Reducing Exposure to Nontuberculous Mycobacteria (NTM)

I have been using life straw filter pitcher for my drinking water, from our filtered house water. Better than anything else, based on NIH reports.

I read dr. F's article about limiting exposure to NTM and still wonder about the idea of an electric water kettle vs. a pot on a stove. can anybody explain that. thank you.

Hi Lilianna,

I had asked Dr. F a similar question awhile back. He explained how temperature and time work together to kill NTM and it was very helpful.

Here is the link on NTMir and content posted below:
https://connect.ntminfo.org/discussion/best-shower-head-for-preventing-bacteria#bm9ea1e9e0-3c6a-4376-aaee-0190da969c13
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Question 1. If raising the temperature on water heaters to between 130-140 results in a massive reduction of NTM in the water supply, would that mean that any liquid (coffee, tea) that maintains that temperature for a certain amount of time would also be NTM-free or largely NTM-free?

Answer 1. Exposure of NTM strains to 130 F (55 C) kills slowly, but because a water heater holds water at that temperature for a long time, there is evidently sufficient dose (i.e., dose = temperature and duration of exposure) to reduce the number of NTM. That means that water heated to 130 F for a short period of time will not kill off NTM; boiling for 10 min will kill 100 % of NTM.As well, 130 F prevents the growth of NTM. That means that the water heater is not increasing the number of NTM.

Question 2. Does soaking shower head in full concentrate Chlorox bleach simply remove a high concentration from the shower head itself-meaning it would likely reduce exposure to NTM that comes through the shower head -or- would it still be likely that you'd be exposed unless you have a filter on the shower head?

Answer 2. I have recommended tat individuals at risk or having NTM, unscrew their shower head monthly and first, clean off the surfaces using a narrow, slender brush and DAWN detergent (squirted in) and leave the detergent in there for 10 min. Then take the showerhead and submerge it in a bucket of Clorox right out of the bottle (6-8 5 chlorine). Leave the showerhead submerged for 30 min and then (wearing gloves) remove and rinse. Then screw it back on. That action keeps the population of NTM low on the surface of the showerhead (a preferred habitat for the NTM), so they don't get entrained with the rapid water flow when showering.

Question 3. I have an electric kettle that boils for less than 10-minutes (auto shut off after it comes to a rolling boil) temperature is 200+ and slowly cools. I'm assuming that is sufficient for sterilization?

Answer 3. I suspect that is sufficient to kill most if not all NTM.

Question 4. On the topic of water sterilization, I'm trying to understand if boiling for 10+ minutes is actually necessary or if a certain temperature for a certain amount of time has a similar effect.

Answer 4. You are on the right track as you have read in my answer to Question 1. At a temperature below boiling (212 F, 100 C), it will take longer to kill any microorganism. NTM are not particularly more resistant to high temperature. At 60 C (140 F), it takes about 3 hr to kill 99.9 % of an NTM population and at 70 C (150 F), it takes just 1 hour. Killing is dependent on the temperature and duration of exposure (higher means shorter).

Joe

Thank you. My electric kettle boils water in a few minutes and then auto shuts off. So I understand it is not enough to kill most of NTM. I open the lid so it does not automatically shuts off but then it boils rapidly and splashes all around. It’s hard to keep it like that for 10 minutes.

I read his answer to question 3 about using the pot differently. He says, “Answer 3. I suspect that is sufficient to kill most if not all NTM.”
I also use a kettle that brings water to a rolling boil and pour it over my equipment and add dawn and let it soak. While it soaks, I boil another pot of waterto rinse it in. I start with hot water that’s about 140. I then use the microwave bag. I hadn’t seen that statement from Dr. F., but had seen the info in answer 1 so thought my little shortcut was prob ok. I still boil everything in soapy water 10” 2x/week to be sure, but maybe I don’t need to and maybe I don’t need the microwave bag.

I've made my life a lot easier by purchasing a baby bottle sterilizer along with turning up the hot water heater to 135. I use hot tap water to soak the gear in Dawn and hot tap to rinse. At night I run the gear through the sterilizer so it's sterilized/dry for the a.m. routine. On the other hand, if you're comfortable with your existing routine that's important. Of far greater importance, it seems to me, is limited exposure to aerosols and dust from soil. There's a lot to take in with these disease precautions. Seems everyone does something slightly differently but the margin of error maybe not significant. Who knows?

I have a Secura electric kettle with an automatic cutoff feature that is great for sanitizing a nebulizer (5 minutes) in distilled water. To get around the auto cutoff, I let the water come to a boil and when the pot turns itself off, I open the lid and prop it on the latch. This leaves a small crack that is just sufficiency to keep the water boiling, Turn the power back on and set a bell timer for the amount of time you need the water to boil. When your timer sounds, MANUALLY turn the power off to the pot. I NEVER LEAVE THE POT UNATTENDED SINCE THIS DOES INTERFERE WITH THE AUTO CUTOFF SAFETY FEATURE. This works for me.

Hi!
I d like to find out more about RO Water I’m not sure that it’s a bad choice for us NTM and patients

That EPA report mentions reverse osmosis filter may grow Mac which of course it would since its a carbon filter but it’s upstream of the reverse osmosis 0.0001 µm filter which would take out any NTM because it’s much larger than that I believe 0.3 0.5 µm

If the carbon filter was last, that would DEFINITELY be a problem

The key to using reverse osmosis seems to be in maintaining it, and changing the filters FAITHFULLY on the timely and suggested manufacturer basis. If you don’t change the filters, then the NMM could get out and spill over just like any other filter.
Of course, any of us who don’t change our filters on any equipment increase the risk of a worse exposure because of all the back up, then overflows and you would get a large concentration of germs etc

I would love to gain more definite information on this if anyone has some.
Didn’t Dr. Falkingham mentioned RO filter change too but not sure whee that info is. Thank you !