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PubMedDate not supplied

[Relationship between water supply, sanitation, public health, and environment: elements for the formulation of a sanitary infrastructure planning model].

The understanding of sanitation infrastructure, public health, and environmental relations is a fundamental assumption for planning sanitation infrastructure in urban areas. This article thus suggests elements for developing a planning model for sanitation infrastructure. The authors performed a historical survey of environmental and public health issues related to the sector, an analysis of the conceptual frameworks involving public health and sanitation systems, and a systematization of the various effects that water supply and sanitation have on public health and the environment. Evaluation of these effects should guarantee the correct analysis of possible alternatives, deal with environmental and public health objectives (the main purpose of sanitation infrastructure), and provide the most reasonable indication of actions. The suggested systematization of the sanitation systems effects in each step of their implementation is an advance considering the association between the fundamental elements for formulating a planning model for sanitation infrastructure.

Environmental Health↗
PubMed1998

Attachment of Escherichia coli O157:H7 in ground beef to meat grinders and survival after sanitation with chlorine and peroxyacetic acid.

The potential for transfer of Escherichia coli O157:H7 from contaminated ground beef to grinding equipment and the inactivation of attached cells during cleaning and sanitizing was examined. Chub-packed ground beef with lean:fat ratios of 75:25, 80:20 or 90:10 was inoculated with 6 log CFU/g or 2 log CFU/g E. coli O157:H7 strain FRIK 910. Samples were consecutively ground in a Hobart meat grinder with stainless steel (SS) chips (1 cm2) glued to the auger housing. Chips were harvested after grinding, detergent washing with or without manual scrubbing and rinsing, sanitizing in a chlorine or peroxyacetic acid sanitizer, and overnight storage. Survival of E. coli O157:H7 was evaluated both by plate count and enrichment in trypticase soy broth. Approximately 3 to 4 log CFU/cm2 were attached to the SS after grinding with all three fat contents. After washing and sanitizing in a chlorine or peroxyacetic acid sanitizer, viable bacteria were infrequently recovered by plate count. Enrichment of chips resulted in a higher survival rate with both sanitizing treatments, indicating that cell numbers below the limit of detection (5 CFU/cm2) or potentially injured organisms remained on the surface. Manual scrubbing during the washing step reduced the recovery rate. The scrubbing step also increased the number of passing scores assigned using an ATP bioluminescence assay of total residual soil on the chips sanitized in chlorine. The overall results indicate that plate counts alone may not be a reliable indicator of sanitation efficacy and may be validated by enrichment assay.

Adenosine Triphosphate↗
PubMed2003

Location and sanitation of dental foci in liver transplantation.

The literature describes various treatment concepts for the pre-operative sanitation of septic foci in the oromaxillofacial area prior to liver transplantation. There are no uniform guidelines, and so far, a connection between dental foci and postoperative infection after transplantation has not yet been proven. Taking into account the complications occurring during focus sanitation, the appropriate extent of, and the most suitable point of time for, focus sanitation have to be ascertained. The clinical and radiological findings from 80 patients were analyzed, with particular attention being paid to dental foci prior to liver transplantation. The complications performed in 39 sanitations and the oral hygiene status of 37 patients were included in the analysis. All the obtained findings were correlated to the etiology of the liver disease and the Child-Pugh stage. Former alcoholics had significantly poorer oral hygiene and more foci than non-alcoholics. After sanitation, complications occurred more frequently in alcoholics (43.8%) and patients in Child-Pugh stage C (41.2%) than in the other groups. Secondary bleeding, severe in some cases, occurred in a total of 15.4% of all patients, despite coagulatory preparations. We can conclude that, given the high rate of complications found in this study after sanitation prior to transplantation, the demand for radical prophylactic dental sanitation should be reconsidered. Rather, it would appear more appropriate for only absolutely necessary sanitation to be carried out prior to transplantation and for the definitive measures to be postponed until after transplantation when liver function has stabilized.

Alcoholism↗
PubMed1985

Effectiveness of a computer-assisted instruction program for teaching sanitation.

