CAUTION !!! - Do not begin this Protocol until you are completely familiar with its entire contents.
I. PLUMBING SAMPLE SELECTION (Refer to Section 5 - Health & Safety - prior to handling any plumbing samples)
1. The following is a list of plumbing material, in order of preference, that may be used in this protocol.
2. The following is a list of plumbing sample types, in order of preference, that may be used in this protocol. The following samples types were selected because they will probably contain the largest volumes of growth and the removal of these plumbing samples tend to be easier. It is very important that the plumbing sample material and type be recorded in the protocol spreadsheet (refer to Appendix A - Protocol Spreadsheet).
A sample will not be used if it does not contain biomass growth.
3. For each chemical, that is being evaluated for biomass removal, approximately five (5) to ten (10) plumbing samples will be required. The number of samples required are due because of the different chemical concentrations that will probably be needed.
4. After the section of plumbing sample has been selected and removed, take the necessary general precautions to avoid contaminating the plumbing samples (i.e. avoid touch growth, avoid losing growth, avoid setting plumbing samples down on table top,.......)
5. The plumbing sample must be given an identification name and label that includes the following information:
EXAMPLE: Saint Elizabeth's Hospital, Mary Rose Building - Second Floor, Sink Number 214 - 1 is where the plumbing sample was removed.
Identification Name: STE-MARY-2ND-214-1
6. In addition to the sample identification label, a sample inventory sheet should be prepared for all the samples transported to the analytical laboratory (refer to Appendix C - Sample Inventory Sheet). This sheet will further assist the laboratory technician in identifying the samples.
7. The plumbing sample must now be prepared for transportation to the analytical laboratory for chemical treatability testing. Each sample must be preserved until it reaches the laboratory, this will be done by filling the plumbing sample with source water and capping both ends. The end caps must be secured tightly to ensure that no water will leak during transportation to the laboratory.
8. After the plumbing sample is filled with source water and capped, all samples should be placed in a proper shipping container that meets all DOT regulation requirements for transportation of infectious materials.
II. CHEMICAL CLEANING PREPARATION (Refer to Section VI - Chemical Support Information - prior to handling any chemicals)
1. Upon receipt of the plumbing samples, the laboratory technician will verify that the samples are all present and accounted for by means of the protocol sample inventory sheet prepared by the sampler at the host institution. This will ensure that all the samples have an identification name and institution source location.
2. This protocol has a spreadsheet which will be used to record all analytical results and observations performed by all laboratory technicians (refer to Appendix A - Protocol Spreadsheet). When a plumbing sample is selected for chemical cleaning, the sample identification name used in section I (5) will be entered in the protocol spreadsheet when testing commences.
3. The following is a list of suggested chemicals that will be used for this pipe cleaning protocol:
Each of the chemicals used will require a background mercury concentration be obtained (refer to Appendix B - Mercury - Analytical Methods).
4. These chemicals will not be used in their full strength concentration, they will require diluting in the 1 - 10 percent range. It is recommended to start with a 5 percent concentration and adjust the concentration up or down pending the results of the 5 percent solution. If the concentrations in the 1 -10 percent range have little or no effect on the samples, then increase the concentration to 25 - 50 percent range, but not exceeding 50 percent. It is important to record each individual chemical concentration for each plumbing sample on the protocol spreadsheet (refer to Appendix A - Protocol Spreadsheet).
5. The water used for diluting concentrated chemicals must be analyzed for total mercury prior to mixing (refer to Appendix B - Mercury - Analytical Methods). Remember, the proper way of combining acid or base is adding acid or base to water.
6. After the diluted chemical solution is prepared, it will also require total mercury analysis (refer to Appendix B - Mercury - Analytical Methods).
7. Sufficient volume of diluted chemistry should be prepared to ensure that the plumbing sample's internal surfaces will be completely wetted.
8. At this point a chemical should be selected, sufficient volume of diluted chemistry prepared and a sample of concentrated chemistry obtained for mercury analysis.
9. Remove the end caps and dispose of any wastewater inside the plumbing sample. All wastes and wastewaters must be disposed via laboratory procedures.
