Current understanding of ozone use for disinfecting hemodialysis water treatment systems.

BACKGROUND Water treatment systems are susceptible to microbial contaminations and periodical disinfection procedures are mandatory to obtain results requested from international standards. According to the Association for the Advancement of Medical Instrumentation, ozone is the most effective method to destroy microorganisms, and to prevent, reduce or remove the biofilm. This study aims to review the literature on the application of ozone in the disinfection of water treatment systems for hemodialysis. METHODS Data were obtained from databases (Ovid MEDLINE, Cochrane, EMBASE, and others). RESULTS Ozone is quite effective in killing bacteria and degrading endotoxins and biofilm, with efficacy being concentration- and time-dependent. However, being a strong oxidant, appropriately compatible materials should be used. Also ozone production should be monitored and its level in ambient air should also be checked periodically to maintain a contamination air standard of 0.1 ppm. CONCLUSION Ozone appears to be promising in hemodialysis. However, further investigations are necessary to approve its wider use.