Disinfecting Shower Heads

markhomer said:
Hi Nigel , sorry to hear , but as your case demonstrates, legionnaires is a real risk ,

"I work in the business of legionella control ........

If you want to keep safe , i would suggest a deep clean of your system , pulling through 400 ppm peroxide over 1 hour , if never done before you may need to repeat until system seems clear , then flush out and retreat at 100 ppm , leave 24 hours , then flush again , dose tanks to 15 ppm and leave as a residual . There after top tank to 10-15 ppm every time you refill ."

Showing my ignorance what exactly is 400ppm? With a tank of one cubic metre ie 1,000,000 ml are we looking at 400ml to achieve this ppm?
And what concentration peroxide?
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PS - this is a more interesting read for some of the background factors;

http://www.waterheaterrescue.com/Troubleshooting/stinky-water-in-hot-water-heaters.html

BTW - I am not entirely sure how just disinfecting the shower head ensures the removal of legionelia - the bacteria is commonly present in water anyway and are we certain in some cases it isnt the pipework behind the shower that may have a high level of contamination if it has been left to stand. Treating the shower head would surely only deal with the bacteria actually in the head - unless the bacteria require aerobic conditions in which to mutiply? I must check.
 
Dave100456 said:
Showing my ignorance what exactly is 400ppm? With a tank of one cubic metre ie 1,000,000 ml are we looking at 400ml to achieve this ppm?
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Seems in the right ballpark - I mix up my annual dose of tank cleaner in a one-litre jug.

Obviously tank sizes and chemical concentrations vary, I just mean that "half a jug" is believable rather than a bucket or an eye-dropper.

Pete
 
nigelmercier said:
After trying six other types, I am now on a more powerful antibiotic (Ciproxin) which is one that is used for Legionella (and Antrax). I seem to be getting better, it is possible that this was Legionella again.
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I had Ciprofloxacin tabs (same thing?) prescribed "one the off chance" I had a stomach upset during doctors check up prior to a trip to India, and it did indeed work in the circumstances, however Indian circumstances being as they were, I found I could acquire the stuff very easily there with no problems, just a wave of the packet was enough. We will lose these valuable drugs if we carry on prescribing them so lightly, and the world will be a terrifying place.

However it sounds like you needed yours more than I needed mine, I just needed to leave India.

(I'm off to boil my shower heads...)

Ooh nearly missed my point, the red mould on shower heads can apparently be toxic too, and funghi are notoriously resilient in the face of antibiotics.
 
ip485 said:
http://www.physiologyweb.com/calculators/dilution_calculator_ppb_ppm_ppt_pph.html

so if I have followed this correctly 5 litres of 12% food grade peroxide on eBay will treat 300L to yield a 400ppm solution.

Is that correct?
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;

Actually, I don't think so. This is why I asked the Mark Homer for clarification. I too have worked with water treatment.

First, hydrogen peroxide by itself is a very poor disinfection agent for potable water. The cell wall of most organisms contain an enzyme that quickly neutralizes the H2O2, unless used at high concentration (drug store stuff is pre-mixed at 3%). If the concentration is high enough to work, it is unhealthy in the water. I do not know of ANY potable water standard, including WHO and USEPA, that approve H2O2 alone as a disinfectant for potable water. If anyone can find a standard that approves plain H2O2 alone for potable water disinfection, please post it.

I believe there are some rather new silver stabilized products (just in the past few years) that can get past this problem, and they are used at the concentrations and in the manner suggested (the recommended ppm are what he stated). However, I am not aware of where these can be purchased at retail, even on the net. That would also be interesting information.

Specifically, this is interesting because H2O2 is not corrosive to aluminium tanks.

I would also like to know what real advantage it has over stabilized chlorine (Aquamega).

This is very new and not yet widely accepted. Just a few trial sites, from what I can see. But I want to know more.
 
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thinwater said:
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Actually, I don't think so. This is why I asked the Mark Homer for clarification. I too have worked with water treatment.

First, hydrogen peroxide by itself is a very poor disinfection agent for potable water. The cell wall of most organisms contain an enzyme that quickly neutralizes the H2O2, unless used at high concentration (drug store stuff is pre-mixed at 3%). If the concentration is high enough to work, it is unhealthy in the water. I do not know of ANY potable water standard, including WHO and USEPA, that approve H2O2 alone as a disinfectant for potable water. If anyone can find a standard that approves plain H2O2 alone for potable water disinfection, please post it.

I believe there are some rather new silver stabilized products (just in the past few years) that can get past this problem, and they are used at the concentrations and in the manner suggested (the recommended ppm are what he stated). However, I am not aware of where these can be purchased at retail, even on the net. That would also be interesting information.

Specifically, this is interesting because H2O2 is not corrosive to aluminium tanks.

I would also like to know what real advantage it has over stabilized chlorine (Aquamega).

