Literature Review of Disinfectants: Effects When Used by CF Divers in Cleaning Rebreather Sets

摘要

As a result of the health concerns expressed by the combat divers the consultant in Diving and Hyperbaric Medicine at CFEME Toronto requested a toxicological review of the disinfectant Virkon S to determine its suitability for continued use as a cleaning/disinfectant of re-breather sets for the Canadian Forces (CF) diving community. An initial assessment of the components of Virkon S revealed the product had not been approved nor was it intended for human topical disinfection. As a result, a literature review was performed on Virkon S, but as well the review was expanded to include other disinfectants used by civilian and military divers around the world. The aim was to assess the health hazards of using disinfectants to clean re-breathers, as well as, assess the capability of disinfectants to kill the full spectrum of biological contaminants (bacterial, viral, and fungal) to which divers might be exposed. 9 disinfectants were found to be used by divers nationally and internationally (Virkon S., Sanizide, Confidence, Advance TBE, BI-Arrest, Buddy Clean, Trigene II, Listerine, Cavicide) and all were evaluated against the same criteria. In order to be recommended for use two mandatory criteria had to be complied with; the product had to exhibit an absence of components that would cause undue risk to human health during use that could not be prevented by reasonable protective measures, and proof must be available to indicate the disinfectant was effective. Products should be able to kill the full spectrum of viruses, bacteria and fungi that divers could be exposed while using a re-breather. Two further considerations were applied in reviewing all disinfectants, compatibility with system components and ease of use. Based upon the above criteria the review of these nine disinfectants revealed that only two products, Virkon S and TriGene II, met all of the criteria considered essential for use by CF divers using rebreather equipment.