Summary of Results AquaJif should be approved for point- of- use drinking water treatment in Haiti, for these reasons:

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Hope Dennis
6 years ago
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AquaJif Review and Recommendations AquaJif is a locally- produced sodium hypochlorite (NaOCl) solution manufactured and distributed by La Perle S.A., a cleaning product manufacturer in Tabarre, Haiti (1).

Tufts University is assisting the Haitian MSPP by evaluating this sample and reviewing materials about the product.

treat drinking water at the point- of- use.

The product can be easily measured, and it delivers a dose that is effective and safe for human consumption. The packaging provides adequate instructions for use written in Kreyól.

1 AquaJif Review and Recommendations AquaJif is a locally- produced sodium hypochlorite (NaOCl) solution manufactured and distributed by La Perle S.A., a cleaning product manufacturer in Tabarre, Haiti (1). The product is manufactured, packaged, and sold for household drinking water treatment. A sample of AquaJif was obtained in Haiti in June Tufts University is assisting the Haitian MSPP by evaluating this sample and reviewing materials about the product. Summary of Results AquaJif should be approved for point- of- use drinking water treatment in Haiti, for these reasons: Its active chemical, NaOCl, is recognized by the US EPA, WHO, and NSF for use to treat drinking water at the point- of- use. Its active chemical, NaOCl, has been shown to improve the microbiological quality of drinking water and reduce diarrheal disease when used at the household level. The product can be easily measured, and it delivers a dose that is effective and safe for human consumption. The packaging provides adequate instructions for use written in Kreyól. However, it is recommended that the product label provide a package labeled with the lot number, and dates of manufacture and expiration. Independent Certifications The AquaJif product itself does not have any international certifications; however, the active ingredient, NaOCl, is listed as complying with NSF / ANSI Standard 60, is registered with the US Environmental Protection Agency (EPA), and is also listed as a possible water treatment method by the World Health Organization (WHO). NSF / ANSI Standard 60: Drinking Water Treatment Chemicals - Health Effects: AquaJif is not listed as complying with NSF / ANSI Standard 60 for use as a drinking water disinfectant. However, dozens of manufacturers have sodium hypochlorite solutions approved for use in drinking water treatment (2). This standard applies to chemicals used for drinking water treatment, and it certifies that the chemical is safe at the maximum dose, and that any impurities are below the maximum acceptable levels (3). US Environmental Protection Agency (EPA) Registration: AquaJif is not registered with the US EPA. However, sodium hypochlorite has been registered with the EPA since 1957, and the EPA issued a registration standard in 1986 saying that sodium hypochlorite products (with 5.25% % chlorine) do not need individual registration review. The document also states that, widely used in disinfecting water supplies for nearly a century, the hypochlorites have been proven safe and practical to use (4). 1

2 World Health Organization (WHO): The World Health Organization does not currently approve products for use to treat drinking water. However, the Guidelines for Drinking Water Quality list liquid NaOCl with concentrations between 0.5% and 1% as a point- of- use water treatment method commonly used to prevent diarrhea in developing countries and for travellers (5). Verification of Composition and Dosage AquaJif is a solution of 0.75% Sodium Hypochlorite (NaOCl). The dosage instructions are to add one capful of the liquid to 5 gallons of water (about 20 liters). The target free chlorine residual (FCR) concentration for treated water is 2 mg/l. A sample of AquaJif was tested at Tufts University in Medford, MA, USA in September The concentration of chlorine in the product was tested using a Hach 8209 iodometric titration method. Then one dose was measured with the cap and mixed into 20 liters of clean, deionized water, and the FCR concentration was measured after 30 minutes with a LaMotte portable colorimeter. In these test results, the AquaJif chlorine concentration was 6% lower than the target concentration (Table 1), and the concentration in the treated water was 13% lower (Table 2). While it was lower than the target, the chlorine concentration of 1.74 mg/l is within the range recommended by the Centers of Disease Control and Prevention for household water treatment with chlorine products (0.2 mg/l 2.0 mg/l) (6). At the recommended dose of 2.0 mg/l, the chlorine concentration in water treated with AquaJif would be below the World Health Organization (WHO) recommended limits for drinking water for free chlorine, which is 5.0 mg/l (5). The US EPA allowable limit for chlorine in drinking water is 4.0 mg/l (7). Table 1: Chlorine Testing for AquaJif Target Cl Concentration in Product (% Cl) Tested Cl Concentration in Product (% Cl) Volume of (L) Table 2: Free Chlorine Residual Testing in AquaJif- Target FCR Concentration, Tested FCR Concentration, WHO Drinking Water Guidelines for FCR (5)

