from reading this article i dont see how the city supply can be blamed if the unit had adequate carbon bedding. was the level that high so as to very rapidly deplete the beds. can anyone offer a thought? here is the article. thanks in advance.
Poor water closes dialysis center

By Paul Wetter -- Daily Telegram Staff Writer
ADRIAN -- A kidney dialysis center in Adrian has been shut down since Tuesday when an employee detected elevated levels of chlorine from a city water supply.

Fresenius Dialysis Services at 715 Lakeshire Trail near Bixby Medical Center has been sending Adrian patients to the company's location in Tecumseh for dialysis, said Sheri Amatucci, area manager. The Adrian facility, which services 28 patients daily, should be open again today or Friday.

Before the center opens each day, employees check water samples for chlorine levels. An employee at the clinic was doing the routine rounds when she discovered the elevated chlorine levels coming from the city water supply to the facility, Amatucci said.

"Our technician did a very good job at identifying the problem and passing it up the line," Amatucci said. "We notified the water plant that there was an elevated chlorine level in our water supply."

The water supply for the dialysis center is filtered before it is used in the center's dialysis machines.

Adrian Utilities Director James Caldwell said filters at the water treatment plant were being cleaned when combined chlorine was released into the water supply.

The levels have returned to normal, Caldwell said. The chlorine was not dangerous for healthy people.

Amatucci said it was the first time she was aware of the dialysis center shutting down because of higher than normal chlorine in the center's water.

"We were fortunate that we were able to make arrangements for our patients at our Tecumseh center," Amatucci said.

Fresenius Medical Care is the world's largest provider of services and products for people undergoing dialysis because of chronic kidney failure, according to the company's Web site.

The company operates more than 1,400 clinics worldwide and provides treatment to more than 108,000 patients.

kdet,

Yes! The carbon beds may or may not actually be depleted but with the elevated level, there may not be adequate removal.

Especially since neither normal or current levels were given, it would be unwise to speculate.

Chuck

I agree with Chuck. There's just too little information from the article to form an opinion. Generally, however, small fluctuations in chlorine levels do not cause a clinic to shut down. The EBCT (empty bed contact time) of the carbon tanks, if set at the required minimum or better, should account for fluctuations. I'm interested to find out more about this. If you have any other information, please do post. This brings up a question I've asked myself in the past. What if you live in an area that routinely runs high chlorine level in the water? Does the EBCT requirement go up? Or is the minimum EBCT requirement accounting for only what the city is normally allowed as a maximum chlorine level? If anyone has any info about that, please do tell. I would like to know. Thanks!

GTSCCS,

I personally have never done the EBCT calculation so I am not certain of the formula, I have always relied on the supplier of my equipment (Marcor Services) to size my tanks. However, I am pretty sure that part of the formula is what your normal chlorine level and flow rates are.

Chuck

I know first hand how this affects the water used for dialysis treatments. For the past month the City Water Department has been hyper chlorniating the water lines that feeds our clinic. They have also been scrubbing the lines for any organic material. We had our carbon tanks rebedded 2 weeks ago and then again just last week due to this. It is very costly but what can you do?

So yes high levels of chlorine in city water can cause carbon tanks to depleat faster than normal.

We have 2 backwashable tanks that each hold 8.5 cubic feet of carbon plus have 200#'s of gravel in the bottom of the tank. As well as a multi latteral distributor at the end of the distribution pipe. It only took a week for 17 cubic feet of carbon to depleat.

The solution we came up with is placing 3 portable exchange carbon tanks that hold 3.6 cubic feet of carbon each in line before the backwashable carbons as workhorses. Like I said this is a costly procedure at $315 bucks a tank. So far this has worked.

Another solution that we have came up with is using a Centar Carbon in our tanks. We have not tried this as it is a special order for our water vendor. After some research we have found that this can help but it may also not help at all. And it is my understanding that this is a costly procedure too. Sure am glad I'm not paying for it.LOL

according to G.E.M. Waters my supplier of carbon tanks, The EBCT is calculated by multiflying 7.48(gallons per cubic foot) by the total carbon (in cubic feet) in the primary bank, devided by the flow to the R.O. system. Elevated chlorine/chloramine is our problem too, because of high chlorine in city water they always say that they(city) have no control for the chlorine in the water coz they just buying it from other source.

OK I was wrong (it happens), the chlorine level is not part of the calculation. The correct formula is:

EBCT= Volume GAC (cu ft.) X 7.48 / flow rate (gpm)

Osmonics has a pretty good page on carbon and chlorine removal at.... http://www.osmonics.com/products/Page1107.htm

Chuck

Chuck,

Sorry if I came across as a konow it all because believe me I don't. I learn something everyday at this job. I am sure that not ALL city water is this way. I have learned this in the last month or so.

Again i am sorry and look forward to your help in the future.

Matt

Matt,

I didn't get that impression at all. My comment was my poor attempt at humor.

I like everyone else will never "know it all". One of the things that I do like to say to people in our clinics when they try to come off as knowing everything is, "I have forgotten more about dialysis than you know" (thats my humor again). Some find it a harsh thing to say but it does tend to humble them a bit.

Chuck

This brings up an important point. It is necessary (or at least helpful) to try and develop a relationship with your local water supplier. I had a similar problem in small town that routinely "flushed" it's system with a high phosphate/chlorine mixture that zapped two carbon tanks and a softener almost immediately (luckily we caught it also). The township did this at night and we were able to explain the importance of informing us and they were very helpful after the initial trouble.

Matt,

Have you checked your silt density? I am thinking that maybe the pores in the carbon might be getting "clogged". I don't know if this is possible but its a thought.

Chuck

Chuck,

I will have my water vendor do this for me.
After we spoke Friday I found it to be the city water department causing us the problem again. Seems there is a bacteria problem down stream of us and they are dousing the line with 2.5 mil/L of Total Chlorine until Wed. Then will go back to the free chlorine with an ammonia buffer. will let you know thanks for all the help.

Matt

Something else to consider is pH. As municipalities move to comply with the "Lead Rule" amendment to the Safe Drinking water act (increase water pH to decrease leaching of lead from old pipes/solder) city supply water pH may be increased. This affects the stability of combined chlorines and adsorption by carbon.

A common question is "Why isn't the chlorine level part of the calculation?"

Carbon is rated by mesh size and iodine number. Mesh size refers to the physical size of the carbon granule and the iodine number is used to indicate the surface area and corresponding number of pores.

Here's a link to the explanation:
http://www.pondrx.com/articles/details.php?articleId=49&parentId=14

Matt,

Remember that once they start using the ammonia, you will then have CHLORAMINE and not just the free chlorine like you are used too.

Chuck

Dennis,

Do you know at what level the ph affects the chlorine removal?

Chuck