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http://dx.doi.org/10.5668/JEHS.2021.47.6.513

A Review on the Health Risks Associated with the Use of Products Containing Benzalkonium Chloride (BKC), Focusing on Humidifier Disinfectant Products  

Kim, Jiwon (Department of Anthropology, Zanvyl Krieger School of Arts & Sciences, Johns Hopkins University)
Zoh, Kyung Ehi (Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University)
Kim, Hana (Department of Public Health Sciences, Graduate School of Public Health, Seoul National University)
Park, Dong-Uk (Department of Environmental Health, Korea National Open University)
Publication Information
Journal of Environmental Health Sciences / v.47, no.6, 2021 , pp. 513-520 More about this Journal
Abstract
Background: Benzalkonium chloride (BKC) has been extensively used as a preservative in industrial products and in hygiene, medical, and cosmetic applications. Humidifier disinfectant (HD) products containing BKC have been used in South Korea. Objectives: This study was aimed to review types of products containing BKC, to summarize the regulations in the US, EU, Japan, and South Korea, and to review the health effects associated with the use of HD. Methods: We reviewed and summarized documents which were searched through PubMed and Google Scholar with the key words: BKC and asthma/contact dermatitis, humidifier disinfectant-associated lung injury (HDLI), and more. Results: Regulations in most countries including South Korea do not allow its use as disinfectants in spray-type of products for medicine, cosmetics, and household products. Two types of HD containing BKC (800~1,270 ppm) were marketed in South Korea from 1996~2003. Health effects reported from people who used products containing BKC were allergic contact dermatitis, erythema, and respiratory disease, including asthma. Two people who responded as HD users containing BKC only were confirmed to have developed asthma. HD-associated lung injury (HDLI) was reported by consumers who used both HD containing polyhexamethylene guanidine (PHMG) and HD containing BKC. Conclusions: In conclusion, the use of BKC as a biocide has to be controlled considering the route and pattern of exposure. Products containing BKC as preservatives were reviewed with exposure routes and sites in the human body such as skin, eyes, and the respiratory tract. HD containing BKC was clinically evaluated to be associated with asthma.
Keywords
Benzalkonium chloride (BKC); humidifier disinfectant; humidifier disinfectant-associated lung injury (HDLI); asthma; contact dermatitis;
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