Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Korea.
Department of Occupational and Environmental Medicine, College of Medicine, Inha University, Incheon, Korea.
PLoS One. 2019 Sep 5;14(9):e0221322. doi: 10.1371/journal.pone.0221322. eCollection 2019.
In Korea, several household humidifier disinfectants (HDs) were clinically confirmed to cause HD-associated lung injury (HDLI). Polyhexamethylene guanidine (PHMG) phosphate is the main ingredient of the HDs found to be associated with lung disease. However, the association of HDs with other interstitial lung disease including idiopathic interstitial pneumonia (IIP) is not clear. We examined the relationship between HD exposure and IIP in a family-based study.
This case-control study included 244 IIP cases and 244 family controls who lived with the IIP patients. The IIP cases were divided into two groups, HDLI and other IIP, and were matched to family controls based on age and gender. Information on exposure to HDs was obtained from a structured questionnaire and field investigations. Conditional logistic regression was used to estimate odds ratio (ORs) and their corresponding 95% confidence interval (CI), investigating the association of HD-related exposure characteristics with IIP risk.
The risks of IIP increased two-fold or more in the highest compared with the lowest quartile of several HD use characteristics, including average total use hours per day, cumulative sleep hours, use of HD during sleep, and cumulative exposure level. In analyses separated by HDLI and other IIP, the risks of HDLI were associated with airborne HD concentrations (adjusted OR = 3.01, 95% CI = 1.34-6.76; Q4 versus Q1) and cumulative exposure level (adjusted OR = 3.57, 95% CI = 1.59-8.01; Q4 versus Q1), but this relationship was not significant in the patients with other IIP. In comparison between HDLI and other IIP, the odds ratios of average total use hours, cumulative use hours, and cumulative sleeps hours was higher for other IIP.
The use of household HDs is associated not only with HDLI but also with other IIP.
在韩国，有几种家用加湿器消毒剂（HDs）已被临床证实会导致与 HD 相关的肺损伤（HDLI）。聚六亚甲基胍（PHMG）磷酸盐是与肺病相关的 HDs 的主要成分。然而，HDs 与包括特发性间质性肺炎（IIP）在内的其他间质性肺疾病之间的关联尚不清楚。我们在一项基于家庭的研究中检查了 HD 暴露与 IIP 之间的关系。
这项病例对照研究包括 244 例 IIP 病例和 244 名与 IIP 患者同住的家族对照。根据年龄和性别，将 IIP 病例分为 HDLI 组和其他 IIP 组，并与家族对照相匹配。从结构化问卷和现场调查中获取有关 HD 暴露的信息。使用条件逻辑回归来估计比值比（ORs）及其相应的 95%置信区间（CI），调查与 IIP 风险相关的 HD 相关暴露特征。
与使用 HD 的最低四分位数相比，使用 HD 的几个特征（包括平均每日总使用时间、累计睡眠时间、睡眠时使用 HD 以及累计暴露水平）最高的 IIP 风险增加了两倍或更多。在 HDLI 和其他 IIP 分别分析中，HDLI 的风险与空气中的 HD 浓度（调整后的 OR=3.01，95%CI=1.34-6.76；Q4 与 Q1）和累计暴露水平（调整后的 OR=3.57，95%CI=1.59-8.01；Q4 与 Q1）相关，但在其他 IIP 患者中，这种关系并不显著。与其他 IIP 相比，HDLI 和其他 IIP 之间的平均总使用时间、累计使用时间和累计睡眠时间的比值比更高。
家用 HD 的使用不仅与 HDLI 相关，而且与其他 IIP 相关。
