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PLoS One. 2016 Mar 18;11(3):e0151849. doi: 10.1371/journal.pone.0151849. eCollection 2016.

Humidifier Disinfectants Are a Cause of Lung Injury among Adults in South Korea: A Community-Based Case-Control Study.

Author information

1
Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju-si, Gyeongsangbuk-do, South Korea.
2
Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, South Korea.
3
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
4
Center for Infectious Disease Control, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, South Korea.
5
Bureau of Public Health Policy, Ministry of Health and Welfare, Sejong, South Korea.
6
Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
7
Department of Nursing, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
8
Department of Nursing, Hanyang University, Seoul, South Korea.
9
Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, South Korea.

Abstract

BACKGROUNDS:

An outbreak of lung injury among South Korean adults was examined in a hospital-based case-control study, and the suspected cause was exposure to humidifier disinfectant (HD). However, a case-control study with community-dwelling controls was needed to validate the previous study's findings, and to confirm the exposure-response relationship between HD and lung injury.

METHODS:

Each case of lung injury was matched with four community-dwelling controls, according to age (±3 years), sex, residence, and history of childbirth since 2006 (for women). Environmental risk factors, which included type and use of humidifier and HD, were investigated using a structured questionnaire during August 2011. The exposure to HD was calculated for both cases and controls, and the corresponding risks of lung injury were compared.

RESULTS:

Among 28 eligible cases, 16 patients agreed to participate, and 60 matched controls were considered eligible for this study. The cases were more likely to have been exposed to HD (odds ratio: 116.1, 95% confidence interval: 6.5-2,063.7). All cases were exposed to HDs containing polyhexamethyleneguanidine phosphate, and the risk of lung injury increased with the cumulative exposure, duration of exposure, and exposure per day.

CONCLUSIONS:

This study revealed a statistically significant exposure-response relationship between HD and lung injury. Therefore, continuous monitoring and stricter evaluation of environmental chemicals' safety should be conducted.

PMID:
26990641
PMCID:
PMC4798643
DOI:
10.1371/journal.pone.0151849
[Indexed for MEDLINE]
Free PMC Article

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