This is very new and not yet widely accepted. Just a few trial sites, from what I can see. But I want to know more.
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I have, for the past 15 years, used one of the silver chelate solutions.
I've never seen it for sale in the UK (possibly because it's more expensive than bleach).
Trade-name AquaClean, made by a German company Yachticon A Nagel gmbh.
website www.yachticon.de

I use it at the recommended strength, every time I leave the boat for more than 3 weeks.
Unlike the suggested methods in the trail, it produces no after-taste, is quite safe to drink and really does work - not very new though.
I'm glad to report that I've never had Legionnaire's disease and, in any case the quinoline antibiotic referred to would be quite lethal for me with G6PD.
Out here in Greece water temperature is about 28C, but I've never heard of a case of Legionnaire's disease here.
Most outbreaks appear to be down to infection of cascade coolers in air-conditioning systems.
 
thinwater said:
;

Actually, I don't think so. This is why I asked the Mark Homer for clarification. I too have worked with water treatment.

First, hydrogen peroxide by itself is a very poor disinfection agent for potable water. The cell wall of most organisms contain an enzyme that quickly neutralizes the H2O2, unless used at high concentration (drug store stuff is pre-mixed at 3%). If the concentration is high enough to work, it is unhealthy in the water. I do not know of ANY potable water standard, including WHO and USEPA, that approve H2O2 alone as a disinfectant for potable water. If anyone can find a standard that approves plain H2O2 alone for potable water disinfection, please post it.

I believe there are some rather new silver stabilized products (just in the past few years) that can get past this problem, and they are used at the concentrations and in the manner suggested (the recommended ppm are what he stated). However, I am not aware of where these can be purchased at retail, even on the net. That would also be interesting information.

Specifically, this is interesting because H2O2 is not corrosive to aluminium tanks.

I would also like to know what real advantage it has over stabilized chlorine (Aquamega).

This is very new and not yet widely accepted. Just a few trial sites, from what I can see. But I want to know more.
Click to expand...


Sorry been busy treating water with silver stabilised hydrogen peroxide commercial and testing , should have mentioned the silver .

Using silver hydrogen peroxide products has transformed my business from the old days of chlorine products ,

Product i use is endosan 50 , which is 50 % hydrogen peroxide , as such you wouldnt sell to generally public ,very corrosive , but id rather handle that than chlorine .

For water tank on boat sizes you only need tiny amounts , but a more dilute , safer to use product may be developed , infact when i was first introduced to silver stabilised hydrogen peroxide it was as a potential agent for a safe 2.5% product for general plumbers , plumbers werent interested in disinfecting water tanks , i went on to become a user of the high conc version myself .

As for dosing amounts its just a matter of maths . I have my own formula for using 50 % silver hydrogen peroxide .
 
markhomer said:
Hi Nigel , sorry to hear , but as your case demonstrates, legionnaires is a real risk ,

I work in the business of legionella control and ive often considered the marine environment an ideal scenario for its growth .

From the water we fill with , often through blue alkathene pipes that run for miles around marinas , with deadlegs , high temps and light penetration all adding to risk factor thats before it gets to your boat !

Then lying in boat systems unused for long times , even in sunny scotland where i live i wouldnt say there isnt any part of my system hitting over 20 c and breeding bacteria .

You will have heard of many people who when cleaning out there pipework find its full of slimy ectoplasm stuff , this is biofilm and food for legionella bacterium and others .

If you want to keep safe , i would suggest a deep clean of your system , pulling through 400 ppm peroxide over 1 hour , if never done before you may need to repeat until system seems clear , then flush out and retreat at 100 ppm , leave 24 hours , then flush again , dose tanks to 15 ppm and leave as a residual . There after top tank to 10-15 ppm every time you refill .

You need to treat/clean all parts of system , investigate and remove deadlegs . On hot side if running from engine or electrical supply , check your calorifier gets to store at 60 c .though most heating systems ive experienced on boats easily do this .

Once peeps get over 45 they fall into higher cat groups for susceptibility to legionnaires, drinkers and smoking increases too .

Most people that get pneumonia dont get tested for legionella ( 12 day incubation for result ) ,

I would always recommend flushing through any showers or outlets that could cause atomised water that havent been in regular use ,or in temps over 20 c , , by putting a polythene bag over outlet , shower head , with hole in bottom and run as long as you can , this will help flush nasty , but if they are in a boat tank no good .


You get legionaires by inhaling infected water droplets into your lungs , not by drinking , hence focus on showers , though a high powered pumped water through a diffuser can cause atomisation too .

This also applies to hotels , villas etc and infact your own home after a cruise of 1 week or more .

Ive often thought there is a market for offering this service, but.
A. General public dont percieve this risk until it happens to them .
B, Boat owners often reluctant to pay commercial rates for services .

