Humidifier disinfectant-associated children's interstitial lung disease

Kyung Won Kim, Kangmo Ahn, Hyeon Jong Yang, Sooyoung Lee, June Dong Park, Woo Kyung Kim, Jin Tack Kim, Hyun Hee Kim, Yeong Ho Rha, Yong Mean Park, Myung Hyun Sohn, Jae Won Oh, Hae Ran Lee, Dae Hyun Lim, Ji-Tae Choung, Man Yong Han, Eun Lee, Hyung Young Kim, Ju Hee Seo, Byoung Ju KimYoung Ah Cho, Kyung Hyun Do, Sun A. Kim, Se Jin Jang, Moo Song Lee, Hwa Jung Kim, Geun Yong Kwon, Ji Hyuk Park, Jin Gwack, Seung Ki Youn, Jun Wook Kwon, Byung Yool Jun, Bok Yang Pyun, Soo Jong Hong

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58 Citations (Scopus)

Abstract

Rationale: Beginning in 2006, epidemics of a fatal lung injury of unknown cause in children were observed in Korea every spring. A recent study demonstrated that this type of children's interstitial lung disease (chILD) is associated with humidifier disinfectant use. Objectives: To determine the clinical characteristics of this type of chILD and to assess whether the nationwide suspension of humidifier disinfectant sales in the autumn of 2011 affected its incidence. Methods: The clinical characteristics of suspected cases between 2006 and 2011 were determined by a nationwide retrospective study. The potential causal relationship with humidifier disinfectants was examined by a prospective surveillance study after humidifier disinfectant sales were suspended. Measurements and Main Results: In total, 138 children were diagnosed with this type of chILD, which was characterized by rapid progression, high mortality, predominance in the spring season, and a familial tendency. The annual incidence increased in 2011 and then dropped to zero in 2012. The children were on average 30.4 months old. The most frequent symptoms at admission were cough and dyspnea. As the disease progressed, the typical complication was spontaneous air leak. Eighty children (58%) died. Two years after humidifier disinfectant-sale suspension, no more new cases were found. Conclusions: This study suggests that humidifier disinfectant inhalation causes an idiopathic type of chILD that is characterized by spontaneous air leak, rapid progression, lack of response to treatment, and high mortality. Further safety studies must be performed on common environmental compounds, particularly those that enter the human body by an unusual route.

Original languageEnglish
Pages (from-to)48-56
Number of pages9
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume189
Issue number1
DOIs
Publication statusPublished - 2014 Jan 1

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Keywords

  • Child
  • Disinfectant
  • Interstitial lung disease

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Kim, K. W., Ahn, K., Yang, H. J., Lee, S., Park, J. D., Kim, W. K., Kim, J. T., Kim, H. H., Rha, Y. H., Park, Y. M., Sohn, M. H., Oh, J. W., Lee, H. R., Lim, D. H., Choung, J-T., Han, M. Y., Lee, E., Kim, H. Y., Seo, J. H., ... Hong, S. J. (2014). Humidifier disinfectant-associated children's interstitial lung disease. American Journal of Respiratory and Critical Care Medicine, 189(1), 48-56. https://doi.org/10.1164/rccm.201306-1088OC