Abstract
The microbial water quality of therapeutic pools operating without disinfection is recurrently compromised, posing a risk to bathers’ health. The complex composition of such waters and the sensitivity of their therapeutic components hinder the use of traditional chlorine-based disinfectants. The present study aimed to investigate the applicability of a hydrogen peroxide-based disinfectant in therapeutic water in comparison with hypochlorite. Disinfection efficacy, byproduct formation, and the fate of therapeutic components were tested for both disinfectants under laboratory conditions, applying different doses and contact times. Disinfection efficacy was found to be matrix-dependent, especially that of hydrogen peroxide against Pseudomonas aeruginosa (a 10- to 1000-fold difference). Hypochlorite treatment presented a significant chemical risk through the generation of byproducts, mainly brominated and iodinated compounds and combined chlorine. Of the alleged therapeutic components, sulfide ions were eliminated (≥86% loss) by both disinfectants, and hypochlorite reacted with iodide ions as well (≥70% removal). Based on their composition, only 2% of Hungarian therapeutic waters can be treated by chlorination due to high concentrations of ammonia and/or organic compounds. Hydrogen peroxide is applicable to 82% of the waters, as the presence of sulfide ions is the only limiting factor. Due to the matrix effect, close control of residual disinfectant concentration is necessary to ensure microbial safety.
Highlights
Balneotherapy is a long-standing tradition in Europe
Hypochlorite proved to be effective for the elimination of E. coli and Pseudomonas aeruginosa in the tested therapeutic water at all applied concentrations, while the efficacy of the hydrogen peroxide-based product against Pseudomonas was only sufficiently effective at 200 mg/L and removal rates dropped with decreasing concentrations
Chemical disinfection with hydrogen peroxide and sodium hypochlorite can be applied to certain therapeutic waters, taking their respective limitations into account
Summary
Balneotherapy is a long-standing tradition in Europe. It is a recognized complementary therapy in the treatment of musculoskeletal, dermatological, and gynecological problems, among others [1,2]. Pool water quality in therapeutic pools is ensured by dilution-based methods (large-scale water replenishment, frequent water exchange) and user behavior (limited pool load and improved bather hygiene). While these measures are important, they are often insufficient against microbial contamination. In Hungary, according to monitoring data from the public health authorities, microbial water quality is significantly more frequently non-compliant in therapeutic fill-and-drain pools than in other types of bathing facilities, e.g., in swimming pools [9,10]
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