Contents

Foreword

Department of Chemistry and Biochemistry, University of South Carolina, Columbus, NC, US

Acronyms and Abbreviations

Disinfectants in Society: Current and Future Perspectives

Toxicity Assessment Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Durham, NC, US

Abstract

Introduction

1. Definitions

2. Historical Approach to Disinfection

3. Regulatory Framing

4. Application Domains, Current Perspectives and Research Areas

Conclusion

Disclaimer

References

Chemical Disinfectants: Toxicology and Health

Abstract

Introduction

1. Toxicology of Disinfectants and Disinfection by-Products

1.1. Surface Active Agents (Surfactants)

1.1.1. General Toxicological Properties

1.1.2. Carcinogenicity and Mutagenicity

1.1.3. Pharmacokinetics, Metabolism and Mode of Action

1.1.4. Risk Characterization

1.2. Peracetic Acid

1.2.1. Toxicity in Humans and Dose-Response in Animals

1.2.2. Carcinogenicity and Mutagenicity

1.2.3. Pharmacokinetics, Metabolism and Mode of Action

1.2.4. Risk Characterization

1.3. Ozone

1.3.1. Toxicity in Humans and Dose-Response in Animals

1.3.2. Pharmacokinetics, Metabolism and Mode of Action

1.3.3. Risk Characterization

1.4. Chlorinated products

1.4.1. General Toxicological Properties

1.5. Disinfection By-Products (DBPs)

1.5.1. Trihalomethanes (THMs)

1.5.1.1. Toxicity in Humans and Dose-Response in Animals

1.5.1.2. Pharmacokinetics, Metabolism and Mode of Action

1.5.2. Haloacetic Acids (HAAs)

1.5.2.1. Toxicity in Humans and Dose-Response in Animals

1.5.2.2. Pharmacokinetics, Metabolism and Mode of Action

1.5.3. Oxyhalides: Chlorite and Bromate

1.5.3.1. Toxicity in Humans and Dose-Response in Animals

1.5.3.2. Pharmacokinetics, Metabolism and Mode of Action

1.5.4. Occurrence, carcinogenicity, mutagenicity and risk characterization

Conclusion

References

Microbiology and Disinfecting Agents

Abstract

Introduction

1. Main Infectious Agents

1.1. Major Sources, Reservoirs and Modes of Transmission of Infectious Agents

1.2. Overview of the Infection Processes

2. Distribution of Infectious Agents and Control Measures

2.1. Water-Related

2.2. Foodborne

2.3. Airborne

2.4. On Inanimate Surfaces and Objects (Fomites)

3. Main Screening Methods of Infectious Agents

4. Development of Microbial Resistance to the Disinfectants

4.1. Phenotypic Differences between Microorganisms

4.2. Biofilms

4.3. Induction of Efflux Pumps

4.4. Inactivation of Disinfectants

4.5. Target Alteration and Impermeability

4.6. Horizontal Gene Transfer

Conclusion

Acknowledgments

References

Disinfectants in the Food Processing Industry

Abstract

Introduction

1. Selection of Disinfectants in the Food Processing Industry

2. Types of Disinfectants and the Sanitation Practice in Food Processing Industry

2.1. Types of Disinfectants

2.1.1. Chlorine Based Disinfectants

2.1.2. Iodine Based Disinfectants

2.1.3. Peroxyacetic Acid

2.1.4. Hydrogen Peroxide

2.1.5. Quaternary Ammonium Compounds

2.1.6. Ozone

2.1.7. Acid Anionic Disinfectants

2.1.8. Alcohol-Based Disinfectants

2.1.9. Aldehydes

2.2. The Sanitation Practice in Food Processing Industry

3. A Method for Control Sanitation Practice in Food Processing Industry

4. Residues and Bacterial Resistance

Conclusion

References

Disinfectants in the Pharmaceutical Industry

Abstract

Introduction

1. Cleaning and Disinfection

2. Regulatory Expectations

3. Environmental Cleanliness Standards

4. Specifying and Purchasing

5. Selecting Disinfectants for Pharmaceutical Use

6. Rotation of Disinfectants

7. Control of Disinfectants

8. Undertaking Cleaning and Disinfection in Pharmaceutical Families

8.1. Order of Cleaning and Disinfection

8.2. Treatment of Detergents and Disinfectants

8.3. Preparation of Detergents and Disinfectants

8.3.1. Detergents

8.3.2. Disinfectants

8.4. Cleaning Materials

8.5. Cleaning and Disinfection Steps

8.6. Cleaning Techniques

8.7. Cleaning and Disinfection Frequencies

8.8. Disinfection of Equipment

