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Effective drinking water disinfection
What
water contaminants may be left after treating water with a disinfectant
POST a QUESTION or COMMENT about the limitations of reliance only on disinfection to make drinking water potable or safe.
Limitations of disinfection's ability to produce safe, potable drinking water: this article describes the limitations of relying only on disinfection (chlorine or other disinfectants) to make drinking water safe and potable.
We explain that some biological or pathogenic drinking water contaminants are either resistant to standard disinfection approaches such as chlorination while other water contaminants such as hazardous chemicals or particulates are simply not addressed by disinfection.
Our page top photo shows potable water being delivered to a storage cistern in San Miguel de Allende, Guanajuato, Mexico.
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- Daniel Friedman, Publisher/Editor/Author - See WHO ARE WE?
Is Water Disinfection Sometimes Ineffective?
There is growing evidence that drinking water disinfection alone can be ineffective in adequately removing drinking water contaminants, both because of procedural errors (discussed here) and possibly because of persistant contaminant sources or contaminants that are partly-encapsulated inside water piping or containers, requiring extra contact time or additional cleaning and disinfection methods to assure a stable sanitary drinking water supply.
In August 2013 The New York Times reported that in the United States drinking water chlorination was first installed in a municipal water supply in Jersey City New Jersey and in Chicago in 1908, leading today to more than 53,000 water supply utilities in that country providing "some of the safest drinking water in the world".
But the article continued to point out that there is growing concern for the effectiveness of chlorination in adequately treating a variety of pathogens. - The New York Times, 27 August 2013
This is not a new water quality concern. Payment (1999) explain that residual chlorine present in drinking water distribution systems was not effective in reducing organisms other than E. coli. Here is an excerpt from the article abstract
Except for Escherichia coli, microorganisms remained relatively unaffected in water from the distribution systems tested. When sewage was added to the water samples, indigenous thermotolerant coliforms were inactivated only when water was obtained from sites very close to the treatment plant and containing a high residual chlorine concentration.
Clostridium perfringens was barely inactivated, suggesting that the most resistant pathogens such as Giardia lamblia, Cryptosporidium parvum, and human enteric viruses would not be inactivated.
Our results suggest that the maintenance of a free residual concentration in a distribution system does not provide a significant inactivation of pathogens, could even mask events of contamination of the distribution, and thus would provide only a false sense of safety with little active protection of public health.
More recently, Richardson (2003) noted that in addition to the pathogen resistance problem we've just noted, disinfection byproducts in drinking water are also hazardous. We discuss DBPs in more detail at
Lazarova (1999) pointed out that there was considerable variation in the effectiveness of chlorination as a water disinfectant depending on the beginning water quality:
Chlorination/dechlorination and advanced disinfection processes (UV irradiation, ozonation, membrane filtration) have been reviewed in terms of their efficiency, regrowth potential, design parameters, experimental set-up, scale-up and industrial experiences. Existing results show the great influence of water quality, in particular of suspended matter concentration and organic content.
... The critical analysis of the literature data and experimental results highlights UV irradiation as an effective and competitive advanced disinfection process. Ozonation is a viable solution in case of higher requirements for water quality including virus and protozoa removal.
Ultrafiltration is a highly efficient process producing an excellent quality and totally disinfected effluent, particularly recommended for groundwater recharge and potable wastewater reuse. The choice between these advanced disinfection technologies depends on wastewater quality, existing standards, specific reuse applications and wastewater treatment work capacity. - Lazarova (1999)
LeChevallier (1999) explain that the turbidity of water affects its successful disinfection using chlorination:
To define interrelationships between elevated turbidities and the efficiency of chlorination in drinking water, experiments were performed to measure bacterial survival, chlorine demand, and interference with microbiological determinations. Experiments were conducted on the surface water supplies for communities which practice chlorination as the only treatment.
Therefore, the conclusions of this study apply only to such systems.
Results indicated that disinfection efficiency (log10 of the decrease in coliform numbers) was negatively correlated with turbidity and was influenced by season, chlorine demand of the samples, and the initial coliform level.
