Systematic Review and Literature Mapping of Naphthalene Adverse Health Outcomes
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Since the posting of the 1998 naphthalene assessment by the U.S. EPA’s Integrated Risk Information System (IRIS) program, the literature on naphthalene has grown significantly. It is important to review the new evidence across evidence streams for evaluating biological plausibility and human relevance of naphthalene-induced toxicities. A systematic review and literature map was used to summarize the literature characteristics in broad categories of evidence streams and health outcomes. First, a broad-based literature search was conducted utilizing four online databases [PubMed, Web of Science (WOS), Toxline and Toxic Substances Control Act Test Submissions (TSCATS)] and additional search strategies that identified 15,766 studies. An initial electronic screen followed by title/abstract and full text screening identified 107 relevant citations based on Populations, Exposures, Comparators, and Outcomes (PECO) criteria that were mapped to human health (n=30), animal toxicology (n=67), and physiologically-based pharmacokinetic (PBPK) models (n=10) studies. Health outcome mapping revealed that the top human health outcome categories included reproductive (n=9), immunological (n=7), hematological (n=3), and endocrine/exocrine (n=3) systems. Mapping of the animal toxicology literature identified ocular (n=41), hepatic (n=21), pulmonary (n=17), renal (n=11), reproductive (n=11), and immunological (n=10) systems as the top health outcome categories. These evidence maps are critical for prioritizing study evaluation and data extraction efforts that shape the evidence synthesis and integration, and dose-response analysis needed for health assessment. Disclaimer: The findings and conclusions in this poster have not been formally disseminated by the U.S. EPA and should not be construed to represent any agency determination or policy.