Disinfection by-products (DBPs) are prevalent contaminants in drinking water and are primarily linked to issues regarding water quality. These contaminants have been associated with various adverse health effects. Among different treatment processes, nanofiltration (NF) has demonstrated superior performance in effectively reducing the levels of DBPs compared to conventional processes and ozone-biological activated carbon (O3-BAC) processes. In this experiment, we systematically investigated the performance of three advanced membrane filtration treatment schemes, namely \"sand filter + nanofiltration\" (SF + NF), \"sand filter + ozone-biological activated carbon + nanofiltration\" (SF + O3-BAC + NF), and \"ultrafiltration + nanofiltration\" (UF + NF), in terms of their ability to control disinfection by-product (DBP) formation in treated water, analyzed the source and fate of DBP precursors during chlorination, and elucidated the role of precursor molecular weight distribution during membrane filtration in relation to DBP formation potential (DBPFP). The results indicated that each treatment process reduced DBPFP, as measured by trihalomethane formation potential (THMFP) and haloacetic acid formation potential (HAAFP), with the SF + O3-BAC + NF process being the most effective (14.27 μg/L and 14.88 μg/L), followed by the SF + NF process (21.04 μg/L and 16.29 μg/L) and the UF + NF process (26.26 μg/L and 21.75 μg/L). Tyrosine, tryptophan, and soluble microbial products were identified as the major DBP precursors during chlorination, with their fluorescence intensity decreasing gradually as water treatment progressed. Additionally, while large molecular weight organics (60-100,000 KDa) played a minor role in DBPFP, small molecular weight organics (0.2-5 KDa) were highlighted as key contributors to DBPFP, and medium molecular weight organics (5-60 KDa) could adhere to the membrane surface and reduce DBPFP. Based on these findings, the combined NF process can be reasonably selected for controlling DBP formation, with potential long-term benefits for human health.

BACKGROUND: Benzalkonium chloride (BAC) is a quaternary ammonium compound (QAC), that can be found in a wide variety of household products-from disinfectants to medicaments and home fragrances-but also professional products. In pets, cats have long been reported as more sensitive than dogs to QACs; in fact, signs of irritation such as oral ulcerations, stomatitis and pharyngitis can be observed after contact with concentrations of 2% or lower. In a review of 245 cases of BAC exposure in cats, reported by the Veterinary Poisons Information Service (United Kingdom) only 1.2% of the cases died or were euthanized. Nevertheless, BAC toxidromes in cats can result in transitory CNS and respiratory distress, as well as severe mucosal and cutaneous lesions. Currently, only a few reports are available concerning BAC poisoning in this species.
METHODS: A 4 month-old kitten presented with severe glossitis, lameness in the hindlimbs and episodes of vomiting and diarrhoea. The cause was unknown until the owners reported use of a BAC-containing mould remover (5%) 4 days later. The patient developed severe oral burns requiring a pharyngeal tube for feeding and severe cutaneous chemical burns. The kitten was managed with supportive therapy and required hospitalization for 10 days. The symptoms disappeared completely 3 weeks after exposure.
CONCLUSIONS: BAC is a very common compound contained in several household and professional products but, to the best of our knowledge, no previous case had been reported in Italy. We hope that this report will help raise awareness on the hazards of BAC products for cats in both domestic and work contexts.

The use of disinfectants, particularly those containing quaternary ammonium compounds (QUACs), has dramatically escalated globally since the coronavirus disease 2019 pandemic. We report a case that highlights the risks associated with ingesting low-concentration QUAC solutions and emphasize the importance of effective management in resolving severe lesions without sequelae. A 17-month-old boy experienced severe respiratory failure after ingesting a disinfectant containing benzalkonium chloride (BAC). The child was initially treated at a local emergency department and was subsequently transferred to a pediatric poison center. Upon evaluation, the child was found to have grade III-A corrosive esophageal lesions and chemical pneumonitis. Several complications, including massive pneumothorax and candidemia, occurred during the clinical course of the disease. However, with timely medical intervention and appropriate supportive care, the patient completely recovered without any long-term sequelae. The properties of BAC and the comprehensive management approach may have been responsible for the patient\'s full recovery, despite the potentially life-threatening effects of ingesting disinfectants.

The biofouling of submerged surfaces such as ship hulls is often prevented by using anti-fouling components in combination with booster biocides. These booster biocides enter the water column and may affect non-target organisms. Although different negative effects have been associated with the use of booster biocides, their effects on non-target organisms are often unknown. So far, the environmental risks for booster biocides have barely been quantified in the North Sea. In this work, the concentration of five commonly used booster biocides as well as tributyltin has been monitored at five dredged spoil disposal sites in the Belgian part of the North Sea and the harbour and ports of Nieuwpoort, Oostende, and Zeebrugge. Hotspots were discovered where the concentration of one or more booster biocides exceeded the predicted no-effect concentration. Tributyltin has been banned since 2008, but concentrations of 237- to 546-fold of the predicted no-effect concentration were detected in the harbours and ports. Moreover, TBT has been detected in the same order of magnitude in other sea basins, emphasizing the need to monitor the trends and impact of booster biocides and TBT in environmental monitoring programs.

