Disinfection efficiency of hospital infectious disease wards with chlorine dioxide and hypochlorous acid.

The disinfection efficiencies of two chemical disinfectants, chlorine dioxide and weak acid hypochlorous water (WAHW), were examined in the soiled room and dishwashing room of a hospital infectious disease ward in Taiwan. The investigations were conducted in two seasons, namely winter and summer, in order to examine the correlation between the bioaerosol concentration and the environmental factors. In addition, a single-daily disinfection mode (SM) and a twice-daily disinfection mode (TM) were applied in this study. The results showed that the bacteria and fungi colony counts were strongly correlated with the temperature. Both disinfectants reduced the bacteria and fungi concentrations in the considered rooms. However, of the two disinfectants, the ClO2 showed a stronger disinfection effect than the WAHW. It means that when using ClO2 as the disinfectant, the disinfection efficiency of the TM treatment mode is significantly better than that of the SM treatment mode. But, when using WAHW as the disinfectant, no significant difference is found between the disinfection efficiencies of the two methods. Overall, the results showed that the application of ClO2 twice daily provided the most effective means of satisfying the Taiwan EPA guidelines for the indoor air quality of hospital medical wards.

Improvement of indoor air quality in pet shop using gaseous chlorine dioxide.

Many studies have shown that pet shops have a high concentration of bioaerosols. Thus, effective disinfection protocols are essential to protect the pet shop staff and visitors to the store. The present study examines the effectiveness of gaseous chlorine dioxide (ClO2) fogging in minimizing the residual bacteria and fungi levels in a typical pet shop in Taiwan consisting of a commodity area, a lodging area, and a grooming area. This investigation uses three disinfection modes (DMs) according to different disinfection periods, namely once every hour (1DM), once every 2 h (2DM), and once every 3 h (3DM). The bacteria and fungi concentrations are measured before and after disinfection treatment, and the effectiveness of each disinfection mode is evaluated using standard statistical techniques. To assess the effect of the environmental factors on the disinfection efficiency, measurements are taken of temperature, relative humidity, airflow velocity, the carbon dioxide concentration, the PM1, PM2.5, PM7, PM10, and TSP level at each sampling locations. The results reveal that the effectiveness of the three disinfection modes depends on both the environmental parameters and the use of the three areas (e.g., commodity, lodging, or grooming). Hence, the choice of disinfection method should be adjusted accordingly. For all three disinfection modes, a faster air velocity is beneficial in spreading the disinfectant throughout the indoor space and improving the disinfection performance. Overall, the results presented in this study confirm that gaseous chlorine dioxide disinfection improves the air quality in the pet shop interior, and thus beneficial in safeguarding the health of the pet shop staff and visitors.

Prevalence, mechanisms and genetic relatedness of the human pathogenic fungus Aspergillus fumigatus exhibiting resistance to medical azoles in the environment of Taiwan.

Emerging azole resistance in Aspergillus fumigatus poses a serious threat to human health. This nationwide surveillance study investigated the prevalence and molecular characteristics of azole-resistant A. fumigatus environmental isolates in Taiwan, an island country with increasing use of azole fungicides. Of the 2760 air and soil samples screened from 2014 to 2016, 451 A. fumigatus isolates were recovered from 266 samples and 34 isolates from 29 samples displayed resistance to medical azoles (itraconazole, voriconazole or posaconazole). The resistance prevalence was 10.9% and 7.5% in A. fumigatus-positive samples and isolates respectively. Most (29, 85.3%) azole-resistant isolates harboured TR34 /L98H mutations, which were widely distributed, clustered genetically with clinical isolates, and had growth rates that were similar to those of the wild-type isolates. Microsatellite genotyping revealed both the global spread of the TR34 /L98H isolates and the occurrence of TR34 /L98H/S297T/F495I isolates belonging to local microsatellite genotypes. AfuMDR3 and atrF, two efflux transporter genes, were constitutively upregulated in two individual resistant isolates without cyp51A mutations, highlighting their potential roles in azole resistance. These results emphasize the need for periodic environmental surveillance at the molecular level in regions in which azole fungicides are applied, and agricultural fungicide management strategies that generate less selective pressure should be investigated.

Disinfection of herbal spa pool using combined chlorine dioxide and sodium hypochlorite treatment.

