An analysis of a humidifier disinfectant case from a toxicological perspective

Abstract

An analysis of patients and fatalities due to exposure to polyhexamethylene guanidine (PHMG) shows that PHMG causes mainly lung diseases such as pulmonary fibrosis. However, no research on the other organs has been conducted on this matter yet. So, an in-depth discussion on toxicological techniques is needed to determine whether or not PHMG is toxic to organs other than just the lungs. For the test of target organ toxicity by PHMG exposure, a toxicokinetic study must first be conducted. However, measurement method for PHMG injected into the body has not yet been established because it is not easy to analyze polymer PHMG, so related base studies on analytical technique for PHMG including radio-labeling chemistry must come first. Moreover, research on exposure-biomarker and effect-biomarker must also be conducted, primarily related to clinical application. Several limitations seem to be expected to apply the biomarker study to the patient because much time has passed after exposure to the humidifier disinfectant. It is why a more comprehensive toxicological researches must be introduced to the causality for the victims.

Antibacterial, chemical and physical properties of sealants with polyhexamethylene guanidine hydrochloride

“…24 However, it is suggested that polyhexamethylene guanidine may be associated to toxic effects, including pulmonary fibrosis, when used in humidifier disinfectants. 23 Thus, the results of this study should be used with caution and more cytotoxic tests should be performed.…”

“…Polyhexamethylene guanidine may have toxic effects, such as causing pulmonary fibrosis, when used in humidifier disinfectants. 23 Other studies showed that PHMGH presented lower…”

Avaliação de soluções antifúngicas de guanidina para resina base de dentadura: um estudo in vitro

“…This result may have a positive impact when the cytotoxicity concern is addressed. Despite the high antibacterial activity, when previously used in humidifier disinfectants, it was suggested that molecules of polyhexamethylene guanidine led to toxicological effects 31 . In this way, the possibility of use PHMGH for a short time of contact with the material may bring advantages, decreasing possible PHMGH remnants on polymer structure and cytotoxic effect.…”

Safety Assessment of Polyaminopropyl Biguanide (Polyhexamethylene Biguanide Hydrochloride) as Used in Cosmetics

“…60 An analysis of patients and fatalities attributed to inhalation exposure to PHMG indicates that this chemical mainly causes lung diseases, such as pulmonary fibrosis. 61 Of the known main components of the humidifier disinfectants, PHMG has been identified as the chemical substance that caused the most deaths. In surveys conducted to identify victims of the humidifier disinfectant, 22% of the research participants answered that they had used the humidifier disinfectant, and 21% complained of side effects.…”