Concern over the transmission of disease or illness between divers sharing equipment has been a sensitive issue for commercial, military, and even recreational divers since the early 1970s. Many different groups have addressed this problem on many levels over the years. With the rise of new organisms in the past few years, it has again become a priority issue. Daryl F. Stanga discloses the recommended cleaning products and procedures collected by the Navy Experimental Diving Unit.

The military has used Wescodyne (Iodine-based cleaning and sanitizing solution) and water as a cleaning and sanitizing agent for over 15 years. This solution has worked with satisfactory results, but there have been several complaints about Wescodyne from operation forces, most often citing confusion and difficulty with mixing the concentrate, and the iodine solution's causing many of the rubber components of the dive gear to become gummy and break down. The rubber's breaking down was most often caused by far too strong a mixture of the solution.

The Navy Experimental Diving Unit (NEDU) received information from diving commands on the West Coast that identified several concerns regarding the use of Wescodyne cleaning solution. The most pressing problem for units of the Pacific Fleet is the lapse of Wescodyne's California Environmental Protection Agency registration in 1988. In response to this situation, NEDU is identifying replacement sanitizing agents and cleaning procedures for use on U.S. Navy diving equipment.

A search of the market and contact with several manufacturers of cleaning, disinfecting, and sanitizing solutions; respiratory therapy departments, both in and outside the Navy; Divers Alert Network; and other groups has resulted in the identification and recommendation of the four following agents: SaniZide Plus, Advance TBE, Bi-Arrest 2, and Confidence Plus.

SaniZide Plus
SaniZide Plus is a germicidal solution that is effective against a broad range of bacteria, viruses, and many fungi. The solution is provided in several sizes, ranging from one-gallon bottles to 16-ounce trigger sprayers. SaniZide is delivered ready for use and requires no mixing. The quaternary ammonium compound is non-corrosive and will not damage lenses, plastics, rubber, or metal surfaces. Manufactured by Safetec, a GSA contract company, the cost is approximately $1.60 per two-ounce spray bottle or $6.00 per 32-ounce spray bottle.

In 30-second contact time, SaniZide Plus kills HIV, influenza A2/HK, and herpes simplex II. Three-minute contact time kills polio I virus and rhinovirus. After five minutes of contact time, Safetec kills staphylococcus aureus, salmonella choleraesuis, pseudomonas aeruginosa, klebsiella pneumoniae, and candida albicans. With a 10-minute contact time, mycobacterium bovis BCG (tuberculosis) bacteria are destroyed.

Advance TBE
Advance TBE is a germicidal compound containing the same quaternary ammonium compound found in SaniZide. The solution has the same disinfective characteristics and requires the same contact time. The Advance TBE is provided ready to use in 16-ounce spray bottle or one-gallon bottle. Manufactured by Infection Control Technology, the cost is approximately $7.00 per 16-ounce bottle or $12.00 per gallon.

Its specific germicidal activity is effective against HIV-1, hepatitis A and B, escherichia coli, herpes simplex, influenza, mycobacterium tuberculosis, pseudomonas aeruginosa, salmonella choleraesuis, staphylococcus aureus, trichophyton mentagrophytes, and aspergillus niger.

Bi-Arrest 2
Bi-Arrest 2 is a non-alkaline germicidal cleaner that offers a broad spectrum of effectiveness against many bacteria, viruses, and fungi. Its germicidal activity is non-corrosive and undiminished by hard water. The solution is provided in a four-ounce concentrate bottle with a pump attached. Mixing directions are: Mix two pumps of the concentrate in a 16-ounce spray bottle of water. Spray bottle is provided with the concentrate. Manufactured by Infection Control Technology (MSA), a GSA contract company, the cost is approximately $3.00 per gallon.

Specific germicidal activity of Bi-Arrest 2, with a 10-minute contact time, will destroy mycobacterium tuberculosis, pseudomonas aeruginosa, staphylococcus aureus, herpes simplex, salmonella choleraesuis, streptococcus hemolyticus, It will also kill diplococcus pneumoniae, salmonella typhosa, escherichia coli, proteus vulgaris, trichophyton interdigitale, aspergillus, and influenza.

Confidence Plus
Confidence Plus is a germicidal solution that is effective against a broad range of bacteria, viruses, and many fungi. The active chemical compounds are closely related to those found in Advance TBE and Sanizide Plus. It requires the same contact time and has similar disinfecting actions. The solution is provided in a 32-ounce bottle of concentrate with a graduated measuring cup built into the top of the container. Mixing directions are to add one ounce per gallon of water. It is manufactured by Mine Safety Appliances Company and costs approximately $12.97 per 32-oz. bottle of concentrate. The specific germicidal activity of Confidence Plus in 10 minutes of contact time will kill salmonella choleraesuis, staphylococcus aureus, streptococcus pyogenes, escherichia coli, enterobacter aerogenes, shigella sonnei, candida albicans, and HIV-1.

