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Childhood interstitial lung diseases (chILD) syndrome is a rare and heterogeneous group of pediatric lung diseases. Despite common inhalation exposures, few studies have associated chemical inhalation exposures with chILD. The purpose of this review was to assess for chILD syndromes following toxic chemical inhalation exposures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed and Embase databases were searched with the following inclusion criteria: (1) toxic chemical inhalation exposure, (2) pediatric subjects, and (3) chILD syndrome. Studies were excluded due to incorrect (1) study design, (2) patient population, and\/or (3) outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and one studies were identified, of which 142 articles were retrieved, with 74 articles included after inclusion\/exclusion criteria were applied by two independent reviewers. Most of the evidence stemmed from two pandemics: humidifier disinfectant associated lung disease (HD\u2010ILD;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927) and e\u2010cigarette, or vaping product associated, lung injury (EVALI;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945). Common signs and symptoms included cough, shortness of breath, hypoxemia, and inspiratory crackles. Common radiographic findings included centrilobular nodules and ground\u2010glass opacities with subpleural sparing. Histopathologic features included airway\u2010centric injury\/inflammation with foamy macrophages, as well as subpleural sparing. Oxidized lipids were common plasma biomarkers associated with both HD\u2010ILD and EVALI. Long\u2010term pulmonary function testing suggests a restrictive phenotype in HD\u2010ILD but variable phenotypes in EVALI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ChILD syndromes secondary to toxic chemical inhalation exposures manifest with common radiographic and histopathologic findings of airway\u2010centric disease with subpleural sparing. Long\u2010term monitoring is under\u2010reported in toxic chemical inhalation chILD syndromes but suggests persistent lung function impairment, especially after high\u2010dose, repeated exposures. Additional monitoring, evaluation, and reporting of chILD syndromes secondary to chemical inhalation exposure are needed to better understand its complex pathogenesis and long\u2010term lung function implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71401","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T08:36:13Z","timestamp":1764232573000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Childhood Interstitial Lung Disease (chILD) Associated With Toxic Chemical Inhalation Exposures: A State\u2010of\u2010the\u2010Art Review"],"prefix":"10.1002","volume":"60","author":[{"given":"William","family":"Hadley","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Pulmonology University of Rochester Medical Center Rochester New York USA"},{"name":"Department of Environmental Medicine University of Rochester Medical Center Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Lacagnina","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Pulmonology University of Rochester Medical Center Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2274-2454","authenticated-orcid":false,"given":"Irfan","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine University of Rochester Medical Center Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3566-9690","authenticated-orcid":false,"given":"Alicia M. 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