Hospital Sanitation - Where Are We Now?


   Mr. W. G. Turney is a staff member of the Division of Engineering of the Michigan State Department of Health. In the following article , he examines The current status of hospital sanitation in Michigan and outlines the development of specific programs designed to solve problems peculiar to hospital sanitation.

   This paper was presented at the 19th Annual Conference on Environmental Sanitation held at the Kellogg Center of the Continuing Education, Michigan State University, East Lansing, Michigan.


Red Water

When this program was begun, a frequently encountered problem relater to cross connections and potential back siphonage situations. Although the situation has greatly improved over the last 10 years, these problems require constant preaching and teaching of the hazards of cross connections and back siphonage situations. A graphic illustration of a back siphonage situation is a case that occurred in a Michigan hospital. The nurses in this hospital complained of rusty water coming from one of  the drinking fountains. They complained for sometime before the maintenance department finally checked. The drinking fountain was located about 2 doors from the autopsy room of the hospital. Autopsy tables used in hospitals contain a sump pump to collect cuttings and washings from the autopsy procedure; they are also equipped with a hose with a spray unit for washing off organs, etc. This table was not equipped with a hook to hang this spray nozzle on , so the pathologist placed the nozzle in the table sump when not in use. This hospital had very severe back siphonage problems and vacuum breakers had not been installed on the autopsy table equipment, As a result blood and other washings from the cadavers were being sucked back into the hospital water supply system and were being encountered at the drinking fountain utilized by the nurses.


Direct Cross Connection

Direct cross connections between the sewage system and the fresh water supply can also create problems. Because strict cross connections are rarely found in plumbing systems today, it might be of interest to describe this particular situation.  A waste water sump was located in the sub-basement of the hospital. A centrifugal pump was on the floor beside this sump with the suction line projecting into the bottom of the sump and the discharge line connected to the sewer pipe overhead. The pump was actuated by a float switch, but because not much sewage entered this sump , the sump operated infrequently and because of the infrequent operation, the pump often lost it=s prime. To facilitate the priming of the pump someone had connected a 3/4" water line from the hospitals fresh water supply to the pump casing. The line was valved and by opening the valve the pump casing could be flooded and the pump would therefore be primed. The hazard with this set up was that, as soon as the pump was primed and began to pump sewage from the sump into the overhead sewer line, it would also pump it back into the hospital=s water supply system.



Vol. 27, No. 4 Journal of Environmental Health, January - February 1965

Contaminated Steam 

During the past ten years, boiler water feed compounds have been developed which are volatile. In other words, when steam is generated in a pressure boiler system , the chemicals carry over with the steam. The compounds used are generally referred to as filming amines and consist of such chemicals as morpholine and octadecyclamine. The purpose of putting these compounds into the boiler and subsequently the steam system is to protect the steam and condensate return lines from corrosion. Problems occur because these compounds are toxic and because steam is sometimes utilized for purposed other than heating. Instances where problems have occurred include the following:

1. Steam kettles of the direct steam injection type have contaminated food when amines were present in the steam supply.

2. Severe cases of dermatitis have resulted from people bathing in hot water heated by injection of steam containing amines.

3. Generally, serious hazards could result from steam or water containing amines in a hospital. Some possibilities include the preparation of infant formula, intravenous solutions and laboratory chemical solutions used in performing various hospital test.