The purpose of this study was to determine whether computer-assisted instruction (CAI) is as effective as the lecture method of instruction (LMI) for teaching sanitation to hospital foodservice employees. Two dependent variables--gain in sanitation knowledge and amount of time required to complete the training experience--and three independent variables--treatment, age, and level of education--were examined for each treatment group. Attitude toward sanitation training and CAI was appraised for the groups prior to training and for the CAI group after training. A sanitation knowledge instrument was administered as a pre- and post-test, and a Likert-type attitude assessment questionnaire was utilized to provide an indication of participants' attitude toward sanitation training and CAI. Findings indicated that significantly more training time (97 vs. 32 minutes) was required by the CAI group than by the LMI group. Participants younger than 25 attained significantly higher gain scores (X = 11 vs. X = 10) with CAI than with LMI. Gain scores for other age categories tended to be higher for individuals taught by CAI; however, they were not significantly different from the scores of those taught by LMI. CAI group members demonstrated an improved attitude toward CAI and sanitation training. It was concluded that the CAI and LMI methods were equally effective for teaching sanitation for most of the employees who participated in the study.

Attitude↗
PubMed1971

Epidemiological model of typhoid fever and its use in the planning and evaluation of antityphoid immunization and sanitation programmes.

An epidemiological model has been constructed for typhoid fever in a stable population in order to study the transmission of infection at different levels of endemicity. It involves a number of parameters representing the proportions of epidemiological subgroups in the population-such as the susceptible, the infected, and the immune-and rates of transition between the groups. Numerical values based on available evidence were assigned to the parameters, to provide a realistic simulation of stable endemicity.Changes were then introduced in the values of some of the parameters in order to study the consequences of mass vaccination and improvements in general health conditions and sanitation, in particular on the incidence of disease.The model shows that a single mass vaccination reduces the incidence of disease considerably, but the gain is largely lost after a few years. Repeated vaccinations at 5-year intervals will produce further decreases in incidence, though the additional gain becomes smaller at each consecutive vaccination.The model was also used to estimate the possible effect of improvements in sanitation. The incidence decreases to a new level of stability when the transmission of the infection is reduced because of improved sanitation. The effect of sanitation is long-lasting and in this respect gives better results than vaccination.The simultaneous application of mass vaccination and sanitation gives a cumulative effect, which in some cases tends to be close to the effect of sanitation alone.The model was used to forecast the probable effect of preventive measures against typhoid fever, such as mass immunization and sanitation programmes, on a selected population in terms of prevention of disease, as well as in terms of relative costs and benefits. It provides a useful guide for the rational use of funds and the facilities to be set aside for typhoid fever control purposes.Other possible uses of the model are briefly discussed.The need to adjust the model in relation to specific conditions in the community is stressed, as is the need to readjust it to take into account changes in the pattern of life and the natural history of typhoid fever.

Communicable Disease Control↗
PubMed1998

Testing a new alcohol-free hand sanitizer to combat infection.

Universal precautions require that perioperative health care personnel wash their hand before and after all patient contact. Time constraints, however, can make adhering to universal precautions, including proper hand washing, difficult. Some perioperative health care workers, therefore, routinely use rise-free hand sanitizers to supplement normal hand washing. This study evaluated immediate and persistent antimicrobial effectiveness of two alcohol--containing hand sanitizers and a novel surfactant, allantoin, benzalkonium chloride (SAB) hand sanitizer using a federally approved effectiveness protocol. Results indicate that all three products were equally effective after a single application. After repeated use, the alcohol-containing sanitizers did not meet federal performance standards, and the alcohol-free sanitizer did. These properties and others illustrated in this article indicate that the nonflammable, alcohol-free SAB hand sanitizer is the most favorable of the rise-free hand sanitizer formulas for normal hand washing.

Adolescent↗
PubMed2002

The impact of alcohol hand sanitizer use on infection rates in an extended care facility.

