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Jain S, Dempsey K, Clezy K, Mitchell BG, Kiernan MA. Sustainability and novel technologies to improve environmental cleaning in healthcare - Implications and considerations. Infect Dis Health 2024:S2468-0451(24)00047-6. [PMID: 39147677 DOI: 10.1016/j.idh.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/10/2024] [Accepted: 07/10/2024] [Indexed: 08/17/2024]
Abstract
Along with emerging technologies electrolysed water (EW) systems have been proposed for cleaning and/or disinfection in clinical areas. There is evidence for the use of EW in food-handling and the dairy industry however there is lack of evidence for EW as an effective cleaning and disinfecting agent in a clinical setting. Existing publications mostly are either laboratory based or from non-clinical settings. This is in direct contrast to other approaches used in healthcare cleaning. The aim of this paper is to provide infection prevention and control professionals with a risk assessment checklist using an evaluation of electrolysed water as an example of the analysis and consideration required prior to the introduction of any new technology and, in particular, the inclusion of sustainability.
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Affiliation(s)
- S Jain
- Healthcare Associated Infection Program, Clinical Excellence Commission, Sydney, New South Wales, Australia.
| | - K Dempsey
- Healthcare Associated Infection Program, Clinical Excellence Commission, Sydney, New South Wales, Australia
| | - K Clezy
- Healthcare Associated Infection Program, Clinical Excellence Commission, Sydney, New South Wales, Australia
| | - B G Mitchell
- School of Nursing, Avondale University, Lake Macquarie, New South Wales, Australia; Nursing and Midwifery, Monash University, Melbourne Victoria; Central Coast Local Health District, Gosford Hospital, Gosford, New South Wales, Australia
| | - M A Kiernan
- School of Nursing, Avondale University, Lake Macquarie, New South Wales, Australia; Richard Wells Research Centre, University of West London, UK
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Zayed N, Munjaković H, Aktan MK, Simoens K, Bernaerts K, Boon N, Braem A, Pamuk F, Saghi M, Van Holm W, Fidler A, Gašperšič R, Teughels W. Electrolyzed Saline Targets Biofilm Periodontal Pathogens In Vitro. J Dent Res 2024; 103:243-252. [PMID: 38185942 DOI: 10.1177/00220345231216660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Preventing the development and recurrence of periodontal diseases often includes antimicrobial mouthrinses to control the growth of the periodontal pathogens. Most antimicrobials are nonselective, targeting the symbiotic oral species as well as the dysbiosis-inducing ones. This affects the overall microbial composition and metabolic activity and consequently the host-microbe interactions, which can be detrimental (associated with inflammation) or beneficial (health-associated). Consequently, guiding the antimicrobial effect for modulating the microbial composition to a health-associated one should be considered. For such an approach, this study investigated electrolyzed saline as a novel rinse. Electrolyzed saline was prepared from sterile saline using a portable electrolysis device. Multispecies oral homeostatic and dysbiotic biofilms were grown on hydroxyapatite discs and rinsed daily with electrolyzed saline (EOS). Corresponding positive (NaOCl) and negative (phosphate-buffered saline) controls were included. After 3 rinses, biofilms were analyzed with viability quantitative polymerase chain reaction and scanning electron microscopy. Supernatants of rinsed biofilms were used for metabolic activity analysis (high-performance liquid chromatography) through measuring organic acid content. In addition, human oral keratinocytes (HOKs) were exposed to EOS to test biocompatibility (cytotoxicity and inflammation induction) and also to rinsed biofilms to assess their immunogenicity after rinsing. Rinsing the dysbiotic biofilms with EOS could reduce the counts of the pathobionts (>3 log10 Geq/mm2 reduction) and avert biofilm dysbiosis (≤1% pathobiont abundance), leading to the dominance of commensal species (≥99%), which altered both biofilm metabolism and interleukin 8 (IL-8) induction in HOKs. EOS had no harmful effects on homeostatic biofilms. The scanning electron micrographs confirmed the same. In addition, tested concentrations of EOS did not have any cytotoxic effects and did not induce IL-8 production in HOKs. EOS showed promising results for diverting dysbiosis in in vitro rinsed biofilms and controlling key periopathogens, with no toxic effects on commensal species or human cells. This novel rinsing should be considered for clinical applications.
