Institute of Chemistry Materials and Natural Resources of Poitiers (IC2MP UMR 7285), University of Poitiers, 1 rue Marcel Doré, Bâtiment B1, TSA 41105, 86073, Poitiers Cedex 9, France.
Laboratoires Anios, Pavé du Moulin, 59260, Lille-Hellemmes, France.
Environ Sci Pollut Res Int. 2019 Feb;26(5):4938-4951. doi: 10.1007/s11356-018-3882-1. Epub 2018 Dec 19.
This study focused on the presence of three biocidal products specific to healthcare facilities, i.e. chlorhexidine digluconate (CHD), bis(aminopropyl)laurylamine (BAPLA), and didecyldimethylammonium chloride (DDAC), in a hospital sewage system. Five sampling campaigns were conducted in 2016 and 2017 throughout the entire Poitiers University Hospital sewage system. DDAC concentrations ranging from 933 ± 119 to 3250 ± 482 μg/L were detected in 24-h composite samples, while lower concentrations (both within the same range) were detected for the two other compounds (i.e. 25 ± 5 to 97 ± 39 μg/L for CHD and 18 ± 3 to 142 ± 16 μg/L for BAPLA). Based on these findings, a mass balance was determined for these discharged compounds to compare the quantities detected in discharges to the amounts used for healthcare in the hospital. Hence, 60-90% of the quantities of DDAC used were found to be present at the hospital sewage outfall. Higher percentages of CHD (100-242%) were noted because of the high presumably quantities used for antiseptic applications, which were not considered in mass balance calculation. Finally, only 10-30% of BAPLA quantities used were detected at the site outfall. Analysis of the results for the different sampling points revealed the nature of the emission sources. For surface applications of DDAC and BAPLA, management of hospital linen is thus a major source of discharged biocidal products, probably following the washing of biocide-soaked textiles used for hospital facility maintenance. Moreover, discharge of biocidal products from a healthcare establishment depends especially on biocide handling practices in the emitting establishment. For BAPLA, compliance with hospital recommended dosages and practices whereby operators are required to prepare tailored quantities of detergents and disinfectants for each specific task could largely explain the limited release of this compound.
本研究关注的是医疗设施中三种特定的杀菌产品的存在情况，即葡萄糖酸氯己定（CHD）、双（氨丙基）月桂酰胺（BAPLA）和二癸基二甲基氯化铵（DDAC），这些产品存在于医院污水系统中。2016 年和 2017 年期间，在整个普瓦捷大学医院污水系统中进行了五次采样。在 24 小时混合样本中检测到 DDAC 的浓度范围为 933±119 至 3250±482μg/L，而其他两种化合物的浓度较低（均在同一范围内），即 CHD 为 25±5 至 97±39μg/L，BAPLA 为 18±3 至 142±16μg/L。基于这些发现，对这些排放化合物进行了质量平衡，以比较排放物中检测到的数量与医院内医疗保健使用的数量。因此，在医院污水排放口发现使用的 DDAC 数量的 60-90%。由于高浓度的 CHD（100-242%）可能用于防腐应用，而这些应用未在质量平衡计算中考虑，因此 CHD 的百分比更高。最后，在排放口仅检测到使用的 BAPLA 数量的 10-30%。对不同采样点的结果进行分析揭示了排放源的性质。对于 DDAC 和 BAPLA 的表面应用，医院布草的管理是排放杀菌产品的主要来源，可能是在洗涤用于医院设施维护的沾有杀菌剂的纺织品之后。此外，医疗机构排放杀菌产品尤其取决于排放机构中杀菌产品的处理方式。对于 BAPLA，遵守医院建议的剂量和做法，即要求操作人员为每个特定任务准备适量的清洁剂和消毒剂，这可以在很大程度上解释这种化合物的有限释放。
