Toxicity and genotoxicity of hospital laundry wastewaters treated with photocatalytic ozonation

Acute inhibition of hospital and medical laboratory wastewater on activated sludge

Sustainable operation is an essential challenge in many municipal wastewater treatment plants. Among many types of wastewater mixed in a sewer, healthcare wastewaters need special attention due to their hazardous substance content, which can be toxic to activated sludge. This study compared the acute inhibitory effects of healthcare wastewaters (HW) and medical laboratory wastewater (MLW) on conventional activated sludge (CAS) and membrane bioreactor (MBR). The sensitivity test showed that nitrifying bacteria (NBs) in MBR sludge have higher resistance to acute toxicity than the CAS. Compared with HW, MLW caused much higher inhibition on both sludges. When the ratio of HW in the tested domestic wastewater was 10%, inhibition of NBs was 39% in AS, while it was 31% in MBR. When the ratio of MLW in the tested domestic wastewater was only 10%, 72% of NBs in AS and 57% of NBs in MBR were already inhibited. The higher resistance of NB in MBR may be explained by the diversity of microorganisms in the MBR operated at high sludge ages. The findings of this study may be used to estimate the acute inhibition effect of HW and MLW discharged directly to the sewage at higher loads.

Performance of a solar photocatalysis reactor as pretreatment for wastewater via UV, UV/TiO2, and UV/H2O2 to control membrane fouling

The performance of a solar photocatalysis reactor as pretreatment for the removal of total organic carbon (TOC) and turbidity from municipal wastewater was achieved by implementing an integrated system as tertiary treatment. The process consisted of ultraviolet (UV) sunlight, UV sunlight/H₂O₂, and UV sunlight/TiO₂ nanocatalysts as pretreatment steps to prevent ultrafiltration (UF) membrane fouling. The characterization of TiO₂ was conducted with X-ray diffraction spectroscopy, Fourier-transform infrared spectroscopy, scanning electron microscopy , and Brunauer–Emmett–Teller surface area analysis. This study investigated the effect of time and solar radiation using UV, UV/H₂O₂, and UV/TiO₂ to remove TOC and turbidity. The transmembrane pressure improvement was studied using a UF membrane system to pretreat wastewater with different UV doses of sunlight for 5 h and UV/H₂O₂ and UV/TiO₂. The results showed that the highest removal efficiency of the turbidity and TOC reached 95% and 31%, respectively. The highest removal efficiency of the turbidity reached 40, 75, and 95% using UV, UV/H₂O₂, and UV/TiO₂, respectively, while the optimal removal efficiency of TOC reached 20%, 30%, and 50%, respectively.

Visible-light-driven 3D Bi5O7I/BiOCl microsphere with enhanced photocatalytic capability: Performance, degradation pathway, antibacterium and mechanism

It is well known that both of the separation efficiency of photogenerated carriers and the response capability to visible light remarkably affect the photocatalytic performance. In the present work, a 3D microsphere of Bi₅O₇I/BiOCl heterojunction catalyst was synthetised. The synergy of Bi₅O₇I and BiOCl not only significantly enhances the transfer rate and separation efficiency of carriers, but also heightens light absorption capacity. As-prepared Bi₅O₇I/BiOCl (40 wt% BiOCl) has a higher degradation efficiency on doxycycline hydrochloride (DC) (90 min, 83.0%) and super high inhibition rate (90 min, 99.92%) on Escherichia coli under visible light, compared to the two monomers. Pollutants DC is finally decomposed into CO₂, H₂O and small molecule intermediates by generated h⁺, •OH and •O₂^-. The effects of reactive radicals follow the order of •OH radicals > h⁺ radicals ≫ •O₂^- and e^- radicals. The possible structures of intermediates and four possible degradation pathways involved were also discussed. In addition, As-synthetised Bi₅O₇I/BiOCl has preferable reusability and excellent chemical stability. Biological toxicity experiments also verify that Bi₅O₇I/BiOCl is a green and environmentally friendly composite material. This strategy provides a green, low-toxic way for the application of traditional type II heterojunction in the fields of environmental remediation and photocatalysis.

