Characteristics of Exposure to Chloromethylisothiazolinone (CMIT) and Methylisothiazolinone (MIT) among Humidifier Disinfectant-Associated Lung Injury (HDLI) Patients in South Korea

Dong Uk Park, Seon Kyung Park, Jiwon Kim, Jihoon Park, Seung Hun Ryu, Ju Hyun Park, So Yeon Lee, Han Bin Oh, Sungkyoon Kim, Kyung Ehi Zoh, Soyoung Park, Jung Hwan Kwon

Research output: Contribution to journalArticlepeer-review

Abstract

This study aimed to quantify both chloromethylisothiazolinone (CMIT) and methylisothiazolinone (MIT) dissolved in different product brands and to characterize the exposure to these chemicals among humidifier disinfectant-associated lung injury (HDLI) patients. Both CMIT and MIT dissolved in different humidifier disinfectant (HD) products were quantified using gas chromatography-mass spectrometry. The inhalation level of CMIT and MIT was estimated based on HD-associated factors as reported by HDLI patients. A total of eleven HD products marketed until the end of 2011 were found to contain CMIT and/or MIT. The level of combined CMIT and/or MIT dissolved in these HD products ranged from 12 to 353 ppm. The level varied among HD products and the year of manufacture. The average inhalation levels were estimated to be 7.5, 4.1, and 3.2 μg/m3 for the definite, probable, and possible groups, respectively. If probable and possible groups were collapsed together, the inhalation level of the collapsed group was significantly different from that of the definite group (p < 0.001). All HDLI patients responded as having used HD not only while sleeping, but also as having a humidifier treated with HD within close proximity every day in insufficiently ventilated spaces. These HD use characteristics of patients may be directly/indirectly linked to the HDLI development.

Original languageEnglish
JournalMolecules (Basel, Switzerland)
Volume25
Issue number22
DOIs
Publication statusPublished - 2020 Nov 12

Keywords

  • chloromethylisothiazolinone (CMIT)
  • humidifier disinfectant (HD)
  • humidifier disinfectant-associated lung injury (HDLI)
  • inhalation exposure
  • methylisothiazolinone (MIT)
  • patient

ASJC Scopus subject areas

  • Analytical Chemistry
  • Chemistry (miscellaneous)
  • Molecular Medicine
  • Pharmaceutical Science
  • Drug Discovery
  • Physical and Theoretical Chemistry
  • Organic Chemistry

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