BACKGROUND: Nosocomial infections are a major problem in health care facilities, resulting in extended durations of care and substantial morbidity. Since alcohol gel hand sanitizers combine high immediate antimicrobial efficacy with ease of use, this study was carried out to determine the effect of the use of alcohol gel hand sanitizer by caregivers on infection types and rates in an extended care facility. METHOD: Infection rate and type data were collected in a 275-bed extended care facility for 34 months (July 1997 to May 2000), during which an alcohol gel hand sanitizer was used by the caregivers in 2 units of the facility. RESULTS: The primary infection types found were urinary tract with Foley catheter, respiratory tract, and wound infections. Comparison of the infection types and rates for the units where hand sanitizer was used with those for the control units where the hand sanitizer was not used showed a 30.4% decrease in infection rates for the 34-month period in the units where hand sanitizer was used. CONCLUSION: This study indicates that use of an alcohol gel hand sanitizer can decrease infection rates and provide an additional tool for an effective infection control program.

Anti-Infective Agents, Local↗
PubMed2003

Use of alcohol hand sanitizer as an infection control strategy in an acute care facility.

BACKGROUND: Nosocomial infections are a major problem in health care facilities, resulting in extended durations of care, substantial morbidity and mortality, and excess costs. Since alcohol gel hand sanitizers combine high immediate antimicrobial efficacy with ease of use, this study was carried out to determine the effect of the use of an alcohol gel hand sanitizer by caregivers on infection types and rates in an acute care facility. Patients were educated about the study through a poster on the unit, and teachable patients were given portable bottles of the alcohol hand gel for bedside use, along with an educational brochure explaining how and why to practice good hand hygiene. METHODS: Infection rate and type data were collected in 1 unit of a 498-bed acute care facility for 16 months (February 2000 to May 2001). An alcohol gel hand sanitizer was provided and used by caregivers in the orthopedic surgical unit of the facility during this period. RESULTS: The primary infection types (more than 80%) found were urinary tract (UTI) and surgical site (SSI) infections. Infection types and rates for the unit during the period the alcohol hand sanitizer (intervention) was used were compared with the infection types and rates for the same unit when the alcohol hand sanitizer was not used (baseline); the results demonstrated a 36.1% decrease in infection rates for the 10-month period that the hand sanitizer was used. CONCLUSION: This study indicates that use of an alcohol gel hand sanitizer can decrease infection rates and provide an additional tool for an effective infection control program in acute care facilities.

Analysis of Variance↗
PubMed1986

Evaluation of dairy and food plant sanitizers against Salmonella typhimurium and Listeria monocytogenes.

Six commonly used dairy and food plant sanitizers were evaluated against Salmonella typhimurium and Listeria monocytogenes. Of these six, two were acid anionic sanitizers, one contained a quaternary ammonium compound, one was based on active iodine, and two contained active chlorine. Of the last two, one contained hypochlorite and the other contained active chlorine in organic form. The chlorine-based sanitizers were effective at 100 ppm of available chlorine against both these organisms. The sanitizer containing iodine was effective at 12.5 and 25 ppm titratable iodine against L. monocytogenes and S. typhimurium, respectively. The acid anionic sanitizers were effective at 200 ppm of active agent against both the bacteria, and the quaternary ammonium-based sanitizer was effective at 100 and 200 ppm of active compound against L. monocytogenes and S. typhimurium, respectively. The sanitizer containing iodine at 12.5 and 25 ppm of titratable iodine showed activity equivalent to 50 and 200 ppm of available chlorine, respectively, against L. monocytogenes and 100 and 200 ppm of available chlorine, respectively, against S. typhimurium.

Dairying↗
PubMed1999

Effect of chemical cleaning agents and commercial sanitizers on ATP bioluminescence measurements.

