Abstract
Worldwide epidemiological reports assert that drinking water is a source for infections and Legionella control represents a critical issue in healthcare settings. Chemical disinfections of water networks are control measures that need to be fine-tuned to obtain satisfactory results in large buildings over prolonged time periods. Aim of study is the evaluation of the effect of anolyte and chlorine dioxide, applied in two different hot water networks of a nursing home to manage Legionella risk. Nursing home has two buildings (A and B), with the same point of aqueduct water entrance. From June 2016, following a shock chlorination, the continuous disinfections with chlorine dioxide and anolyte were applied in hot networks of building A and B, respectively. Hot water was sampled at the central heating system and at two points of use for Legionella research, while chemical tests of manganese (Mn), iron (Fe), zinc (Zn) and trihalomethanes compounds (THM) were implemented to evaluate the disinfection by-products presence. Before chlorination Legionella pneumophila sg1 was recovered with a mean count of 2.4 × 104 CFU/L, while chemical compounds concentrations were within the law limits (Directive 98/83/EC). Then the disinfections Legionella was not recovered in both hot water plants. After the disinfection with chlorine dioxide (from June 2016 to May 2018), a statistically significant increase of iron, zinc and THM concentrations was detected in building A (p = 0.012; p = 0.004; p = 0.008). Both disinfectants appear effective against Legionella spp. growth in water network, but anolyte ensures a lower disinfection by-products release.
Highlights
Legionella spp. is a waterborne pathogen frequently associated with nosocomial infections, among immunosuppressed, transplanted patients and people undergoing aggressive chemotherapy [1]
Aim of study is the evaluation of the effect of anolyte and chlorine dioxide, applied in two different hot water networks of a nursing home to manage Legionella risk
We report a plan for Legionnaires’ disease prevention, which was scheduled to compare two different water disinfection strategies, applied in an Italian nursing home by using anolyte and chlorine dioxide, for continuous hot water disinfection
Summary
Legionella spp. is a waterborne pathogen frequently associated with nosocomial infections, among immunosuppressed, transplanted patients and people undergoing aggressive chemotherapy [1]. Hot water network treatments may be applied with different compounds such as chlorine dioxide [5], sodium hypochlorite [6], monochloramine [7] [8] and hydrogen peroxide [9] ensuring a continuous disinfection procedure All these treatments are useful to control Legionella spp. counts, but some disinfectants may get worse the chemical water quality after the pipelines corrosion [10]. Worldwide studies reported that high concentrations of toxic disinfection by-products (DBPs) in drinking water favor the probability to be taken up through inhalation, ingestion and dermal absorption, increasing the potential health risks of exposure for the users [11] [12] For this reason, a planned choice of appropriate pipelines materials and chemical disinfection methods must be done for each healthcare water network [13]
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