Cleaning technologies integrated in duct flows for the inactivation of pathogenic microorganisms in indoor environments: A critical review of recent innovations and future challenges.

Pathogenic microorganisms are a major concern in indoor environments, particularly in sensitive facilities such as hospitals, due to their potential to cause nosocomial infections. This study evaluates the concentration of airborne bacteria and fungi in the University Hospital Complex of Albacete (Spain), comparing the results with recent literature. Staphylococcus is identified as the most prevalent bacterial genus with a percentage distribution of 35%, while Aspergillus represents the dominant fungal genus at 34%. The lack of high Technology Readiness Levels (TRL 6, TRL 7) for effective indoor air purification requires research efforts to bridge this knowledge gap. A screening of disinfection technologies for pathogenic airborne microorganisms such as bacteria and fungi is conducted. The integration of filtration, irradiation or and (electro)chemical gas treatment systems in duct flows is discussed to enhance the design of the air-conditioning systems for indoor air purification. Concerns over microbial growth have led to recent studies on coating commercial fibrous air filters with antimicrobial particles (silver nanoparticles, iron oxide nanowires) and polymeric materials (polyaniline, polyvinylidene fluoride). Promising alternatives to traditional short-wave UV-C energy for disinfection include LED and Far-UVC irradiation systems. Additionally, research explores the use of TiO2 and TiO2 doped with metals (Ag, Cu, Pt) in filters with photocatalytic properties, enabling the utilization of visible or solar light. Hybrid photocatalysis, combining TiO2 with polymers, carbon nanomaterials, or MXene nanomaterials, enhances the photocatalytic process. Chemical treatment systems such as aerosolization of biocidal agents (benzalkonium chloride, hydrogen peroxide, chlorine dioxide or ozone) with their possible combination with other technologies such as adsorption, filtration or photocatalysis, are also tested for gas disinfection. However, the limited number of studies on the use of electrochemical technology poses a challenge for further investigation into gas-phase oxidant generation, without the formation of harmful by-products, to raise its TRL for effectively inactivating airborne microorganisms in indoor environments.

Quantitative and qualitative approaches for CEC prioritization when reusing reclaimed water for irrigation needs - A critical review.

The use of reclaimed water for irrigation is an option that is becoming increasingly widespread to alleviate water scarcity and to cope with drought. However, reclaimed water, if used for irrigation, may introduce Contaminants of Emerging Concern (CECs) into the agroecosystems, which may be taken up by the crops and subsequently enter the food chain. The number of CECs is steadily increasing due to their continuous introduction on the market for different uses. There is an urgent need to draw up a short list of potential high priority CECs, which are substances that could be taken up by plants and accumulated in food produce, and/or that could have negative effects on human health and the environment. This review presents and discusses the approaches developed to prioritize CECs when reclaimed water is (re-)used for irrigation. They are divided into quantitative methodologies, which estimate the risk for environmental compartments (soil and water), predators and humans through equations, and qualitative methodologies, which are instead conceptual frameworks or procedures based on the simultaneous combination of data/information/practices with the judgment of experts. Three antibiotics (erythromycin, sulfamethoxazole and ciprofloxacin), one estrogen (17-α ethinylestradiol) and one analgesic (ibuprofen) were found on at least two priority lists, although comparison among studies is still difficult. The review remarks that it is advisable to harmonize the different methodologies in order to identify the priority CECs to include in monitoring programs in reclaimed water reuse projects and to ensure a high level of protection for humans and the environment.

Understanding the influence of the bioaerosol source on the distribution of airborne bacteria in hospital indoor air.

The composition and concentration of airborne microorganisms in hospital indoor air has been reported to contain airborne bacteria and fungi concentrations ranged 101-103 CFU/m3 in inpatients facilities which mostly exceed recommendations from the World Health Organization (WHO). In this work, a deeper knowledge of the performance of airborne microorganisms would allow improving the designs of the air-conditioning installations to restrict hospital-acquired infections (HAIs). A solution containing Escherichia coli (E. coli) as a model of airborne bacteria was nebulized using the Collison nebulizer to simulate bioaerosols in various hospital areas such as patients' rooms or bathrooms. Results showed that the bioaerosol source had a significant influence on the airborne bacteria concentrations since 4.00 102, 6.84 103 and 1.39 104 CFU mL-1 were monitored during the aerosolization for 10 min of urine, saliva and urban wastewater, respectively. These results may be explained considering the quite narrow distribution profile of drop sizes around 1.10-1.29 µm obtained for urban wastewater, with much vaster distribution profiles during the aerosolization of urine or saliva. The airborne bacteria concentration may increase up to 107 CFU mL-1 for longer sampling times and higher aerosolization pressures, causing several cell damages. The cell membrane damage index (ID) can vary from 0 to 1, depending on the genomic DNA releases from bacteria. In fact, the ID of E. coli was more than two times higher (0.33 vs. 0.72) when increasing the pressure of air flow was applied from 1 to 2 bar. Finally, the ventilation air flow also affected the distribution of bioaerosols due to its direct relationship with the relative humidity of indoor air. Specifically, the airborne bacteria concentration diminished almost below 3-logs by applying more than 10 L min-1 during the aerosolization of urine due to their inactivation by an increase in their osmotic pressure.