9. Cleaning and Disinfection Protocols

10. Assessing Disinfectant Effectiveness: Environmental Monitoring

11. Validating Disinfectants to Be Used in Cleanrooms

11.1. Validation Standards

11.2. European Requirements

11.2.1. Basic Suspension Test (Phase 1)

11.2.2. Quantitative Suspension Test: Bactericidal and Fungicidal Tests (Phase 2, Step 1)

11.2.3. Surface Tests (Phase 2, Step 2)

11.2.4. Culture Media

11.2.5. Field Trials

11.3. Hand Sanitization

11.4. Continuing Evaluation of Disinfectants

Conclusion

References

Disinfectants, Sterilization, and Antiseptics in the Healthcare Sector

Abstract

Introduction

1. Areas of Scope

1.1. Definition of Terms

2. Disinfection and Disinfectants in the Healthcare Setting

2.1. Types of Disinfection and Their Applications

2.1.1. Heat Disinfection

2.1.2. Chemical Disinfection

2.2. Criteria for Selection of Disinfectants

2.3. Disinfectants Recommended for the Prevention of Prion Disease

2.3.1. Environmental Cleaning and Disinfection

2.4. Disinfection of Medical Devices (MD)

2.5. Chemical Sterilants

3. Occupational Health (Exposure Contexts, Risk Assessment, Health Effects, Prevention, and Control)

4. Sterilization and Sterilants in the Healthcare Setting

4.1. High Temperatures Sterilization Processes

4.1.1. Steam Sterilization

4.1.2. Immediate Use Steam Sterilization

4.1.3. Dry Heat Sterilization

4.2. Low Temperatures Sterilization Processes

4.2.1. Ethlylene Oxide (EO) “Gas” Sterilization

4.2.2. Hydrogen Peroxide Gas Plasma (HPGP)

4.2.3. Vaporized Hydrogen Peroxide (VHP)

4.3. Other Sterilization Methods Used in the Healthcare Setting

4.4. Sterilization Used For Prevention of Prion Diseases

5. Asepsis, Antisepsis, and Antiseptics in the Healthcare Setting

5.1. Area of Scope

5.2. Definition of Terms

5.3. Preventive Antiseptic Use

5.3.1. Remanent Agents in Pre-Operative Antiseptic Procedures

5.3.2. Surgical Site Infections and Pre-Operative Procedures

5.3.2.1. Instrument Reprocessing

5.3.2.2. Hand Disinfection

5.3.2.3. Pre-Operative Hair Removal in the Surgical Area

5.3.2.4. Pre-Operative Washing

5.3.2.5. Pre-Operative Skin Antisepsis

5.3.3. Requirements on Antiseptics for Preventive Application

5.3.4. The Currently Most Widely Used Dermal and Mucosal Antiseptics

5.4. Commonly Used Antiseptic Agents

5.4.1. Alcohols: Ethanol, 1-Propanol, 2-Propanol

5.4.2. Remanent Agents

5.4.2.1. Chlorhexidine

5.4.2.2. Iodophors – PVP-Iodine

5.4.2.3. Octenidine

5.4.2.4.Polyhexanide

Conclusion

References

Disinfection in Recreational Areas

Abstract

Introduction

1. Historical Background

1.1. First Standards for Swimming Pool Water

1.2. Early Chlorine Concentrations

1.3. Early Microbiological Standards

1.4. Further Development of Standards

1.5. Modern Standards

2. Comparison of Drinking and Recreational Water

3. Transmission of Infectious Diseases

4. Pseudomonas Aeruginosa

5. Legionella Species

6. Factors Stimulating Growth of Microorganisms

7. Types of Disinfectants and Their Applications

7.1. Overview

7.2. Chlorine and Chlorine Compounds

7.3. Chemistry of Hypohalogenous Compounds

7.4. Chlorine Dioxide

7.5. Bromine and Bromine Releasing Compounds

7.6. Iodine

7.7. Isocyanuric Acid

7.8. Quaternary Ammonium Compounds

7.9. Ozone

7.10. Peroxides

7.11. Metals

7.12. Ultraviolet Radiation

7.13. Others - Algicides

8. Disinfection By-Products

8.1. Classification of Disinfection By-Products

8.2. Precursors for Disinfection By-Products

8.3. Reactions of the Disinfectants

8.4. Sources Containing Disinfection By-Products before Entering The pool

9. Public Health: Exposure to Disinfectants and Risks Associated with Disinfection By-Products

Conclusion

References

Disinfection of Drinking Water

Abstract

Introduction

1. Main Disinfectants and Disinfection Practices

1.1. Chlorine

1.2. Chlorine Dioxide

1.3. Ozone

1.4. Chloramine

1.5. Ultraviolet Light

1.6. Other Non-Chlorine Disinfectants

1.6.1. Bromine

1.6.2. Iodine