Total organic carbon was found to be associated with turbidity and was shown to interfere with maintenance of a free chlorine residual by creating a chlorine demand. Interference with coliform detection in turbid waters could be demonstrated by the recovery of typical coliforms from apparently negative filters.
The incidence of coliform masking in the membrane filter technique was found to increase as the turbidity of the chlorinated samples increased. the magnitude of coliform masking in the membrane filter technique increased from less than 1 coliform per 100 ml in water samples of less than 5 nephelometric turbidity units to greater than 1 coliform per 100 ml in water samples of greater than 5 nephelometric turbidity units. Statistical models were developed to predict the impact of turbidity on drinking water quality. T
he results justify maximum contaminant levels for turbidity in water entering a distribution system as stated in the National Primary Drinking Water Regulations of the Safe Drinking Water Act. - LeChevallier (1999)
Examples of Water Disinfection Limitations
Watch out: as we report throughout this article series, different disinfection methods vary in their effectiveness in combating different types of water contaminants. If you rely on a single disinfection method, for example chlorine disinfection, your water supply could still be contaminated by cryptosporidium, or if chemical contaminants are present, those, too, might remain.
Municipal water supplies are generally safe as their water treatment efficacy is monitored regularly as required by federal regulations. But private water supplies may be at risk.
Consulting with your local health department and local water testing laboratories can provide locally-accurate advice on what water tests are most important to perform in order to understand what water treatment may be necessary for your home or building.
Drinking water disinfection does not remove chemical contaminants
If the drinking water has been tested only for bacteria and subsequently treated only with disinfection, there is a risk that other contaminants may still be present in the water. In our experience this is partiularly the case if a private water well has become contaminated by ground water leaking into the well.
Groundwater or surface-runoff easily pick up surface contaminants such as road salt, pesticides, weed killers or other chemicals used above ground anywhere where these substances may be transported to a leak into a well.
Disinfectants that don't kill cysts
The Times article continued to note that following earlier disease outbreaks principally due to protozoan cysts of the parasite Cryptosporidium, the U.S. EPA added additional regulations requiring additional treatment for municipalities like New York city who were using un-filtered surface-reservoir water supplies.
New York City was reported to have instituted use of ultra voilet light to treat Cryptosporidium cysts that are otherwise resistant to just chlorination disinfection methods.
Watch out: Bleach will not kill Giardia in typical drinking water disinfection methods such as those discussed here. While chlorine can kill Giardia cysts if used in high enough concentration and for sufficient contact time, typically the chlorine concentration in water necessary for Giardia would be too high for drinking purposes.
The chlorine concentration that one would find in a swimming pool, levels of chlorine not suitable for
drinking water consumption would require about 20 minutes to kill a Giardia cyst.
Cryptosporidium cysts might even survive a typical municipal chlorine disinfection process (such as at a municipal water treatment plant).
[Click to enlarge any image]
For this reason some municipalities where Cryptosporidium cysts are a concern add a water treatment step using chlorine dioxide. Others may use a combination of UV light and chlorine in the water treatment procedure. This treatment is also available to hikers, travelers, and for emergency water supply use.
Aquamira™ and Katadyn™ (Micropur) provide portable or field-use water treatment kits using chlorine dioxide.
Persistent Bacterial Sources in Water & Limitations of Chlorine Disinfection of Drinking Water
We have observed many instances of effective well shocking that resulted in a "passed" water test only to find that bacterial contamination has reappeared in the well water days or weeks after the well shock procedure. In these cases most often we suspet that there was a persistent bacterial source that was simply temporarily dealt-with by the disinfectant. Persistent bacterial water contamination sources might be
In the water aquifer itself, possibly contaminated by nearby failing septic systems
In ground water leaking into the well
In coatings formed on the inside surfaces of a well casing or water supply piping or in water handling equipment (water tanks, water heaters) in the building itself
Chlorine-resistant biological pathogens in the drinking water
Biofilm encapsulation of pathogens such as Pseudomonas aeruginosa (Xu, 1996)
The New York Times article cited above pointed out that testing for coliform bacteria, the most common water "potability test" does not include testing for even other microorganisms such as methylobacteria, sphingomonads, mycobacteria, and the Giardia or Cryptosporidium cysts reported above. Bacteria located within protozoan cysts can survive in that form for literally hundreds of years if not effectively treated.