Disinfection of polymicrobial urines by electrochemical oxidation: Removal of antibiotic-resistant bacteria and genes.

In this work, data obtained from the University Hospital Complex of Albacete (Spain) were selected as a case study to carry out the disinfection experiments. To do this, different configurations of electrochemical reactors were tested for the disinfection of complex urines. Results showed that 4-6 logs bacterial removal were achieved for every bacterium tested when working with a microfluidic flow-through reactor after 180 min (0.423 Ah dm-3). The MIKROZON® cell reached a total disinfection after 60 min (1.212 Ah dm-3), causing severe damages induced in the cell walls observed in SEM images. The concentration profiles of the electrogenerated disinfectants in solution could explain the differences observed. Additionally, a mean decrease in the ARGs concentration ranked as follows: blaKPC (4.18-logs) > blaTEM (3.96-logs) > ermB (3.23-logs) using the MIKROZON® cell. This electro-ozonizer could be considered as a suitable alternative to reduce the risk of antibiotic resistance spread. Hence, this study provides an insight into different electrochemical reactors for the disinfection of complex hospital urine matrices and contributes to reduce the spread of antibiotic resistance through the elimination of ARGs. A topic of great importance nowadays that needs to be further studied.

Electrochemical Technologies to Decrease the Chemical Risk of Hospital Wastewater and Urine.

The inefficiency of conventional biological processes to remove pharmaceutical compounds (PhCs) in wastewater is leading to their accumulation in aquatic environments. These compounds are characterized by high toxicity, high antibiotic activity and low biodegradability, and their presence is causing serious environmental risks. Because much of the PhCs consumed by humans are excreted in the urine, hospital effluents have been considered one of the main routes of entry of PhCs into the environment. In this work, a critical review of the technologies employed for the removal of PhCs in hospital wastewater was carried out. This review provides an overview of the current state of the developed technologies for decreasing the chemical risks associated with the presence of PhCs in hospital wastewater or urine in the last years, including conventional treatments (filtration, adsorption, or biological processes), advanced oxidation processes (AOPs) and electrochemical advanced oxidation processes (EAOPs).

A review on disinfection technologies for controlling the antibiotic resistance spread.

The occurrence of antibiotic-resistant bacteria (ARB) in water bodies poses a sanitary and environmental risk. These ARB and other mobile genetic elements can be easily spread from hospital facilities, the point in which, for sure, they are more concentrated. For this reason, novel clean and efficient technologies are being developed for allowing to remove these ARB and other mobile genetic elements before their uncontrolled spread. In this paper, a review on the recent knowledge about the state of the art of the main disinfection technologies to control the antibiotic resistance spread from natural water, wastewater, and hospital wastewater (including urine matrices) is reported. These technologies involve not only conventional processes, but also the recent advances on advanced oxidation processes (AOPs), including electrochemical advanced oxidation processes (EAOPs). This review summarizes the state of the art on the applicability of these technologies and also focuses on the description of the disinfection mechanisms by each technology, highlighting the promising impact of EAOPs on the remediation of this important environmental and health problem.

Enhancement of UV disinfection of urine matrixes by electrochemical oxidation.

This work focuses on the removal of antibiotic-resistant bacteria (ARB) contained in hospital urines by UV disinfection enhanced by electrochemical oxidation to overcome the limitations of both single processes in the disinfection of this type of effluents. UV disinfection, electrolysis, and photoelectrolysis of synthetic hospital urine intensified with K. pneumoniae were studied. The influence of the current density and the anode material was assessed on the disinfection performance of combined processes and the resulting synergies and/or antagonisms of coupling both technologies were also evaluated. Results show that the population of bacteria contained in hospital urine is only reduced by 3 orders of magnitude during UV disinfection. Electrolysis leads to complete disinfection of hospital urine when working at 50 A m-2 using Boron Doped Diamond (BDD) and Mixed Metal Oxides (MMO) as anodes. The coupling of electrolysis to the UV disinfection process leads to the highest disinfection rates, attaining a complete removal of ARB for all the current densities and anode materials tested. The use of MMO anodes leads to higher synergies than BDD electrodes. Results confirm that UV disinfection can be enhanced by electrolysis for the removal of ARB in urine, considering both technical and economic aspects.