1.6.3. Silver and Cooper

1.6.4. Hydrogen Peroxide and Silver

1.6.5. Chlorinated Isocyanurate

2. Formation of Disinfection By-Produts

2.1. Chlorine

2.2. Ozone

2.3. Chlorine Dioxide

2.4. Chloramine

3. Strategies for Disinfectant By-Produt Control

3.1. Precursor Removal

3.1.1. Coagulation Process

3.1.2. Adsorption by Granular Active Carbon

3.1.3. Membrane Filtration

3.1.4. Powder Activated Carbon Adsorption

3.2. Alternative Disinfectants

3.3. DBPs Removal

4. Models for Predicting Disinfectant By-Product Formation

5. Analytical Methods

5.1. Analytical Methods for Disinfectants

5.2. Analytical Methods for Disinfectants By-Products

Conclusion

References

Environmental Impact of Disinfectants (Water, Air, Soil)

Abstract

Introduction

1. Environmental Impact Caused by Disinfectant Use

1.1. Environmental Components Potentially Damaged by Disinfectants

1.2. Environmental Impacts of Disinfection Technologies

1.3. Factors That Lead to Environmental Impact Risks

1.3.1. Persistence

1.3.2. Bioaccumulation

1.3.3. By-Products Formation

1.3.4. Toxicity

1.4. How Disinfectants Damage the Environment

1.4.1. Microbial Tolerance

1.4.2. Disrupting Environmental Organisms

2. Chemical Disinfection Residues in Water

3. Life Cycle Assessment: A Tool to Investigate the Environmental Impact

Conclusion

References

Case Study I: A Novel Disinfection Method for Water and Treated Wastewater by Using Pressurized Carbon Dioxide

Abstract

Introduction

1. Disinfection Mechanism by Pressurized Carbon Dioxide

1.1. Burning Cell Membrane by Explosive Decompression of Pressurized Bubbles

1.2. High Dissolved CO2 Diffused in Cytoplasmic Components

1.3. Lowered Intracellular pH Caused by CO2 Bubbles

2. Inactivation Effect of Pressurized Carbon Dioxide against Microorganisms

2.1. Inactivation Effect of Pressurized CO2 to E. coli Cells

2.2. Inactivation Effect of Pressurized CO2 to Bacteriophages

2.3. pH Effect Caused by Pressurized CO2 to Microbial Inactivation

2.4. Temperature Effect in Microbial Inactivation by Pressurized CO2

2.5. Effect of Environmental Water in Microbial Inactivation by Pressurized CO2

Conclusion

References

Case Study II: A Novel Disinfectant for Controlling Nosocomial and Foodborne Pathogens

Abstract

Introduction

1. Chemistry of Disinfectants

1.1. Halogen-Releasing Agents

1.1.1. Chlorine Releasing Compounds

1.1.2. Iodine and Iodine Releasing Compounds

1.2. Alcohols

1.3. Aldehydes

1.3.1. Glutaraldehyde

1.3.2. Formaldehyde

1.3.3. Formaldehyde Releasing Compounds

1.4. Anilides and Diamidines

1.5. Phenol Derivatives

1.5.1. Bisphenols

1.5.2. Halophenols

1.6. Heavy Metal Compounds

1.7. Peroxygens

1.8. Quaternary Ammonium Compounds

2. Current Regulations Governing the Use of Disinfectants in the United States and European Union

2.1. Regulatory Agencies in United States

2.2. Classification of Disinfectants

2.3. Approval Procedure for Disinfectants

2.4. European Union

3. The Next Generation of Disinfectants: Case Study on Octenidine Dihydrochloride

3.1. Mechanism of Action

3.2. Toxicity, Tolerability and Safety of the Compound

4. Applications of Octenidine Dihydrochloride in the Healthcare Industry

4.1. Disinfection of Hospital Environment and High-Risk Surfaces

4.1.1. Sporicidal Efficacy

4.1.2. Antibiofilm Efficacy

4.2. Improving Hand Hygiene in Healthcare Setting

4.3. Sanitization of Indwelling Devices and Insertion Sites

4.4. Treatment of Skin Infections, Wounds and Ulcers

4.5. Dental Disinfection and Antiplaque Activity

4.6. Applications in Food Industry

Conclusion

References

About the Editors

Assistant Professor

Faculty of Pharmacy of the University of Lisbon, Department of Toxicological and Bromatological Sciences

Present Position: Ph.D. Student at Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa

Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa

Present Position: Academic Consultant, TESES+ - Academic Support Consulting

Analytical chemist, SAPEC Agro S.A.

Index