title: Inhalation toxicity of humidifier disinfectants as a risk factor of children's interstitial lung disease in Korea: a case-control study.
abstract: BACKGROUND
  The occurrence of numerous cases of interstitial lung disease in children (chILD) every spring in Korea starting in 2006 raised suspicion about a causal relationship with the use of humidifier disinfectants (HDs). The aim of this study was to evaluate the association between HD use and the risk of chILD.
  
  
  METHODS
  This retrospective, 1∶3 matched case-control study consisted of 16 cases of chILD that had developed between 2010 and 2011. The three groups of parallel controls (patients with acute lobar pneumonia, asthma, and healthy children) were matched by age, gender, and index date. Indoor/outdoor environmental risk factors, including HD use, were investigated by asking the guardians to complete a questionnaire.
  
  
  RESULTS
  The median age of the affected children (43.8% male) was 26 months (18.25-36.25). The chILD group did not differ significantly from the control groups with respect to socio-demographic and clinical variables. Indoor and outdoor environmental factors were not associated with a risk of chILD. However, the previous use of HDs (OR; 2.73. 95% CI; 1.41-5.90, P = 0.00) were independently associated with an increased risk.
  
  
  CONCLUSIONS
  This study showed that HDs, which are widely used in South Korea in the winter season, independently increased the risk of chILD in spring. Therefore, continuous monitoring and, if needed, changes in policy are essential to prevent and control pediatric diseases caused by toxic chemicals.
authors.affiliation: Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Hyeon-Jong
authors.initials: HJ
authors.lastname: Yang
authors.forename: Hwa-Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jinho
authors.initials: J
authors.lastname: Yu
authors.forename: Eun
authors.initials: E
authors.lastname: Lee
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Jung
authors.forename: Hyung-Young
authors.initials: HY
authors.lastname: Kim
authors.forename: Ju-Hee
authors.initials: JH
authors.lastname: Seo
authors.forename: Geun-Yong
authors.initials: GY
authors.lastname: Kwon
authors.forename: Ji-Hyuk
authors.initials: JH
authors.lastname: Park
authors.forename: Jin
authors.initials: J
authors.lastname: Gwack
authors.forename: Seung-Ki
authors.initials: SK
authors.lastname: Youn
authors.forename: Jun-Wook
authors.initials: JW
authors.lastname: Kwon
authors.forename: Byung-Yool
authors.initials: BY
authors.lastname: Jun
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Kim
authors.forename: Kangmo
authors.initials: K
authors.lastname: Ahn
authors.forename: Soo-Young
authors.initials: SY
authors.lastname: Lee
authors.forename: June-Dong
authors.initials: JD
authors.lastname: Park
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Kwon
authors.forename: Byoung-Ju
authors.initials: BJ
authors.lastname: Kim
authors.forename: Moo-Song
authors.initials: MS
authors.lastname: Lee
authors.forename: Kyung-Hyun
authors.initials: KH
authors.lastname: Do
authors.forename: Se-Jin
authors.initials: SJ
authors.lastname: Jang
authors.forename: Bok-Yang
authors.initials: BY
authors.lastname: Pyun
authors.forename: Soo-Jong
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000389:Air Conditioning; D000393:Air Pollutants / Q000633:toxicity*; D016902:Air Pollution, Indoor; D016022:Case-Control Studies; D002675:Child, Preschool; D004202:Disinfectants / Q000633:toxicity*; D005260:Female; D006801:Humans; D007223:Infant; D017563:Lung Diseases, Interstitial / Q000139:chemically induced*; D008297:Male; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000393:Air Pollutants; D004202:Disinfectants