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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↗
PubMedDate not supplied

Effect of isolation and sanitation on the recovery of F-strain mycoplasma gallisepticum from chronically infected hens held in biological isolation units.

Two trials were conducted to determine if individual housing or improved sanitation would enable hens to clear Mycoplasma gallisepticum (MG) infection. In each of the two trials, 40 commercial leghorn hens were infected with F strain MG (F-MG) and confined in biological isolation units in two groups: 1) hens housed individually in each of eight isolation units and 2) hens housed in groups of four in each of eight other units. Each of these two groups was further subdivided into two groups: 1) non-sanitized, having the isolation unit interior cleaned but not sanitized once each 2 weeks; and 2) sanitized, having the isolator interior thoroughly cleaned and sanitized twice weekly. Choanal cleft swabs were obtained five times over a period of 16 weeks in Trial 1 and six times over 22 weeks in Trial 2. Isolates were identified as F-MG positive by agar plate fluorescent-antibody method. The incidence of isolation of F-MG did not differ significantly between individually housed and group-housed hens, except that the percentage of positive isolations was significantly lower in individually housed/sanitized hens than group-housed/sanitized hens in Trial 1. Sanitizing had no consistent beneficial effect. The results do not support the theory that hens can clear F-MG infection if isolated from other infected hens.

Animal Husbandry↗
PubMed2004

Effect of water and sanitation on childhood health in a poor Peruvian peri-urban community.

BACKGROUND: Inadequate water and sanitation adversely affect the health of children in developing countries. We aimed to assess the effects of water and sanitation on childhood health in a birth cohort of Peruvian children. METHODS: We followed up children once a day for diarrhoea and once a month for anthropometry, and obtained data for household water and sanitation at baseline. FINDINGS: At 24 months of age, children with the worst conditions for water source, water storage, and sanitation were 1.0 cm (95% CI 0.1-0.8) shorter and had 54% (-1 to 240) more diarrhoeal episodes than did those with the best conditions. Children from households with small storage containers had 28% (1-63) more diarrhoeal episodes than did children from households with large containers. Lack of adequate sewage disposal explained a height deficit of 0.9 cm (0.2-1.7) at 24 months of age. Better water source alone did not accomplish full health benefits. In 24-month-old children from households with a water connection, those in households without adequate sewage disposal and with small storage containers were 1.8 cm (0.1-3.6) shorter than children in households with sewage and with large storage containers. INTERPRETATION: Our findings show that nutritional status is a useful endpoint for water and sanitation interventions and underscores the need to improve sanitation in developing countries. Improved and more reliable water sources should discourage water storage at risk of becoming contaminated, decrease diarrhoeal incidence, and improve linear growth in children.

Age Factors↗
PubMed1999

A close look at alcohol gel as an antimicrobial sanitizing agent.

BACKGROUND: Hand transmission of microbes by health care workers is a primary cause of nosocomial infections in both long-term and acute care facilities. Compliance with effective handwashing and hand sanitization regimens can break this cycle. METHODS: We investigated the antimicrobial efficacy and irritation potential of 5 handwash product regimens: a nonantimicrobial lotion soap, an antimicrobial lotion soap, an alcohol gel sanitizer, a nonantimicrobial lotion soap with an alcohol gel sanitizer, and an antimicrobial lotion soap with an alcohol gel sanitizer. The regimens were evaluated by using a Healthcare Personnel Handwash procedure, and irritation was assessed by using expert hand evaluation after 25 consecutive washes. RESULTS: The Healthcare Personnel Handwash data showed that the mean log reductions from baseline were greatest for the lotion soaps with alcohol gel sanitizer, less for the alcohol and the antimicrobial soap alone, and least for the bland soap. All of the product regimens showed a low potential for skin irritation. CONCLUSION: In terms of both microorganism reduction and skin irritation, the most effective product regimens were the use of alcohol gel sanitizer in combination with either an antimicrobial or a plain lotion soap.

Adult↗
PubMed2003

Ingestion of Salmonella enterica serotype Poona by a free-living mematode, Caenorhabditis elegans, and protection against inactivation by produce sanitizers.

