1.What Have We Learnt from the Tragic Events Related to Humidifier Disinfectant Inhalation in 2011?.
Journal of Korean Medical Science 2016;31(12):1855-1856
No abstract available.
Humidifiers*
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Inhalation*
2.The humidifier disinfectant incident and the self-examination of environmental toxicology and public health experts.
Environmental Health and Toxicology 2015;30(1):e2015016-
No abstract available.
Ecotoxicology*
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Humidifiers*
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Public Health*
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Self-Examination*
3.The humidifier disinfectant incident and the self-examination of environmental toxicology and public health experts.
Environmental Health and Toxicology 2015;30(1):e2015016-
No abstract available.
Ecotoxicology*
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Humidifiers*
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Public Health*
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Self-Examination*
4.Humidifier disinfectants, unfinished stories.
Environmental Health and Toxicology 2016;31(1):e2016004-
Once released into the air, humidifier disinfectants became tiny nano-size particles, and resulted in chemical bronchoalveolitis. Families had lost their most beloved members, and even some of them became broken. Based on an estimate of two million potential victims who had experienced adverse effects from the use of humidifier disinfectants, we can say that what we have observed was only the tip of the iceberg. Problems of entire airways, as well as other systemic effects, should be examined, as we know these nano-size particles can irritate cell membranes and migrate into systemic circulation. The story of humidifier disinfectant is not finished yet.
Cell Membrane
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Disinfectants*
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Humans
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Humidifiers*
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Ice Cover
5.The humidifier disinfectant case and the legislative challenges of the 20th Congress.
Environmental Health and Toxicology 2016;31(1):e2016015-
A number of absurdities surrounding the humidifier disinfectant (HD) incident may have occurred because 1) a judicial system operates on the underlying false assumption that the involved parties are equals in knowledge, information and resource mobilization capabilities, regardless of respective real status as company or individual; 2) there is a lack of a system that mandates a company to prevent and actively manage possible catastrophes; 3) the regulatory scheme makes companies believe that as long as they are complying with the existing regulations, they have satisfied all of their responsibilities. I believe that this issue is an opportunity to bring about changes in the judicial redress system, the system of internal management of manufacturers, and the regulatory system of the government. The following regulation amendments are needed to move towards the changes stated above. First, legislation relating to victim relief that is applicable to the HD incident must be established. Second, a risk management system must be formed within the manufacturing company and to this end an institutional environment for the system must be established within regulatory framework. Furthermore, legislation must be passed that could punish companies themselves that have caused severe damage to individuals because they had failed to take necessary actions to avoid foreseeable harm. Finally, the framework of regulation must be changed so that the company, who has the necessary information regarding the product and the component chemicals used in the product, must self-directed experiment and assessment of the safety of their own products.
Humidifiers*
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Risk Management
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Social Control, Formal
6.Major concerns regarding lung injury and related health conditions caused by the use of humidifier disinfectant.
Environmental Health and Toxicology 2016;31(1):e2016014-
A total of 221 patients were evaluated to be humidifier disinfectant associated with lung injury (HDLI) through two rounds of programs through April 2015. The humidifier disinfectant (HD) brands most often associated with HDLI were found to be Oxy (n=151, 68 %) and Cefu (n=26, 17 %). Polyhexamethylene guanidine used for disinfectant for four types of HD brands including Oxy was found to be associated with the highest number of HDLI cases (n=188). Further programs are operating to identify various health effects including lung injury which may be associated with the use of HD. Not only national agencies, but also pertinent environmental health societies should cooperate in the necessary investigations so that this tragedy can be properly addressed and future incidents concerning chemicals and chemical-containing products can be prevented.
Environmental Health
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Guanidine
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Humans
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Humidifiers*
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Lung Injury*
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Lung*
7.What must be done to prevent another humidifier disinfectant disaster?.
Environmental Health and Toxicology 2016;31(1):e2016024-
The humidifier disinfectant disaster (HDD) was not a simple poisoning accident by biocides, but a singular disaster in history created by chemicals in household products. This disaster was a result of the failure of a system for the management of chemical and product safety. Since the management authority for chemical usage safety is different from those for chemical safety in products, many blind areas for chemical safety management in products still remain. The ‘Act on the Registration and Evaluation, etc. of Chemical Substances (ARECS)’ or the new ‘Biocidal Product Act’ must not only address the blind areas in the management system for chemical and product safety, but also prevent a second HDD. To prevent another HDD, an integrated registration, evaluation, and management system for chemicals and consumer products must be incorporated into the ‘ARECS’ as an essential part for chemical safety in consumer products.
Chemical Safety
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Disasters*
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Disinfectants
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Household Products
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Humidifiers*
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Poisoning
8.Prevalence of Dry Eye Syndrome and Association with Life Behaviors in Adolescents.