The presence of pathogenic microorganisms in public spa pools poses a serious threat to human health. The problem is particularly acute in herbal spas, in which the herbs and microorganisms may interact and produce undesirable consequences. Accordingly, the present study investigated the effectiveness of a combined disinfectant containing chlorine dioxide and sodium hypochlorite in improving the water quality of a public herbal spa in Taiwan. Water samples were collected from the spa pool and laboratory tests were then performed to measure the variation over time of the microorganism content (total CFU and total coliforms) and residual disinfectant content given a single disinfection mode (SDM) with disinfectant concentrations of 5.2 × 10, 6.29 × 10, 7.4 × 10, and 11.4 × 10(-5) N, respectively. Utilizing the experience gained from the laboratory tests, a further series of on-site investigations was performed using three different disinfection modes, namely SDM, 3DM (once every 3 h disinfection mode), and 2DM (once every 2 h disinfection mode). The laboratory results showed that for all four disinfectant concentrations, the CFU concentration reduced for the first 6 h following SDM treatment, but then increased. Moreover, the ANOVA results showed that the sample treated with the highest disinfectant concentration (11.4 × 10(-5) N) exhibited the lowest rate of increase in the CFU concentration. In addition, the on-site test results showed that 3DM and 2DM treatments with disinfectant concentrations in excess of 9.3 × 10 and 5.5 × 10(-5) N, respectively, provided an effective reduction in the total CFU concentration. In conclusion, the experimental results presented in this study provide a useful source of reference for spa businesses seeking to improve the water quality of their spa pools.

Disinfection of indoor air microorganisms in stack room of university library using gaseous chlorine dioxide.

As with all indoor public spaces in Taiwan, the stack rooms in public libraries should meet the air quality guidelines laid down by the Taiwan Environmental Protection Administration. Accordingly, utilizing a university library in Taiwan for experimental purposes, this study investigates the efficiency of gaseous chlorine dioxide (ClO2) as a disinfection agent when applied using three different treatment modes, namely a single-daily disinfection mode (SIM), a twice-daily disinfection mode (TWM), and a triple-daily disinfection mode (TRM). For each treatment mode, the ClO2 is applied using an ultrasonic aerosol device and is performed both under natural lighting conditions and under artificial lighting conditions. The indoor air quality is evaluated before and after each treatment session by measuring the bioaerosol levels of bacteria and fungi. The results show that for all three disinfection modes, the application of ClO2 reduces the indoor bacteria and fungi concentrations to levels lower than those specified by the Taiwan EPA (i.e., bacteria <1500 CFU/m(3), fungi <1000 CFU/m(3)), irrespective of the lighting conditions under which the disinfection process is performed. For each disinfection mode, a better disinfection efficiency is obtained under natural lighting conditions since ClO2 readily decomposes under strong luminance levels. Among the three treatment modes, the disinfection efficiencies of the TWM and TRM modes are very similar under natural lighting conditions and are significantly better than that of the SIM mode. Thus, overall, the results suggest that the TWM treatment protocol represents the most cost-effective and efficient method for meeting the indoor air quality requirements of the Taiwan EPA.

Evaluation and improvement of air quality in school public elevator.

Public elevators are an essential requirement in modern high-rise buildings. However, the confined, crowded interior of an elevator provides an ideal breeding ground for all manners of biological aerosols. Consequently, when using an elevator at a university in Taiwan as the research target, this study performs an experimental investigation into the effectiveness of hand-sprayed gaseous chlorine dioxide as a disinfection agent. The air quality before and after disinfection is evaluated by measuring the bioaerosol concentrations of bacteria and fungi, respectively. The average background levels of bacteria and fungi before disinfection are found to be 635.7 ± 469.6 and 1296.8 ± 966.6 colony-forming unit (CFU)/m(3), respectively. Following disinfection, the bacteria and fungi concentrations reduced by an average of 35 and 25 %, respectively. The multivariate analysis of variance (MANOVA) results showed that the residual bacteria and fungi concentration levels were determined primarily by the number of individuals within the elevator and the elapsed time following disinfection. In general, the present results show that given a maximum of five individuals within the elevator, a disinfection schedule of once every 40 min is sufficient to reduce the bioaerosol concentrations of bacteria and fungi to the levels specified by the Taiwan Environmental Protection Agency (EPA).

Disinfection efficiency of chlorine dioxide gas in student cafeterias in Taiwan.