A humidifier disinfectant (HD) has been prohibited by the government due to its serious effects on the human body. Several studies on the relationship between HD and lung diseases have been performed independently on children and adults. However, there have been no reports on the effects of HD exposure on pregnant women and their foetuses. Therefore, the present study was conducted to investigate the effects of HD exposure on the foetuses of women who encountered HD during pregnancy. A total of 56 cases were recruited from 2017 to 2019 through the Korea Environmental Industry & Technology Institute, and data obtained from the medical records included maternal date of birth, maternal date of death, maternal start and end date of HD exposure, maternal date of symptom onset, neonatal birthday, neonatal birthweight, gestational age, and neonatal survival status within 28 days. All data were retrospectively investigated through medical records. Of the 47 mothers, 20 (42.6%) mothers survived, and 27 (57.4%) mothers died. In the group of survivors, there was a shorter period of total HD use, period of HD use before pregnancy and period of HD use to onset of symptoms. Shorter durations of HD use resulted in higher survival rate of mothers. HD use caused an increase in gestational age surviving foetuses, and foetal mortality increased when clinical symptoms developed before birth.

The global crisis we are facing with regard to antibiotic resistance has been largely attributed to the overuse and misuse of antibiotics in healthcare and agriculture. However, there is also growing global concern about cross-resistance between biocides and antibiotics. This has made clear the need for more research in this area along with easy-to-perform, but realistic, methods to characterise the potential risk associated with cross-resistance to antibiotics due to biocide use. The primary aim of this work was to develop a repeat-exposure method for predicting bacterial resistance to microbicides, including their cross-resistance to antibiotics. Realism is incorporated in the presented protocol through the use of relevant concentrations and contact times, validated neutralisers, appropriate test organisms and repeat-exposures. The protocol can be applied to formulated microbicides, as shown in the liquid handwash case study presented here. Five bacterial strains were included in the study: Staphylococcus aureus ATCC 6538, Pseudomonas aeruginosa ATCC 15442, Staphylococcus epidermidis ATCC 14990, Escherichia coli ATCC 10536 and Enterococcus hirae ATCC 10541. The protocol parameters used in the case study reflected a worst-case exposure scenario (in terms of contact time and concentration). The results demonstrated that repeated exposure to the liquid handwash would not be expected to lead to development of bacterial resistance or cross-resistance to antibiotics. It is envisaged that this protocol could be used by manufacturers of microbicidal formulations to assess whether repeated use of the test products would contribute to bacterial resistance development or cross-resistance to antibiotics.

UNASSIGNED: Following debridement, the skin and mucous membranes around the wound must be disinfected with broad-spectrum disinfectants like Iodophor, 75 % ethanol, chlorhexidine, and bromogeramine. Despite the fact that it is rarely reported, skin allergy to disinfectants is extremely detrimental to wound recovery after debridement.
METHODS: In this study, a 29-year-old man with no previous allergic history developed delayed contact dermatitis after being exposed to multiple disinfectants, including iodophor, 75 % ethanol, and Erythromycin ointment. Given the possibility of the patient\'s allergic constitution, skin patch tests were repeated to confirm the allergic disinfectants. To avoid the allergy, the wound was simply rinsed with 0.9 % sodium chloride solution and Cefdinir (0.1 g, tid) was taken orally, while all local disinfectants were discontinued. The wound healing process was gradually accelerated, and allergic symptoms were alleviated. Furthermore, our findings revealed that the frequency and immunosuppressive function of Tregs were significantly lower in patients than in healthy controls (P < 0.05).
UNASSIGNED: By minimizing allergic reactions and providing appropriate wound care, the use of 0.9 % sodium chloride solution with oral antibiotics could expedite the healing process. This enabled the wound to close faster and reduces the risk of complications.
CONCLUSIONS: The use of 0.9 % sodium chloride solution for wound irrigation, combined with oral administration of antibiotics, could be modified to mitigate further allergic reactions and enhance the recovery process following debridement. However, individual patient characteristics and medical history should also be taken into consideration when making these alterations.

