Fatal lung disease in adults and children using humidifiers at home containing detergent biocides

A new interstitial lung disease has been described with unique histology showing bronchocentric acute lung injury which was temporally homogenious with subpleural and peripheral alveolar preservation. Specimens taken early in the disease showed obliterative bronchiolitis. Hyaline membranes and intra-alveolar fibroblastic pugs were frequent. There were no granuloma or honeycombing. BAL showed mostly normal lymphocytrs (0-18%), eosinophilia (0-61% mean 9%), neutrophils mean 9% (0-61%).

An outbreak os rapidly progressive respiratory disease in children and adults has been caused by biocides/detergents used in home humidifiers. Most were attributed to polyhexamethyleneguanidine. Removal of the detergent/biocide from humidifiers stopped the outbreak. Pregnant women were particularly susceptible.

References

	Kim HJ, Lee M, Hong S, Huh JW, Do K, Jang SJ, Lim C, Chae EJ, Lee H, Jung M, Park Y, Park J, Kwon G, Gwack J, Youn S, Kwon J, Yang B, Jun B, Kim Y, Cheong H, Chun BC, Kim H, Lee K, Koh Y, A cluster of lung injury cases associated with home humidifier use: an epidemiological investigation, Thorax, 2014;69:703-708,

	Pickering CAC, Humidifiers: the use of biocides and lung disease, Thorax, 2014;69:692-693,

	Hong S, Kim HJ, Huh JW, Do K, Jang SJ, Song JS, Choi S, Heo Y, Kim Y, Lim C, Chae EJ, Lee H, Jung M, Lee K, Lee M, Koh Y, A cluster of lung injury associated with home humidifier use: clinical, radiological and pathological description of a new syndrome, Thorax, 69;694-702:,

Comments

Is there any links to cpap units with humidifiers in them

2/4/2015

some related to humidifiers Kim HJ, Lee M, Hong S, Huh JW, Do K, Jang SJ, Lim C, Chae EJ, Lee H, Jung M, Park Y, Park J, Kwon G, Gwack J, Youn S, Kwon J, Yang B, Jun B, Kim Y, Cheong H, Chun BC, Kim H, Lee K, Koh Y, A cluster of lung injury cases associated with home humidifier use: an epidemiological investigation, Thorax, 2014;69:703-708, Koschela D, Stark W, Karmann F, Sennekamp J, Müller-Wening D, Extrinsic allergic alveolitis caused by misting fountains, Respir Med, 2005;99:943-947, Nakagawa A, Yamaguchi T, Takao T, Amano H, A case of hypersensitivity pneumonitis probably caused by a humidifier in winter [Japanese], Nippon Kyobu Shikkan Gakkai Zasshi, 1995;33:202-208, Hagiwara S, Ishii Y, Sugiyama Y, Kitamura S, Hypersensitivity pneumonitis caused by a home humidifier [Review] [Japanese], Nippon Kyobu Shikkan Gakkai Zasshi, 1995;33:1024-1029, Tsujino I, Betsuyaku T, Inaba S, Yoshikawa T, Terai T, A case of hypersensitivity pneumonitis caused by a humidifier., Nippon Kyobu Shikkan Gakkai Zasshi, 1992;30:1864-1868, Oie S, Masumoto N, Hironaga K, Koshiro A, Kamiya A, Microbial contamination of ambient air by ultrasonic humidifier and preventive measures, Microbios, 1992;72:161-166, Jost M, Lehmann M, Humidifier syndrome as occupational disease in Switzerland., Schweiz Rundsch Med Prax, 1990;79:797-803, Robertson AS, Burge PS, Wieland GA, Carmalt MH, Extrinsic allergic alveolitis caused by a cold water humidifier, Thorax, 1987;42:32-37, Matsumoto H, Nakano H, Fujikane T, Akaishi T, Sasaki N, Shimizu T, Onodera S, Hypersensitivity pneumonitis caused by home humidifier, a case report, Nippon Kyobu Shikkan Gakkai Zasshi, 1987;25:*-*, Mikasa K, Mikami R, Sawaki M, Ito S, Katada H, Kasuga H, Shioya N, Narita N, A case of hypersensitivity pneumonitis caused by a humidifier, Nippon Kyobu Shikkan Gakkai Zasshi, 1986;24:1288-1291, Burge PS, Finnegan M, Horsfield N, Emery D, Austwick P, Davies PS, Pickering CAC, Occupational asthma in a factory with a contaminated humidifier, Thorax, 1985;40:248-254, COCKCROFT A, EDWARDS J, BEVAN C, CAMPBELL I, COLLINS G, HOUSTON K, JENKINS D, LATHAM S, SAUNDERS M, TROTMAN D, An investigation of operating theatre staff exposed to humidifier fever antigens, Br J Industr Med, 1981;38:144-151, van Assendelft A, Forsen KO, Keskinen H, Alanko K, Humidifier-associated extrinsic allergic alveolitis, Scand J Work Environ Health, 1979;5:35-41, Tourville DR, Weiss WI, Wertlake PT, Leudemann GM, Hypersensitivity pneumonitis due to contamination of home humidifier, J Allergy Clin Immunol, 1972;49:245-251, Sweet LC, Anderson JA, Callies QC, Coates EO, Hypersensitivity pneumonitis related to a home furnace humidifier, J Allergy Clin Immunol, 1971;48:171-178, Hong S, Kim HJ, Huh JW, Do K, Jang SJ, Song JS, Choi S, Heo Y, Kim Y, Lim C, Chae EJ, Lee H, Jung M, Lee K, Lee M, Koh Y, A cluster of lung injury associated with home humidifier use: clinical, radiological and pathological description of a new syndrome, Thorax, 69;694-702:,

2/7/2015