Free-living nematodes are known to ingest food-borne pathogens and may serve as vectors to contaminate preharvest fruits and vegetables. Caenorhabditis elegans was selected as a model to study the effectiveness of sanitizers in killing Salmonella enterica serotype Poona ingested by free-living nematodes. Aqueous suspensions of adult worms that had fed on S. enterica serotype Poona were treated with produce sanitizers. Treatment with 20 microg of free chlorine/ml significantly (alpha = 0.05) reduced the population of S. enterica serotype Poona compared to results for treating worms with water (control). However, there was no significant difference in the number of S. enterica serotype Poona cells surviving treatments with 20 to 500 microg of chlorine/ml, suggesting that reductions caused by treatment with 20 microg of chlorine/ml resulted from inactivation of S. enterica serotype Poona on the surface of C. elegans but not cells protected by the worm cuticle after ingestion. Treatment with Sanova (850 or 1,200 microg/ml), an acidified sodium chlorite sanitizer, caused reductions of 5.74 and 6.34 log(10) CFU/worm, respectively, compared to reductions from treating worms with water. Treatment with 20 or 40 microg of Tsunami 200/ml, a peroxyacetic acid-based sanitizer, resulted in reductions of 4.83 and 5.34 log(10) CFU/worm, respectively, compared to numbers detected on or in worms treated with water. Among the organic acids evaluated at a concentration of 2%, acetic acid was the least effective in killing S. enterica serotype Poona and lactic acid was the most effective. Treatment with up to 500 microg of chlorine/ml, 1% hydrogen peroxide, 2,550 microg of Sanova/ml, 40 microg of Tsunami 200/ml, or 2% acetic, citric, or lactic acid had no effect on the viability or reproductive behavior of C. elegans. Treatments were also applied to cantaloupe rind and lettuce inoculated with S. enterica serotype Poona or C. elegans that had ingested S. enterica serotype Poona. Protection of ingested S. enterica serotype Poona against sanitizers applied to cantaloupe was not evident; however, ingestion afforded protection of the pathogen on lettuce. These results indicate that S. enterica serotype Poona ingested by C. elegans may be protected against treatment with chlorine and other sanitizers, although the basis for this protection remains unclear.

Animals↗
PubMed2000

Reduction of Escherichia coli O157:H7 counts on whole fresh apples by treatment with sanitizers.

The objectives of this study were to determine if washing of whole apples with solutions of three different sanitizers (peroxyacetic acid, chlorine dioxide, or a chlorine-phosphate buffer solution) could reduce a contaminating nonpathogenic Escherichia coli O157:H7 population by 5 logs and at what sanitizer concentration and wash time such a reduction could be achieved. Sanitizers were tested at 1, 2, 4, 8, and 16 times the manufacturer's recommended concentration at wash times of 5, 10, and 15 min. Whole, sound Braeburn apples were inoculated with approximately 1 x 108 or 7 x 106 CFU per apple, stored for 24 h, then washed with sterile water (control) or with sanitizers for the prescribed time. Recovered bacteria were enumerated on trypticase soy agar. Washing with water alone reduced the recoverable population by almost 2 logs from the starting population; this can be attributed to physical removal of organisms from the apple surface. No sanitizer, when used at the recommended concentration, reduced the recovered E. coli population by 5 logs under the test conditions. The most effective sanitizer, peroxyacetic acid, achieved a 5-log reduction when used at 2.1 to 14 times its recommended concentration, depending on the length of the wash time. The chlorine-phosphate buffer solution reduced the population by 5 logs when used at 3 to 15 times its recommended concentration, depending on wash time. At no concentration or wash time tested did chlorine dioxide achieve the 5-log reduction.

Buffers↗
PubMed1993

Effect of heating-ventilation-air conditioning system sanitation on airborne fungal populations in residential environments.

