BACKGROUND Use of humidifier disinfectants (HD) at home leads to chemical airborne exposure, causing HD associated lung injury (HDLI) with high mortality. However, the lung function in children diagnosed with HDLI is not well studied. We investigated the effect of HD exposure on lung function, prognosis, and exposure characteristics associated with the lung function phenotype in children. METHODS Eighty-one children diagnosed with HDLI in a nationwide cohort were tested for spirometry and diffusing capacity of the lung for carbon monoxide (DLco) from July 2013 and followed up with at five time points over 2 years. The results were compared with 122 children without HD exposure as controls. Home investigation and questionnaire analysis were conducted to assess HD inhalation exposure. RESULTS HDLI survivor's mean percent of predicted forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and corrected DLco were significantly lower compared with the control group. On longitudinal assessment, FVC was within the normal range, but flattened, and spirometry showed a predominantly restrictive pattern. Corrected DLco did not normalize above 80% despite increasing age. The persistently low phenotype of lung function was associated with initial exposure age, especially less than 12 months of age. Higher density HD exposure during sleep and close distance between the bed and the humidifier were significantly associated with persistently low corrected DLco. CONCLUSIONS HD exposure affects prolonged decrement in lung function, especially DLco, particularly among children who are exposed within the first year of life. These results suggested that early-life HD exposure determines long-term prognosis of lung function in children.

中文翻译：

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早期接触加湿器消毒剂可确定儿童肺功能的预后。

背景技术在家中使用加湿器消毒剂（HD）会导致化学空气传播，导致高死亡率的HD相关肺损伤（HDLI）。然而，对诊断为HDLI的儿童的肺功能还没有很好的研究。我们调查了高清暴露对儿童肺功能，预后以及与肺功能表型相关的暴露特征的影响。方法从2013年7月开始，在全国范围内对88名诊断为HDLI的儿童进行了肺活量测定和肺中一氧化碳（DLco）扩散能力的测试，并在2年中的5个时间点进行了随访。将结果与122名未进行HD暴露的儿童进行比较。进行家庭调查和问卷分析以评估高清吸入暴露。结果HDLI幸存者 与对照组相比，在1 s内预测的强制呼气量（FEV1），强制肺活量（FVC）和校正后的DLco的平均百分数显着降低。在纵向评估中，FVC在正常范围内，但变平，肺活量测定法显示主要为限制性模式。尽管年龄增加，但校正后的DLco仍未正常化至80％以上。肺功能的持续低表型与初始暴露年龄有关，尤其是小于12个月大。睡眠期间较高密度的HD暴露以及床与加湿器之间的近距离与持续较低的校正DLco显着相关。结论HD暴露会影响肺功能（尤其是DLco）的长期下降，尤其是在生命的第一年内暴露的儿童中。