UNLABELLED: In Taiwan, the food and drink requirements of students and faculty members are met by student cafeterias. The air quality within these cafeterias should satisfy the guidelines laid down by the Taiwan Environmental Protection Agency (Taiwan EPA). Accordingly, this study performed an experimental investigation into the efficiency of two different gaseous chlorine dioxide (ClO2) treatments in disinfecting a local student cafeteria, namely a single, one-off application and a twice-daily application. In both cases, the ClO2 was applied using strategically placed aerosol devices. The air quality before and after disinfection was evaluated by measuring the bioaerosol levels of bacteria and fungi. Moreover, a stepwise discriminant analysis method was applied for predicting the residual concentrations of bacteria and fungi, as a function of the environmental parameters and the ClO2 concentration. The experimental results showed that the average background levels of bacteria and fungi prior to ClO2 disinfection were 972.5 +/- 623.6 and 1534.1 +/- 631.8 colony-forming units (CFU)/m3, respectively. A single ClO2 application was found to reduce the bacterial and fungal concentration levels by as much as 65% and 30%, respectively. By contrast, a twice-daily ClO2 application was found to reduce the bacterial and fungal concentration levels by as much as 74% and 38%, respectively. The statistical analysis results showed that the residual bacterial concentration level was determined primarily by the number of individuals present in the cafeteria, the temperature, and the ClO2 concentration, whereas the residual fungal concentration level was determined mainly by the temperature, the total number of suspended particles, and the ClO2 concentration. Thus, the integrated results suggest that the air quality guidelines prescribed by the Taiwan EPA for student cafeteria can best be achieved by applying ClO2 twice daily using an appropriate deployment of aerosol devices. IMPLICATIONS: ClO2 gas can destroy all manner of microorganisms, including bacteria, spores, fungi, viruses, and even protozoans, in indoor environments. Moreover, it is popularly known that bioaerosols are able to grow and propagate on a wide variety of building materials and indoor surfaces. Thus, through optimal ClO2 disinfection methodology, the indoor microbial contaminants can be decreased and the residual concentrations of bacteria and fungi as a function of the environmental parameters and the ClO2 concentration can be predicted via some statistical techniques.

Application of chlorine dioxide for disinfection of student health centers.

In Taiwan, the immediate health care requirements of students and faculty members are satisfied by on-campus medical service centers. The air quality within these centers should comply with the guidelines laid down by the Taiwan Environmental Protection Agency (EPA). Accordingly, this study performed an experimental investigation into the efficiency of various chlorine dioxide applications in disinfecting a local student health center (SHC). The air quality before and after disinfection were evaluated in terms of the bioaerosol levels of bacteria and fungi. The average background levels of bacteria and fungi before disinfection were found to be 1,142 ± 455.4 CFU/m(3) and 520 ± 442.4 CFU/m(3), respectively. Chlorine dioxide (0.3 mg/m(3)) was applied using three different methods, namely a single, one-off application, multiple applications within a single day, and regular (daily) applications. Among the three disinfection methods, the regular application method was found to yield a high disinfection efficiency for both bacteria and fungi, i.e., 6.5 ± 0.7% and 4.2 ± 0.3%, respectively. The average residual bacteria and fungi levels after regular daily interval disinfection were 318.8 ± 51.5 CFU/m(3) and 254.0 ± 43.8 CFU/m(3), respectively. Therefore, the results suggest that the air quality guidelines prescribed by the Taiwan EPA for SHCs and other healthcare facilities can best be achieved by applying chlorine dioxide at regular (daily) intervals.

Improvement of the air quality in student health centers with chlorine dioxide.

This study aims to monitor bioaerosol levels of a local campus of a student health center in Taiwan and then to perform disinfection by applying chlorine dioxide. First, air samples were taken and evaluated in the six areas of the center. The average background bioaerosol levels were 714 +/- 1706 CFU/m(3) for bacterium and 802 +/- 633 CFU/m(3) for fungi. Then, chlorine dioxide was applied through three different procedures: single, multiple and regular disinfections. The results indicated that both multiple and regular disinfections can achieve efficiency levels higher than 59.0%. The regression analysis on bioaerosol levels showed that the number of people present correlating to the number of persons entering the room per door-opening, had a correlation of p < 0.05. Utilizing this analysis result, an empirical model was developed to predict indoor bioaerosol concentrations. It can be inferred that for indoor human activity of health centers, regular disinfection is a very effective process.

The effect of metal ions on humic acid removal and permeation properties in an ultrafiltration system.

With a view to improving the removal of humic acid from aqueous solution, the effect of metal ion addition on the separation of humic acid from water in an utrafiltration (UF) system was investigated. The valence of the metal ion and the molar ratio of humic acid to metal ion strongly affected the permeation flux during ultrafiltration. It was found that the ionic strength, dissociation constant and operating pressure were not major factors affecting the separation performance of the ultrafiltration process. As well as indicating that a suitable ratio of humic acid to metal ion and valence of metal ion were the key factors in improving separation efficiency. The results also showed that separation of humic acid depended on the level of formation of humic acid-metal ion complexes, and on the degree of fouling on the membrane surface.