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KMID : 1156220200460030335
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Journal of Environmental Health Sciences
2020 Volume.46 No. 3 p.335 ~ p.343
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Classification and Characterization of Exposure Rating in Humidifier Disinfectants through Calculation of PHMG Reference Concentration
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Kim Eun-Chae
Ryu Hyeon-Su
Park Jin-Hyeon
Choe Young-Tae
Heo Jung
Lee Seul-A
Jo Eun-Kyung
Choi Yoon-Hyeong
Cho Man-Su
Yang Won-Ho
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Abstract
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Objectives: The Korean Ministry of Environment has identified cases of people suspected of suffering lung disease potentially caused by polyhexamethylene guanidine (PHMG) used in humidifier disinfectants (HDs).
Exposure assessment for the HDs was conducted using a questionnaire during face-to-face interview. The main purposes of this study were to develop a methodology to effectively classify levels of exposure to HDs based on a questionnaire.
Methods: We first identified the overall participants’ exposure characteristics by HD exposure levels; Second, we selected misclassified subjects and investigated characteristics of overestimated and underestimated subjects, focusing on exposure cases to PHMG-containing HDs. An inhalation reference concentration (RfC) for PHMG was produced on the basis of inhalation toxicity values. We made a cross-tabulation of the exposure classes (Exposure classes 1-to-4) by clinical classes based on the RfC. When the value of the exposure class minus the clinical class was 0 or 1, we assumed these were true values. When the value was ≥2 and ≤ ?2, we assigned these cases to the overestimation group and underestimation group, respectively.
Results: The overestimated group may have already recovered and responded excessively due to psychological anxiety or in order to receive compensation. On the other hand, relatively high mortality rates and surrogate responses for those under 10 years of age may have resulted in inaccurate exposure assessment for underestimated groups. For the characteristics of exposure, it was shown that for the underestimated group, the exposure was relatively weaker than the overestimated group, even though a high overall clinical rating was determined.
Conclusions: This study may suggest ways to reduce bias and overcome the limitations of current HD exposure assessment.
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KEYWORD
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Humidifier disinfectant, exposure assessment, past exposure, questionnaire, misclassification
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