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Yang HJ, Kim HJ, Yu J, Lee E, Jung YH, Kim HY, Seo JH, Kwon GY, Park JH, Gwack J, Youn SK, Kwon JW, Jun BY, Kim KW, Ahn K, Lee SY, Park JD, Kwon JW, Kim BJ, Lee MS, Do KH, Jang SJ, Pyun BY, Hong SJ. Inhalation toxicity of humidifier disinfectants as a risk factor of children's interstitial lung disease in Korea: a case-control study. PLoS One 2013; 8:e64430. [PMID: 23755124 PMCID: PMC3673956 DOI: 10.1371/journal.pone.0064430] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/15/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The occurrence of numerous cases of interstitial lung disease in children (chILD) every spring in Korea starting in 2006 raised suspicion about a causal relationship with the use of humidifier disinfectants (HDs). The aim of this study was to evaluate the association between HD use and the risk of chILD. METHODS This retrospective, 1∶3 matched case-control study consisted of 16 cases of chILD that had developed between 2010 and 2011. The three groups of parallel controls (patients with acute lobar pneumonia, asthma, and healthy children) were matched by age, gender, and index date. Indoor/outdoor environmental risk factors, including HD use, were investigated by asking the guardians to complete a questionnaire. RESULTS The median age of the affected children (43.8% male) was 26 months (18.25-36.25). The chILD group did not differ significantly from the control groups with respect to socio-demographic and clinical variables. Indoor and outdoor environmental factors were not associated with a risk of chILD. However, the previous use of HDs (OR; 2.73. 95% CI; 1.41-5.90, P = 0.00) were independently associated with an increased risk. CONCLUSIONS This study showed that HDs, which are widely used in South Korea in the winter season, independently increased the risk of chILD in spring. Therefore, continuous monitoring and, if needed, changes in policy are essential to prevent and control pediatric diseases caused by toxic chemicals.
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Affiliation(s)
- Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hwa-Jung Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Cancer Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Ho Jung
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyung-Young Kim
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea
| | - Geun-Yong Kwon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Ji-Hyuk Park
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Jin Gwack
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Seung-Ki Youn
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Jun-Wook Kwon
- Center for Infectious Disease Surveillance and Response, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Byung-Yool Jun
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
- Center for Infectious Disease Surveillance and Response, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Kyung Won Kim
- Department of Pediatrics and Institute of Allergy, Biomolecule Secretion Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Young Lee
- Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - June-Dong Park
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul University College of Medicine, Seoul, Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul University College of Medicine, Seungnam, Korea
| | - Byoung-Ju Kim
- Department of Pediatrics, Inje University Haeundae Paik Hospital, University of Inje College of Medicine, Busan, Korea
| | - Moo-Song Lee
- Department of Preventive Medicine, Asan Cancer Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Hyun Do
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Se-Jin Jang
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bok-Yang Pyun
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- * E-mail: (BYP); (SJH)
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- * E-mail: (BYP); (SJH)
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Kang HJ, Choi SM, Jeong YJ, Park JS, Lee SW, Yoon HI, Lee JH, Lee CT, Cho YJ. Severe Acute Fibrinous and Organizing Pneumonia with Acute Respiratory Distress Syndrome. Tuberc Respir Dis (Seoul) 2011. [DOI: 10.4046/trd.2011.71.5.368] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hyo Jae Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Sun Mi Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Jeong Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Sun Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sei Won Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ho Il Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jae Ho Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Choon-Tack Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Young-Jae Cho
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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