Widespread use of disinfectants raises concerns over their involvement in altering microbial communities and promoting antimicrobial resistance. This study explores the influence of disinfection protocols on microbial populations and resistance genes within an isolated enclosure environment and in the gut of giant pandas (GPs) held within. Samples of panda feces, air conditioning ducts, soil and bamboo were collected before and after disinfection. High-throughput sequencing characterized the microbial flora of GP gut and environmental microbes inside the artificial habitat. Microbial cultures showed that Escherichia coli (34.6%), Enterococcus (15.4%) and other pathogenic bacteria deposited in feces and the enclosure. Isolates exhibit a consistent resistance to disinfectant, with the greatest resistance shown to cyanuric acid, and the lowest to glutaraldehyde-dodecyl dimethyl ammonium bromide (GD-DDAB) and dodecyl dimethyl ammonium bromide (DDAB). The total number of the culturable bacteria in soil and bamboo were significantly diminished after disinfection but increased in the gut. After disinfection, the richness (Chao1 index) of environment samples increased significantly (P < 0.05), while the richness in gut decreased significantly (P < 0.05). Ten genera showed significant change in feces after disinfection. Metagenome sequencing showed that 126 types of virulence genes were present in feces before disinfection and 37 in soil. After disinfection, 110 virulence genes localized in feces and 53 in soil. Eleven virulence genes including ECP and T2SS increased in feces. A total of 182 antibiotic resistance genes (ARGs) subtypes, potentially conferring resistance to 20 classes of drugs, were detected in the soils and feces, with most belonging to efflux pump protein pathways. After disinfection, the number of resistance genes increased both in gut and soil, which suggests disinfection protocols increase the number of resistance pathways. Our study shows that the use of disinfectants helps to shape the microbial community of GPs and their habitat, and increases populations of resistant strain bacteria.

BACKGROUND Peracetic acid is among the disinfectants that irritate the upper respiratory tract, skin, and conjunctiva. It can cause symptoms of eye irritation, secondary to an inflammatory process that can lead to various manifestations. Irritation happens due to the high reduction potential of the acid, which causes the consequent release of reactive oxygen species. This fact serves to reinforce the importance of personal protective equipment when handling peracetic acid. CASE REPORT During an accident at work, a 21-year-old patient received a strong jet of disinfectant solution directly into both eyes. The composition of the disinfectant solution was 15% peracetic acid, 15-16% hydrogen peroxide, 22-23% acetic acid, and 16-17% horticultural sanitizers. Twenty-four hours after the incident, eye damage (punctate keratitis and low visual acuity) had occurred, and was treated by washing the eye with ice water and frequently applying lubricating eye drops. The next day, the patient returned with an improvement of irritative symptoms, but with a major complaint of low visual acuity in left eye, secondary to optic neuritis, detected by fundoscopy and confirmed by optical coherence tomography. In the following week, fluorescent angiography indicated the persistence of neuritis in the left eye. This was treated with prednisone, 40 mg/day, which brought about gradual improvement. Two months later, the patient returned with test results showing normal magnetic resonance imaging and negative serologies (for syphilis, HIV, and herpes virus), visual acuity 20/20 in both eyes, and normalization of angiography and optical coherence tomography parameters. CONCLUSIONS Until now, there have been no published studies demonstrating neuritis caused by direct contact of peracetic acid into the eyes. Therefore, this is the first report in the world literature of this manifestation of ocular exposure to peracetic acid. This is a chemical formulation that is widely useful and prevents the growth of various pathogens. Further investigation and studies on the subject should be encouraged to improve its management and use.

Living organisms adapt to their environment, and this adaptive response to environmental changes is influenced by both genomic and epigenomic components. As adaptation underpins tolerance to stressors, it is crucial to consider biological adaptation in evaluating the adverse outcomes of environmental chemicals, such as biocides. Daphnid studies have revealed differences in sensitivity to environmental chemicals between conspecific populations or clones, as well as between species. This study aimed to identify whether sensitivity to chemicals is subject to intraspecific variation, and whether this sensitivity depends on the genetic and epigenetic backgrounds of the daphnid population. We used an integrative approach to assess the comparative toxicity of a mixture of 5-chloro-2-methyl-4-isothiazoline-3-one and 2-methyl-4-isothiazolin-3-one (CMIT/MIT), a commonly used isothiazolinone biocide, by measuring mortality, reproduction, physiological traits, global DNA methylation, and proteomic expression at the species and strain levels. The results showed that the variation in sensitivity to CMIT/MIT between conspecific strains (Daphnia pulex; DPR vs. DPA strains) could exceed that observed between congeneric species (D. magna vs. D. pulex DPR strain). Under the control conditions, DPR (the strain most sensitive to CMIT/MIT) was characterized by a larger body size, a higher heart rate, and a higher level of global DNA methylation compared to its counterpart (DPA), and proteome profiles differed between the two strains. Particularly, the study identified strain-specific epigenetic and proteomic responses to LC20 of CMIT/MIT, demonstrating putative critical proteins and biological pathways associated with the observed differences in phenotype and sensitivity to CMIT/MIT. Downregulation of certain proteins (e.g., SAM synthase, GSTs, hemoglobin, and cuticle proteins) and DNA hypomethylation can be proposed as key events (KEs) of adverse outcome pathway (AOP) for isothiazolinone toxicity. Our findings indicate that both genetic variations and epigenetic modifications can lead to intraspecific variation in sensitivity to chemicals, and this variation should be considered in the ecological risk assessment framework for chemical substances. We suggest conducting further analysis on methylated gene regions and observing transgenerational effects to verify the role of crosstalk between genetic and epigenetic factors in phenotypic and protein expressions. DATA AVAILABILITY: Proteomic data is available in supplementary materials.