Commercial air duct sanitation services are advertised to the public as being effective in reducing indoor aeroallergen levels despite the absence of published supporting data. Eight residential heat-ventilation-air conditioning (HVAC) systems in six homes and seven HVAC systems in five homes in winter and summer, respectively, were sampled to determine fungal colony forming units (CFUs) prior to and after an HVAC sanitation procedure was performed by a local company. Two houses in which no sanitation procedure was performed served as controls in each study phase. Two sample sets were obtained at each HVAC system prior to cleaning in order to determine baseline CFU levels. The test HVAC systems were then cleaned, and the HVAC systems allowed to operate as desired by the residents. Posttreatment sampling was performed 48 hours and then weekly after cleaning for 8 weeks. The HVAC systems were analyzed by exposing sterile 2% malt extract media plates at a 90-degree angle to the air flow at the air supply and air return vents. The baseline CFUs were similar in the control and study houses. Eight weeks after sanitation, the study houses demonstrated an overall CFU reduction of 92% during winter and 84% during summer. No reduction in CFU values was observed over the 8-week study period for the houses selected as controls. Further, HVAC sanitation appeared to reduce the number of fungal colonies entering and leaving the HVAC system, suggesting that the HVAC contained a significant percentage of the total fungal load in these homes. These data suggest that HVAC sanitation may be an effective tool in reducing airborne fungal populations in residential environments.

Air Conditioning↗
PubMed1996

The effect of toilet sanitizers and detergents on immunological occult blood tests.

Effects of time-releasing toilet bowl sanitizers and their main constituents, detergents, on immunological fecal occult blood tests were examined. Six kinds of toilet sanitizers and 19 kinds of detergents were included. Patients' fecal samples and hemoglobin solutions were measured by means of quantitative immunological fecal occult blood tests after being mixed with sanitizer or detergent solutions. Marked reduction in hemoglobin concentration or antigenicity was observed after the addition of sanitizers or detergents at a final concentration of 0.5 g/l. Most of these inhibitory reactions were dose dependent. In contrast with the immunological method, the chemical method using o-tolidine and guaiac were not affected by the detergents tested. In sampling feces for immunological fecal occult blood tests, contact of samples with sanitizer solutions should be avoided.

Detergents↗
PubMed2003

The role of health education and sanitation in the control of helminth infections.

Health education and sanitation are two important components of primary health care system introduced by the World Health Organization (WHO) as a basis for the prevention and control of communicable diseases. However, the roles of health education and sanitation in disease control have been controversial, especially in the wake of recent advances in safe and effective oral drugs. This article has reviewed the various health education and sanitation interventions around the world to determine what roles they have played in the past relative to other intervention strategies and the role they have to play in future control efforts. It appears clear-cut from the review, that while chemotherapy has been and will remain the best option for morbidity control, sanitation has an important role to play not only to sustain the benefits of chemotherapy but also to protect the uninfected. Health education that is effective, simple and low-cost remains the only tool for creating the enabling environment for both chemotherapy and sanitation to thrive.

Animals↗
PubMed2000

Effect of hand sanitizer use on elementary school absenteeism.

BACKGROUND: Several studies have indicated a connection between handwashing and illness-related absenteeism in school settings. The difficulty of ensuring consistent and effective handwashing among student populations has also been noted. The purpose of this study was to assess the effectiveness of the use of an alcohol gel hand sanitizer in the classroom to help decrease the illness-related absentee rate for elementary school students. METHODS: This study involved 5 individual school districts, 16 individual schools, and more than 6000 students in Delaware, Ohio, Tennessee, and California. Individual schools in each district were paired into product and control groups. In the product group schools, an alcohol gel hand sanitizer was used by the students and staff when entering and leaving the classroom. Absenteeism due to infection was recorded, and the data were statistically analyzed. RESULTS: The overall reduction in absenteeism due to infection in the schools included in this study was 19.8% for schools that used an alcohol gel hand sanitizer compared with the control schools (P <.05). Data from the school system with the largest teacher population (n = 246) showed that teacher absenteeism decreased 10.1% (trend) in the schools where sanitizer was used. CONCLUSION: Elementary school absenteeism due to infection is significantly reduced when an alcohol gel hand sanitizer is used in the classroom as part of a hand hygiene program.

Absenteeism↗
PubMed2002

Estimating the burden of disease from water, sanitation, and hygiene at a global level.