Improving the biodegradability of hospital urines polluted with chloramphenicol by the application of electrochemical oxidation.

This work focuses on improving the biodegradability of hospital urines polluted with antibiotics by electrochemical advanced oxidation processes (EAOPs). To do this, chloramphenicol (CAP) has been used as a model compound and the influence of anodic material (Boron Doped Diamond (BDD) and Mixed Metal Oxide (MMO)) and current density (1.25-5 mA cm-2) on the toxicity and the biodegradability was evaluated. Results show that a complete CAP removal was attained using BDD anodes, being the process more efficient at the lowest current density tested (1.25 mA cm-2). Conversely, after passing 4 Ah dm-3, only 35% of CAP removal is reached using MMO anodes, regardless of the current density applied. Furthermore, a kinetic study demonstrated that there is a clear competitive oxidation between the target antibiotic and the organic compounds naturally contained in urine, regardless the current density and the anode material used. During the first stages of the electrolysis, acute toxicity is around 1% EC50 but it increases once CAP and its organic intermediates have been degraded. The formation and accumulation of inorganic oxidants may justify the remaining acute toxicity. This also helps to explain the trend observed in the rapid biodegradability assays. Finally, a 60% of standard biodegradability (Zahn-Wellens test) was achieved which suggests that electrochemical oxidation with BDD anodes could be the most appropriate technology to reduce the hazard of hospital urines at the operating conditions tested.

Electrolytic and electro-irradiated technologies for the removal of chloramphenicol in synthetic urine with diamond anodes.

Hospital effluents are a major source for the occurrence of pharmaceuticals in the environment. In this work, the treatment of synthetic urine polluted with chloramphenicol is studied by using three different conductive-diamond electrochemical oxidation technologies: electrolysis (single electrolysis), photoelectrolysis and high-frequency ultrasound sonoelectrolysis. These technologies were evaluated at 10 and 100 mA cm-2. Results shows that not only chloramphenicol but also other organics contained in urine are completely mineralized by electrolysis. Ammonium is the main inorganic nitrogen species formed and it can react with the electrogenerated hypochlorite, favouring the formation of chloramines. These species prevent the potential formation of perchlorate from chlorides contained in urine at low current densities (10 mA cm-2) and delay its occurrence at high current densities (100 mA cm-2). On the other hand, irradiation of ultraviolet (UV) light or high-frequency ultrasound (US) produce changes in the performance of the electrolytic treatment, but these changes are not as important as in other cases of study shown in the literature. Nonetheless, the effect of electroirradiated technologies seems to be higher and depends on the type of pollutant when working at low current densities (10 mA cm-2). It is positive in the case of the degradation of the antibiotic and the uric acid and negative in the case of urea where there is a clear antagonistic effect. Production of oxidants increases with the current density although in lower ratio than expected. These results are of great importance because clearly point out that electrolytic technologies can be applied to minimize the diffuse pollution associated to pharmaceuticals before discharge into municipal sewers.

Effect of the cathode material on the removal of nitrates by electrolysis in non-chloride media.

In this work, the effect of the cathode material (conductive diamond, stainless steel, silicon carbide, graphite or lead) and the current density (150-1400 A m(-2)) on the removal of nitrates from aqueous solutions is studied by electrolysis in non-divided electrochemical cells equipped with conductive diamond anodes, using sodium sulphate as the electrolyte. The results show that the cathode material very strongly influences both the process performance and the product distribution. The main products obtained are gaseous nitrogen (NO, N(2)O and NO(2)) and ammonium ions. Nitrate removal follows first order kinetics, which indicates that the electrolysis process is controlled by mass transfer. Furthermore, the stainless steel and graphite cathodes show a great selectivity towards the production of ammonium ions, whereas the silicon carbide cathode leads to the highest formation of gaseous nitrogen, which production is promoted at low current densities.

Electro-oxidation of As(III) with dimensionally-stable and conductive-diamond anodes.

In this work, arsenic oxidation by an electrochemical process was studied in a batch bench-scale electrolysis plant equipped with mono- and bi-compartment cells, dimensionally-stable anodes (DSAs) and conductive-diamond anodes (CDAs). The results demonstrate that the electrolysis is an adequate technology to transform As(III) into As(V) species, which is an important pre-treatment stage for removing of arsenic from water using technologies such as coagulation or electro-coagulation. The process requires large current densities in non-divided cells to obtain a good As(V)/As(III) ratio, but it can be more efficiently performed at low current densities in cells divided by cationic membranes. The presence of chlorides or sulphates can significantly affect the results due to the formation of powerful oxidants that contribute to the net oxidation process.