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Water The Universal Solvent

Ever changing and Universally Different
QLD SRACA September 2012

Water the universal solvent

Water is the most fundamental requirement for your

cleaning, thermal disinfection and autoclaving processes

The need to for suitable quality water to be used for

instrument reprocessing has historically been ignored or
not appreciated.

Universally different ever changing

Waters aint waters

The solutes contained in water differ from region to region

and they change over time

The changing solute matrix changes the character of water

and the way it interacts / impacts on materials exposed to it.

Overview

We will look at some of the possible variations in water

quality both by region and over time

Look at how some of the adverse water quality can impact

instrument quality

Objectives

Understand that water quality changes both by region and

over time

Understand it is essential to monitor water quality on site at

point of use

Water the universal solvent

Detergent/chemistry
Cleaning solution Chemistry < 1%
Neutralizing Solution Chemistry < 0.3%

Water

Rinsing solution Chemistry <0.03%

Autoclave = 100% water (or it should be)

What is the recommended water quality

Recommendations for water quality taken from RKI red book
and are based on DIN EN 285 feed water quality for boilers

Common impurities in water

What should we monitor

What elements/parameters should we monitor at the point of use.

Which of the parameters tell most about the water suitability for use in CSSD

Conductivity or total dissolved solids (TDS)

The most telling parameter, captures the most information

conductivity increases with increasing dissolved salts

Chloride

(chromomorphic salt - #1 suspect for pitting and crevice corrosion)

Hardness

Alkalinity & pH

If there is appreciable alkalinity you should monitor temporary hardness
(Bicrabonate)

Temporary hardness gives rise to elevated pH in the thermal rinse

Why should we monitor?

We need to monitor at site level because water changes from region to

region and over time

In June this year urban utilities put out a notification of a predicted spike
of 1000-1100 s/cm (approx 600 TDS). QUU expected the elevated
conductivity to be present in the water for several days

The following slides sets out the conductivity of mains water as

measured coming into hospitals at various localities around Qld.

Do you remember the recommendations for conductivity for water used

for instrument reprocessing and for boiler feed water

Answer = 5 s/cm although experience suggests that 15 s/cm should

be well tolerated

Source RKI red book 9th edition and DIN EN 285 (2006)

John Flynn Hospital Gold Coast

Holy Spirit Northside

Mater Brisbane

Mater Bundaberg

Mt Isa

Rockhampton Base

Toowoomba Hospital

Cairns Base

Brisbane Drinking water quality

Brisbane Drinking water quality

Gold Coast City Council

1st July 2011 to 39 June 2012

Ipswich Drinking water quality

Ipswich Drinking water quality

SEQ Water Grid issues monthly quality reports for five zones

Compare with
my home town
Melb water Dams

Compare with my
home town
City west water
Melbourne

Conductivity & Total Dissolved solids

TDS is measured by conductivity

Increasing the level of dissolved solids in water increases the ability of

water to conduct an electrical current, which is measured using a
conductivity meter or TDS meter.

Recommended Conductivity for final rinse water (at 25 C)* 5 S/cm

Experience has shown that conductivity of approximately 15 S/cm can
be tolerated.

Conductivity & Total Dissolved solids

TDS comprises all the salts and impurities dissolved in

water

Includes

Hardness (salts of Ca Mg Ba precipitate as the carbonate,
phosphate, hydroxide or sulfate)

All additional impurities which do not readily precipitate eg Sodium,
Potassium, Chlorides & nitrates

Increasing conductivity = increasing salt & TDS

Associated with any or all of the following

Increasing corrosion

Increasing hardness & scale

Increasing alkalinity

Conductivity & Total Dissolved solids

Any dissolved solids in the final rinse will produce water marks when the
water beads evaporate. If the salt contains chloride its bad news for
steels

Water
Marks
Water
Marks

Conductivity & Total Dissolved solids

Chlorides

The presence of chloride in the high temperature phases of

a wash program is one of the most notable causes of pitting
and crevice corrosion on stainless steel instruments
WFHSS guidelines on chloride 2 mg/l in final rinse

Chloride induced pitting

Pitting

Chloride induced pitting & crevice corrosion

Crevice Corrosion

Hardness, Temporary Hardness and Alkalinity

Everybody knows hardness is responsible for making scale

However the related parameters of temporary hardness

(Bicarbonate hardness) & alkalinity pose some very specific
problems for both thermal disinfection and autoclaving
which are less understood and even more problematic for
sterilizing departments

Hardness, Temporary Hardness and Alkalinity

If water contains bicarbonate (temporary hardness) and is

heated then the following reaction occurs
2HCO3- + Heat = CO2 + H2O + CO32The formation of carbonate (CO32- ) in water as a result of
heating produces two undesirable effects for the liquid
medium:

An alkaline shift in the pH of the water

Precipitation of temporary hardness to form carbonate scale.

The alkaline shift caused by the formation of free carbonate

in the high temperature thermal disinfection cycle will strip
color from anodized aluminum and powder natural
aluminium

Hardness, Temporary Hardness and Alkalinity

The presence of free carbonate in the thermal disinfection

cycle can elevate the pH to 10 or higher

Carbonate at high temp is corrosive to aluminum and

anodised surfaces
pH 8

pH 9

pH 10

pH11

Hardness, Temporary Hardness and Alkalinity

If water contains bicarbonate (temporary hardness) and is heated then

the following reaction occurs

2HCO3- + Heat = CO2 + H2O + CO32-

The production of Carbon Dioxide CO2in a boiler has 2 very

undesirable effects on the steam/vapor medium

CO2 is a non-condensable gas

Presence of non-condensable gas in the steam means loss of sterilizing
efficiency

Some of the CO2 combines with steam condensate to form Carbonic acid
producing acid steam

Acid steam is a primary cause of corrosion in steam lines

Have you ever seen rust in the autoclave or on top of your wraps???

Hardness, Temporary Hardness and Alkalinity

Silica

WFHSS recommend Silicates (SiO2) 1 mg/l

Silica , silicic acid in soft water results in staining & discoloration of steel
surfaces

Silica levels being reported in Brisbane drinking water are levels that
can cause significant staining

Silica
Typical silica discoloration in the rinsing chamber and on the surface of the
instrument caused by cleaning agent containing silicate, or excessive levels of
silica in the water.

Water The Universal Solvent

Ever changing and Universally Different
QLD SRACA September 2012