Psychological Responses among Humidifier Disinfectant Disaster Victims and Their Families

et al. 2021

Ann Occup Environ Med

Background Injuries caused by humidifier disinfectants (HDs) can no longer be grouped under the concept of HD lung injury. Focusing on individual cases, we were able to evaluate the relevance not only of diseases for which epidemiological correlation is recognized but also all diseases and symptoms that the victims complain of. Methods In-depth interviews and reassessment of 113 HD-exposed patients who had not been acknowledged as victims by the government were conducted, and their medical records were reviewed. Based on these processes, an assessment questionnaire for the injuries related to HDs was completed and the involvement of HDs was assessed either as “strong association,” “association,” or “no association.” Results In this study, of the 113 patients included who claimed damages, 78 (69.0%) had HD-related injuries. Among the cases of 22 patients who applied for injury acknowledgment due to upper respiratory inflammation that was not included among the acknowledged diseases, 17 (77.3%) were judged to be HD-related injuries (strong association vs. association: 10 [45.5%] vs. 7 [31.8%]). When the cases of 12 rhinitis patients were reassessed, 9 were HD-related injuries (strong association vs. association: 4 [33.3%] vs. 5 [41.7%]). When the cases of 18 asthma patients unacknowledged as a victim were reassessed, 17 (94.4%) were humidifier-related injuries (strong association vs. association: 12 [66.6%] vs. 5 [27.8%]). Among 4 interstitial lung disease patients unacknowledged as a victim, 2 (50.0%) were HD-related injuries. Conclusions HD-related health injuries should be assessed through both individual interviews and detailed chart reviews for more accurate injury acknowledgment. In the future, efforts should go beyond existing methods based on the adherence to acknowledgment criteria to directly listen to the victims.

Section: Discussionmentioning

confidence: 99%

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

Kim

Mun

et al. 2021

Ann Occup Environ Med

“…The most common psychological symptoms in patients with HD-ILDs as well as their family members are anxiety, followed by fear and depression. 42) The bereaved of the patients with HD-ILDs showed higher rates of alcohol and smoking abuse and insomnia than those of other psychologic responses. 42) Therefore, support for psychologic health is urgently needed along with monitoring of the health of patients with HD-ILDs and their family.…”

Section: Psychologic Health In Patients With Hd-ildsmentioning

confidence: 98%

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

Hong

2020

Clin Exp Pediatr

Self Cite

Exposure to environmental factors can cause interstitial lung diseases (ILDs); however, such types of ILDs are rare. From 2007 to 2011, an ILD epidemic occurred in South Korea owing to inhalational exposure to toxic chemicals in humidifier disinfectants (HDs). HD-associated ILDs (HD-ILDs) are characterized by rapidly progressing respiratory failure with pulmonary fibrosis and a high mortality rate of 43.8%−58.0%. Although 18.1%−31.1% of the general population used HDs, only a small proportion of HD users were diagnosed with HD-ILDs. This finding suggests that investigation of the pathophysiologies underlying HD-ILDs is needed in addition to the identification of susceptibility to HD-ILDs. Further, there have been several concerns regarding the diverse health effects of exposure to toxic chemicals in HDs, including those that have not been identified, and long-term prognoses in terms of pulmonary function and residual pulmonary lesions observed on follow-up chest images. In this review, we summarize the clinical features, pathologic findings, and changes in radiologic findings over time in patients with HD-ILDs and the results of previous experimental research on the mechanisms underlying the effects of toxic chemicals in HDs. Studies are currently underway to identify the pathophysiologies of HD-ILDs and possible health effects of exposure to HDs along with the development of targeted therapeutic strategies. The experience of identification of HD-ILDs has encouraged stricter control of safe chemicals in everyday life.

“…Also, a study that conducted a maladaptive cognitive emotion regulation survey of 40 victims of humidifier disinfectants in 2018 concluded that those with insomnia, depression, and PTSD were more likely to engage in self-blame, repetitive rumination on the past, and catastrophizing of the government's late response [6]. A survey of 26 victims at the National Mental Health Center in 2018 also revealed anxiety disorders (10 cases, 38.5%) and depression (10 cases, 38.5%) [4].…”

Section: Mental Health Impact On a Humidifier Disinfectant Victimmentioning

confidence: 99%

“…Despite the fact that not only physical injury has been linked to humidifier disinfectants, but also emotional and mental injuries-such as post-traumatic stress disorder (PTSD), depression, and suicide attempts due to the death of family members-the recognition criteria have not been reviewed [3,4]. Researchers and the government have focused on identifying causality of physical injury related to humidifier disinfectants; however, physical injury in these cases also leads to unintentional abusers and victims in the family.…”

mentioning

confidence: 99%

Mental health impact on a humidifier disinfectant disaster victim: a case report

Nam

Kim

et al. 2020

Ann Occup Environ Med

In Korea, the cause of lung disease of unknown origin was identified as humidifier disinfectants in November 2011. In February 2017, the 'Special Act on Remedy for Damage Caused by Humidifier Disinfectants' was promulgated. Even though emotional and mental injuries caused by humidifier disinfectants have been reported, the focus of the special act has been on physical injury only, and criteria for recognizing mental health impact have not been considered. This case considers emotional and mental injury caused by humidifier disinfectants. After a humidifier disinfectant was used from January 2005 to April 2006, the patient's son aged 20 months was hospitalized with respiratory symptoms, and he died within two weeks. Also, the patient was hospitalized for a month with the same symptoms, and then she led a normal life with no symptoms. After both mother and son were diagnosed with definite (level 1) humidifier disinfectant lung injury (HDLI) in 2017, she took to drinking alcohol because of extreme guilt over her son's death. In March 2018 she died from acute liver failure due to alcohol use disorder. The patient's death was caused by continuous alcoholism, due to emotional and mental trauma caused by her son's death after HDLI was revealed as the cause. The government did not acknowledge her death was due to humidifier disinfectants, but the company that sold the humidifier disinfectants recognized her as a victim and compensated the family of the victim. There are still lots of psychological responses among humidifier disinfectant disaster victims. Mental health impact on humidifier disinfectant victims should be considered more carefully, and institutional improvements should be made into establish psychological interventions and measures.