Epidemiol Health.  2016;38:e2016037. 10.4178/epih.e2016037.

Evaluation report on the causal association between humidifier disinfectants and lung injury

• Ha M
• Lee SY
• Hwang SS
• Park H
• Sheen S
• Cheong HK
• Choi BY

• KMID: 2380727
• DOI: http://doi.org/10.4178/epih.e2016037

Abstract

OBJECTIVES
As of November 2011, the Korean government recalled and banned humidifier disinfectants (HDs) from the market, because four case-control studies and one retrospective epidemiological study proved the association between HDs and lung injury of unknown cause. The report reviewed the causal role of HDs in lung injury based on scientific evidences.
METHODS
A careful examination on the association between the HDs and lung injury was based on the criteria of causality inference by Hill and the US Surgeon General Expert Committee.
RESULTS
We found that all the evidences on the causality fulfilled the criteria (strength of association, consistency, specificity, temporality, biologic gradient, plausibility, coherence, experiment, analogy, consideration of alternative explanations, and cessation of exposure), which proved the unknown cause lung injury reported in 2011 was caused by the HDs. In particular, there was no single reported case of lung injury since the ban in selling HDs in November 2011 as well as before the HDs were sold in markets.
CONCLUSIONS
Although only a few epidemiological studies in Korea have evaluated the association between lung injury and the use of HDs, those studies contributed to proving the strong association between the use of the HDs and lung injury, based on scientific evidence.

Keyword

Causality; Humidifiers; Disinfectants; Hill's criteria; Lung injury; Association

MeSH Terms

Case-Control Studies
Disinfectants*
Epidemiologic Studies
Evaluation Studies as Topic*
Humidifiers*
Korea
Lung Injury*
Lung*
Retrospective Studies
Sensitivity and Specificity
Disinfectants