Adverse health effects of humidifier disinfectants in Korea: lung toxicity of polyhexamethylene guanidine phosphate

J Toxicol Sci. 2016;41(6):711-717. doi: 10.2131/jts.41.711.

Abstract

Exposure to humidifier disinfectants was identified in 2011 as the potential cause of an outbreak of lung disease in Korea. It is estimated that over 8 million people have been exposed to humidifier disinfectants-chemicals added to the water used in humidifiers to prevent the growth of microorganisms-since their commercial introduction. The primary component of humidifier disinfectant products involved was polyhexamethylene guanidine phosphate (PHMG-P), a guanidine-based antimicrobial agent. Lesions observed in the lungs of patients were similar to those observed in laboratory animals exposed to PHMG-P. In this review, we outline the physicochemical and toxicological properties of PHMG-P, and introduce a putative mechanism for its lung toxicity based in large part on research findings to date.

Publication types

  • Review

MeSH terms

  • Animals
  • Bronchiolitis Obliterans / chemically induced*
  • Bronchiolitis Obliterans / epidemiology
  • Bronchiolitis Obliterans / pathology
  • Disinfectants / adverse effects*
  • Equipment Contamination / prevention & control*
  • Guanidines / adverse effects*
  • Humans
  • Humidifiers*
  • Lung / drug effects*
  • Lung / pathology
  • Pulmonary Fibrosis / chemically induced*
  • Pulmonary Fibrosis / epidemiology
  • Pulmonary Fibrosis / pathology
  • Republic of Korea
  • Risk Assessment
  • Toxicity Tests

Substances

  • Disinfectants
  • Guanidines
  • polyhexamethyleneguanidine