An assessment of hospital wastewater and biomedical waste generation, existing legislations, risk assessment, treatment processes, and scenario during COVID-19

Hospitals release significant quantities of wastewater (HWW) and biomedical waste (BMW), which hosts a wide range of contaminants that can adversely affect the environment if left untreated. The COVID-19 outbreak has further increased hospital waste generation over the past two years. In this context, a thorough literature study was carried out to reveal the negative implications of untreated hospital waste and delineate the proper ways to handle them. Conventional treatment methods can remove only 50%-70% of the emerging contaminants (ECs) present in the HWW. Still, many countries have not implemented suitable treatment methods to treat the HWW in-situ. This review presents an overview of worldwide HWW generation, regulations, and guidelines on HWW management and highlights the various treatment techniques for efficiently removing ECs from HWW. When combined with advanced oxidation processes, biological or physical treatment processes could remove around 90% of ECs. Analgesics were found to be more easily removed than antibiotics, β-blockers, and X-ray contrast media. The different environmental implications of BMW have also been highlighted. Mishandling of BMW can spread infections, deadly diseases, and hazardous waste into the environment. Hence, the different steps associated with collection to final disposal of BMW have been delineated to minimize the associated health risks. The paper circumscribes the multiple aspects of efficient hospital waste management and may be instrumental during the COVID-19 pandemic when the waste generation from all hospitals worldwide has increased significantly.

A review of ecotoxicity reduction in contaminated waters by heterogeneous photocatalytic ozonation

The widespread deterioration of our water systems requires new wastewater treatment technologies to ensure environmental protection. Conventional wastewater treatments were not designed for, and are therefore ineffective, at removing contaminants of emerging concern (CECs) such as pharmaceuticals, personal care products, pesticides, and industrial chemicals. Furthermore, treatment processes capable of breaking down CECs may produce toxic transformation products more harmful than the parent chemicals. Heterogeneous photocatalytic ozonation provides a promising option with high degradation and mineralization of organic compounds. The aim of the present paper is to review ecotoxicity reduction in water treated by heterogeneous photocatalytic ozonation as a measure of process viability. The discussion investigates changes in toxicity based on a variety of toxicity tests performed to evaluate potential effects on ecosystems, the types of catalysts and radiation sources used, the nature of the target contaminants, and the type of water matrix treated. Acute toxicity testing, TiO₂ catalysts, and mercury-vapour lamps including blacklights were dominant in the reviewed studies, investigated in 86%, 84% and 79% of the papers, respectively. Pharmaceuticals were the main group of chemicals treated and the water matrices used were predominantly pure water and secondary effluent. Overall, the findings of these studies provide evidence that photocatalytic ozonation is an efficient process to remove persistent organic compounds while, most of the time, not increasing the toxicity of the effluent (as reported by 86% of the studies). Due to the wide variation in experimental set-ups, no clear correlation between reaction conditions and toxicity was determined, however, V. fischeri acute toxicity assays and chronic/sublethal tests appeared most sensitive to transformation products. Future studies need to a) incorporate multiple toxicity tests to produce a more reliable and inclusive ecotoxicity assessment of treated effluent and b) investigate immobilized catalysts and energy efficient radiation sources (i.e. solar and LEDs) for industrial applications.

Water pathways through the ages: Integrated laundry wastewater treatment for pollution prevention

Rapid urbanization and the rising global population have led to the generation of substantial volumes of laundry wastewater. Accordingly, treatment of laundry wastewater has been advocated to curb water pollution and achieve water sustainability. However, technological limitations in treating (specifically) laundry wastewater and the lack of regulations governing the levels of contaminants for such discharges have been perennial problems. This review bridges the knowledge gap by delineating the feasibility of current technologies in laundry wastewater treatment and the experiences of various countries in adopting different approaches. Besides, the feasible methods for collecting laundry wastewater are elaborated. The development of the treatment technologies is highlighted, in which the integrated-treatment processes (physicochemical, biological, and combination of both) are critically discussed based on their functions and methods. A judicious selection of the technologies not only improves the energy efficiency and quality of the treated wastewater, but also mitigates capitals and operational costs. This is projected to enhance public acceptance towards the reuse of laundry wastewater. Thus, the comprehensive assessment herein is envisioned to insightfully guide national policymakers in exploring the viability of the technologies and water-recycling projects. Future research should focus on the techno-economic aspects of the treatment processes, especially their industrial scale-up.