We estimated the disease burden from water, sanitation, and hygiene at the global level taking into account various disease outcomes, principally diarrheal diseases. The disability-adjusted life year (DALY) combines the burden from death and disability in a single index and permits the comparison of the burden from water, sanitation, and hygiene with the burden from other risk factors or diseases. We divided the world's population into typical exposure scenarios for 14 geographical regions. We then matched these scenarios with relative risk information obtained mainly from intervention studies. We estimated the disease burden from water, sanitation, and hygiene to be 4.0% of all deaths and 5.7% of the total disease burden (in DALYs) occurring worldwide, taking into account diarrheal diseases, schistosomiasis, trachoma, ascariasis, trichuriasis, and hookworm disease. Because we based these estimates mainly on intervention studies, this burden is largely preventable. Other water- and sanitation-related diseases remain to be evaluated. This preliminary estimation of the global disease burden caused by water, sanitation, and hygiene provides a basic model that could be further refined for national or regional assessments. This significant and avoidable burden suggests that it should be a priority for public health policy.

Adolescent↗
PubMed1998

Efficacy of washing and sanitizing trailers used for swine transport in reduction of Salmonella and Escherichia coli.

Healthy pigs can carry Salmonella in their intestine and may shed this pathogen because of stresses incurred during transportation, contaminating trailer floors and bedding material. If not cleaned and sanitized between trips, trailers and bedding have the potential to infect other farms, the abattoir environment, or other animals with Salmonella. Floors and bedding material from pig trailers were sampled to determine the efficacy of the abattoir-developed washing and sanitizing regime on the level of Salmonella before and after a single haul. Escherichia coli levels were an indicator of high contamination. The study also determined the effect of ambient temperature (during four seasons) and of the distance the pigs traveled in the haulers (> 500 miles or < 500 miles) on bacterial levels. Salmonella was isolated from 80% of the bedding material tested. Of the 188 floor samples taken, 41.5% were positive for Salmonella before washing, and 2.7% were positive after washing and sanitizing. E. coli was isolated from all bedding material and floor samples before washing, but washing and sanitizing significantly decreased levels (P < 0.05) by 2 logs. There was no significant difference (P > 0.05) in the number of Salmonella- or E. coli-positive trailers attributable to distance traveled or season of the year. These results demonstrate that washing and sanitizing the trailers after each load significantly reduced levels of Salmonella and its possible spread by the contaminated trailer and bedding, which ultimately could promote improvement in food safety.

Animals↗
PubMed1998

Effect of chemical sanitizing agents on ATP bioluminescence measurements.

Experiments were conducted to determine the effects of sodium hypochlorite (SH), quaternary ammonium (QA), trisodium phosphate (TSP), lactic acid (LA), hydrogen peroxide (HP), and trichlosan (TR) on ATP bioluminescence measurements. Each sanitizer was tested at three different levels and compared to a control group containing no sanitizer. ATP from three sources was analyzed, Escherichia coli, chicken blood, and a pure ATP standard. The effect of each sanitizer was reported as a percent decrease in log10 relative light units (LRLU) for the treatment groups when compared to LRLU from the control groups. SH concentrations of 30, 50, and 70 ppm and quaternary ammonium at concentrations of 10, 20, and 30 ppm had no effect on LRLU measurements, regardless of the ATP source. LA concentrations of 0.5% and higher reduced LRLU by 75%. LRLU measurements were significantly (P < or = 0.05) reduced by approximately 60% when levels of TSP exceeded 1%. HP had no effect on LRLU measurements from any of the ATP sources at 0.1%; however, at 1% HP significantly (P < or = 0.05) decreased LRLU measurements by approximately 60% for all ATP sources. TR at 0.25% had no significant effect on LRLU measurements from any of the ATP sources. TR at 0.5 and 1% reduced LRLU measurements by 30 and 50%, respectively. These results indicate that commercial sanitizers containing LA, TSP, HP, or TR may negatively affect LRLU measurements if the sanitizer is allowed to come into direct contact with the ATP bioluminescence reagents.

Adenosine Triphosphate↗
PubMed2001

Wrinkled alfalfa seeds harbor more aerobic bacteria and are more difficult to sanitize than smooth seeds.