Schoenen (2002) pointed out that despite the use of chlorine disinfection of drinking water, water-bourne disease outbreaks have continued around the world, particularly where there are fecal contaminants in drinking water!
Transmission of pathogens with drinking water is a widespread problem, which affects not only the countries with low hygienic standards but the industrialized countries as well. The pathogens are excreted by man or animals and are picked up orally. Chlorination of drinking water has been introduced to the water supply in the beginning of the 19th century in order to stop the spreading of pathogens especially typhoid fever by drinking water.
Despite the worldwide use of chlorine for disinfection of drinking water, water-mediated disease outbreaks occur again and again. Disinfection of drinking water with chlorine has undoubtedly contributed to the reduction of typhoid fever mortality. However, it must be clear that other factors play an important role in the mortality drop. Filtration of water is a long-known and very effective process for eliminating pathogens from the drinking water.
Pathogens in particles cannot be killed sufficiently by a chemical disinfectant. Even small fecal particles have to be eliminated reliably from the water by filtration. Disinfection of drinking water cannot replace filtration. The disinfection should be used to minimize the residual risk due to the presence of pathogens in the water but cannot be used for bringing fecally contaminated water into a hygienically sound condition. - Schoenen (2002)
Previously Xu (1996) pointed out that pathogens entrapped in biofilms can limit the rate (and thus effectiveness) of chlorine disinfection:
An artificial biofilm system consisting of Pseudomonas aeruginosa entrapped in alginate and agarose beads was used to demonstrate transport limitation of the rate of disinfection of entrapped bacteria by chlorine. Alginate gel beads with or without entrapped bacteria consumed chlorine. ... Chlorine fully penetrated cell-free agarose beads rapidly; the concentration of chlorine at the bead center reached 50% of the bulk concentration within approximately 10 min after immersion in chlorine solution.
When alginate and bacteria were incorporated into an agarose bead, pronounced chlorine concentration gradients persisted within the gel bead. Chlorine did gradually penetrate the bead, but at a greatly retarded rate; the time to reach 50% of the bulk concentration at the bead center was approximately 46 h. ...
Spatially nonuniform killing of bacteria within the beads was demonstrated by measuring the transient release of viable cells during dissolution of the beads. Bacteria were killed preferentially near the bead surface. Experimental results were consistent with transport limitation of the penetration of chlorine into the artificial biofilm arising from a reaction–diffusion interaction. The methods reported here provide tools for diagnosing the mechanism of biofilm resistance to reactive antimicrobial agents in such applications as the treatment of drinking and cooling waters. - Xu (1996)
Conversely, chlorine disinfection of drinking water may be more effective against some troublesome biological contaminants than previously thought: Shin (2000) discuss the resistance of a particular contaminant, norovirus, to chlorine disinfection of drinking water with a surprising result.
In an effort to validate previous research suggesting remarkable resistance of norovirus to free chlorine disinfection, we characterized the disinfection response of purified and dispersed Norwalk virus (NV) by bench-scale free chlorine disinfection using RT-PCR for virus assays. The inactivation of NV by two doses of free chlorine (1 and 5 mg/L) at pH 6 and 5 °C based on two RT-PCR assays was similar to that of coliphage MS2, but much faster than that of poliovirus 1.
Despite the underestimation of virus inactivation by RT-PCR assays, the predicted CT values for NV based on RT-PCR assays are lower than the ones for most other important waterborne viruses and the CT guidelines for chlorine disinfection of viruses under the Surface Water Treatment Rule by the United States Environmental Protection Agency.