Toxicity evaluation of hospital laundry wastewaters treated by microbial fuel cells and constructed wetlands

Hospital laundries generate high wastewater volumes with the presence of several contaminants. Nevertheless, few studies have investigated the toxicity of these effluents and looked for treatment alternatives that might reduce this eventual toxicity. So, the present study assessed the performance of an integrated system combining a microbial fuel cell (MBFC) and a constructed wetland (CW) to reduce toxic effects of wastewaters generated at a hospital laundry. After collection, raw effluents remained 7 days at the first unit (MBFC) of integrated system. Afterward, they were transferred to the second unit (CW) unit where remained more 7 days totaling a hydraulic detention time of 14 days. The toxicity evaluation involved three different organisms: Daphnia magna (acute ecotoxicity), Lactuca sativa (phytotoxicity) and Allium cepa (phytotoxicity, cytotoxicity, mutagenicity, and genotoxicity). Got results revealed an extremely acute ecotoxicity against D. magna, high phytotoxic effects in the L. sativa and A. cepa assays, and genotoxicity in the A. cepa assay for the untreated effluents. Furthermore, no significant incidence of micronuclei was observed in the raw wastewaters. Regarding the treatment, after the first stage, it was possible to verify that MBFC reduced the toxicity of the wastewaters only in some tested assays (endpoints) while after the CW (second stage) the effluents presented a complete absence of toxicity of the investigated bioassays. Therefore, the use of the integrated system combining two environmentally friendly technologies can be considered promising, since both MBFC and CW presented a complimentary effect with excellent results regarding the reduction of the overall toxicity of hospital laundry wastewaters.

Laundry wastewater treatment using a combination of sand filter, bio-char and teff straw media

Numerous researchers have expressed concern over the emerging water scarcity issues around the globe. Economic water scarcity is severe in the developing countries; thus, the use of inexpensive wastewater treatment strategies can help minimize this issue. An abundant amount of laundry wastewater (LWW) is generated daily and various wastewater treatment researches have been performed to achieve suitable techniques. This study addressed this issue by considering the economic perspective of the treatment technique through the selection of easily available materials. The proposed technique is a combination of locally available absorbent materials such as sand, biochar, and teff straw in a media. Biochar was prepared from eucalyptus wood, teff straw was derived from teff stem, and sand was obtained from indigenous crushed stones. In this study, the range of laundry wastewater flow rate was calculated as 6.23–17.58 m³/day; also studied were the efficiency of the media in terms of the removal percentage of contamination and the flux rate. The performances of biochar and teff straw were assessed based on the operation parameters and the percentage removal efficiency at different flux rates; the assessment showed 0.4 L/min flux rate to exhibit the maximum removal efficiency. Chemical oxygen demand, biological oxygen demand, and total alkalinity removal rate varied from 79% to ≥83%; total solids and total suspended solids showed 92% to ≥99% removal efficiency, while dissolved oxygen, total dissolved solids, pH, and electrical conductivity showed 22% to ≥62% removal efficiency. The optimum range of pH was evaluated between 5.8–7.1. The statistical analysis for finding the correlated matrix of laundry wastewater parameters showed the following correlations: COD (r = −0.84), TS (r = −0.83), and BOD (r = −0.81), while DO exhibited highest negative correlation. This study demonstrated the prospective of LWW treatment using inexpensive materials. The proposed treatment process involved low-cost materials and exhibited efficiency in the removal of contaminants; its operation is simple and can be reproduced in different scenarios.

Environmental assessment in health care organizations

The aim of this research is to design a multi-criteria model for environmental assessment of health care organizations. This is a model which guarantees the objectivity of the results obtained, is easy to apply, and incorporates a series of criteria, and their corresponding descriptors, relevant to the internal environmental auditing processes of the hospital. Furthermore, judgments were given by three experts from the areas of health, the environment, and multi-criteria decision techniques. From the values assigned, geometric means were calculated, giving weightings for the criteria of the model. This innovative model is intended for application within a continuous improvement process. A practical case from a Spanish hospital is included at the end. Information contained in the sustainability report provided the data needed to apply the model. The example contains all the criteria previously defined in the model. The results obtained show that the best-satisfied criteria are those related to energy consumption, generation of hazardous waste, legal matters, environmental sensitivity of staff, patients and others, and the environmental management of suppliers. On the other hand, those areas returning poor results are control of atmospheric emissions, increase in consumption of renewable energies, and the logistics of waste produced. It is recommended that steps be taken to correct these deficiencies, thus leading to an acceptable increase in the sustainability of the hospital.

