Humidifier Disinfectant Consumption and Humidifier Disinfectant-Associated Lung Injury in South Korea: A Nationwide Population-Based Study

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2021 Jul 2

PMID 34204162

Citations 7

Authors

Jeonggyo Yoon

Minsun Kang

Jaehun Jung

Min Jae Ju

Sung Hwan Jeong

Wonho Yang

Yoon-Hyeong Choi

Affiliations

Soon will be listed here.

Abstract

Humidifier disinfectant (HD) is a household biocidal product used in humidifier water tanks to prevent the growth of microorganisms. In 2011, a series of lung injury cases of unknown causes emerged in children and pregnant women who had used HD in Korea. This study investigated changes in the nationwide number of cases of humidifier disinfectant-associated lung injury (HDLI) in concordance with nationwide HD consumption using data covering the entire Korean population. More than 25 kinds of HD products were sold between 1994 and 2011. The number of diagnosed HDLI, assessed by S27.3 (other injuries of lungs) of the Korea National Health Insurance Service (NHIS) data, sharply increased by 2005, subsequently decreased after 2005, and almost disappeared after 2011 in concordance with the annual number of HD sales. The number of self-reported HDLIs, assessed using data from all suspected HDLI cases registered in the Korea Ministry of Environment, changed with the annual number of HD sales, with a delay pattern, potentially induced by the late awareness of lung injury diseases. The present study suggests that changes in the nationwide annual consumption of HD products were consistent with changes in the annual number of HDLI cases in Korea.

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References

Seong S, Kim Y, Khang Y, Park J, Kang H, Lee H . Data Resource Profile: The National Health Information Database of the National Health Insurance Service in South Korea. Int J Epidemiol. 2016; 46(3):799-800. PMC: 5837262. DOI: 10.1093/ije/dyw253. View

Johannson K, Vittinghoff E, Lee K, Balmes J, Ji W, Kaplan G . Acute exacerbation of idiopathic pulmonary fibrosis associated with air pollution exposure. Eur Respir J. 2013; 43(4):1124-31. PMC: 5555605. DOI: 10.1183/09031936.00122213. View

Kim H, Lee M, Hong S, Huh J, Do K, Jang S . A cluster of lung injury cases associated with home humidifier use: an epidemiological investigation. Thorax. 2014; 69(8):703-8. DOI: 10.1136/thoraxjnl-2013-204132. View

Park Y, Jeong M, Bang I, Kim H, Chung K . Guanidine-based disinfectants, polyhexamethylene guanidine-phosphate (PHMG-P), polyhexamethylene biguanide (PHMB), and oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride (PGH) induced epithelial-mesenchymal transition in A549 alveolar epithelial.... Inhal Toxicol. 2019; 31(4):161-166. DOI: 10.1080/08958378.2019.1624896. View

Pickering C . Humidifiers: the use of biocides and lung disease. Thorax. 2014; 69(8):692-3. DOI: 10.1136/thoraxjnl-2014-205739. View

Kim W, Hong S . Humidifier Disinfectant-Associated Lung Injury: Six Years after the Tragic Event. Tuberc Respir Dis (Seoul). 2017; 80(4):351-357. PMC: 5617851. DOI: 10.4046/trd.2017.0048. View

Kim H, Shin D, Chung K . The role of NF-κB signaling pathway in polyhexamethylene guanidine phosphate induced inflammatory response in mouse macrophage RAW264.7 cells. Toxicol Lett. 2015; 233(2):148-55. DOI: 10.1016/j.toxlet.2015.01.005. View

Lee J, Kim Y, Kwon J . Fatal misuse of humidifier disinfectants in Korea: importance of screening risk assessment and implications for management of chemicals in consumer products. Environ Sci Technol. 2012; 46(5):2498-500. DOI: 10.1021/es300567j. View

Cosgrove G, Bianchi P, Danese S, Lederer D . Barriers to timely diagnosis of interstitial lung disease in the real world: the INTENSITY survey. BMC Pulm Med. 2018; 18(1):9. PMC: 5773175. DOI: 10.1186/s12890-017-0560-x. View

10.

Song J, Jung K, Yang M, Han S, Lee K . Assessment of acute and repeated pulmonary toxicities of oligo(2-(2-ethoxy)ethoxyethyl guanidium chloride in mice. Toxicol Res. 2021; 37(1):99-113. PMC: 7806702. DOI: 10.1007/s43188-020-00058-x. View

11.

Chioma O, Hesse L, Chapman A, Drake W . Role of the Microbiome in Interstitial Lung Diseases. Front Med (Lausanne). 2021; 8:595522. PMC: 7885795. DOI: 10.3389/fmed.2021.595522. View

12.

Salisbury M, Han M, Dickson R, Molyneaux P . Microbiome in interstitial lung disease: from pathogenesis to treatment target. Curr Opin Pulm Med. 2017; 23(5):404-410. PMC: 5638128. DOI: 10.1097/MCP.0000000000000399. View

13.

Yee J, Cho Y, Yoo H, Yun H, Gwak H . Short-term exposure to air pollution and hospital admission for pneumonia: a systematic review and meta-analysis. Environ Health. 2021; 20(1):6. PMC: 7792212. DOI: 10.1186/s12940-020-00687-7. View

14.

Janson S, Becker G . Reasons for delay in seeking treatment for acute asthma: the patient's perspective. J Asthma. 1998; 35(5):427-35. DOI: 10.3109/02770909809048951. View

15.

Lee E, Lee S, Hong S . The past, present, and future of humidifier disinfectant-associated interstitial lung diseases in children. Clin Exp Pediatr. 2020; 63(7):251-258. PMC: 7374007. DOI: 10.3345/cep.2019.01326. View

16.

Paek D, Koh Y, Park D, Cheong H, Do K, Lim C . Nationwide Study of Humidifier Disinfectant Lung Injury in South Korea, 1994-2011. Incidence and Dose-Response Relationships. Ann Am Thorac Soc. 2015; 12(12):1813-21. DOI: 10.1513/AnnalsATS.201504-221OC. View

17.

Belloli E, Martinez F, Flaherty K . Update in Interstitial Lung Disease 2014. Am J Respir Crit Care Med. 2015; 192(5):538-43. DOI: 10.1164/rccm.201504-0768up. View

18.

Naghavi M, Richards N, Chowdhury H, Eynstone-Hinkins J, Franca E, Hegnauer M . Improving the quality of cause of death data for public health policy: are all 'garbage' codes equally problematic?. BMC Med. 2020; 18(1):55. PMC: 7061466. DOI: 10.1186/s12916-020-01525-w. View

19.

Park J, Kim H, Kwon G, Gwack J, Park Y, Youn S . Humidifier Disinfectants Are a Cause of Lung Injury among Adults in South Korea: A Community-Based Case-Control Study. PLoS One. 2016; 11(3):e0151849. PMC: 4798643. DOI: 10.1371/journal.pone.0151849. View

20.

Harari S, Raghu G, Caminati A, Cruciani M, Franchini M, Mannucci P . Fibrotic interstitial lung diseases and air pollution: a systematic literature review. Eur Respir Rev. 2020; 29(157). PMC: 9488644. DOI: 10.1183/16000617.0093-2020. View