mothball (99%)"}],"identifiers":{"common_names":["g6pd deficiency triggers (fava beans, naphthalene, drug-induced hemolysis)"],"aliases":[],"manufacturer":null,"brands":[]},"brand_examples":[{"brand":"Gerber","manufacturer":"Nestlé","market_position":"mass_market","notable":"Leading jarred baby food brand"},{"brand":"Beech-Nut","manufacturer":"Beech-Nut","market_position":"mass_market","notable":"Natural baby food brand"},{"brand":"Folgers","manufacturer":"JM Smucker","market_position":"mass_market","notable":"Ground coffee (furan in roasting)"}],"brand_examples_disclaimer":"Representative branded products of this category. Concerning ingredients listed in materials.concerning[] apply to the category, not necessarily to every named brand. Specific formulations vary by SKU and may have changed since this record was written; consult the brand's current ingredient label before drawing brand-level conclusions.","sources":[{"type":"expert_curation","name":"ALETHEIA Safety Database","date":"2026-03-25"},{"type":"regulation","title":"California Proposition 65 (Safe Drinking Water and Toxic Enforcement Act of 1986)","jurisdiction":"USA — California","id":"src_c8d390dd"},{"type":"regulation","title":"REACH Regulation (EC) No 1907/2006","jurisdiction":"EU","id":"src_7b98e8e0"},{"id":"iarc_82_naphthalene","type":"regulatory","title":"IARC Monographs Volume 82: Some Traditional Herbal Medicines, Some Mycotoxins, Naphthalene and Styrene — Naphthalene Group 2B Evaluation","year":2002,"inherited_from_compound":"hq-c-org-000096"},{"id":"epa_iris_naphthalene","type":"regulatory","title":"US EPA: Naphthalene — IRIS Toxicological Review, Carcinogenicity Assessment and Reference Concentrations (Group C)","year":1998,"inherited_from_compound":"hq-c-org-000096"}],"meta":{"schema_version":"4.0.0","last_updated":"2026-03-25","timestamp":"2026-05-14T01:24:09.096Z"}}