The role of surfactants in wastewater treatment: Impact, removal and future techniques: A critical review

Wastewater treatment has an important responsibility to react to changing consumer and industrial produced wastes that pose environmental challenges. Surfactants are one of these emerging contaminants. They are of interest because of their increasingly ubiquitous domestic and industrial use and the difficulty their presence causes traditional treatment. In response to this developing area, this critical review considers research from a variety of technical backgrounds to provide an up to date overview of the impact of surfactants on the environment, health and their removal. This found major concerns about surfactants on the environment and on health being corroborated in the past five years. Current research into removal focuses on existing biological and chemical wastewater treatment optimisation. Despite improvements being found to traditional biological methods using chemical pre-treatments there is a clear lack of consensus regarding the ideal strategy. Drawbacks and potential solutions for a range of these technologies, including Fenton reaction and aerobic degradation, are discussed. In this field the authors recommend an improved diversity in surfactants used for the research and addressing of significant knowledge gaps. Novel methods, such as Carbon Nanotube (CNT) use are also discussed. These methods, while showing promising results, will require continual research effort to resolve present issues such as variable performance and environmental concerns. Larger scale work is also needed to validate the initial work done. Potential uses of surfactants to optimise wastewater treatment, such as Surfactant Modified Zeolites (SMZs), are also discussed. This review finds that surfactant removal from wastewater is a promising and challenging field that warrants further investigation.

Is A/A/O process effective in toxicity removal? Case study with coking wastewater

The anaerobic-anoxic-oxic (A/A/O) process is the commonly used biological wastewater treatment process, especially for the coking wastewater. However, limit is known about its ability in bio-toxicity removal from wastewater. In this study, we evaluated the performance of A/A/O process in bio-toxicity removal from the coking wastewater, using two test species (i.e. crustacean (Daphnia magna) and zebra fish (Danio rerio)) in respect of acute toxicity, oxidative damage and genotoxicity. Our results showed that the acute toxicity of raw influent was reduced gradually along with A/A/O process and the effluent presented no acute toxicity to Daphnia magna (D. magna) and zebra fish. The reactive oxygen species (ROS) level in D. magna and zebra fish was promoted by the effluent from each tank of A/A/O process, showing that coking wastewater induced oxidative damage. Herein, the oxidative damage to D. magna was mitigated in the oxic tank, while the toxicity to zebra fish was reduced in the anoxic tank. The comet assays showed that genotoxicity to zebra fish was removed stepwise by A/A/O process, although the final effluent still presented genotoxicity to zebra fish. Our results indicated that the A/A/O process was efficient in acute toxicity removal, but not so effective in the removal of other toxicity (e.g. oxidative damage and genotoxicity). Considering the potential risks of wastewater discharge, further advanced toxicity mitigation technology should be applied in the conventional biological treatment process, and the toxicity index should be introduced in the regulation system of wastewater discharge.

Combined use of VUV and UVC photoreactors for the treatment of hospital laundry wastewaters: Reduction of load parameters, detoxification and life cycle assessment of different configurations

The present research investigated the treatment of hospital laundry wastewaters by the combined use of photochemical VUV and UVC reactors. Seven different configurations were tested and the performances of each of them were evaluated based on the removal of the load parameters, detoxification and life cycle assessment (LCA). The characterization of studied wastewaters included analysis of the following parameters: COD, BOD₅, TKN, total P, pH, turbidity and conductivity. Acute ecotoxicity was evaluated using Daphnia magna. Ultraviolet-Visible (UV-Vis) spectroscopy was performed to determine the organic fraction and chromatography coupled to the mass spectrometer (GC-MS) was used for the qualitative characterization of priority pollutants. Characterization parameters showed the presence of drugs like lidocaine and dipyrone and a high organic load with a poor biodegradability. Wastewaters presented an extreme acute toxicity against D. magna (EC₅₀ 6.7%). The ozonation process (mainly generated by the VUV reactor) obtained the best results concerning the ratio between the consumed energy and the removed COD and the UVC process presented the lowest environmental impacts for the characterization and normalization parameters of the LCA. Normalization revealed that the highest environmental burdens were associated with human toxicity, ecotoxicity and eutrophication of surface waters as well as to the use of non-renewable resources. VUV/UVC/O₃ process presented the best results considering detoxification (EC₅₀ 100%).

