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Peracetic acid (PAA) has emerged in North America as a cost-effective alternative to other mature disinfection technologies with its ability to eliminate the use of chlorine, address disinfection by-product formation, and meet disinfection compliance at facilities. There are now several US installations of PAA disinfection that have been deployed to meet either Escherichia coli or Enterococcus limits for wastewater discharge; however, there is limited information related to use of PAA disinfection to meet fecal coliform compliance either as a stand-alone process or in conjunction with ultraviolet (UV) disinfection. This research studies bench-scale and pilot investigations to evaluate the feasibility of PAA as a disinfectant, alone as well as in conjunction with an existing UV disinfection system. Bench-scale results indicated PAA could be used as a stand-alone technology or as a backup to UV disinfection; thus pilot testing was implemented. During pilot testing, fecal coliform limits were met with a dose of 0.6 mg/L PAA and four UV reactors in operation on medium power. Additionally, these effluent limits were also met with a dose of 1 mg/L PAA and the UV system turned off. Effluent carbonaceous biochemical oxygen demand (cBOD5) was indistinguishable between pre- and post-PAA, and all pH data points fell within a range of 6.03–7.72. These results show that municipalities can utilize bench-scale kinetics to adequately implement PAA disinfection at their facilities. [ABSTRACT FROM AUTHOR]

Background and Objectives: Higher mortality risk reported with reuse versus single use of dialyzers is potentially related to reuse reagents that modify membrane surface characteristics and the blood-membrane interface. A key mechanism may involve stimulation of an inflammatory response., Design, Setting, Participants, & Measurements: In a prospective crossover design, laboratory markers and mortality from 23 hemodialysis facilities abandoning reuse with peracetic acid mixture were tracked. C-reactive protein (CRP), white blood cell (WBC) count, albumin, and prealbumin were measured for 2 consecutive months before abandoning reuse and subsequently within 3 and 6 months on single use. Survival models were utilized to compare the 6-month period before abandoning reuse (baseline) and the 6-month period on single use of dialyzers after a 3-month "washout period.", Results: Patients from baseline and single-use periods had a mean age of approximately 63 years; 44% were female, 54% were diabetic, 60% were white, and the mean vintage was approximately 3.2 years. The unadjusted hazard ratio for death was 0.70 and after case-mix adjustment was 0.74 for single use compared with reuse. Patients with CRP≥5 mg/L during reuse (mean CRP=26.6 mg/ml in April) declined on single use to 20.2 mg/L by August and 20.4 mg/L by November. WBC count declined slightly during single use, but nutritional markers were unchanged., Conclusions: Abandonment of peracetic-acid-based reuse was associated with improved survival and lower levels of inflammatory but not nutritional markers. Further study is needed to evaluate a potential link between dialyzer reuse, inflammation, and mortality.