Evidence map›Paper›PMID 37905312›Full record

ArticleEpidemiology and health2023

Evidence integration on health damage for humidifier disinfectant exposure and legal presumption of causation.

Mina Ha, Taehyun Park, Jong-Hyun Lee, Younghee Kim, Jungyun Lim, Yong-Wook Baek, Sol Yu, Hyen-Mi Chung, Kyu Hyuck Chung, Hae-Kwan Cheong and 1 more

Abstract read
In one paragraph

Article in Epidemiology and health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. The Humidifier Disinfectant Disaster in Korea: Implications for Preventive Medicine and Public Health.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2026
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mina HaDepartment of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea.
Taehyun ParkLaw School of Kangwon National University, Chuncheon, Korea.
Jong-Hyun LeeEH R&C Co., Incheon, Korea.
Younghee KimHumidifier Disinfectant Health Center, Environmental Health Research Department, National Institute of Environmental Research, Incheon, Korea.
Jungyun LimHumidifier Disinfectant Health Center, Environmental Health Research Department, National Institute of Environmental Research, Incheon, Korea.
Yong-Wook BaekHumidifier Disinfectant Health Center, Environmental Health Research Department, National Institute of Environmental Research, Incheon, Korea.
Sol YuHumidifier Disinfectant Health Center, Environmental Health Research Department, National Institute of Environmental Research, Incheon, Korea.
Hyen-Mi ChungHumidifier Disinfectant Health Center, Environmental Health Research Department, National Institute of Environmental Research, Incheon, Korea.
Kyu Hyuck ChungSungkyunkwan University School of Pharmacy, Suwon, Korea.
Hae-Kwan CheongSungkyunkwan University School of Medicine, Suwon, Korea.
Review Committee for the Epidemiological Correlations between Humidifier Disinfectants Exposure and Health Effects

Funding

Ministry of EnvironmentNational Institute of Environmental Research NIER-2022-04-03-001National Institute of Environmental Research NIER-2023-01-02-089
6 · The paper itself

Abstract

objectivesInhalation exposure to humidifier disinfectants has resulted to various types of health damages in Korea. To determine the epidemiological correlation necessary for presuming the legal causation, we aimed to develop a method to synthesize the entire evidence.

methodsEpidemiological and toxicological studies are systematically reviewed. Target health problems are selected by criteria such as frequent complaints of claimants. Relevant epidemiologic studies are reviewed and the risk of bias and confidence level of the total evidence are evaluated. Toxicological literature reviews are conducted on three lines of evidence including hazard information, animal studies, and mechanistic studies, considering the source-to-exposure-to-outcome continuum. The confidence level of the body of evidence is then translated into the toxicological evidence levels for the causality between humidifier disinfectant exposure and health effects. Finally, the levels of epidemiological and toxicological evidence are synthesized.

resultsUnder the Special Act revised in 2020, if the history of exposure and the disease occurred/worsened after exposure were approved, and the epidemiological correlation between the exposure and disease was verified, the legal causation is presumed unless the company proves the evidence against it. The epidemiological correlation can be verified through epidemiological investigations, health monitoring, cohort investigations and/or toxicological studies. It is not simply as statistical association as understood in judicial precedents, but a general causation established by the evidence as a whole, i.e., through weight-of-the-evidence approach.

conclusionsThe weight-of-the-evidence approach differs from the conclusive single study approach and this systematic evidence integration can be used in presumption of causation.

Indexed as

DisinfectantsHumidifiersAnimalsCausalityHumansInhalation ExposureDisinfectantsEpidemiological correlationEvidence integrationHumidifier disinfectantsPresumption of causationSystematic reviewsWeight-of-the-evidence approach

Identifiers

PMID37905312
PMCPMC10876420

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.