Association between use of humidifier disinfectant and allergic rhinitis in Korean children: a cross-sectional study based on the eighth Panel Study on Korean Children (PSKC)

Abstract

Background: Rhinitis was the most frequently diagnosed disorder among users of humidifier disinfectants (HDs). The aim of our study was to investigate on the relationship between allergic rhinitis (AR) and HD uses. Methods: Our study used the data from the eighth Panel Study on Korean Children; a total of 1,540 participants were enrolled. The χ 2 test and multiple logistic regression analyses were conducted to debunk the association between AR and HD uses. Results: In our analysis, odds ratios (ORs) of doctor-diagnosed AR increased significantly when simply the response of whether HDs were used in the past was considered. When the brands of HD were considered, ORs of doctor-diagnosed AR were found to be increased significantly for those who have used polyhexamethylene guanidine phosphate/oligo(2-[2-ethoxy]-ethoxyethyl)guanidinium-containing HDs (model 3: 1.41, 95% confidence interval [CI]: 1.02-1.95). However, once duration of usage was additionally considered, ORs of doctor-diagnosed AR increased significantly only for those who have used chloromethylisothiazolinone/methylisothiazolinone-containing HDs for more than or equal to 3 months (model 3: 2.08, 95% CI: 1.17-3.69). Further, past use of HD was associated with significantly increased ORs of AR diagnosed before 2013 (model 3: 1.35, 95% CI: 1.02-1.79). Conclusions: Results of our study suggest that past uses of HDs may be associated with an increased risk of AR.

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

“…Recently, the Panel Study on Korean Children reported a correlation between the use of HDs and diagnosis of allergic rhinitis, 12 24 and also revealed a correlation with upper respiratory disease, which is a precursor to lower respiratory disease. 12 In addition to respiratory disease, there have also been experimental results demonstrating the possibility of systemic toxic effects.…”

Health Effects Associated With Humidifier Disinfectant Use: A Systematic Review for Exploration

“…For group 1, studies published on humans, a total of 49 articles were selected ( Table 2 ). 1 2 3 4 5 6 7 9 10 11 12 13 14 17 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 The suspicion that humidifier disinfectant might be a cause of lung damage was suggested in 2011. Studies in international journals began to appear in 2013.…”

“…28 Overall, annual humidifier disinfectant sales showed high correlations with the concentration and number of HDLI cases. 29 30 31 Respiratory diseases such as idiopathic interstitial pneumonia, 17 bronchitis and allergic rhinitis, 32 33 and asthma 34 have been described in human studies on non-HDLI diseases. Leem et al 35 proposed that these disease types should be grouped and named humidifier disinfectant-related respiratory syndrome.…”

“… 34 Two follow-up data collections gathered for a purpose different than the evaluation of humidifier disinfectant exposure reported that the risk of acquiring upper and lower respiratory tract allergy-type diseases such as asthma and allergic rhinitis was also increased. 33 127 Furthermore, an animal study showed that humidifier disinfectants may worsen existing asthma. 87 Given that children exposed to humidifier disinfectants account for roughly 30% of the population at the time of the sales, 49 there could be more children with undiagnosed humidifier disinfectant-related diseases.…”

Trends in prevalence of allergic diseases in Korean children: how and why?

“…On the contrary, allergic rhinitis has shown interesting increase in prevalence [ 6 ]. Humidifier disinfectant use is also a risk factor for allergic rhinitis; demonstrations in rat experiments showed degeneration of the normal nasal epithelium [ 9 ]. However, with the decreasing use of humidifier disinfectants, the prevalence of allergic rhinitis has increased while that of asthma has decreased, which defies the concept of a one-airway disease [ 6 ].…”