Sorry to dreeb on , but if one life saved , worth it .
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Thank you for sharing that. I have always been puzzled why nearly every time I go back to my job in Africa, I get an ear infection. From now on, I am going to dismantle and bleach the shower head in my accommodation...
 
All of the 'experts' and practitioners here have missed the obvious. I cannot think why?

Don't use the shower - strip wash instead. Bye bye legionella risk.
 
EdWingfield said:
All of the 'experts' and practitioners here have missed the obvious. I cannot think why?

Don't use the shower - strip wash instead. Bye bye legionella risk.
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I think you might have missed the significance of the word "aerosol" in the transmission of legionella.
 
To kill Legionnaires bacteria the water temperature in the calorifier needs to be above 60C. I used to clean our water tank, pipes, taps and shower head every year with one cup of bleach for 40 gallons of water. Run the taps and shower head to clean them and the pipes for a short time on....off. Leave for 12 hours, empty the tank, fill with water flush through the tank/s, taps and shower head, empty tank and fill with water.
 
sarabande said:
I think you might have missed the significance of the word "aerosol" in the transmission of legionella.
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I knew that I would be howled down by the 'experts'.

I used to enforce legislation/offer guidance on ships and boats.

I cannot recall learning of one legionella case attributed to ordinary use of water eg. washing up, washing hands and face? I will duly grovel to Mr Sarabande if he can point me to such a proven investigation.
 
not an expert, I merely wrote the plans to respond to and prevent infection when we had an outbreak in the South West.

It's not just aerosol transmission, physical contact between people (possibly with respiratory transmission also) is a documented here:-

nejm.org/doi/full/10.1056/NEJMc1505356#t=article

where reference is made to "a small area of the nonventilated room" as a possible place of transmission.

I cannot see how a strip wash, using contaminated water, will not give the bacteria a high opportunistic access to where they grow in lungs. Dermal translocation, generation of aerosols by movement of towel, finger/mouth contact, there are numerous ways to get the bug into the body.

There are also non-pneumonic forms of the infection, and it is really hard to see how intimate contact with legionella infected water does not present a very high risk of infection, especially amongst at-risk people.

Would you for instance, go swimming in a pool known to have legionella in it ?


PS. It's not about grovelling, it's about spreading the knowledge - which this thread has done so well - and enabling people to reduce risks by appropriate management and control of the vectors.
 
I don't think the shower head is the real issue. I do agree there is a real risk of legionnaires disease though. Water often sits in tanks for months and in summer, except maybe for in the uk, the conditions are perfect for the bugs to breed on the crud accumulated in the bottom of the tank or on the biofilm build up. In a commercial building this situation would attract the attention of the authorities with the power to prosecute for negligent maintenance.

A good procedure is is to keep the tanks clean, bleach sterilise at least annually and let the water flow out of the pipes if it has been left for a while stagnating.

To sterilise, some organisations and people use for example a treatment with sodium hypochlorite 5% solution mixed 250g to 400g per 1000lt. WHO has various similar recommended procedures.

Leave 30 mins contact then flush to avoid lingering smells.

Silver hydrogen peroxide can help treat the biofilm, but I don't believe it is a silver bullet.;-)
 
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>I do agree there is a real risk of legionnaires disease though. Water often sits in tanks for months and in summer, except maybe for in the uk, the conditions are perfect for the bugs to breed on the crud accumulated in the bottom of the tank or on the biofilm build up.

Temperatures of 32°C- 40°C (90°- 105°F) are ideal for growth of Legionnaires disease. If you think the tank water reaches that range of temperatures then use bleach as in my previous post.
 
Most freshwater will contain legionella. Yes I'll swim in freshwater.

As you said earlier, infected aerosol into lungs is the issue. Other transmissions, if they exist, are most unlikely.

I agree, control the vector - My answer = don't shower. But the 'trade' cannot make a living recommending that. I understand.

In my time I remember 3 investigations. The cases wanted compensation and required my evidence. Sadly, I disappointed them. Onset and incubation showed they were infected before boarding.

Mr Sarabande, if you appear in court as an 'expert witness', you'd better be sure of your ground or you will crash and burn. I wasn't, I sought backup from my NHS epidemiologists.
 
EdWingfield said:
Most freshwater will contain legionella. Yes I'll swim in freshwater.

As you said earlier, infected aerosol into lungs is the issue. Other transmissions, if they exist, are most unlikely.

I agree, control the vector - My answer = don't shower. But the 'trade' cannot make a living recommending that. I understand.

In my time I remember 3 investigations. The cases wanted compensation and required my evidence. Sadly, I disappointed them. Onset and incubation showed they were infected before boarding.

Mr Sarabande, if you appear in court as an 'expert witness', you'd better be sure of your ground or you will crash and burn. I wasn't, I sought backup from my NHS epidemiologists.
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thank God for someone who actually knows what they're talking about - I thought the thread was something from a leg-pull exercise!!
 
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