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Chlorine Dioxide Date Written 2007
Author Joe Holmes Date Revised  

An evaluation of the safety and use of chlorine dioxide for human consumption and treatments. (Our comments are in italics bracketed and colored)

Reports indicate that Chlorine Dioxide is safe for human consumption. There were numerous such reports on pub med and I only quoted a few. Report 2 reveals interesting facts relating to high copper levels and chlorine dioxide to lower copper levels. See Copper and Metallothionein Chlorine Dioxide is shown to kill viruses and bacteria even the dreaded legionnaires disease see report 4. See also use as a mouth wash report 7. I could find no reports on pub med indicating chlorine dioxide is not safe for human consumption. In a google search there are articles indicating chlorine dioxide in gas form is dangerous such as the US dept of Labor report see number 8 below.

1. The effects of chronic administration of chlorite to glucose-6-phosphate dehydrogenase deficient healthy adult male volunteers. "Under controlled laboratory conditions,...Upon evaluation of an extensive battery of tests designed to measure the biochemical and physiological response to chlorite ingestion, no clinically significant changes were detected." PMID: 6520729  PMID: 6520728

2. "G6PD-deficiency: a potential high-risk group to copper and chlorite ingestion.
Moore GS, Calabrese EJ.

Although humans may accept fairly large amounts of orally ingested copper (0.25 to 1.0 gm) without visible harmful effects, patients with Wilson's disease, and persons with G6PD deficiency may represent persons at unusual risk to hemolytic anemia from ingestion of Cu(II). This study reports that in vitro exposure of G6PD deficient red blood cells to copper produced marked elevations of methemoglobin and decreases in GSH when compared with normal red cells. Chlorite, a by-product of chlorine dioxide disinfection of water, produced decreases in GSH and G6PD activity, while increasing methemoglobin levels markedly over red cells with normal G6PD activity. The combined action of chlorite and copper was additive in producing increased levels of hemoglobin and decreases in levels of GSH and G6PD deficient cells. (lowers copper so it helps those with high copper) The combined ingestion of copper and chlorite may represent an increased risk to persons with G6PD deficiency. (those with low copper should avoid chlorine dioxide) PMID: 7462905

3. "Study on subchronic toxicity of chlorine dioxide and by-products in water.
Qingdong X, Guangming Z, Li W.

Department of Architecture Engineering, Shenzhen Polytechnic, China.

Subchronic toxicity of the mixture of ClO2, ClO2- and ClO3- in water on rat was studied through feeding test for 90 days. Statistical analyses of variance on weight gained, food utilization efficiency, indexes of blood and serum, liver/bodyweight and kidney/bodyweight ratios, and histopathological examination on liver and kidney were carried out. The results showed that solution of ClO2 and its by-products ClO2- and ClO3- at a concentration of 553 mg/L was not toxic. PMID: 16854807

4. "Point-of-care controls for nosocomial legionellosis combined with chlorine dioxide potable water decontamination: a two-year survey at a Welsh teaching hospital.
Hosein IK, Hill DW, Tan TY, Butchart EG, Wilson K, Finlay G, Burge S, Ribeiro CD.

Infection Prevention and Control Department, Cardiff and Vale NHS Trust, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, Wales, UK.

