Humidifier Lung: Hypersensitivity Pneumonitis Related to Thermotolerant Bacterial Aerosols

Köhler, Peter F.; Gross, Gary P.; Salvaggio, John E.; Hawkins, June

doi:10.1378/chest.69.2_supplement.294

Cited by 29 publications

(6 citation statements)

References 1 publication

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“…Table 2 summarizes the results of several reports on allergies and hypersensitivity disease caused by the use of humidifiers in residential, office, and factory environments (66,69,(77)(78)(79)(80)(81)(82)(83)(84)(85)(86)(87) Low-level exposure to formaldehyde has produced adverse health effects such as irritation to the skin, eyes and throat, respiratory disorders and allergies (1).…”

Section: Humidifiersmentioning

confidence: 99%

Indirect health effects of relative humidity in indoor environments.

Arundel¹,

Sterling²,

Biggin³

et al. 1986

Environ Health Perspect

242

172

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A review of the health effects of relative humidity in indoor environments suggests that relative humidity can affect the incidence of respiratory infections and allergies. Experimental studies on airborne-transmitted infectious bacteria and viruses have shown that the survival or infectivity of these organisms is minimized by exposure to relative humidities between 40 and 70%. Nine epidemiological studies examined the relationship between the number of respiratory infections or absenteeism and the relative humidity of the office, residence, or school. The incidence of absenteeism or respiratory infections was found to be lower among people working or living in environments with mid-range versus low or high relative humidities. The indoor size of allergenic mite and fungal populations is directly dependent upon the relative humidity. Mite populations are minimized when the relative humidity is below 50% and reach a maximum size at 80% relative humidity. Most species of fungi cannot grow unless the relative humidity exceeds 60%. Relative humidity also affects the rate of offgassing of formaldehyde from indoor building materials, the rate of formation of acids and salts from sulfur and nitrogen dioxide, and the rate of formation of ozone. The influence of relative humidity on the abundance of allergens, pathogens, and noxious chemicals suggests that indoor relative humidity levels should be considered as a factor of indoor air quality. The majority of adverse health effects caused bLy relative humidity would be minimized by maintaining indoor levels between 40 and 60%. This would require humidification during winter in areas with cold winter climates. Humidification should preferably use evaporative or steam humidifiers, as cool mist humidifiers can disseminate aerosols contaminated with allergens.

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Section: Humidifiersmentioning

confidence: 99%

Indirect health effects of relative humidity in indoor environments.

Arundel¹,

Sterling²,

Biggin³

et al. 1986

Environ Health Perspect

242

172

View full text Add to dashboard Cite

show abstract

“…In addition cross-reactions have been found between mold fungi and actinomyces antigens (5). Also thermotolerant bacteria (11) and endotoxins may, because of indirect complement activation (19), be etiologic factors in the development of extrinsic allergic alveolitis or a similar febrile reaction.…”

Section: Discussionmentioning

confidence: 99%

Humidifier-associated extrinsic allergic alveolitis.

Assendelft¹,

Forsén²,

Keskinen³

et al. 1979

Scand J Work Environ Health

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“…Other orga¬ nisms, including thermotolerant gram-negative rods, have also been reported in this situation. 5 Individuals using cool mist ma¬ chines have had cases reported of hypersensitivity pneumonitis. Two examples cited herein show no anti¬ gen identified in one,6 while A fumi¬ gatus was identified in the other.1 The latter case was interesting in that a man with laryngeal carcinoma un¬ dergoing radiation therapy sought the cool mist for relief of his dry throat, but it was his wife who actually got hypersensitivity pneumonitis.…”

Section: Report Of a Casementioning

confidence: 99%

Hypersensitivity Pneumonitis From Home Mist Machine After Laryngectomy

Myers¹,

Meyers²

1987

Archives of Otolaryngology - Head and Neck Surgery

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\s=b\ Hypersensitivity pneumonitis is an unusual complication of using humidification devices. It is characterized by the acute onset of dyspnea, cough, fever, and chills after exposure to an offending antigen. This report describes a 54-year-old female laryngectomee who had repeated hospitalizations for postoperative dyspnea with normal chest roentgenograms and sputum cultures, but findings and history consistent with acute hypersensitivity pneumonitis. This seems to be the first reported case of hypersensitivity pneumonitis in a laryngectomee using a home mist machine. When repeated episodes of dyspnea occur in such patients, hypersensitivity pneumonitis should be considered in the differential diagnosis. (Arch Otolaryngol Head Neck Surg 1987;113:667-668) Hypersensitivity pneumonitis, an unusual complication' from a home mist machine, is not often seen by the otolaryngologist. The following is a report of a case of acute hypersen¬ sitivity pneumonitis caused by a home mist machine in a laryngectomee. REPORT OF A CASEA 54-year-old woman presented with a T3, NO, MO squamous cell carcinoma of the left piriform sinus. Her medical history was significant for stable, periodic reactive airway disease that had been treated with isoproterenol hydrochloride (Isuprel Mistometer) inhaler. She had a 40-pack-year smoking history.The findings from the physical examina¬ tion were normal with the exception of the laryngeal lesion. A chest roentgenogram showed a stable right upper lobe density unchanged for approximately five years. Bronchoscopy and cytologie studies dis¬ closed no abnormalities.She underwent a total laryngectomy and had an uneventful postoperative course. She was discharged from the hospital two weeks after surgery, receiving mild pain medications. The routine stoma care regi¬ men included suction and humidification via a home mist machine. The patient had no significant bronchospasm during her postoperative course.Three weeks after surgery, the patient was readmitted to the hospital with a pharyngocutaneous fistula. She was treated conservatively with nasogastric tube feedings and local wound care. Her pulmonary status remained unchanged and she was discharged from the hospital four days later when tube feedings were proceeding well.Eleven days after hospital discharge, she was seen in the emergency room with complaints of general malaise, fever, cough, and dyspnea. These were not relieved by using the isoproterenol inhaler and subjectively were different from her reactive airway disease flare-ups. Physical examination showed the patient to be in mild respiratory distress. Her temperature was 39.4°C orally, respirations were 25/ min, pulse rate was 100 beats per minute, and blood pressure was 134/70 mm Hg.Auscultation of lung fields showed rare basilar rhonchi. Results of the remainder of the physical examination were normal except for the pharyngocutaneous fistula, which had decreased in size. A chest roent¬ genogram was unchanged since the previ¬ ous film. There was a peripheral leukocytosis of 20 500 ce...

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Humidifier Lung: Hypersensitivity Pneumonitis Related to Thermotolerant Bacterial Aerosols

Cited by 29 publications

References 1 publication

Indirect health effects of relative humidity in indoor environments.

Indirect health effects of relative humidity in indoor environments.

Humidifier-associated extrinsic allergic alveolitis.

Hypersensitivity Pneumonitis From Home Mist Machine After Laryngectomy

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