• 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.