1 Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea.
Am J Respir Crit Care Med. 2014 Jan 1;189(1):48-56. doi: 10.1164/rccm.201306-1088OC.
Beginning in 2006, epidemics of a fatal lung injury of unknown cause in children were observed in Korea every spring. A recent study demonstrated that this type of children's interstitial lung disease (chILD) is associated with humidifier disinfectant use.
To determine the clinical characteristics of this type of chILD and to assess whether the nationwide suspension of humidifier disinfectant sales in the autumn of 2011 affected its incidence.
The clinical characteristics of suspected cases between 2006 and 2011 were determined by a nationwide retrospective study. The potential causal relationship with humidifier disinfectants was examined by a prospective surveillance study after humidifier disinfectant sales were suspended.
In total, 138 children were diagnosed with this type of chILD, which was characterized by rapid progression, high mortality, predominance in the spring season, and a familial tendency. The annual incidence increased in 2011 and then dropped to zero in 2012. The children were on average 30.4 months old. The most frequent symptoms at admission were cough and dyspnea. As the disease progressed, the typical complication was spontaneous air leak. Eighty children (58%) died. Two years after humidifier disinfectant-sale suspension, no more new cases were found.
This study suggests that humidifier disinfectant inhalation causes an idiopathic type of chILD that is characterized by spontaneous air leak, rapid progression, lack of response to treatment, and high mortality. Further safety studies must be performed on common environmental compounds, particularly those that enter the human body by an unusual route.
自 2006 年起，韩国每年春季都会观察到一种病因不明的致命儿童肺部损伤的流行。最近的一项研究表明，这种类型的儿童间质性肺病（chILD）与加湿器消毒剂的使用有关。
确定这种类型的 chILD 的临床特征，并评估 2011 年秋季全国范围内停止销售加湿器消毒剂是否影响其发病率。
通过全国性回顾性研究确定 2006 年至 2011 年间疑似病例的临床特征。在停止销售加湿器消毒剂后，通过前瞻性监测研究来检查与加湿器消毒剂的潜在因果关系。
共有 138 名儿童被诊断患有这种类型的 chILD，其特征为快速进展、高死亡率、主要发生在春季和家族倾向。2011 年的年发病率增加，然后在 2012 年降至零。儿童平均年龄为 30.4 个月。入院时最常见的症状是咳嗽和呼吸困难。随着疾病的进展，典型的并发症是自发性气胸。80 名儿童（58%）死亡。停止销售加湿器消毒剂两年后，未发现新病例。
本研究表明，加湿器消毒剂吸入会导致一种特发性类型的 chILD，其特征是自发性气胸、快速进展、对治疗无反应和高死亡率。必须对常见的环境化合物进行进一步的安全性研究，特别是那些通过不寻常途径进入人体的化合物。