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Affiliation(s)
- N Zayed
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - H Munjaković
- Department of Oral Medicine and Periodontology, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - M K Aktan
- Department of Materials Engineering (MTM), Biomaterials and Tissue Engineering Research Group, Leuven, Belgium
| | - K Simoens
- Chemical and Biochemical Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - K Bernaerts
- Chemical and Biochemical Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - N Boon
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - A Braem
- Department of Materials Engineering (MTM), Biomaterials and Tissue Engineering Research Group, Leuven, Belgium
| | - F Pamuk
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
| | - M Saghi
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
| | - W Van Holm
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - A Fidler
- Department of Endodontic and Restorative Dentistry, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - R Gašperšič
- Department of Oral Medicine and Periodontology, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - W Teughels
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
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Pan Q, Zhao P, Gao L, Liu H, Hu H, Dong L. In-Depth Study on the Effects of Impurity Ions in Saline Wastewater Electrolysis. Molecules 2023; 28:4576. [PMID: 37375129 DOI: 10.3390/molecules28124576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Concentration followed by electrolysis is one of the most promising ways for saline wastewater treatment, since it could produce H2, Cl2, and an alkaline solution with deacidification potential. However, due to the diversity and difference of wastewater, knowledge on the suitable salt concentration for wastewater electrolysis and the effects of mixed ions are still lacking. In this work, electrolysis experiments of mixed saline water were conducted. The salt concentration for stable dechlorination was explored, with in-depth discussions on the effects of typical ions such as K+, Ca2+, Mg2+, and SO42-. Results showed that K+ had a positive effect on the H2/Cl2 production of saline wastewater through accelerating the mass transfer efficiency in the electrolyte. However, the existence of Ca2+ and Mg2+ had negative effects on the electrolysis performance by forming precipitates, which would adhere to the membrane, reduce the membrane permeability, occupy the active sites on the cathode surface, and also increase the transport resistance of the electrons in the electrolyte. Compared to Mg2+, the damaging effect of Ca2+ on the membrane was even worse. Additionally, the existence of SO42- reduced the current density of the salt solution by affecting the anodic reaction while having less of an effect on the membrane. Overall, Ca2+ ≤ 0.01 mol/L, Mg2+ ≤ 0.1 mol/L and SO42- ≤ 0.01 mol/L were allowable to ensure the continuous and stable dechlorination electrolysis of saline wastewater.
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Affiliation(s)
- Qicheng Pan
- College of Resources and Environment, Hubei University of Technology, Wuhan 430068, China
- State Key Laboratory of Coal Combustion, School of Energy and Power Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Peixuan Zhao
- State Key Laboratory of Coal Combustion, School of Energy and Power Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Linxia Gao
- College of Resources and Environment, Hubei University of Technology, Wuhan 430068, China
| | - Huimin Liu
- State Key Laboratory of Coal Combustion, School of Energy and Power Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
- Shenzhen Research Institute of Huazhong University of Science and Technology, Shenzhen 518063, China
| | - Hongyun Hu
- State Key Laboratory of Coal Combustion, School of Energy and Power Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
- Shenzhen Research Institute of Huazhong University of Science and Technology, Shenzhen 518063, China
| | - Lu Dong
- State Key Laboratory of Coal Combustion, School of Energy and Power Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
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Rodríguez-Morales O, Mendoza-Téllez EJ, Morales-Salinas E, Arce-Fonseca M. Effectiveness of Nitazoxanide and Electrolyzed Oxiding Water in Treating Chagas Disease in a Canine Model. Pharmaceutics 2023; 15:pharmaceutics15051479. [PMID: 37242721 DOI: 10.3390/pharmaceutics15051479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/03/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Chagas disease (CD) is caused by the protozoan Trypanosoma cruzi, and affects seven million people in Latin America. Side effects and the limited efficacy of current treatment have led to new drug research. The objective of this work was to evaluate the effectiveness of nitazoxanide (NTZ) and electrolyzed oxidizing water (EOW) in a canine model of experimental CD. Náhuatl dogs were infected with the T. cruzi H8 strain and NTZ- or EOW-treated orally for 10 days. Seronegativity was shown at 12 months post-infection (mpi) in the NTZ-, EOW-, and benznidazole (BNZ)-treated groups. The NTZ and BNZ groups had high levels of IFN-γ, TNF-α, IL-6, IL-12B, and IL-1β at 1.5 mpi and low levels of IL-10. Electrocardiographic studies showed alterations from 3 mpi and worsening at 12 mpi; NTZ treatment produced fewer cardiac pathomorphological changes compared to EOW, similar to BNZ treatment. There was no cardiomegaly in any group. In conclusion, although NTZ and EOW did not prevent changes in cardiac conductivity, they were able to avoid the severity of heart damage in the chronic phase of CD. NTZ induced a favorable proinflammatory immune response after infection, being a better option than EOW as a possible treatment for CD after BNZ.
