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Early-life exposure to humidifier disinfectant determines the prognosis of lung function in children

BACKGROUND: Use of humidifier disinfectants (HD) at home leads to chemical airborne exposure, causing HD associated lung injury (HDLI) with high mortality. However, the lung function in children diagnosed with HDLI is not well studied. We investigated the effect of HD exposure on lung function, prog...

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Autores principales: Cho, Hyun-Ju, Lee, So Yeon, Park, Donguk, Ryu, Seung-Hun, Yoon, Jisun, Jung, Sungsu, Lee, Eun, Yang, Song-I, Hong, Soo-Jong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6929365/
https://www.ncbi.nlm.nih.gov/pubmed/31870444
http://dx.doi.org/10.1186/s12890-019-1028-y
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author Cho, Hyun-Ju
Lee, So Yeon
Park, Donguk
Ryu, Seung-Hun
Yoon, Jisun
Jung, Sungsu
Lee, Eun
Yang, Song-I
Hong, Soo-Jong
author_facet Cho, Hyun-Ju
Lee, So Yeon
Park, Donguk
Ryu, Seung-Hun
Yoon, Jisun
Jung, Sungsu
Lee, Eun
Yang, Song-I
Hong, Soo-Jong
author_sort Cho, Hyun-Ju
collection PubMed
description BACKGROUND: Use of humidifier disinfectants (HD) at home leads to chemical airborne exposure, causing HD associated lung injury (HDLI) with high mortality. However, the lung function in children diagnosed with HDLI is not well studied. We investigated the effect of HD exposure on lung function, prognosis, and exposure characteristics associated with the lung function phenotype in children. METHODS: Eighty-one children diagnosed with HDLI in a nationwide cohort were tested for spirometry and diffusing capacity of the lung for carbon monoxide (DLco) from July 2013 and followed up with at five time points over 2 years. The results were compared with 122 children without HD exposure as controls. Home investigation and questionnaire analysis were conducted to assess HD inhalation exposure. RESULTS: HDLI survivor’s mean percent of predicted forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC), and corrected DLco were significantly lower compared with the control group. On longitudinal assessment, FVC was within the normal range, but flattened, and spirometry showed a predominantly restrictive pattern. Corrected DLco did not normalize above 80% despite increasing age. The persistently low phenotype of lung function was associated with initial exposure age, especially less than 12 months of age. Higher density HD exposure during sleep and close distance between the bed and the humidifier were significantly associated with persistently low corrected DLco. CONCLUSIONS: HD exposure affects prolonged decrement in lung function, especially DLco, particularly among children who are exposed within the first year of life. These results suggested that early-life HD exposure determines long-term prognosis of lung function in children.
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spelling pubmed-69293652019-12-30 Early-life exposure to humidifier disinfectant determines the prognosis of lung function in children Cho, Hyun-Ju Lee, So Yeon Park, Donguk Ryu, Seung-Hun Yoon, Jisun Jung, Sungsu Lee, Eun Yang, Song-I Hong, Soo-Jong BMC Pulm Med Research Article BACKGROUND: Use of humidifier disinfectants (HD) at home leads to chemical airborne exposure, causing HD associated lung injury (HDLI) with high mortality. However, the lung function in children diagnosed with HDLI is not well studied. We investigated the effect of HD exposure on lung function, prognosis, and exposure characteristics associated with the lung function phenotype in children. METHODS: Eighty-one children diagnosed with HDLI in a nationwide cohort were tested for spirometry and diffusing capacity of the lung for carbon monoxide (DLco) from July 2013 and followed up with at five time points over 2 years. The results were compared with 122 children without HD exposure as controls. Home investigation and questionnaire analysis were conducted to assess HD inhalation exposure. RESULTS: HDLI survivor’s mean percent of predicted forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC), and corrected DLco were significantly lower compared with the control group. On longitudinal assessment, FVC was within the normal range, but flattened, and spirometry showed a predominantly restrictive pattern. Corrected DLco did not normalize above 80% despite increasing age. The persistently low phenotype of lung function was associated with initial exposure age, especially less than 12 months of age. Higher density HD exposure during sleep and close distance between the bed and the humidifier were significantly associated with persistently low corrected DLco. CONCLUSIONS: HD exposure affects prolonged decrement in lung function, especially DLco, particularly among children who are exposed within the first year of life. These results suggested that early-life HD exposure determines long-term prognosis of lung function in children. BioMed Central 2019-12-23 /pmc/articles/PMC6929365/ /pubmed/31870444 http://dx.doi.org/10.1186/s12890-019-1028-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Cho, Hyun-Ju
Lee, So Yeon
Park, Donguk
Ryu, Seung-Hun
Yoon, Jisun
Jung, Sungsu
Lee, Eun
Yang, Song-I
Hong, Soo-Jong
Early-life exposure to humidifier disinfectant determines the prognosis of lung function in children
title Early-life exposure to humidifier disinfectant determines the prognosis of lung function in children
title_full Early-life exposure to humidifier disinfectant determines the prognosis of lung function in children
title_fullStr Early-life exposure to humidifier disinfectant determines the prognosis of lung function in children
title_full_unstemmed Early-life exposure to humidifier disinfectant determines the prognosis of lung function in children
title_short Early-life exposure to humidifier disinfectant determines the prognosis of lung function in children
title_sort early-life exposure to humidifier disinfectant determines the prognosis of lung function in children
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6929365/
https://www.ncbi.nlm.nih.gov/pubmed/31870444
http://dx.doi.org/10.1186/s12890-019-1028-y
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