Overall, the results of this study indicate that NV is not highly resistant to free chlorine disinfection as suggested by previous research and it is likely that NV contamination of drinking water can be controlled by adequate free chlorine disinfection practices with provision of proper pre-treatment processes before chlorination. - Shin (2000)
Water disinfectant effectiveness limited by water pH
We explain in this separate but important article that WELL DISINFECTANT pH ADJUSTMENT may also be necessary for effective water disinfection.
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In addition to any citations in the article above, a full list is available on request.
Arnold, Benjamin F., and John M. Colford Jr. "Treating water with chlorine at point-of-use to improve water quality and reduce child diarrhea in developing countries: a systematic review and meta-analysis." American journal of tropical medicine and hygiene 76, no. 2 (2007): 354-364.
Lazarova, V., Ph Savoye, M. L. Janex, E. R. Blatchley III, and M. Pommepuy. "Advanced wastewater disinfection technologies: state of the art and perspectives." Water Science and Technology 40, no. 4 (1999): 203-213.
LeChevallier, Mark W., T. M. Evans, and Ramon J. Seidler. "Effect of turbidity on chlorination efficiency and bacterial persistence in drinking water." Applied and environmental microbiology 42, no. 1 (1981): 159-167.
Payment, Pierre. "Poor efficacy of residual chlorine disinfectant in drinking water to inactivate waterborne pathogens in distribution systems." Canadian journal of Microbiology 45, no. 8 (1999): 709-715. Abstract: To evaluate the inactivating power of residual chlorine in a distribution system, test microorganisms (Escherichia coli, Clostridium perfringens, bacteriophage phi-X 170, and poliovirus type 1) were added to drinking water samples obtained from two water treatment plants and their distribution system. Except for Escherichia coli, microorganisms remained relatively unaffected in water from the distribution systems tested. When sewage was added to the water samples, indigenous thermotolerant coliforms were inactivated only when water was obtained from sites very close to the treatment plant and containing a high residual chlorine concentration. Clostridium perfringens was barely inactivated, suggesting that the most resistant pathogens such as Giardia lamblia, Cryptosporidium parvum, and human enteric viruses would not be inactivated. Our results suggest that the maintenance of a free residual concentration in a distribution system does not provide a significant inactivation of pathogens, could even mask events of contamination of the distribution, and thus would provide only a false sense of safety with little active protection of public health. Recent epidemiological studies that have suggested a significant waterborne level of endemic gastrointestinal illness could then be explained by undetected intrusions in the distribution system, intrusions resulting in the infection of a small number of individuals without eliciting an outbreak situation.Key words: drinking water, chlorine, disinfection, pathogens, distribution system.
Richardson, Susan D. "Disinfection by-products and other emerging contaminants in drinking water." TrAC Trends in Analytical Chemistry 22, no. 10 (2003): 666-684.
Schoenen, D. "Role of disinfection in suppressing the spread of pathogens with drinking water: possibilities and limitations." Water research 36, no. 15 (2002): 3874-3888.
Shin, Gwy-Am, and Mark D. Sobsey. "Inactivation of norovirus by chlorine disinfection of water." Water research 42, no. 17 (2008): 4562-4568.
Sobsey, Mark D., Sanitation Water, and World Health Organization. "Managing water in the home: accelerated health gains from improved water supply/prepared by Mark D. Sobsey." (2002).
Xu, Xiaoming, Philip S. Stewart, and Xiao Chen. "Transport limitation of chlorine disinfection of Pseudomonas aeruginosa entrapped in alginate beads." Biotechnology and bioengineering 49, no. 1 (1996): 93-100.
Peter Andrey Smith, "A Quest for Even Safer Drinking Water", The New York Times, 27 August 2013, p. D3
Mark Cramer Inspection Services Mark Cramer, Tampa Florida, Mr. Cramer is a past president of ASHI, the American Society of Home Inspectors and is a Florida home inspector and home inspection educator. (727) 595-4211 mark@BestTampaInspector.com 11/06
Hankey and Brown home inspectors, Eden Prairie, MN, technical review by Roger Hankey, prior chairman, Standards Committee, American Society of Home Inspectors - ASHI. 952 829-0044 - hankeyandbrown.com 11/06
Dr. Omar Amin, of the Tempe AZ
Parasitology Center, corresponded with one of our readers asking about peroxide: "You can use hydrogen peroxide if you want to
but we do not have a track record of percentage dilution".
