Inhalation Toxicity of Humidifier Disinfectants as a Risk Factor of Children’s Interstitial Lung Disease in Korea: A Case-Control Study

• Published in: PloS one Vol. 8; no. 6; p. e64430
• Main Authors: Yang, Hyeon-Jong, Kim, Hwa-Jung, Yu, Jinho, Lee, Eun, Jung, Young-Ho, Kim, Hyung-Young, Seo, Ju-Hee, Kwon, Geun-Yong, Park, Ji-Hyuk, Gwack, Jin, Youn, Seung-Ki, Kwon, Jun-Wook, Jun, Byung-Yool, Kim, Kyung Won, Ahn, Kangmo, Lee, Soo-Young, Park, June-Dong, Kwon, Ji-Won, Kim, Byoung-Ju, Lee, Moo-Song, Do, Kyung-Hyun, Jang, Se-Jin, Pyun, Bok-Yang, Hong, Soo-Jong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 05.06.2013; Public Library of Science (PLoS)
• Subjects: Air Conditioning; Air Pollutants - toxicity; Air Pollution, Indoor; Allergies; Asthma; Cancer; Case studies; Case-Control Studies; Child health; Child, Preschool; Children; Children & youth; Childrens health; Demographic variables; Demographics; Disease control; Disease prevention; Disinfectants; Disinfectants - toxicity; Ecological risk assessment; Environmental factors; Environmental monitoring; Environmental protection; Environmental risk; Epidemiology; Female; Health care; Hospitals; Humans; Hydrogen sulfide; Indoor environments; Infant; Infection control; Infectious diseases; Inhalation; Lung diseases; Lung Diseases, Interstitial - chemically induced; Male; Medical research; Medicine; Mortality; Nanoparticles; Pediatric diseases; Pediatrics; Physicians; Pneumonia; Preventive medicine; Republic of Korea; Respiration; Retrospective Studies; Risk analysis; Risk Factors; Spring; Surveys and Questionnaires; Toxic diseases; Toxicity; Republic of Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0064430

The occurrence of numerous cases of interstitial lung disease in children (chILD) every spring in Korea starting in 2006 raised suspicion about a causal relationship with the use of humidifier disinfectants (HDs). The aim of this study was to evaluate the association between HD use and the risk of chILD. This retrospective, 1∶3 matched case-control study consisted of 16 cases of chILD that had developed between 2010 and 2011. The three groups of parallel controls (patients with acute lobar pneumonia, asthma, and healthy children) were matched by age, gender, and index date. Indoor/outdoor environmental risk factors, including HD use, were investigated by asking the guardians to complete a questionnaire. The median age of the affected children (43.8% male) was 26 months (18.25-36.25). The chILD group did not differ significantly from the control groups with respect to socio-demographic and clinical variables. Indoor and outdoor environmental factors were not associated with a risk of chILD. However, the previous use of HDs (OR; 2.73. 95% CI; 1.41-5.90, P = 0.00) were independently associated with an increased risk. This study showed that HDs, which are widely used in South Korea in the winter season, independently increased the risk of chILD in spring. Therefore, continuous monitoring and, if needed, changes in policy are essential to prevent and control pediatric diseases caused by toxic chemicals.