Treatment of hospital laundry wastewater by UV/H2O2 process

Hospitals consume a large volume of water to carry out their activities and, hence, generate a large volume of effluent that is commonly discharged into the local sewage system without any treatment. Among the various sectors of healthcare facilities, the laundry is responsible for the majority of water consumption and generates a highly complex effluent. Although several advanced oxidation processes (AOPs) are currently under investigation on the degradation of a variety of contaminants, few of them are based on real wastewater samples. In this paper, the UV/H₂O₂ AOP was evaluated on the treatment of a hospital laundry wastewater, after the application of a physicochemical pretreatment composed of coagulation-flocculation and anthracite filtration. For the UV/H₂O₂ process, a photoreactor equipped with a low-pressure UV-C lamp was used and the effects of initial pH and [H₂O₂]/chemical oxygen demand (COD) ratio on COD removal were investigated through a randomized factorial block design that considered the batches of effluent as blocks. The results indicated that the initial pH had no significant effect on the COD removal, and the process was favored by the increase in [H₂O₂]/COD ratio. Color and turbidity were satisfactorily reduced after the application of the physicochemical pretreatment, and COD was completely removed by the UV/H₂O₂ process under suitable conditions. The results of this study show that the UV/H₂O₂ AOP is a promising candidate for hospital laundry wastewater treatment and should be explored to enable wastewater reuse in the washing process.

A system coupling hybrid biological method with UV/O3 oxidation and membrane separation for treatment and reuse of industrial laundry wastewater

The possibilities of application of a three-step system combining hybrid biological treatment followed by advanced UV/O3 oxidation with in situ generated O3 and membrane separation (ultrafiltration (UF) and nanofiltration (NF)) to treat and reuse the wastewater from an industrial laundry are presented. By the application of a hybrid moving bed biofilm reactor (HMBBR), the total organic carbon concentration was reduced for about 90 %. However, since the HMBBR effluent still contained organic contaminants as well as high concentrations of inorganic ions and exhibited significant turbidity (8.2 NTU), its further treatment before a possible reuse in the laundry was necessary. The UV/O3 pretreatment prior to UF was found to be an efficient method of the membrane fouling alleviation. During UF, the turbidity of wastewater was reduced below 0.3 NTU. To remove the inorganic salts, the UF permeate was further treated during NF. The NF permeate exhibited very low conductivity (27-75 μS/cm) and contained only small amounts of Ca(2+) and Mg(2+); thus ,it could be reused at any stage of the laundry process.

Predicted and measured concentrations of pharmaceuticals in hospital effluents. Examination of the strengths and weaknesses of the two approaches through the analysis of a case study

This study deals with the chemical characterization of hospital effluents in terms of the predicted and measured concentrations of 38 pharmaceuticals belonging to 11 different therapeutic classes. The paper outlines the strengths and weaknesses of the two approaches through an analysis of a case study referring to a large hospital. It highlights the observed (and expected) ranges of variability for the parameters of the adopted model, presents the results of an uncertainty analysis of direct measurements (due to sampling mode and frequency and chemical analysis) and a sensitivity analysis of predicted concentrations (based on the annual consumption of pharmaceuticals, their excretion rate and annual wastewater volume generated by the hospital). Measured concentrations refer to two sampling campaigns carried out in summer and winter in order to investigate seasonal variability of the selected compounds. Predicted concentrations are compared to measured ones in the three scenarios: summer, winter and the whole year. It was found that predicted and measured concentrations are in agreement for a limited number of compounds (namely atenolol, atorvastatin and hydrochlorothiazide), and for most compounds the adoption of the model leads to a large overestimation in all three periods. Uncertainties in predictions are mainly due to the wastewater volume and excretion factor, whereas for measured concentrations, uncertainties are mainly due to sampling mode.