Dr. Amin has done research for the US military and for the CDC.
Potable Aqua® emergency drinking water germicidal tablets are produced by the Wisconsin Pharmacal Co., Jackson WI 53037. 800-558-6614 pharmacalway.com
Aquamira™ chlorine dioxide water purification kits - see www.aquamira.com/
"Aquamira Water Treatment Drops were introduced to the Outdoor market in 1999 and have been a favorite of top outdoor guides and instructors ever since. Whether you are camping, traveling in a foreign country or faced with a disaster, our goal is to provide you with safe, pure and good tasting drinking water. Our complete line of water treatment products include leading edge purification and filtration technologies developed and tested in the lab and proven in the field. We offer systems and products that will provide water for a single individual or a village and almost anything in between."
Katadyn™, a Swiss corporation provides water filters, desalinization equipment, and their Micropur chlorine dioxide water purification - see www.katadyn.com/usen/
"Katadyn offers a wide variety of water filtration and purification products suitable for any need. This allows outdoor enthusiasts and travelers to take along products for making their own drinking water when preparing their trips."
Wilderness Medical Society has advice about boiling water for consumption
Princeton University - www.princeton.edu
"Bacteria in Drinking Water" - "Chlorine," Karen Mancl, water quality specialist, Agricultural Engineering, Ohio State University Extension. Mancl explains factors affecting the effectiveness of chlorine in water as a means to destroy bacteria and other microorganisms. OSU reports as follows:
Chlorine kills bacteria, including disease-causing organisms and the nuisance organism, iron bacteria. However, low levels of chlorine, normally used to disinfect water, are not an effective treatment for giardia cysts. A chlorine level of over 10 mg/1 must be maintained for at least 30 minutes to kill giardia cysts. -- http://ohioline.osu.edu/b795/index.html is the front page of this bulletin.
Crystal Clear Supply provides portable ceramic water filter purifiers and portable reverse osmosis water treatment equipment - see http://www.crystalclearsupply.com/category_s/7.htm
"Do Iodine Water Purification Tablets Provide an Effective Barrier against Cryptosporidium parvum?", Starke, Jeffrey A., Bowman, Dwight D., Labare, Michael, Fogarty, Elizabeth A., and others, Military Medicine, 25 October 2001 [possibly a later version of this article appeared in 2005 -DF] http://www.amsus.org/military medicine/milmed.htm
"Drinking Water Safety in Emergencies", University of Minnesota extension, extension.umn.edu/info-u/nutrition/BJ646.html
FDA Warning about drinking hydrogen peroxide: www.truthorfiction.com/rumors/h/hydrogen-peroxide.htm This article cites a 2003 entry in Journal
of Food and Science on using Hy.Perox to sterilize vegetables, referring to E.coli - NOT to Giardia.
www.epa.gov/ogwdw/mdbp/pdf/alter/chapt_2.pdf provides an article on use of disinfectants for water treatment
This patent application for UV light sterilization www.patentstorm.us/patents/6565803.html Lists good references on water
purification for Giardia et als
Giardia exposure limits for drinking water: see www.mass.gov/dep/water/drinking/standards/giardia.htm is the current regulatory exposure limit (your minimum target for
sterilization)
U.S. Army Field Manual 21-10, Field Hygiene and Sanitation, 1988, web search 07/02/2010, original source: http://www.enlisted.info/field-manuals/fm-21-10-field-hygiene-and-sanitation.shtml The purpose of this manual is to assist individual soldiers, unit commanders, leaders and field sanitation teams in preventing disease and environmental injuries. The manual provides information on preventive medicine measures (PMM) to the individual soldier as well as essential information for the unit commander, unit leaders, and the unit field sanitation team on applying unit level PMM.
Wikipedia on history of use of hydrogen peroxide: Information on Hydrogen peroxide as a sterilant is in Wikipedia at en.wikipedia.org/wiki/Sterilization_(microbiology) HO2 has been
used for a long time, including by vaporization for sterilizing freeze dryers.