Nine chemical cleaning agents at three concentrations were studied to determine the effect on ATP bioluminescence measurements from pure ATP (PATP) and ATP from chicken exudate (CJATP). The nine commercial cleaning and sanitizing chemicals were concentrated foaming acid (FA), acid sanitizer (AS), iodine cleaner-disinfectant (ZI), alkaline cleaner-degreaser (PC), chlorinated alkaline cleaner (CA), chlorinated sanitizer (CS), quaternary ammonium (QA), antibiofilm agent (AB), and acidic peroxygen sanitizer (HP). Effect was reported as a percent change from the log10 relative light unit (LRLU) measurements of the control groups. All cleaners and sanitizers were tested at one-tenth of the manufacturer's recommended level (MRL), MRL, and two times MRL. FA, PC, and CA at all three concentrations significantly decreased PATP and CJATP LRLU. AS decreased PATP and CJATP LRLU at 200 and 400 ppm quaternary ammonium. ZI decreased PATP LRLU at MRL or greater, while CJATP LRLU were decreased by all concentrations of ZI tested. CS decreased PATP LRLU in a dose-dependent manner; however, for CJATP, LRLU decreased slightly at the two lower concentrations but were not affected by 1,200 ppm CS. QA at MRL or above for PATP or at all concentrations for CJATP significantly increased LRLU. AB decreased LRLU at all concentrations tested for PATP or at MRL or greater for CJATP. HPA at MRL or greater for PATP or at all concentrations for CJATP significantly reduced LRLU. These results demonstrate that commercial sanitizers and cleansers may squelch or increase LRLU measurements when the chemical comes into direct contact with the ATP bioluminescence reagents. Hence, when using ATP bioluminescence as a means of determining sanitary quality of food-processing equipment, it is essential to consider the type and concentration of chemical cleaner or sanitizer being used on the equipment prior to testing.

Adenosine Triphosphate↗
PubMed1999

Different responses of planktonic and attached Bacillus subtilis and Pseudomonas fluorescens to sanitizer treatment.

Three commercial sanitizers containing iodophor (I), peracetic acid/ hydrogen peroxide (PAH), or chlorhexidine gluconate (CG) were evaluated in vitro against planktonic and sessile Bacillus subtilis or Pseudomonas fluorescens cells grown in Standard One Nutrient Broth. Sessile cells were attached to stainless steel or polyurethane test surfaces. Planktonic and attached cells of both bacteria were enumerated by plate counts after sanitizer treatment for 1, 3, or 5 min. Sessile cells were dislodged from test surfaces by shaking them with beads. Cell morphologies were monitored by scanning electron microscopy (SEM). Attached B. subtilis and P. fluorescens cells on both surface types were less susceptible to all three sanitizers than their planktonic counterparts. PAH, I, and CG were equally effective against planktonic P. fluorescens cells, which were reduced by 99.999% after 1, 3, and 5 min exposure. PAH was the only sanitizer effective against attached P. fluorescens cells on both surface types; it reduced counts by < or = 99.9% after 1, 3, and 5 min exposure. PAH was also the most effective sanitizer against planktonic B. subtilis cells, reducing counts by 99.9% after 1, 3, and 5 min. Sessile B. subtilis cells on both surface types were the least susceptible to all sanitizers; counts were reduced by only 99.5% or less after exposure to PAH for 5 min. SEM revealed that planktonic and attached cells of both bacteria exhibited symptoms of surface roughness, indentations, and shape distortions after treatment with any of the sanitizers.

Animals↗
PubMed2003

Comparison of sodium hypochlorite-based foam and peroxyacetic acid-based fog sanitizing procedures in a salmon smokehouse: survival of the general microflora and Listeria monocytogenes.

The effects of fog sanitization with peroxyacetic acid (hydrogen peroxide, peracetic acid, and acetic acid in combination) on general hygiene (aerobic plate count) and on Listeria monocytogenes were assessed in a slicing area at a salmon smokehouse and compared with the effects of foam sanitization with sodium hypochlorite (routinely performed at the smokehouse). Two hundred twenty-three environmental samples were collected with sponges and swabs after each of the sanitization procedures, and 68 samples were collected during production. The total culturable aerobic plate count was determined for each sample, and a total of 288 bacterial strains were randomly isolated and tentatively identified to genus level by physiological and biochemical tests. The microflora was dominated by Neisseriaceae, Enterobacteriaceae, and lactic acid bacteria during production. Foam sanitization caused a change in the composition of the flora, with Pseudomonas spp. and Alcaligenes spp. being the dominant gram-negative bacteria and Kurthia spp. and Bacillus spp. being the surviving gram-positive bacteria. Bacteria were very sensitive to fog sanitization, and yeasts accounted for almost half of the surviving flora. By a selective isolation method, strains of L. monocytogenes were isolated and subsequently characterized by random amplified polymorphic DNA (RAPD) typing. Following foam sanitization, 14 to 42% of the samples contained <10 CFU per site, whereas 29 to 78% of the samples collected after fog sanitization contained this level of bacteria. The prevalence of L. monocytogenes was unchanged, but L. monocytogenes was found only in poorly cleaned areas such as drains. The RAPD types for all positive samples were identical to the type that had persisted in the smokehouse since 1995, indicating the importance of drains as a niche.