A review of the literature and discussion with experts in the field determined that these agents possessed greater sanitizing abilities and were much easier to use in field conditions than the Wescodyne.

The agents were used to clean and sanitize various pieces of diving gear following the manufacturers' directions and recommendations. The equipment was then placed in a small pressure vessel and pressurized to 100 psig. (pounds per square inch gauge pressure), heated to 100 degrees F and held for four hours.

A sample of the gas was drawn off and analyzed by the Navy Underwater Equipment Lab using gas chromatograph and mass spectrometry. The samples were analyzed and found to be safe for hyperbaric use. A recommended procedure for sanitizing diving equipment with these agents has been developed as an interim procedure until changes can be made in the Navy Dive Manual, PMS system, and Maintenance manuals.

Cleaning procedures
To clean scuba regulators with a scrub brush and a non-ionic detergent solution, remove any gross contamination from the regulator. Rinse thoroughly with fresh water, then spray a liberal coat of solution on and into the mouthpiece and all second stage parts until all surfaces are wet. Let stand for 10 minutes. If solution appears to be drying, apply more solution to keep it wet for the full 10 minutes. After 10 minutes, rinse the entire second stage in a container of clean fresh water, or rinse under running potable water.

Recommended cleaning procedures for BIBS masks involve removing the BIBS mask from the hose and spraying a liberal coat of solution to all surfaces, including straps. Let stand for 10 minutes. If the solution appears to be drying, apply more solution to keep it wet for the full 10 minutes. After 10 minutes, rinse the entire mask in a container of clean fresh water, or rinse under running potable water. Allow to air dry before placing back in the chamber.

Clean the MK 20 with a scrub brush and a non-ionic detergent solution, removing any gross contamination from the mask. Rinse thoroughly with fresh water and spray the entire oral-nasal mask interior and nose-clearing device with solution until all surfaces are wet. Let stand for 10 minutes. If the solution appears to be drying, apply more solution to keep it wet for the full 10 minutes. After 10 minutes, rinse the entire mask in a container of clean fresh water, or rinse under running potable water.

For the MK 21, use a scrub brush and a non-ionic detergent solution to remove any gross contamination from the mask and helmet. Rinse thoroughly with fresh water. Remove nose-clearing device and oral-nasal mask from helmet and spray entire oral-nasal mask and nose-clearing device with solution until all surfaces are wet. Let stand for 10 minutes. If the solution appears to be drying, apply more solution to keep it wet for the full 10 minutes, then rinse the entire mask in a container of clean fresh water, or rinse under running potable water. Reinstall mask and nose-clearing device in helmet. Follow the same procedures for the MK 24 facemask as those used for the MK 21.

Clean the MK 16 breathing hose and mouthpiece with a scrub brush and a non-ionic detergent solution, removing any gross contamination from breathing hose assembly. Rinse thoroughly with fresh water, remove hoses from backpack and rinse with fresh water; spray a liberal coat of solution on and into the mouthpiece and into hoses. Let stand for 10 minutes, applying more solution if solution appears to be drying, keeping it wet for the full 10 minutes. After 10 minutes, rinse the entire assembly in a container of clean fresh water, or rinse under running potable water.

Chamber oxygen hood cleaning procedures require spraying the entire inside surface of the hood and neck dam with solution, allowing it to stand for 10 minutes - applying more solution if necessary, to keep it wet for the full 10 minutes. After 10 minutes, rinse the entire hood in a container of clean fresh water, or rinse under running potable water and allow to air dry before placing back in the chamber.

Finally, cleaning the recompression chamber interior requires that you clean interior surfaces of chamber with non-ionic detergent solution to remove any gross contamination; rinse with fresh water; spray solution directly on chamber bulkheads, deck-plates, or benches, or pour solution onto a lint-free cloth and use it to wipe down surfaces. (Do not apply to bedding.) Allow to stand for 10 minutes and wipe down with fresh water.

NEDU continues to query the market to insure that these agents and procedures are the most current, effective, and safe agents available. UW

HM1/SCW/IDC/DV Daryl F. Stanga attended the U.S. Navy Dive School in 1984. He served aboard the USS L.Y. Spear, 1984-1990; at the Naval Medical Research Institute, 1990-1994; and at the Independent Duty School in 1994. A member of Underwater Construction Team One, 1994-1999, he has been a member of the Naval Experimental Diving Unit since 1999.