Biomedical subjects

K Kümmerer

Publications and source records attributed to K Kümmerer.

25 records · Page 2Linked to original sources

PubMed1998

[Roentgen contrast media, source for AOX-contamination of waste water by hospitals].

PURPOSE: To identify the sources for the exceeding of the upper limit of the AOX (adsorbable organic halogen, X = Cl, Br, I) in hospital waste-water and to estimate the contribution of hospital waste-water to the AOX of municipal waste-water. METHODS: For several hospitals with different medical directions, the expected AOX-concentration, as far as it is caused by iodine contrast media, was ascertained by the contrast media consumption and the water consumption. The results were compared with the measured AOX concentrations. RESULTS: The AOX-concentration of hospital waste-water varies between 0.41 mg/l and 0.94 mg/l. CONCLUSION: As a source of AOX iodine contrast media have been identified and may contribute considerably to the AOX. Hospitals with a radiological department may exceed the upper limit of the AOX which has to be observed in German municipal waste-water.

Contrast Media↗

PubMed1997

Analysis of benzalkonium chloride in the effluent from European hospitals by solid-phase extraction and high-performance liquid chromatography with post-column ion-pairing and fluorescence detection.

A highly reproducible and specific method for the analysis of the quaternary ammonium compound, benzalkonium chloride, in effluents from European hospitals is presented. Benzalkonium chloride was extracted with end-capped RP-18 solid-phase cartridges and was selectively eluted. The resulting solution was analyzed by high-performance liquid chromatography (HPLC). After elution from the analytical column of the HPLC system, 9,10-dimethoxyanthracene-2-sulfonate was added continuously as a fluorescence marker, forming a hydrophobic ion-pair with benzalkonium chloride. The ion-pair was analyzed by fluorescence detection. The method was applied to highly complex effluent samples from different sized European hospitals. The measured concentrations were between 0.05 and 6.03 mg/l. The amounts emitted per bed and year were 4.5-362 g and did not correlate with the size of the hospital. The total amounts were 2.6-909 kg/year.

Anthracenes↗

PubMed1997

Biological degradation of cyclophosphamide and its occurrence in sewage water.

The mutagenic and cancerogenic antineoplastic agent cyclophosphamide (CP) is released into sewage water by cancer patient excretion. To assess the biological degradability of CP two standardized test systems, the Zahn-Wellens/EMPA test (OECD 302B) and a laboratory scale sewage treatment plant, were used. In both test systems the agent exhibited only poor degradability. To verify the expected occurrence of CP in hospital sewage, water samples were analyzed for CP with GC/MS after enrichment by solid-phase extraction. CP could be detected in concentrations ranging from 20 ng/L to 4.5 micrograms/L. The occurrence of the agent could also be proved in samples from the influent and the effluent of the communal sewage treatment plant into which the hospital's sewage water is shed. Concentrations ranged from 7 to 143 ng/L. In an attempt to assess the contribution of CP to the genotoxicity detected in hospital waste water in a recent study, the effects of CP in the umuC test, a bacterial genotoxicity assay, were investigated. However, no genotoxic effects of CP were found up to concentrations of 1 g/L.

Antineoplastic Agents, Alkylating↗

PubMed1997

Mercury emissions from dental chairs by disinfection.

Dental aspirator kits are equipped with amalgam separators, which eliminate the particulate matter from the effluent. When the aspirator kits are disinfected, the disinfectant solution is in contact with the separated amalgams over night and over the weekend. Oxidizing components of the disinfectants dissolve mercury from the separated amalgam. The dissolved mercury is released into the environment along with the effluent on the beginning of the following workday. The degree of mercury remobilization depends on the amount and oxidizing power of the disinfectant components. The mercury concentrations measured in the effluent of the aspirator kits after the application of seven different disinfectants were 18.4 micrograms/l-1396 micrograms/l. The emission of mercury by dental aspirator kits is lowered substantially by using disinfectants which contain no oxidizing substances. Disinfecting of dental aspirator kits for hygienic reasons is not necessary. Therefore we propose only cleaning rather than disinfecting dental aspirator kits.

Dental Amalgam↗

PubMed1997

Environmental auditing in hospitals: approach and implementation in an university hospital.

Medical audit in infection control today is accepted as an important element in the quality assurance of health care. In contrast, environmental auditing, which was approved in 1993 by the Council of the European Communities for industry ("Eco-Management and Audit Scheme-EMAS), has not so far been used as a tool to control and reduce environmental pollution caused by medical care in hospitals. The aim of this study was to investigate, whether environmental auditing in hospitals is useful. This process should also be cost effective. In this paper, methodological and organizational issues are described. Initially an environmental review of activities at the University Hospital, Freiburg and an eco-analysis of the input and output were performed. The first results of the study and a critical discussion will be presented in another paper.

Conservation of Energy Resources↗

PubMed1996

[Tests of biodegradation of cytostatics cyclophosphamide and ifosfamide using the Closed Bottle Test (OECD 301 D)].

Hospital and communal waste water differ with respect to their content of specific chemical substances like disinfectants or medicaments. Some medicaments are metabolized poorly by patients after administration. Antineoplastic substances are supposed to be carcinogen, mutagen and fetotoxic and embryotoxic substances. At the present there is no information available about their behaviour in the environment. Therefore the biodegradation of ifosfamide and cyclophosphamide was investigated by using the Closed Bottle Test (OECD 301 D). Both the structural isomeric antineoplastics were not biodegraded at a concentration of 5 mg/l in the Closed Bottle Test within 28 days ("not readily biodegradable"). A prolongation of the test up to 57 days did not alter the result. Abiotic elimination was neglectible. Cyclophosphamide and ifosfamide were not found toxic against waste water microorganisms. Further investigations about the elimination of ifosfamide and cyclophosphamide in the process of waste water treatment are necessary to get more knowledge about the possible risk connected with these substances.

Acinetobacter↗

PubMed1995

[Mercury release from separated amalgam after the use of different disinfectants].

Set amalgam, annealed for twelve days, was cut with water cooling and sucked into eight dental units (Systematica 1062 T), equipped with an amalgam separator (Multisystem Type 1). Disinfection of the suction devices was performed with seven commonly used disinfectants according to the manufacturer's guidelines. Rinsing with water served as a control in the last experimental series. The waste water was collected at the beginning of the experiments and after disinfection. Repeating the experiments for seven times resulted in 112 specimens that were analyzed by atomic absorption spectrophotometry. The use of Green & Clean M2 and S & M matic resulted in very low releases of mercury. Disinfection with Alprojet D and Alprojet DD M2 was comparable with the control group. The release of mercury was significantly increased, if compared to Green & Clean and S & M matic (p < or = 0.05). The use of Orotol Ultra, Aseptoclean 2, and Tiutol resulted in significantly higher releases of mercury, if compared to all other disinfectants (p < or = 0.05). Disinfectants containing oxidizing agents provoke an increasing release of mercury, thus accumulating the amounts of mercury in the general environment.

Analysis of Variance↗