Animals↗
PubMed1998

Effectiveness of Rack Sanitation Procedures for Elimination of Bacteria from Automatic Watering Manifolds.

An important responsibility of animal care programs is to protect research animals from exposure to potentially pathogenic microorganisms. To validate the need for steam sterilization of rodent automatic watering racks, we evaluate the post-sanitation microbial contamination of experimentally inoculated racks and of racks that had been used to house conventional mice. We tested three sanitation protocols: rack-washer sanitation without manifold flush, sanitation that included manifold flush, and sanitation that included manifold flush followed by autoclaving. Rack sanitation, with or without manifold flush, did not reliably eliminate microbial flora from the lixits or manifold drainage water. A total of 43% of all non-autoclaved racks were positive for bacterial contamination after sanitation, and racks that had been used for conventional animal housing were more frequently positive than were experimentally inoculated racks (79% vs 18%). These data indicate that steam sterilization is necessary for eliminating bacteria from automatic watering systems. These observations are particularly important in light of increasing numbers of immune-impaired rodents that may be inadvertently and unnecessarily exposed to microbial pathogens via the automatic watering system.

Journal Article↗
PubMed1954

Economic aspects of rural sanitation in the United States of America.

Although health conditions in the rural areas of the USA are comparatively good, they are inferior to those in the urban areas. An important reason for this inferiority is the fact that rural sanitation is less a social responsibility than an individual responsibility, which many rural families cannot finance. The rural culture imposes many handicaps on the rural family's health and wealth. Such handicaps may be moderated by sanitation and related social and economic measures, if the measures selected are appropriate to the local needs and resources, which may vary greatly. Although sanitation needs are common to all rural areas, the refinement and complexity of sanitation facilities and services cannot be uniform. Allowing for variable circumstances, however, the basic elements of rural sanitation in the USA can be realized within a generation. The probable net gains in farm productivity would seem to warrant support for a rural sanitation programme on economic grounds alone, if an economic market may be assumed for the increase in agricultural production.

Agriculture↗
PubMed2003

Natural antimicrobial agent (reuterin) produced by lactobacillus reuteri for sanitization of biological tissues inoculated with pseudomonas aeruginosa.

The study was done to evaluate the efficacy of using reuterin produced by Lactobacillus reuteri to sanitize biological tissues. The microorganism tested in the study was Pseudomonas aeruginosa, a common cause of nosocomial biomaterial-related infections. The inhibitory effect of reuterin on P. aeruginosa for an inoculated tissue was investigated at different conditions of concentration, temperature, and pH. Additionally, the cellular compatibility of the reuterin-sanitized tissue was evaluated. Glutaraldehyde was employed as a control. It was noted that the minimum inhibitory concentration (MIC, 33.0 +/- 2.9 ppm) and minimum bactericidal concentration (MBC, 50.0 +/- 0.0 ppm) values of reuterin for P. aeruginosa were significantly lower than their glutaraldehyde counterparts (MIC, 130.0 +/- 8.2 ppm and MBC, 180.0 +/- 18.3 ppm). This indicated that reuterin was more efficient than glutaraldehyde as an antimicrobial agent. The addition of reuterin on the inoculated tissue led to a reduced viability of P. aeruginosa. The reduction in the P. aeruginosa culture was more pronounced with increasing the concentration of reuterin (0-100 ppm). At increasing temperature (25-45 degrees C), there was an increasing effect of reuterin on its sanitization activity. However, it should be pointed out that the growth of P. aeruginosa in the nutrient broth was also significantly affected by temperature. The sanitization activity of reuterin was more evident with increasing the pH level (pH 6.5-8.5). The cytotoxicity of reuterin was significantly lower than that of glutaraldehyde. Additionally, the cellular compatibility of the reuterin-sanitized tissue was superior to its glutaraldehyde-sanitized counterpart.

