Analysis On Sanitary Quality Of Hemodialysis Water In Hospital Of Hunan Province During The Period Of2003～2011

Objective:In order to understand the water hygienic quality influencing factors used in hospital hemodialysis and to provide scientific basis for supervision and monitoring on hospital hemodialysis water.Method:223random samples of hemodialysis-used water in128hospital consist of36upper first class hospitals and92non-A hospitals,were collected by Hunan Provincial Center for Disease Control and Prevention from2003to2011. These samples were extracted for physical, chemical and microbiological indicators testing, test items include calcium, aluminum,magnesium,copper,sodium,zinc,potassium,chloramines, chloride,nitrate,fluoride,sulfate,lead,arsenic,silver,mercury,selenium,chro mium (hexavalent),cadmium,barium, volatile phenols,and anionic synthetic detergents and other22physical and chemical indicators,total number of colonies and endotoxins are the two kinds of microorganismsindicators.All samples were calculated with qualified rate of hemodialysis water indexes and test values, and Excel2007and SPSS13.0software package were used for analysis of the qualified rate of hemodialysis water indexes and test valuesaccording to different years,levels of hospitals,treatment types,and cleaning frequency.Result:1.The total qualified rate of hemodialysis water were36.3%, wherein themagnesium, potassium, sulfate, copper,barium, nitrate, selenium, arsenic, silver, chromium, mercury, phenols, anionic and other13projects were100%qualified; calcium, chloride, chloramine, sodium, lead, cadmium, fluoride, aluminum, zinc andnine kinds of pass rates were92.0%,91.7%,97.7%,99.4%,98.9%,99.4%,99.4%,99.4%,98.9% respectively,and the qualified rate of total number of colonies, and endotoxins was70.3%and41.7%respectively.2. In the duration of the survey, of all the indicators of the detected samples, such as calcium, chloride, chloramine, sodium, lead, cadmium, fluoride, aluminum, and zinc are essentially in a declining trend, and only the qualified rate of the total number of colonies raise as the yearspass.3. No differences in the qualified rate of detected index between the three level hospitals and non three hospitals. Among the various detection index of hemodialysis water,only cadmium, fluoride, aluminum, zinc show a lower detection value in the three level hospitals than that in non three hospitals.4. Under different treatment methods, only the qualified rate of endotoxin shows a difference. The bipolar processing treatmentwas significantly higher in quality than the unipolar processing teatment. There is no difference in using the two kind of treatment system in detection index such as calcium, lead, cadmium, fluoride, aluminum, and the total number of colonies,while the detected value ofchloride, chloramine,sodium, zincwas significantly higher when using the unipolarprocessing treatment than bipolar processing treatment. There is a certain correlation between thequalified rate of chloramine as well as endotoxin anddifferent ways of treatments.5. The qualified rate of all detected indexes of hemodialysis water with cleaning frequency<4times/year and cleaning frequency of12times/year showed no significant differenceand so are their detection index values.Conclusion:1. From2003to2011,thoughthe detected values of indexes of water sampling in casual inspection in hemodialysis units in Hunan, showed a declining trend, the hygienic quality has not been improved significantly,which the key indicatorsinfluencing the quality of hemodialysis water and sanitation is endotoxin.2. There are differences insanitary quality of water for different levels of hospitals, hemodialysis water used in three A hospitals is of better sanitary quality than that of the other hospitals.3. Different types of treatment in hemodialysis water is an important factor affecting it’ssanitary quality, the use of bipolar processing treatment provide a better sanitary quality than unipolar processing treatment.4. The key for improving the sanitationqualiry of hemodialysis water is to melioratethe water treatment system and to keep up with regular maintenance. In addition,improving regular monitoring system, strengthening sector management and preventing secondary pollution are also significant measures in orderto achieve this goal.