Treatment and toxicity reduction of textile dyeing wastewater using the electrocoagulation-electroflotation process

A pilot-scale study was conducted using the electrocoagulation-electroflotation (EC-EF) process to treat textile dyeing raw wastewater to evaluate treatment performance. The effects of some key factors, such as current density, hydraulic retention time (HRT), and removal of conductivity, total suspended solids (TSS), chemical oxygen demand (COD), and color were investigated. The operating variables were current density of 0-300 A m(-2), HRT of 0-30 min, and a coagulant (anionic polyacrylamide (A-PAM)) dosage of 0-30 mg L(-1). Daphnia magna was used to test acute toxicity in raw and treated wastewater. Under the operating conditions without added coagulant, maxima of 51%, 88%, 84%, and 99% of conductivity, TSS, COD, and color were removed, respectively, with a HRT of 30 min. The coagulant enhanced removal of all wastewater parameters. Removal maxima of 59%, 92%, 94%, and 98% for conductivity, TSS, COD, and color were observed, respectively, with an optimal dosage of 30 mg L(-1) and a shortened HRT of 20 min. The 48 h-LC50 D. magna test showed that the raw wastewater was highly toxic. However, the EC-EF process decreased toxicity of the treated samples significantly, and >70% toxicity reduction was achieved by the EC-EF process with the addition of 15-30 mg L(-1) coagulant, HRT of 20 min, and current density of 150-300 A m(-2). The pilot scale test (0.3 m(3 )h(-1)) shows that the EC-EF process with added coagulant effectively treated textile dyeing wastewater.

Organic pollutants removal in wastewater by heterogeneous photocatalytic ozonation

Heterogeneous photocatalysis and ozonation are robust advanced oxidation processes for eliminating organic contaminants in wastewater. The combination of these two methods is carried out in order to enhance the overall mineralization of refractory organics. An apparent synergism between heterogeneous photocatalysis and ozonation has been demonstrated in many literatures, which gives rise to an improvement of total organic carbon removal. The present overview dissects the heterogeneous catalysts and the influences of different operational parameters, followed by the discussion on the kinetics, mechanism, economic feasibility and future trends of this integrated technology. The enhanced oxidation rate mainly results from a large amount of hydroxyl radicals generated from a synergistically induced decomposition of dissolved ozone, besides superoxide ion radicals and the photo-induced holes. Six reaction pathways possibly exist for the generation of hydroxyl radicals in the reaction mechanism of heterogeneous photocatalytic ozonation.

Reduction of acute toxicity and genotoxicity of dye effluent using Fenton-coagulation process

Dye wastewater exhibits significant ecotoxicity even though its physico-chemical parameters meet the discharge standards. In this work, the acute toxicity and genotoxicity of dye effluent were tested, and the Fenton-coagulation process was carried out to detoxify this dye effluent. The acute toxicity was evaluated according to the mortality rate of zebrafish, and genotoxicity was evaluated by micronucleus (MN) and comet assays. Removal of color and chemical oxygen demand (COD) was also investigated. The results indicated that the dye effluent showed strong acute toxicity and genotoxicity to zebrafish. After 4h of treatment by Fenton-coagulation process, the dye effluent exhibited no significant acute toxicity and genotoxicity to zebrafish. In addition, its COD was less than 50mg/L, which met the discharge standard. It demonstrates that Fenton-coagulation process can comprehensively reduce the acute toxicity and genotoxicity as well as the COD of the dye effluent.

Glutaraldehyde degradation in hospital wastewater by photoozonation

In this paper, we assessed aqueous solutions of glutaraldehyde (GA), a chemical used for the disinfection of hospital materials, using advanced oxidative processes, O3, and UV, and the combination of the latter two. Assays with different ozone concentrations at distinct pH levels were conducted to determine the best treatment process. GA concentrations before and after each treatment were measured by spectrophotometry. The best treatment was that which combined O3 and UV, yielding a degradation of 72.0-75.0% in relation to the initial concentration with pH between 4 and 9. Kinetics demonstrated that GA degradation is not dependent on pH, as there was a first-order reaction with a rate constant of k = 0.0180 min(-1) for initial pH 9 and of k = 0.0179 min(-1) for initial pH 7, that is, the values are virtually the same. Secondary wastewater samples were also analysed using the septic tank/filter system of a regional hospital in Vale do Rio Pardo, state of Rio Grande do Sul, southern Brazil. In this case, the characteristics of the wastewater were described and, after treatment, a GA degradation rate of 23.3% was noted, with reductions of 75% for chemical oxygen demand, 81% for biochemical oxygen demand, 68% for turbidity, 70% for surfactants and total disinfection in terms of thermotolerant coliforms.