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Environ Anal Health Toxicol > Volume 38:2023 > Article
Environmental Analysis Health and Toxicology 2023;38(1):e2023002-0. doi: https://doi.org/10.5620/eaht.2023002
Toxic hepatitis after exposure to humidifier disinfectant: A case series report
Hyung Doo Kim2 , Hwan-Cheol Kim1 , Jong-Han Leem1
1Departement of Occupational and Environmental Medicine Inha University College of Medicine, Incheon, Republic of Korea
2Infectious Disease Control Division, Incheon, Republic of Korea
Corresponding Author: Jong-Han Leem ,Email: ekeeper21@naver.com
Received: September 19, 2022;  Accepted: February 8, 2023.
Health damage from humidifier disinfectants is an unprecedented environmental health disaster. Humidifier disinfectants were used broadly in Korea from 1994 to 2011. Most studies have focused on respiratory problems because of the exposure route and primary respiratory symptoms. This overlooks the previous research results that humidifier disinfectants could move to extrapulmonary organs and induce toxic effects. Thus, the objective of this study was to examine toxic hepatitis cases developed after inhaling humidifier disinfectant. We focused on the indications of toxic hepatitis in two pediatric cases and one female adult case. All patients were exposed to humidifier disinfectants in a residential space. These disinfectants all contained polyhexamethylene guanidine (PHMG). Rapid increases in blood hepatic enzyme levels were seen. Two patients were discharged after treatment. Death occurred in one patient who was diagnosed with fulminant hepatitis of unknown cause. This human case series study supports prior knowledge that hepatotoxicity can occur by inhaling humidifier disinfectant.
Keywords: Toxic hepatitis, Humidifier disinfectant, PHMG, Mitochondrial dysfunction
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