This study reports a two-year programme of attempted eradication of Legionella (Leagonairs disease) colonization in the potable water supply of a 1000-bed tertiary care teaching hospital in Wales. There was a simultaneous, point-of-care, sterile-water-only policy for all intensive care units (ICU) and bone marrow and renal transplant units in order to prevent acquisition of nosocomial Legionnaires' disease. The programme was initiated following a case of nosocomial pneumonia caused by Legionella pneumophila serogroup 1-Bellingham-like genotype A on the cardiac ICU. The case occurred 14 days after mitral and aortic valve replacement surgery. Clinical and epidemiological investigations implicated aspiration of hospital potable water as the mechanism of infection. Despite interventions with chlorine dioxide costing over 25000 UK pounds per annum, Legionella has remained persistently present in significant numbers (up to 20000 colony forming units/L) and with little reduction in the number of positive sites. Two further cases of nosocomial disease occurred over the following two-year period; in one case, aspiration of tap water was implicated again, and in the other case, instillation of contaminated water into the right main bronchus via a misplaced nasogastric tube was implicated. These cases arose because of inadvertent non-compliance with the sterile-water-only policy in high-risk locations. Enhanced clinical surveillance over the same two-year period detected no other cases of nosocomial disease. This study suggests that attempts at eradication of Legionella spp. from complex water systems may not be a cost-effective measure for prevention of nosocomial infections, and to the best of our knowledge is the first study from the UK to suggest that the introduction of a sterile-water-only policy for ICUs and other high-risk units may be a more cost-effective approach. (In other words this report says chlorine dioxide will eradicate legionairs disease. Three other reports are shown that report similar findings) PMID: 1600217, PMID: 3761383, PMID: 18376574, PMID: 18376573

5. Evaluation of the immunomodulatory effects of the disinfection by-product, sodium chlorite, in female B6C3F1 mice: a drinking water study.
Karrow NA, Guo TL, McCay JA, Johnson GW, Brown RD, Musgrove DL, Germolec DR, Luebke RW, White KL Jr.

Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298-6013, USA.

Sodium chlorite is an inorganic by-product of chlorine dioxide formed during the chlorination of drinking water. Relatively little is known about the adverse health effects of exposure to sodium chlorite in drinking water. (see previous reports on this page showing it is safe) In this study, we evaluated sodium chlorite's immunomodulatory properties (its effectivness as an antibacterial agent) using female B6C3F1 mice...An increasing trend in the number of spleen antibody-forming cells was observed over the range of sodium chlorite concentrations. ...although a decrease in augmented natural killer cell activity (42%) was observed at the lowest sodium chlorite treatment level. These results suggest that sodium chlorite, within the range 0.1-30 mg/L, produces minimal immunotoxicity in mice. (this report indicates low doses have minimal effect and may even decrease antibacterial activity) PMID: 11452397

6. Effects of chlorine dioxide on thyroid function in the African green monkey and the rat.
Harrington RM, Shertzer HG, Bercz JP.

In a previous study from this laboratory, chlorine dioxide (ClO2) treated drinking water depressed thyroxine (T4) levels in the African green monkey. The present study again demonstrated a decrease in T4 levels in the same species after 4 wk of oral exposure. However, after 8 wk of treatment T4 levels rebounded to above pretreatment levels, coinciding with an increase in thyroid radioiodide uptake. This T4 rebound phenomenon and increased iodide uptake may be due to a compensatory endocrinological mechanism. In rats, T4 levels dropped during the 8-wk ClO2 treatment period in a dose-dependent manner, and no rebound effect was observed. Iodide uptake values in the rat were not affected. It appears that ClO2 may have an effect on thyroid function in both species. (the end result in this report indicates the possibility of eventual improvement in t4 and thyroid function but is not definitive or significant) PMID: 3761383

6. Protective effect of low-concentration chlorine dioxide gas against influenza A virus infection.
Ogata N, Shibata T.

Research Institute, Taiko Pharmaceutical Co. Ltd, 3-34-14 Uchihonmachi, Suita, Osaka 564-0032, Japan.

Influenza virus infection is one of the major causes of human morbidity and mortality. Between humans, this virus spreads mostly via aerosols excreted from the respiratory system. Current means of prevention of influenza virus infection are not entirely satisfactory because of their limited efficacy. Safe and effective preventive measures against pandemic influenza are greatly needed. We demonstrate that infection of mice induced by aerosols of influenza A virus was prevented by chlorine dioxide (ClO(2)) gas at an extremely low concentration (below the long-term permissible exposure level to humans, namely 0.1 p.p.m.). Mice in semi-closed cages were exposed to aerosols of influenza A virus (1 LD(50)) and ClO(2) gas (0.03 p.p.m.) simultaneously for 15 min. Three days after exposure, pulmonary virus titre (TCID(50)) was 10(2.6+/-1.5) in five mice treated with ClO(2), whilst it was 10(6.7+/-0.2) in five mice that had not been treated (P=0.003). Cumulative mortality after 16 days was 0/10 mice treated with ClO(2) and 7/10 mice that had not been treated (P=0.002). In in vitro experiments, ClO(2) denatured viral envelope proteins (haemagglutinin and neuraminidase) that are indispensable for infectivity of the virus, and abolished infectivity. Taken together, we conclude that ClO(2) gas is effective at preventing aerosol-induced influenza virus infection in mice by denaturing viral envelope proteins at a concentration well below the permissible exposure level to humans. ClO(2) gas could therefore be useful as a preventive means against influenza in places of human activity without necessitating evacuation.PMID: 18089729 PMID: 18089729

