• Journal of Environmental Health Sciences
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• v.46 no.5
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• pp.495-503
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• 2020

Objective: This study aimed to compare the characteristics of humidifier disinfectant-like products (HD-like products) and humidifier disinfectant products (HD products) and introduce actual cases of the usage of HD-like products in hospitals based on an on-site investigation. Methods: The characteristics, chemical components, and usage of HD-like products (Hichlor or Biospot) and HD products (N-with) containing NaDCC (sodium dichloroisocyanurate) were compared. In the process of conducting the on-site investigation, four hospitals were identified as previously using HD-like products. Each on-site investigation to identify the use of HD-like products was composed of four parts: 1) hospital infection control guidelines, 2) manual for humidifiers in patient's rooms, 3) interviews with nursing staff, infection managers, and purchase managers, 4) searching on the product purchase system. Results: Although HD-like products (Hichlor and Biospot) and HD products (N-with) were sold for different usage purposes, they were all white-colored and coin-shaped foaming tablets with the same chemical component, NaDCC. The manual for using HD-like products and HD products was similar (inserting the tablet in a humidifier container with water). Among the four hospitals, one had used Hichlor in the same manner as HD (N-with) by inserting a tablet in 1L of water in a filled humidifier container and Biospot as a kind of detergent for humidifier container cleaning. Another two hospitals had used Biospot and/or Aniosyme as a kind of detergent for humidifier container cleaning. The other hospital had used unknown product in the same manner as N-with, so we thus assumed it was either an HD products (N-with) or HD-like products (Hichlor, Biospot). Conclusion: This study raises the possibility of the development of adverse health effects similar to exposure to an HD-products when exposed to an HD-like products and the possibility of further use in other medical institutions or multi-use facilities. Therefore, an expansion of the investigation is needed in order to confirm whether there have been similar cases in the past.

• Journal of Environmental Health Sciences
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• v.46 no.4
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• pp.433-443
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• 2020

Objective: This study aimed to introduce the use of humidifier disinfectant (HD) in hospitals based on an on-site investigation. Methods: A preliminary survey and on-site investigation of HD use were conducted in 23 hospitals. Among them, one hospital without previous information on HD use was selected for a pilot investigation; 22 hospitals were selected based on previous documents and exposure statements from parliamentary investigation and exposure assessment regarding HD. Descriptive statistics were used to present distribution and characteristics of HD purchase and HD use in hospitals. Also, details on interviews from the on-site investigation were described. Results: Among the 23 hospitals, a total of ten were confirmed to have purchased and used an HD (nine hospitals) or HD-like product (one hospital). For the purchased HD products, four hospitals reported 'Aekyung Gaseupgi Mate', two hospitals reported 'Oxy Ssakssak New Gaseupgi Dangbun', and one hospital reported 'Homeplus Gaseupgi Chungjungje' (one hospital used three kinds of HD products). One hospital reported an HD-like product and four hospitals were 'Unknown'. For the number of HD products purchased, five hospitals reported '100 or less', two hospitals reported 'More than 100', and three hospitals were 'Unknown'. For each of the ten hospitals, we described detailed characteristics of HD purchase and its exposure status obtained through on-site investigation, including the purchase volume (i.e., number of products), exposure space (i.e., patient's room, staff space), and exposure period. Additionally, a comparison of on-site investigation and parliamentary investigation or exposure assessment regarding HD was reported. Conclusion: This study introduced detailed cases of HD purchase and HD use in hospitals based on an on-site investigation, and our findings revealed a possibility of a considerable volume of HD exposure in various multiuse facilities, including hospitals.