Peracetic Acid in the Disinfection of a Hospital Water System Contaminated With <i>Legionella</i> Species

Ditommaso, Savina; Biasin, Cinzia; Giacomuzzi, Monica; Zotti, Carla Maria; Cavanna, Alberto; Moiraghi, Angela

doi:10.1086/502573

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…two‐ to sevenfold greater in dental staff (16–50%) compared with the general population (5–8%) (Fotos et al ., 1985; Reinthaler et al ., 1988). A strong legionellae/NTM contamination (1 E + 03 to 1 E + 04 cfu ml −1 ) has also been found in whirlpool spa environments (Lumb et al ., 2004; Ditommaso et al ., 2005; Azara et al ., 2006) and are associated with prevalence of adverse health effects. In the present study we determined that dental unit water was contaminated by both Legionella spp.…”

Section: Discussionmentioning

confidence: 99%

Aerosolization of mycobacteria and legionellae during dental treatment: low exposure despite dental unit contamination

Dutil

Veillette

Mériaux

et al. 2007

Environmental Microbiology

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Dental unit waterlines (DUWL) support growth of a dense microbial population that includes pathogens and hypersensitivity-inducing bacteria, such as Legionella spp. and non-tuberculous mycobacteria (NTM). Dynamic dental instruments connected to DUWL generate aerosols in the work environment, which could allow waterborne pathogens to be aerosolized. The use of the real-time quantitative polymerase chain reaction (qPCR) provides a more accurate estimation of exposure levels compared with the traditional culture approach. Bioaerosol sampling was performed 13 times in an isolated dental treatment room according to a standardized protocol that included four dental prophylaxis treatments. Inhalable dust samples were taken at the breathing zone of both the hygienist and patient and outside the treatment room (control). Total bacteria as well as Legionella spp. and NTM were quantified by qPCR in bioaerosol and DUWL water samples. Dental staff and patients are exposed to bacteria generated during dental treatments (up to 4.3 E + 05 bacteria per m(3) of air). Because DUWL water studied was weakly contaminated by Legionella spp. and NTM, their aerosolization during dental treatment was not significant. As a result, infectious and sensitization risks associated with legionellae and NTM should be minimal.

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Section: Discussionmentioning

confidence: 99%

Aerosolization of mycobacteria and legionellae during dental treatment: low exposure despite dental unit contamination

Dutil

Veillette

Mériaux

et al. 2007

Environmental Microbiology

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“…PAA has been used as a cooling water biocide [32,162], as it has a good potential for the removal of Legionella pneumophila [142,[163][164][165]. The continuous doses used for Legionella removal varied considerably (3-1000 mg/L) and re-growth after treatment was reported [142,[163][164][165].…”

Section: Industrial Effluentsmentioning

confidence: 99%

“…The continuous doses used for Legionella removal varied considerably (3-1000 mg/L) and re-growth after treatment was reported [142,[163][164][165]. A potentially effective approach for the long-term Legionella control could be an initial high-shock dose, with a smaller, continuous dose administered afterwards [8].…”

