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Safety and Effectiveness of Monochloramine Treatment for Disinfecting Hospital Water Networks

Author

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  • Isabella Marchesi

    (Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy)

  • Stefania Paduano

    (Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy)

  • Giuseppina Frezza

    (Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy)

  • Luca Sircana

    (University Hospital Policlinico of Modena, Largo del Pozzo 71, 41124 Modena, Italy)

  • Elena Vecchi

    (University Hospital Policlinico of Modena, Largo del Pozzo 71, 41124 Modena, Italy)

  • Pietro Zuccarello

    (Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy)

  • Gea Oliveri Conti

    (Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy)

  • Margherita Ferrante

    (Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy)

  • Paola Borella

    (Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy)

  • Annalisa Bargellini

    (Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy)

Abstract

The formation of potentially carcinogenic N-nitrosamines, associated with monochloramine, requires further research due to the growing interest in using this biocide for the secondary disinfection of water in public and private buildings. The aim of our study was to evaluate the possible formation of N-nitrosamines and other toxic disinfection by-products (DBPs) in hospital hot water networks treated with monochloramine. The effectiveness of this biocide in controlling Legionella spp. contamination was also verified. For this purpose, four different monochloramine-treated networks, in terms of the duration of treatment and method of biocide injection, were investigated. Untreated hot water, municipal cold water and, limited to N-nitrosamines analysis, hot water treated with chlorine dioxide were analyzed for comparison. Legionella spp. contamination was successfully controlled without any formation of N-nitrosamines. No nitrification or formation of the regulated DBPs, such as chlorites and trihalomethanes, occurred in monochloramine-treated water networks. However, a stable formulation of hypochlorite, its frequent replacement with a fresh product, and the routine monitoring of free ammonia are recommended to ensure a proper disinfection. Our study confirms that monochloramine may be proposed as an effective and safe strategy for the continuous disinfection of building plumbing systems, preventing vulnerable individuals from being exposed to legionellae and dangerous DBPs.

Suggested Citation

  • Isabella Marchesi & Stefania Paduano & Giuseppina Frezza & Luca Sircana & Elena Vecchi & Pietro Zuccarello & Gea Oliveri Conti & Margherita Ferrante & Paola Borella & Annalisa Bargellini, 2020. "Safety and Effectiveness of Monochloramine Treatment for Disinfecting Hospital Water Networks," IJERPH, MDPI, vol. 17(17), pages 1-11, August.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:17:p:6116-:d:402662
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    References listed on IDEAS

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    1. Stefania Paduano & Isabella Marchesi & Maria Elisabetta Casali & Federica Valeriani & Giuseppina Frezza & Elena Vecchi & Luca Sircana & Vincenzo Romano Spica & Paola Borella & Annalisa Bargellini, 2020. "Characterisation of Microbial Community Associated with Different Disinfection Treatments in Hospital hot Water Networks," IJERPH, MDPI, vol. 17(6), pages 1-17, March.
    2. Maria Anna Coniglio & Margherita Ferrante & Mohamed H. Yassin, 2018. "Preventing Healthcare-Associated Legionellosis: Results after 3 Years of Continuous Disinfection of Hot Water with Monochloramine and an Effective Water Safety Plan," IJERPH, MDPI, vol. 15(8), pages 1-11, July.
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    Cited by:

    1. Maria Cristina Collivignarelli & Alessandro Abbà & Marco Carnevale Miino & Francesca Maria Caccamo & Vincenzo Torretta & Elena Cristina Rada & Sabrina Sorlini, 2020. "Disinfection of Wastewater by UV-Based Treatment for Reuse in a Circular Economy Perspective. Where Are We at?," IJERPH, MDPI, vol. 18(1), pages 1-24, December.

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