Need for individual-based evaluation to determine the association between humidifier disinfectants and health injuries

Hyeong-Cheol Kim; Hyunil Kim; Eun-Chan Mun; Yesung Lee; Soyoung Park

doi:10.35371/aoem.2021.33.e21

Need for individual-based evaluation to determine the association between humidifier disinfectants and health injuries

Ann Occup Environ Med. 2021 Jun 18:33:e21. doi: 10.35371/aoem.2021.33.e21. eCollection 2021.

Authors

Hyeong-Cheol Kim¹, Hyunil Kim¹, Eun-Chan Mun¹, Yesung Lee¹, Soyoung Park¹

Affiliation

¹ Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

Background: Injuries caused by humidifier disinfectants (HDs) can no longer be grouped under the concept of HD lung injury. Focusing on individual cases, we were able to evaluate the relevance not only of diseases for which epidemiological correlation is recognized but also all diseases and symptoms that the victims complain of.

Methods: In-depth interviews and reassessment of 113 HD-exposed patients who had not been acknowledged as victims by the government were conducted, and their medical records were reviewed. Based on these processes, an assessment questionnaire for the injuries related to HDs was completed and the involvement of HDs was assessed either as "strong association," "association," or "no association."

Results: In this study, of the 113 patients included who claimed damages, 78 (69.0%) had HD-related injuries. Among the cases of 22 patients who applied for injury acknowledgment due to upper respiratory inflammation that was not included among the acknowledged diseases, 17 (77.3%) were judged to be HD-related injuries (strong association vs. association: 10 [45.5%] vs. 7 [31.8%]). When the cases of 12 rhinitis patients were reassessed, 9 were HD-related injuries (strong association vs. association: 4 [33.3%] vs. 5 [41.7%]). When the cases of 18 asthma patients unacknowledged as a victim were reassessed, 17 (94.4%) were humidifier-related injuries (strong association vs. association: 12 [66.6%] vs. 5 [27.8%]). Among 4 interstitial lung disease patients unacknowledged as a victim, 2 (50.0%) were HD-related injuries.

Conclusions: HD-related health injuries should be assessed through both individual interviews and detailed chart reviews for more accurate injury acknowledgment. In the future, efforts should go beyond existing methods based on the adherence to acknowledgment criteria to directly listen to the victims.

Keywords: Humidifier disinfectant; Humidifier disinfectant lung injury (HDLI); Humidifier disinfectant related health injury.