Section: Industrial Effluentsmentioning

confidence: 99%

Peracids in water treatment: A critical review

Luukkonen

Pehkonen

2016

Critical Reviews in Environmental Science and Technology

272

122

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Peracids have gained interest in the water treatment over the last few decades. Peracetic acid (CH 3 CO 3 H) has already become an accepted alternative disinfectant in wastewater disinfection whereas performic acid (CHO 3 H) has been studied much less, although it is also already commercially available. Peracids have also been tested for drinking water disinfection, oxidation of aqueous (micro)pollutants, sludge treatment and ballast water treatment, to name just a few examples. The purpose of this review paper is to represent comprehensive up-to-date information about the water treatment applications, aqueous reaction mechanisms, and disinfection byproduct formation of peracids, namely performic, peracetic and perpropionic acids. and PFA have several of the qualities of an ideal disinfectant: toxicity to microorganisms, but not to higher forms of life; effectivity at ambient temperatures; stability and long shelf-life; low corrosivity; deodorizing ability; widespread availability and reasonable cost [12].PAA and PFA are colorless liquids with characteristic pungent odors. Both are thermodynamically unstable and can decompose spontaneously or explode when highly concentrated, heated, under mechanical stress or exposed to catalytic effects of impurities [1,13,14]. The recommended storage temperatures are below 30 and 20°C for PAA and PFA, respectively [6,14]. Longer carbon chain length increases stability, and thus PAA is more stable than PFA [1]. However, the O-O bond dissociation energy of PFA and PAA has been calculated to be similar: 48 kcal/mol [15]. Percarboxylic acids have typically pK a values 3-4 units higher than the parent carboxylic acids [1]. Nonetheless, PFA and PAA are corrosive [16]. ACCEPTED MANUSCRIPT ACCEPTED MANUSCRIPT 3Exposure to PAA and PFA causes irritation and possibly permanent damage to the skin (cutaneous emphysema), eyes and the respiratory system. In the skin contact, 0.2% is proposed as the no-observed-effect concentration (NOEC) for short and medium length exposure [17].When inhaled, airborne concentrations less than 0.16-0.17 ppm (0.50-0.52 mg/m 3 ) are considered to cause no irritation [17,18]. However, higher concentrations are harmful and a case study suggested that PAA could cause occupational asthma [19].The largest users of PAA on a global scale (estimated in 2013) are shown in Fig. 1. Similar numbers are not available for PFA, but it is probably used at significantly lower quantities.The largest user, the food industry, applies PAA as a disinfectant in fresh produce washing water, clean-in-place (CIP) processes, on food processing equipment, and in pasteurizers, to name just a few examples [21,22]. PFA is also a suitable disinfectant in low-temperature refrigerated food processing and storage rooms [23]. In healthcare, PAA is used for instance in Recently, methods to determine the residual PAA from wastewater were compared: the spectrophotometric method using DPD and catalase was recommended for 0.1-0.5 mg/L PAA concentrations and the cerimetric/iodometric titration...

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“…Peracetic acid (PAA) belongs to this group of biocides, though our knowledge of its efficacy as a drinking water disinfectant is still limited (Ragazzo et al 1997;Monarca et al 2002;Schiavano et al 2006). PAA has been proposed as a disinfectant with a wide spectrum of antimicrobial applications due to its effectiveness as a bactericidal, virucidal, and sporicidal agent shown in various food industries (Alvaro et al 2009), as well as its use in the disinfection of a hospital water system (Ditommaso et al 2005), medical devices, flexible scopes, and hemodialyzers (McDonnel & Denver Russel 1999). It has also been proposed for disinfecting wastewater (Briancesco et al 2005;Koivunen & Heinonen-Tanski 2005) or water surface, for the eradication of Legionella and biofilm control (McDonnel 2007), as well as for disinfecting microfiltered water dispensers (Zanetti et al 2009).…”

Section: Introductionmentioning

confidence: 99%

Disinfection efficacy of chlorine and peracetic acid alone or in combination against Aspergillus spp. and Candida albicans in drinking water

Sisti

Brandi

Santi

et al. 2011

Journal of Water and Health

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The aim of the present study was to evaluate the fungicidal activity of chlorine and peracetic acid in drinking water against various pathogenic Aspergillus spp. and Candida albicans strains. A. nidulans exhibited the greatest resistance, requiring 10 ppm of chlorine for 30 min contact time for a complete inactivation. Under the same experimental conditions, peracetic acid was even less fungicidal. In this case, A. niger proved to be the most resistant species (50 ppm for 60 min for complete inactivation).All Aspergillus spp. were insensitive to 10 ppm even with extended exposure (>5 h). The combination of chlorine and peracetic acid against Aspergillus spp. did not show synergistic effects except in the case of A. flavus. Complete growth inhibition of C. albicans was observed after about 3 h contact time with 0.2 ppm. C. albicans was less sensitive to peracetic acid. Hence the concentrations of chlorine that are usually present in drinking water distribution systems are ineffective against several Aspergillus spp. and peracetic acid cannot be considered an alternative to chlorine for disinfecting drinking water. The combination of the two biocides is not very effective in eliminating filamentous fungi at the concentrations permitted for drinking water disinfection.

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Peracetic Acid in the Disinfection of a Hospital Water System Contaminated With Legionella Species

Abstract: Peracetic acid may be useful in emergency situations, but does not provide definitive protection even if used monthly.

Cited by 12 publications

References 21 publications

Aerosolization of mycobacteria and legionellae during dental treatment: low exposure despite dental unit contamination

Aerosolization of mycobacteria and legionellae during dental treatment: low exposure despite dental unit contamination

Peracids in water treatment: A critical review

Disinfection efficacy of chlorine and peracetic acid alone or in combination against Aspergillus spp. and Candida albicans in drinking water

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