3 In summary, the tested chlorine concentration is close to the expected concentration, free chlorine residual is within the recommended range for water treatment, and water treated with AquaJif is safe for human consumption. Verification of Effectiveness When dissolved in water, NaOCl disinfects with free available chlorine in the form of hypochlorous acid (HOCl). Chlorination is known to be an effective at disinfecting drinking water, and it has been used in municipal systems all over the world since the early 1900s (8). There have been several studies of liquid NaOCl used in developing countries to disinfect stored household drinking water. These studies show that NaOCl solution is effective at improving the microbiological quality of drinking water and can also reduce diarrhea incidence (9-15). Product Packaging and Labeling The AquaJif packaging is labeled in Haitian Kreyól. The bottle lists the product composition, volume of water to treat, dosage, and instructions for use. Manufacturing lot number, manufacture date, and expiration date are not listed. Recommendations The use and promotion of this product for household water treatment should be approved in Haiti. However, it is recommended that the manufacturer provide a package labeled with the lot number, and dates of manufacture and expiration. 3

4 References (1) Building Markets. Général Industriel La Perle SA. (2) NSF Product and Service Listings, Sodium Hypochlorite. ame=sodium+hypochlorite&productfunction=&plantstate=&plantcountry=&plantregion= (3) NSF / ANSI Standard 60 (4) United States Environmental Protection Agency, Reregistration Eligibility Document Facts: Sodium and Calcium Hypochlorite Salts. (5) WHO Guidelines for drinking water quality. 4th ed. Geneva: World Health Organization, (6) Centers for Disease Control and Prevention Chlorine Residual Testing Fact Sheet. (7) United States Environmental Protection Agency Primary Drinking Water Regulations, (8) Black & Veatch Corporation, White s Handbook of Chlorination and Alternative Disinfectants, 5th ed. John Wiley & Sons, Inc., Hoboken, NJ, USA. (9) Crump, John A, Peter O Otieno, Laurence Slutsker, Bruce H Keswick, Daniel H Rosen, R Michael Hoekstra, John M Vulule, and Stephen P Luby Household based treatment of drinking water with flocculant- disinfectant for preventing diarrhoea in areas with turbid source water in rural western Kenya: cluster randomised controlled trial. BMJ (Clinical research ed.) 331(7515): (10) Luby, Stephen P, Mubina Agboatwalla, Robert M Hoekstra, Mohammad H Rahbar, Ward Billhimer, and Bruce H Keswick Delayed effectiveness of home- based interventions in reducing childhood diarrhea, Karachi, Pakistan. The American journal of tropical medicine and hygiene 71(4): (11) Quick, Robert E, Akiko Kimura, Angelica Thevos, Mathias Tembo, Isidore Shamputa, Lori Hutwagner, and Eric Mintz Diarrhea prevention through household- level water disinfection and safe storage in Zambia. The American journal of tropical medicine and hygiene 66(5): (12) Quick, R E, L V Venczel, E D Mintz, L Soleto, J Aparicio, M Gironaz, L Hutwagner, K Greene, C Bopp, K Maloney, D Chavez, M Sobsey, and R V Tauxe Diarrhoea prevention in Bolivia through point- of- use water treatment and safe storage: a promising new strategy. Epidemiology and infection 122(1):

5 (13) Reller, Megan E, Carlos E Mendoza, M Beatriz Lopez, Maricruz Alvarez, Robert M Hoekstra, Christy A Olson, Kathleen G Baier, Bruce H Keswick, and Stephen P Luby A randomized controlled trial of household- based flocculant- disinfectant drinking water treatment for diarrhea prevention in rural Guatemala. The American journal of tropical medicine and hygiene 69(4): (14) Semenza, J C, L Roberts, A Henderson, J Bogan, and C H Rubin Water distribution system and diarrheal disease transmission: a case study in Uzbekistan. The American journal of tropical medicine and hygiene 59(6): (15) Harshfield, Eric, Daniele Lantagne, Anna Turbes, and Clair Null Evaluating the sustained health impact of household chlorination of drinking water in rural Haiti. The American journal of tropical medicine and hygiene 87(5):

Aquatabs should be approved for point- of- use drinking water treatment in Haiti, for these reasons:

Aquatabs should be approved for point- of- use drinking water treatment in Haiti, for these reasons: Aquatabs Review and Recommendations Aquatabs are a point- of- use water treatment tablet manufactured by Medentech Ltd. in Wexford, Ireland. They are solid tablets composed of sodium dichloroisocyanurate