Humidifier fever and endotoxin exposure

Rylander, Ragnar; Haglind, Per; Lundholm, Monica; Mattsby, Inger; Stenqvist, Karin

doi:10.1111/j.1365-2222.1978.tb01504.x

Cited by 124 publications

(50 citation statements)

References 14 publications

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“…In previous studies similar symptoms have been described in relation with endotoxin fever, humidifier fever, or Monday morning fever and extrinsic allergic alveolitis (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). As etiologic agent(s) fungi, bacteria, amoeba, endotoxins, and antigenic material from humidifiers have been suggested.…”

mentioning

confidence: 82%

Relationship of airborne microorganisms with the lung function and leucocyte levels of workers with a history of humidifier fever.

Kateman¹,

Heederik²,

Pal³

et al. 1990

Scand J Work Environ Health

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mentioning

confidence: 82%

Relationship of airborne microorganisms with the lung function and leucocyte levels of workers with a history of humidifier fever.

Kateman¹,

Heederik²,

Pal³

et al. 1990

Scand J Work Environ Health

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“…The fact that the onset of symptomsin the present case occurred immediately following the use of the humidifier for the first time favors this notion. It has been suggested that bacterial endotoxin may play a role in humidifier lung (12)(13)(14)(15). The reports of bath water fever and humidifier lung demonstrated high concentrations of endotoxin (0.…”

Section: Discussionmentioning

confidence: 99%

Humidifier Lung: Possible Contribution of Endotoxin-induced Lung Injury.

et al. 2002

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A 56-year-old man was admitted with cough, fever, myalgia, and arthralgia. Chest computed tomography demonstrated bilateral diffuse ground-glass opacities predominantly in the upper lungs. Subpleural non-segmental consolidation was observed in the late phase. Hypersensitivity pneumonitis was suspected, and an environmental provocation test with the incidental use of a home ultrasonic humidifier was positive. Unlike typical hypersensitivity pneumonitis, serum KL-6 levels were normal. Although several microorganisms were isolated from the humidifier water, there was no evidence for immunesensitization. Wedetected high amounts of endotoxin in the humidifier water, which mayhave contributed to the lung injury of this patient.

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“…Inhaled endotoxin events associated with water Rylander et al (1978) were among the first to theorize that endotoxin was the causal agent in unexplained cases of fever after exposure to contaminated water in humidifiers and in a sauna (Kohler et al 1976;Metzger et al 1976;Pickering et al 1976). This was accomplished by measuring endotoxin O antigen antibody titers in three subjects who developed 'humidifier disease' from a humidifier contaminated with two unidentified species of Flavobacterium.…”

Section: Introductionmentioning

confidence: 99%

Estimation of endotoxin inhalation from shower and humidifier exposure reveals potential risk to human health

Anderson

Dixon

Mayfield

2007

Journal of Water and Health

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This paper investigates potential exposure to endotoxin in drinking water through the inhalation of aerosols generated by showers and humidifiers. Adverse health effects attributable to the inhalation of airborne endotoxin in various occupational settings are summarized, as are controlled laboratory inhalation studies. Data from investigations estimating aerosolization of particulate matter by showers and humidifiers provide a basis for similar analyses with endotoxin, which like minerals in water, is nonvolatile. A theoretical assessment of the inhalation of aerosolized endotoxin showed that while the likelihood of an acute response while showering is minimal, the same is not true for humidifiers. Ultrasonic and impeller (cool mist) humidifiers efficiently produce large numbers of respirable particles. It is predicted that airway inflammation can occur if humidifier reservoirs are filled with tap water, sometimes even at typical drinkingwater distribution-system endotoxin concentrations. Higher endotoxin levels occasionally found in drinking water (.1,000 EU/ml) are very likely to induce symptoms such as chills and fever if used as humidifier feed water. While it is unlikely that treated drinking water would contain extremely high endotoxin levels occasionally observed in cyanobacterial blooms (.35,000 EU/ml), the potential for serious acute health consequences exist if used in humidifiers.

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Humidifier fever and endotoxin exposure

Cited by 124 publications

References 14 publications

Relationship of airborne microorganisms with the lung function and leucocyte levels of workers with a history of humidifier fever.

Relationship of airborne microorganisms with the lung function and leucocyte levels of workers with a history of humidifier fever.

Humidifier Lung: Possible Contribution of Endotoxin-induced Lung Injury.

Estimation of endotoxin inhalation from shower and humidifier exposure reveals potential risk to human health

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