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Affiliation(s)
- Olivia Rodríguez-Morales
- Laboratory of Molecular Immunology and Proteomics, Department of Molecular Biology of Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1, Col. Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Erika Jocelin Mendoza-Téllez
- Laboratory of Molecular Immunology and Proteomics, Department of Molecular Biology of Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1, Col. Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Elizabeth Morales-Salinas
- Department of Pathology of Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Av. Universidad 3000, Col. Copilco Universidad, Coyoacán, Mexico City 04510, Mexico
| | - Minerva Arce-Fonseca
- Laboratory of Molecular Immunology and Proteomics, Department of Molecular Biology of Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1, Col. Sección XVI, Tlalpan, Mexico City 14080, Mexico
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Electrolyzed-Reduced Water: Review I. Molecular Hydrogen Is the Exclusive Agent Responsible for the Therapeutic Effects. Int J Mol Sci 2022; 23:ijms232314750. [PMID: 36499079 PMCID: PMC9738607 DOI: 10.3390/ijms232314750] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2022] Open
Abstract
Numerous benefits have been attributed to alkaline-electrolyzed-reduced water (ERW). Sometimes these claims are associated with easily debunked concepts. The observed benefits have been conjectured to be due to the intrinsic properties of ERW (e.g., negative oxidation-reduction potential (ORP), alkaline pH, H2 gas), as well enigmatic characteristics (e.g., altered water structure, microclusters, free electrons, active hydrogen, mineral hydrides). The associated pseudoscientific marketing has contributed to the reluctance of mainstream science to accept ERW as having biological effects. Finally, through many in vitro and in vivo studies, each one of these propositions was examined and refuted one-by-one until it was conclusively demonstrated that H2 was the exclusive agent responsible for both the negative ORP and the observed therapeutic effects of ERW. This article briefly apprised the history of ERW and comprehensively reviewed the sequential research demonstrating the importance of H2. We illustrated that the effects of ERW could be readily explained by the known biological effects of H2 and by utilizing conventional chemistry without requiring any metaphysical conjecture (e.g., microclustering, free electrons, etc.) or reliance on implausible notions (e.g., alkaline water neutralizes acidic waste). The H2 concentration of ERW should be measured to ensure it is comparable to those used in clinical studies.
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LeBaron TW, Sharpe R, Ohno K. Electrolyzed-Reduced Water: Review II: Safety Concerns and Effectiveness as a Source of Hydrogen Water. Int J Mol Sci 2022; 23:ijms232314508. [PMID: 36498838 PMCID: PMC9736533 DOI: 10.3390/ijms232314508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Many studies demonstrate the safety of alkaline-electrolyzed-reduced water (ERW); however, several animal studies have reported significant tissue damage and hyperkalemia after drinking ERW. The mechanism responsible for these results remains unknown but may be due to electrode degradation associated with the production of higher pH, in which platinum nanoparticles and other metals that have harmful effects may leach into the water. Clinical studies have reported that, when ERW exceeds pH 9.8, some people develop dangerous hyperkalemia. Accordingly, regulations on ERW mandate that the pH of ERW should not exceed 9.8. It is recommended that those with impaired kidney function refrain from using ERW without medical supervision. Other potential safety concerns include impaired growth, reduced mineral, vitamin, and nutrient absorption, harmful bacterial overgrowth, and damage to the mucosal lining causing excessive thirst. Since the concentration of H2 in ERW may be well below therapeutic levels, users are encouraged to frequently measure the H2 concentration with accurate methods, avoiding ORP or ORP-based H2 meters. Importantly, although, there have been many people that have used high-pH ERW without any issues, additional safety research on ERW is warranted, and ERW users should follow recommendations to not ingest ERW above 9.8 pH.
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Affiliation(s)
- Tyler W. LeBaron
- Centre of Experimental Medicine, Institute for Heart Research, Slovak Academy of Sciences, 841 04 Bratislava, Slovakia
- Molecular Hydrogen Institute, Enoch, UT 84721, USA
- Department of Kinesiology and Outdoor Recreation, Southern Utah University, Cedar City, UT 84720, USA
- Correspondence: (T.W.L.); (K.O.); Tel.: +1-435-586-7818 (T.W.L.); +81-52-744-2447 (K.O.); Fax: +1-435-865-8057 (T.W.L.); +81-52-744-2449 (K.O.)
| | | | - Kinji Ohno
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
- Correspondence: (T.W.L.); (K.O.); Tel.: +1-435-586-7818 (T.W.L.); +81-52-744-2447 (K.O.); Fax: +1-435-865-8057 (T.W.L.); +81-52-744-2449 (K.O.)
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