Potable Aqua® emergency drinking water germicidal tablets are produced by the Wisconsin Pharmacal Co., Jackson WI 53037. 800-558-6614 pharmacalway.com
Principles and Practice of Disinfection, Preservation and Sterilization (Hardcover)
by A. D. Russell (Editor), W. B. Hugo (Editor), G. A. J. Ayliffe (Editor), Blackwell Science, 2004. ISBN-10: 1405101997, ISBN-13: 978-1405101998.
"This superb book is the best of its kind available and one that will undoubtedly be useful, if not essential, to workers in a variety of industries. Thirty-one distinguished specialists deal comprehensively with the subject matter indicated by the title ... The book is produced with care, is very readable with useful selected references at the end of each chapter and an excellent index. It is an essential source book for everyone interested in this field. For pharmacy undergraduates, it will complement the excellent text on pharmaceutical microbiology by two of the present editors."
The Pharmaceutical Journal: "This is an excellent book. It deals comprehensively and authoritatively with its subject with contributions from 31 distinguished specialists. There is a great deal to interest all those involved in hospital infection ... This book is exceptionally well laid out. There are well chosen references for each chapter and an excellent index. It is highly recommended." The Journal of Hospital Infection.: "The editors and authors must be congratulated for this excellent treatise on nonantibiotic antimicrobial measures in hospitals and industry ... The publication is highly recommended to hospital and research personnel, especially to clinical microbiologists, infection-control and environmental-safety specialists, pharmacists, and dieticians."
New England Journal of Medicine: City Hospital, Birmingham, UK. Covers the many methods of the elimination or prevention of microbial growth. Provides an historical overview, descriptions of the types of antimicrobial agents, factors affecting efficacy, evaluation methods, and types of resistance. Features sterilization methods, and more. Previous edition: c1999. DNLM: Sterilization--methods.
Handbook of Disinfectants and Antiseptics, Joseph M. Ascenzi (Editor), CRC, 1995, ISBN-10: 0824795245 ISBN-13: 978-0824795245 "The evaluation of chemical germicides predates the golden age of microbiology..." -
This well-focused, up-to-date reference details the current medical uses of antiseptics and disinfectants -- particularly in the control of hospital-acquired infections -- presenting methods for evaluating products to obtain regulatory approval and examining chemical, physical, and microbiological properties as well as the toxicology of the most widely used commercial chemicals.
When Technology Fails, Matthew Stein, Chelsea Green Publisher, 2008,493 pages. ISBN-10: 1933392452 ISBN-13: 978-1933392455, "... how to find and sterilize water in the face of utility failure, as well as practical information for dealing with water-quality issues even when the public tap water is still flowing". Mr. Stein's website is www.whentechfails.com/
"Bacteria in Drinking Water" - "Chlorine," Karen Mancl, water quality specialist, Agricultural Engineering, Ohio State University Extension. Mancl explains factors affecting the effectiveness of chlorine in water as a means to destroy bacteria and other microorganisms. OSU reports as follows:
Chlorine kills bacteria, including disease-causing organisms and the nuisance organism, iron bacteria. However, low levels of chlorine, normally used to disinfect water, are not an effective treatment for giardia cysts. A chlorine level of over 10 mg/1 must be maintained for at least 30 minutes to kill giardia cysts. -- http://ohioline.osu.edu/b795/index.html is the front page of this bulletin.
CHLORINE IN DRINKING WATER - Does Chlorine in Drinking Water Harm the Septic Tank? - Septic Tank Cleaning Advice
Ohio State University article on the concentration of chlorine necessary to act as an effective disinfectant, and the effects of the water's pH and temperature: See http://ohioline.osu.edu/b795/b795_7.html for details.
