Family-based case-control study of exposure to household humidifier disinfectants and risk of idiopathic interstitial pneumonia.

Abstract

BACKGROUND:

In Korea, several household humidifier disinfectants (HDs) were clinically confirmed to cause HD-associated lung injury (HDLI). Polyhexamethylene guanidine (PHMG) phosphate is the main ingredient of the HDs found to be associated with lung disease. However, the association of HDs with other interstitial lung disease including idiopathic interstitial pneumonia (IIP) is not clear. We examined the relationship between HD exposure and IIP in a family-based study.

METHODS:

This case-control study included 244 IIP cases and 244 family controls who lived with the IIP patients. The IIP cases were divided into two groups, HDLI and other IIP, and were matched to family controls based on age and gender. Information on exposure to HDs was obtained from a structured questionnaire and field investigations. Conditional logistic regression was used to estimate odds ratio (ORs) and their corresponding 95% confidence interval (CI), investigating the association of HD-related exposure characteristics with IIP risk.

RESULTS:

The risks of IIP increased two-fold or more in the highest compared with the lowest quartile of several HD use characteristics, including average total use hours per day, cumulative sleep hours, use of HD during sleep, and cumulative exposure level. In analyses separated by HDLI and other IIP, the risks of HDLI were associated with airborne HD concentrations (adjusted OR = 3.01, 95% CI = 1.34-6.76; Q4 versus Q1) and cumulative exposure level (adjusted OR = 3.57, 95% CI = 1.59-8.01; Q4 versus Q1), but this relationship was not significant in the patients with other IIP. In comparison between HDLI and other IIP, the odds ratios of average total use hours, cumulative use hours, and cumulative sleeps hours was higher for other IIP.

CONCLUSION:

The use of household HDs is associated not only with HDLI but also with other IIP.

• Authors: Dirga Kumar Lamichhane, Jong-Han Leem, Sang-Min Lee, Hyeon-Jong Yang, Jaiyong Kim, Jong-Hyun Lee, Jung Keun Ko, Hwan Cheol Kim, Dong-Uk Park, Hae-Kwan Cheong
• Journal: PloS one (PLoS One) Vol. 14 Issue 9 Pg. e0221322 ( 2019) ISSN: 1932-6203 [Electronic] United States
• PMID: 31487292 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Disinfectants

Topics

• Adult
• Case-Control Studies
• Disinfectants (adverse effects)
• Family Characteristics
• Female
• Humans
• Humidifiers (statistics & numerical data)
• Idiopathic Interstitial Pneumonias (epidemiology, etiology, pathology)
• Incidence
• Inhalation Exposure (adverse effects)
• Male
• Middle Aged
• Republic of Korea (epidemiology)
• Risk Factors
• Surveys and Questionnaires
• Young Adult