Jong Joo LEE ; Jae Yun SUNG ; Sung Bok LEE
Journal of the Korean Ophthalmological Society 2017;58(4):387-394
PURPOSE: To investigate the prevalence and risk factors of dry eye syndrome (DES) among adolescents based on the Ocular Surface Disease Index (OSDI) questionnaire. METHODS: A questionnaire survey was conducted on middle and high school students in Daejeon. DES was diagnosed by an OSDI score ≥ 13. According to the OSDI score, DES was classified as mild (13-22 points), moderate (23-32 points), or severe (33-100 points). Additionally, responses to the questions regarding adolescents' life behaviors including the duration of electronic device use per week (cellphone, computer, TV), study hours per day, sleeping hours per day, contact lenses use, glasses use, and humidifier use were analyzed to determine the associations with DES. RESULTS: Of 332 students, DES was diagnosed in 147 (44.3%), and 54 (16.3%) complained of severe DES. The prevalence of DES was higher in female students (p = 0.004), long-time electronic device users (divided on the basis of the mean value, 15.3 hours per week, p = 0.011), and contact lenses users (p = 0.001). The prevalence of DES was 53.9% in groups with ≥ 14 hours of electronic device usage time per week, 40.2% in groups with ≥ 7 hours, and 33.7% in groups with < 7 hours (p = 0.002). The duration of electronic device use per week was a significant risk factor of DES for male students, and contact lenses use was a significant risk factor of DES for female students (p = 0.009). CONCLUSIONS: The prevalence of DES was high among adolescents. Long-time electronic device usage and contact lenses wear were associated with DES and increased the risk of DES.
Adolescent*
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Contact Lenses
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Dry Eye Syndromes*
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Eyeglasses
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Female
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Glass
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Humans
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Humidifiers
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Male
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Prevalence*
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Risk Factors
9.An analysis of a humidifier disinfectant case from a toxicological perspective.
Environmental Health and Toxicology 2016;31(1):e2016013-
An analysis of patients and fatalities due to exposure to polyhexamethylene guanidine (PHMG) shows that PHMG causes mainly lung diseases such as pulmonary fibrosis. However, no research on the other organs has been conducted on this matter yet. So, an in-depth discussion on toxicological techniques is needed to determine whether or not PHMG is toxic to organs other than just the lungs. For the test of target organ toxicity by PHMG exposure, a toxicokinetic study must first be conducted. However, measurement method for PHMG injected into the body has not yet been established because it is not easy to analyze polymer PHMG, so related base studies on analytical technique for PHMG including radio-labeling chemistry must come first. Moreover, research on exposure-biomarker and effect-biomarker must also be conducted, primarily related to clinical application. Several limitations seem to be expected to apply the biomarker study to the patient because much time has passed after exposure to the humidifier disinfectant. It is why a more comprehensive toxicological researches must be introduced to the causality for the victims.
Chemistry
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Guanidine
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Humans
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Humidifiers*
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Lung
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Lung Diseases
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Methods
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Polymers
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Pulmonary Fibrosis
10.Eye irritation tests of polyhexamethylene guanidine phosphate (PHMG) and chloromethylisothiazolinone/methylisothiazolinone (CMIT/MIT) using a tissue model of reconstructed human cornea-like epithelium
Juyoung PARK ; Handule LEE ; Kwangsik PARK
Environmental Health and Toxicology 2019;34(1):e2019004-
Disinfectants including polyhexamethylene guanidine phosphate (PHMG) and mixtures of chloromethylisothiazolinone/methylisothiazolinone (CMIT/MIT) have been widely used in Korea to prevent microbial growth in the humidifier water, which triggered an outbreak of serious respiratory diseases. In addition to the respiratory syndrome, disease-related symptoms including liver toxicity, asthma, and skin allergies were also found after extensive survey of people exposed to the humidifier disinfectants (HDs). In this study, eye irritation tests were performed based on the Organization for economic co-operation and development (OECD) test guidelines 492 using EpiOcular™ which is a tissue model of reconstructed human cornea-like epithelium. As results, the raw materials of PHMG (26% as active ingredient) and CMIT/MIT (1.5% as active ingredient) were classified under UN globally harmonized system of classification and labeling of chemical (GHS) category 1 or category 2. However, aqueous dilutions of raw materials such as market products of HDs that contain 0.13% of PHMG and 0.03% of CMIT/MIT or further dilutions of the market products for humidifier that contain 0.0013% of PHMG and 0.0003% of CMIT/MIT were classified under any category, which suggested absence of eye irritation at the test concentration.
Asthma
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Classification
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Disinfectants
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Epithelium
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Guanidine
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Humans
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Humidifiers
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Hypersensitivity
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Korea
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Liver
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Skin
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United Nations
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Water