背景:自从在韩国爆发由加湿器消毒剂引起的肺部疾病以来,已经有10年了,但是对健康的影响还没有总结。因此,这项研究旨在系统地研究迄今发现的加湿器消毒剂对健康的影响。
方法:所有以加湿器消毒剂及其代表成分为主要词汇的文献均基于网络收集,包括PubMed,研究信息共享服务,和政府出版报告。共检索了902项研究,其中196人被选中。他们分为四组:已发表的人类研究(第1组),已发表的动物和细胞毒性研究(第2组),技术报告(第3组),和灰色文献(第4组)。
结果:在196项研究中,97(49.5%)作为原创研究发表在同行评审期刊上。第一组由49篇文章(50.5%)组成,而第2组由48篇(49.5%)组成。总的来说,呼吸系统疾病,如加湿器消毒剂相关的肺损伤,间质性肺病,和哮喘有明显的相关性,但其他影响,如肝脏,心,胸腺,甲状腺,胎儿生长,代谢异常,在毒理学实验研究中观察到眼睛,但尚未在流行病学研究中发现。
结论:目前的证据水平并不能完全排除湿化消毒剂对肺外疾病的影响。根据目前的毒理学证据,需要持续监测加湿器消毒剂暴露的人群,看看是否发生类似的损害。
BACKGROUND: It has been 10 years since the outbreak of lung disease caused by humidifier disinfectants in Korea, but the health effects have not yet been summarized. Therefore, this study aims to systematically examine the health effects of humidifier disinfectants that have been discovered so far.
METHODS: All literature with humidifier disinfectants and their representative components as the main words were collected based on the web, including PubMed, Research Information Sharing Service, and government publication reports. A total of 902 studies were searched, of which 196 were selected. They were divided into four groups: published human studies (group 1), published animal and cytotoxicology studies (group 2), technical reports (group 3), and gray literature (group 4).
RESULTS: Out of the 196 studies, 97 (49.5%) were published in peer-reviewed journals as original research. Group 1 consisted of 49 articles (50.5%), while group 2 consisted of 48 articles (49.5%). Overall, respiratory diseases such as humidifier disinfectant associated lung injury, interstitial lung disease, and asthma have a clear correlation, but other effects such as liver, heart, thymus, thyroid, fetal growth, metabolic abnormalities, and eyes are observed in toxicological experimental studies, but have not yet been identified in epidemiologic studies.
CONCLUSIONS: The current level of evidence does not completely rule out the effects of humidifier disinfectants on extrapulmonary disease. Based on the toxicological evidence so far, it is required to monitor the population of humidifier disinfectant exposure continuously to see if similar damage occurs.