WELL CHLORINATION & SHOCKING - Procedure for Shocking a Well to (temporarily or maybe longer) "Correct" Bacterial Contamination
Crystal Clear Supply provides portable ceramic water filter purifiers and portable reverse osmosis water treatment equipment - see http://www.crystalclearsupply.com/category_s/7.htm
Handbook of Disinfectants and Antiseptics, Joseph M. Ascenzi (Editor), CRC, 1995, ISBN-10: 0824795245 ISBN-13: 978-0824795245 "The evaluation of chemical germicides predates the golden age of microbiology..." -
This well-focused, up-to-date reference details the current medical uses of antiseptics and disinfectants -- particularly in the control of hospital-acquired infections -- presenting methods for evaluating products to obtain regulatory approval and examining chemical, physical, and microbiological properties as well as the toxicology of the most widely used commercial chemicals.
Potable Aqua® emergency drinking water germicidal tablets are produced by the Wisconsin Pharmacal Co., Jackson WI 53037. 800-558-6614 pharmacalway.com
Principles and Practice of Disinfection, Preservation and Sterilization (Hardcover)
by A. D. Russell (Editor), W. B. Hugo (Editor), G. A. J. Ayliffe (Editor), Blackwell Science, 2004. ISBN-10: 1405101997, ISBN-13: 978-1405101998.
"This superb book is the best of its kind available and one that will undoubtedly be useful, if not essential, to workers in a variety of industries. Thirty-one distinguished specialists deal comprehensively with the subject matter indicated by the title ... The book is produced with care, is very readable with useful selected references at the end of each chapter and an excellent index. It is an essential source book for everyone interested in this field. For pharmacy undergraduates, it will complement the excellent text on pharmaceutical microbiology by two of the present editors."
The Pharmaceutical Journal: "This is an excellent book. It deals comprehensively and authoritatively with its subject with contributions from 31 distinguished specialists. There is a great deal to interest all those involved in hospital infection ... This book is exceptionally well laid out. There are well chosen references for each chapter and an excellent index. It is highly recommended." The Journal of Hospital Infection.: "The editors and authors must be congratulated for this excellent treatise on nonantibiotic antimicrobial measures in hospitals and industry ... The publication is highly recommended to hospital and research personnel, especially to clinical microbiologists, infection-control and environmental-safety specialists, pharmacists, and dieticians."
New England Journal of Medicine: City Hospital, Birmingham, UK. Covers the many methods of the elimination or prevention of microbial growth. Provides an historical overview, descriptions of the types of antimicrobial agents, factors affecting efficacy, evaluation methods, and types of resistance. Features sterilization methods, and more. Previous edition: c1999. DNLM: Sterilization--methods.
U.S. Army Field Manual 21-10, Field Hygiene and Sanitation, 1988, web search 07/02/2010, original source: http://www.enlisted.info/field-manuals/fm-21-10-field-hygiene-and-sanitation.shtml The purpose of this manual is to assist individual soldiers, unit commanders, leaders and field sanitation teams in preventing disease and environmental injuries. The manual provides information on preventive medicine measures (PMM) to the individual soldier as well as essential information for the unit commander, unit leaders, and the unit field sanitation team on applying unit level PMM.
When Technology Fails, Matthew Stein, Chelsea Green Publisher, 2008,493 pages. ISBN-10: 1933392452 ISBN-13: 978-1933392455, "... how to find and sterilize water in the face of utility failure, as well as practical information for dealing with water-quality issues even when the public tap water is still flowing". Mr. Stein's website is www.whentechfails.com/
Our recommended books about building & mechanical systems design, inspection, problem diagnosis, and repair, and about indoor environment and IAQ testing, diagnosis, and cleanup are at the InspectAPedia Bookstore. Also see our Book Reviews - InspectAPedia.
In addition to citations & references found in this article, see the research citations given at the end of the related articles found at our suggested
Carson, Dunlop & Associates Ltd., 120 Carlton Street Suite 407, Toronto ON M5A 4K2. Tel: (416) 964-9415 1-800-268-7070 Email: info@carsondunlop.com. Alan Carson is a past president of ASHI, the American Society of Home Inspectors.
Carson Dunlop Associates provides extensive home inspection education and report writing material. In gratitude we provide links to tsome Carson Dunlop Associates products and services.