At least 14 separate outbreaks of food poisoning attributed to either Salmonella enterica or Escherichia coli O157:H7 have been traced to sprouts in the past decade. Seeds contaminated with human pathogens caused most of these outbreaks, thus many sprout growers are now treating alfalfa seeds with the sanitizing agent, calcium hypochlorite (Ca[OCl]2), prior to sprouting. The efficacy of alfalfa seed sanitation varies between seed lots and between seeds within each lot. Alfalfa seeds from different seed lots were sorted by type in an effort to determine if certain seed types carry more aerobic bacteria than other seed types. Seeds with a wrinkled type, characteristic of lygus bug damage, had significantly higher levels of culturable aerobic bacteria and were more difficult to sanitize than smooth, healthy seeds. After sanitation, wrinkled alfalfa seeds that had been inoculated with S. enterica ser. Newport carried significantly higher levels of Salmonella Newport than smooth seeds. If S. enterica is present on wrinkled seeds in naturally contaminated seed lots, it may be difficult to chemically sanitize the seed lot. Removal of the wrinkled alfalfa seeds from the seed lots, perhaps by adapting color sorting equipment similar to that used to sort rice grains and other seeds, should reduce the level of aerobic bacteria in seed lots and may result in lower levels of human pathogens on contaminated alfalfa seeds.

Bacteria, Aerobic↗
PubMed2000

Water, sanitation and diarrhoea.

Water, sanitation and health are inseparably linked. Diarrhoea and other water related diseases are the major causes of health problems in developing countries. Although the need for water and sanitation interventions for health promotion has been recognised, these are labeled as costly and are often neglected in the primary healthcare programmes. Lack of proper water and sanitation initiatives based on appropriate techniques, technologies, knowledge and/or implementation methods have hindered the expected achievements through water and sanitation interventions. Since water and sanitation initiatives include both availability of provisions and their effective use (which mean behavioral changes), they are technically and socially challenging. Disasters and emerging water quality problems, such as arsenic in groundwater, have further been complicating this situation. After reviewing relevant articles, several research issues are suggested in the context of developing country perspectives.

Developing Countries↗
PubMed2001

Sanitation, community environments, and childhood diarrhoea in rural Zimbabwe.

Childhood diarrhoea can be transmitted within the household and community environments. This study examined the effect of partial latrine coverage on diarrhoeal morbidity at the household and community levels. Weekly morbidity data on 272 children, aged less than five years, were collected for 45 weeks from October 1996 to August 1997 in two neighbouring semi-arid communities in rural Zimbabwe. The communities were similar except for sanitation. In Community A, 62% of the children lived in households with a latrine, and in Community B, there was no sanitation. Diarrhoeal morbidity was 68% lower in Community A than in Community B. In addition, the children from the households in Community A without a latrine had lower diarrhoeal morbidity than the children in Community B. The inter-community difference in diarrhoeal morbidity was likely to be due to the latrines and associated hygiene education interrupting intra- and inter-household transmission of diarrhoea. The latrines reduced faecal contamination of the community environment, and as diarrhoeal morbidity fell, contact between infectives and susceptibles within the community would also have fallen. The neighbourhoods in Community A where the adjacent households did not have sanitation had higher diarrhoeal morbidity than in the neighbourhoods where one household did have sanitation. The results of the study suggest that sanitation programmes, which share building costs between the state and individuals, i.e. households, and hence, do not achieve complete coverage in a community, benefit the whole community, because the households that cannot afford a latrine experience lower diarrhoeal morbidity due to the safer community environment.

Child↗
PubMed1985

The essential role of drinking water and sanitation in primary health care.

The purpose of the paper is to draw attention to the fact that drinking water supply and the provision of sanitation facilities form an indispensable element in disease prevention and primary health care programmes. The world situation regarding the availability of drinking water and sanitation facilities is dramatic, in that more than 1500 million people lact proper facilities; the implications in terms of health and cost are stupendous. It is therefore a fortunate development that the International Drinking Water and Sanitation Decade (1981-1990) is on its way to an appealing initiative. The paper discusses water and sanitation related diseases, and the established experience that water and sanitation programmes can only have a health impact if they are jointly developed, and if they are integrated with health education. Operational implications of such programmes as an element of primary health care are reviewed.

Adolescent↗