Warning: fopen(/home/virtual/epih/journal/upload/ip_log/ip_log_2025-03.txt): failed to open stream: Permission denied in /home/virtual/lib/view_data.php on line 95 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 96 Risk of non-cancer respiratory diseases attributed to humidifier disinfectant exposure in Koreans: age-period-cohort and differences-in-difference analyses
Skip Navigation
Skip to contents

Epidemiol Health : Epidemiology and Health

OPEN ACCESS
SEARCH
Search
Advanced Search
mobile menu button

Articles

Page Path
HOME > Epidemiol Health > Accepted Articles > Article
Original article Risk of non-cancer respiratory diseases attributed to humidifier disinfectant exposure in Koreans: age-period-cohort and differences-in-difference analyses
Jaiyong Kim3orcid , Kyoung Sook Jeong4orcid , Seungyeon Heo4orcid , Younghee Kim5orcid , Jungyun Lim5orcid , Sol Yu5orcid , Suejin Kim5orcid , Sun-Kyoung Shin6orcid , Hae-Kwan Cheong2orcid , Mina Ha1orcid
Epidemiol Health 2025;e2025006
DOI: https://doi.org/10.4178/epih.e2025006 [Accepted]
Published online: February 22, 2025
1Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
2Sungkyunkwan University School of Medicine, Suwon, Korea
3National Health Insurance Service, Wonju, Korea
4Wonju College of Medicine, Yonsei University, Wonju, Korea
5National Institute of Environmental Research, Incheon, Korea
6National Health Insurance Service, Incheon, Korea
Corresponding author:  Hae-Kwan Cheong,
Email: minaha@dku.edu
Mina Ha,
Email: minaha@dku.edu
Received: 22 October 2024   • Revised: 19 January 2025   • Accepted: 5 February 2025
  • 532 Views
  • 28 Download
  • 0 Crossref
  • 0 Scopus
Full Article

Download PDF Download PDF

Abstract

OBJECTIVES
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.
METHODS
Using National Health Insurance data from 2002 to 2019, we performed age–cohort–period and difference-in-differences analyses (comparing periods before versus 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.
RESULTS
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, women of reproductive age (19–44 years) experienced 1.1-9.2 times more excess episodes than men.
CONCLUSIONS
This study provides epidemiological evidence that inhalation exposure to HDs affects the entire respiratory tract and identifies vulnerable groups.

Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.
TOP