Aldehydes↗
PubMed1998

Bacteriocidal activity of sanitizers against Enterococcus faecium attached to stainless steel as determined by plate count and impedance methods.

Enterococcus faecium attached to stainless steel chips (100 mm2) was treated with the following sanitizers: sodium hypochlorite, peracetic acid (PA), peracetic acid plus an organic acid (PAS), quaternary ammonium, organic acid, and anionic acid. The effectiveness of sanitizer solutions on planktonic cells (not attached) was evaluated by the Association of Official Analytical Chemists (AOAC) suspension test. The number of attached cells was determined by impedance measurement and plate count method after vortexing. The decimal reduction (DR) in numbers of the E. faecium population was determined for the three methods and was analyzed by analysis of variance (P < 0.05) using Statview software. The adhered cells were more resistant (P < 0.05) than nonadherent cells. The DR averages for all of the sanitizers for 30 s of exposure were 6.4, 2.2, and 2.5 for the AOAC suspension test, plate count method after vortexing, and impedance measurement, respectively. Plate count and impedance methods showed a difference (P < 0.05) after 30 s of sanitizer exposure but not after 2 min. The impedance measurement was the best method to measure adherent cells. Impedance measurement required the development of a quadratic regression. The equation developed from 82 samples is as follows: log CFU/chip = 0.2385T2-0.96T + 9.35, r2 = 0.92, P < 0.05, T = impedance detection time in hours. This method showed that the sanitizers PAS and PA were more effective against E. faecium than the other sanitizers. At 30 s, the impedance method recovered about 25 times more cells than the plate count method after vortexing. These data suggest that impedance measurement is the method of choice when evaluating the number of bacterial cells adhered to a surface.

Bacterial Adhesion↗
PubMed2002

Evaluation of household sanitizers for reducing levels of Escherichia coli on iceberg lettuce.

Diluted solutions of various household sanitizers (apple cider vinegar, white vinegar, bleach, and a reconstituted lemon juice product) were tested for their effectiveness in reducing counts of inoculated Escherichia coli and naturally present aerobic, mesophilic bacteria on lettuce. Sanitization treatments were carried out at 4 degrees C and at room temperature (ca. 21 degrees C) with and without agitation and at different exposure times (0, 1, 5, and 10 min). Of the sanitizers tested, 35% white vinegar (1.9% acetic acid) was the most effective in reducing E. coli levels (with a 5-log10 reduction after 5 min with agitation and after 10 min without agitation) and in reducing aerobic plate counts (with a >2-log10 reduction after 10 min with agitation). Lettuce samples treated with diluted household sanitizers were analyzed for consumer acceptability by sensory evaluation using a 9-point hedonic scale. The sanitized samples did not differ in acceptability (P > 0.05), except for samples treated with white vinegar. Samples treated with the white vinegar for 10 min were noticeably sour and slightly wilted in appearance. Consumer acceptability was maintained with all sanitization treatments, including those involving 35% white vinegar.

Acetic Acid↗
PubMed1991

Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma.

A total of 144 studies were analysed to examine the impact of improved water supply and sanitation facilities on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma. These diseases were selected because they are widespread and illustrate the variety of mechanisms through which improved water and sanitation can protect people. Disease-specific median reduction levels were calculated for all studies, and separately for the more methodologically rigorous ones. For the latter studies, the median reduction in morbidity for diarrhoea, trachoma, and ascariasis induced by water supplies and/or sanitation was 26%, 27%, and 29%, respectively; the median reduction for schistosomiasis and dracunculiasis was higher, at 77% and 78%, respectively. All studies of hookworm infection were flawed apart from one, which reported a 4% reduction in incidence. For hookworm infection, ascariasis, and schistosomiasis, the reduction in disease severity, as measured in egg counts, was greater than that in incidence or prevalence. Child mortality fell by 55%, which suggests that water and sanitation have a substantial impact on child survival. Water for personal and domestic hygiene was important in reducing the rates of ascariasis, diarrhoea, schistosomiasis, and trachoma. Sanitation facilities decreased diarrhoea morbidity and mortality and the severity of hookworm infection. Better water quality reduced the incidence of dracunculiasis, but its role in diarrhoeal disease control was less important than that of sanitation and hygiene.

Ascariasis↗