Characterization of Polyhexamethylene Guanidine Oligomers in Solutions and Aerosols Emitted during Humidifier Use

The behavior of polyhexamethylene guanidine (PHMG), the causative agent of many humidifier-induced lung diseases, is not well known because of its various oligomer structures and analytical difficulties. The aim of this study was to identify different PHMG oligomer types both in solution and aerosols and to estimate the airborne concentration of oligomers during humidifier use. Three products containing PHMG as the main component were diluted to the manufacturer’s recommended concentration (6.5 ppm) or the worst-case concentration (65 ppm or 125 ppm). Samples were qualitatively and quantitatively analyzed with liquid chromatography-quadrupole time-of-flight (LC-qToF) mass spectrometry in the diluted solution and in the air at 0.5 m and 1 m. The LC-qToF data were processed using UNIFI software to characterize the PHMG structure. For all products in both the humidifier solution and air, the linear type was predominant over the branched/cyclic structure, but each product had different characteristics. The linear structure in the Oxy product, the main product of lung diseases, accounted for 90.6%, while that of the Scunder and BOC Sciences’ products accounted for 78.6% and 75.8%, respectively. The concentration of the oligomer in air for the Oxy product was estimated to be 35.89 and 390.96 μg/m³ at 6.5 and 65 ppm, respectively. Most of the oligomers in the solution were found in air at a short distance (0.5 m), with a negligible concentration beyond 1 m. Oligomers with 1–7 monomer units were identified in the humidifier solution, whereas mainly monomers, dimers, and trimers were identified in the air. The results of this study will facilitate further investigations of the mechanisms of lung disease by identifying the behaviors and forms of PHMG in the air, along with previously revealed toxicity results.