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Evaluation of hospital-grade disinfectants on viral deposition on surfaces after toilet flushing

  • Author Footnotes
    1 Present Address: School of Life and Environmental Science, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
    Hannah P. Sassi
    Correspondence
    Address correspondence to Hannah P. Sassi, MS, PhD, Water and Energy Sustainable Technology Center, University of Arizona, 2959 W Calle Agua Nueva, Tucson, AZ 85745. (H.P. Sassi).
    Footnotes
    1 Present Address: School of Life and Environmental Science, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
    Affiliations
    Water and Energy Sustainable Technology Center, University of Arizona, Tucson, AZ

    School of Life and Environmental Science, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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  • Kelly A. Reynolds
    Affiliations
    Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
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  • Ian L. Pepper
    Affiliations
    Water and Energy Sustainable Technology Center, University of Arizona, Tucson, AZ
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  • Charles P. Gerba
    Affiliations
    Water and Energy Sustainable Technology Center, University of Arizona, Tucson, AZ
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  • Author Footnotes
    1 Present Address: School of Life and Environmental Science, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
Published:January 02, 2018DOI:https://doi.org/10.1016/j.ajic.2017.11.005

      Highlights

      • Droplet deposition of virus occurred on surfaces around the toilet when untreated infectious material was flushed.
      • The highest concentration and incidence of surface contamination occurred nearest to the toilet bowl on the toilet seat and the toilet bowl rim.
      • The deposition of droplets was significantly reduced (P < .05) when the waste was treated using a peracetic acid, quaternary ammonium, and chlorine-based disinfectant prior to flushing.

      Background

      Past studies have shown that infectious aerosols created during toilet flushing result in surface contamination of the restroom. The goals of this study were to quantify viral contamination of surfaces in restrooms after flushing and the impact of disinfectants added to the toilet bowl prior to flushing on reducing surface contamination.

      Methods

      The degree of contamination of surfaces in the restroom was assessed with and without the addition of coliphage MS2 to the toilet bowl before flushing. The bowl water and various surfaces in the restroom were subsequently tested for the presence of the virus.

      Results

      The toilet bowl rim, toilet seat top, and toilet seat underside were contaminated in all trials without a disinfectant added to the bowl water before flushing. All disinfectants significantly reduced concentrations on surfaces when the contact time was ≥15 minutes. Hydrogen peroxide resulted in very little reduction of virus in the toilet bowl (<1 log10). Peracetic acid and quaternary ammonium had the greatest log reductions on virus in the organic matter in the toilet.

      Conclusions

      Toilet flushing resulted in extensive contamination of surfaces within the restroom. Addition of disinfectant to the toilet bowl prior to flushing reduced the level of contamination in the bowl and fomites after flushing.

      Key Words

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