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Characteristics of a new respiratory syndrome associated with the use of a humidifier disinfectant: humidifier disinfectant-related respiratory syndrome (HDRS)

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Leem J. H., Joh J.-S., Hong Y.-S., Kim J., Park S., Lim S., Kim Y.
International Journal of Occupational Medicine and Environmental Health
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2020
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vol. 33
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issue 6
829-839
EN
ObjectivesThe purpose of this study was to characterize a new respiratory syndrome associated with exposure to a humidifier disinfectant (HD) in South Korea that is distinct from the well-known HD-related lung injury (HDLI). The authors identified this condition in 24 study subjects who were family members of patients with definite or probable HDLI (referred to as index cases), and were exposed to HD in the same room as the index cases.Material and MethodsThe authors reviewed medical records of 236 family members in 110 families who were exposed to HD in the same rooms and residences as the index cases.ResultsThey identified 24 family members who were exposed to HD in the same rooms and residences as the index cases, and who developed respiratory disorders that were distinct from HDLI. The clinical signs and symptoms of these individuals were in the upper respiratory tract, such as allergic rhinitis and croup, or in the lower respiratory tract, such as bronchitis and pneumonia. The diffusing capacity of the lung fordetermicarbon monoxide was reduced in 9 of 12 children (data not available for 1 child), and in 4 of 5 adults (data not available for 6 adults). The percent forced vital capacity and forced expiratory volume in one second/forced vital capacity ratios were within the normal ranges in most patients. The computed tomography findings, which mostly indicated non-specific inflammation, were inconsistent with the radiological diagnostic criteria for HDLI, but were abnormal in 8 of 11 adults, and in 2 of 13 children.ConclusionsThe authors propose a new condition, i.e., HD-related respiratory syndrome (HDRS), which is characterized by mild to moderate or atypical respiratory symptoms and signs, and is related to HD exposure, but is distinct from HDLI. The recognition of HDRS may provide a basis for understanding the natural history of HD-related respiratory problems, and for capturing the whole spectrum of HD-related clinical manifestations in the respiratory tract.
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Trudne wybory – kto może liczyć na odpowiednią opiekę zdrowotną podczas pandemii COVID-19 w 2020 roku?

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Łaszewska-Hellriegel M., Hellriegel C.
Krytyka Prawa. Niezależne studia nad prawem
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2020
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vol. 12
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issue 4
105-123
EN
The recent pandemic has forced us in 2020 to rethink the priority of access to medical care. The purpose of this article is to offer a brief account of how two countries – Sweden and the US – have reacted to the pandemic. The authors wish to show how the functions of the regulations and guidelines applied by hospitals and institutions during the COVID-19 pandemic differ from the objectives of health policies based on the principles of the distributive justice theory. The article will thus risk a preliminary assessment of the role of law in a crisis. A short summary of the main points of the distributive justice theory will be followed by an analysis of two cases: the guidelines issued by local authorities in Sweden and the American models applied during the COVID-19 pandemic. The conducted analysis results in a thesis that the objective of the justice theory differs from the regulations actually applied. In the case of Sweden, the recommendations seem to clearly prioritise the life of young people over the life of the elderly, even if there is no shortage of resources. In the case of the United States, we can see more objectives of distributive justice implemented in the analysed triages, but they are still not free from discrimination. The authors therefore call for an improvement of mobility of medical care resources in order to mitigate crises. The cognitive value has an international quality, and is aimed at Polish audiences dealing with the problems in question, be it at the level of a hospital or legislation.
PL
Pandemia w 2020 r., zmusiła nas do ponownego przemyślenia kwestii priorytetów opieki zdrowotnej. Celem artykułu jest krótkie przedstawienie reakcji na pandemię dwóch krajów: Szwecji i USA. funkcje przepisów i wytycznych stosowanych przez szpitale i instytucje w czasie pandemii COVID-19 różnią się od celów polityki zdrowotnej opartej na zasadach teorii sprawiedliwości dystrybucyjnej. Artykuł więc zaryzykuje pierwszą, wstępną ocenę funkcji prawa w sytuacji kryzysowej. Po krótkim podsumowaniu głównych założeń teorii sprawiedliwości dystrybucyjnej zostaną przeanalizowane dwa przypadki: wytyczne władz lokalnych Szwecji i amerykańskie plany triage funkcjonujące podczas pandemii COVID-19. Wynikiem analizy jest teza, że cel teorii sprawiedliwości różni się od funkcji stosowanych przepisów. W Szwecji zalecenia te wydają się wyraźnie przedkładać młode życie nad starsze, nawet bez zaistnienia sytuacji niedoborów zasobów. W przypadku amerykańskim widzimy więcej celów sprawiedliwości dystrybucyjnej implementowanych w przykładowych triagach, jednak nie są one wolne od elementów dyskryminacyjnych. Autorzy postulują więc wzmocnienie mobilności zasobów opieki zdrowotnej w celu zmniejszenia sytuacji kryzysowych. Artykuł podejmujący międzynarodowe kwestie skierowany jest do polskich odbiorców.
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