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Humidifier Disinfectant-associated Children’s Interstitial Lung Disease

Authors
 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 Kim  ;  Young 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 
Citation
 AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol.189(1) : 48-56, 2014 
Journal Title
 AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 
ISSN
 1073-449X 
Issue Date
2014
MeSH
Child, Preschool ; Disinfectants/adverse effects* ; Epidemics ; Female ; Household Articles* ; Humans ; Lung/diagnostic imaging ; Lung/pathology ; Lung Diseases, Interstitial/chemically induced* ; Lung Diseases, Interstitial/diagnostic imaging ; Lung Diseases, Interstitial/epidemiology ; Lung Diseases, Interstitial/mortality ; Lung Diseases, Interstitial/pathology ; Male ; Prospective Studies ; Radiography ; Republic of Korea/epidemiology ; Retrospective Studies ; Seasons
Keywords
disinfectant ; interstitial lung disease ; chILD
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.
Full Text
http://www.atsjournals.org/doi/abs/10.1164/rccm.201306-1088OC#.VJDQO9KsXTo
DOI
10.1164/rccm.201306-1088OC
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98120
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