10. Observe the physical appearance and condition of each plumbing sample and record all observations on the protocol spreadsheet (refer to Appendix A - Protocol Spreadsheet). For samples that have different amounts of biomass, recorded observations will be important for interpreting test results.
11. After all the wastewater has drained out of the plumbing sample, it is important to obtain a representative sample of biomass solids. This will act as the background mercury for that plumbing sample. You will need approximately 1.0 gram of biomass, this will be enough for the total mercury analysis (refer to Appendix B - Mercury - Analytical Methods).
All analytical results must be recorded on protocol spreadsheet!!!!!!!!!!
III. CHEMICAL CLEANING
1. Prior to introducing the plumbing sample to diluted chemicals make sure there is sufficient volume of diluted treatment chemical prepared to completely wet the entire internal surfaces of the plumbing sample, and a sample of diluted treatment chemical should also have been obtained.
2. Make sure a biomass sample has been taken for mercury analysis and observations are made about the sample prior to submerging into diluted chemicals.
3. Make sure that one end of the plumbing sample is water tight prior to the addition of the treatment chemical. Be careful when filling the sample with treatment chemical not to pour the chemistry directly at or into the plumbing sample, this is done to avoid physical removal of the biomass.
4. Plumbing samples should be allowed to soak for a limited period of time. The maximum amount of soaking time is 2 hours. During that soaking period there should be observation taken approximately every 15 to 20 minutes to evaluate the chemicals performance. All of these observations must be recorded and will be used to help determine the length of soaking that will be required when the chemical is used full scale.
5. Once a visual determination is made that the chemical appears to be finished cleaning, or the soaking period has elapsed, then the treatment chemical can be removed from the plumbing sample. After removing the treatment chemical, allow sufficient time for the sample to drip dry into the collected used treatment chemical. The length of the soaking time and final visual observations should be recorded on the protocol spreadsheet.
6. If after 2 hours of chemical soaking and none of the protocol's objectives are met, then the testing is completed for that chemical concentration. If the same result occurs at a concentration of 50 percent for the same chemical than that chemical will no longer be tested. Remember to record all observations, especially for chemicals that have no effect on the biomass.
7. A representative sample of the residual chemical, which now contains biomass, must be obtained and analyzed for total mercury (refer to Appendix B - Mercury - Analytical Methods).
All analytical results must be recorded on protocol spreadsheet!!!!!!!!!!
IV. CHEMICAL RINSING
1. The plumbing sample will be triple rinsed to determine if complete growth removal was successful.
2. First rinsing step (Rinse Water I) will be a 20 minute soaking in previously analyzed water. The plumbing sample's internal surfaces must once again be completely wetted. At the end of the 20 minutes remove the rinse water and allow to completely drip dry. Set aside the used rinse water for mercury sampling.
3. Second rinsing step (Rinse Water II) will consist of pouring previously analyzed water through the plumbing sample and into a clean beaker or container. The volume of rinse water that should be used in this step will be approximately 2 liters. Set aside the used rinse water for mercury sampling after you have allowed the sample to drip dry sufficiently.
4. Third rinsing step (Rinse Water III) will consist of pouring an additional 2 liters of previously analyzed water through the plumbing sample, same as Rinse Water II step, and collecting all rinse water in a clean beaker or container. Set aside the used rinse water for mercury sampling.
5. It is important to allow sufficient drip time between rinsing steps. This will minimize the amount of chemical and biomass dragout between rinse stations.
6. After Rinse Water III step, record any final observation and dispose of the plumbing sample via laboratory disposal procedures..
7. Obtain a representative sample of the rinse waters for steps I, II and III and have them analyzed for total mercury (refer to Appendix B for Mercury Analytical Procedures). It is very important that the samples of rinse water obtained are representative.
8. After the three representative rinse water samples have been analyzed and you are satisfied with the analytical results, then all spent rinse water may be disposed via laboratory procedures.
9. After all the information is entered in to the protocol spreadsheet and any final observations or comments are made and recorded, then the treatability testing for this chemical is completed.
All analytical results must be recorded on protocol spreadsheet!!!!!!!!!!
V. HEALTH AND SAFETY
VI. CHEMICAL SUPPORT INFORMATION