DOI QR코드

DOI QR Code

Individual Exposure Characteristics according to the Humidifier Disinfectant Exposure Assessment Cycle - Focusing on Cycles I-to-V Applicants -

가습기살균제 피해구제 신청자들의 신청 차수별 노출 특성 변화 - 1차에서 5차 신청자를 중심으로 -

  • Seula Lee (Korean Society of Environmental Health) ;
  • Eun-Kyung Jo (Korean Society of Environmental Health) ;
  • Habyeong Kang (Institute of Health Sciences, Korea University) ;
  • Wonho Yang (Department of Health and Safety, Daegu Catholic University) ;
  • Yoon-Hyeong Choi (School of Health and Environmental Science, Korea University)
  • Received : 2023.06.05
  • Accepted : 2023.06.23
  • Published : 2023.06.30

Abstract

Background: An ongoing environmental exposure assessment of humidifier disinfectants (HDs) has been conducted since November 2011 among individuals who experienced HD exposure-related adverse health effects. It is being performed in order to determine and quantify exposure to humidifier disinfectants in victims and their families. To date, the assessment has encompassed Cycles I-to-V. There is no report summarizing the characteristics of the subjects from the overall cycles. Objectives: We intended to examine the individual characteristics related to demographics, HD usage, and HD exposure using integrated data from Cycles I-to-V of the environmental exposure assessment of HDs and the changes with the cycles. Methods: We included 7,543 individuals who participated in Cycles I-to-V of the environmental exposure assessment of HDs. We summarized the participants' characteristics regarding their demographics (e.g., sex, education level, and age), HD usage history (e.g., product name, ingredient, and frequency of HD use), and HD exposure (e.g., daily time of HD use, cumulative time of HD use, and exposure intensity). In addition, their characteristics were compared across the cycles of the exposure assessment. Results: Among the 7,543 participants from Cycles I-to-V, there were more male participants than females (51.05% overall), except for Cycles I and III. Across all cycles, a higher proportion of survivors was observed than deceased individuals. While PHMG was the most prevalent ingredient in HDs throughout all the cycles, its proportion gradually decreased over the course of the examination cycles. Participants in Cycle I reported longer daily times of HD use compared to those in the subsequent cycles. On the other hand, cumulative time of HD use was shorter in the earlier cycles than in the later cycles. Conclusions: Using the integrated data from the full cycles of the environmental exposure assessment, this study identified changes in demographic characteristics as well as the HD exposure characteristics between the participants across different cycles.

Keywords

Acknowledgement

이 논문은 한국환경산업기술원의 '가습기살균제 피해구제신청자 환경노출조사' 자료를 이용하여 분석하였습니다. 데이터 관리 및 정제에 도움주신 신정현, 정다영, 류지윤 선생님에게 감사의 말을 전합니다.

References

  1. Korea Centers for Disease Control and Prevention. White paper on the health-related damage caused by humidifier disinfectants. Cheongju: Hanrimwon; 2014.
  2. Korean Society of Environmental Health (KSEH). Case studies on victims of humidifier disinfectants. Seoul: KSEH; 2012.
  3. Kim J, Zoh KE, Kim H, Park DU. A review on the health risks associated with the use of products containing benzalkonium chloride (BKC), focusing on humidifier disinfectant products. J Environ Health Sci. 2021; 47(6): 513-520. https://doi.org/10.5668/JEHS.2021.47.6.513
  4. Seo D, Jo J. Humidifier disinfectant, sodium dichloroisocyanurate (NaDCC): assessment of respiratory effects to protect workers' health. Sci Rep. 2021; 11(1): 15681.
  5. Lee JH, Kang HJ, Seol HS, Kim CK, Yoon SK, Gwack J, et al. Refined exposure assessment for three active ingredients of humidifier disinfectants. Environ Eng Res. 2013; 18(4): 253-257. https://doi.org/10.4491/eer.2013.18.4.253
  6. Park S, Lee K, Lee EJ, Lee SY, In KH, Kim HK, et al. Humidifier disinfectant-associated interstitial lung disease in an animal model induced by polyhexamethylene guanidine aerosol. Am J Respir Crit Care Med. 2014; 190(6): 706-708. https://doi.org/10.1164/rccm.201404-0710LE
  7. Yoon J, Kang M, Jung J, Ju MJ, Jeong SH, Yang W, et al. Humidifier disinfectant consumption and humidifier disinfectant-associated lung injury in South Korea: a nationwide population-based study. Int J Environ Res Public Health. 2021; 18(11): 6136.
  8. Asian Citizen's Center for Environment and Health. Report on total sales of humidifier disinfectant. Seoul: Asian Citizen's Center for Environment and Health; 2017 Aug. Report No.: 296, 2017-23.
  9. Lee KM, Paek D, Cheong HK, Kim S, Seo JW, Hong Y, et al. Population size estimates for the use of humidifier disinfectants and experience of health effects from exposure to humidifier disinfectants. J Environ Health Sci. 2019; 45(3): 273-284.
  10. Korea Environmental Industry & Technology Institute. Comprehensive portal for humidifier disinfectant damage support: statistics. Available: https://www.healthrelief.or.kr/home/content/stats01/view.do [accessed 30 April 2023].
  11. Ministry of Environment. Enforcement decree of the special act on remedy for damage caused by humidifier disinfectants. Article 1. Available: https://elaw.klri.re.kr/eng_mobile/viewer.do?hseq=50789&type=sogan&key=16 [accessed 29 May 2023].
  12. Lee S, Yoon J, Ock J, Jo EK, Ryu H, Yang W, et al. Individual exposure characteristics to humidifier disinfectant according to exposure classification groups - focusing on 4-1 and 4-2 applicants -. J Environ Health Sci. 2019; 45(4): 370-380.
  13. Choi YH, Ryu H, Yoon J, Lee S, Kwak JH, Han BY, et al. Demographic characteristics and exposure assessment for applicants who have been injured by humidifier disinfectant - focusing on 4-1 and 4-2 applicants -. J Environ Health Sci. 2018; 44(4): 301-314.
  14. Park DU, Ryu SH, Lim HK, Kim SK, Ahn J, Roh HS, et al. Characteristics of exposure to humidifier disinfectant by lung injury patients. J Environ Health Sci. 2016; 42(3): 147-159. https://doi.org/10.5668/JEHS.2016.42.3.147
  15. Korea Environmental Industry & Technology Institute. Environmental damage relief and support. Available: https://www.healthrelief.or.kr/home/main.do [accessed 29 May 2023].
  16. Korea Centers for Disease Control and Prevention (KCDC). 1st Study on the relationship between the use of humidifier disinfectant and lung injury. Cheongju: KCDC; 2014. p.6-9.
  17. Ministry of Environment. 2nd Study on the relationship between the use of humidifier disinfectant and lung injury. Sejong: Ministry of Environment; 2015.
  18. Choi Y. Questions and answers about the humidifier disinfectant disaster as of February 2017. J Environ Health Sci. 2017; 43(1): 1-22. https://doi.org/10.5668/JEHS.2017.43.1.1
  19. Special Investigation Commission on Humidifier Disinfectants and 4.16 Sewol Ferry Disasters. Comprehensive report on the humidifier disinfectant. Seoul: Special Investigation Commission on Humidifier Disinfectants and 4.16 Sewol Ferry Disasters; 2022.
  20. Park DU, Ryu SH, Lim HK, Kim SK, Roh HS, Cha WS, et al. Estimation of humidifier disinfectant amounts inhaled into the respiratory system. J Environ Health Sci. 2016; 42(3): 141-146. https://doi.org/10.5668/JEHS.2016.42.3.141