Kim Jaiyong, Jeong Kyoung Sook, Heo Seungyeon, Kim Younghee, Lim Jungyun, Yu Sol, Kim Suejin, Shin Sun-Kyoung, Cheong Hae-Kwan, Ha Mina
Department of Big Data Research and Development, National Health Insurance Service, Wonju, Korea.
Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Epidemiol Health. 2025;47:e2025006. doi: 10.4178/epih.e2025006. Epub 2025 Feb 22.
Humidifier disinfectants (HDs) were sold in Korea from 1994 until their recall in 2011. We examined the incidence patterns of 8 respiratory diseases before and after the HD recall and estimated the attributable risk in the Korean population.
Using National Health Insurance data from 2002 to 2019, we performed age-cohort-period and differences-in-diffference analyses (comparing periods before vs. after the recall) to estimate the population-attributable fraction and the excess number of episodes. The database comprised 51 million individuals (99% of the Korean population). The incidence of 8 diseases-acute upper respiratory infection (AURI), acute lower respiratory infection (ALRI), asthma, pneumonia, chronic sinusitis (CS), interstitial lung disease (ILD), bronchiectasis, and chronic obstructive pulmonary disease (COPD)-was defined by constructing episodes of care based on patterns of medical care and the clinical characteristics of each disease.
The relative risks (RRs) for AURI, ALRI, asthma, pneumonia, CS, and ILD were elevated among younger individuals (with an RR as high as 82.18 for AURI in males), whereas chronic conditions such as bronchiectasis, COPD, and ILD showed higher RRs in older individuals. During the HD exposure period, the population-attributable risk percentage ranged from 4.6% for bronchiectasis to 25.1% for pneumonia, with the excess number of episodes ranging from 6,218 for ILD to 3,058,861 for CS. Notably, females of reproductive age (19-44 years) experienced 1.1-9.2 times more excess episodes than males.
This study provides epidemiological evidence that inhalation exposure to HDs affects the entire respiratory tract and identifies vulnerable groups.
加湿器消毒剂（HDs）于1994年在韩国上市销售，直至2011年被召回。我们研究了HDs召回前后8种呼吸道疾病的发病模式，并估算了韩国人群中的归因风险。
利用2002年至2019年的国民健康保险数据，我们进行了年龄-队列-时期分析和差值法分析（比较召回前后的时期），以估算人群归因分数和额外发病数。该数据库包含5100万人（占韩国人口的99%）。通过根据医疗护理模式和每种疾病的临床特征构建护理事件，定义了8种疾病——急性上呼吸道感染（AURI）、急性下呼吸道感染（ALRI）、哮喘、肺炎、慢性鼻窦炎（CS）、间质性肺疾病（ILD）、支气管扩张和慢性阻塞性肺疾病（COPD）的发病率。
AURI、ALRI、哮喘、肺炎、CS和ILD的相对风险（RRs）在较年轻个体中升高（男性AURI的RR高达82.18），而支气管扩张、COPD和ILD等慢性疾病在老年个体中显示出较高的RRs。在HD暴露期间，人群归因风险百分比范围从支气管扩张的4.6%到肺炎的25.1%，额外发病数范围从ILD的6218例到CS的3058861例。值得注意的是，育龄女性（19 - 44岁）的额外发病数比男性多1.1 - 9.2倍。
本研究提供了流行病学证据，证明吸入HDs会影响整个呼吸道，并确定了易感人群。
