Effects of a mixture of chloromethylisothiazolinone and methylisothiazolinone on peripheral airway dysfunction in children

Abstract

BackgroundChildren who were only exposed to a mixture of chloromethylisothiazolinone (CMIT) and methylisothiazolinone (MIT) as humidifier disinfectant (HD) components were evaluated for humidifier disinfectant-associated lung injury (HDLI) from 2012. This study was to evaluate the pulmonary function using, impulse oscillometry (IOS) for children exposed to a mixture of CMIT/MIT from HD.MethodsTwenty-four children who were only exposed to a mixture of CMIT/MIT, with no previous underlying disease, were assessed by IOS. Diagnostic criteria for HDLI were categorized as definite, probable, possible, or unlikely. Home visits and administration of a standardized questionnaire were arranged to assess exposure characteristics.ResultsDefinite and probable cases showed higher airborne disinfectant exposure intensity during sleep (32.4 ± 8.7 μg/m3) and younger age at initial exposure (3.5 ± 3.3 months) compared with unlikely cases (17.3 ± 11.0 μg/m3, p = 0.026; 22.5 ± 26.2 months, p = 0.039, respectively). Reactance at 5 Hz was significantly more negative in those with high-density exposure during sleep (mean, -0.463 kPa/L/s vs. low density, -0.296, p = 0.001). The reactance area was also higher with high-density exposure during sleep (mean, 3.240 kPa/L vs. low density, 1.922, p = 0.039). The mean bronchodilator response with high-density exposure was within the normal range for reactance.ConclusionsSignificant peripheral airway dysfunction were found in children with high levels of inhalation exposure to a mixture of CMIT/MIT during sleep. Strict regulation of a mixture of CMIT/MIT exposure were associated with positive effects on lung function of children.

Contact allergy to methylchloroisothiazolinone/methylisothiazolinone in north‐eastern Italy: a temporal trend from 1996 to 2016

“…Their biocide activity also encourages their use in humidifier disinfectant and air conditioning systems. 1 Following the definite increase in isothiazolinone-associated contact allergy rates in Europe, 2 MCI/MI and MI are forbidden in leave-on cosmetics and allowed in rinse-off cosmetics up to max of 15 ppm. Concerning non-cosmetic products (e.g.…”

In-vitro DNA and cell damage induced by 5-chloro-2-methyl-4-isothiazolin-3-one (CMIT) and suppressive effect of selected phytochemicals against CMIT toxicity

“…The information on the toxicity of CMIT/MIT mixture and individual component is limited, although the toxicity and reactivity of CMIT has been reported to be more potent than MIT (Cho et al, 2017). The carcinogenicity of CMIT was ruled out by IARC (Kahrilas et al, 2014), but chronic and high exposure can cause a detrimental effect at DNA and cellular level.…”

“…Recently, significant peripheral airway dysfunction has been reported in children with high-level inhalation exposure to a mixture of CMIT/MIT (Cho et al, 2017). CMIT/MIT mixture has been registered as a secondary inhalation toxicant by US Environmental Protection Agency (EPA).…”

The past, present, and future of humidifier disinfectant-associated interstitial lung diseases in children

“…In real clinical situations in humans, HD-ILDs had been occurred after exposure to CMIT and MIT, which showed similar patterns of pulmonary inflammation and fibrosis as those associated with exposure to PHMG and PGH. [26][27][28] A possible degree of association means cases with incomplete clinical features and radiological and pathological findings of HD-ILDs and therefore needs additional considerations on other subtypes of ILDs.…”