7.Evaluation of ultrasonic scaling unit waterline contamination after use of chlorine dioxide mouthrinse lavage.
Wirthlin MR, Marshall GW JR.

Department of Stomatology, University of California San Francisco, 94143-0762, USA.

BACKGROUND: An infection control problem in dental operatories which is not fully controlled is waterline contamination by heterotrophic mesophilic bacteria. These bacteria are present in water supplies as a planktonic phase and adhere to the lumen of tubings as a biofilm comprised of their external cell surface glycocalyx and by production of extracellular carbohydrate polymers. The adherent film is most difficult to remove. The accumulated planktonic phase can be reduced significantly by flushing water from the lines before use in patient treatment, but will return when the equipment is idle through the accumulation of more planktonic phase and by slough of the biofilm surface-adsorbed phase not yet enmeshed in the carbohydrate matrix. Chlorine dioxide has antimicrobial activity against many bacteria, spores, and viruses. It is used in water supply treatment as a disinfectant and slime preventive and has an advantage over chlorine in that carcinogenic trihalomethanes are not generated. METHODS: This study compared use of phosphate buffer-stabilized chlorine dioxide (0.1%) mouthrinse as a lavage in ultrasonic dental scaler units with the use of tap water as a control. Sterile water flushed through the units onto heterotrophic plate count (HPC) sampler plates was cultured 7 days at room temperature and colonies were counted at 12x. One test and one control unit were used for biopsy of internal tubing and scanning electron microscopy imaging. RESULTS: The HPC counts, in colony forming units (CFU)/ml, were reduced 3- to 5-fold by flushing tap water through the units, but they returned after units were idle overnight. When phosphate-buffered chlorine dioxide mouthrinse was used as a lavage, CFU/ml were reduced 12- to 20-fold. Holding chlorine dioxide in waterlines overnight reduced recurrent buildup compared to water (P <0.05). Scanning electron microscopy images indicated a significant reduction of biofilm coverage by chlorine dioxide as compared to water (P<0.001). CONCLUSIONS: Phosphate-buffered chlorine dioxide mouthrinse was effective in these short-term trials for control of waterline contamination in ultrasonic dental scaling units. It should prove as useful in dental professional waterline applications as it has in industrial uses for biofilm control. PMID: 11327069  

8. US Dept of Labor. Effects on Humans: Chlorine dioxide is a severe respiratory and eye irritant in humans. Inhalation can produce coughing, wheezing, respiratory distress, and congestion in the lungs [Patnaik 1992]. Irritating effects in humans was intense at concentration levels of 5 ppm. Accidental exposure at 19 ppm of the gas inside a bleach tank resulted in the death of one worker (time of exposure is not specified) [ACGIH 1991]. Workers exposed for 5 years to average chlorine dioxide concentrations below 0.1 ppm but with excursions to higher concentrations had symptoms of eye and throat irritation, nasal discharge, cough, and wheezing; on bronchoscopy, bronchitis was observed in seven of the 12 workers [Clayton and Clayton 1982]. Concentrations of 0.25 ppm and less have been reported to worsen mild respiratory ailments [ACGIH 1991]. Two adults who ingested 250 ml of a 40 mg/l solution of chlorine dioxide experienced headache, nausea, abdominal discomfort, and lightheadedness within 5 minutes of ingestion. The symptoms disappeared within another 5 minutes [NLM US Dept of Labor




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