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The Latest Word from Dr Honda on Sterilizing & Boiling
Presented today at the NJH NTM & Bronchiectasis: Patient & Family Conference!
Boiling tap water at a rolling boil for 5 minutes is plenty - tested in 10 labs across the country in January & June, at a variety of elevations. The water remains sterile at room temperature for up to 2 weeks in sanitized containers. Tap water was inoculated with multiple strains of NTM. (By 3 minutes all bacteria was gone, except M xenopii took 5 minutes.)
Boiling, the microwave sterilizers, baby bottle sterilizers, and travel pots - ALL WORK!
Purified spring water is safest. Some bottled waters contain varying levels of NTM, but none were MAC or Abscessus - they were the ones considered not to be human infection risks.
There is more about cleaning showerheads & household disinfectants, but I don't have time to cover it now.
The bottom line - we don't need to worry so much...
The slide deck is too large to download, I will work on it later.
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@thorne I bring my spring water to a restaurant (of course I'm not talking a $100 plate). I decline water and just keep my own bottled water by my side and quietly drink that. Never have I been told I can't do this. If they ever ask me, I'm just going to tell them I'm immunocompromised and I feel safer not drinking the restaurant tap water.
@thorne I know for a legal reasons, when Dr. Honda did similar work at her research lab at National Jewish Health, she was not able to release the water brand names. What is most important is that no pathogenic NTM were found in any of the tested water.
Happy weekend,
Linda Esposito
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2 Reactions@becleartoday I guess I am wondering how this lines up with the research that Dr. Falkingham did that showed only spring water was free of NTM?
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2 Reactions@thorne I'm not sure when Dr Falkinham did his research, but is it possible that bottlers have become more careful?
@thorne I’m not familiar with independent research he has conducted, but perhaps you know of something I haven’t seen. I thought that was his expert recommendation. I believe the research she did at NJH was in collaboration with Dr. Falkinham. ❤️Linda
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2 Reactions@scoop Personally, I think plain soap and tap water suffices. That's what I have been doing for the last two years since developing BE. I just recently changed to rinsing with distilled water since IMO the tap water here in AZ has a "metallic" taste.
A summary of Dr Falkingham's research on bottled water https://pubmed.ncbi.nlm.nih.gov/34835388/
His lab bought ordinary store-bought bottled distilled, purified and spring water. Distilled and purified water grew roughly 10–1,000 CFU/mL of NTM and included multiple NTM species. Bottled spring water was ≤10 CFU/mL. He therefore specifically recommends bottled water labeled “spring water” for people with NTM or NTM risk when away from home and unable to boil, filter or UV-treat water.
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3 ReactionsWe just got a filtration system for our sink and I’m trying to trust it. I am still boiling distilled water for my baby bottle sterilizer but I’m thinking I can just use boiled water from my filtered water. Am I overthinking this? I’m also traveling in Nov. and wondering if I should buy spring or distilled water for my microwave bags to clean my neb stuff? Any thoughts?
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1 Reaction@rbl just posed a really good question regarding whether distilled water is adequate to use for microwave steaming our equipment. We've been told that distilled water potentially carries NTM. If we only microwave the equipment for 3 minutes (per instructions) with 4 oz of distilled water in the bag, how can NTM be destroyed in that short of time, assuming that the front part of the 3 minutes is at lower than boiling temps? The equipment may be undergoing only a couple of minutes of optimal steam time.
@rbl
Check the manufacturer's recommendations for cleaning and sterilizing your equipment when in doubt. They've tested their equipment and know what their equipment can handle. Pay attention to replacement times. If it says replace every 3 months and you are cautious, do that.
If using distilled water in a baby bottle sterilizer there is no need to sterilize first. The baby bottle sterilizer will do that for you while sterilizing your equipment, as long as the cycle is over 5 minutes. I believe most of them are, and average between 8-13 minutes of steaming time.
The reason to use distilled water with our equipment has to do with mineral build up. Period. Spring water from your filtered system it seems will still have minerals (which our bodies need for drinking). That said, mineral buildup takes time to build up. You probably will replace your equipment before it becomes an issue.
The nebulizer I use is sensitive as it contains a metal mesh head. Manufacturer says to boil for 5 minutes in distilled water, so that's what I do. Replacement heads are expensive, $125 so I take good care of them. Sprint LC and Aeroeclipse nebulizers are much less expensive and are made of all plastic making them conductible to microwaving. 3+ minutes in microwave with spring water is fine. Look up manufacture instructions and follow them.
Remember that most of the cautions we read about originated around those living with cystic fibrosis, a very very vulnerable population.
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