Relationship between Exposure to Household Humidifier Disinfectants and Risk of Lung Injury: A Family-Based Study

• Published in: PloS one Vol. 10; no. 5; p. e0124610
• Main Authors: Park, Dong-Uk, Choi, Ye-Yong, Ahn, Jong-Ju, Lim, Heung-Kyu, Kim, Sun-Kyung, Roh, Hyun-Suk, Cheong, Hae-Kwan, Leem, Jong-Han, Koh, Dong-Hee, Jung, Hye-Jung, Lee, Kyoung-Mu, Lee, Jong-Hyeon, Kim, Yong-Hwa, Lim, Sin-Ye, Paek, Do-Myung, Lim, Chae-Man, Hong, Soo-Jong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 15.05.2015; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Care and treatment; Case-Control Studies; Child; Children & youth; Confidence intervals; Control methods; Development and progression; Disease control; Disease prevention; Disinfectants; Disinfectants - toxicity; Disinfection & disinfectants; Environmental health; Epidemiology; Exposure; Families & family life; Family studies; Female; Field tests; Health care; Health risks; Hospitals; Household Products - toxicity; Humans; Humidifiers; Inhalation; Injuries; Lung diseases; Lung Injury - chemically induced; Lung Injury - epidemiology; Lung Injury - etiology; Lungs; Male; Patients; Pregnancy; Preventive medicine; Regression analysis; Regression models; Republic of Korea; Respiration; Respiratory tract diseases; Risk; Risk factors; Statistical analysis; Studies; Surveys and Questionnaires; Tuberculosis; Young Adult; Republic of Korea; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0124610

In South Korea, a cluster of acute lung disease patients included lung injury disease suspected of being caused by the use of humidifier disinfectants. We examined the relationship between humidifier disinfectant exposure and clinically diagnosed humidifier disinfectant-associated lung injury (HDLI) in a family-based study. This case-control study included 169 clinically confirmed HDLI cases and 303 family controls who lived with the HDLI patients. A range of information on exposure to humidifier disinfectants was obtained using a structured questionnaire and field investigations. Odds ratios (ORs) and confidence intervals (CIs) were estimated using unconditional logistic regression models that were adjusted for age, sex, presence of a factory within 1 km of residence, and the number of household chemical products used. HDLI risk increased approximately two-fold or more among the highest quartile compared with the lowest quartile in terms of the hours sleeping in a room with an operating humidifier treated with disinfectant (adjusted OR = 2.0, 95 % CI = 1.1-3.7), average hours of disinfectant-treated humidifier use per day (adjusted OR = 2.1, 95 % CI = 1.0-4.5), airborne disinfectant intensity (adjusted OR = 2.6, 95% CI = 1.2-5.3), and cumulative disinfectant inhalation level (adjusted OR = 2.0, 95% CI = 1.0-4.1). HDLI risk increased as the distance of the bed from humidifier gets shorter; compared with longer distance (> 1 m), the odds ratio was 2.7 for 0.5 to 1 m (95 % CI = 1.5-5.1) and 13.2 for <0.5 m (95 % CI = 2.4-73.0). The use of household humidifier disinfectants was associated with HDLI risk in a dose-response manner.